{"uin":"BAJHGSP24060V012324","name":"Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PM JAY), Mukhyamantri Amrutam (MA) and Mukhyamantri Amrutam Vatsalaya (MAV) Yojana In the State of Gujarat","url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324","insurer":{"slug":"bajaj-general-insurance","name":"Bajaj General Insurance Limited","url":"https://indiainsurances.com/insurer/bajaj-general-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"This is a Gujarat AB-PMJAY, MA and MAV health indemnity scheme for beneficiary family units. It provides Rs. 1,00,000 per family per annum on a family floater and cashless basis, with pre-existing conditions covered from the first day.","analysis":{"state":"machine","analysed_at":"2026-10-19 19:01:28.771851+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"quote-verified","value":["Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana","Mukhyamantri Amrutam","Mukhyamantri Amrutam Vatsalya"],"display":"AB-PMJAY, MA and MAV","note":null,"quote":"in respect of \"Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana\" (the AB-PMJAY), a Government of India scheme, Mukhyamantri Amrutam (MA) or Mukhyamantri Amrutam Vatsalya (MAV) Yojana","sources":[{"clause":null,"heading":"Policy Wordings","page":1,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-policy-wordings"}],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"The standard Policy Cover Period is 12 calendar months from the start date, or a lesser period as per the Insurance Contract, unless cancelled earlier.","display":"12 calendar months, or lesser period as per Insurance Contract","note":null,"quote":"Policy Cover Period shall mean the standard period of 12 calendar months from the date of start of the Policy Cover or lesser period as per Insurance Contract entered between SHA and Insurer, unless cancelled earlier in accordance with Insurance Contract.","sources":[{"clause":"3(d)","heading":null,"page":4,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-3-d-2"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"quote-verified","value":"For emergency admission, the request for authorisation must reach the insurer within 3 hours of admission. EHCPs must submit claims electronically as early as possible but not later than 7 days after discharge; claims beyond 45 days of discharge are not admissible, with public EHCP relaxation as defined by SHA.","display":"Emergency RAL within 3 hours of admission; claim submission within 7 days after discharge, beyond 45 days not admissible","note":"These timelines are for the Empanelled Health Care Provider, which submits the claim on behalf of covered beneficiaries.","quote":"The RAL should reach the authorisation department of the Insurer within 3 hours of admission in case of emergency. ... The Insurer shall require the Empanelled Health Care Providers to submit their Claims electronically as early as possible but not later than 7 days after discharge in the defined format to be prescribed by the NHA/SHA/Insurer. ... Claims submitted beyond 45 days of discharge of patients will not be admissible.","sources":[{"clause":"15(d)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-15-d-2"},{"clause":"2(a)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-2-a-2"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"quote-verified","value":["request for authorisation letter","necessary medical details","bills and documents","proper and relevant Claim documents"],"display":"RAL, necessary medical details, bills and documents, and proper claim documents","note":null,"quote":"Request for Hospitalization shall be forwarded by the EHCP after obtaining due details from the treating doctor, i.e. “request for authorisation letter” (RAL). ... The Insurer guarantees payment only after receipt of RAL and the necessary medical details. ... The Insurer upon receipt of the bills and documents would release the authorized amount. ... if the Empanelled Health Care Provider submits the proper and relevant Claim documents that substantiates their right to re-open such claims.","sources":[{"clause":"15(c)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-15-c-2"},{"clause":"15(j)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-15-j"},{"clause":"15(q)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-15-q"},{"clause":"3(b)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-3-b-6"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"quote-verified","value":"Claims processing and payment must be acted on within 15 days of claim submission for claims within the state and 30 days for claims from outside the state, counted as days during which the claim is with the insurer.","display":"15 days for in-state claims; 30 days for portability cases","note":null,"quote":"Action within 15 days of claim submission for claims within state and 30 days & for claims from outside state (Portability cases). ... *** in case of claims processing, TAT will be determined as days during which claim is with IC (Excluding the days claim is pending at EHCPs end)","sources":[{"clause":null,"heading":"Bajaj General Insurance Limited","page":16,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-bajaj-general-insurance-limited-2"},{"clause":null,"heading":"Bajaj General Insurance Limited","page":17,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-bajaj-general-insurance-limited-3"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"quote-verified","value":["Condition that does not require Hospitalization and can be treated under Out Patient Care","expenses incurred at Hospital or Nursing