Overview
The Bajaj Allianz Health Care Supreme Ultimo plan is a premium health insurance policy offering comprehensive coverage for medical expenses. Beyond the standard features, it provides physiotherapy coverage (on OPD basis), no room rent restrictions, no disease wise sub-limits, no co-payment and a 100% sum insured reinstatement benefit (once during each policy year for different illness) if exhausted. It also offers in-built maternity benefits and coverage for newborn babies.
Experts Review
Written by Nikhil Nair
Senior Writer
The Bajaj Allianz Health Care Supreme Ultimo plan is a robust health insurance solution that offers extensive coverage with no room rent restrictions, no disease wise sub-limits, and no co-payment, cover for daycare and AYUSH available, pre-post hospitalization (60-90 days respectively) making it suitable for those seeking comfort during hospitalization, however, it lacks domiciliary coverage.
It includes benefits like physiotherapy coverage and a cumulative bonus for claim-free years, although the bonus is 10% increase capped at a 50% of sum insured. Compared to other variants like Vital and Smart, Ultimo provides more comprehensive benefits but is 15-20% more expensive due to its premium features.
Bajaj Allianz's 3-year (2021-24) average claim settlement ratio of 95% supports its operational efficiency, but buyers should weigh the higher premium costs against the enhanced benefits before purchasing this policy. The plan's comprehensive coverage and lack of sub-limits make it ideal for those seeking extensive protection.
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 ₹75,000 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
K
Kavita Singh
No room rent restrictions is excellent! Can choose any room without worrying about caps.
A
Anand Krishnan
100% sum insured reinstatement is a great feature if the base sum gets exhausted.
S
Shruti Sharma
Physiotherapy coverage included, which is often needed post-hospitalization.
S
Suresh G.
While comprehensive, the high price might not be justifiable for everyone compared to other market options.
M
Mohanlal P.
This Ultimo variant is 15-20% more expensive than Vital and Smart variants. Quite a premium.
B
Ben Carter
Cumulative bonus is decent, though capped at 50% increase.
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Frequently Asked Questions
Does Health Care Supreme Ultimo 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 Ultimo have room rent restrictions?
Does Health Care Supreme Ultimo offer a restoration benefit?
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