Health insurance is a contract that covers medical expenses, protecting insured individuals from financial losses. It offers various types of coverage including hospitalization, critical illness, and personal accident covers, with additional benefits like cashless facilities and tax benefits. Key considerations for choosing health insurance include age, family history, policy benefits, and the insurer's service history.

1. Health Insurance
- An Overview
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2. What is Health Insurance
• Health insurance, also known as medical
insurance, is a type of insurance coverage that pays
the insured for medical and surgical expenses
• It is a contract between the health insurance
company (insurer) and the insured. The insured a
premium and in return the insurer promises to pay
a predetermined sum of money to meet the claims.
• This protects the insured and his dependents
against the financial losses caused by expensive
medical treatment

3. Benefits of Health Insurance
Medical insurance saves the insurer from huge
financial losses incurred due to medical expenses
and post-illness care. Some of the key benefits
include of Bajaj Allianz Health insurance include:
• Coverage for hospitalization expenses.
• Provides access to cashless facility at empanelled
hospitals across India (subject to exclusions and
conditions).

4. Benefits of Health Insurance
• It covers pre and post hospitalization expenses
which include relevant medical expenses incurred
60 days prior to and 90 days after hospitalization.
• 130 daycare procedures are covered subject to terms
and conditions.
• Income tax benefit on the premium paid as per
Section 80D of the Income Tax Act.
• The benefit of an in-house Health Administration
Team which ensures faster claim settlement and
more control over claims settlement and customer
service.

5. Types of Health Insurance
• Hospitalization Cover
Hospitalization cover provides the insured a cover for all the
expenses arising out of hospitalization on account of treatment
required for illness or accident. This is an indemnity cover, which
ensures, making good for the loss an insured suffers. All the
expenses are paid based on the details mentioned on required bills
and hospital documents. Each cover comes with its own coverage,
exclusion and limitations.
• Hospital Cash Cover
Hospital cash cover takes care of those expenses which are not
covered under a pure hospitalization cover. Though hospitalization
cover takes care of medical expenses, there are also incidental
expenses which are non-medical in nature. For example, expenses
arising out of traveling to and from the hospital, or stay, special
dietary food expense.

6. Types of Health Insurance
• Critical Illness Cover
Critical illness policy is a benefit cover which covers the insured for
any grave or critical illness (such as cancer, paralysis, major organ
transplant etc.) for which hospitalization expenses may or may not
be covered in a pure hospitalization cover. Some serious illnesses
may require prolonged recovery which entails additional costs such
as incidental expenses, possible loss of income, or structural changes
in the family.
• Personal Accident Cover
Personal accident policy covers the insured for expenses incurred
only on account of accident. This is a benefit plan, where the opted
cover is paid as a lump sum based on the degree of disability and/or
death.

7. Types of Health Insurance
• Top-up Cover
A top-up health cover is an extension over your existing
health/hospitalization policy. This policy can be taken as an add-on
cover to your existing hospitalization policy. In case of higher
expenses due to illness or accidents when the existing policy sum
insured gets exhausted, a top-up cover takes care of the additional
expenses.

8. Choosing Health Insurance
There are several important things to consider while
you decide on your health insurance cover. These
include:
• Age and Family Size
Your health portfolio will vary based on your age and marital status.
When you are younger, you are expected to have fewer illnesses or
pre-existing health conditions. This is why the health insurance
policy for a person who is 25 and single can include a standard
standalone hospitalization cover. However, if a person is 30 and
married, then the health insurance portfolio can be upgraded to a
family floater policy.

9. Choosing Health Insurance
• Purchasing Power
If you have the funds, securing your health adequately should be
your priority. While keeping an eye on the premium, one must also
read through the features of the plan, the discounts available,
deductibles and co-payments, standard deductions, illness sub-limits
and other restrictions.
• Family History
If an individual has a family history of lifestyle diseases, the
probability of it being passed on to the next generations is higher.
Any individual who is genetically in a high-risk category should buy
wider health insurance coverage when he is young and healthy.

10. Choosing Health Insurance
• Policy Benefits
Understanding your health coverage, getting familiar with the
services covered and how much you will have to pay in case of an
unfortunate eventuality is important. If you opt for a health
insurance cover that is not adequate or is restrictive it might not
solve the very purpose it’s bought for.
• Service
It is also important to check on the service history of the company
you invest in. The last thing you would want to do while dealing
with illness is spend precious time in coordinating with your insurer
to settle a legitimate claim.

11. Health Insurance Claim Process

12. Why Should You Choose Bajaj
Allianz
• Tie-ups with over 3700+ Network Hospitals to provide
cashless facility.
• Best claims settlement ratio in the private sector
General Insurance companies.
• The company has tie-ups with dental , optical , fitness
chains and many other value added services.
• ISO re-certification for health claims processing.
• 24X7 call assistance for claims settlement.

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