Health Insurance

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Why Do You Need Bharti AXA Health Insurance?

Health insurance is designed to cover your medical expenses and give you the freedom to avail quality healthcare. It enables you to access medical treatment of the covered risks without any hassles. Fast-paced life coupled with high levels of pollution, unhealthy food habits, and job-related stress are some of the major factors that may result in health-related emergencies. In the event that you have not covered yourself and your loved ones under a health insurance plan, a medical emergency can end up becoming a financial emergency in no time. All this can be avoided by simply paying a small amount of premium.

So, why wait for an emergency to happen when you can financially safeguard yourself with a health insurance plan. Furthermore, rising healthcare costs also stress the need for a health insurance plan for every individual. 
Bharti AXA’s new-age health insurance plans are not just limited to providing coverage before, during, and after hospitalization. Our health insurance plans are intended to provide protection against medical emergencies, in-patient treatments and day care procedures too. This ensures that your pockets do not drain due to any kind of medical emergency. 

Thus, regardless of your financial capability, with a health insurance plan, you can avail the best treatment at network of hospitals. After you have purchased a health insurance policy, not only will it bring peace of mind but in addition, you can avail tax deductions under Section 80D of the Income Tax Act.

Types Of Health Insurance By Bharti AXA

Smart Super Health Insurance Policy

  • Wide coverage from Rs. 5 Lakh to Rs. 1 Cr.
  • No capping on room rent
  • Pre and post-hospitalization of 60 days and 90 days
  • Restoration of sum insured up to 100%
  • Organ donor expenses covered up to sum insured
  • No- claim bonus up to 100% Sum Insured
  • Option to choose for critical illness cover/ hospital cash
  • Annual health check-up
  • Day care treatment up to Sum insured
  • AYUSH treatment

Smart Health Assure

  • Pre & Post Hospitalisation Covered
  • Tax Benefit (Save under section 80 D)
  • Restoration of Sum Insured (100% Reload of Sum Insured at No Extra Cost)
  • Over 130 Day Care Treatments Covered
  • Ambulance Cover
  • Hospital Cash Allowance
  • Maternity Benefit
  • Critical Illness Cover
  • Annual Health Check-up
  • No Claim Bonus
  • Organ Donor Cover
  • Lifelong Renewability

Policy's Coverage (Inclusion)

Smart Super Health Insurance Policy

  • Annual health check-ups
  • Option to choose for critical illness cover/hospital cash
  • In-patient  treatment : Up to sum insured
  • Pre-hospitalization - 60 Days : Up to sum insured
  • Post-hospitalization- 90 Days : Up to sum insured
  • Organ donor : Up to sum insured
  • Day care treatment  : Up to sum insured as per listed provided in policy document
  • Ayush treatment  : Up to sum insured
  • Domiciliary hospitalization : Up to sum insured
  • Restoration of sum insured : Up to 100% of sum insured
  • Emergency surface ambulance charges : ₹3000/event
  • Convalescence benefit : As per specified limit and plan opted
  • Outpatient emergency treatment (accident only):  As per specified limit and plan opted
  • Animal bite (vaccination): As per specified limit and plan opted
  • Domestic  air ambulance (max once in a policy year / per life): As per specified limit and plan opted
  • Outpatient dental emergency (arising out of accident only): As per specified limit and plan opted
  • No claim bonus:
    -For age<45 yrs. 50% of expiring policy sum insured not exceeding 100%
    -For age>45 yrs. 20% of expiring policy sum insured not exceeding 100%
  •  Hospital cash allowance (up to maximum up to 30 days with one day deductible): As per specified limit and plan opted
  • Maternity benefit:
    -Maternity benefit with 9 month waiting period, up to first 2 deliveries/mtp in lifetime ( available only with 3 yr. Policy term) 
    -New born baby for first 90 days
  • Lump sum benefit for critical illnesses (over and above sum insured)
  • * Please refer to the policy brochure for detailed summary of product feature and benefits.

