{"uin":"BAJHLIP23184V012223","name":"Nidaan Swasthya Bima Policy","url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223","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":"Nidaan Swasthya Bima Policy is an individual health indemnity and benefit policy for persons with specified disabilities and individuals with HIV/AIDS. It offers sum insured options of 4 lacs and 5 lacs for a 1 Year policy period, with a 30 days initial illness waiting period and a 36 months PED waiting period.","analysis":{"state":"machine","analysed_at":"2026-10-19 19:00:57.58924+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":["Individual basis only"],"display":"Individual basis only","note":"No named plan variants are stated in the policy wording.","quote":"Coverage Basis | Individual basis only","sources":[{"clause":null,"heading":"TABLE OF BENEFITS","page":16,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-table-of-benefits"}],"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":"1 Year","display":"1 Year","note":null,"quote":"Policy Period | 1 Year","sources":[{"clause":null,"heading":"TABLE OF BENEFITS","page":16,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-table-of-benefits"}],"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":"Emergency hospitalization must be intimated within 24 hours from the date emergency hospitalization is required or before discharge, whichever is earlier. Planned hospitalization must be intimated at least 48 hours before admission.","display":"Emergency: within 24 hours or before discharge, whichever is earlier; planned: at least 48 hours prior to admission.","note":null,"quote":"Notice with full particulars shall be sent to the Company/TPA (if applicable) as under:\ni) Within 24 hours from the date of emergency hospitalization required or before the Insured Person’s discharge from Hospital, whichever is earlier.\nii) At least 48 hours prior to admission in Hospital in case of a planned Hospitalization.","sources":[{"clause":"3","heading":"Notification of Claim","page":15,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-3-7"}],"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":["Duly Completed claim form.","Photo Identity proof of the patient","Medical practitioner's prescription advising admission.","Original bills with itemized break-up","Payment receipts","Discharge summary including complete medical history of the patient along with other detail","Investigation/ Diagnostic test reports etc. supported by the prescription from attending medical practitioner","OT notes or Surgeon's certificate giving details of the operation performed (for surgical cases).","Sticker/invoices of the Implants, wherever applicable.","MLR (Medico Legal Report copy if carried out and FIR (First information report) if registered, wherever applicable.","NEFT Details (to enable direct credit of claim amount in bank account) and cancelled cheque.","KYC (Identity proof with Address) of the proposer, where claim liability is above Rs 1 Lakh as per AML Guidelines","Legal heir/succession certificate, wherever applicable","Any other relevant document required by Company/TPA for assessment of the claim."],"display":"Claim form, identity proof, admission prescription, original itemised bills, receipts, discharge summary, diagnostic reports, surgical/implant records, MLR/FIR where applicable, NEFT/cancelled cheque, KYC above Rs 1 Lakh, legal heir certificate where applicable, and any other relevant document.","note":"The policy also gives a separate document list for HIV/AIDS lump-sum claims.","quote":"i) Duly Completed claim form.\nii) Photo Identity proof of the patient\niii) Medical practitioner's prescription advising admission.\niv) Original bills with itemized break-up\nv) Payment receipts\nvi) Discharge summary including complete medical history of the patient along with other detail\nvii) Investigation/ Diagnostic test reports etc. supported by the prescription from attending medical practitioner\nviii) OT notes or Surgeon's certificate giving details of the operation performed (for surgical cases).\nix) Sticker/invoices of the Implants, wherever applicable.\nx) MLR (Medico Legal Report copy if carried out and FIR (First information report) if registered, wherever applicable.\nxi) NEFT Details (to enable direct credit of claim amount in bank account) and cancelled cheque. xii. KYC (Identity proof with Address) of the proposer, where claim liability is above Rs 1 Lakh as per AML Guidelines\nxii) Legal heir/succession certificate, wherever applicable\nxiii) Any other relevant document required by Company/TPA for assessment of the claim.","sources":[{"clause":"4","heading":"Documents to be submitted","page":15,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-4-7"}],"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":"The company shall settle or reject a claim within 15 days from the date of receipt of the last necessary document. If investigation is required it must be completed not later than 30 days from receipt of the last necessary document, with interest at 2% above bank rate for delay beyond the stipulated 15 days.","display":"15 days from receipt of last necessary document; investigation, if needed, not later than 30 days; delay interest 2% above bank rate.","note":null,"quote":"i) The Company shall settle or reject a claim as the case may be, 15 days