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Frequently Asked Questions on Extra Care – II


Continuing on from our last post (Frequenty Asked Questions on Extra Care – I), here is part 2 of the most frequently asked questions on Extra Care:

1.  Can I cover my parents, brothers and sisters as dependants?

Parents, sisters and brothers are not covered as dependants. Family means self, spouse and children. Parents have to opt for a separate policy for self and spouse.

2.     Do I get a family discount?

Family discount is not applicable for Extra Care policy

3.     Is a Cumulative Bonus available in this plan?

Cumulative bonus is not available in Extra Care product.

4.     I am covered under Health Guard policy since last 4 years; I want to opt for Extra Care policy as add on to the Health Guard policy. Please confirm what benefits would be given under Extra Care policy?

If you are covered under any hospitalization policy without any break, the continuity benefits would be passed under Extra Care policy.

In case you are covered under our Health Guard policy since 5 years, continuity would be given for the 4 years waiting period of pre-existing illness and joint replacement surgery

5.     What would be the continuity benefits if I am having health policy with other company?

In case of other company renewals, continuity would also be given for the 4 years of waiting period for pre-existing illness and joint replacement surgery.

6.     What would be continuity benefits if I am covered under Group Mediclaim policy of my employer?

Continuity would be given for the 4 years waiting period of pre-existing illness and joint replacement surgery for Group Mediclaim insurance policy also in case the insured is covered in group Mediclaim policy for more than 4 years .

7.     What are the exclusions under the policy?

  • All diseases existing at the time of inception for 4 years
  • Any diseases contracted within the first 30 days of commencement of cover
  • Non-allopathic medicine
  • Congenital diseases
  • All expenses arising out of AIDS and other related diseases
  • Cosmetic and aesthetic treatments. Use of intoxicants, drugs, or alcohol
  • Joint replacement surgery (other than due to accidents shall have a waiting period of 4 years)

For detailed list of exclusions, please refer to the policy wordings.

8.     What are pre and post hospitalization expenses?

The relevant expenses (investigation expenses, medicines, etc) incurred before and after the hospitalization period. Under Extra Care, we cover 60 days pre-hospitalization expenses and 90 days post-hospitalization expenses which are related to the hospitalization claim.

9.     What is the provision for rebate on the premium paid under Section 80-D of IT Act?

As per current IT rules, you can get a rebate up to a maximum sum of Rs.15,000/- under Section 80-D.

10. Is maternity covered in Extra Care?

Maternity is not covered under the plan.

11. Are Day-care procedures covered under the policy?

Day-care procedures are not covered under the policy.

12. Does the policy covers the treatment expenses incurred out of India?

This medical cover is available only for events occurring and treatment taken in India as per policy terms and conditions.

13. Is dental treatment covered?

Dental treatment or surgery of any kind unless requiring hospitalization and as a result of accidental bodily injury to natural teeth.

14. Does Extra Care policy cover OPD (Outdoor Patient Department) charges?

OPD expenses are not covered, but if they are incurred during pre or post hospitalization, they can be covered under the pre-post expenses if the hospitalization claim is admissible.

15. I want to increase my coverage amount. What is the procedure?

During the policy period you cannot increase you sum assured. When you receive your renewal notice, you can send an application to the local Bajaj Allianz office for increasing your sum assured.  SI can be increased only up to 70 yrs.

16. Can I opt for a lower sum insured from a higher sum insured?

Under the policy, the plan can be changed only during renewal and the client can opt for a higher plan

Know more about this Bajaj Allianz Extra Care Policy.
View our entire range of health insurance policies.

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Published on:25 Apr, 2013

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