{"uin":"BAJHLIP23208V032223","name":"Critical Illness","url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223","insurer":{"slug":"bajaj-general-insurance","name":"Bajaj General Insurance Limited","url":"https://indiainsurances.com/insurer/bajaj-general-insurance"},"line":"health","category":"critical-illness","category_name":"Critical illness","irdai_type":"Revision","kind":"product","status":"active","approved_on":"2020-07-23","withdrawn_on":null,"summary":"Bajaj General's Critical Illness Insurance pays a lump sum Critical Illness Benefit if an insured person aged 3 months to 65 years at entry is diagnosed with one of 12 listed critical illnesses and survives 30 days from diagnosis. Illnesses diagnosed in the first 90 days are excluded, Joint Replacement is capped at INR 500,000, and the policy ceases for that person after a claim, except that after a Joint Replacement claim cover continues for the other 11 illnesses with the reduced sum insured.","analysis":{"state":"extracted","analysed_at":"2026-10-16 04:48:11.51034+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 or variants; the documents only describe 1-year and 2- or 3-year policy periods and instalment premium options.","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":"The policy can be taken for 1 year or as a 2- or 3-year long term policy.","display":"1, 2 or 3 years","note":"Long term discount: 4% for 2 years, 8% for 3 years; not available where premium is paid in instalments.","quote":"For 1-year Policy Period: ... For 2- or 3-Year Long Term Policy Period: ... 4 % discount is applicable if policy is opted for 2 years. ... 8 % discount is applicable if policy is opted for 3 years.","sources":[{"clause":"Section E(vii)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-section-e-vii"},{"clause":null,"heading":"Scenario 3 –","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-scenario-3"},{"clause":"Section E(i)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-section-e-i"},{"clause":"Section E(ii)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-section-e-ii"}],"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":"Inform the insurer in writing within 48 hours of diagnosis of a listed critical illness.","display":"In writing within 48 hours of diagnosis","note":"Claim documents must be given within 30 days of diagnosis or discharge from hospital (if admitted). Time limits may be waived in extreme hardship.","quote":"You or someone claiming on Your behalf must inform Us in writing immediately within 48 hours of diagnosis of any of the listed Critical Illnesses.","sources":[{"clause":"Section E(i)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-section-e-i-2"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"cross-checked","value":["Critical Illness Insurance Claim Form signed by the insured, with NEFT Form signed by the Claimant","Original Discharge Summary / Discharge Certificate","Original Final Hospital Bill","Policy copy","First consultation letter for Illness","Medical certificate for the duration of illness","All required Original Investigation Reports as per the Illness","Medical certification from specialist","Aadhar card & PAN card Copies (not mandatory if linked with the policy or a previous claim)"],"display":"Claim form with NEFT form, discharge summary, final hospital bill, policy copy, first consultation letter, medical certificates, investigation reports, specialist certification, Aadhar and PAN copies","note":null,"quote":"Critical Illness Insurance Claim Form duly signed by the insured along with NEFT Form signed by the Claimant. ... Original Discharge Summary / Discharge Certificate. ... Original Final Hospital Bill. ... Policy copy. ... First consultation letter for Illness. ... Medical certificate for the duration of illness. ... All required Original Investigation Reports as per the Illness. ... Medical certification from specialist. ... Aadhar card & PAN card Copies (Not mandatory if the same is linked with the policy while issuance or in previous claim).","sources":[{"clause":"Section E(iv)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-section-e-iv-2"}],"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":"Settlement is offered within 15 days of receipt of all documents and paid within 7 days of acceptance; where investigation is needed, it is completed within 30 days and the claim settled within 15 days of the last necessary document.","display":"Settlement offer within 15 days of all documents; payment within 7 days of acceptance","note":"Rejections are communicated in writing within 15 days of complete documents. Investigations finish within 30 days of the last necessary document. Interest at 2% above bank rate for delay. CIS says: 'TAT for claim settlement: 15 Working Days'.","quote":"On receipt of all the documents and on being satisfied with regard to the admissibility of the claim as per policy terms and conditions, we shall offer within a period of 