from the date of receipt of last necessary document. ... iii) However, where the circumstances of a claim warrant an investigation in the opinion of the Company, it shall initiate and complete such investigation at the earliest, in any case not later than 30 days from the date of receipt of last necessary document- ln such cases, the Company shall settle or reject the claim within 15 days from the date of receipt of last necessary document. ... iv) ln case of delay beyond stipulated 15 days, the Company shall be liable to pay interest to The Policyholder at a rate 2% above the bank rate from the date of receipt of last necessary document to the date of payment of claim.","sources":[{"clause":"3(i)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-3-i"},{"clause":"3(iii)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-3-iii"},{"clause":"3(iv)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-3-iv"}],"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":["Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months","Expenses related to the treatment of the listed Conditions; surgeries/treatments shall be excluded until the expiry of 24 months","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","Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded.","Expenses related to any admission primarily for enforced bed rest and not for receiving treatment.","Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions","Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex.","Expenses for cosmetic or plastic surgery or any treatment to change appearance","Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports","Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent.","Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof.","Medical treatment expenses traceable to childbirth","Any medical treatment taken outside India.","Outpatient diagnostic, medical and surgical procedures or treatments, non-prescribed drugs and medical supplies, hormone replacement therapy and expenses related to Domiciliary hospitalization shall not be covered.","Venereal/ Sexually Transmitted disease other than HIV/AIDS."],"display":"Main exclusions include 36 months PED waiting, 24 months specified disease/procedure waiting, first 30 days illness waiting, diagnostic-only admission, rest cure, obesity surgery outside conditions, gender-change treatment, cosmetic/plastic surgery, professional adventure sports, criminal breach of law, alcohol/drug/substance abuse, maternity, treatment outside India, outpatient/domiciliary expenses, and STDs other than HIV/AIDS.","note":null,"quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months (as mentioned in Policy Schedule) ... Expenses related to the treatment of the listed Conditions; surgeries/treatments shall be excluded until the expiry of 24 months (as mentioned in Policy Schedule) ... 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 ... Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded. ... Expenses related to any admission primarily for enforced bed rest and not for receiving treatment. ... Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions: ... Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex. ... Expenses for cosmetic or plastic surgery or any treatment to change appearance ... Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports ... Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent. ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. ... i) Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy. ... Any medical treatment taken outside India. ... Outpatient diagnostic, medical and surgical procedures or treatments, non-prescribed drugs and medical supplies, hormone replacement therapy and expenses related to Domiciliary hospitalization shall not be covered. ... Venereal/ Sexually Transmitted disease other than HIV/AIDS.","sources":[{"clause":"1","heading":"Pre-Existing Diseases (Code- Excl01)","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-1-4"},{"clause":"2(a)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-2-a"},{"clause":"3","heading":"First 30 days waiting period- Code- Excl03","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-3-4"},{"clause":"Excl04","heading":"Investigation & Evaluation- Code- Excl04","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-excl04"},{"clause":"Excl05","heading":"Rest Cure, rehabilitation, and respite care- Code- Excl05","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-excl05"},{"clause":"Excl06","heading":"Obesity/ Weight Control: Code- Excl06","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-excl06"},{"clause":"4","heading":"Change-of-Gender treatments: Code- Excl07","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-4-4"},{"clause":"5","heading":"Cosmetic or plastic Surgery: Code- Excl08","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-5-4"},{"clause":"6","heading":"Hazardous or Adventure sports: Code- Excl09","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-6-4"},{"clause":"7","heading":"Breach of law: Code- Excl10","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-7-4"},{"clause":"9","heading":"Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof.","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-9-3"},{"clause":"15","heading":"Maternity: Code