{"uin":"BAJHLIP23069V032223","name":"Extra Care Plus","url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223","insurer":{"slug":"bajaj-general-insurance","name":"Bajaj General Insurance Limited","url":"https://indiainsurances.com/insurer/bajaj-general-insurance"},"line":"health","category":"health-topup","category_name":"Top-up and super top-up","irdai_type":"Individual","kind":"product","status":"active","approved_on":"2020-03-18","withdrawn_on":null,"summary":"Extra Care Plus is a Bajaj General super top-up health policy that pays hospital expenses in India once covered expenses in the policy period exceed an aggregate deductible, for individuals or a family floater, with sum insured from 300000 to 5000000 and terms of 1, 2 or 3 years. Pre-existing diseases, listed conditions and maternity each have a 12-month waiting period, illnesses a 30-day initial wait, there is no co-payment, and Air Ambulance Cover is optional.","analysis":{"state":"extracted","analysed_at":"2026-10-16 08:29:38.424795+00","note":"Every stated fact carries a verbatim quote found in the cited clause."},"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":"not-stated","value":null,"display":null,"note":"No named plans are printed. The wording names 'Extra Care Plus-Individual/Family Floater', which are cover types; sum insured and aggregate deductible combinations are chosen in the schedule.","quote":null,"sources":[],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"cross-checked","value":"1 year, 2 years or 3 years.","display":"1, 2 or 3 years","note":"Long term discount: 4% for 2 years, 8% for 3 years (not for instalment premiums).","quote":"Tenure of Policy: 1 year, 2 years or 3 years.","sources":[{"clause":"Section C","heading":"OPERATIVE PARTS","page":6,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-section-c"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"cross-checked","value":"Planned hospitalisation must be intimated 48 hours before admission; emergency hospitalisation within 24 hours for cashless and within 48 hours for reimbursement.","display":"Planned: 48 hours before admission; emergency: within 24 hours (cashless) or 48 hours (reimbursement)","note":"Reimbursement documents within 30 days of discharge. Delay may be waived if notice was not possible in the circumstances.","quote":"In case of Planned hospitalization, You/the Insured Person/Insured’s representative shall intimate such admission before 48 hours of such hospitalization. ... In case of Emergency hospitalization, You / Insured Person / Insured’s representative shall intimate such admission within 24 hours of such hospitalization. ... You or someone claiming on Your behalf must inform Us in writing immediately within 48 hours of hospitalization in case of emergency hospitalization and 48 hours prior to hospitalization in case of planned hospitalization ... You or someone claiming on Your behalf must promptly and in any event within 30 days of discharge from a Hospital give Us the documentation. ... Waiver of conditions (i), (v) and (vi) may be considered where it is proved to the satisfaction of the Company that under the circumstances in which the insured was placed it was not possible from him or any other person to give notice or file claim within the prescribed time limit.","sources":[{"clause":"Section E(a)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-section-e-a-3"},{"clause":"Section E(b)(i)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-section-e-b-i"},{"clause":"Section E(b)(v)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-section-e-b-v"},{"clause":"Section E(b)(viii)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-section-e-b-viii"}],"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":"cross-checked","value":["First Consultation letter from the Doctor","Duly completed claim form and NEFT Form signed by the Claimant","Original Hospital Discharge Card","Original Hospital Bill giving detailed break up of all expense heads","Original Money Receipt, duly signed with a Revenue Stamp","All original Laboratory and Diagnostic Test Reports","In case of a Cataract Operation, IOL Sticker","Claim decision letter from the other insurer in case of partial settlement"],"display":null,"note":"Additional documents may be called for where fraud is suspected. The brochure also lists Aadhaar and PAN copies. Air Ambulance claims: claim form and original transport bills.","quote":"First Consultation letter from the Doctor. ... Duly completed claim form and NEFT Form signed by the Claimant. ... Original Hospital Discharge Card. ... Original Hospital Bill giving detailed break up of all expense heads mentioned in the bill. ... Original Money Receipt, duly signed with a Revenue Stamp. ... All original Laboratory and Diagnostic Test Reports. ... In case of a Cataract Operation, IOL Sticker will have to be enclosed. ... Claim decision letter from the other insurer in case of partial settlement. ... In cases where a fraud is suspected, we may call for any additional document(s) in addition to the documents listed