15 days a settlement of the claim to you. Upon acceptance of an offer of settlement by you, the payment of the amount due shall be made within 7 days from the date of acceptance of the offer by you. ... the Company will 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. In such cases, the Company will settle the claim within 15 days from the date of receipt of last necessary document.","sources":[{"clause":"Section E(iii)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-section-e-iii"},{"clause":"Section E(iv)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-section-e-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":"cross-checked","value":["Any Critical Illness diagnosed within the first 90 days of the date of commencement of the Policy","Any Critical Illness for which care, treatment or advice was recommended or received, or which first manifested itself or was contracted, before the start of the Policy Period","Any sexually transmitted diseases or any condition caused by or associated with AIDS","Treatment arising from or traceable to pregnancy, childbirth, birth defects and congenital anomalies","Occupational diseases","War, invasion, terrorism, civil war, riot and similar perils","Naval or military operations of the armed forces or airforce","Any natural peril","Radioactive contamination","Consequential losses of any kind","Intentional self-injury and/or the use or misuse of intoxicating drugs and/or alcohol","Treatment for any other system other than modern medicine (allopathy) and AYUSH therapies"],"display":"First 90 days, pre-existing critical illness, STD/AIDS, pregnancy and congenital anomalies, occupational diseases, war and terrorism, military operations, natural perils, radioactive contamination, consequential losses, self-injury and drugs/alcohol, non-allopathic non-AYUSH treatment","note":"The 90-day exclusion does not apply on renewals without a break. Each listed illness also has its own exclusions in its definition.","quote":"Any Critical Illness diagnosed within the first 90 days of the date of commencement of the Policy is excluded. ... Any Critical Illness for which care, treatment, or advice was recommended by or received from a Physician, or which first manifested itself or was contracted before the start of the Policy Period ... Any sexually transmitted diseases ... commonly referred to as AIDS. ... Treatment arising from or traceable to pregnancy, childbirth postpartum complications including but not limited to caesarian section, birth defects and congenital anomalies. ... Occupational diseases. ... War, whether war be declared or not, invasion, act of foreign enemy, hostilities, civil war, insurrection, terrorism ... Naval or military operations of the armed forces or airforce ... Any natural peril ... Radioactive contamination. ... Consequential losses of any kind ... Intentional self-injury and/or the use or misuse of intoxicating drugs and/or alcohol. ... Treatment for any other system other than modern medicine (allopathy) and AYUSH therapies.","sources":[{"clause":"Section D","heading":"EXCLUSIONS UNDER THE POLICY – WAITING PERIOD","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-section-d"},{"clause":"1","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-1-4"},{"clause":"2","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-2-4"},{"clause":"3","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-3-4"},{"clause":"4","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-4-4"},{"clause":"5","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-5-4"},{"clause":"7","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-7-4"},{"clause":"8","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-8-4"},{"clause":"9","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-9-4"},{"clause":"10","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-10-4"},{"clause":"11","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-11-4"},{"clause":"12","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-12-3"}],"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 e-mail careforyou@bajajgeneral.com (seniorcitizen@bajajgeneral.com for senior citizens); then the Grievance Redressal Officer at ggro@bajajgeneral.com; then the care specialist line; then the Insurance Ombudsman.","display":"Level 1: careforyou@bajajgeneral.com; Level 2: Grievance Redressal Officer ggro@bajajgeneral.com; then Insurance Ombudsman","note":null,"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 ... 