Home primarily for evaluation / diagnostic purposes only","Any dental treatment or surgery which is corrective, prosthetic, cosmetic procedure, filling of tooth cavity, root canal including wear and tear of teeth, periodontal diseases, dental implants etc.","Any assisted reproductive techniques, or infertility related procedures, unless featuring in the National Health Benefit Package list.","Vaccination and immunization","Surgeries related to ageing face & body, laser procedures for tattoo removals, augmentation surgeries and other purely cosmetic procedures","Circumcision for children less than 2 years of age shall be excluded","Persistent Vegetative State"],"display":"OPD-only conditions, evaluation/diagnostic admissions, most dental, infertility/ART, vaccination, cosmetic procedures, circumcision under 2 years, and Persistent Vegetative State","note":null,"quote":"Condition that does not require Hospitalization and can be treated under Out Patient Care ... further expenses incurred at Hospital or Nursing Home primarily for evaluation / diagnostic purposes only ... Any dental treatment or surgery which is corrective, prosthetic, cosmetic procedure, filling of tooth cavity, root canal including wear and tear of teeth, periodontal diseases, dental implants etc. are excluded. ... Any assisted reproductive techniques, or infertility related procedures, unless featuring in the National Health Benefit Package list. ... Vaccination and immunization ... Surgeries related to ageing face & body, laser procedures for tattoo removals, augmentation surgeries and other purely cosmetic procedures such as fat grafting, neck lift, aesthetic rhinoplasty etc. ... Circumcision for children less than 2 years of age shall be excluded ... Persistent Vegetative State","sources":[{"clause":"1","heading":"Condition that does not require Hospitalization and can be treated under Out Patient Care","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-1-3"},{"clause":"2","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-2-3"},{"clause":"3","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-3-3"},{"clause":"4","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-4-2"},{"clause":"5","heading":"Vaccination and immunization","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-5-2"},{"clause":"6","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-6-2"},{"clause":"7","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-7-2"},{"clause":"8","heading":"Persistent Vegetative State","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-8-2"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"quote-verified","value":"District authorities are the frontline for redressal and attempt to solve grievances first; the scheme has three-tier Grievance Redressal Committees.","display":"District authorities first, then three-tier Grievance Redressal Committees","note":null,"quote":"The District authorities shall act as a frontline for the redressal of Beneficiaries’ / Providers / other Stakeholder’s grievances. The District authorities shall also attempt to solve the grievance at their end. ... Under the Grievance Redressal Mechanism of AB PMJAY-MA, set of three tier Grievance Redressal Committees have been set up to attend to the grievances of various stakeholders at different levels.","sources":[{"clause":"11","heading":"Grievance Redressal","page":21,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-11-2"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"quote-verified","value":"The sum insured is Rs. 1,00,000 per AB PMJAY-MA Beneficiary Family Unit per annum on a family floater basis.","display":"Rs. 1,00,000 per family per annum on family floater basis","note":"No alternative selectable sum insured options are stated.","quote":"the AB PMJAY-MA Yojana Sum Insured in respect of the Risk Cover for each AB PMJAY-MA Beneficiary Family Unit shall be Rs. 1,00,000 (Rupees One Lakhs Only) per family per annum on family floater basis.","sources":[{"clause":"2","heading":null,"page":7,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-2-2"}],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"not-stated","value":null,"display":null,"note":"No general initial illness waiting period is stated.","quote":null,"sources":[],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"quote-verified","value":{"unit":"months","amount":0},"display":"Covered from the first day","note":"Subject to the exclusions in Schedule 2/Section C.","quote":"Pre-existing conditions/diseases are to be covered from the first day of the start of Policy","sources":[{"clause":"3","heading":null,"page":7,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-3-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"not-stated","value":null,"display":null,"note":"No waiting period for named illnesses or procedures is stated.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"not-stated","value":null,"display":null,"note":"No list of illnesses or procedures with a specific waiting period is stated.","quote":null,"sources":[],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"not-stated","value":null,"display":null,"note":"No moratorium period is stated.