Overview
The Bajaj Allianz Health Guard Silver plan is a basic health insurance policy offering coverage for in-patient hospitalization, pre- and post-hospitalization expenses (60-90 days respectively), and daycare. It provides sum insured options of ₹1.5 lakhs and ₹2 lakhs, with a room rent restriction of up to 1% per day of the sum insured. The plan includes AYUSH treatment, organ donor expenses, bariatric surgery cover (up to 25% of Sum Insured) and wellness benefits. .
Experts Review
Written by Ishita Jain
Editor
The Bajaj Allianz Health Guard Silver plan is a straightforward health insurance solution suitable for basic medical needs. Its coverage includes pre- and post-hospitalization expenses, which are standard across most plans. The plan covers AYUSH treatment, convalescence benefit up to ₹5,000 per policy year and preventive health check-up up to 1% of the sum insured, capped at ₹2,000 during the block of 3 years. . However, the room rent restriction, no domiciliary cover and disease wise limits (for example: cataract sub-limit 20% of the sum insured,subject to maximum of Rs 1,00,000) may limit coverage for high-cost procedures.
Bajaj Allianz has a 3-year (2021-24) average claim settlement ratio of 95%, indicating reliable claims processing. However, the plan's limited sum insured options and restrictive nature might not provide comprehensive protection for more extensive medical needs.
Pros
Insurer has a solid track record with great claim and service metrics.
Cons
Not very feature-rich.
No coverage if you are forced to hospitalize at home, which is a notable gap.
Maternity benefits not offered, which could be a drawback for some.
Doctor consultations are not covered, which is a key feature.
Bajaj Allianz
Key Insights
Founded
2001
Bajaj Allianz was established 24 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
97% claims settled in 30 Days
Bajaj Allianz settles 97% of all claims it receives demonstrating strong credibility.
Network Hospitals
12,000+
Bajaj Allianz has a strong network with over 12,000 hospitals, ensuring wide accessibility and convenience for policyholders.
Complaints
3 complaints per 10,000 claims registered
Bajaj Allianz maintains a low volume of complaints, reflecting strong customer satisfaction and effective service.
Features
All
Great
Good
Bad
Co-payment
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.
Room Rent
Your insurer won’t let you stay in a room whose rent exceeds 1% of the sum insured. But in the event, you breach this limit, get ready to pay a lot more.
Disease sub-limit
Your insurance cover won’t be fully available in case you are treated for eye related diseases like cataracts, up to 20% of base sum insured max. of ₹1,00,000 will be covered.
Pre existing diseases waiting
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 you wait for 3 years.
Pre/Post hospitalization
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 - 60 days before you are hospitalized and 90 days after discharge. This includes the cost of medication by the way.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Diagnostic expenses not related or incidental to current diagnosis and treatment are excluded.
Expenses for admission primarily for bed rest and not for treatment are excluded.
Custodial care at home or in a facility for help with daily activities is excluded.
Services for terminally ill individuals addressing non-medical needs are excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy .
Any type of gastrointestinal ulcers
Cataracts (any type)
Any type of fistula
Macular degeneration
Benign prostatic hypertrophy (BPH)
Waiting Period
30 days Initial waiting period
3 years Pre-existing disease waiting period
Ditto's Take
◦ Standard ◦
After a close look at the waiting periods, it’s safe to say they are fairly standard overall. However, there is no specific illness waiting period which is a plus.
What's missing in the policy
No coverage if you are forced to hospitalize at home.
Maternity benefits not offered.
Doctor consultations are not covered.
Customer Reviews
A
Aryan M.
Affordable premium makes it a good budget-friendly option.
A
Avani I.
Covers pre and post hospitalization expenses, which is essential.
A
Ayaan M.
In-patient hospitalization is covered, providing basic security.
G
Gayatri C.
The 95% claim settlement ratio is good, but the limitations of the plan itself are a concern for bigger needs.
F
Fatima D.
Room rent restrictions and sub-limits on treatments can lead to out-of-pocket expenses.
E
Eesha J.
Good for young individuals or those looking for a starter policy.
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Frequently Asked Questions
Does Health Guard Silver have 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 2 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 3-year waiting period for any pre-existing disease you may have while buying the policy.
Does Health Guard Silver have room rent restrictions?
Does Health Guard Silver offer a restoration benefit?
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