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 ... If you are still not satisfied with the decision of the Insurance Company, you may approach the Insurance Ombudsman","sources":[{"clause":"13","heading":"Grievance Redressal Procedure","page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-13-2"},{"clause":"13(a)","heading":"Level 1","page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-13-a"},{"clause":"13(b)","heading":"Level 2","page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-13-b"},{"clause":"13(c)","heading":"Level 3","page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-13-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":"not-stated","value":null,"display":null,"note":"No list of sum insured options; the CIS refers to the policy schedule. Renewals at age 61 and above are capped at Rs 5,00,000 or the expiring sum insured, whichever is lower, and Joint Replacement is capped at INR 500,000.","quote":null,"sources":[],"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":90},"display":"90 days","note":"Applies to the first policy; not on renewals without a break. Applies afresh to any enhanced sum insured.","quote":"Any Critical Illness diagnosed within the first 90 days of the date of commencement of the Policy is excluded. This exclusion shall not apply to an Insured for whom coverage has been renewed by the Named Insured, without a break, for subsequent years.","sources":[{"clause":"Section D","heading":"EXCLUSIONS UNDER THE POLICY – WAITING PERIOD","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-section-d"}],"law":[]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"not-stated","value":null,"display":null,"note":"Only the standard definition (up to 24 months) appears; no specific waiting period is applied in this policy.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"cross-checked","value":{"unit":"months","amount":60},"display":"sixty continuous months","note":"After it, no claim is contestable except for proven fraud and permanent exclusions. For an enhanced sum insured, it runs from the date of enhancement on the enhanced part.","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. ... completion of 60 continuous months would be applicable from date of enhancement of sums insured only on the enhanced limits","sources":[{"clause":"3","heading":"Moratorium Period","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-3-5"},{"clause":"12","heading":null,"page":1,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/13#c-12"}],"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 policy can be ported to another insurer by applying at least 30 days, but not earlier than 60 days, before the renewal date, with accrued continuity benefits in waiting periods as per IRDAI guidelines.","display":"Yes, apply 30 to 60 days before renewal; waiting-period credit carried over","note":"Migration to other Bajaj General health products is also available, applying 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 as per IRDAI guidelines related to portability. ... the proposed Insured beneficiary will get the accrued continuity benefits in waiting periods as per IRDAI guidelines on portability.","sources":[{"clause":"11","heading":"Portability","page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-11-5"}],"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, lifetime renewal","note":"Cover for an insured ends on the occurrence of a Critical Illness. Renewals at age 61 and above are capped at Rs 5,00,000 or the expiring sum insured, whichever is lower.","quote":"Under normal circumstances, lifetime renewal benefit is available under the policy except on the grounds of fraud, misrepresentation or moral hazard or Upon the occurrence of an event of Critical Illness.","sources":[{"clause":null,"heading":"Scenario 3 –","page":13,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-scenario-3-2"}],"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 and not based on individual policy claim experience.","display":"No, loadings are at portfolio level, not on individual claims","note":"A health loading of 10% to 150% may be applied at the proposal stage for adverse health conditions and continues on renewals with the Company.","quote":"For this policy, the loadings on renewal premium shall be at portfolio and not based upon any individual policy claim experience.","sources":[{"clause":"5(iv)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-5-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":"cross-checked","value":["Any Critical Illness for which care, treatment, or advice was recommended or received, or which first manifested itself or was contracted, before the start of the Policy Period, or for which a claim could have been made under any earlier policy","Any sexually transmitted diseases or AIDS-related condition","Treatment arising from or traceable to pregnancy, childbirth, birth defects and congenital anomalies","Occupational diseases","War, invasion, terrorism, civil war, riot, confiscation or destruction by any government and similar perils","Naval or military operations of the armed forces or airforce","Any natural peril","Radioactive contamination","Consequential losses of any kind","Intentional self-injury and/or the use or misuse of intoxicating drugs and/or alcohol","Treatment for any other system other than modern medicine (allopathy) and AYUSH therapies"],"display":"Pre-existing