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8/14/2019 Non-life insurance
1/31
PGDM 2009-2011
Corporate Finance Project 2009:
Non Life Insurance
Course Facilitator Pawan Jain
Term II
Submitted by:
Ben C Kurian 2009067Janit Yadav
2009088Karan Sood
2009090
Chandani Beri2009102
Chandni Caul 2009103Hitansh Vij
2009110Ashish Jose Kavi
2009116
8/14/2019 Non-life insurance
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Aditi Goel2009117
Ayush Bindal 2009120Neha Patet
2009317
Non Life Insurance
Meaning of Insurance
Insurance provides financial protection against a loss arising out of happening of an uncertain
event. A person can avail this protection by paying premium to an insurance company.
A pool is created through contributions made by persons seeking to protect themselves from
common risk. Premium is collected by insurance companies which also act as trustee to the pool.
Any loss to the insured in case of happening of an uncertain event is paid out of this pool.
Insurance works on the basic principle of risk-sharing. A great advantage of insurance is that it
spreads the risk of a few people over a large group of people exposed to risk of similar type.
Definition
Insurance is a contract between two parties whereby one party agrees to undertake the risk of
another in exchange for consideration known as premium and promises to pay a fixed sum of
money to the other party or to indemnify the other party on happening of an uncertain event.
(General Insurance).
The party bearing the risk is known as the 'insurer' or 'assurer' and the party whose risk is
covered is known as the 'insured' or 'assured'.
General insurance only pays out when an insured event occurs. It includes:
home insurance (contents and/or buildings)
car insurance
travel insurance
private medical insurance
accident, sickness or unemployment insurance toprotect your income, mortgage or loan payments (also
called 'Payment protection insurance')
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Now we are analyzing various non life insurance schemes offered by following companies
ICICI Lombard Insurance 24x7
Reliance General Insurance
United India Insurance
Bajaj Allianz Insurance
Iffco-Tokyo General Insurance
Home insurance, also commonly called hazard insurance orhomeowners insurance is the
type of property insurance that covers private homes. It is an insurance policy that combinesvarious personal insurance protections, which can include losses occurring to one's home, its
contents, loss of its use (additional living expenses), or loss of other personal possessions of the
homeowner, as well as liability insurance for accidents that may happen at the home. It requiresthat at least one of the named insured occupies the home. The dwelling policy (DP) is similar,
but used for residences which don't qualify for various reasons, such as non-occupancy or age.
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Point of
comparison
Reliance General
Insurance
ICICI Lombard
Insurance 24x7
Bajaj Allianz United India
Insurance
IFFCO-
TOKIO
Policy Reliance Home
Protect
Home Insurance House-Holders
Insurance Policy
Householders
Policy
Home Suvidh
Key
Benefits
1. Comprehensive
cover: Provides
cover for a large no.
of items including
valuables, glass
items, electronics,
etc.
2.Flexibility inchoosing the cover:
The policy is pretty
flexible in the sense
that you can choose
the amount of cover
and contents of
home that you
would like to be
covered.
3.Attractive
Discounts: Discount
is offered on thepremium depending
on the no. of covers
chosen. There is
also a possibility of
high discounts if
you chose large no.
of covers or if you
have a favorable
claim history.
1. Comprehensive
Cover: Covers
both structure and
contents of your
home.
2.Flexibility in
choosing the
cover: There is a
provision for
optional covers.
eg. Terrorism and
additional
expenses of rent
for alternative
accommodation.
You also have achoice to choose
alternate covers.
3.Attractive
Discounts: The
company provides
15% discount on 3
years home
insurance policy
and a 25%
discount on 5
years policy.
1. Comprehensive
Cover: A single
policy covers all
the risks related to
home.
2. Flexibility in
choosing the
cover: There is
availability of
customized cover
option. Also,
related items get
covered under
respective
sections.
3.Attractive
discounts and
affordable rates:
There are benefits
on sectional
discounts which
will reduce the
premium. Also,
the complete
coverage can be
done at reduced
costs with no
strain on pocketsof insured.
1. Comprehensive
Cover: A wide
variety of
household items
are covered which
includes even the
liability to third
party.
2. Flexibility in
choosing the
cover: Benefits
under four or more
sections can be
chosen in case the
householder is
exposed to any of
the given
contingencies.
1.
Comprehensi
Cover: Provid
comprehensiv
protection for
your househo
assets, interes
liability, fami
members, etc
2.Flexibility
choosing the
cover: You ca
choose the
amount of cov
with no
maximum lim
for sum insur
under any
section of the
policy.
