Arogya Sanjeevani Health Insurance Policy

The Arogya Sanjeevani Health Insurance Policy, introduced by the Insurance Regulatory and Development Authority of India(IRDAI), is designed to provide affordable and standardised health coverage for individuals and families. This policy offers coverage of up to INR 5 lakh, ensuring financial support for medical treatments without straining your savings. The Arogya Sanjeevani Policy from Bajaj General Insurance Limited includes hospitalisation coverage, ICU expenses, room rent, and modern treatments. Available in individual and family floater options, this policy protects against unexpected medical expenses, offering benefits for pre- and post-hospitalisation care, advanced treatments, and a simple claim process. It’s an essential solution for anyone seeking reliable yet cost-effective health insurance coverage.

Importance of Arogya Sanjeevani Health Insurance Policy

In a world where healthcare costs are rising rapidly, the Arogya Sanjeevani Health Insurance Policy offers essential protection. Health issues can be unpredictable, and a serious illness or accident can lead to considerable financial strain. This policy ensures that individuals and families can access quality healthcare without exhausting their savings. Covering hospitalisation, daycare procedures, modern treatments, and more, this policy provides well-rounded coverage for diverse medical needs. Additionally, it includes a cumulative bonus for every claim-free year, meaning your sum insured can increase over time, offering even greater protection. Bajaj General Insurance Limited’s Arogya Sanjeevani Policy empowers you to handle medical emergencies with confidence, knowing that financial support is available when it’s most needed.

Benefits/Features of Arogya Sanjeevani

The Arogya Sanjeevani Policy by Bajaj General Health Insurance will help you get that financial support and protect you from the financial burden at the time of hospitalization. With arogya sanjeevani health insurance, you can stop worrying about emptying your savings and deal with any medical emergency head-on.

Extensive Coverage

Arogya Sanjeevani health insurance policy covers you for*:

a) Hospitalization:
- Room Rent, Boarding, Nursing Expenses
- Intensive Care Unit (ICU)/Intensive Cardiac Care Unit (ICCU)
- Road ambulance cover

b) Listed Modern Treatment Methods

c) All Day Care Treatments

d) AYUSH Treatment: Medical Expenses incurred for Inpatient Care treatment under Ayurveda, Yoga and Naturopathy, Unani, Sidha and Homeopathy systems of medicines during each Policy Year upto the limit of Sum Insured as specified in the Policy Schedule in any AYUSH Hospital.

e) Cataract Treatment: Medical Expenses incurred for treatment of Cataract

*subject to limits

Policy Type

There are two types of Arogya Sanjeevani health insurance policies, both with a tenure of one year:

a) Arogya Sanjeevani Policy, Bajaj General Insurance Limited – Individual

b) Arogya Sanjeevani Policy, Bajaj General Insurance Limited – Family Floater

Annual Policy

You and your family members will be covered for a period of one year with Arogya Sanjeevani health insurance policy.

Discounts

Family Discount: 10% family discount shall be offered if 2 eligible Family Members are covered under a single Policy and 15 % if more than 2 of any of the eligible Family Members are covered under a single Policy. Moreover, this family discount will be offered for both new policies as well as for renewal policies.

Online/Direct Business Discount: Discount of 5% will be offered in this product for policies underwritten through direct/online channel.

Note: this discount is not applicable for Employees who get employee discount

Medical Procedures Covered

Arogya Sanjeevani health insurance policy covers the following procedures either as In-patient or as part of day care treatment in a hospital*:

a) Uterine Artery Embolization and HIFU (High Intensity focused ultrasound)

b) Balloon Sinuplasty

c) Deep Brain Stimulation

d) Oral Chemotherapy

e) Immunotherapy - Monoclonal Antibody to be given as injection

f) Intra vitreal injections

g) Robotic surgeries

h) Stereotactic radio surgeries

i) Bronchical Thermoplasty

j) Vaporisation of the prostrate (Green laser treatment or holmium laser treatment)

k) IONM – (Intra Operative Neuro Monitoring)

l) Stem Cell Therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered.

*subject to limits

Premium Payment in Instalment

Premium Payment can be made either in Full or in instalments- Half Yearly, Quarterly, Monthly.

Lifetime Renewal

Arogya Sanjeevani policy comes with lifetime renewal benefits.

The Arogya Sanjeevani health insurance Plan Provides Extensive Coverage With Multiple Benefits:

Renewability:

Lifetime Renewal benefit is available under this policy.

Hassle-free claim settlement:

With our cashless and reimbursement claim settlement process, we make your filing, tracking and claim settlement process very smooth and convenient.

Premium Payment in Instalment:

Premium can be paid on instalment basis- Annual, Half yearly, Quarterly or Monthly.

No Pre-policy check-up till 45 years of age:

For new proposals, you do not have to undergo any medical test up to 45 years of age.

