Critical Illness is a benefit plan. (No reimbursement) Statistics in India shown an Upward trend incidence of life threatening diseases. With rapid progress made in Medical Science and Clinical Examination methods during recent years. Doctors and diagnose and treat these life threatening diseases much earlier. Thanks to such developments, many lives have been saved. However, the financial burden of the affected persons and there families can still be extremely painful. Many serious illnesses can only be cured using state of the art and highly expensive form of therapy. Rehabilitation and the sudden changed circumstances caused by serious illness also exact high prices.
In an effort to support you in such trying times Bajaj Allianz offers the Critical Illness Cover.
Q. What Does The Policy Pays For?
The policy pays the benefit in case the insured suffers from any of the followings events,
* First Heart Attack
The death of a portion of heart muscle as a result of inadequate blood supply to the relevant area.
* Bypass Surgery ( Coronary Artery )
The undergoing of open chest surgery for the treatment of a blockage of two or more coronary arteries with bypass grafts (CABG)
* Stroke
Any cerebrovascular incident producing neurological sequel lasting more than twenty-four hours and causing infartion of the brain tissue.
* Cancer
The presence of one or more malignant tumors characterized by the uncontrollable growth and spread of malignant cells and the invansion and destruction of normal tissue.
* Kidney Failure
Chronic irreversible failure of kidneys to function as a result of which either regular dialysis is instituted or a renal transplantation is carried out
* Major Organ Transplantation
The undergoing as a recipient of a transplant of a heart, lung, liver, kidney, pancreas.
* Multiple Sclerosis
Where a persons immune system attacks the normal tissues of the brain and spinal cord, incapacitation an individual
* Aorta Graft Surgery
The undergoing of surgery to correct any narrowing, aneurysm of the thoracic or abdominal aorta. Narrowing of Aorta of congenital is excluded.
* Primary Pulmonary Arterial Hypertension
Is a condition of high pressure in the blood vessels in the lung caused by leaking blood vessels.
* Paralysis
The complete and permanent loss of use of both arms or both legs or one arm and one leg, through paralysis caused by illness or accidents persisting for at least six months from the date of illness.
What Are The Advantages of Critical Illness Cover ?
The advantages are as follows :
* The benefit amount is payable as soon as the disease is diagnosed meeting specific criteria and the insured survives 30 days after the diagnosis
* The insured receives the amount in advance (unlike the mediclaim policy-first pay, then claim) so that he can plan the treatment accordingly.
* Expenses like donor expenses in a transplant surgery, which are not covered under the Mediclaim, can be paid out of the amount received under this cover both in India & abroad.
* Claims procedure: The insured needs to submit the claim form along with certificate from the specialist confirming occurrence of the critical illness.
What Are The Key Features ?
The Key features are as follows :
1. Premium paid is exempt under the Income Tax Section 80 D
2. Very competitive Premium Rates.
3. Insured can opt for Sum Assured from 50,000 to Rs.50,00,000.
What Are The Exclusions ?
* Any critical illness for which care, treatment,or advice was recommended or which was first manifested or contraced before the start of the Policy Period, or for which a claim has or could have been made under any earlier policy
* Any critical illness diagnosed within the first 90 days
* Death with in 30 days following the diagnosis of the critical illness.
* Presence of HIV/AIDS infection
* Treatment arising from or traceable to pregnancy or childbirth, including caesarean section, birth defects.
* War, invansion, act of foreign enemy, terrorism, hostilities (whether war be declared or not) civil war, rebellion, revolution
* Naval or military operations of the armed forces or air force and participation in operations requiring the use of arms or which are ordered by military authorities for combating terrorists, rebels and the like. Any natural peril
* Consequential losses of any kind, be they by way of loss of profit, loss of opportunity, loss of gain, business interruption etc
The details furnished above do not constitute the entire terms and conditions. For more details on the policy, please visit out office nearest to you. Our executives will be pleased to furnish further details.
What is a critical illness cover?
The cover provides for payment of a benefit amount opted in event of the diagnosis/occurrence of the listed events (critical ailments).
Why should I buy a critical illness cover?
* Just to let you know, a study conducted in Toronto’s leading cardiac emergency hospital showed — 91% of the patients who were admitted with a heart attack would have qualified for a Critical Illness pay out
* Similarly –75% of all stroke victims survive and 60% of stroke survivors are left with a disability
* In other words with the medical profession now saving more and more people and prolonging their life —It’s almost as important to get critical illness insurance as life insuranc
Which ailments are covered?
1. First heart attack
2. Cancer
3. Bypass surgery (coronary artery bypass surgery)
4. Paralysis
5. Kidney Transplant
6. Major Organ transplant (heart, lung, liver, pancreas)
7. Primary Pulmonary Hypertension (Increased pressure in the blood vessels of lungs resulting into the enlargement of the right side of the heart)
8. Aorta Graft Surgery
9. Multiple Sclerosis (Disease affecting the brain and the spinal cord, which is of autoimmune type. It means the body’s own defense mechanism attacks the cells of the brain and the spinal cord)
10. Stroke
I have a mediclaim policy? Can I buy a critical illness policy?