3.Attractive
Discounts:There is a
provision for
premium
discount if six
or more sectio
are covered b
you.
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Point of
compariso
n
Reliance
General
Insurance
ICICI Lombard Bajaj Allianz United India
Insurance
IFFCO-TOKIO
Policy
Coverage
1. Fire and
Allied Perils:
Covers the
structure and
contents of your
home, againstfire and other
natural and
manmade
disasters
including
earthquake.
2.Burglary andHousebreaking:
Cover against the
loss or damage to
the contents of
your home
against burglary
and
housebreaking.
3.All Risk Cover:
All risk cover to
your jewellery
and valuables
anywhere in
India.
4.Domestic
Mechanical and
Electrical
Appliances:
Coverage to
electrical and
mechanical
appliances in
your home
against
mechanical and
electricalbreakdown.
1. Natural &
man-made
calamities: The
calamities
covered are:
- Fire
- Riot, strike &
malicious
damage
- Explosion &
implosion
- Earthquake
- Lightning
- Storm, cyclone,
tempest, tornado,hurricane, flood
& inundation
- Damage due to
impact by
vehicles
- Missile testing
operation
- Subsidence,
landslides and
rockslides
- Leakage from
automatic
Sprinkler
installations
- Aircraft
damage
- Bursting and/or
overflowing of
water tanks,apparatus and
pipes.
2. Burglary and
theft cover: The
contents of your
home are also
covered against
loss due to
burglary or an
1.Fire & allied
perils: Building
& contents -
Covers not only
property, but
also contents.
2.Burglary &
Theft: Covers
loss of house
hold contents
and expenses
Incurred due to
damage causedon incidence of
house-breaking
& theft.
3.Jewellery &
Precious Items:
All risk
coverage for
jewellery and
precious stones.
4.Plate Glass:
Coverage
against
accidental
breakage of
glass.
5.Domestic
Appliances:
Covered against
any electrical or
mechanical
breakdown.
1. Building and
contents: Fire,
lightning, Acts of
God, Riot and
Strike, impact,
explosion of gasin domestic
appliances,
overflow of water
tanks.
2. Burglary,
House breaking
and Theft.
3. Jewellery and
Valuables - Any
accidental
loss/damage Plate
Glass Any
accidental
loss/damage.
4.Baggage -
While on travel,
any accidental
loss/damage.
5. Domestic
Appliances: Any
accidentalloss/damage
entirely due to
electrical/mechani
cal breakdown.
6. TV, VCR,
Audio System.
1.Fire and Allied
Perils: Your residenti
building as well as
various types of
contents is covered
against fire, explosionbursting/overflowing
water tanks, riots,
strikes, malicious
damage, earthquake,
flood, cyclone, landsl
etc.
2.Burglary and otherPerils: Covers the sam
properties as in Fire a
Allied Perils Section
against housebreaking
burglary, robbery or
dacoity.
3.All Risk: Covers
valuable items such a
jewellery, items of go
silver and other precio
metals or stones,
watches, clocks,
photographic
equipments, etc.
4.
Fixed Glass andSanitary Fittings:
Covers accidental
breakage of fixed glas
and sanitary fittings in
your premises.
5.Electronic
Equipment: Covers lo
or damage to electron
e ui ments like
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ACCIDENT INSURANCE PROVIDED BY DIFFERENT COMPANIES
Reliancegeneral
insurance
ICICILombard
Bajaj Allianz United IndiaInsurance
Iffco-Tokyo
olicy Personal
Accident
Policy
Personal
Accident
Policy
Personal Accident
Policy
Personal
Accident Policy
Personal Accident Policy
olicy
overage
Accidental
Death,Permanent
Total
Disability,
PermanentPartial
Disability,TemporaryTotal
Disability
Accidental
Death,Permanent
total
Disablement
and againstTerrorism
and Act ofTerrorism
Covers Death,
PermanentPartiality
Disability,
Permanent Total
Disability, &Temporary Total
disability.
In case of
Temporary TotalDisability 1% of SI
or Rs 5000 / week
(whichever islesser) will be
payable up to max
100 weeks.
Death ,
Permanent TotalDisablement ,
Loss of two
limbs/ Two eyes
or one limb andone eye,Loss of
one limb or oneeye , PermanentPartial
Disablement ,
Temporary TotalDisablement
Death, loss of both hand
both feet or one hand,Lof one hand/foot and s
of one eye ,Loss of spe
or hearing in b
ears,Permanent tdisability
ligibility This policy can
be issued topersons in the
age group of 5
years to 70years.