Cumulative Bonus :

Cumulative Bonus will be increased by 5% in respect of each claim free policy year (no claims are reported), provided the policy is renewed with the company without a break subject to maximum of 50% of the sum insured under the current policy year.

Free Look Period :

The Insured or Insured Person(s) shall be allowed a period of fifteen days from date of receipt of the Policy to review the terms and conditions of the Policy, and to return the same if not acceptable.

Choosing Bajaj General Insurance Limited Healthcare Insurance is a smart decision for those seeking reliability, convenience, and comprehensive coverage. Here’s why:

Comprehensive Coverage

The Arogya Sanjeevani Policy offers extensive protection against a wide range of medical expenses.

Wide Network of Hospitals

Enjoy cashless treatment across a vast network of hospitals, ensuring convenience during medical emergencies.

Competitive Premium Options

Flexible and cost-effective premium plans cater to different budgets without compromising on coverage quality.

Exceptional Customer Support

Available 24/7, the dedicated support and claim assistance teams provide immediate help whenever needed.

Seamless Digital Experience

Manage your policy online easily with options to renew, check coverage, and file claims via the website or mobile app.

Additional Benefits

Features like No Claim Bonus and Lifetime Renewability add extra value to the healthcare plan.

Choosing Bajaj General Insurance Limited Healthcare Insurance means opting for a trusted partner that prioritises your health and financial well-being with comprehensive, convenient, and customer-centric solutions.

Cashless facility at network hospitals is available 24x7, throughout the year, without any interruption in service. The list of hospitals where cashless settlement can be availed is dynamic and liable to change without notice. You must check the hospital list before getting admitted. The updated list is available on our website and with our call center. Bajaj General Health Card along with a government ID proof is mandatory at the time of availing cashless facility.

When you are opting for cashless claims, follow the steps given below:

- Get the pre-authorization request form filled and signed by the treating doctor/hospital and signed by member/patient, at the hospital’s insurance desk.

- Network hospital will fax the request to the Health Administration Team (HAT).

- HAT doctors will examine the pre-authorization request form & decide on cashless availability, as per the policy guidelines.

- Authorization letter (AL)/denial letter/additional requirement letter is issued within 3 hours depending on the plan and its benefits.

- At the time of discharge, the hospital will share the final bill and discharge details with HAT and based on their assessment, final settlement will be processed. Also, the insured person has to verify and sign the discharge papers, pay for non-medical and inadmissible expenses.

Important Points to Note

- In case of planned hospitalization, register/reserve your admission as per the network hospital’s procedure for admission in advance.

- Admission at network hospital is subject to availability of a bed.

- Cashless facility is always subject to your policy terms and conditions.

- The policy does not cover the following:

- Telephone

- Food and beverages for relatives

- Toiletries

- The cost of the above services have to be borne by you and paid directly to the hospital before discharge.

- In-room rent nursing charges are included. However, if a higher cost room is used then the incremental charges will be borne by you.

- In case the treatment is not covered as per the policy terms and conditions, your claim, cashless or reimbursement, will be denied.

- In case of inadequate medical information, pre-authorization for cashless claim can be denied.

- The denial of cashless facility does not mean denial of treatment and does not in any way prevent you from seeking necessary medical attention or hospitalization.

Reimbursement of Pre/post Hospitalization Expenses

Relevant medical expenses incurred before admission and after discharge from the hospital will be reimbursed as per the policy. Prescriptions and bills/receipts of such services should be submitted to Bajaj General Insurance along with the duly signed claim form.

Arogya Sanjeevani Policy Claim Process

Inform the Bajaj General Insurance HAT about the hospitalization.

Register your health insurance claim online.

To register your claim offline, please call us on our toll-free number: 1800-209-5858.

Documents Required for Reimbursement Claim:

- Duly completed claim form

- Photo identity proof of the patient

- Medical practitioner’s prescription advising admission.

- Original bills with itemized break-up

- Payment receipts

- Discharge summary including complete medical history of the patient along with other details

- Investigation / Diagnostic test reports etc. supported by the prescription from attending medical practitioner

- OT notes or Surgeon’s certificate giving details of the operation performed (for surgical cases)

- Sticker/Invoice of the Implants, wherever applicable.

- MLR (Medico Legal Report) copy if carried out and FIR (First Information Report) if registered, wherever applicable.

- NEFT Details (to enable direct credit of claim amount in bank account) and cancelled cheque

- KYC (identity proof with address) of the proposer, where claim liability is above Rs. 1 Lakh as per AML Guidelines.

- Legal heir/ succession certificate, wherever applicable

- Any other relevant document required by Company/ TPA for assessment of the claim

Complete set of claim documents needs to be forwarded to

Health Administration Team,
Bajaj General Insurance Limited.
2nd floor, Bajaj Finserv Building, Behind Weikfield IT Park, Off Nagar Road,Viman Nagar-Pune - 411 014.