Excl18","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-15-3"},{"clause":"1","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-1-5"},{"clause":"11","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-11-4"},{"clause":"13","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-13-4"}],"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":"quote-verified","value":"First complain through the insurer's toll-free number, branch, website or email. Escalation is Level 1 at careforyou@bajajgeneral.com or seniorcitizen@bajajgeneral.com, Level 2 to the Grievance Redressal Officer at ggro@bajajgeneral.com, and Level 3 by missed call or SMS before approaching the Insurance Ombudsman.","display":"Level 1: careforyou@bajajgeneral.com or seniorcitizen@bajajgeneral.com; Level 2: ggro@bajajgeneral.com; Level 3: missed call +91 80809 45060 or SMS 575758; then Insurance Ombudsman.","note":null,"quote":"1. Our toll-free number 1-800-209- 5858 or 020-30305858, say Say “Hi” on WhatsApp on +91 7507245858\n2. Branches for resolution of your grievances / complaints, the Branch details can be found on our website www.bajajgeneralinsurance.com/branch-locator.html\n3. Register your grievances / complaints on our website www.bajajgeneralinsurance.com/about-us/customer-service.html\n4. E-mail ... a) Level 1: Write to careforyou@bajajgeneral.com and for senior citizens to seniorcitizen@bajajgeneral.com ... b) 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 ... c) Level 3: If in case, your grievance is still not resolved, and you wish to talk to our care specialist, please give a missed call on +91 80809 45060 OR SMS To 575758 and our care specialist will call you back\n5. If you are still not satisfied with the decision of the Insurance Company, you may approach the Insurance Ombudsman","sources":[{"clause":"16","heading":"Redressal of Grievance","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-16-4"},{"clause":"16(a)","heading":"Level 1","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-16-a"},{"clause":"16(b)","heading":"Level 2","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-16-b"},{"clause":"16(c)","heading":"Level 3","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-16-c"}],"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":"4lacs and 5 lacs","display":"4lacs and 5 lacs","note":null,"quote":"Sum insured available (in INR) | 4lacs and 5 lacs","sources":[{"clause":null,"heading":"TABLE OF BENEFITS","page":16,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-table-of-benefits"}],"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":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days for illness claims, except claims arising due to an accident","note":"The annexure states 90 days for lump-sum benefit under “Specific Conditions Applicable for Persons with HIV- AIDS”.","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, provided the same are covered. ... Initial Waiting period | 30 days for all claims except resulting from Accident and 90 days for lumpsum benefit under “Specific Conditions Applicable for Persons with HIV- AIDS”","sources":[{"clause":"3","heading":"First 30 days waiting period- Code- Excl03","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-3-4"},{"clause":null,"heading":"TABLE OF BENEFITS","page":16,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-table-of-benefits"}],"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":36},"display":"36 months for PED; 24 months for pre-existing Disability covered","note":"Pre-existing Disability covered under the policy has a 24 months waiting period.","quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months (as mentioned in Policy Schedule) of continuous coverage after the date of inception of the first policy with Insurer. ... 36 months | For pre-existing diseases other than the pre-existing Disability covered\n24 months | For pre-existing Disability covered under the policy, irrespective of Life-threatening or otherwise","sources":[{"clause":"1","heading":"Pre-Existing Diseases (Code- Excl01)","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-1-4"},{"clause":null,"heading":"WAITING PERIODS","page":17,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-waiting-periods"}],"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":"quote-verified","value":{"unit":"months","amount":24},"display":"24 months","note":"This exclusion does not apply for claims arising due to an accident.","quote":"Expenses related to the treatment of the listed Conditions; surgeries/treatments shall be excluded until the expiry of 24 months (as mentioned in Policy Schedule) of continuous coverage after the date of inception of the first Policy with us.","sources":[{"clause":"2(a)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-2-a"}],"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":"quote-verified","value":["Benign ENT disorders","Tonsillectomy","Adenoidectomy","Mastoidectomy","Tympanoplasty","Hysterectomy","All internal and external benign tumors, cysts, polyps of any kind, including benign breast lumps.","Benign prostate hypertrophy","Cataract and age-related eye ailments","Gastric/ Duodenal Ulcer","Gout and Rheumatism","Hernia of all types","Hydrocele","Non-Infective Arthritis","Piles, Fissures and Fistula in anus","Pilonidal sinus, Sinusitis and related disorders","Prolapse inter Vertebral Disc and Spinal Diseases unless arising from accident.","Calculi in urinary system, Gall Bladder and Bile duct, excluding malignancy.","Varicose Veins and Varicose Ulcers","Internal Congenital Anomalies"],"display":"Benign ENT disorders; tonsillectomy; adenoidectomy; mastoidectomy; tympanoplasty; hysterectomy; benign tumors/cysts/polyps; benign prostate hypertrophy; cataract and age-related eye ailments; gastric/duodenal ulcer; gout and rheumatism; hernia; hydrocele; non-infective arthritis; piles/fissures/fistula; pilonidal sinus/sinusitis; prolapsed intervertebral disc/spinal diseases; urinary/gall bladder/bile duct calculi; varicose veins/ulcers; internal congenital anomalies.","note":null,"quote":"24 Months waiting period.