It can be
extended tocover persons
beyond the age
of 70 years and
up to 80 yearson payment of
suitable
additionalpremiums.
Age criteria
at entry:Minimum 18
years ,
Maximum 70years.(the
applicant can
buy thepolicy for his
spouse aged
between 18-
70 years)
Age 3 Months 55
years.
Any individual
or group ofindividuals
( through
employer,association, and
institution etc)
aged between 12and 70. Subject
to medical
examination at
70, a person canbe covered up to
80.
If you are not involved in
any activity that ishazardous like aviation,
ballooning etc. and you a
not a member of the armforces and you fall within
the specified age limits (
to70 years), you can applfor this Policy and get
complete protection for
yourself and your
familymembers.
http://www.icicilombard.com/app/ilom-en/PersonalProducts/Home/Silver_plan.aspxhttp://www.icicilombard.com/app/ilom-en/PersonalProducts/Home/Silver_plan.aspxhttp://www.icicilombard.com/app/ilom-en/PersonalProducts/Home/Silver_plan.aspxhttp://www.icicilombard.com/app/ilom-en/PersonalProducts/Home/Silver_plan.aspxhttp://www.icicilombard.com/app/ilom-en/PersonalProducts/Home/Silver_plan.aspxhttp://www.icicilombard.com/app/ilom-en/PersonalProducts/Home/Silver_plan.aspxhttp://www.icicilombard.com/app/ilom-en/PersonalProducts/Home/Silver_plan.aspxhttp://www.icicilombard.com/app/ilom-en/PersonalProducts/Home/Silver_plan.aspx8/14/2019 Non-life insurance
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xclusions Pregnancy orrelated
consequence
Any mental
disorder
Any pre-existing
conditions /
disabilities
Needlessexposure to
peril, except in
an attempt tosave human
life
Intentional
self-injury,suicide or
attempted
suicide
Influence ofintoxicating
liquor or drugs
Insured
committingany breach of
law with
criminal intent
War and
nuclear perils
Riots, Crimes,
Misdemeanours and Felonies
Intentionalself injury,
suicide,
whilst under
the influenceof
intoxicatingliquor ordrugs,
aviation or
ballooning,whilst
mounting
into or from,
aircraft otherthan as a
passenger,
insanity,criminal
intent, war,
Invasion,civil war,
childbirth or
pregnancy
Pregnancy or relatedconsequence
Any mental disorder
Any pre-existing
conditions /disabilities
Needless exposure to
peril, except in an
attempt to save
human life
Intentional self-
injury, suicide or
attempted suicide
Influence ofintoxicating liquor or
drugs
Insured committing
any breach of lawwith criminal intent
War and nuclear
perils
Compensationunder more
than one
clause for
same periodof disability
not exceedingcapital suminsured
Any payment
after
admission of aclaim for 50
% / 100 % of
Capital SumInsured
Any claim in
the same
period ofinsurance
exceeding the
Capital SumInsured
Suicide,
attempt there
at, VD,criminal
breach of
law,accidentaldeath/injury
under
influence of
liquor/drugs
Pregnancy
related claim
War and
nuclear perils
Some of the importantExclusions under the Pol
are self-injury, suicide,
venereal disease, insanity
influence of intoxicatingliquor or drugs, pregnanc
or childbirth, HIV or AIDwar and nuclear risks etc
ey Benifits It not only Covers Children's On payment of For that extra protection
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providescompensation to
the family in
case of the
accidental deathof the insured
but also takes onthe onus ofproviding the
insured with
compensation incase of injury,
whether
temporary or
permanent.
The sum insured
increases by 5%
for eachcompleted
claim-free year
of insurance,subject to a
maximum of a
50% increase.
This policy canalso be
expanded to
cover actualmedical
expenses
arising out ofthe accident
claimsarising out of
Terrorism or
act of
terrorismChoice of
cover period3,4,5 yearsNo health
checkup
requiredEasy Claim
process with
nominal
documentation
Educational Bonusbenefit.
Daily hospital
confinement
allowance payable incase of
hospitalization dueto accident*
Medical expenses
reimbursement incase of
hospitalization due
to accidents*,
Highest
compensation of
125% of the SI incase of Permanent
Total Disability.
Hassle free in house
claim settlement.
Cumulative bonus
@ 5% per claim free
year to a maximum
of 50%.
