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PGDM 2009-2011

Corporate Finance Project 2009:

Non – Life Insurance

Course Facilitator – Pawan Jain


Term II

Submitted by:

Ben C Kurian 2009067


Janit Yadav
2009088
Karan Sood
2009090
Chandani Beri
2009102
Chandni Caul 2009103
Hitansh Vij
2009110
Ashish Jose Kavi
2009116
Aditi Goel
2009117
Ayush Bindal 2009120
Neha 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 to
protect your income, mortgage or loan payments (also
called 'Payment protection insurance')
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 or homeowners insurance is the
type of property insurance that covers private homes. It is an insurance policy that combines
various 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 requires
that 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.
Point of Reliance General ICICI Lombard Bajaj Allianz United India IFFCO-
comparison Insurance 24x7 Insurance TOKIO
Insurance

Policy Reliance Home Home Insurance House-Holders’ Householders Home Suvidha


Protect Insurance Policy Policy

Key 1. Comprehensive 1. Comprehensive 1. Comprehensive 1. Comprehensive 1.


Benefits cover: Provides Cover: Covers Cover: A single Cover: A wide Comprehensive
cover for a large no. both structure and policy covers all variety of Cover: Provides
of items including contents of your the risks related to household items comprehensive
valuables, glass home. home. are covered which protection for
items, electronics, includes even the your household
etc. liability to third assets, interests,
party. liability, family
members, etc.

2. Flexibility in 2. Flexibility in 2. Flexibility in


2. Flexibility in choosing the 2. Flexibility in
choosing the cover: choosing the choosing the
cover: There is a cover: There is cover: Benefits choosing the
The policy is pretty under four or more cover: You can
flexible in the sense provision for availability of
optional covers. customized cover sections can be choose the
that you can choose chosen in case the amount of cover
the amount of cover eg. Terrorism and option. Also,
additional related items get householder is with no
and contents of exposed to any of maximum limits
home that you expenses of rent covered under
for alternative respective the given for sum insured
would like to be contingencies. under any
covered. accommodation. sections.
You also have a section of the
choice to choose policy.
alternate covers.

3. Attractive
Discounts: The
3. Attractive company provides 3. Attractive
Discounts: Discount 15% discount on 3 discounts and
years home affordable rates: 3. Attractive
is offered on the Discounts:
premium depending insurance policy There are benefits
and a 25% on sectional There is a
on the no. of covers provision for
chosen. There is discount on 5 discounts which
years policy. will reduce the premium
also a possibility of discount if six
high discounts if premium. Also,
the complete or more sections
you chose large no. are covered by
of covers or if you coverage can be
done at reduced you.
have a favorable
claim history. costs with no
strain on pockets
of insured.
Point of Reliance ICICI Lombard Bajaj Allianz United India IFFCO-TOKIO
compariso General Insurance
n
Insurance

Policy 1. Fire and 1. Natural & 1. Fire & allied 1. Building and 1. Fire and Allied
Coverage Allied Perils: man-made perils: Building contents: Fire, Perils: Your residential
Covers the calamities: The & contents - lightning, Acts of building as well as
structure and calamities Covers not only God, Riot and various types of
contents of your covered are: property, but Strike, impact, contents is covered
home, against also contents. explosion of gas against fire, explosion,
fire and other - Fire in domestic bursting/overflowing of
natural and - Riot, strike & appliances, water tanks, riots,
manmade malicious overflow of water strikes, malicious
damage 2. Burglary &
disasters Theft: Covers tanks. damage, earthquake,
including - Explosion & flood, cyclone, landslide
implosion loss of house
earthquake. 2. Burglary, etc.
- Earthquake hold contents
House breaking
- Lightning and expenses
and Theft.
- Storm, cyclone, Incurred due to
2. Burglary and tempest, tornado, damage caused 2. Burglary and other
Housebreaking: hurricane, flood on incidence of Perils: Covers the same
Cover against the & inundation house-breaking 3. Jewellery and properties as in Fire and
loss or damage to - Damage due to & theft. Valuables - Any Allied Perils Section
the contents of accidental against housebreaking,
impact by
your home loss/damage Plate burglary, robbery or
vehicles
against burglary Glass Any dacoity.
- Missile testing 3. Jewellery &
and accidental
operation Precious Items:
housebreaking. loss/damage.
- Subsidence, All risk
landslides and coverage for 3. All Risk: Covers
rockslides jewellery and valuable items such as
3. All Risk Cover: - Leakage from precious stones. 4. Baggage - jewellery, items of gold,
All risk cover to automatic While on travel, silver and other precious
your jewellery Sprinkler any accidental metals or stones,
and valuables installations loss/damage. watches, clocks,
4. Plate Glass:
anywhere in - Aircraft Coverage photographic
India. damage against equipments, etc.
- Bursting and/or accidental 5. Domestic
4. Domestic overflowing of Appliances: Any
breakage of
Mechanical and water tanks, accidental
glass. 4. Fixed Glass and
Electrical apparatus and loss/damage Sanitary Fittings:
Appliances: pipes. entirely due to Covers accidental
Coverage to electrical/mechani
5. Domestic breakage of fixed glass
electrical and cal breakdown.
Appliances: and sanitary fittings in
mechanical
2. Burglary and Covered against your premises.
appliances in
theft cover: The any electrical or
your home
contents of your mechanical 6. TV, VCR,
against
home are also breakdown. Audio System. 5. Electronic
mechanical and
covered against Equipment: Covers loss
electrical
loss due to or damage to electronic
breakdown.
burglary or an equipments like
ACCIDENT INSURANCE PROVIDED BY DIFFERENT COMPANIES

