HEALTH CARE SUPREME

A Comprehensive Plan with a wide range of benefits ensuring a cover for maximum expenses related to Illness and Accidents No matter what stage of life you're at, our Health Care Supreme will take care of your priorities-

Basic inclusions

• Hospitalization Expenses
• Pre Hospitalization
• Post Hospitalization
• Road Ambulance
• Air Ambulance
• Day Care Procedures
• Out Patient Expenses
• Organ Donor Expenses
• Recovery benefit
• Physiotherapy Expenses
• Sum Insured Reinstatement Benefit
• Ayurvedic and Homoeopathic Hospitalisation treatment
• Maternity Expenses
• New Born Baby Cover
• Annual Free Preventive Health Check Up
• Add-ons
• Ancillary Expenses Benefit
• Personal Accident cover
• 15 Critical Illness cover
• Plans

HOSPITALISATION BENEFIT

• Covers hospitalisation expenses, with No sublimit on room rent, illnesses etc
• The medical expenses incurred during the 60 /90 days immediately pre & post hospitalization
• Unlimited day care procedures covered
• Hospitalization expenses incurred for Ayurvedic & homeopathic hospitalizations, no sub limits applicable
• Expenses are covered up to Hospitalization Sum Insured

Air Ambulance Expenses
Expenses for ambulance transportation in an airplane or helicopter for emergency life threatening health conditions which require immediate and rapid ambulance transportation

Coverage up to 10% of Hospitalisation Sum Insured

• Road Ambulance
• Expenses incurred on an ambulance for transferring insured to the nearest Hospital,
• No sub limits applicable.
• Expenses covered upto hospitalisation Sum Insured

Out Patient Expenses
The OPD section covers you for specialist consultations including diagnostic tests & medicines No other waiting periods applicable except 30 days from date of inception

Physiotherapy Expenses

• Physiotherapy treatment on day care basis / OPD basis provided the treatment is prescribed by a Specialist consultant,
• up to 10 Sittings per Illness
• Up to 1% of Hospitalisation Sum Insured
• 90 days waiting period

Maternity Expenses

• Medical Expenses incurred for maternity including pre-natal and post-natal hospitalization expenses
• Maximum 2 deliveries or termination(s)
• Waiting period of 2 years

New Born Baby Cover
Hospitalization Expenses towards treatment of your new born baby
Mandatory Vaccinations of the new born baby up to 90 days
Maternity expenses and New Born Baby expenses are covered up to the Sum insured under maternity benefit

Organ Donor Expenses
Lump sum amount as specified under the policy schedule towards organ donor’s treatment for harvesting of the donated organ Claim payable only if the main hospitalisation claim is acceptable

Recovery benefit
Lump Sum benefit amount is paid to take care of the Incidental expenses for illnesses which require long term care. Claim payable only if the main hospitalisation claim is acceptable

Free Annual Preventive Health Check Up
At our empanelled Diagnostic centers Or Hospitals, regardless of claim history

Sum Insured Reinstatement benefit

• If the Hospitalization Sum Insured and cumulative benefit is exhausted , Sum Insured we will be reinstated up to 100% of Sum Insured Under Hospitalization benefit for future claims
• Payable only for the illness/ailments for which the claim is not made earlier, in the policy period

Discounts
Add on Cover Discount :
5% discount if all add on covers are opted along with the basic cover
2. Family Discount :
5% discount, If 2 or more dependent family members are covered under a single policy
3. Claim Free Renewal Discount :
5% discount, if the policy is claim free at the time of renewal
4. Group Discount :
Discount of 5% to 30% will be applicable for Group policies based on the Size of the Group
5. Employee Discount: 20% employee discount for Employees of Bajaj Allianz & its group companies

Exclusions

• Any expenses for investigations/ treatment taken without existence of any disease/ illness, signs /symptoms
• Any expenses for diagnostic tests, investigations / treatment taken without the Specialist Consultant advising the same and which is not
• duly supported by his prescriptions
• Cost of Annual Health Check up
• Any expenses in excess of the maximum payable amount under the
• Outpatient medical expenses limit.
• Any expense for Treatments which is not specified under Section A7.
• Treatment taken at a hospital which does not fulfill the criteria as per the policy definition
• Treatment exceeding the limit as specified under the Plan opted
• Any expenses incurred for treatment taken for other Ayurvedic & Homeopathic therapy which is not defined & covered under the policy
• Treatment taken for Unani, naturopathy or any other stream of Medicine except as specified under the policy
• Treatment taken in Wellness Centre/Spa/Naturopathy centers/Panchakarma centers or any other treatment centers which do not qualify as per
• the policy definition of Hospital
• Circumcision unless required for the treatment of Illness
• Any form of plastic surgery unless necessary for the treatment of cancer ,burns or accidental Bodily Injury or treatment or surgery for change of life/gender
• Any condition directly or indirectly caused by or associated with Human Immunodeficiency Virus
• Venereal disease or any sexually transmitted disease or sickness.
• Intentional self-injury (including but not limited to the use or misuse of any intoxicating drugs or alcohol), treatment due to use or abuse of any substance, drug
• Any fertility, sub fertility, impotence, assisted conception operation or sterilization procedure
• Accidental Bodily Injury that you/your family member named in the schedule meets with:
• through suicide, attempted suicide or self inflicted injury or illness.
• While under the influence of liquor or drugs.
• Arising or resulting from the insured person committing any breach of law with criminal intent.
• Consequential losses of any kind or insured person’s actual or alleged legal liability.
• Any injury/disablement/death directly or indirectly arising out of or contributed to any pre-existing condition
• War (whether declared or not), civil war, invasion, act of foreign enemies
• Any Critical Illness which first manifested itself or was contracted before the start of the Policy Period
• Occupational diseases.
• Any sexually transmitted diseases or any condition directly or indirectly caused by AIDS
• Treatment arising from or traceable to pregnancy, childbirth
• Consequential losses of any kind or insured person’s actual or alleged legal liability.
• Any natural peril like storm, tempest, avalanche, earthquake, volcanic eruptions
• War (whether declared or not), civil war, invasion, act of foreign enemies
• Radioactive contamination

Unique Selling Proposition

• Comprehensive Health cover with, wide range of coverage under single policy including maternity, OPD, Sum insured Restoration , air ambulance
• SI options ranging from 5L to 50L on individual and floater Sum insured basis
• Complete package policy, with 15 covers under Hospitalization section and options of add on covers to top up your coverage
• No restriction on entry age, Min entry age 3 months
• Lifetime renewal option
• Free Annual Health Check up regardless of Claims history
• Unique coverage like Ayurvedic and Homoeopathic treatment cover with no restrictions, Air ambulance cover, physiotherapy expenses Coverage for unlimited Day care procedures