Smart Health Assure Policy

  • In-patient treatment : Up to sum insured
  • Pre-hospitalization - 60 Days : Up to sum insured
  • Post-hospitalization- 90 Days : Up to sum insured
  • Annual health check-ups
  • Organ donor : Up to sum insured
  • Day care treatment : Up to sum insured as per list provided in policy document
  • AYUSH treatment : Up to sum insured
  • Domiciliary hospitalization : Up to sum insured
  • Restoration of sum insured : Up to 100% of sum insured
  • Emergency surface ambulance charges : RS 3000/event
  • Hospital cash allowance (up to maximum of 30 days with one day deductible):As per specified limit and plan opted
  • Maternity benefit :
    -Maternity benefit with 9 month waiting period,up to first 2 deliveries/mtp in lifetime (available only with Family Floater Policy 3 yr. Policy term)
    -New born baby for first 90 days
  • Lump sum benefit for critical illnesses (over and above sum insured)

Select The Right Health Insurance That Suits Your Needs

Sum Insured

Smart Health Insurance Plan

Smart Super Health Insurance Plan

Value

Classic

Uber

3 Lakh 4 Lakh
5 Lakh 7.5 Lakh
10 Lakh 15 Lakh 20 Lakh
20 L 30 L 50 Lakh and Above

Exclusion & Waiting Period

Smart Super Health Insurance Plan

  • Initial waiting period: 30 days for all illnesses
  • Pre-existing diseases covered after 48 months
  • 24 months for the specific diseases or illness or procedures/surgeries (refer to the policy wordings for entire list)
  • Initial waiting period: 30 days for all illnesses (not applicable on renewal or for accidents
  • Maternity expenses: Where maternity cover is opted, waiting period until 9 months since the inception of the first Policy with the Company
  • Critical Illness – 60 days waiting period and 30 days survival period
  • Internal Congenital Anomalies are covered after a waiting period of 48 months
  • Genetic disorders are covered after a waiting period of 48 months
  • War (whether declared or not) and war like occurrence or invasion, acts of foreign enemies, hostilities, civil war, rebellion, revolutions, insurrections, mutiny, military or usurped power, seizure, capture, arrest, restraints and detainment of all kinds.
  • Disease/ illness/ injury while performing duties as a serving member of a military or a police force
  • Any illness or injury directly or indirectly resulting in or arising from or occurring during the commission of any breach of any law by the insured person with criminal intent

 

*Please refer to the policy brochure for detailed summary of product feature and benefits.

Smart Health Assure Plan

  • Smart Super Health Assure Initial waiting period: 30 days for all illnesses (not applicable on renewal or for accidents)
  • 24 months for the specific diseases or illness or procedures/surgeries (refer to the policy wordings for entire list)
  • Pre-existing diseases covered after 48 months
  • Maternity expenses: Where maternity cover is opted, waiting period until 9 months since the inception of the first Policy with the Company
  • Internal Congenital Anomalies are covered after a waiting period of 48 months
  • Genetic disorders are covered after a waiting period of 48 months
  • Critical Illness – 60 days waiting period and 30 days survival period
  • War (whether declared or not) and war like occurrence or invasion, acts of foreign enemies, hostilities, civil war, rebellion, revolutions, insurrections, mutiny, military or usurped power, seizure, capture, arrest, restraints and detainment of all kinds.
  • Disease/ illness/ injury while performing duties as a serving member of a military or a police force
  • Any illness or injury directly or indirectly resulting in or arising from or occurring during the commission of any breach of any law by the insured person with criminal intent.

Benefits Of Having Health Insurance

Comprehensive Range Of Medical Cover Up To Rs. 1 Crore

With Bharti AXA GI you can select out of the 17 different options ranging - up to Rs. 1 Crore for smart super health insurance plan sum Insured. Bharti AXA Smart Super Health Assure Plan also covers you from 20 different life-threatening health conditions, like cancer, first heart attack, major burns, major organ transplant, kidney failure, etc.

