Health Insurance

StepUp Benefit Rider

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Terms & Conditions

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Key Features

From Hospitalisation to Wellness—All Covered in One

Coverage Highlights

Essential protections that keep you covered, always

Policy Tenure (Up to 5 Years)

Get long-term protection for up to 5 years with flexible multi-year options.

Consumables Plus

Wider list of non-medical items is covered, reducing out-of-pocket costs during hospitalisation.

Global Coverage

International treatment support for globally mobile customers.

Future-proof Features

Benefits like Age Shield, StepUp Benefit, Smart Tenure, and Super Cumulative Bonus are available to keep your plan relevant as your life evolves.

Wellness & OPD Support

Coverage for teleconsultations, lab tests, dental, fitness, and emotional wellness with Health Prime Rider (HPR) at an additional cost.

Health Limitless

Option to cover the cost of hospitalisation or a catastrophic medical event once, with no sum insured limit.

Note

Please read policy wording for detailed terms and conditions.

Inclusions

What’s covered?

Hospitalisation Cover

Covers all major hospitalisation expenses, like room rent, ICU, doctors' fees, surgery costs, medicines, implants, and diagnostic tests, if the insured is admitted for more than 24 hours.

Pre- & Post-Hospitalisation Costs

Medical expenses up to 60 days before hospitalisation and expenses up to 90 days after discharge for the same illness are covered.

Day Care Procedures

Covers medical procedures (such as cataract surgery, minor surgeries, etc.) that need less than 24 hours of hospitalisation due to technological advancements.

Modern Treatment Methods

Covers advanced procedures such as robotic surgeries, oral chemotherapy, immunotherapy injections, stem cell treatments for eligible conditions, and other listed modern treatments.

AYUSH Treatment

Covers AYUSH treatments (ayurveda, yoga, naturopathy, Unani, Siddha, homeopathy) when hospitalised for more than 24 hours.

Ambulance Cover

Covers emergency ambulance transportation to the nearest hospital or for hospital-to-hospital transfer.

Domiciliary Hospitalisation

Covers medically necessary treatment at home when hospital admission is not possible (with a list of excluded illnesses).

Organ Donor Expenses

Covers the organ donor's medical expenses related to organ harvesting, only when the insured is the recipient.

Family Visit

If the insured is hospitalised 200+ km away from home, travel expenses for one family member to visit are covered (as per specified limits).

Cumulative Bonus

Get a 25% increase in sum insured (up to 100% of sum insured) each claim-free year.

Unlimited Sum Insured Reinstatement

If the sum insured is exhausted, it gets refilled unlimited times in the same policy year for new health events (as per the policy conditions).

Note

Please read policy wording for detailed inclusions.

Exclusions

What’s not covered?

Waiting Period

An initial waiting period right after policy issuance is applicable for pre-existing diseases, and an additional waiting period for specific illnesses or procedures (as per the policy details) also applies.

Standard Policy Exclusions

Certain treatments, services, or items may not be covered under the policy (as these fall under standard exclusions) or may have restricted coverage based on the modified terms upon addition of any add-ons/riders.

Non-Medical Items

Expenses on non-medical items are generally not covered under the policy. However, if you choose to add a consumables cover or rider, some of these items may be included, but only as specified in the policy’s list or annexure.

International Treatment Conditions

Treatment outside India is not covered by default and is only included if you opt for an International or Global coverage option. Coverage for treatment outside India is subject to meeting the policy’s eligibility criteria and specific terms and conditions.

Note

Please read policy wording for detailed exclusions.

Additional Covers

What else can you get?

Global Cover (Planned + Emergency)

Coverage for planned and emergency treatment abroad (as per the eligible sum insured slabs and co-pay options apply).

Age Shield

Pay the premium amount that was set as per the entry age at the time of policy inception until a claim is paid.

StepUp Benefit

Option to enhance the existing sum insured (at first policy renewal) to the next available slab for sum insured without starting the waiting period again.

Smart Tenure

Consolidates the total sum insured available during a multi-year policy for the insured.