Family discount of
10%
Highest
compensation of125% of the SI in
case of Permanent
Total Disability.
extra premium,medical
expenses
incurred up to 25
% of claim or 10% of Sum
Insured can becovered.
Policy also paysfor education
fund for
dependantchildren (2) of
deceased insured
and expenses ofcarriage of dead
body of insuredfrom accidentsite ( as per
details in policy)
Attractive
cumulativebonus at the time
of renewal, by
way of
increasing the
Sum Insured by5 % for each
completed claimfree year of
insurance
( maximum of 50% CSI ) without
collecting extra
premium as perpolicy.
relief in those hard timesITGI's Personal Acciden
Insurance Policy also giv
the following additional
benefits:
Education Benefit:
In the unfortunate event
death or loss of limbs/ey
or permanent totaldisablement of the Insure
the education cost of
dependant children is
covered under the Policyupto specified limits.
Employment Benefit:
This cover provides
financial compensation uspecified limits in the ev
of loss of employment of
the Insured following anaccident resulting in loss
limbs/eyes or permanent
total disablement.
Ambulance Benefit:
If any accident results inuse of an ambulance by t
Insured to reach a hospit
then the Policy will pay tnecessary charges upto
specified limits.
Cumulative Benefit:
Besides these benefits,
Policy also offers benefit
like compensation forclothing damaged in an
accident, expenses for
carriage of dead body etc
On payment of nominalextra premium, our Perso
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Accident Insurance Polic
can also be extended toprovide a whole range of
additional coverages.
Medical Expenses
In addition to the death o
disablement benefits, thePolicy will provide
reimbursement upto
specified limits for mediexpenses incurred for
treatment following an
accident.
Cost of Supporting Item
If the use of supporting
items like crutches,
wheelchair, artificial lim
etc. becomes necessary dto injuries sustained in an
accident, then the costs a
reimbursed upto specifielimits.
Cost of Travel
If the Insured is disabled
a place other than his
normal residence due to accident, then we will pa
upto specified limits for
of travel of the injuredperson for returning hom
and also for the travel co
of any accompanying frior relative to join the
Insured and for returning
home.
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HEALTH INSURANCE
Health Insurance: What are its types?
There are primarily two types of health insurance available to individuals:
1. Fee for Service: Here the insured patient can get treatment from a medical professionalof his choice. The cost of treatment is then claimed by the insured or the medical providerfrom the insurer.
2. Managed Care Health Insurance Plan: This plan is designed in such a way that it helps
minimize unnecessary costs for healthcare. It may provide physicians with reasonable
incentives, may control the admission of inpatients, sign contracts with selective health
care providers and provide incentives to share cost for outpatient surgery. The ManagedCare Health Plan is further divided into 3 types:
Health Maintenance Organization (HMO): In a Group Model HMO plan the insured patient
may visit doctors, who are employees of this HMO, at a centralized medical center. The HMOsare also in contract with the Individual Practice Associations (IPAs) who also have groups of
physicians or individual doctors providing health care.
The HMO may also refer a primary care physician or PCP for an insured patient who seeks a
specialist's service. The patient needs to settle the co-payment as per the agreement and the rest
of the cost will be borne by the insurance company.
a. Preferred Provider Organization (PPO): With this type of healthcare theinsured patients are entitled to receiving medical services from hospitals and other
care providers in contract with the PPO. This can be done at a lesser fee. Patientsseeking medical care from within the PPO network pay lesser than those seekingoutside the network.
The PPO plan reimburses only 70% of the cost incurred. The remaining 30%, i.e.
the difference between the amount that the plan reimburses and what the providercharges has to be met by the insured.
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b. Point of Service (POS): This plan also includes a network of hospitals,
physicians and other care providers. Members of such plans who opt for out-of-network care get little coverage. The advantage of such a plan, however, is that it
offers more choices to the members. Even if members choose a physician outside
the network, they can still be covered to a certain extent.
Reliance
General
Insurance
ICICI
Lombard
Bajaj Allianz Iffco Tokio United India
Insurance
Individual
Mediclaim
Policy
Health
Advantage
Plus
Health Guard Critical illness Uni medicare
insurance
Reliance
Healthwise
Family Floater Silver Health Surgery protector
Personal
Accident
Critical illness Workmens
compensation
Hospital Cash
Star Package
e-opinion
Insta Insure
Health Ensure
Personal Guard
Reliance General Insurance
1) Individual Mediclaim Policy
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Features
A family deserves the best especially when it comes to medical care.