Get Deduction Up To Rs. 1,00,000 Under Section 80D

The health insurance premium allows you to save tax under section 80D of income tax act, 1961. You can claim health insurance premium paid up to Rs. 50,000/- for your family (where one of the member is a senior citizen) and additional up to Rs. 50,000/- for senior citizen parents. The family will include self, spouse and depended children. For senior citizen parents even the cost of medical treatments can be included within the limit read with the amendment in Finance Act, 2018. You can also include the money spent on preventive health check-up for your family in a financial year up to Rs. 5,000/- within the overall limits prescribed in the section 80D.

Cashless Hospitalization Across 4500+ Network Hospitals

There could be few people across the world that would be prepared for hospitalization with cash. Even if you start to plan and build this backup today, it’ll take months to be useful. With health insurance, however, you create the backup for emergency health situations in one day. Cashless hospitalization will allow you and family to receive treatment without worrying about the bills. Health insurance policy offered by Bharti AXA allows cashless hospitalisation in 4500+ network hospitals across India. The wide coverage along with emergency outpatient cover allows you to receive treatment at the nearest network hospital without worrying about the costs.

24/7 Claim Assistance

With Health insurance policy offered by Bharti AXA, you can be assured of assistance anytime of the day. You can contact us using the toll-free numbers: • For claims & your queries for renewal of existing policies 1800-103-2292 • For buying new plan: 022-6118-8888 Additionally, you can drop us an e-mail on customer.service@bhartiaxa.com. Although our hospital network is wide, at times, you may have to avail services of a non-network hospital and paying the bill out of your pocket. However, you should inform us about the hospitalization as soon as possible using any of the above methods.

Why Bharti AXA?

1.3 Million Policies issued

Yes, that’s right. We have delivered that many health insurance policies at the snap of a finger. Our instant and simple policy issuance process makes buying medical insurance online, a breeze.

PAN India Cashless Network Hospital

Hospitalization can get financially stressful with hefty bills to pay. Moreover, it’s also emotionally taxing. We agree. Just seek admission in any of our cashless network hospitals that is nearest to you. We’ll directly settle the bills with the hospital. Life’s simpler, isn’t it?

98.27% Claim-Settlement Ratio

We understand that you’re already stressed when the need for filing a mediclaim arises. Therefore, we have established a smooth and fast process for settling claims. Claim settlement ratio is one metric that you can look at to check the claim settlement experience of any insurer’s customers.

152 Branches Across India

When we make you a promise to have you covered, we work to live up to it. That’s why we have spread our presence all across the nation so that you can easily find your nearest branch. We just want to be there for you at all times.

Health Insurance Blogs

Health Insurance Frequently Asked Questions

All

What are the various exclusions in Health insurance policy offered by Bharti AXA?

The major exclusions under health insurance policy are:

  • Pre-existing diseases, illness, or injury. Health insurance benefits will not be available for any condition(s) as defined in the policy, until 48 months of continuous coverage have elapsed, since the inception of the first policy with the Company
  • Any benefit under critical illness within the first 30 days of inception of the policy for the first year. This exclusion doesn't apply for subsequent renewals with the Company without a break.
  • Medical expenses incurred for treatment undertaken for disease or illness and/or for critical illness within 30 days of the inception date of health insurance policy. This exclusion doesn't apply for subsequent renewals with the Company without a break.
  • Routine medical, eye and ear examinations, cost of spectacles, laser surgery, contact lenses or hearing aids, vaccinations and inoculation of any kind, issuing of medical certificates and examinations as to suitability for employment or travel.
  • Vitamins and tonics unless forming part of treatment for the disease, illness, or injury.
  • Any stay in Hospital without undertaking any treatment or where there is no active regular treatment by the Medical Practitioner
  • Prostheses, corrective devices, and medical appliances, which are not required intra-operatively or for the disease/ illness/ injury for which the Insured / Insured Person was hospitalized
  • Charges incurred primarily for diagnostic, X-ray or laboratory examinations or other diagnostic studies not consistent with or incidental to the diagnosis and treatment.
  • Costs of donor screening or treatment, unless specifically covered and specified in the Schedule to this Policy.
  • Naturopathy treatment.
  • Any treatment received outside India.
  • And treatment of the following health conditions: 
    • Cataract, Benign Prostatic Hypertrophy, Myomectomy, Hysterectomy or menorrhagia or fibromyoma unless because of malignancy, dilation, and curettage
    • Hernia, hydrocele, congenital internal disease, fistula in anus, and sinusitis
    • Skin and all internal tumors/ cysts/nodules/ polyps of any kind including breast lumps unless malignant, adenoids and hemorrhoids 
    • Dialysis required for chronic renal failure, Gastric, and Duodenal ulcers
    • Joint Replacement surgeries unless necessitated by accident during the first two years of the operation of the Policy. 
       

Can parents be covered under my health insurance policy?

We cover self, spouse, and two dependent children under the age of 23 years under one health insurance policy.

Is there an age limit to buy our health insurance policy? Up to what age children's are covered?

We cover self, spouse, and two dependent children up to the age of 23 years. Lifelong renewal is offered under our health insurance policies.

If your child is between 3 months and five years of age, he/she can be covered as part of a family floater policy provided at least one parent is covered. If the child is between 5 years and 23 years of age, you can choose between continuing the family floater policy or taking a separate health insurance policy for the child.

What is a floater health insurance policy? How is it beneficial to take it?

A family floater health insurance policy covers all family members (insured, his or her spouse, and two dependent children up to the age of 23 years) under one single policy. The sum insured floats over the entire family, and a consolidated premium needs to be paid. You can cover your family member under comprehensive medical insurance policy to get family floater advantage.

What is the sum insured under health insurance plan?

Sum insured is the maximum amount paid to the insured by the Insurer in the event of a claim as per the health insurance policy.

Claims

What is the claim settlement ratio? What are the reasons for the denial of the claim for health insurance?

Claim Settlement ratio is the ratio of claims settled against claims reported during thce year. Bharti AXA health insurance claim settlement ratio is 92.37% for FY 2016-17.

How to avail reimbursement facility?

  • Insured gets admitted to the hospital
  • Takes treatment and pays hospital bills.
  • Gets back all original documents from the hospital.
  • Submits all original and necessary documents to the TPA along with duly filled claim form.
  • TPA will review the documents and effect payment within 30 days of receiving the complete documents.
  • If the health insurance claim is rejected, a letter will be sent along with the reasons for rejection.
  • For any query one can connect us on  1800-103-2292/ or drop us a mail on customer.service@bhartiaxa.com
     

How many health insurance claims are allowed over a year?

Any number of claims can be made during the health insurance policy period subject to the sum insured mentioned under the policy.

How to avail cashless hospitalization facility?

  • In case of Emergency Hospitalization in Network Hospitals:
  • The patient takes admission in the hospital by showing a Health ID card
  • The cashless claim request form to be filled by the hospital & signed by the hospital authority & insured and faxed  or mailed to TPA or submitted to the insurance help desk at the hospita TPA will review the claim
  • TPA will inform the insured and the hospital with the status via SMS, email or fax notification usually within 6 hours of submission of the request
  • TPA will approve only the medical expenses covered under the policy. 
  • These expenses will be settled by Bharti AXA General Insurance directly.
     

What is the claims procedure?

Bharti AXA General Insurance offers both Cashless services and Non-cashless (reimbursement) facilities for its customers. You can find our impanelled list of cashless hospitals where claims are managed by Third Party Administrators (TPAs) to offer claims service during hospitalization. 