Health Limitless

For one claim, a high-cost hospitalisation can be paid without the annual sum insured capping.

Consumables Expenses

Coverage for specified consumables/non-medical items as per the policy.

Super Cumulative Bonus (SCB)

Get 100% cumulative bonus for each claim-free year. The sum insured can be increased up to 600% during a 5-year policy.

Major Illness & Accident Multiplier

Coverage for medical expenses up to twice the sum insured amount for listed events in the policy.

Health Prime Rider

Coverage for cashless OPD services such as teleconsultations, lab tests, and dental procedures.

Specialised Riders

Option to add some specialised riders like NRInsure, Insta Shield, Fetal Flourish, and more.

Air Ambulance

Air ambulance evacuation in life-threatening emergencies within India (coverage is up to ₹10 lakh).

Note

Coverage, limits, sub-limits, deductibles, co-pays (if any), and waiting periods apply as per the policy schedule.

Privacy Policy

I/We hereby give voluntary consent to BGIL/Company to share my/our personal information and data provided in this proposal form with its group companies or any other person in connection with the Insurance Policy or otherwise, including for providing products and services of group companies that may be of interest to me/us, to be used in accordance with their respective privacy policies and subject to appropriate measures being in place to safeguard my/our personal information.
Click here to read our Privacy Policy

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What is the StepUp Benefit Rider?

The StepUp Benefit rider is an optional add-on available with the My Health Care EDGE+ health insurance plan. This health insurance sum insured enhancement rider provides you with a once-in-a-lifetime chance to increase your sum insured amount at your first renewal. To avail this, you have to remain claim-free for a year.

Quick Overview on Health Insurance

1
Add-on: StepUp Benefit rider is an optional rider which enhances your sum insured amount at first renewal (R1).
2
Purpose: It serves as a once-in-a-lifetime opportunity to increase your coverage to combat inflation and emergencies.
3
Policy Flexibility: This rider is available for both individual and family floater MHCP EDGE+ plans.
4
No Waiting Reset: When you choose this rider, you do not have to serve your waiting periods from the beginning.
5
Primary Condition: To get this benefit, you have to remain claim-free for the first year of your policy tenure.
6
Premium Advancement: You can jump to your next sum insured slab. For example, from ₹10 lakh to ₹15 lakh.
7
Age Eligibility: The entry age is flexible, and anyone from 3 months old to 65 years old can get this coverage.
8
Combine With Others: You can combine this rider with other riders and reap maximum benefits.

Key Benefits of StepUp Benefit

With our StepUp Benefit, you can get a higher sum insured amount within your existing My Health Care EDGE+ health insurance policy.

Long-Term Security

By opting for the StepUp Benefit health insurance rider, you can increase your sum insured early in your policy tenure. It helps you get adequate coverage for future medical costs.

Sum Insured Enhancement

With this Bajaj General rider, you can jump to your next available sum insured slab during your first renewal. For example, you can go from ₹10 lakh to ₹15 lakh.

No New Waiting Period

When you choose the StepUp Benefit rider, you don’t have to worry about restarting your waiting periods. Your previous waiting periods will carry forward to the new slab.

Who is Eligible for StepUp Benefit?

Before buying the StepUp Benefit rider, you must know the eligibility criteria. They are as follows:

Eligibility Criteria	Specification
Policy Type	This rider is available under the My Health Care EDGE+ plan by Bajaj General Insurance.
Claim Status	You have to maintain claim-free status for the preceding year of your policy.
Specific Timing	You can only avail this benefit at the time of your first renewal (R1).
Initial Selection	You have to buy the Bajaj General StepUp Benefit rider at the time of inception.
Age Requirement	The insured person should be at least 3 months to 65 years of age

How the StepUp Benefit Works?

Choosing the StepUp Benefit rider has its benefits. But how does it work in real life? Let’s see below:

You choose the MHCP EDGE+ plan and select the StepUp rider when buying the policy.

During the first year of your policy, you have to remain claim-free. You can still use your health prime rider, as it does not affect your claim status.