above.","sources":[{"clause":"1","heading":null,"page":17,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-1-8"},{"clause":"2","heading":null,"page":17,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-2-7"},{"clause":"3","heading":null,"page":17,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-3-7"},{"clause":"4","heading":null,"page":17,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-4-7"},{"clause":"5","heading":null,"page":17,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-5-7"},{"clause":"6","heading":null,"page":17,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-6-6"},{"clause":"7","heading":null,"page":17,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-7-6"},{"clause":"8","heading":null,"page":17,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-8-6"},{"clause":"9","heading":null,"page":17,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-9-6"}],"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":"cross-checked","value":"The claim is settled or rejected within 15 days from receipt of the last necessary document; where investigation is needed it is completed within 30 days and the claim decided within 15 days of the last document.","display":"15 days from the last necessary document","note":"Interest at 2% above bank rate for delay. CIS says '15 Working Days'. Cashless: pre-authorisation reply within 1 hour, final discharge authorisation within 3 hours.","quote":"The Company shall settle or reject a claim, as the case may be, within 15 days from the date of receipt of last necessary document. ... not later than 30 days from the date of receipt of last necessary document ... at a rate 2% above the bank rate ... our representative then within 1 hour will respond with Approval, Rejection or more information. ... the same will be processed within 3 hours from the final documents received. ... TAT for claim settlement: 15 Working Days","sources":[{"clause":"5(i)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-5-i"},{"clause":"5(iii)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-5-iii"},{"clause":"5(iv)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-5-iv"},{"clause":"Section E(a)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-section-e-a-3"},{"clause":null,"heading":"CUSTOMER INFORMATION SHEET","page":2,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/278#c-customer-information-sheet-2"}],"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":"cross-checked","value":["Pre-existing diseases for 12 months (Excl01)","Listed conditions and surgeries for 12 months (Excl02)","Any illness within 30 days of first policy commencement, except accidents (Excl03)","Maternity until 12 months continuous period","Claim amounts falling within the Aggregate Deductible","Any Medical Expenses of the new born baby","Admission primarily for diagnostics and evaluation (Excl04)","Rest cure, rehabilitation and respite care (Excl05)","Cosmetic or plastic surgery (Excl08)","Hazardous or adventure sports as a professional (Excl09)","Alcoholism, drug or substance abuse (Excl12)","Sterility and infertility (Excl17)","Dental treatment unless requiring hospitalization due to accidental injury","Any treatment received outside India","Intentional self-injury"],"display":null,"note":"Full list in permanent_exclusions; Annexure II non-medical items are also excluded.","quote":"Pre-existing Diseases waiting period (Excl01) ... until the expiry of 12 months of continuous coverage ... Specified disease/procedure waiting period- (Excl02) ... shall be excluded until the expiry of 12 months of continuous coverage ... 3. 30-day waiting period (Excl03): ... Expenses related to the treatment of any illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an accident ... until 12 months continuous period has elapsed since the inception of the first Extra Care Plus with US ... We are not liable for claim(s) amount falling within Aggregate Deductible limit ... Any Medical Expenses of the new born baby. ... Investigation & Evaluation (Excl04) ... Rest Cure, rehabilitation and respite care- (Excl05) ... Cosmetic or plastic Surgery (Excl08) ... Hazardous or Adventure Sports (Excl09) ... Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. (Excl12) ... Sterility and Infertility (Excl17) ... Dental treatment or surgery of any kind unless requiring hospitalization and as a result of accidental Bodily Injury to natural teeth. ... Any treatment received outside India is not covered under this Policy. ... Intentional self-injury","sources":[{"clause":"1","heading":"Pre-existing Diseases waiting period (Excl01)","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-1-5"},{"clause":"2","heading":"Specified disease/procedure waiting period- (Excl02)","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-2-4"},{"clause":"2(a)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-2-a"},{"clause":"2(f)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-2-f"},{"clause":"2(a)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-2-a-2"},{"clause":null,"heading":"III. Waiting Period for Maternity