\n1. Benign ENT disorders\n2. Tonsillectomy\n3. Adenoidectomy\n4. Mastoidectomy\n5. Tympanoplasty\n6. Hysterectomy\n7. All internal and external benign tumors, cysts, polyps of any kind, including benign breast lumps.\n8. Benign prostate hypertrophy\n9. Cataract and age-related eye ailments\n10. Gastric/ Duodenal Ulcer\n11. Gout and Rheumatism\n12. Hernia of all types\n13. Hydrocele\n14. Non-Infective Arthritis\n15. Piles, Fissures and Fistula in anus\n16. Pilonidal sinus, Sinusitis and related disorders\n17. Prolapse inter Vertebral Disc and Spinal Diseases unless arising from accident.\n18. Calculi in urinary system, Gall Bladder and Bile duct, excluding malignancy.\n19. Varicose Veins and Varicose Ulcers\n20. Internal Congenital Anomalies","sources":[{"clause":"2(e)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-2-e"}],"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":"quote-verified","value":{"unit":"months","amount":60},"display":"sixty continuous months","note":"For enhanced sum insured, sixty continuous months applies from the date of enhancement only on the enhanced limits.","quote":"After completion of sixty continuous months of coverage (including portability and migration) no look back would be applied. This period of sixty months is called as moratorium period. ... 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":"12","heading":"Moratorium Period","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-12-5"}],"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":"quote-verified","value":"The insured person can port the policy to other insurers as per portability guidelines and get accrued continuity benefits in waiting periods. Application to port the entire policy must be made at least 30 days before, but not earlier than 60 days from, the policy renewal date.","display":"Yes, to other insurers with accrued waiting-period continuity; apply at least 30 days before and not earlier than 60 days from renewal.","note":null,"quote":"The Insured Person will have the option to port the Policy to other insurers as per extant Guidelines related to portability ... the proposed Insured Person will get all the accrued continuity benefits in waiting periods ... 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 as per IRDAI guidelines related to Portability.","sources":[{"clause":"9","heading":"Portability","page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-9-5"},{"clause":"9(ii)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-9-ii"}],"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":"quote-verified","value":true,"display":"Yes, lifetime renewal benefit is available under normal circumstances","note":"The explicit phrase “lifetime renewal benefit” is from the lower-priority brochure; the policy wording states the policy is renewable except on specified grounds.","quote":"Your Policy shall be renewable except on grounds of established fraud or non-disclosure or misrepresentation by You, provided this policy is not withdrawn and also subject to conditions stated at “Moratorium Period” of this Schedule. ... Under normal circumstances, lifetime renewal benefit is available under the policy, except on the grounds of Your moral hazard, misrepresentation, non- cooperation or fraud.","sources":[{"clause":"10(i)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-10-i"},{"clause":null,"heading":null,"page":1,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3088#c-s1"}],"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":"quote-verified","value":"Renewal premium loading is at portfolio level and not based on any individual policy claim experience. The policy shall not be denied renewal because the insured made claims in preceding policy years.","display":"Not based on individual policy claim experience; renewal loading is at portfolio level.","note":null,"quote":"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 ... For this policy, the loadings on renewal premium shall be at portfolio and not based upon any individual policy claim experience.","sources":[{"clause":"10(ii)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-10-ii"},{"clause":"10(iv)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-10-iv"}],"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":["Investigation & Evaluation- Code- Excl04","Rest Cure, rehabilitation, and respite care- Code- Excl05","Obesity/ Weight Control: Code- Excl06","Change-of-Gender treatments: Code- Excl07","Cosmetic or plastic Surgery: Code- Excl08","Hazardous or Adventure sports: Code- Excl09","Breach of law: Code- Excl10","Excluded Providers: Code- Excl11","Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. Code- Excl12","Treatments received in heath hydros, nature