Insurance Plans India 703 views September 20, 2021

Bajaj Allianz M-Care Plan protects you financially against medical expenses that might occur due to vector-borne diseases. The insurer provides you and your family members coverage against up to seven vector-borne diseases. So, if you and any of the family members fall sick due to the covered illness, a lump sum benefit shall be payable. Continue reading this page below and learn about the Bajaj Allianz M-Care Plan coverage.

Vector-borne Diseases Covered Under Bajaj Allianz M-Care Plan

The seven vector-borne diseases covered under Bajaj Allianz M-Care Plan are shown below –

Dengue Fever

This Bajaj Allianz insurance plan shall pay the benefit as specified against this disease in the policy schedule if any of the covered members are diagnosed with Dengue Fever and get hospitalized. You can get the admissible claim amount subject to the following conditions –

  • A medical practitioner should confirm the diagnosis of Dengue
  • Laboratory examinations countersigned by a Pathologist/Microbiologist
  • Immunoglobulins /Polymerase Chain Reaction (PCR) tests are positive

Malaria

  • The medical practitioner should confirm the diagnosis of Malaria and the subsequent hospitalization. The laboratory tests should indicate the presence of Plasmodium Falciparum, Vivax, Malaria in the blood.
  • These tests are valid if they are countersigned by a pathologist/microbiologist in peripheral blood smear or positive rapid diagnostic test (antigen detection test).

Filariasis (Payable only once in a lifetime)

The medical practitioner should confirm the diagnosis of Filariasis which is commonly known as elephantiasis, with the presence of microfilariae in a blood smear and any of the two through a microscopic examination –

  • Lymphoedema
  • Elephantiasis
  • Scrotal swelling

Note: Concurrent to the above, the final diagnosis should be confirmed as Filariasis. If the insured person already had suffered from Filariasis before the policy inception, this benefit will not be extended for a lifetime. Once a claim is paid against this disease for any insured person, no other claim for this particular condition is available to his/her entire lifetime.

Kala Azar

The company shall pay your hospitalization expenses if you’re diagnosed with Visceral Leishmaniasis (Kala Azar). Common symptoms of Kala Azar are shown below –

  • Irregular bouts of fever
  • Substantial weight loss
  • Swelling of the spleen and liver

Anaemia

The Medical Practitioner should confirm the diagnosis of Kala Azar through parasite demonstration in bone marrow, spleen, lymph node aspiration or in culture medium as positive serological tests.

Chikungunya

When you are hospitalized during the policy period due to Chikungunya, the insurer shall pay your bills. The common symptoms of Chikungunya are –

  • Abrupt onset of fever with Joint pain
  • Muscle pain, headache, nausea, fatigue and rash
  • The disease must be confirmed by a Medical Practitioner through Serological tests, such as enzyme-linked immunosorbent assays (ELISA), confirming the presence of IgM and IgG anti-chikungunya antibodies.

Japanese Encephalitis

The diagnosis of Japanese Encephalitis should be confirmed by a Medical Practitioner through serological tests, such as –

  • Immunoglobulin M (IgM) antibody capture ELISA (MAC ELISA) for serum
  • Cerebrospinal fluid (CSF)

The common symptoms of Japanese Encephalitis are –

  • Rapid onset of high fever
  • Headache
  • Neck stiffness
  • Disorientation
  • Coma
  • Seizures
  • Spastic paralysis
  • Zika Virus

In case you’re hospitalized due to Zika Virus with symptoms like mild fever, skin rash, conjunctivitis, muscle and joint pain, malaise or headache, it should be confirmed by a registered medical practitioner. The diagnosis should be confirmed by plaque reduction neutralization testing (PRNT).

Bajaj Allianz M-Care Plan Sum Insured & Premium Options

The following sum insured options are available under Bajaj Allianz M-Care Plan, check out the table below and know more.

Number of Insured PersonsSum Insured (In INR)Number of Admissible Claims
1000015000250005000075000
11602404008001,2001
22503606001,2001,2001
3 or 43204808001,6002,4002
5 or 64006001,0002,0003,0002

General Exclusions from Bajaj Allianz M-Care Plan

No payment shall be made by the company in case of the following:

  • Treatment for any illness other than the above vector-borne diseases
  • Hospitalization is for less than 24 hours
  • Diagnosis and treatment of the above vector-borne diseases outside India. However, this exclusion shall not apply to – New Zealand, Japan, Singapore, Canada, Switzerland, Dubai, USA, Hong Kong, Malaysia, Countries of the European Union

Waiting Period

A 15-day waiting period shall apply to Bajaj Allianz M-Care Plan from the date of its inception. If you have purchased Bajaj Allianz M-Care Plan after the occurrence of any of the above vector-borne diseases, a 60-day waiting period shall apply for the specific ailment from the date of your previous admission.

Once you file a claim under the policy, upon renewal, a 60-day waiting period shall apply from the date of the previous admission for the specific ailment you have filed a claim. If you renew the policy within 60 days from the date of admission of the previously paid claim, a 60-day cooling-off period shall apply for the ailment. Whereas, if you renew the policy after 60 days from the date of admission of the previously paid claim, a 15-day waiting period shall apply to all listed vector-borne diseases.

Grace Period

During the grace period of 30 days, the insurer isn’t liable to pay for the hospitalization expenses if your or any member is diagnosed with the above vector-borne disease. If you submit the renewal request after completion of a 30-day grace period, a fresh application needs to be submitted. Your premium amount or any changes in terms & conditions on renewal and on the subsequent continuation is subject to the Insurance Regulatory and Development Authority of India (IRDAI) approval.

Eligibility Criteria for Bajaj Allianz M-Care Plan

You can purchase Bajaj Allianz M-Care Plan subject to the following conditions –

  • Minimum Entry Age for Proposer, Spouse, Dependent Parents – 18 years
  • Maximum Entry Age for Proposer, Spouse, Dependent Parents – 65 years
  • Minimum Entry Age for Dependent Children – 0 days

Free Look Period

A 15-day free look period starts from the date of receipt of the policy document to review the terms and conditions. If you have any objections, cancel the policy stating the reasons for it. Upon cancellation, the insurer refunds the paid premium after a deduction of medical examination expenses and stamp duty charges, if the risk is not commenced. Where the risk has commenced, a deduction of the stamp duty charges, medical examination charges & proportionate risk premium for the period on the cover will be made. If only a part of risk has commenced, a deduction of such proportionate risk premium commensurates with the risk covered during the free look period.

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