Expenses","page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-iii-waiting-period-for-maternity-expenses"},{"clause":"1","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-1-6"},{"clause":"2","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-2-5"},{"clause":"2(c)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-2-c-2"},{"clause":"2(b)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-2-b-3"},{"clause":"5","heading":"Cosmetic or plastic Surgery (Excl08)","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-5-4"},{"clause":"6","heading":"Hazardous or Adventure Sports (Excl09)","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-6-3"},{"clause":"9","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-9-3"},{"clause":"14","heading":"Sterility and Infertility (Excl17)","page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-14-2"},{"clause":"3","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-3-5"},{"clause":"11","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-11-3"},{"clause":"8","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-8-4"}],"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":"cross-checked","value":"First contact the toll-free number 1-800-209- 5858, a branch, the website, or write to careforyou@bajajgeneral.com (senior citizens: seniorcitizen@bajajgeneral.com); if not satisfied, write to the Grievance Redressal Officer at ggro@bajajgeneral.com.","display":"careforyou@bajajgeneral.com or toll-free 1-800-209- 5858; then GRO at ggro@bajajgeneral.com","note":"Level 3: missed call on +91 80809 45060 or SMS to 575758. Then the Insurance Ombudsman.","quote":"Our toll-free number 1-800-209- 5858 or 020-30305858 ... Level 1: Write to careforyou@bajajgeneral.com and for senior citizens to seniorcitizen@bajajgeneral.com ... Level 2: In case you are not satisfied with the response given to you at Level 1 you may write to our Grievance Redressal Officer at ggro@bajajgeneral.com","sources":[{"clause":"17","heading":"Grievance Redressal Procedure","page":14,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-17-2"},{"clause":"17(a)","heading":"Level 1","page":14,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-17-a"},{"clause":"17(b)","heading":"Level 2","page":14,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-17-b"}],"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":"cross-checked","value":"Sum insured of Rs 300000, 500000, 1000000, 1500000, 2000000, 2500000 or 5000000, each paired with set aggregate deductible options.","display":"300000, 500000, 1000000, 1500000, 2000000, 2500000 or 5000000","note":"From the sales brochure; the wording and CIS refer to the policy schedule. Deductibles: 3 lakh SI with 2 lakh; 5 lakh with 2 or 3 lakh; 10 lakh with 2, 3 or 5 lakh; 15 lakh with 3 or 5 lakh; 20, 25 and 50 lakh with 3, 5 or 10 lakh.","quote":"WHAT ARE THE SUM INSURED OPTIONS UNDER THE POLICY? ... Sum Insured (in INR) | Aggregate Deductible Options (in INR) ... 300000 | 200000 | - | - | - ... 500000 | 200000 | 300000 | - | - ... 1000000 | 200000 | 300000 | 500000 | - ... 1500000 | - | 300000 | 500000 | - ... 2000000 | - | 300000 | 500000 | 1000000 ... 2500000 | - | 300000 | 500000 | 1000000 ... 5000000 | - | 300000 | 500000 | 1000000","sources":[{"clause":"19(d)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/279#c-19-d"}],"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":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":"Does not apply to accidents, or if the insured has continuous coverage for more than twelve months; applies afresh to an enhanced sum insured.","quote":"Expenses related to the treatment of any illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an accident ... This exclusion shall not, however apply if the Insured has Continuous Coverage for more than twelve months. ... The within referred waiting period is made applicable to the enhanced Sum Insured in the event of granting higher Sum Insured subsequently.","sources":[{"clause":"2(a)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-2-a-2"},{"clause":"2(b)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-2-b-2"},{"clause":"2(c)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-2-c-2"}],"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":"cross-checked","value":{"unit":"months","amount":12},"display":"12 months","note":"Applies afresh to any sum insured increase; reduced by prior continuous cover under portability; PED must be declared and accepted.","quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 12 months of continuous coverage after the date of inception of the first Extra Care Plus policy with us. ... In case of enhancement of sum insured the exclusion shall apply afresh to the extent of sum insured increase. ... waiting period for the same would be reduced to the extent of prior coverage. ... Coverage under the policy after the expiry of 12 months for any pre-existing disease is subject to the same being declared at the time of application and accepted by us.","sources":[{"clause":"1","heading":"Pre-existing Diseases waiting period (Excl01)","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-1-5"}],"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":"cross-checked","value":{"unit":"months","amount":12},"display":"12 months","note":"Not for accidents. Maternity also has a 12-month waiting period.","quote":"Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 12 months of continuous coverage after the date of inception of the first Extra Care Plus policy with us. This exclusion shall not be applicable for claims arising due to an accident. ... until 12 months continuous period has elapsed since the inception of the first Extra Care Plus with US","sources":[{"clause":"2(a)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-2-a"},{"clause":null,"heading":"III. Waiting Period for Maternity Expenses","page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-iii-waiting-period-for-maternity-expenses"}],"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":"cross-checked","value":["Any types of gastric or duodenal ulcers","Benign prostatic hypertrophy","All types of sinuses","Hemorrhoids","Dysfunctional uterine bleeding","Endometriosis","Stones in the urinary and biliary systems","Surgery on ears / tonsils / adenoids / paranasal sinuses","Surgery for intervertebral disc disorders","Cataracts","Hernia of all types","Fistulae, Fissure in ano","Hydrocele","Fibromyoma","Hysterectomy","Surgery for any skin ailment","Surgery on all internal or external tumours / cysts / nodules / polyps of any kind including breast lumps with exception of Malignant tumor or growth","All Joint Replacement surgeries","Internal Congenital"],"display":null,"note":null,"quote":"Any types of gastric or duodenal ulcers. ... Hernia of all types. ... Benign prostatic hypertrophy. ... Fistulae, Fissure in ano. ... All types of sinuses. ... Hydrocele. ... Hemorrhoids. ... Fibromyoma. ... Dysfunctional uterine bleeding. ... Hysterectomy. ... Endometriosis. ... Surgery for any skin ailment. ... Stones in the urinary and biliary systems. ... Surgery on all internal or external tumours / cysts / nodules / polyps of any kind including breast lumps with exception of Malignant tumor or growth. ... Surgery on ears / tonsils / adenoids / paranasal sinuses. ... All Joint Replacement surgeries. ... Surgery for intervertebral disc disorders. ... Internal Congenital. ... Cataracts.","sources":[{"clause":"2(f)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-2-f"}],"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":"cross-checked","value":{"unit":"months","amount":60},"display":"60 months","note":"For an enhanced sum insured, sixty months run from the date of enhancement on the enhanced limits.","quote":"After completion of sixty continuous months of coverage (including portability and migration) no look back would be applied. ... After the expiry of Moratorium Period no claim under this policy shall be contestable except for proven fraud and permanent exclusions specified in the policy contract.","sources":[{"clause":"7","heading":"Moratorium Period","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-7-5"}],"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":"cross-checked","value":"Yes. The whole policy can be ported to another insurer by applying at least 30 days, but not earlier than 60 days, before renewal, with accrued continuity benefits in waiting periods.","display":"Yes, apply 30 to 60 days before renewal; waiting-period credit kept","note":"Migration to other Bajaj General products also allowed (apply at least 30 days before renewal).","quote":"The Insured beneficiary will have the option to port the policy to other insurers by applying to such insurer to port the entire policy along with all the members of the family, if any, at least 30 days before, but not earlier than 60 days from the policy renewal date ... will get the accrued continuity benefits in waiting periods as per IRDAI guidelines on portability ... The Insured beneficiary will have the option to migrate the policy to other health insurance products/plans offered by the company by applying for migration of the policy atleast 30 days before the policy renewal date","sources":[{"clause":"15","heading":"Portability","page":13,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-15-2"},{"clause":"10","heading":"Migration","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-10-3"}],"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":"cross-checked","value":true,"display":"Yes, for adults; children up to 35 years","note":"From the sales brochure; the wording says the policy shall be renewable except on grounds of established fraud or non-disclosure or misrepresentation, without a maximum age.","quote":"For proposer/ spouse/ dependent parents: Life time Renewal ... For dependent children policy is renewable up to 35 years","sources":[{"clause":"19","heading":null,"page":5,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/279#c-19"}],"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":"cross-checked","value":"No. Renewal loadings are at portfolio level, not based on any individual policy claim experience; renewal is not denied