Cover

If I am only admitted in a hospital for less than a day, are the expenses still covered?

Hospitalization expenses are covered in the health insurance policy. Hospitalization expenses are covered in the plan if you have been hospitalized for a minimum period of 24 hours. However, specific day care treatments, which do not require 24-hour hospitalization, are also covered under our health insurance policy. 

The treatments include: 

  • Dialysis
  • Chemotherapy
  • Radiotherapy
  • Eye surgery
  • Dental surgery
  • Lithotripsy 
  • Tonsillectomy
  • Dilatation and Curettage
  • Cardiac Cauterization
  • Hydrocele surgery
  • Hernia repair surgery
     

Will the health insurance policy cover me in case of any hospitalization abroad?

No, the health insurance policy is meant to cover hospitalization only in India

What is a critical illness cover?

The critical illness cover takes care of expenses incurred for treatment of any of the below specified critical illnesses. The Coverage is available in either of the following options:

Payment of lump sum benefit amount if the Insured Person is being diagnosed as contracting any of specified Critical Illnesses and surviving for more than 30 days post such diagnosis.
Payment /reimbursement of expenses incurred for treatment of such specified Critical Illness in a Hospital / Nursing Home

This benefit is available after a survival period of 30 days from the date of inception of the first year health insurance Policy. The SI available under this benefit is separate and is in addition to the SI available under the hospitalization benefit section of the Policy.

The following critical illnesses are covered under the Smart Super Health Insurance Policy:

  • Cancer
  • First Heart Attack
  • Coronary Artery Disease
  • Coronary Artery Bypass surgery
  • Heart Valve Surgery
  • Surgery to Aorta
  • Stroke resulting in permanent symptoms
  • Kidney Failure requiring regular dialysis
  • Aplastic Anaemia
  • End Stage Lung Disease
  • End Stage Liver Failure
  • Coma of specified severity
  • Major Burns
  • Major Organ or Bone Marrow Transplantation
  • Multiple Sclerosis with persisting symptoms
  • Fulminant Hepatitis
  • Motor Neurone Disease
  • Primary Pulmonary Hypertension
  • Terminal Illness
  • Bacterial Meningitis
     

What is domiciliary hospitalization? What do you cover under it?

Domiciliary hospitalization means treatment done at home in India for a period exceeding three days for disease, illness, or injury, which in the normal course, would require hospitalization. This could happen if either the condition of the patient is such that he or she cannot be moved to hospital or nursing home, or due to lack of accommodation.

We cover the cost of the treatment as well as expenses, if any, on the employment of qualified nurses, employed on the recommendation of the attending medical practitioner. The cover is limited to a maximum of 10% of the sum insured and will be payable if the treatment exceeds three days.
 

What is meant by pre and post hospitalization expenses?

Pre and post hospitalization means the medical expenses incurred during a period before and after hospitalization for any disease, illness, or injury sustained, respectively.

What is the cashless facility?

The cashless claim is a facility that is available in our network of tied-up hospitals where we settle health insurance claims directly with the hospital or nursing home without you having to pay any amount to the hospital.

In the case of a pre-planned hospitalization, if the chosen hospital is included in our network of cashless hospitals, all that you need to do is request the hospital to send us a claim form along with certification from the doctor about the nature of the illness and treatment.

Once our Third-Party Administrator receives the information, and if the health insurance claim is admissible, the TPA sends you a pre-authorization in a few hours, for the cashless claim. We have an extensive network of more than 4,300+ network hospitals all over India where you can avail this facility.
 

General

My employer already covers all the medical bills for my family and me. Do I still need Health Insurance?

The medical insurance cover provided by your employer is available to you only as long as you are an employee of the company. Moreover, the sum insured under your employer's health insurance plan may not be adequate for your needs. Hence it would be advisable to go for a separate health insurance policy.

Are health cards provided?