Yes, you can opt for the CI policy even if you have a mediclaim cover. In fact, this policy is different in many ways:
* Contrary to mediclaim where you are required to First Pay and then get it Reimbursed, the CI policy pays the benefit once the diagnosis is established and the insured survives 30 days
* Expenses such as donor expenses in case of transplant surgeries are not reimbursed by Mediclaim which can paid through CI
* Since the money is in advance, treatment can be planned accordingly. Even costly treatments can be resorted to both in India and over seas
What is the eligible age?
18 to 59 years
What is the sum assured available?
Coverage varies to a maximum of 50 lacs (Minimum 1 lac).
How long is the policy valid for?
The policy is valid for one year.
Does the policy pay for my hospitalization expenses? Any cashless benefit?
It is benefit plan. The amount is paid once diagnosis is confirmed (after the survival period). Unlike a indemnity (reimbursement) type of health insurance, there is no cashless hospitalization available under this plan.
What is the procedure to buy the policy?
* You have to opt for sum assured
* Complete a proposal form and submit to our local office. Based on the information, we may request you to go through a medical check (at selected centers). Shall communicate to you once the medical information is available to our U/Ws regarding the acceptance and the amount of premium to be paid.
* The amount that you have paid for the medical check/investigations (which are discounted) shall be reimbursed to you once the proposal is accepted by the company
Do I have to undergo any medical examination?
Medical examination may be required in some cases, based on the sum assured and the age of the person.
Do I have to undergo a Medical check up every year?
* Medical check up is valid for 3 years if the insured renews it with out a break and the sum assured remains the same.
Who pays for the medical examination?
* The proposer to begin with, has to pay for the medical examination to the doctor/diagnostic center. The company will help you with arranging the appointment with the doctor/diagnostic center.
* On acceptance of the proposal, the expenses so incurred shall be reimbursed to you
Can I go to my family doctor for pre enrollment examination?
The medical examination/tests shall be conducted by the doctors/diagnostic centers who are on the panel of the company. Bajaj Allianz has roped in the services of a service provider who will help you in:
* Identifying the panel doctor in the nearest area of your home/office (through the help desk)
* Confirm appointments with them
* Inform them and you about the amount that you shall incur (on cash payment will be accepted)
* Arrange to send the reports to our office for processin
How do I get my money reimbursed?
The expenses shall be reimbursed if the proposal is accepted. You need to submit the receipt of payment (that was made to the medical provider) to our service provider who shall reimburse you through a cheque.
What are the exclusions under the policy?
* Any critical illness for which care, treatment, or advice was recommended or which was first manifested or contracted before the start of the Policy Period, or for which a claim has or could have been made under any earlier policy
* Any critical illness diagnosed within the first 90 days of the date of commencement of the policy. This is not applicable for lives whose coverage has been renewed for subsequent
* Death with in 30 days following the diagnosis of the critical illness
* Sexually transmitted diseases, HIV/AIDS
* Treatment arising from or traceable to pregnancy or childbirth, including caesarian section, birth defects and congenital anomalies
* Occupational diseases
* War, invasion, act of foreign enemy, hostilities civil war, rebellion, revolution, insurrection military or usurped power of civil commotion or loot or pillage in connection herewith
* Consequential losses of any kind or any legal liability of any kind whatsoever. Intentional self-injury and use of intoxicating drugs/alcohol
Is the premium exempted from Income Tax?
The premium is exempt under Section 80D of the IT
NOTE:
This is only a summary of the product features.The actual benefits available are as described in the policy, and will be subject to the policy terms, conditions and exclusions.Please seek the advice of your insurance advisor if you require any further information or clarification.
Or visit : Bajaj Alliance Mediclaim
- How To Get Your Finances Under Control - Step 4 Create a Budget AND Follow It! This article is step 4 of the series called How to Get Your Finances Under Control One of the most important steps on your journey to getting your finances under control is establishing a budget....
- Comparing Life Insurance Policies pt 2 Continued from part one. What are the advantages of this type of insurance? Term life insurance policies tend to be a lot less expensive in comparison to other types of insurances, including whole life insurance,...
- 4 Habits for Saving Money on Routine Family Medical Care The following guest column is from Paul at www.healthharbor.com. HealthHarbor is a site devote to helping people be smarter consumers of healthcare. It provides ideas and guidance on saving money on healthcare, getting the most...
- Review Your Medical Insurance For Hidden Freebies The other day, I was on my company-provided medical insurance website searching for a primary-care physician with and office near my home to schedule a routine physical. After finding what I was looking for, I...
- Time for a Closer Look at Long-Term Care Insurance Mr. ToughMoneyLove is looking again at long-term care insurance. So should many of you. I will tell you why in a minute. First, let's deal with a misconception that you may have..... Long-Term Care Insurance...