because of claims.","display":"No loading for your own claims","note":"A discount may be given for good claims experience.","quote":"For this policy, the loadings on renewal premium shall be at portfolio and not based upon any individual policy claim experience. ... We shall not deny the renewal of this policy on the ground that You have made a claim or claims in the preceding policy years","sources":[{"clause":"8(iv)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-8-iv"},{"clause":"8(ii)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-8-ii"}],"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":"cross-checked","value":["Investigation & Evaluation (Excl04)","Rest Cure, rehabilitation and respite care (Excl05)","Obesity/Weight Control (Excl06)","Change-of-gender treatments (Excl07)","Cosmetic or plastic Surgery (Excl08)","Hazardous or Adventure Sports (Excl09)","Breach of law (Excl10)","Excluded Providers (Excl11)","Alcoholism, drug or substance abuse or any addictive condition (Excl12)","Treatments in heath hydros, nature cure clinics, spas (Excl13)","Dietary supplements and substances that can be purchased without prescription (Excl14)","Refractive Error less than 7.5 dioptres (Excl15)","Unproven Treatments (Excl16)","Sterility and Infertility (Excl17)","Claim amounts within the Aggregate Deductible","Any Medical Expenses of the new born baby","Dental treatment unless requiring hospitalization due to accidental injury to natural teeth","Spectacles, contact lenses, hearing aids, crutches and other external appliances","War, invasion, acts of foreign enemies","Circumcision unless required for treatment, cosmetic or aesthetic treatments","External medical equipment used at home","Intentional self-injury","Vaccination or inoculation unless part of post bite or necessary treatment","All non-medical Items as per Annexure II","Any treatment received outside India","Treatment for any other system other than modern medicine and AYUSH","Venereal disease or any sexually transmitted disease","Congenital external diseases or defects or anomalies, growth hormone therapy, stem cell implantation"],"display":null,"note":"Excl18 is not printed. Hematopoietic stem cells for bone marrow transplant are an exception to the stem cell exclusion.","quote":"Investigation & Evaluation (Excl04) ... Rest Cure, rehabilitation and respite care- (Excl05) ... Obesity/Weight Control (Excl06) ... Change-of-gender treatments (Excl07) ... Cosmetic or plastic Surgery (Excl08) ... Hazardous or Adventure Sports (Excl09) ... Breach of law (Excl10) ... Excluded Providers (Excl11) ... Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. (Excl12) ... Treatments received in heath hydros, nature cure clinics, spas ... (Excl13) ... Dietary supplements and substances that can be purchased without prescription ... (Excl14) ... Refractive Error (Excl15) ... refractive error less than 7.5 dioptres ... Unproven Treatments (Excl16) ... Sterility and Infertility (Excl17) ... We are not liable for claim(s) amount falling within Aggregate Deductible limit ... Any Medical Expenses of the new born baby. ... Dental treatment or surgery of any kind unless requiring hospitalization and as a result of accidental Bodily Injury to natural teeth. ... The cost of spectacles, contact lenses, hearing aids, crutches ... War, invasion, acts of foreign enemies ... Circumcision unless required for the treatment of Illness or Accidental bodily injury, cosmetic or aesthetic treatments of any description ... External medical equipment of any kind used at home ... Intentional self-injury ... Vaccination or inoculation unless forming a part of post bite treatment or if medically necessary ... All non-medical Items as per Annexure II. ... Any treatment received outside India is not covered under this Policy. ... Treatment for any other system other than modern medicine (also known as Allopathy) and AYUSH therapies. ... Venereal disease or any sexually transmitted disease ... Congenital external diseases or defects or anomalies, growth hormone therapy, stem cell implantation ... except for Hematopoietic stem cells for bone marrow transplant for hematological conditions","sources":[{"clause":"2(c)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-2-c-2"},{"clause":"2(b)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-2-b-3"},{"clause":"3","heading":"Obesity/Weight Control (Excl06)","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-3-4"},{"clause":"4","heading":"Change-of-gender treatments (Excl07)","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-4-4"},{"clause":"5","heading":"Cosmetic or plastic Surgery (Excl08)","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-5-4"},{"clause":"6","heading":"Hazardous or Adventure Sports (Excl09)","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-6-3"},{"clause":"7","heading":"Breach of law (Excl10)","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-7-3"},{"clause":"8","heading":"Excluded Providers (Excl11)","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-8-3"},{"clause":"9","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-9-3"},{"clause":"11","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-11-2"},{"clause":"12","heading":"Refractive Error (Excl15)","page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-12-2"},{"clause":"13","heading":"Unproven Treatments (Excl16)","page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-13-2"},{"clause":"14","heading":"Sterility and Infertility (Excl17)","page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-14-2"},{"clause":"1","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-1-6"},{"clause":"2","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-2-5"},{"clause":"3","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-3-5"},{"clause":"4","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-4-5"},{"clause":"5","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-5-5"},{"clause":"6","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-6-4"},{"clause":"7","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-7-4"},{"clause":"8","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-8-4"},{"clause":"9","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-9-4"},{"clause":"10","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-10-2"},{"clause":"11","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-11-3"},{"clause":"12","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-12-3"},{"clause":"13","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-13-3"},{"clause":"14","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-14-3"}],"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":"cross-checked","value":"On 7 days written notice: pro-rata refund for the unexpired period if no claim was made in the policy year; for multi-year policies, years not yet started are refunded in full; medical examination costs are deducted.","display":"Pro-rata refund if no claim in the policy year","note":"Instalment policies: pro-rata if no claim in the policy year. No refund if the company cancels for misrepresentation, non-disclosure or fraud.","quote":"The Policyholder can cancel this Policy by providing a written notice of 7 days. ... Annual Policy: The premium refund for the unexpired risk period will be on a pro-rata basis, provided no claim has been made during the policy year. ... For any policy year where the risk date has not yet started, the premium will be refunded without any deduction. ... expenses incurred by the Company on medical examination of the Policyholder will also be deducted before refunding of premium.","sources":[{"clause":"11(ii)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-11-ii"}],"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":"cross-checked","value":"India only: treatment availed within India; treatment outside India is not covered.","display":"India only","note":null,"quote":"We cover insured events arising during the Policy Period for treatment availed within India only. ... Any treatment received outside India is not covered under this Policy.","sources":[{"clause":"Section E(a)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-section-e-a-2"},{"clause":"11","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-11-3"}],"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":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":"New policies only, not renewals or porting. Refund less medical examination and stamp duty costs, or proportionate risk premium. CIS says 'up to 30 days from the first inception of policy'.","quote":"The insured person shall be allowed free look period of thirty days from date of receipt of the policy document to review the terms and conditions of the policy, and to return the same if not acceptable. ... Insured has an option of cancelling his/her policy up to 30 days from the first inception of policy with Us","sources":[{"clause":"13","heading":"Free Look Period","page":13,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-13-4"},{"clause":null,"heading":"CUSTOMER INFORMATION SHEET","page":2,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/278#c-customer-information-sheet-2"}],"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":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":"Fifteen days for monthly instalments.","quote":"We shall condone a delay in renewal up to the Grace Period (30 days) from the due date of renewal without considering such condonation as a Break in Policy. ... The grace period of fifteen days (where premium is paid on a monthly instalments) and thirty days (where premium is paid in quarterly/half yearly/annual instalments)","sources":[{"clause":"8(iii)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-8-iii"},{"clause":"4","heading":"Premium Payment in Instalments (Wherever applicable)","page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-4-6"}],"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":"cross-checked","value":"From 3 months to 80 years at the commencement of the policy period.","display":"3 months to 80 years","note":"Brochure: adults (proposer, spouse, dependent parents) 18 to 80 years; dependent children 3 