Yes, we send you a health card along with the policy schedule and 80D certificate, once you take a health insurance plan with us. Health card is like an identity card issued by the insurer (insurance company) to the insured (individual). It is a useful card providing you the access to the network hospitals. You would need to provide your health card at the time of admission into the hospital. This card will be beneficial for availing cashless facility as well.

What is the period of insurance for a health insurance policy? Will you issue a policy for more than one year?

We issue health insurance policies for tenure of 1 year, 2 years, and 3 years, which can be renewed subsequently.

Why should I choose Bharti AXA over other mediclaim policies?

Usually, mediclaim policies cover expenses related to treatment and hospitalization but do not offer protection for other non-billable expenses. Our health insurance plans give you 360 degree cover for hospital bills and incidental expenses. 

Our comprehensive health insurance cover provides a cashless facility in over 4300+ hospitals and also provides 11 different value-added benefits. What's more, we help you pick a plan that's suited for your health needs.
 

How can I buy a Bharti AXA Health Insurance Policy online?

You can choose from our health insurance plans, designed keeping your needs in mind here. Get your quote online, fill the proposal form, and check out making the payment. You will receive the health insurance policy documents through email instantly.

What are the benefits of buying Bharti AXA Health Insurance Policy?

The Health insurance policy offered by Bharti AXA acts as a support system for you and your family. With this health insurance plan, you can avail the following benefits, which include: 

Hospitalization expenses including: 

  • Hospital charges (room & boarding and operation theatre)
  • Fees of surgeon, anesthetist, nurses, and specialists 
  • The cost of diagnostic tests, medicines, blood, oxygen, appliances like pacemaker, artificial limbs, and organs, etc
  • Domiciliary hospitalization expenses including payment of medical treatment for a period exceeding three days for disease, illness or injury, which in a regular course, would require hospitalization, but is taken at home
  • Daycare treatment wherein 24 hours hospitalization is not required
  • Pre and post hospitalization expenses including related medical fees for a specified period incurred before and after hospitalization for disease, illness, or injury sustained and considered a part of a claim admissible under the health insurance policy
  • Pre-existing conditions are covered from the 5th year onwards, after four years of continuous coverage with us
     

In addition to the above, our health insurance policy offers a host of value-added benefits under SHIP and SSHIP 

  • Hospital cash allowance
  • Home nursing
  • Ambulance charges
  • In-patient physiotherapy charges
  • Accompanying person's expenses
  • Parent accommodation as a companion for a child
  • Out-patient dental emergency treatment arising out of accidents.
  • Out-patient emergency treatment for accidents
     

Why do I need health insurance?

Health insurance covers you and your family against expenses incurred in a medical emergency. With medical bills on the rise, insurance helps in reducing the financial burden during hospitalization. Also, the cases of critical illnesses and lifestyle-related ailments have increased rapidly. Health insurance allows you to be better prepared for such events. 

The premium that you pay for your health insurance is eligible for tax deduction under Section 80D of the Income Tax Act
 

How can I renew my health insurance policy after one year?

Kindly call our customer support help desk at 1800-103-2292 (Toll-free) to renew your health insurance policy.

Policy

Can parents be covered under my Health insurance policy?

We cover self, spouse, and two dependent children under the age of 21 years under one policy.

Is there an age limit to buy Health insurance policy offered by Bharti AXA? Up to what age children's are covered?

We cover self, spouse, and two dependent children up to the age of 23 years. Lifelong renewal is offered under our health insurance policies.

If your child is between 3 months and five years of age, he/she can be covered as part of a family floater policy provided at least one parent is covered. If the child is between 5 years and 23 years of age, you can choose between continuing the family floater policy or taking a separate health insurance policy for the child.
 

What is a floater policy? How is it beneficial to take?

A family floater health insurance policy covers all family members (insured, his or her spouse, and two dependent children up to the age of 23 years) under one single policy. The sum insured floats over the entire family, and a consolidated premium needs to be paid. You can cover your family member under comprehensive health insurance to get family floater advantage.