When you complete your 1-year policy tenure, you can choose to avail this rider and increase your sum insured amount.

Choosing this rider is only possible during your first renewal (R1). You cannot avail this later.

After enhancing your sum insured amount to the next slab, you can enjoy your continued waiting periods.

Having these documents organised and submitted on time will speed up the claim approval process and help you receive benefits without delay.

StepUp Benefit vs Cumulative Bonus – What's the Difference?

Many people think that the My Health Care Plan Edge Plus StepUp is the same as the No-Claim Bonus. However, these two serve different purposes. Here are the differences:

Features	StepUp Benefit	Cumulative Bonus
Frequency	Once-in-a-lifetime opportunity	Recurring for every claim-free year
Type of Cover	Optional rider for MHCP EDGE+ policy	Inbuilt base policy cover automatically triggers
Timing	Available only at first renewal R1	Available for every renewal after a claim-free year
Increase in Sum Insured	Enhances your sum insured to the next slab	Enhances 25% of your base sum insured per annum
Maximum Limit	Next slab level only	Up to 100% of your sum insured amount
Impact of Claims	Disqualifies you from availing the rider	Decreases or resets the no-claim bonus to zero

Download Policy Document

Before buying the My Health Care EDGE+ plan, you must read the inclusions and exclusions. You can find these in the brochure and policy wordings. Also, find the proposal form and customer information sheet here.

Brochure

Policy Wordings

Proposal Form

Claims Form

Customer Info Sheet

Download

What are the Documents Required for Stepup Benefit?

To buy the StepUp Benefit rider from Bajaj General Insurance, you have to provide certain documents. These include:

Digital or physical proposal form

Proof of identity (KYC), including Aadhaar card/passport/Voter ID/etc

Proof of Address, such as utility bills

Birth certificate/Aadhaar card/passport for age proof

Medical reports (if required)

Having these documents organised and submitted on time will speed up the claim approval process and help you receive benefits without delay.

Step-by-Step Guide

How to Buy Stepup Benefit Online?

How to Buy

1

Visit Bajaj General website
2

Enter personal details
3

Compare health insurance plans
4

Select suitable coverage
5

Check discounts & offers
6

Add optional benefits
7

Proceed to secure payment
8

Receive instant policy confirmation

Buy Now

How to Renew

1

Login to the app
2

Enter your current policy details
3

Review and update coverage if required
4

Check for renewal offers
5

Add or remove riders
6

Confirm details and proceed
7

Complete renewal payment online
8

Receive instant confirmation for your policy renewal

Renew Now

How to Claim

1

Notify Bajaj General about the claim using app
2

Submit all the required documents
3

Choose cashless or reimbursement mode for your claim
4

Avail treatment and share required bills
5

Receive claim settlement after approval

Claim Now

How to Port

1

Check eligibility for porting
2

Compare new policy benefits
3

Apply before your current policy expires
4

Provide details of your existing policy
5

Undergo risk assessment by Bajaj General
6

Receive approval from Bajaj General
7

Pay the premium for your new policy
8

Receive policy documents & coverage details

Port Now

FAQs

What is StepUp Benefit?

StepUp Benefit rider is an insurance rider that automatically enhances your base sum insured to the next slab. It helps to counter inflation, without requiring fresh medical underwriting.

When can I opt for the StepUp Benefit rider?

You have to buy the rider at the inception of your policy. You can avail the benefits of this rider at the first renewal (R1) if you maintain a claim-free policy year.

Can I upgrade my Sum Insured by two slabs using StepUp Benefit?

No, you cannot upgrade your sum insured amount by 2 slabs. With the StepUp Benefit rider, you can only jump to the next slab. For example, if your sum insured is ₹10 lakh, you can get to ₹15 lakh with this rider.

Is StepUp Benefit a one-time option?

Yes, StepUp rider is a one-time benefit that you can take during your first renewal (R1). If you don't, you cannot take this rider later during your policy period.

Is the StepUp Benefit available for both Individual and Floater policies?