Reliance ICICI Bajaj Allianz United India Iffco-Tokyo


general Lombard Insurance
insurance
Policy Personal Personal Personal Accident Personal Personal Accident Policy
Accident Accident Policy Accident Policy
Policy Policy
Policy Accidental Accidental Covers Death, Death , Death, loss of both hands or
coverage Death, Death, Permanent Permanent Total both feet or one hand,Loss
Permanent Permanent Partiality Disablement , of one hand/foot and sight
Total total Disability, Loss of two of one eye ,Loss of speech
Disability, Disablement Permanent Total limbs/ Two eyes or hearing in both
Permanent and against Disability, & or one limb and ears,Permanent total
Partial Terrorism Temporary Total one eye,Loss of disability
Disability, and Act of disability. one limb or one
Temporary Terrorism eye , Permanent
Total In case of Partial
Disability Temporary Total Disablement ,
Disability 1% of SI Temporary Total
or Rs 5000 / week Disablement
(whichever is
lesser) will be
payable up to max
100 weeks.

Eligibility This policy can Age criteria Age – 3 Months – 55 Any individual If you are not involved in
be issued to at entry: years. or group of any activity that is
persons in the Minimum 18 individuals hazardous like aviation,
age group of 5 years , ( through ballooning etc. and you are
years to 70 Maximum 70 employer, not a member of the armed
years. years.(the association, and forces and you fall within
It can be applicant can institution etc) the specified age limits (5
extended to buy the aged between 12 to70 years), you can apply
cover persons policy for his and 70. Subject for this Policy and get
beyond the age spouse aged to medical complete protection for
of 70 years and between 18- examination at yourself and your
up to 80 years 70 years) 70, a person can familymembers.
on payment of be covered up to
suitable 80.
additional
premiums.
Exclusions Pregnancy or Intentional Pregnancy or related Compensation Some of the important
related self injury, consequence under more Exclusions under the Policy
consequence suicide, than one are self-injury, suicide,
whilst under Any mental disorder clause for venereal disease, insanity,
Any mental the influence same period influence of intoxicating
disorder of Any pre-existing of disability liquor or drugs, pregnancy
intoxicating conditions / not exceeding or childbirth, HIV or AIDS ,
Any pre- liquor or disabilities capital sum war and nuclear risks etc.
existing drugs, insured
conditions / aviation or Needless exposure to
disabilities ballooning, peril, except in an Any payment
whilst attempt to save after
Needless mounting human life admission of a
exposure to into or from, claim for 50
peril, except in aircraft other Intentional self- % / 100 % of
an attempt to than as a injury, suicide or Capital Sum
save human passenger, attempted suicide Insured
life insanity,
criminal Influence of Any claim in
Intentional intent, war, intoxicating liquor or the same
self-injury, Invasion drugs period of
suicide or ,civil war, insurance
attempted childbirth or Insured committing exceeding the
suicide pregnancy any breach of law Capital Sum
with criminal intent Insured
Influence of
intoxicating War and nuclear Suicide,
liquor or drugs perils attempt there
at, VD,
Insured criminal
committing breach of
any breach of law,accidental
law with death/injury
criminal intent under
influence of
War and liquor/drugs
nuclear perils
Pregnancy
Riots, Crimes, related claim
Misdemeanour
s and Felonies War and
nuclear perils

Key Benifits It not only Covers Children's On payment of For that extra protection and
provides claims Educational Bonus extra premium, relief in those hard times,
compensation to arising out of benefit. medical ITGI's Personal Accident
the family in Terrorism or Daily hospital expenses Insurance Policy also gives
case of the act of confinement incurred up to 25 the following additional
accidental death terrorism allowance payable in % of claim or 10 benefits:
of the insured Choice of case of % of Sum
but also takes on cover period hospitalization due Insured can be Education Benefit:
the onus of 3,4,5 years to accident* covered.
providing the No health In the unfortunate event of
insured with checkup Medical expenses Policy also pays death or loss of limbs/eyes
compensation in required reimbursement in for education or permanent total
case of injury, Easy Claim case of fund for disablement of the Insured,
whether process with hospitalization due dependant the education cost of
temporary or nominal to accidents*, children (2) of dependant children is
permanent. documentatio deceased insured covered under the Policy
n Highest and expenses of upto specified limits.
compensation of carriage of dead
125% of the SI in body of insured Employment Benefit:
The sum insured case of Permanent from accident
increases by 5% Total Disability. site ( as per This cover provides
for each details in policy) financial compensation upto
completed Hassle free in house specified limits in the event
claim-free year claim settlement. Attractive of loss of employment of
of insurance, cumulative the Insured following an
subject to a Cumulative bonus bonus at the time accident resulting in loss of
maximum of a @ 5% per claim free of renewal, by limbs/eyes or permanent
50% increase. year to a maximum way of total disablement.
of 50%. increasing the
Sum Insured by Ambulance Benefit:
Family discount of 5 % for each
This policy can 10% completed claim If any accident results in the
also be free year of use of an ambulance by the
expanded to Highest insurance Insured to reach a hospital,
cover actual compensation of ( maximum of 50 then the Policy will pay the
medical 125% of the SI in % CSI ) without necessary charges upto
expenses case of Permanent collecting extra specified limits.
arising out of Total Disability. premium as per
the accident policy. Cumulative Benefit:
Besides these benefits,
Policy also offers benefits,
like compensation for
clothing damaged in an
accident, expenses for
carriage of dead body etc.