critical illness, STD/AIDS, pregnancy and congenital anomalies, occupational diseases, war and terrorism, military operations, natural perils, radioactive contamination, consequential losses, self-injury and drugs/alcohol, non-allopathic non-AYUSH treatment","note":"The policy uses its own numbered Specific Exclusions (items 5 and 6 run together as one clause), not the IRDAI Excl01 to Excl18 codes.","quote":"Any Critical Illness for which care, treatment, or advice was recommended by or received from a Physician, or which first manifested itself or was contracted before the start of the Policy Period, or for which a claim has or could have been made under any earlier policy. ... Any sexually transmitted diseases ... commonly referred to as AIDS. ... Treatment arising from or traceable to pregnancy, childbirth postpartum complications including but not limited to caesarian section, birth defects and congenital anomalies. ... Occupational diseases. ... War, whether war be declared or not, invasion, act of foreign enemy, hostilities, civil war, insurrection, terrorism ... destruction by any government or public authority ... Naval or military operations of the armed forces or airforce ... Any natural peril ... Radioactive contamination. ... Consequential losses of any kind ... Intentional self-injury and/or the use or misuse of intoxicating drugs and/or alcohol. ... Treatment for any other system other than modern medicine (allopathy) and AYUSH therapies.","sources":[{"clause":"1","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-1-4"},{"clause":"2","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-2-4"},{"clause":"3","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-3-4"},{"clause":"4","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-4-4"},{"clause":"5","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-5-4"},{"clause":"7","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-7-4"},{"clause":"8","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-8-4"},{"clause":"9","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-9-4"},{"clause":"10","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-10-4"},{"clause":"11","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-11-4"},{"clause":"12","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-12-3"}],"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":"With 7 days written notice, the premium for the unexpired period is refunded pro-rata, provided no claim was made in the policy year; for multi-year policies, future years are refunded in full.","display":"Pro-rata refund for the unexpired period if no claim was made in the policy year","note":"Multi-year policy years not yet started are refunded without deduction. Medical examination expenses are also deducted once risk has commenced. Instalment-paid policies: pro-rata refund if no claim in the policy year.","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 has started, the premium will be refunded on a pro-rata basis for that policy year, provided no claim has been made during the policy year and in full for future policy years.","sources":[{"clause":"10","heading":"Cancellation","page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-10-5"}],"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: the Company's liability to make any payment is within India and in Indian Rupees only.","display":"India (payment within India, in Indian Rupees only)","note":"The clause (Territorial Limits) limits where and in what currency payment is made; it does not say whether a diagnosis outside India is covered.","quote":"The Company’s liability to make any payment shall be within India and in Indian Rupees only.","sources":[{"clause":"Section E(b)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-section-e-b"}],"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":"thirty days","note":"New individual policies only, not renewals or ported/migrated policies. Refund is premium less medical examination expenses and stamp duty (or proportionate risk premium if risk has commenced). CIS counts the 30 days from the first inception of the policy rather than from receipt of the policy document.","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. ... Free Look Cancellation: Insured has an option of cancelling his/her policy up to 30 days from the first inception of policy with Us","sources":[{"clause":"9","heading":"Free Look Period","page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-9-5"},{"clause":"12","heading":null,"page":1,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/13#c-12"}],"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 where premium is paid in 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":"5(iii)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-5-iii"},{"clause":"4","heading":"Premium Payment in Instalments (Wherever applicable)","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-4-5"}],"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 