{"uin":"BAJHLIP27080V012627","name":"My Swasthya Care","url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627","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":"My Swasthya Care is a 1 year individual wellness policy from Bajaj General for ages 18 to 65 that arranges services on a cashless basis only through the Service Provider's app and pays no hospital bills. Each Policy Year it gives 1 Annual Health Check-up, 1 specialist and 3 GP tele consultations, any 2 lab test profiles, 6 diet consultations and 4 face scans, with no waiting period for pre-existing disease, within India only.","analysis":{"state":"extracted","analysed_at":"2026-10-16 08:29:40.716475+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":"cross-checked","value":["Individual Policy"],"display":"Individual Policy only","note":"One plan; no named variants are printed. From the prospectus.","quote":"What type of plans are available? Individual Policy","sources":[{"clause":null,"heading":null,"page":1,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/301#c-s1"}],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"cross-checked","value":"1 year.","display":"1 year","note":"From the prospectus. The wording's cancellation clause also describes multi-year policies, but only a 1 year tenure is offered.","quote":"What is the Policy Tenure available? 1 Year","sources":[{"clause":null,"heading":null,"page":1,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/301#c-s1"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"not-stated","value":null,"display":null,"note":"No intimation deadline is printed. Benefits are booked by scheduling an appointment through the Company's app.","quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":"No claim document list. The wording only says the insurer reserves rights for asking additional documents related to claims.","quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":"No settlement timeline is printed; services are availed cashless through the app.","quote":null,"sources":[],"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":["Obesity/Weight Control (Code-Excl06)","Breach of law (Code-Excl10)","Excluded Providers (Code-Excl11)","Treatment for Alcoholism, drug or substance abuse or any addictive condition (Excl12)","Treatments received in health hydros, nature cure clinics, spas or similar establishments (Code-Excl13)","Dietary supplements and substances that can be purchased without prescription (Code-Excl14)","Unproven Treatments (Code-Excl16)","Treatment or other healthcare expenses arising from the results of the Annual Health Check-up","In-clinic/physical consultation","Reimbursement of expenses incurred for teleconsultation benefit","Medicines, diagnostics, procedures or other treatment advised during teleconsultation","Any lab tests other than those specified in the list","Consultation, treatment, hospitalization, medicines, procedures, or follow-up medical expenses arising from the laboratory findings","Cost of food items, nutritional supplements, vitamins, meal replacement products, or health foods","Cost of wearable devices, smartphones, fitness bands, smartwatches, or related accessories"],"display":"Excl06, Excl10, Excl11, Excl12, Excl13, Excl14, Excl16 and benefit-specific exclusions (no treatment arising from check-ups, lab tests or tele consultations)","note":"There are no waiting-period exclusions: no waiting period applies for Pre-Existing Disease or Specific Disease/ Procedure. Exclusions are also printed against each benefit (check-up, tele consultation, lab tests, diet, face scan, AI models, fitness videos, step tracker, health insight).","quote":"Obesity/Weight Control (Code-Excl06) ... Breach of law (Code-Excl10) ... Excluded Providers (Code-Excl11) ... Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. ... Excl12 ... Treatments received in health hydros, nature cure clinics, spas or similar establishments ... (Code-Excl13) ... Dietary supplements and substances that can be purchased without prescription ... (Code-Excl14) ... Unproven Treatments (Code-Excl16) ... consultation, medication, Medical Treatment, procedure or other healthcare expenses arising from the results of the Annual Health Check-up ... In-clinic/physical consultation is not covered under this cover of Policy. ... Reimbursement of expenses incurred for teleconsultation benefit is excluded. ... medicines, diagnostics, procedures or other treatment advised during teleconsultation are not covered ... Any lab tests other than those specified in above list. ... Consultation, treatment, hospitalization, medicines, procedures, or follow-up medical expenses arising from the laboratory findings ... Cost of food items, nutritional supplements, vitamins, meal replacement products, or health foods. ... Cost of wearable devices, smartphones, fitness bands, smartwatches, or related accessories.","sources":[{"clause":"1","heading":"Obesity/Weight Control (Code-Excl06)","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-1-4"},{"clause":"2","heading":"Breach of law (Code-Excl10)","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-2-4"},{"clause":"3","heading":"Excluded Providers (Code-Excl11)","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-3-4"},{"clause":"4","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-4-4"},{"clause":"Excl12","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-excl12"},{"clause":"5","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-5-4"},{"clause":"6","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-6-4"},{"clause":"7","heading":"Unproven