Overview
The Bajaj Allianz Health Care Supreme Smart plan is a comprehensive health insurance policy offering extensive coverage for medical expenses. The plan provides physiotherapy coverage on an outpatient basis, no co-payment clause, full coverage for all diseases without sub-limits and no room rent restrictions. It also offers in-built maternity benefits and a short waiting period of two years for pre-existing conditions.
Experts Review
Written by Nikhil Nair
Senior Writer
The Bajaj Allianz Health Care Supreme Smart plan is a robust health insurance solution that covers most medical needs comprehensively. It offers physiotherapy coverage, no co-payment clause, no room rent restrictions, cover for daycare and AYUSH available and full coverage for all diseases without sub-limits, enhancing its appeal for those seeking comprehensive protection, however, it lacks domiciliary coverage.
The plan includes benefits like doctor consultations and a cumulative bonus for claim-free years, although the bonus is limited to 10% compared to other plans offering up to 50%. Also, the plan is considered 15-20% more expensive than comparable policies like Care Supreme, which offers similar benefits with a longer post-hospitalization coverage period when compared to 60-90 days pre-post hospitalization coverage provided here.
Pros
Feature set is satisfactory.
Insurer has a solid track record with great claim and service metrics.
Offers Physiotherapy Coverage, which makes this policy stand out.
Cons
No coverage if you are forced to hospitalize at home, which is a notable gap.
Bajaj Allianz
Key Insights
Founded
2001
Bajaj Allianz was established 24 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
97% claims settled in 30 Days
Bajaj Allianz settles 97% of all claims it receives demonstrating strong credibility.
Network Hospitals
12,000+
Bajaj Allianz has a strong network with over 12,000 hospitals, ensuring wide accessibility and convenience for policyholders.
Complaints
3 complaints per 10,000 claims registered
Bajaj Allianz maintains a low volume of complaints, reflecting strong customer satisfaction and effective service.
Features
All
Great
Good
Maternity
STANDOUT
The insurer will also cover expenses related to maternity— Think hospitalization expenses incurred while giving birth. But they’ll only pay upto ₹40,000 and make you wait 2 years before covering this expense. Also, you’ll only get the benefits if both, you and your spouse are enrolled in a single-family floater plan.
Physiotherapy Coverage
STANDOUT
You get coverage for Physiotherapy up to defined limits based on the base cover taken. This benefit is available on an Out-Patient basis up to 10 sessions per illness/injury in a policy year.
Co-payment
The insurer will bear the entire cost of treatment (up to the sum insured). You won’t have to pay a single penny. Meaning this policy has no co-payment.
Room Rent
Shared room, single room, deluxe room or any room that’s available. The insurer won’t nitpick on your choice of room since the policy has no restrictions on room rent.
Disease sub-limit
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
Add-ons
Ancillary Expenses
Lump sum payout of a fixed amount in cash every day for your stay at the hospital subject to certain limits.
Critical Illness
Get a lump sum payout in the event you are diagnosed with 15 listed critical illnesses outlined in the policy document.
Personal Accident Cover
Paid out as a lump sum amount for Accidental Death, Total Permanent Disability, Permanent Partial Disability up to defined limits.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Diagnostic expenses not related or incidental to current diagnosis and treatment are excluded.
Expenses for admission primarily for bed rest and not for treatment are excluded.
Custodial care at home or in a facility for help with daily activities is excluded.
Services for terminally ill individuals addressing non-medical needs are excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy for 2 years.
Any type of gastrointestinal ulcers
Cataracts
Any type of fistula
Macular degeneration
Benign prostatic hypertrophy
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
2 years Pre-existing disease waiting period
Ditto's Take
◦ Excellent ◦
After a close look at the waiting periods, we can say that the waiting periods on this policy are excellent. Especially the PED waiting period which is better than usual.
What's missing in the policy
No coverage if you are forced to hospitalize at home.
Customer Reviews
A
Ananya Sharma
Physiotherapy coverage on an outpatient basis is a really good benefit. Very useful for recovery.
R
Rajesh Pillai
No co-payment clause is a big relief! Full coverage up to sum insured.
F
Fatima Khan
Full coverage for all diseases without sub-limits is the best part. No hidden surprises.
K
Krishnan T.
Post-hospitalization coverage period could be longer. Some plans offer more.
A
Arjun Reddy
The cumulative bonus is only 10%, which is quite low compared to other plans offering 50%.
G
George K.
The plan is quite comprehensive, covers most things one would need.
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Frequently Asked Questions
Does Health Care Supreme Smart have waiting periods?
- 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
- There’s a 1 to 2-year waiting period for a list of diseases which is a mandate before you can start claiming.
- Pre-Existing Disease Waiting Period: There's a 2-year waiting period for any pre-existing disease you may have while buying the policy.
- Maternity and Newborn Waiting Period: There’s a 2-year waiting period before you can make claims related to pregnancy and childbirth.
Does Health Care Supreme Smart have room rent restrictions?
Does Health Care Supreme Smart offer a restoration benefit?
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