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Bajaj Allianz

Bajaj Allianz

Health Ensure Family Plan

It's a decent policy for your family and if any of you have pre-existing diseases (like diabetes), you can rest easy knowing that they'll cover complications arising out of these complications only after 2 years. But the policy does have a few unsavory conditions including limits on room rent. So you might want to read more.

What's good here?

coPay

You’ll never have to split the bill

The insurer will bear the entire cost of treatment (up to the sum insured). You won’t have to pay a single penny. Meaning this policy has no co-payment.

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ped

Short waiting period for Pre Existing Diseases

If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after just 2 years. It’s probably the best deal you can get to be honest.

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dayCare

Day Care treatments covered

If you’re hospitalized for less than 24 hours in lieu of a minor procedure, then the insurer will cover these costs too. Think dialysis, chemotherapy or minor surgeries.

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prePost

Pre & Post hospitalization expenses covered

No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 30 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.

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ayush

Covers Alternative Medicine

Think of getting Ayurvedic, Homeopathic or other alternative treatments to cure an illness? Your insurer will cover you fully, up to the sum insured.

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What's bad here?

special mention
warning
Be aware of

Restrictions on the rooms you can pick and much more

Your insurer won’t let you stay in a room whose rent exceeds 1% of the sum insured. If it’s an ICU they’ll bump it to 2% of the sum insured. And in the event you breach these limits, then you’ll have to pay a lot more - Read more here

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diseaseSublimit

Your insurer won’t pay the full bill for certain diseases

Your insurance cover won’t be fully available in case you are treated for eye related diseases like cataracts, up to a max. of ₹40,000 will be covered.

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domiciliary

No coverage if you are forced to hospitalize at home

The insurer will not cover the costs if you are forced to hospitalize at home due to a medical condition. In insurance lingo, they call this a policy with no domiciliary cover.

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What's okay here?

ncb

Underwhelming bonus feature

Your sum insured increases by 5% each year, so long as you make no claims during this period. But before you get too ahead of yourself, do note that they’ll stop offering you the bonus when your sum insured increases by 25%. And while this is a decent deal, most insurance companies offer a much higher bonus. But hey, it's still a bonus.

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healthCheckup

No free Health Checkups unless you wait 3 years

If you’re planning on getting a full body checkup just to make sure you’re in fine working condition, the insurer will cover the cost once in 3 years. However, just so you know, most insurance policies offer free yearly health checkups.

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What's lacking here?

restoration

No Restoration Benefit

Some policies will tell you - Even after you claim part of the cover on one occasion, you will have the full cover restored, if you are hospitalized another time during the same year. So if you have a family cover and multiple members of the family are hospitalized in the same year, this feature will come in handy. Unfortunately, this policy offers no such benefit.

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Add-ons

Cumulative Bonus Enhancement

With this add-on, you get a no-claim bonus of 25% upto 200% of the base sum insured instead of 5% upto 25% of the base cover. Also, your no-claim bonus will not be clawed back if the total claim is less than ₹1,00,000. This benefit is available for sum insured 5 lakhs and above.

Room Rent Modifier

With this add-on, the insurance company modifies the room rent restriction from 1% of Sum Insured maximum upto ₹5000/day to a Single Private Room.

Double Sum Insured for Cancer

With this add-on, the insurance company will give additional coverage up to 100% of Sum Insured for medical expenses linked to Cancer.

Personal Accident cover

With this add-on, the insurance company will payout a lumpsum amount based on the cover chosen, in case the selected insured member of the policy passes away in an accident.

Restoration

With this add-on, the insurer will reinstate your base sum once you exhaust your entire cover, you will have 100% of the cover restored, if you are hospitalized one more time in a bid to treat a different complication or a same one (with 15 days cooling-off period for the same member). But remember, this benefit is available once in the policy lifetime for hospitalization related to Cancer & Kidney failure requiring regular dialysis.

Frequently Asked Questions

Yes. Health Ensure Family Plan imposes 3 kinds of waiting periods -
  • 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
  • Specific Illness Waiting Period: There’s a 1 to 3-year waiting period for a list of diseases which is a mandate before you can start claiming.
  • Pre-Existing Disease Waiting Period: There's a 2-year waiting period for any pre-existing disease you may have while buying the policy.
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