Treatments (Code-Excl16)","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-7-4"},{"clause":"1","heading":"Annual Health Check-up (AHC)","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-1-3"},{"clause":"2","heading":"Tele Consultation (Specialist and General Practitioner/Internal Medicine)","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-2-3"},{"clause":"3","heading":"Lab Test (Profile)","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-3-3"},{"clause":"4","heading":"Diet Consultations","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-4-3"},{"clause":"8","heading":"Step Tracker","page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-8-3"}],"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":"Level 1: Customer Experience Team (toll free 1800 209 5858, careforyou@bajajgeneral.com); Level 2: Grievance Redressal Officer at ggro@bajajgeneral.com; Level 3: missed call on +91 80809 45060 or SMS 575758, then Head of Customer experience; then the Insurance Ombudsman.","display":"Customer Experience Team, then Grievance Redressal Officer (ggro@bajajgeneral.com), then Head of Customer experience","note":"Senior citizens: 1800-103-2529 or seniorcitizen@bajajgeneral.com. The CIS adds WhatsApp +91 7507245858 and 020-30305858.","quote":"Level 1 In case you have any concern, you may please reach out to our Customer Experience Team through any of the following options: ... Call us on our Toll free no 1800 209 5858 ... Mail us on careforyou@bajajgeneral.com ... Level 2 In case you are not satisfied with the response given to you by our team, you may write to our Grievance Redressal Officer at ggro@bajajgeneral.com ... Level 3 If in case, your grievance is not resolved and you wish to talk to our care specialist, please Give a missed on +91 80809 45060 OR SMS to 575758 ... write to Head of Customer experience direc head.customerservice@bajajgeneral.com ... you may approach the Insurance Ombud established by the Central Government","sources":[{"clause":"8","heading":"Redressal of Grievance","page":14,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-8-4"}],"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":"CIS says 'Kindly refer to Your Policy schedule/Certificate of Insurance'. Benefits are fixed service counts (sessions, tests, scans) rather than a rupee amount.","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":"not-stated","value":null,"display":null,"note":"Not mentioned. The documents say there is no waiting period for pre-existing disease or specific disease/procedure, but do not address an initial waiting period.","quote":null,"sources":[],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"cross-checked","value":{"unit":"months","amount":0},"display":"None","note":"Same in the prospectus and CIS.","quote":"No waiting period applicable for Pre-Existing Disease or Specific Disease/ Procedure under this policy.","sources":[{"clause":"Section D","heading":"WAITING PERIOD AND EXCLUSIONS - STANDARD EXCLUSIONS","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-section-d"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"cross-checked","value":{"unit":"months","amount":0},"display":"None","note":"The standard definition of Specific Waiting Period (up to 24 months) is printed but the product applies none.","quote":"No waiting period applicable for Pre-Existing Disease or Specific Disease/ Procedure under this policy.","sources":[{"clause":"Section D","heading":"WAITING PERIOD AND EXCLUSIONS - STANDARD EXCLUSIONS","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-section-d"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"cross-checked","value":["None: no waiting period applicable for Specific Disease/ Procedure"],"display":"None","note":"No illness carries a specific waiting period.","quote":"No waiting period applicable for Pre-Existing Disease or Specific Disease/ Procedure under this policy.","sources":[{"clause":"Section D","heading":"WAITING PERIOD AND EXCLUSIONS - STANDARD EXCLUSIONS","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-section-d"}],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"not-stated","value":null,"display":null,"note":"The renewal clause refers to conditions stated at 'Moratorium Period', but no moratorium clause or period is printed.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"not-stated","value":null,"display":null,"note":"Only the free-look clause mentions 'Porting the Policy'; no portability clause is printed.","quote":null,"sources":[],"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","note":"From the prospectus. The wording says renewal is not denied except for established fraud, non-disclosure or misrepresentation, provided the product is not withdrawn.","quote":"Under normal circumstances, lifetime renewal benefit is available under the policy except on the grounds of fraud, misrepresentation or moral hazard.","sources":[{"clause":null,"heading":null,"page":1,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/301#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":"cross-checked","value":"No. Renewal loadings are at portfolio level and not based on your own claims; a discount may be given for good claims experience.","display":"No, loadings are portfolio-wide, not claim-based","note":null,"quote":"For this policy, the loadings on Renewal premium shall be at portfolio and not based upon any individual