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"quote-verified","value":"Benefits are portable across the country at any EHCP, and the SHA may seek migration of the policies to another insurance company before expiration or termination. Waiting-period credit is not discussed.","display":"Benefits portable across India; SHA may migrate policies to another insurer","note":"This is scheme portability and SHA-led migration, not an individual retail portability clause.","quote":"The benefits of AB PMJAY-MA will be portable across the country and a Beneficiary covered under the Scheme will be able to get benefits under the Scheme across the country at any EHCP. ... At least 120 days prior to the expiration of the Policy or the Termination Date, the SHA may issue a written request to the Insurer seeking a migration of the Policies for all the districts in the Service Area (Migration Request) to another insurance company (New Insurer).","sources":[{"clause":"2(a)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-2-a"},{"clause":"8(a)","heading":null,"page":20,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-8-a-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"not-stated","value":null,"display":null,"note":"No lifelong renewal right or maximum renewal age is stated.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"not-applicable","value":null,"display":null,"note":"Beneficiaries are covered under a government scheme and are not charged a separate premium by the insurer, so individual claim-based premium loading does not apply.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"quote-verified","value":["Condition that does not require Hospitalization and can be treated under Out Patient Care","further expenses incurred at Hospital or Nursing Home primarily for evaluation / diagnostic purposes only","Any dental treatment or surgery which is corrective, prosthetic, cosmetic procedure, filling of tooth cavity, root canal including wear and tear of teeth, periodontal diseases, dental implants etc.","Any assisted reproductive techniques, or infertility related procedures, unless featuring in the National Health Benefit Package list.","Vaccination and immunization","Surgeries related to ageing face & body, laser procedures for tattoo removals, augmentation surgeries and other purely cosmetic procedures","Circumcision for children less than 2 years of age shall be excluded","Persistent Vegetative State"],"display":"OPD-only conditions, evaluation/diagnostic admissions, dental, ART/infertility, vaccination, cosmetic procedures, circumcision under 2 years, and Persistent Vegetative State","note":"The wording does not print IRDAI Excl04 to Excl18 codes.","quote":"Condition that does not require Hospitalization and can be treated under Out Patient Care ... further expenses incurred at Hospital or Nursing Home primarily for evaluation / diagnostic purposes only ... Any dental treatment or surgery which is corrective, prosthetic, cosmetic procedure, filling of tooth cavity, root canal including wear and tear of teeth, periodontal diseases, dental implants etc. are excluded. ... Any assisted reproductive techniques, or infertility related procedures, unless featuring in the National Health Benefit Package list. ... Vaccination and immunization ... Surgeries related to ageing face & body, laser procedures for tattoo removals, augmentation surgeries and other purely cosmetic procedures such as fat grafting, neck lift, aesthetic rhinoplasty etc. ... Circumcision for children less than 2 years of age shall be excluded ... Persistent Vegetative State","sources":[{"clause":"1","heading":"Condition that does not require Hospitalization and can be treated under Out Patient Care","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-1-3"},{"clause":"2","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-2-3"},{"clause":"3","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-3-3"},{"clause":"4","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-4-2"},{"clause":"5","heading":"Vaccination and immunization","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-5-2"},{"clause":"6","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-6-2"},{"clause":"7","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-7-2"},{"clause":"8","heading":"Persistent Vegetative State","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-8-2"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"quote-verified","value":"For SHA/end-of-contract refund, after adjusting flat 15% of premium towards administrative cost and settling all claims, 100 percent of leftover surplus is refunded by the insurer to SHA. If the insurer fails to refund within the 90-day period, SHA may recover it with applicable penalty as a debt due.","display":"After 15% admin cost and claim settlement, 100% leftover surplus refunded to SHA; 90-day recovery clause","note":"This clause is for SHA/end-of-contract refund, not individual beneficiary cancellation.","quote":"After adjusting flat 15% percent of premium towards administrative cost (including all costs excluding only service tax and any cess, if applicable) and after settling of all claims, if there remains surplus: 100 percent of leftover surplus should be refunded by the Insurer to the SHA ... If the Insurer fails to refund the Premium within 90-day period and/ or the default interest thereon, the SHA shall be entitled to recover such amount along with applicable Penalty as a debt due from the Insurer.","sources":[{"clause":"10(b)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-10-b-2"},{"clause":"10(c)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-10-c-2"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"quote-verified","value":"The service area is all districts in Gujarat, and benefits are portable across the country at any EHCP within India.","display":"Gujarat service area; portable across India at any EHCP","note":null,"quote":"Service Area refers to all the districts in the State of Gujarat covered and included under this Tender Document ... The benefits of AB PMJAY-MA will be portable across the country and a Beneficiary covered under the Scheme will be able to get benefits under the Scheme across the country at any EHCP. ... The Insurer is required to honour claims from any Empaneled Health Care Provider/hospital under the Scheme within India","sources":[{"clause":"3(b)(ii)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-3-b-ii-2"},{"clause":"2(a)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-2-a"},{"clause":"2(c)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-2-c"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"not-stated","value":null,"display":null,"note":"No free-look period is stated.