Health Guard Silver
Overview
Bajaj Allianz Health Guard Silver is the most affordable variant in the Health Guard lineup offered by Bajaj Allianz General Insurance Company Ltd. The plan covers basic hospitalisation expenses, convalescence benefit for a longer hospitalisation and preventive health check-up. Daily room rent cover is restricted to 1% of the sum insured.
Low sum insured options under this variant can be a choice for people under a tight budget. Otherwise, the plan offers better variants.
Pros and Cons
- Economical health insurance option – Good choice for those under a tight budget.
- Never spills the bill – The plan does not include a mandatory copay. Inpatient hospitalisation expenses are fully covered up to the sum insured.
- Pre and Post Hospitalisation expenses covered – The insurer pays for medical expenses up to 60 days before hospitalisation and 90 after the discharge.
- Room rent limit – Includes daily room rent limit up to 1% of the sum insured.
- Disease-specific limit – Includes sub-limit on common treatments like cataract surgery.
- Consumables not covered – Does not cover the cost of consumables. You bear the cost out-of-pocket.
- Domiciliary Hospitalisation – No cover if you are forced to be hospitalised at home.
Plan Benefits
Inpatient hospitalisation expenses covered
The plan covers inpatient hospitalisation expenses up to the sum insured. Room rent limit is restricted to 1% of the base sum insured per day. However, ICU charges are covered at actuals.
Pre and post-hospitalisation expenses cover available
The plan covers hospitalisation-related medical expenses 60 days before and 90 days after hospitalisation. These include consultation fees, diagnostic tests, medication and other related expenses.
Road ambulance charges covered
The insurer covers road ambulance charges up to Rs. 20,000/- per policy year.
Includes cover for daycare procedures
Many advanced surgeries or procedures done under anesthesia now require less than 24 hour hospitalisation. These are called day care treatments. Your insurer fully covers the cost of such procedures up to sum insured.
Get cover for alternative treatment
Want to take an alternative treatment like Ayurveda or Homeopathy? Don’t worry. The insurer fully covers your hospitalisation and related expenses.
Organ donor expenses covered
If you are an organ recipient, the insurer covers the hospitalisation expenses related to harvesting the organ from the donor.
One-time restoration of sum insured available
If you claim a part of your base cover, you don’t have to worry about the coverage for future claims. The insurer restores your full sum insured once during a policy year upon full exhaustion of base cover. The restored amount can be used only for subsequent claims during the policy year.
Get convalescence benefit in case of longer hospitalisation
If the hospitalisation exceeds 10 consecutive days, the insurer provides you a fixed convalescence benefit of Rs. 5,000 for incidental expenses. This benefit has a separate limit over and above the sum insured.
Get daily cash benefit for accompanying a child
If a child aged less than 12 years is hospitalised, you get a daily cash benefit of Rs. 500/- per day for accompanying the insured child, for a maximum of 10 days every policy year. This benefit has a separate limit over and above the sum insured.
Get free preventive health check-up
Free preventive health check-up is available once in a block of 3 years for all lives in an individual policy. Family floaters provide preventive health check-up only for the policyholder and spouse.
Get cover for weight-loss treatment
Want to undergo weight loss treatment? The plan covers hospitalisation expenses for weight loss treatment up to the sum insured if certain conditions are met.
Stay healthy and get a discount on renewal premium
Stay healthy and monitor your health. You can get up to a 12.5% discount on the subsequent premium if certain health parameters meet the insurer’s benchmark.
Policy Conditions
| Sum Insured Range | Rs. 1.5 Lakh and Rs. 2 Lakh |
| Entry Age | 91 Days – 30 Years for dependent children; 18 Years onwards for adults |
| Policy Tenure Options | 1, 2 or 3 Years |
| Coverage Types | Individual and Family Floater |
| Family Coverage | Self, Spouse, Dependent Children, Grandchildren, Parents, Sister, Brother, Parents-in-law, Aunt, Uncle can be covered under individual option. Up to 2 adults and 2 children under the family floater option. |
| Premium Payment Options | Monthly, Quarterly, Half-Yearly and Annual |
Exclusions
Waiting Periods
- Initial Waiting Period: 30 days (except accidents)
- Specific Illness Waiting Period: 24 months and 36 months, depending on the illness
- Waiting Period on Pre-Existing Diseases: 36 months
- Bariatric Surgery Waiting Period: 36 months
Medical Exclusions
- Change of gender treatment
- Cosmetic surgeries (unless due to accident, cancer, etc.)