With medical expenses shooting sky high, Reliance Mediclaim Insurance Policy helps meet
hospitalization costs. It frees from financial worries so that one can give full attention to
loved ones.
Key Advantages
a) Hospitalization Care for the Family
Reliance Mediclaim Insurance Policy covers you and your family for hospitalization
and related expenses.
Family members between the ages of 5 and 80 years can be covered.
The policy also provides health insurance for children between the ages of 3 months
and 5 years if one of the parents is covered concurrently.
b) Claim-Free Bonus
We reward you with a no-claim bonus of 5% on every claim-free renewal. This can
be accumulated up to a maximum of 50%.
c)Tax Advantage
With health insurance you not only protect your family but also can avail of tax benefits
under Section 80D of the Income Tax Act.
d) Policy Coverage
Value Added Benefits
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Reliance Healthwise
Key Highlights
Rs. 2 lakh cover for a family of two at Rs. 2245 per annum
24 x 7 cashless facility and TPA support
No medical check-up up to age of 45 years
Income Tax benefit under Section 80 D
Features
Access to quality healthcare is a necessity today. The Reliance Healthwise Policy ensures you
provide the best medical care to your family. We offer a health insurance policy that gives you
the optimum value for money without compromising on the quality of medical attention.
Key Advantages
a)Affordable Premiums
We offer premiums as low as Rs. 2245 p.a. for a sum insured of Rs. 2 lakhs, for a
couple
The Family Floater benefit covers the entire family, ensuring that the cover is used
Reliance Mediclaim Insurance Policy offers you value-added benefits to give you extra
cushioning and added cover.
The policy will cover pre-hospitalization expenses for 30 days and post-hospitalization
expenses for 60 days.
It also provides you with health cover for technologically advanced treatment that does
not require 24-hour hospital stay.
No medical check-up up to the age of 45.
Free medical check-up after 4 claim-free renewals.
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optimally
Policies are available for people up to the age of 65 years.
b)Convenience all the way
No health checkups for people under the age of 45 years. With our instant health-kit issuance, your health cover gets an instant start.
A 24-hour cashless facility is provided at more than 4,300 hospitals across India.
c) The Reliance Advantage
Pre-existing illnesses will commence after two years or four years (depending on the plan
you choose) of continuous cover We also provide you and your family with extended coverage for pre- and post-
hospitalization expenses.
What's more, we reward you with a no-claim bonus of 5% on every claim-free renewal.
This can be accumulated up to a maximum of 50%.
d) Tax-wise
With the Reliance HealthWise Policy, you can avail of tax benefits under Section 80D ofthe Income Tax Act.
Value Added Benefits
Reliance General Insurance strives to provide more than what is expected. Our value-added
benefits include:
Nursing allowance for a maximum of five days.
Reimbursement of charges towards ambulance services
Allowance for expenses of a person accompanying the insured, for a maximum of five
days
Reimbursement of cost of health check-up after four claim-free renewals.
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Outpatient Department (OPD)
Basic Hospitalization Cover
It covers inpatient Hospitalization expenses up to sum insured of Rs. 2 or Rs. 3 Lakhs
(depending on the plan chosen). You can avail the cashless claim facility in any of the 4500+
network hospitals across India.
Basic Hospitalization cover includes:
Medical expenses incurred as an inpatient during Hospitalization for more than 24 hours,
including room charges, doctors / surgeons fee, medicines, diagnostic tests, etc.
30 days prior to Hospitalization
60 days post Hospitalization
Pre-existing diseases shall be covered after 24 months of continuous coverage since inception
of first individual health policy with the company.
Technologically advanced treatment that do not need 24-hour Hospitalization but are covered
under this policy are:-
- Cataract
- Lithotripsy (Kidney Stone Removal)
- Tonsillectomy
- Eye Surgery
- Dialysis
- Dilatation & Curettage
- Chemotherapy
- Radiotherapy
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- Coronary Angiography
- Cardiac Catheterization
Coverage limit for specific ailments / conditions:
Certain specific ailment(s) / surgery(s)/ procedure(s) are covered up to pre-defined limits under
this policy.
All others ailment(s) / surgery(s)/ procedure(s) are covered up to the sum insured under the
policy.
*- Pre-Hospitalization period, the period of Hospitalization and the Post-Hospitalization period,
should fall within the Period of Insurance
Outpatient Department (OPD)
This covers outpatient treatment expenses in the form of reimbursement of medical bills, dental
expenses, etc. In case of an OPD treatment (Outpatient Department), the claims will be settled
later after furnishing the medical prescription documents/bills.