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"not-stated","value":null,"display":null,"note":"No grace period for premium payment is stated.","quote":null,"sources":[],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"not-stated","value":null,"display":null,"note":"The wording gives beneficiary-list eligibility but does not state youngest or oldest entry age.","quote":null,"sources":[],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"not-stated","value":null,"display":null,"note":"The policy says premium is paid in installments according to the Work Order, but it does not state yearly, half-yearly, quarterly or monthly modes.","quote":null,"sources":[],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"not-stated","value":null,"display":null,"note":"No optional covers sold for an extra premium are stated.","quote":null,"sources":[],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"not-stated","value":null,"display":null,"note":"No cover during a grace period is stated.","quote":null,"sources":[],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for the hospital room, or the room category allowed. If you take a costlier room, other bills can be cut in proportion.","status":"not-stated","value":null,"display":null,"note":"Package rates include bed charges, but no separate per-day room-rent amount or cap is stated.","quote":null,"sources":[],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"not-stated","value":null,"display":null,"note":"No room category entitlement is stated.","quote":null,"sources":[],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"not-stated","value":null,"display":null,"note":"No ICU per-day limit or amount is stated.","quote":null,"sources":[],"law":[]},{"key":"proportionate_deduction","label":"Proportionate deduction","section":"Limits and co-pay","meaning":"If you choose a room above your limit, whether the insurer reduces associated charges (doctor fees, tests, procedures) by the same proportion.","status":"not-stated","value":null,"display":null,"note":"No proportionate deduction clause for choosing a room above entitlement is stated.","quote":null,"sources":[],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"quote-verified","value":"No co-payment is stated within the scheme limits: beneficiaries are to be provided treatment free of cost for covered ailments within limits, sub-limits and sum insured. If the wallet or coverage amount is exhausted or exceeded, the insurer is not liable for the remaining treatment cost.","display":"No beneficiary payment within limits; excess after wallet/coverage exhaustion is not insurer liability","note":null,"quote":"The AB-PMJAY, MA and MAV Beneficiaries shall be provided treatment free of cost for all such ailments covered under the Scheme within the limits/ sub-limits and Sum Insured ... upon exhaustion of the Beneficiary AB PMJAY-MA wallet of Rs.10.00 Lakhs (wherein liability of Insurer is limited up to Rs. 1,00,000 only), or if the treatment cost exceeds the benefit coverage amount available with the Beneficiary families then the liability for such remaining treatment cost as per the package rates defined in the Schedule 3 to the Insurance Contract will not be of the Insurer.","sources":[{"clause":"15(a)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-15-a-2"},{"clause":"10(c)","heading":"AB PMJAY-MA","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-10-c"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"An amount of each claim or each year that you bear before the policy pays.","status":"quote-verified","value":"No deductible is stated within the scheme limits: treatment is free of cost for covered ailments within limits, sub-limits and sum insured. Remaining cost after the wallet or coverage amount is exhausted or exceeded is not the insurer’s liability.","display":"No deductible within limits; excess after wallet/coverage exhaustion is not insurer liability","note":null,"quote":"The AB-PMJAY, MA and MAV Beneficiaries shall be provided treatment free of cost for all such ailments covered under the Scheme within the limits/ sub-limits and Sum Insured ... upon exhaustion of the Beneficiary AB PMJAY-MA wallet of Rs.10.00 Lakhs (wherein liability of Insurer is limited up to Rs. 1,00,000 only), or if the treatment cost exceeds the benefit coverage amount available with the Beneficiary families then the liability for such remaining treatment cost as per the package rates defined in the Schedule 3 to the Insurance Contract will not be of the Insurer.","sources":[{"clause":"15(a)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-15-a-2"},{"clause":"10(c)","heading":"AB PMJAY-MA","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-10-c"}],"law":[]},{"key":"disease_sublimits","label":"Disease or procedure sub-limits","section":"Limits and co-pay","meaning":"Caps on what is