cure clinics, spas or similar establishments or private beds registered as a nursing home attached to such establishments or where admission is arranged wholly or partly for domestic reasons. Code- Excl13","Dietary supplements and substances that can be purchased without prescription, including but not limited to Vitamins, minerals and organic substances unless prescribed by a Medical Practitioner as part of hospitalization claim or day care procedure. Code- Excl14","Refractive Error: Code- Excl15","Unproven Treatments: Code- Excl16","Sterility and Infertility: Code- Excl17","Maternity: Code Excl18","Any medical treatment taken outside India.","Hospitalization for donation of any body organs by an Insured including complications arising from the donation of organs.","War, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, commotion, unrest, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalisation or requisition of or damage by or under the order of any government or public local authority.","Treatment with alternative medicines or Treatment, experimental or any other treatment such as acupuncture, acupressure, magnetic, osteopath, naturopathy, chiropractic, reflexology and aromatherapy.","Suicide, Intentional self-injury","Vaccination or inoculation except as post bite treatment for animal bite.","Outpatient diagnostic, medical and surgical procedures or treatments, non-prescribed drugs and medical supplies, hormone replacement therapy and expenses related to Domiciliary hospitalization shall not be covered.","Dental treatment or Surgery of any kind unless requiring Hospitalisation as a result of accidental Bodily Injury.","Venereal/ Sexually Transmitted disease other than HIV/AIDS.","Stem cell storage.","Any medical procedure or treatment, which is not medically necessary or not performed by a Doctor.","Treatment for any other system other than modern medicine (allopathy) and AYUSH therapies"],"display":"Permanent exclusions include Excl04 to Excl18 and product-specific exclusions such as treatment outside India, organ donation, war, alternative/experimental systems, suicide/self-injury, vaccination except post-bite, outpatient and domiciliary expenses, dental except accidental hospitalization, STDs other than HIV/AIDS, stem cell storage, non-medically necessary treatment, and other systems outside allopathy and AYUSH.","note":null,"quote":"Investigation & Evaluation- Code- Excl04 ... Rest Cure, rehabilitation, and respite care- Code- Excl05 ... Obesity/ Weight Control: Code- Excl06 ... Change-of-Gender treatments: Code- Excl07 ... Cosmetic or plastic Surgery: Code- Excl08 ... Hazardous or Adventure sports: Code- Excl09 ... Breach of law: Code- Excl10 ... Excluded Providers: Code- Excl11 ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. Code- Excl12 ... Treatments received in heath hydros, nature cure clinics, spas or similar establishments or private beds registered as a nursing home attached to such establishments or where admission is arranged wholly or partly for domestic reasons. Code- Excl13 ... Dietary supplements and substances that can be purchased without prescription, including but not limited to Vitamins, minerals and organic substances unless prescribed by a Medical Practitioner as part of hospitalization claim or day care procedure. Code- Excl14 ... Refractive Error: Code- Excl15 ... Unproven Treatments: Code- Excl16 ... Sterility and Infertility: Code- Excl17 ... Maternity: Code Excl18 ... Any medical treatment taken outside India. ... Hospitalization for donation of any body organs by an Insured including complications arising from the donation of organs. ... War, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, commotion, unrest, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalisation or requisition of or damage by or under the order of any government or public local authority. ... Treatment with alternative medicines or Treatment, experimental or any other treatment such as acupuncture, acupressure, magnetic, osteopath, naturopathy, chiropractic, reflexology and aromatherapy. ... Suicide, Intentional self-injury (including but not limited to the use or misuse of any intoxicating drugs or alcohol) ... Vaccination or inoculation except as post bite treatment for animal bite. ... Outpatient diagnostic, medical and surgical procedures or treatments, non-prescribed drugs and medical supplies, hormone replacement therapy and expenses related to Domiciliary hospitalization shall not be covered. ... Dental treatment or Surgery of any kind unless requiring Hospitalisation as a result of accidental Bodily Injury. ... Venereal/ Sexually Transmitted disease other than HIV/AIDS. ... Stem cell storage. ... Any medical procedure or treatment, which is not medically necessary or not performed by a Doctor. ... Treatment for any other system other than modern medicine (allopathy) and AYUSH therapies","sources":[{"clause":"Excl04","heading":"Investigation & Evaluation- Code- Excl04","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-excl04"},{"clause":"Excl05","heading":"Rest Cure, rehabilitation, and respite care- Code- Excl05","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-excl05"},{"clause":"Excl06","heading":"Obesity/ Weight Control: Code- Excl06","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-excl06"},{"clause":"4","heading":"Change-of-Gender