65 years of age at the commencement of the Policy Period.","display":"3 months to 65 years","note":null,"quote":"has attained the age of 3 months and is not older than 65 years of age at the commencement of the Policy Period","sources":[{"clause":"3","heading":"Named Insured/ Insured","page":6,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-3-2"}],"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 instalments (for long term policies only)","Half Yearly","Quarterly","Monthly"],"display":"Full premium at inception, or instalments: annual (long term only), half-yearly, quarterly, monthly","note":"Instalment options apply wherever applicable, as mentioned in the policy schedule.","quote":"Payment of Premium on an instalment basis i.e. Annual (for long term polices only), Half Yearly, Quarterly or Monthly ... Cancellation of policy where full premium received at policy inception","sources":[{"clause":"4","heading":"Premium Payment in Instalments (Wherever applicable)","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-4-5"},{"clause":"10","heading":"Cancellation","page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-10-5"}],"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":"not-stated","value":null,"display":null,"note":"No optional covers or add-ons for extra premium are described in the wording or CIS; the only options are policy period (1, 2 or 3 years) and instalment premium payment.","quote":null,"sources":[],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"Only for instalment premiums: if the premium is paid in instalments, cover continues during the grace period. Otherwise coverage is not available for the period for which no premium is received.","display":"Yes for instalment premiums; otherwise no cover for the unpaid period","note":"Renewal clause: within the 30-day renewal grace period the policy is treated as continuous, but any disease or accident contracted during the break period is not admissible.","quote":"Coverage is not available for the period for which no premium is received. ... Coverage shall be available during the Grace period, if the premium is paid in Instalments during the Policy Period on due date. ... If the premium is paid in instalments during the policy period, coverage will be available for the grace period also. ... In case of 0ur own renewal a grace period of 30 days is permissible and the Policy will be considered as continuous for the purpose of waiting period. Any medical expenses incurred as a result of disease condition/ Accident contracted during the break period will not be admissible under the policy.","sources":[{"clause":"17","heading":"Grace Period","page":2,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-17"},{"clause":"4","heading":"Premium Payment in Instalments (Wherever applicable)","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-4-5"},{"clause":null,"heading":"Scenario 3 –","page":13,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-scenario-3-2"}],"law":[]},{"key":"illness_count","label":"Number of illnesses covered","section":"Cover","meaning":"How many critical illnesses are listed. The definitions matter more than the count.","status":"quote-verified","value":12,"display":"12","note":"Joint Replacement is capped at INR 500,000 and payable once in a lifetime.","quote":"the Company shall pay a lump sum Critical Illness Benefit, for conditions specified in table below: 1. Myocardial Infarction (First Heart Attack of specific severity). 2. Open Chest CABG. 3. Stroke Resulting in Permanent Symptoms. 4. Cancer of Specified Severity. 5. Kidney Failure Requiring Regular Dialysis. 6. Major Organ Transplantation. 7. Multiple Sclerosis with Persisting Symptoms. 8. Surgery of Aorta. 9. Primary (Idiopathic) Pulmonary Hypertension. 10. Permanent Paralysis of Limbs. 11. Neuro Surgery. 12. Joint Replacement.","sources":[{"clause":"Row 5","heading":"Policy Coverage (What the Policy Covers)","page":1,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/13#c-row-5"}],"law":[]},{"key":"illness_list","label":"Illnesses covered","section":"Cover","meaning":"The listed illnesses. Standard definitions are set by IRDAI.","status":"cross-checked","value":["Myocardial Infarction (First Heart Attack of specific severity)","Open Chest CABG","Stroke Resulting in Permanent Symptoms","Cancer of Specified Severity","Kidney Failure Requiring Regular Dialysis","Major Organ Transplantation","Multiple Sclerosis with Persisting Symptoms","Surgery of Aorta","Primary (Idiopathic) Pulmonary Hypertension","Permanent Paralysis of Limbs","Neuro Surgery","Joint Replacement"],"display":"12 listed critical illnesses","note":"Full definitions are in Section C of the wording.","quote":"1. Myocardial Infarction (First Heart Attack of specific severity). 2. Open Chest CABG. 3. Stroke Resulting in Permanent Symptoms. 4. Cancer of Specified Severity. 5. Kidney Failure Requiring Regular Dialysis. 