What is the sum insured?

Sum insured is the maximum amount paid to the insured by the insurance company in the event of a claim as per the health insurance contract.

What are the various exclusions in Health insurance policy offered by Bharti AXA?

The major exclusions under health insurance policy are:

  • Pre-existing diseases, illness, or injury. Health insurance benefits will not be available for any condition(s) as defined in the policy, until 48 months of continuous coverage have elapsed, since the inception of the first policy with the Company
  • Any benefit under critical illness within the first 30 days of inception of the policy for the first year. This exclusion doesn't apply for subsequent renewals with the Company without a break.
  • Medical expenses incurred for treatment undertaken for disease or illness and/or for critical illness within 30 days of the inception date of health insurance policy. This exclusion doesn't apply for subsequent renewals with the Company without a break.
  • Routine medical, eye and ear examinations, cost of spectacles, laser surgery, contact lenses or hearing aids, vaccinations and inoculation of any kind, issuing of medical certificates and examinations as to suitability for employment or travel.
  • Vitamins and tonics unless forming part of treatment for the disease, illness, or injury.
  • Any stay in Hospital without undertaking any treatment or where there is no active regular treatment by the Medical Practitioner
  • Prostheses, corrective devices, and medical appliances, which are not required intra-operatively or for the disease/ illness/ injury for which the Insured / Insured Person was hospitalized
  • Charges incurred primarily for diagnostic, X-ray or laboratory examinations or other diagnostic studies not consistent with or incidental to the diagnosis and treatment.
  • Costs of donor screening or treatment, unless specifically covered and specified in the Schedule to this Policy.
  • Naturopathy treatment.
  • Any treatment received outside India.
  • And treatment of the following health conditions: 
    • Cataract, Benign Prostatic Hypertrophy, Myomectomy, Hysterectomy or menorrhagia or fibromyoma unless because of malignancy, dilation, and curettage
    • Hernia, hydrocele, congenital internal disease, fistula in anus, and sinusitis
    • Skin and all internal tumors/ cysts/nodules/ polyps of any kind including breast lumps unless malignant, adenoids and hemorrhoids 
    • Dialysis required for chronic renal failure, Gastric, and Duodenal ulcers
    • Joint Replacement surgeries unless necessitated by accident during the first two years of the operation of the Policy. 
       

Premium

Can I decide the amount of health insurance I require or does the insurance company decide it?

You can decide the amount of health insurance on your own. We have a variety of sum insured options for you to choose from. You can decide on the amount based on the number of family members to be covered under the policy, the age of family members, the expected costs of treatment and the amount of premium you are willing to pay.

How is the premium calculated for Health Insurance?

The premium payable on your health insurance policy is based on the following factors:

  • Sum insured option is chosen
  • The number of family members to be covered
  • The age of the senior most person in the family to be covered
  • The type of policy you opt for - Basic, Premium, Optimum,  Smart Super Health Insurance Policy 
     

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General Benefits

  3 LAKH 4 LAKH 5 LAKH 7.5 LAKH
Room Rent (per day) Upto SI. No Cap Upto SI. No Cap Upto SI. No Cap

Upto SI. No Cap

Pre-Hospitalisation  60 days 60 days 60 days

60 days

Post Hospitalization 90 days 90 days 90 days

90 days

Restoration of Sum Insured Upto 100% of S.I Upto 100% of S.I Upto 100% of S.I Upto 100% of S.I
Day Care Treatment Upto SI Upto SI Upto SI Upto SI
No Claim Bonus If Age at the inception of 1st Policy year <= 45yrs then - 50% of expiring Policy SI per annum not exceeding Cumulative Bonus of 100% of current Policy SI If Age at the inception of 1st Policy year < 45yrs then - 50% of expiring Policy SI per annum not exceeding Cumulative Bonus of 100% of current Policy SI
 