Outpatient Department Covers:
Room, Boarding Expenses as charged by the Hospital
Nursing Expenses
Expenses related to Dental Treatment
Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees
Anesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Consumables, Medicines and
8/14/2019 Non-life insurance
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Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of
Pacemaker, Cost of Artificial Limbs External Medical Aids, Dental treatment charges,
Ambulance charges
Claims under OPD Benefit can be made only on a re-imbursement basis. You can lodge a
claim only once during the Period of Insurance, i.e. 90 days after commencement of policy
and 30 days after expiry of the Period of Insurance.
Sum Insured for Plans covering 2 individuals comes under the Floater benefit.
Key Benefits
Floater benefit The floater benefit would mean that one policy covers 2 family members with
one sum insured and one premium. This takes care of Hospitalization expenses as well as
Outpatient Treatment expenses in case of a sudden illness, accident or planned surgery of either
of the family members.
Optimum income tax benefit under section 80 D*. Save up to Rs. 5099/- on your Policy
premium.
Fixed premium of Rs 15,000 for all plans excluding Senior Citizens aged 65 & above.
Reimbursement of OPD expenses upto Rs. 10,000/- This includes diagnostics tests, dental
treatment, etc. (OPD Benefit depends on age of senior most insured member and the plan
chosen)
Declared pre-existing illness covered after 2 years, i.e. from the 3rd year.
Cashless claim facility available at over4,500 network hospitals across India.
http://www.icicilombard.com/app/ilom-en/personalproducts/Health/Health-Advantage.aspxhttp://www.icicilombard.com/app/Personalproducts/Health/Network-Hospitals.asphttp://www.icicilombard.com/app/ilom-en/personalproducts/Health/Health-Advantage.aspxhttp://www.icicilombard.com/app/Personalproducts/Health/Network-Hospitals.asp8/14/2019 Non-life insurance
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No health check up required upto the age of 55 years (as on last birthday).
Free health check-up coupon for any one insured family member.
Medical check-up mandatory for insured of age 56 years and above.
Eligibility
The enrolment age (of the senior most family member) should be between 5 years to 65 years.
The policy cover is renewable till the age of 70 years.
The customer can buy the policy only for his two family members - defined as self, spouse or
dependent children or dependent parents for the purpose of income tax exemption u/s Sec. 80D.
Family Floater
Policy Coverage
This is a comprehensive Tax-Saving health plan and provides 2 covers:
Basic Hospitalization Cover
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Outpatient Department (OPD)
Basic Hospitalization Cover
This covers inpatient Hospitalization expenses up to sum insured of Rs. 2 or Rs. 3 Lakhs
(depending on the plan chosen). You can avail the cashless claim facility in any of the 4500+
network hospitals across India.
Basic Hospitalization cover includes:
Medical expenses incurred as an inpatient during Hospitalization for more than 24 hours,
including room charges, doctors / surgeons fee, medicines, diagnostic tests, etc.
30 days prior to Hospitalization
60 days post Hospitalization
Pre-existing diseases shall be covered after 24 months of continuous coverage since inception
of first individual health policy with the company.
Technologically advanced treatment that do not need 24-hour Hospitalization but are covered
under this policy are:-
- Cataract
- Lithotripsy (Kidney Stone Removal)
- Tonsillectomy
- Eye Surgery
- Dialysis
- Dilatation & Curettage
- Chemotherapy
- Radiotherapy
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- Coronary Angiography
- Cardiac Catheterization
Coverage limit for specific ailments / conditions:
Certain specific ailment(s) / surgery(s)/ procedure(s) are covered up to pre-defined limits under
this policy.
All others ailment(s) / surgery(s)/ procedure(s) are covered up to the sum insured under the
policy.
*- Pre-Hospitalization period, the period of Hospitalization and the Post-Hospitalization period,
should fall within the Period of Insurance
Outpatient Department (OPD)
This covers outpatient treatment expenses in the form of reimbursement of medical bills, dental
expenses, etc. In case of an OPD treatment (Outpatient Department), the claims will be settled
later after furnishing the medical prescription documents/bills.
Outpatient Department Covers:
Room, Boarding Expenses as charged by the Hospital
Nursing Expenses
Expenses related to Dental Treatment
Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees
Anesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Consumables, Medicines and
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Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of
Pacemaker, Cost of Artificial Limbs External Medical Aids, Dental treatment charges,
Ambulance charges
Claims under OPD Benefit can be made only on a re-imbursement basis. You can lodge a
claim only once during the Period of Insurance, i.e. 90 days after commencement of policy
and 30 days after expiry of the Period of Insurance.