6. Major Organ Transplantation. ... 7. Multiple Sclerosis with Persisting Symptoms. 8. Surgery of Aorta. 9. Primary (Idiopathic) Pulmonary Hypertension. 10. Permanent Paralysis of Limbs. 11. Neuro Surgery. 12. Joint Replacement.","sources":[{"clause":"Row 5","heading":"Policy Coverage (What the Policy Covers)","page":1,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/13#c-row-5"}],"law":[]},{"key":"payout","label":"Payout","section":"Cover","meaning":"Lump sum on diagnosis, staged payouts by severity, or reimbursement.","status":"cross-checked","value":"A lump sum Critical Illness Benefit, as specified in the policy schedule, on diagnosis of a listed critical illness if the insured survives 30 days.","display":"Lump sum Critical Illness Benefit on diagnosis","note":"Joint Replacement is paid at the sum insured or 5 Lacs, whichever is lower, once in a lifetime.","quote":"if the Insured survives for a minimum of 30 days from the date of diagnosis, the Company shall pay a lump sum Critical Illness Benefit","sources":[{"clause":"Row 5","heading":"Policy Coverage (What the Policy Covers)","page":1,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/13#c-row-5"}],"law":[]},{"key":"survival_period","label":"Survival period","section":"Waiting periods","meaning":"Days you must survive after diagnosis before the money is paid.","status":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":null,"quote":"if the Insured survives for a minimum of 30 days from the date of diagnosis, the Company shall pay a Critical Illness Benefit","sources":[{"clause":"Section C","heading":"COVERAGE","page":6,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-section-c"}],"law":[]},{"key":"multiple_claims","label":"Multiple claims","section":"Cover","meaning":"Whether you can claim for more than one illness.","status":"cross-checked","value":"No, except after Joint Replacement. The policy ceases for an insured once a Critical Illness occurs; if the first claim is Joint Replacement, cover continues for the remaining illnesses with the sum insured reduced by the amount paid, and the policy ceases after the next claim.","display":"One claim per insured, except a Joint Replacement claim first","note":null,"quote":"upon the occurrence of an event of Critical Illness and (subject to the terms, conditions and exclusions of this Policy) without prejudice to the Company’s obligation to make payment, this Policy shall immediately cease to exist with reference to that Insured. ... If the first claim payable is of Joint Replacement, then the liability for any subsequent claim for the remaining listed critical illnesses (other than Joint Replacement) will be reduced by the amount paid under Joint Replacement benefit, post which the policy would cease.","sources":[{"clause":"Section E(vi)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-section-e-vi"},{"clause":"Section E(vii)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-section-e-vii"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing conditions","section":"Waiting periods","meaning":"Whether an illness you already had can ever be claimed: after a waiting period, or never.","status":"quote-verified","value":"Never. Any critical illness that was treated or advised, first manifested or was contracted before the start of the Policy Period is excluded, with no waiting period after which it becomes covered.","display":"Never covered: a critical illness that began or was treated before the policy started is excluded","note":"Listed among the Specific Exclusions, with no time limit.","quote":"Any Critical Illness for which care, treatment, or advice was recommended by or received from a Physician, or which first manifested itself or was contracted before the start of the Policy Period, or for which a claim has or could have been made under any earlier policy.","sources":[{"clause":"1","heading":null,"page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14#c-1-4"}],"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"}]}],"documents":[{"kind":"wording","label":"Critical Illness Policy Wordings","pages":15,"fetched_at":"2026-10-16 04:47:34.012753+00","source_url":"https://www.bajajgeneralinsurance.com/download-documents/health-insurance/Health-PW/Critical-Illness_PW.pdf","url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/14"},{"kind":"cis","label":"Critical Illness Customer Information Sheet","pages":4,"fetched_at":"2026-10-16 04:47:32.535872+00","source_url":"https://www.bajajgeneralinsurance.com/download-documents/health-insurance/Health-CIS/Critical-Illness_CIS.pdf","url":"https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223/document/13"}],"versions":[{"uin":"BAJHLIP21117V022021","version":null,"approved_on":null},{"uin":"BAJHLIP23208V032223","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":"Critical Illness (UIN BAJHLIP23208V032223), IndiaInsurances, https://indiainsurances.com/policy/bajaj-general-insurance/critical-illness-bajhlip23208v032223"}