If Age at the inception of 1st Policy year > 45yrs and <=65yrs then - 20% of expiring Policy SI per annum not exceeding Cumulative Bonus of 100% of current Policy SI If Age at the incception of 1st Policy year > 45yrs and < 65yrs then - 20% of expiring Policy SI per annum not exceeding Cumulative Bonus of 100% of current Policy SI
 
Domiciliary Hospitalization  Upto SI Upto SI Upto SI

Upto SI

Maternity Benefit (Optional)

Rs.35,000 - Maternity

Rs.25,000 - New Born

Rs.35,000 - Maternity

Rs.25,000 - New Born

Rs.35,000 - Maternity

Rs.25,000 - New Born

Rs.35,000 - Maternity

Rs.25,000 - New Born

Organ Donor  
 
Upto SI Upto SI Upto SI Upto SI
Hospital Cash Allowance (Add On) Option of Rs.100, 200, 300, 500/ day* (as per policy wordings) Option of Rs. 500, Rs. 1000 / day* (as per policy wordings)

 

General Benefits

  3 LAKH 4 LAKH 5 LAKH 7.5 LAKH
Room Rent (per day) ✔  ✔  ✔ 

✔ 

Pre-Hospitalisation  ✔  ✔  ✔ 

✔ 

Post Hospitalization ✔  ✔  ✔ 

✔ 

Restoration of Sum Insured ✔  ✔  ✔  ✔ 
Day Care Treatment ✔  ✔  ✔  ✔ 
No Claim Bonus     ✔  ✔  ✔  ✔ 
Domiciliary Hospitalization ✔ 

Maternity Benefit (Optional)

✔ 

✔ 

✔ 

✔ 

Organ Donor  
 
✔  ✔  ✔  ✔ 
Hospital Cash Allowance (Add On) ✔  ✔  ✔  ✔ 

Ambulance Benefits

  3 LAKH     4 LAKH     5 LAKH     7.5 LAKH    
Domestic air ambulance
Emergency Surface Ambulance Charges

 

Ambulance Benefits

  3 LAKH     4 LAKH     5 LAKH     7.5 LAKH    
Domestic air ambulance Not Available Not Available Not Available Not Available
Emergency Surface Ambulance Charges Rs.3000/event Rs.3000/event Rs.3000/event Rs.3000/event

Miscellaneous Benefits

  3 LAKH     4 LAKH     5 LAKH     7.5 LAKH    
AYUSH Treatment
Health Check-up
Critical Illness (Add On)
Animal bite ( Vaccination) As per policy wordings As per policy wordings As per policy wordings As per policy wordings
Convalescence Benefit (on continious 10 days of hospitalization or more)
Out-patient Dental Emergency Treatment (Accidents only) As per policy wordings As per policy wordings As per policy wordings As per policy wordings
Out-patient Emergency Treatment (Accidents only) As per policy wordings As per policy wordings As per policy wordings As per policy wordings

 

Miscellaneous Benefits

  3 LAKH     4 LAKH     5 LAKH     7.5 LAKH    
AYUSH Treatment Upto SI Upto SI Upto SI Upto SI
Health Check-up Annual – Annual – Annual Basic - Annual Basic -
As per Annexure – II of the Policy Wordings As per Annexure – II of the Policy Wordings As per Appendix – III of the Policy Wordings As per Appendix – III of the Policy Wordings
Critical Illness (Add On) As per policy wordings As per policy wordings As per policy wordings As per policy wordings
Animal bite ( Vaccination) As per policy wordings As per policy wordings As per policy wordings As per policy wordings
Convalescence Benefit (on continious 10 days of hospitalization or more) Not Available Not Available Not Available Not Available
Out-patient Dental Emergency Treatment (Accidents only) Not Available Not Available Not Available Not Available
Out-patient Emergency Treatment (Accidents only) Not Available     Not Available     Not Available     Not Available    

 

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