paid for named treatments (cataract, knee replacement...), even if the sum insured is higher.","status":"not-stated","value":null,"display":null,"note":"The wording says reimbursement is as per limits prescribed for procedures in Schedule 3, but the named disease/procedure sub-limit table is not printed in these clauses.","quote":null,"sources":[],"law":[]},{"key":"pre_hospitalisation","label":"Pre-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days before admission that are paid if related to the hospitalisation.","status":"not-stated","value":null,"display":null,"note":"Pre-hospitalisation expenses are covered for consultation, diagnostic tests and medicines before admission in the same hospital, but no number of days before admission is stated.","quote":null,"sources":[],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days after discharge that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":15},"display":"Up to 15 days after discharge","note":null,"quote":"cost of diagnostic tests and medicines and up to 15 days of the discharge from the hospital for the same ailment/surgery","sources":[{"clause":"6","heading":"Pre and Post Hospitalisation expenses","page":7,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-6"}],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital (chemotherapy, dialysis, cataract) and whether all or only listed ones are covered.","status":"quote-verified","value":"Defined day care treatments, procedures and medical treatments in Schedule 3 are covered. Day care treatment is treatment at an empanelled provider or day care centre in less than 24 hours that would otherwise have required hospitalisation.","display":"Defined day care treatments in Schedule 3, in less than 24 hours","note":null,"quote":"Day Care Treatment means any Medical Treatment and/or Surgical Procedure which is undertaken under general anaesthesia or local anaesthesia at an Empanelled Health Care Provider or Day Care Centre in less than 24 hours due to technological advancements, which would otherwise have required Hospitalization. ... The Insurance Company shall provide coverage for the defined day care treatments, procedures and medical treatments as given in Schedule 3 of the Insurance Contract.","sources":[{"clause":"3(d)","heading":null,"page":2,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-3-d"},{"clause":"4","heading":null,"page":7,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-4"}],"law":[]},{"key":"domiciliary","label":"Treatment at home","section":"Cover","meaning":"Whether treatment at home is covered when hospital admission is not possible or a doctor advises it.","status":"not-stated","value":null,"display":null,"note":"No domiciliary or home treatment cover is stated.","quote":null,"sources":[],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"not-stated","value":null,"display":null,"note":"No Ayurveda, Yoga, Unani, Siddha or Homeopathy treatment cover is stated.","quote":null,"sources":[],"law":[{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 1","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 2","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 1","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II A.I(1)","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"modern_treatments","label":"Modern treatments","section":"Cover","meaning":"Robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and the like, and any cap on them.","status":"not-stated","value":null,"display":null,"note":"No cover or cap for robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy or similar modern treatments is stated.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 2","url":"https://indiainsurances.com/law/irdai-health-mc-2024"}]},{"key":"organ_donor","label":"Organ donor expenses","section":"Cover","meaning":"Whether the donor's hospital costs for an organ transplant are paid.","status":"not-stated","value":null,"display":null,"note":"No organ donor hospital expense cover is stated.","quote":null,"sources":[],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"The policy includes transportation cost of Rs.300 during each hospitalization.","display":"Rs.300 transportation cost during each hospitalization","note":"The wording calls this transportation cost, not road or air ambulance cover.","quote":"Transportation cost of Rs.300 during each hospitalization","sources":[{"clause":"5","heading":"AB-PMJAY, MA and MAV Cover","page":7,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-5"}],"law":[]},{"key":"restoration","label":"Restoration of sum insured","section":"Cover","meaning":"Whether the sum insured is refilled after it is used up in a year, how much, how often, and whether it works for the same illness.","status":"not-stated","value":null,"display":null,"note":"No restoration or refill of sum insured is stated.","quote":null,"sources":[],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"not-stated","value":null,"display":null,"note":"No no-claim bonus or cumulative bonus is stated.","quote":null,"sources":[],"law":[]},{"key":"consumables","label":"Consumables and non-medical items","section":"Cover","meaning":"Gloves, PPE, syringes and other items hospitals bill that standard policies exclude; whether this policy pays them.","status":"not-stated","value":null,"display":null,"note":"Package rates include medicines, drugs, appliances, implants and other expenses related to treatment, but consumables or non-medical items are not specifically stated.","quote":null,"sources":[],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"not-stated","value":null,"display":null,"note":"No childbirth or maternity benefit, limit or waiting period is stated.","quote":null,"sources":[],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"New-born child/children benefits are included under the risk cover, marked as Health Cover Only.","display":"New-born child/ children benefits (Health Cover Only)","note":"The wording does not give further newborn limits or conditions in these clauses.","quote":"New-born child/ children benefits (Health Cover Only)","sources":[{"clause":"5","heading":"AB-PMJAY, MA and MAV Cover","page":7,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-5"}],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"not-stated","value":null,"display":null,"note":"No in-patient mental illness cover is stated.