Sum Insured for Plans covering 2 individuals comes under the Floater benefit.
Key Benefits
Floater benefit The floater benefit would mean that one policy covers 2 family members with
one sum insured and one premium. This takes care of Hospitalization expenses as well as
Outpatient Treatment expenses in case of a sudden illness, accident or planned surgery of either
of the family members.
Optimum income tax benefit under section 80 D*. Save up to Rs. 5099/- on your Policypremium.
Fixed premium of Rs 15,000 for all plans excluding Senior Citizens aged 65 & above.
Reimbursement of OPD expenses upto Rs. 10,000/- This includes diagnostics tests, dental
treatment, etc. (OPD Benefit depends on age of senior most insured member and the plan
chosen)
Declared pre-existing illness covered after 2 years, i.e. from the 3rd year.
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Cashless claim facility available at over4,500 network hospitals across India.
No health check up required upto the age of 55 years (as on last birthday).
Free health check-up coupon for any one insured family member.
Medical check-up mandatory for insured of age 56 years and above.
Eligibility
The enrolment age (of the senior most family member) should be between 5 years to 65 years.
The policy cover is renewable till the age of 70 years.
The customer can buy the policy only for his two family members - defined as self, spouse or
dependent children or dependent parents for the purpose of income tax exemption u/s Sec. 80D.
Personal Accident
Policy Coverage
Personal Accident policy covers you for
Terrorism and Acts of Terrorism: In case of the death of the insured arising out of terrorism
or acts of terrorism within the policy period, the nominee (mentioned in the policy) is
compensated with the sum Insured. The Company shall also pay compensation against
permanent and total loss of limbs, sight etc. (of the insured) arising out of terrorism or acts of
terrorism.
Accidental Death: In case of death of the insured due to an accident within the policy period,
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the nominee (mentioned in the policy) is compensated with the Sum Insured.
Permanent Total Disablement (PTD) : Personal Accident pays compensation against the
permanent and total loss of limbs, sight etc. due to an accident.
Note: If any such injury as mentioned above shall result in the inability to remain gainfully
employed, then the Capital Sum Insured payable will be 100%.
Key Benefits
Covers claims arising out of Terrorism or acts of Terrorism
Covers against Accidental Death or Permanent Total Disablement (PTD)
Choose among Sum insured options of Rs. 3, 5, 10 and 20 Lakhs
Choice of cover period: 3, 4 or 5 years
No health check-up required
Easy Claim Process with minimal documentation
Eligibility
Age criteria at entry: Minimum 18 years, Maximum 70 years.
The applicant can buy the policy for his spouse aged between 18-70 years.
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Health Guard
HEALTH GUARD -COVERS ALL MEDICAL EXPENSES ON HOSPITALIZATION
It is rightly said Health is Wealth. We are all aware that health care costs are high and getting
higher. At times, unfortunately we fall prey to unanticipated accidents & illness. Bajaj Allianz
promises to stand by you during those difficult times of physical and mental stress. Our Health
Guard policy takes care of your hospitalization expenses & also offers a wide coverage of pre
& post hospitalization expenses. We are the first company to provide the higher coverage of SI
10 lacs.
Features
The member has cashless facility at over 2400 hospitals across India The member can opt for hospitals besides the empanelled ones, in which the expenses
incurred by him shall be reimbursed within 14 working days from submission of all
documents.
Pre and post - hospitalization expenses covers relevant medical expenses incurred 60
days prior to and 90 days after hospitalization.
Cumulative bonus of 5 % is added to your sum assured for every claim free year.
Family discount of 10 % is applicable.
Covers ambulance charges in an emergency subject to limit of Rs. 1000 /-
No tests required up to 45 years up to SI 10 lacs*
10% co- payment applicable if treatment taken in non-network hospitals. Waiver of co-
payment is available on payment of additional premium
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Pre-existing diseases covered after 4 years continuous renewal with Bajaj Allianz
Benefits
In house Health Administration Team for Hospitalization claims to lower turn around
time
Access to over 2400 hospitals all over India for cashless facility.
No Sub-limits applicable on room rent and other expenses.
Hassle-free claim settlement due to In-house claim administration.
Income tax benefit on the premium paid as per section 80-D of Income Tax Act as per
existing IT law.