months to 25 years. The brochure features list also says 'Entry age 91 days to 80 years'.","quote":"has attained the age of 3 months and is not older than 80years of age at the commencement of the Policy Period.","sources":[{"clause":"6","heading":"Named Insured/Insured","page":6,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-6-2"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"cross-checked","value":["Full premium at policy inception","Annual (for long term polices only)","Half Yearly","Quarterly","Monthly"],"display":null,"note":"Instalments 'wherever applicable'. The long term discount does not apply to instalment premiums.","quote":"Cancellation of policy where full premium received at policy inception ... Annual (for long term polices ... only), Half Yearly, Quarterly or Monthly","sources":[{"clause":"11(ii)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-11-ii"},{"clause":"4","heading":"Premium Payment in Instalments (Wherever applicable)","page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-4-6"}],"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":"cross-checked","value":["Air Ambulance Cover"],"display":null,"note":"Air ambulance limit as per schedule (brochure: Rs 2 lakh to 10 lakh by base sum insured); deductible not applied; return transport excluded.","quote":"OPTIONAL COVER ... Air Ambulance Cover ... In consideration of payment of additional premium by the Insured","sources":[{"clause":"II","heading":"OPTIONAL COVER","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-ii"},{"clause":"1","heading":"Air Ambulance Cover","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-1-4"}],"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":"cross-checked","value":"Only for instalment premiums: cover continues during the grace period when the premium is paid in instalments. Otherwise coverage need not be available for the period with no premium.","display":"Yes for instalment premiums; otherwise no cover for the unpaid period","note":"Brochure: 'Coverage is not available during the grace period' and no payment for hospitalisation during the grace period.","quote":"If the premium is paid in instalments during the policy period, coverage will be available for the grace period also. ... Coverage need not be available during the period for which no premium is received.","sources":[{"clause":"4","heading":"Premium Payment in Instalments (Wherever applicable)","page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-4-6"},{"clause":"15","heading":"Grace Period","page":2,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-15"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"The amount (per claim or per year) that must be crossed before this policy pays. Your base policy or you pay this part.","status":"cross-checked","value":"An aggregate deductible chosen in the schedule: the policy pays only once covered expenses in the policy period exceed it, up to the sum insured.","display":"Aggregate deductible as per schedule (200000, 300000, 500000 or 1000000)","note":"Deductible amounts from the sales brochure, linked to the sum insured. Deductible does not apply to Free Medical Check-up and Air Ambulance Cover.","quote":"Any claim under this policy shall be payable by the Company only if the aggregate of covered Reasonable Medical Expenses during the policy period exceeds the aggregate deductible limit provided in the Policy Schedule, subject to a maximum of Sum Insured. ... Aggregate Deductible Options (in INR) ... 1000000 | 200000 | 300000 | 500000 | - ... 2000000 | - | 300000 | 500000 | 1000000 ... Additional benefits (Additional benefits for which aggregate deductible is not applicable). ... Deductible will not be applied on the claim admissible under Air Ambulance cover.","sources":[{"clause":"Section C","heading":"OPERATIVE PARTS","page":6,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-section-c"},{"clause":"19(d)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/279#c-19-d"},{"clause":"4(iii)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-4-iii"},{"clause":"1","heading":"Air Ambulance Cover","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-1-4"}],"law":[]},{"key":"deductible_basis","label":"Per claim or aggregate","section":"Limits and co-pay","meaning":"Top-up: deductible applies to each claim. Super top-up: to the total of all claims in the year.","status":"cross-checked","value":"aggregate","display":"Aggregate for the policy period","note":"Super top-up (brochure: 'A SUPER TOP UP PLAN').","quote":"The deductible is applicable in aggregate towards hospitalization expenses incurred during the policy period.","sources":[{"clause":"2","heading":"Aggregate Deductible","page":1,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-2"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"Daily room limit, if any.","status":"cross-checked","value":"No room rent limit: room rent is covered and the CIS lists road ambulance as the only sub-limit, with other limits not applicable.","display":"No room rent limit","note":"The CIS lists road ambulance as the only sub-limit