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"not-stated","value":null,"display":null,"note":"No preventive health check-up benefit is stated.","quote":null,"sources":[],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"quote-verified","value":"Conditions that do not require hospitalisation and can be treated under out-patient care are excluded, except expenses covered under pre and post hospitalisation expenses.","display":"OPD-only conditions excluded, except pre and post hospitalisation expenses","note":null,"quote":"Condition that does not require Hospitalization and can be treated under Out Patient Care ... Except those expenses covered under pre and post hospitalisation expenses","sources":[{"clause":"1","heading":"Condition that does not require Hospitalization and can be treated under Out Patient Care","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-1-3"},{"clause":"2","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-2-3"}],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"not-stated","value":null,"display":null,"note":"No city or zone-based premium or co-pay is stated.","quote":null,"sources":[],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"quote-verified","value":"The scheme provides cashless access: covered expenses are paid directly by the insurer to empanelled health care providers, and benefits are available on a cashless and paperless basis at any EHCP.","display":"Cashless and paperless at any EHCP","note":null,"quote":"Cashless Access Service means a facility extended by the Insurer to the Beneficiaries where the payments of the expenses that are covered under the Benefit Risk Cover are directly made by the Insurer to the Empanelled Health Care Providers ... The benefits under the AB-PMJAY, MA and MAV Cover shall, subject to the available AB-PMJAY, MA and MAV Sum Insured, be available to the AB-PMJAY, MA and MAV Beneficiary on a cashless and paperless basis at any EHCP.","sources":[{"clause":"3","heading":null,"page":1,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-3"},{"clause":null,"heading":"Benefits Available only through Empanelled Health Care Providers","page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-benefits-available-only-through-empanelled-healt"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"quote-verified","value":"If the insurer hires a TPA, the TPA may process claims and recommend action, but the final decision on approval or rejection of claims is made by the insurer.","display":"TPA may process; insurer makes final approval or rejection","note":null,"quote":"In case the insurer hires Third Party Administrator (TPA), it shall ensure that the TPA does not approve or reject any Claims on its behalf and that the TPA is only engaged in the processing of Claims. The TPA may however recommend to the Insurer on the action to be taken in relation to a Claim. However, the final decision on approval and rejection of Claims shall be made by the Insurer.","sources":[{"clause":"2(j)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-2-j"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"quote-verified","value":true,"display":"Yes, on family floater basis","note":null,"quote":"Rs. 1,00,000 (Rupees One Lakhs Only) per family per annum on family floater basis.","sources":[{"clause":"2","heading":null,"page":7,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217#c-2-2"}],"law":[]}],"documents":[{"kind":"wording","label":"Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PM JAY), Mukhyamantri Amrutam (MA) and Mukhyamantri Amrutam Vatsalaya (MAV) Yojana In the State of Gujarat Policy Wordings","pages":22,"fetched_at":"2026-10-17 19:43:38+00","source_url":"https://www.bajajgeneralinsurance.com/download-documents/health-insurance/Policy-Wording-AB-PM-JAY-MA-Gujarat-11-07-2023.pdf","url":"https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324/document/3217"}],"versions":[],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"Bajaj General Insurance official website","url":"https://www.bajajgeneralinsurance.com/","note":"Buy directly from the insurer."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"insurer","name":"Claims","url":"https://www.bajajgeneralinsurance.com/general-insurance-claims.html","note":null},{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"insurer","name":"Online grievance form","url":"https://www.bajajgeneralinsurance.com/forms/form-online-grievance.html","note":null},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PM JAY), Mukhyamantri Amrutam (MA) and Mukhyamantri Amrutam Vatsalaya (MAV) Yojana In the State of Gujarat (UIN BAJHGSP24060V012324), IndiaInsurances, https://indiainsurances.com/policy/bajaj-general-insurance/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pm-jay-mukhyamantri-amrutam--bajhgsp24060v012324"}