Health Check up for maximum amount of Rs. 1000 /- at the end of continuous four
claim free years
Family discount of 10% is applicable
Coverage
10 lacs coverage available from 3 months up to 55 years*
Policy can be renewed up to 70 years*
In built E-opinion cover for SI 5 lacs & above.
Silver Health
SILVER HEALTH POLICY - EXCLUSIVE HEALTH INSURANCE FOR PEOPLE AGED
46YRS AND ABOVE
As the age of an individual increases the health care costs increase & become a burden on the
individual. The senior citizens have to pay out the hard earned savings to meet the expenses.
Bajaj Allianzs Silver Health plan is exclusively designed for the senior citizens, which covers
medical expenses incurred during hospitalization period.
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HOSPITAL CASH - COVERS NON-MEDICAL EXPENSES DURING HOSPITALIZATION
With a Hospital Cash policy from Bajaj Allianz you and your family can now breathe a sigh of
relief! As this is a benefit policy which covers the incidental expenses incurred during the
Hospitalization period. In the event of hospitalization this policy provides a cash allowance of
Rs 500-2500 for each day of hospitalization.
Benefits
Covers miscellaneous expenses incurred during hospitalization.
Comprehensive coverage with nominal premium.
Premium amount upto Rs.15000/- p.a. is eligible for tax exemption under section 80-D
of Income Tax Act as per existing IT law.
Dependent spouse and children can be also covered under this policy.
5% family discount is applicable if cover taken for family
Coverage
SI available from 500-2500.
Cover available for 30days & 60 days.
Star Package
STAR PACKAGE - COVERS HEALTH & HOME IN A SINGLE PLAN
Star Package policy is a unique family floater policy which protects your family against
various risks and contingencies. It provides a gamut of covers for various health risks,
household contents, education grant, travel baggage and public liability all under a single
policy. It has 8 sections and you would have to opt for a minimum 3 sections to avail for this
policy.
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Features
Covers Hospital Cash, Health Guard, Critical Illness, Personal accident, Education
Grant, Householders contents, Traveling Baggage & Public liability.
Family floater can be opted by paying 50% & 25% of self premium for spouse &
children respectively.
Add on covers can be opted under Health Guard.
12 Dreaded diseases are covered under Critical illness.
The policy can be taken for maximum 3 years to avoid yearly renewal.
10-15% section discount can be availed if 4 or more sections are opted.
10-15% Long term discount can be availed if the policy is taken for 2 or more years.
Benefits
Wide coverage from Health to Home.
Access to over 2400 hospitals all over India for cashless facility.
No Sub-limits applicable on room rent and other expenses.
Hassle-free claim settlement due to In-house claim administration
Income tax benefit on the premium paid as per section 80-D of Income Tax Act* as per
existing IT lawCoverage
Age 3 Months 55 years.
Wide range of Sum Insured is available under different cover
TRAVEL POLICIES
BAJAJ ALLAINZ
1) Swades Yatra
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Travelling has become very frequent be it for business or leisure. The risk of accidents increase
due to frequency of travel. Any accident would affect your finances either due to medical
expenses incurred or loss of income to the family due to unfortunate circumstances like death or
disability. Swades Yatra is a comprehensive package policy for domestic travelers which
provides complete personal accident benefit cover including hospitalization expenses as a resultof accident.
2) Travel Assist
Bajaj Allianz General Insurance along with ASSIST CARD a Swiss company has launched a
co-branded travel insurance product called TRAVEL ASSIST. The product has all the benefits
of the existing travel insurance products plus several value-added services to quality-sensitive
customers.
1) Travel Companion
Whether you travel for business or pleasure, international travel involves risk. Medical
treatment abroad can be expensive & one never knows, when one would require it. Having to
spend for medical bills in foreign currency can be an expensive proposition. There are other
difficult situations also, that one might face like loss of passport or baggage. Bajaj Allianz's
Travel companion is specially designed to help you deal with situations while overseas travel
1) Travel Elite
Bajaj Allianz General Insurance has recently launched an exclusive policy for high end
travellers called Travel Elite- a cluster of benefits policy made for the specific customer group.
Travel Elite is a plan for high end travellers who have various plans and packages to choose
from : Travel Elite,Travel Age Elite,Travel Corporate Elite,Student Elite,Travel Asia
Elite,Travel Elite Family.
ICICI POLICY
1) Platinum-Plan
Overseas Travel Insurance covers unexpected and unplanned medical and non-medical
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