Yes, this rider is available for both individual and family floater plans under the MHCP EDGE+ health insurance policy.

Will my waiting period reset after upgrading via StepUp Benefit?

No, with our Bajaj General MHCP EDGE+ StepUp Benefit rider, you can enjoy your continued waiting period when you use this rider. No need to worry about resetting waiting periods.

Will the premium change after exercising the StepUp Benefit?

The premium may change or increase to adjust for the higher sum insured slab. For more details, please read the policy wording or talk to our experts.

Can I combine StepUp Benefit with other riders like Super Cumulative Bonus?

Yes, you can combine the StepUp Benefit with other riders like the Super Cumulative Bonus. Combining these 2 will enhance your coverage, and you don't have to worry about your hospital bills.

What happens if a claim is made in the first policy year?

If you make a claim in your first year, you cannot avail the StepUp Benefit rider. However, you can still enjoy your chosen sum insured amount.

What is the UIN of the StepUp Benefit rider?

The UIN of the SteUp Benefit rider is BAJHLIA27077V012627. You can find it in our policy wordings.

Is StepUp Benefit available with all Sum Insured slabs?

Yes, you can get the SteUp Benefit for whichever sum insured you have chosen.

Can I claim mediclaim in the first year?

Yes, it is possible. First-year claims usually cover sudden accidents, though pre-existing diseases and specific illnesses might have waiting periods. To avoid confusion early on about health insurance claim in first year, go through the details of your Bajaj General Insurance plan carefully. That way, you know exactly what is included - and when.

How to claim health insurance?

Hassle-free experience is guaranteed with Bajaj General Insurance. Smooth claims begin with clear steps. So, understand the ways of how to claim health insurance. You can opt for cashless options at partner hospitals after promptly informing Bajaj General team. Or, cover costs yourself, then file claims for reimbursement with medical reports, bills, and discharge summaries later.

Can we claim 100% medical insurance?

Even though Bajaj General Insurance aims to cover many treatments, getting 100 percent claim for health insurance in India for every medical cost depends on what your plan actually includes. Some policies have Deductibles and co-payments which change how much money you receive. Medical coverage helps lower sudden expenses. Always review your policy documents for knowing the benefits and to understand your complete coverage for out-of-pocket costs.

Can I claim health insurance without hospitalization?

Medical care doesn’t always mean staying overnight in a hospital. Bajaj General Insurance steps in for health insurance without hospitalization claims for various services like OPD consultations, diagnostic tests, day care procedures, and even specified home healthcare. Every detail depends on what your specific plan includes. Check the policy wordings for full understanding of inclusions.

What do you mean by No claim bonus in health insurance plans?

A No Claim Bonus (NCB) in health insurance plan grows quietly under Bajaj General Insurance. Instead of paying more, your sum-insured amount may rise when it's time to renew. Or perhaps the cost stays lower even as protection expands. Protection lifts higher without touching your pocket.

What documents are required to file a health insurance claim?

To file a health insurance claim, you'll generally need a diligently filled claim form along with health insurance claim documents like the original hospital bills, payment receipts, discharge summary, all relevant medical reports and prescriptions. For reimbursement claims, also provide your bank details. These essential health insurance claim documents ensure a smooth process.

What happens if my health insurance claim is rejected? Can I appeal?

A health insurance claim rejection can be concerning. With Bajaj General Insurance, if your claim is rejected, you absolutely can appeal. You first need to assess the specific reason mentioned for the denial. Then, gather supporting documents and formally submit the appeal to us. We are committed to meticulously providing a fair and transparent resolution.

What factors affect my health insurance premium?

Your health insurance premium is influenced by several factors affecting health insurance premium. These generally include your age, medical history, and lifestyle choices. The chosen sum insured, type of policy, and any add-ons also play a significant role. At Bajaj General Insurance, we aim to provide clear pricing, helping you choose comprehensive coverage that fits your unique health needs and budget.

What is the maximum number of health insurance claims allowed in a year?