On payment of nominal
extra premium, our Personal
Accident Insurance Policy
can also be extended to
provide a whole range of
additional coverages.

Medical Expenses

In addition to the death or


disablement benefits, the
Policy will provide
reimbursement upto
specified limits for medical
expenses incurred for
treatment following an
accident.

Cost of Supporting Items

If the use of supporting


items like crutches,
wheelchair, artificial limbs
etc. becomes necessary due
to injuries sustained in an
accident, then the costs are
reimbursed upto specified
limits.

Cost of Travel

If the Insured is disabled in


a place other than his
normal residence due to an
accident, then we will pay
upto specified limits for cost
of travel of the injured
person for returning home
and also for the travel cost
of any accompanying friend
or relative to join the
Insured and for returning
home.
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 professional
of his choice. The cost of treatment is then claimed by the insured or the medical provider
from 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 Managed
Care 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 HMOs
are 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 the


insured 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. Patients
seeking medical care from within the PPO network pay lesser than those seeking
outside 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 provider
charges has to be met by the insured.
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 ICICI Bajaj Allianz Iffco Tokio United India


General Lombard Insurance
Insurance

Individual Health Health Guard Critical illness Uni – medicare


Mediclaim Advantage insurance
Policy Plus

Reliance Family Floater Silver Health Surgery protector


Healthwise

Personal Critical illness Workmen’s


Accident compensation

Hospital Cash

Star Package

e-opinion

Insta Insure

Health Ensure

Personal Guard

Reliance General Insurance

1) Individual Mediclaim Policy


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


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.


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
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 of
the 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.


Exclusions

In order to ensure that you do not face any unpleasant surprises when you make a claim, we
would like you to know some of the major exclusions under the policy.

• Any pre–existing illness for the first two years/ four years of the policy.
• Specified illnesses for the 1st year.
• Specified illnesses in the case of domiciliary Hospitalization.
• Any treatment for the first 30 days from the time of inception of policy, unless due to an
accident.
• Treatment related to HIV / AIDS
• Treatment due to abuse of alcohol or intoxicants.
• Vaccination and inoculation.
• Nuclear and war perils.

Eligibility

Eligibility norms for this policy are:

• Children above the age of three months and adults below the age of 65 years.
• Children between three months and five years can be covered only if one or both parents
are covered.

• Maximum age to enter the Plan is 65 & 60 years for Standard and Silver Plan
respectively

ICICI Lombard

Health Advantage Plus

Policy Coverage
This is a comprehensive Tax-Saving health plan and provides 2 covers:

Basic Hospitalization Cover


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, doctor’s / surgeon’s 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
- 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
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 over 4,500 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.

Family Floater

Policy Coverage
This is a comprehensive Tax-Saving health plan and provides 2 covers:

Basic Hospitalization Cover


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, doctor’s / surgeon’s 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
- 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
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 over 4,500 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,
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.
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
• 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 Allianz’s Silver Health plan is exclusively designed for the senior citizens, which covers
medical expenses incurred during hospitalization period.
Features

• Pre-existing diseases covered from the second year of the policy.


• A flat benefit of 3% of admissible hospitalization expenses are paid towards pre & post
hospitalization expenses.
• Cashless facility : With Silver Health plan, the member has access to cashless facility at
various network of over 2400 hospitals across India (subject to exclusions and
conditions)
• If admission in non-network hospitals the expenses incurred would be reimbursed
within 14 days from the submission of all documents.
• 20% of co-payment of the admissible claim to be paid by the member if treatment is
taken in a hospital other than a network hospital.

• Waiver of co-payment is available on payment of additional premium.

Advantages

• Cumulative bonus of 5 % added to your sum assured for every claim free year.
• Health Check up at the end of continuous four claim free years.
• Family discount of 5 % is applicable.

• Income tax benefit on the premium paid as per section 80-D of the Income Tax Act as
per existing IT law.

Coverage

• Policy can be taken form 46-70yrs *


• Renewal up to 75 yrs*

• SI can be opted form 50,000 – 5, 00,000.

Hospital Cash
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.
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 law
Coverage

• Age – 3 Months – 55 years.


• Wide range of Sum Insured is available under different cover

TRAVEL POLICIES

BAJAJ ALLAINZ

1) Swades Yatra
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 result
of 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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