- Unproven treatments
- Refractive error correction for less than 7.5 diopters
- OPD expenses and Dental OPD treatment
- Maternity and related expenses
- Sterility and infertility
Non-Medical Exclusions
- Expenses related to any admission primarily for diagnostics and evaluation purposes
- Expenses related to any admission primarily for enforced bed rest
- Self-injury or attempt to suicide
- Alcoholism, drug or substance abuse
- Treatment necessitated by committing breach of law with criminal intent
- Treatment taken by a medical practitioner outside his discipline
- War, terrorism, nuclear events
- Injuries from hazardous sports
About the Insurer
Bajaj Allianz General Insurance Company Limited was established in 2001. It is a joint venture between Bajaj Finserv Limited and Allianz SE, a global insurance leader based in Germany. Over the years, the company has grown to become one of the country’s largest private general insurers, with a presence in over 1,100 towns and cities.
The company offers a comprehensive range of insurance products, including health, motor, travel, home, and commercial insurance, catering to both individual and corporate clients. With its customer-centric approach, the company has been able to deliver superior customer service. It reflects in the insurer’s decent claim settlement ratio and minimal number of claim-related complaints.
Performance Highlights (FY24)
Turnover – Rs. 20,473 Crore
Claim Settlement Ratio – 93.65%
Incurred Claim Ratio – 73.80%
Volume of Claim Complaints – 2.87
Network Hospitals – 18,400+
Get In Touch
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Frequently Asked Questions
What is the entry age for the Bajaj Allianz Health Guard Silver Plan?
Individuals aged 18 years and above can be covered, while dependent children aged between 91 days and 30 years can be included under the family floater option.
Is there a maximum age limit for coverage under Bajaj Allianz Health Guard Silver?
There is no maximum age limit under this plan. The policy offers lifelong renewability.
What is the policy period available under the Bajaj Allianz Health Guard Silver Plan?
The policy can be purchased for a term of 1, 2, or 3 years.
Can I cover my entire family under this plan?
Yes, you can cover your family members under the family floater option.
Does the policy cover pre and post-hospitalisation expenses?
Yes, the plan covers pre-hospitalisation expenses up to 60 days and post-hospitalisation expenses up to 90 days.
Are daycare procedures covered?
Yes, the plan covers daycare procedures that do not require 24 hour hospitalisation.
Is maternity and newborn baby cover included under Bajaj Allianz Health Guard Silver Plan?
No, the plan does not cover maternity and newborn baby expenses.
Does the plan cover organ donor expenses?
Yes, expenses incurred in harvesting the organ from the donor are covered.
Are alternative treatments like AYUSH covered?
Yes, hospitalisation expenses incurred under Ayurveda, Yoga, Unani, Siddha, and Homeopathy are covered up to the sum insured.
Is there a wellness benefit under the plan?
Yes, you can enjoy a wellness benefit discount of up to 12.5% on your renewal premiums by maintaining good health.
Are ambulance charges covered?
Yes, road ambulance charges are covered up to Rs. 20,000 per policy year.
Is there a daily hospital cash benefit?
Yes, if your insured child (under 12 years) is hospitalised, you are eligible for a daily cash benefit of Rs. 500 per day, covering reasonable accommodation expenses for up to 10 days per policy year.
How can I renew my policy?
You can renew your health insurance policy online through the Bajaj Allianz website or mobile app. Alternatively, you can contact your health insurance advisor for renewal support.
Is there a grace period for renewal?
Yes, there is a 30 day grace period from the annual renewal date during which you can renew your policy without losing the continuity benefits.
Can I port my existing health insurance policy to the Health Guard Silver Plan?
Yes, you can port your existing health insurance policy to the Health Guard Silver Plan, subject to underwriting approval.
What is the process for cashless hospitalisation?
You need to inform the insurer 48 hours prior to a planned hospitalisation or within 24 hours of an emergency admission. The hospital will then coordinate with the insurer for cashless approval.
Are there any tax benefits?
Yes, premiums paid for the policy are eligible for tax deductions under Section 80D of the Income Tax Act.
Is there a family discount available?
Yes, a 10% family discount is available if two members are covered. 3 or more family members, if covered under the same policy, get a 15% family discount.
Are there any discounts for healthy individuals?
Yes, maintaining good health can earn you a wellness benefit discount of up to 12.5% on your renewal premiums.
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