Bharti AXA Health Insurance Plans

Starting in August 2008 in India, Bharti AXA General Insurance has now 59 corporate branch offices in the country. The company holds the distinction of being the first in its class to receive the ISO 27001:2005 and ISO 9001:2008 certifications in the very first year of commencement of business in the country.

The Bharti AXA health insurance has following features:

  • It has a network of 5000+ hospitals in the country
  • Allows waiting period for pre-existing diseases of four years
  • Incurred claims ratio is 85.41%
  • Total number of issued policies is 21,002
  • Grievances solved are 99.14%
  • Renewable up to lifetime

Smart Health Insurance

This health insurance by Bharti AXA covers all the expenses made by the customers towards hospital admission. The plan covers lucrative features like tax exemption up to the amount of premiums paid, percentage of Sum Assured being available for health checkups and 5% discount on the premium for the year next to the year in which no claim is made. The detailed features list is as under:

  1. Eligibility/ Entry Age: any resident Indian with a minimum age of 91 days can be covered under this plan without upper limit for age. In case of family floater, four members are covered in the plan which includes, one adult, spouse and two children up to the age of 23 (minimum age is 91 days for the children too).
  2. Period and renewability of policy: the police period is 12 months which can be renewed for lifetime.
  3. Sum Assured: the sum assure can be 3, 4, 5, 7, 10, 15, 20, 25, 50 or 60 lakhs which can be enhanced on renewal. Insurance coverage can be doubled if there is critical illness.
  4. Terminal benefits: plan offers 5% renewal discount, IT benefit under section 80D and free health checkup in every 4 claim free years.
  5. Coverage:
    • Home nursing and ambulance charges
    • Hospital cash allowance
    • Organ transplant
    • Hospitalization expenses
    • Cover for critical illnesses like coma, cancer, etc
    • Day care treatment even if there is no need of 24 hours hospitalization
    • Treatment and care taken at home (Domiciliary hospitalization)
    • Pre-existing diseases: the diseases where the symptoms and conditions exist at the time of purchasing the policy but policy benefits are availed for the first time after four continuous renewals

Smart Health Critical Illness Insurance

As clear from the name itself, this scheme helps the customers to get benefits against any form of critical illness. The plan benefits the customers in the way of hospital claims and other medical expenses which are actually very huge in volume when we talk about critical illness. The highlights and geatures of the plan are stated below:

  1. Eligibility/ Entry Age: any resident Indian with a minimum age of 91 days can be covered under this plan with an upper limit of 55 years. Children can also be covered from the age of 90 days to 5 years if any of the parents is covered under the policy.
  2. Period and renewability of policy: the police period is 12 months which can be renewed for lifetime.
  3. Sum Assured: there enhancement in sum assured is possible only at the time of renewal with a condition that no claim is paid/ lodged in the plan. The insured can opt for next available sum assured in the same plan subject to above mentioned condition and submission of good health declaration.
  4. Standard benefits:
    • Pre hospitalization expenses
    • Hospitalization expenses
    • Post hospitalization expenses
    • Home nursing
    • Hospital cash allowance
    • Organ transplant
    • Dread disease recuperation
    • Ambulance charges
    • Recovery grant
    • Children education fund
    • Mortal remains
    • Expenses of person accompanying
    • In-patient physiotherapy charges
  5. Coverage:
    • Kidney failure
    • Stroke
    • Cancer
    • Surgery to aorta
    • First heart attck
    • Heart valve surgery
    • Coronary artery bypass surgery
    • Coronary artery disease
    • End stage lungs disease
    • Aplastic anemia
    • Major burns
    • End stage liver failure
    • Bone marrow/ organ transplantation
    • Coma
    • Fulminant hepatitis
    • Primary pulmonary hypertension
    • Multiple sclerosis
    • Motor neuron disease
    • Bacterial meningitis
    • Terminal illness

Smart Individual Personal Accident Insurance

This plan of Bharti AXA is specially made for assurance to the family in case the life insured meets any accident which causes death of that person or result in disability. Some of the main features of the plan are discussed below:

  1. Eligibility/ Entry Age: any resident Indian with a minimum age of 18 years can take this policy with an upper age limit if 75 years
  2. Period and renewability of policy: the police period is 12 months which can be renewed for lifetime.
  3. Sum Assured: there enhancement in sum assured is possible only at the time of renewal with a condition that no claim is paid/ lodged in the plan. The insured can opt for next available sum assured in the same plan subject to above mentioned condition and submission of good health declaration.
  4. Terminal benefits:
    • Pre hospitalization expenses
    • Hospitalization expenses
    • Post hospitalization expenses
    • Home nursing
    • Hospital cash allowance
    • Organ transplant
    • Dread disease recuperation
    • Ambulance charges
    • Recovery grant
    • Children education fund
    • Mortal remains
  5. Additional benefits:
    • Reimbursement of medical examination cost
    • Permanent total disability or double death benefit (payment of 200% Sum Assured in such cases) while accident is caused in travel in a public transport
    • Free look period of 15 days
    • Income tax benefit U/S 80D
    • 5% discount on renewal
  6. Coverage:
    • Accidental death including transportation of mortal remains
    • Permanent total disability
    • Temporary total disability
    • Permanent partial disability
    • Education grant for children
    • Funeral expenses
    • Accidental medical expenses
    • Legal expenses
    • Hospital daily cash allowance
    • Permanent total disability or double indemnity death, while travel in public transport

Inclusion: incidents covered in the policy

  • Medical conditions falling under the category of “day care treatments” as said by the hospitals, which do not require hospitalization of more than 24 hours. For example, eye surgery, dialysis, lithotripsy, chemotherapy, etc,
  • Injury or diseases that require domiciliary hospitalization i.e. rest at home along with medical intervention, that exceeds 3 days.
  • Critical illnesses are: cancer, kidney failure, bacterial meningitis, stroke, multiple sclerosis, coma, motor neuron disease, heart valve surgery, aplastic anemia, first heart attack, bypass surgery and coronary artery disease, terminal lung disease, terminal illness, liver failure, bone marrow or major organ transplant, major burns, primary pulmonary hypertension, surgery to aorta.

Exclusions: incidents not covered by the policy

  • Any expenses incurred on hospitalization of the insured for disease that afflicts within 30 days of the policy inception. The clause is applicable only to new policy and not any subsequent renewal.
  • Some medical conditions are excluded from the cover of the policy in first two years from the date of inception of the policy, which are, dilation & curettage, laser surgery, cataract, joint replacement (unless caused by the accidents), hysterectomy or myomectomy unless caused by malignancy, dental procedures, circumcision, sex change or such treatments, chronic renal failure requiring dialysis, sinusitis, hydrocele, hernia, piles/ haemorrhoids, fistula in anus, birth related procedures, conception or fertility related operations, hormone replacement therapy, fertility, pregnancy and birth control, procedures related to birth, caesarean section, AIDS and related diseases, eyes and ears routine checkup along with cost of spectacles, gastric and duodenal ulcers and erosions, all types of skin conditions, cysts, internal tumors, nodules.

Additional benefits/ Perks given by Bharti AXA Health Insurance

  1. Discount on renewal: a discount of 5% is given as against every claim-free year on subsequent renewal with an upper limit of 25% on progressive scale.
  2. Tax Benefits: all the premiums paid for Bharti AXA health insurance are subject to benefits as per section 80D of Income Tax Act, 1961.
  3. Health checkups: for consecutive 4 years of no claim being made, as sum of 1% of sum assured is forwarded to the insured against complete health checkup.
  4. Pre policy checkup: if it is necessary to undergo for medical checkup before the approval of the policy, the expenses for the checkup are borne by the company. However, if in case the policy is decclined, then the amount spent by the company for such checkups will be deducted from the amount of refund.
  5. Policy serving: the health insurance policy is serviced by a TPA (Third Party Administrator) appointed by the company who will be responsible for providing cashless facility in network hospitals for hospitalization.
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