treatments: Code- Excl07","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-4-4"},{"clause":"5","heading":"Cosmetic or plastic Surgery: Code- Excl08","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-5-4"},{"clause":"6","heading":"Hazardous or Adventure sports: Code- Excl09","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-6-4"},{"clause":"7","heading":"Breach of law: Code- Excl10","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-7-4"},{"clause":"8","heading":"Excluded Providers: Code- Excl11","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-8-3"},{"clause":"9","heading":"Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof.","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-9-3"},{"clause":"10","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-10-3"},{"clause":"11","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-11-3"},{"clause":"12","heading":"Refractive Error: Code- Excl15","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-12-3"},{"clause":"13","heading":"Unproven Treatments: Code- Excl16","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-13-3"},{"clause":"14","heading":"Sterility and Infertility: Code- Excl17","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-14-3"},{"clause":"15","heading":"Maternity: Code Excl18","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-15-3"},{"clause":"1","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-1-5"},{"clause":"2","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-2-5"},{"clause":"4","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-4-5"},{"clause":"7","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-7-5"},{"clause":"8","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-8-4"},{"clause":"9","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-9-4"},{"clause":"11","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-11-4"},{"clause":"12","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-12-4"},{"clause":"13","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-13-4"},{"clause":"14","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-14-4"},{"clause":"18","heading":null,"page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-18-3"},{"clause":"19","heading":"Treatment for any other system other than modern medicine (allopathy) and AYUSH therapies","page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-19-3"}],"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":"quote-verified","value":"The policyholder can cancel with 7 days written notice. For annual policies, the premium refund for the unexpired risk period is on a pro-rata basis if no claim has been made during the policy year, with medical examination expenses deducted where applicable.","display":"7 days written notice; pro-rata refund for unexpired risk period if no claim, with medical examination expenses deducted where applicable.","note":"For multi-year policies, future policy years where risk has not started are refunded without deduction; instalment-basis cancellations also use pro-rata refund if no claim has been made during the policy year.","quote":"The Policyholder can cancel this Policy by providing a written notice of 7 days. In such a case, the Company will refund the premium for the unexpired policy period as detailed below:\n1. Cancellation of policy where full premium received at policy inception -\n• 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. ... if (i) the risk under the Policy has already commenced, or (ii) only a part of the insurance coverage has commenced, and the option of Policy cancellation is exercised by the Policyholder, then expenses incurred by the Company on medical examination of the Policyholder will also be deducted before refunding of premium.","sources":[{"clause":"7","heading":"Cancellation","page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-7-6"}],"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":"Medical treatment taken outside India is excluded, so the cover is for India only.","display":"India only","note":null,"quote":"Any medical treatment taken outside India.","sources":[{"clause":"1","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-1-5"}],"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":"quote-verified","value":{"unit":"days","amount":30},"display":"thirty days from date of receipt of the Policy document","note":"Applicable on new individual health insurance policies and not on renewals.","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.","sources":[{"clause":"15","heading":"Free Look Period","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-15-5"}],"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":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days for quarterly/half-yearly/annual instalments; 15 days for monthly instalments","note":"Monthly instalments have 15 days. The Table of Benefits states yearly 30 days and all other modes 15 days, which differs from the detailed instalment clause for quarterly and half-yearly modes.","quote":"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) is available on the premium due date, to pay the premium. ... Grace Period | For Yearly payment of mode, a fixed period of 30 days is to be allowed as Grace. Period and for all other modes of payment a fixed period of 15 days be allowed as grace period.","sources":[{"clause":"11","heading":"Premium