and 'Other Limits: Not Applicable'.","quote":"Room Rent/Boarding and Nursing Expenses. ... Sub limits: Road Ambulance - max. up to ₹ 3,000/- per Hospitalization. ... Other Limits: Not Applicable.","sources":[{"clause":"1","heading":"Medical Expenses","page":6,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-1-3"},{"clause":null,"heading":"CUSTOMER INFORMATION SHEET","page":2,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/278#c-customer-information-sheet-2"}],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"Share of each admissible claim you pay.","status":"cross-checked","value":"No co-payment.","display":"None","note":null,"quote":"Co-payment: Not Applicable.","sources":[{"clause":null,"heading":"CUSTOMER INFORMATION SHEET","page":2,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/278#c-customer-information-sheet-2"}],"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":"conflicting","value":"Yes. Cashless treatment is available at network hospitals, and the wording says cashless is offered everywhere, even at non-network hospitals that meet the IRDAI definition of a hospital.","display":"Yes, at network hospitals and also non-network hospitals (\"Cashless Everywhere\")","note":"CIS says: \"Cashless treatment is only available at Network Hospitals.\" Brochure says cashless only through Bajaj General network hospitals (5500+).","quote":"Cashless treatment is available at Network Hospitals. ... We offer Cashless Everywhere, even in hospitals which are not part of our network subject to hospitals fullfiing IRDAI definition of Hospital facility ... Cashless treatment is only available at Network Hospitals.","sources":[{"clause":"Section E(a)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-section-e-a-3"},{"clause":null,"heading":"CUSTOMER INFORMATION SHEET","page":2,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/278#c-customer-information-sheet-2"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"conflicting","value":"Claims are settled by the company's in-house claims settlement team; the wording adds 'and TPA is engaged', the brochure says no TPA is engaged.","display":"In-house claims team (documents disagree on whether a TPA is engaged)","note":"Brochure says: 'no TPA is engaged'. The wording's 'and TPA is engaged' may be a missing 'no'.","quote":"All Claims will be settled by In House claims settlement team of the Company and TPA is engaged. ... All Claims will be settled by In house claims settlement team of the company and no TPA is engaged.","sources":[{"clause":"Section E","heading":"GENERAL TERMS AND CLAUSES – OTHER TERMS AND CLAUSES","page":16,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-section-e-3"},{"clause":"19(d)(vii)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/279#c-19-d-vii"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"cross-checked","value":true,"display":"Yes","note":"Brochure: self, spouse, dependent children and dependent parents, up to six members under a single floater policy.","quote":"“Extra Care Plus-Individual/Family Floater”. ... Coverage opted on floater basis with overall Sum Insured (Only one sum insured is available for the entire family) ... Self, spouse, dependent children, dependent parents can be covered under this policy. A maximum of six members can be covered under single floater policy.","sources":[{"clause":"Section C","heading":"OPERATIVE PARTS","page":6,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277#c-section-c"},{"clause":null,"heading":"CUSTOMER INFORMATION SHEET","page":2,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/278#c-customer-information-sheet-2"},{"clause":"19","heading":null,"page":5,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/279#c-19"}],"law":[]}],"documents":[{"kind":"wording","label":"Extra Care Plus Policy Wordings","pages":22,"fetched_at":"2026-10-16 08:29:38.233078+00","source_url":"https://www.bajajgeneralinsurance.com/download-documents/health-insurance/Health-PW/Extra-Care-Plus_PW.pdf","url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/277"},{"kind":"cis","label":"Extra Care Plus Customer Information Sheet","pages":6,"fetched_at":"2026-10-16 08:29:38.233078+00","source_url":"https://www.bajajgeneralinsurance.com/download-documents/health-insurance/Health-CIS/Extra-Care-Plus_CIS.pdf","url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/278"},{"kind":"brochure","label":"Extra Care Plus Brochure","pages":13,"fetched_at":"2026-10-16 08:29:38.233078+00","source_url":"https://www.bajajgeneralinsurance.com/download-documents/health-insurance/extra-care-plus/Extra_Care_Plus_brochure.pdf","url":"https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223/document/279"}],"versions":[{"uin":"BAJHLIP20147V021920","version":null,"approved_on":null},{"uin":"BAJHLIP23069V032223","version":null,"approved_on":null}],"where_to_buy":[],"claims_and_complaints":[],"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":"Extra Care Plus (UIN BAJHLIP23069V032223), IndiaInsurances, https://indiainsurances.com/policy/bajaj-general-insurance/extra-care-plus-bajhlip23069v032223"}