With Bajaj General Insurance, there isn't a specific health insurance claim limit per year concerning the number of claims you can make. Your policy covers multiple valid claims within your chosen sum insured for the policy period. Our focus is ensuring you receive comprehensive financial support for necessary medical treatments, up to your total sum insured, as and when needed.

Can I renew my health insurance after 60 or 65 years of age?

As you age, medical problems tend to rise this means you needs more financial protection for healthcare. At Bajaj General Insurance, health insurance renewal after 60 or 65 is seamlessly possible. We proudly offer lifelong renewability with our various health plans, aligning with IRDAI guidelines and customer needs. This means your comprehensive healthcare can remain uninterrupted.

What to do if my health insurance policy renewal date is missed?

A missed health insurance renewal date can be concerning. With insurance, you usually get a grace period, often 30-45 days depending on your policy terms, for renewal. During this time, you can renew your policy without losing valuable benefits like no-claim bonus(NCB) and waiting period credits. You generally cannot make a claim during this period. Renewing promptly ensures your uninterrupted coverage and continued financial protection.

Why should you avoid policy renewal during the grace period?

Grace period acts as a boon in case you miss the deadline. But, it is also important to understand details of renewing health insurance in grace period risks. If a medical emergency arises during this time, claims may not be admissible. This leaves you financially vulnerable. Timely renewal before expiry ensures seamless coverage with Bajaj General Insurance, protecting your health and finances without any gaps.

Do I get a discount on the renewal of the policy with the same health insurance company?

Bajaj General Insurance offers various benefits that can lead to a health insurance renewal discount. A claim-free record on your policy often provides a No Claim Bonus(NCB), potentially reducing your premium or increasing your sum insured. Additionally, there is a wellness discount of 12.5% for staying fit. Explore options and basis your tailored requirements & plans, you might be rewarded .

Can a health insurance policy expire if it is not renewed on time?

A health insurance policy has an expiry date and will eventually lapse if not renewed by its due date or within the specified grace period. This expiry means your coverage ceases, leading to the loss of accumulated benefits like No Claim Bonus & waiting periods may reset. Bajaj General Insurance emphasizes timely renewal. Understanding these essential health insurance policy expiry rules helps you plan your financial protection better.

What if I miss the health insurance policy premium renewal date?

If you have missed health insurance premium renewal, there is still a possibility to retain your benefits. Your insurance policy has a grace period (typically 15-30 days) to renew your policy. Renewing within this keeps your policy active, retaining crucial benefits like No Claim Bonus. Beyond this period, your policy will lapse. Thereafter, your requirement for insurance will be treated as a new application & reset waiting periods.

Can I increase my health insurance cover during renewal?

Considering an increase in sum insured at renewal is a beneficial step for you to address rising medical costs. Bajaj General Insurance has options to enhance your health cover, providing more comprehensive financial protection. While this may lead to a corresponding premium adjustment, it's a proactive way to align your policy with evolving healthcare needs, ensuring continued & adequate coverage.

Is there a grace period for health insurance renewal?

To ensure uninterrupted protection, understanding the health insurance renewal grace period is crucial. Typically, Bajaj General policies provide a grace period of 15 to 30 days after the policy expires, allowing you to renew your health insurance without losing accumulated benefits or facing new waiting periods. This gives you a window for continuous health coverage and stress-free renewal.

Can I transfer my health insurance policy without losing renewal benefits?

It is possible to transfer(port) your health insurance policy to Bajaj General Insurance, without losing accumulated renewal benefits like No Claim Bonus and completed waiting periods. This facility, known as health insurance portability, ensures continuity of your coverage. To safeguard these valuable health insurance portability benefits, it is important to initiate the transfer process well in advance of your current policy's expiry.

Do I get any discount on the premium at the time of my health insurance policy renewal?

At Bajaj General Insurance, your renewal premium discount on health insurance can be influenced by several factors. A No Claim Bonus for claim-free years reduces your premium. Additionally, our unique plans offer wellness discounts rewarding a healthy lifestyle & special loyalty benefits. Maximize potential savings & continuous coverage by exploring our offerings.

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