Payment in Instalments","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-11-5"},{"clause":null,"heading":"TABLE OF BENEFITS","page":16,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-table-of-benefits"}],"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":"quote-verified","value":"Adults can enter from 18 years to 65 years. Children can enter from New Born to 30 years.","display":"Adults: 18 years to 65 years; Children: New Born to 30 years","note":null,"quote":"Eligibility | Policy can be availed on Individual basis. Age eligibility for Adults: 18 years to 65 years Age eligibility for Children: New Born to 30 years","sources":[{"clause":null,"heading":"TABLE OF BENEFITS","page":16,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-table-of-benefits"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"quote-verified","value":["Annual (for long term polices only)","Half Yearly","Quarterly","Monthly"],"display":"Annual (for long term polices only), Half Yearly, Quarterly or Monthly","note":null,"quote":"If the Insured Person has opted for Payment of Premium on an instalment basis i.e. Annual (for long term polices only), Half Yearly, Quarterly or Monthly, as mentioned in the Policy Schedule","sources":[{"clause":"11","heading":"Premium Payment in Instalments","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-11-5"}],"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":"quote-verified","value":["Waiver of Co-payment"],"display":"Waiver of Co-payment: 20% co-payment can be waived by paying additional 25% premium","note":null,"quote":"Waiver of Co-payment Load: Co-payment of 20% can be waived off by paying additional 25% premium.","sources":[{"clause":"Section E(I)(a)(v)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-section-e-i-a-v"}],"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":"quote-verified","value":"Coverage is available for the grace period if premium is paid in instalments during the policy period. The general definition says coverage need not be available during the period for which no premium is received.","display":"Available during grace period for instalment premiums; otherwise coverage need not be available where premium is not received.","note":null,"quote":"Coverage need not be available during the period for which no premium is received. The grace period for payment of the premium for all types of insurance policies shall be: fifteen days where premium payment mode is monthly and thirty days in all other cases. Provided the insurers shall offer coverage during the grace period, if the premium is paid in instalments during the policy period. ... If the premium is paid in instalments during the Policy Period, coverage will be available for the Grace Period also.","sources":[{"clause":"17","heading":"Grace Period","page":2,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-17"},{"clause":"11","heading":"Premium Payment in Instalments","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161#c-11-5"}],"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":null,"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":null,"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":null,"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":null,"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":null,"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":null,"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":null,"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":null,"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":null,"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":null,"quote":null,"sources":[],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":null,"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":null,"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":null,"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":null,"quote":null,"sources":[],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":null,"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":null,"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":null,"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]}],"documents":[{"kind":"wording","label":"Nidaan Swasthya Bima Policy Policy Wordings","pages":27,"fetched_at":"2026-10-17 19:41:30+00","source_url":"https://www.bajajgeneralinsurance.com/download-documents/health-insurance/Health-PW/Nidaan-Swasthya-Bima_PW.pdf","url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3161"},{"kind":"cis","label":"Nidaan Swasthya Bima Policy Customer Information Sheet","pages":6,"fetched_at":"2026-10-17 19:37:11+00","source_url":"https://www.bajajgeneralinsurance.com/download-documents/health-insurance/Health-CIS/Nidaan-Swasthya-Bima-Policy_CIS.pdf","url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3042"},{"kind":"brochure","label":"Nidaan Swasthya Bima Policy Brochure","pages":6,"fetched_at":"2026-10-17 19:38:45+00","source_url":"https://www.bajajgeneralinsurance.com/download-documents/health-insurance/Nidaan-Swasthya-Bima/Nidaan-Swasthya-Bima-Policy-brochure.pdf","url":"https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223/document/3088"}],"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":"Nidaan Swasthya Bima Policy (UIN BAJHLIP23184V012223), IndiaInsurances, https://indiainsurances.com/policy/bajaj-general-insurance/nidaan-swasthya-bima-policy-bajhlip23184v012223"}