policy claim experience. However, discount in premium may be provided by Us to You for good claims experience.","sources":[{"clause":"3(iv)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-3-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":["Obesity/Weight Control (Code-Excl06)","Breach of law (Code-Excl10)","Excluded Providers (Code-Excl11)","Treatment for Alcoholism, drug or substance abuse or any addictive condition (Excl12)","Treatments received in health hydros, nature cure clinics, spas or similar establishments (Code-Excl13)","Dietary supplements and substances that can be purchased without prescription (Code-Excl14)","Unproven Treatments (Code-Excl16)","In-clinic/physical consultation","Reimbursement of expenses incurred for teleconsultation benefit","Any lab tests other than those specified in the list","Cost of food items, nutritional supplements, vitamins, meal replacement products, or health foods","In-patient dietary management or Hospital-based nutrition services","Purchase or rental or maintenance of exercise equipment, fitness equipment, devices, or accessories","Cost of wearable devices, smartphones, fitness bands, smartwatches, or related accessories"],"display":"Excl06, Excl10, Excl11, Excl12, Excl13, Excl14, Excl16 and benefit-specific exclusions","note":"In the wording the Excl12 code is printed as a separate fragment after the alcoholism text.","quote":"Obesity/Weight Control (Code-Excl06) ... Breach of law (Code-Excl10) ... Excluded Providers (Code-Excl11) ... Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. ... Excl12 ... Treatments received in health hydros, nature cure clinics, spas or similar establishments ... (Code-Excl13) ... Dietary supplements and substances that can be purchased without prescription ... (Code-Excl14) ... Unproven Treatments (Code-Excl16) ... In-clinic/physical consultation is not covered under this cover of Policy. ... Reimbursement of expenses incurred for teleconsultation benefit is excluded. ... Any lab tests other than those specified in above list. ... Cost of food items, nutritional supplements, vitamins, meal replacement products, or health foods. ... In-patient dietary management or Hospital-based nutrition services. ... Purchase or rental or maintenance of exercise equipment, fitness equipment, devices, or accessories. ... Cost of wearable devices, smartphones, fitness bands, smartwatches, or related accessories.","sources":[{"clause":"1","heading":"Obesity/Weight Control (Code-Excl06)","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-1-4"},{"clause":"2","heading":"Breach of law (Code-Excl10)","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-2-4"},{"clause":"3","heading":"Excluded Providers (Code-Excl11)","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-3-4"},{"clause":"4","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-4-4"},{"clause":"Excl12","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-excl12"},{"clause":"5","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-5-4"},{"clause":"6","heading":null,"page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-6-4"},{"clause":"7","heading":"Unproven Treatments (Code-Excl16)","page":12,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-7-4"},{"clause":"2","heading":"Tele Consultation (Specialist and General Practitioner/Internal Medicine)","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-2-3"},{"clause":"3","heading":"Lab Test (Profile)","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-3-3"},{"clause":"4","heading":"Diet Consultations","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-4-3"},{"clause":"7","heading":"Fitness Videos Access","page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-7-3"},{"clause":"8","heading":"Step Tracker","page":11,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-8-3"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"cross-checked","value":"On 7 days' written notice, a pro-rata refund of premium for the unexpired period, provided no claim has been made during the Policy Year; medical examination expenses are deducted once risk has commenced.","display":"Pro-rata refund for the unexpired period if no claim in the Policy Year","note":"Same pro-rata rule for instalment premiums. Refund delayed beyond 7 days carries interest at 2% above the bank rate. Clause E9 also deducts stamp duty. The documents do not say what is refunded if a claim was made.","quote":"The Insured/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. ... expenses incurred by the Company on medical examination of the Insured Persons will also be deducted before refunding of premium. ... In case of any delay in refund of premium beyond stipulated 7 days, the Company shall refund such amounts along with interest, at a rate 2% above the bank rate ... expenses incurred by the Company on medical examination of the Insured Beneficiary and the stamp duty charge will also be deducted before refund of premium to Insured.","sources":[{"clause":"4","heading":"Cancellation","page":13,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-4-5"},{"clause":"9","heading":"Deductions in case of cancellation/return of Policy","page":16,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-9-5"}],"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 only.","display":"India only","note":"Only Indian nationals residing in India are considered for the policy.","quote":"Our liability to make available any benefit or make any payment under this Policy shall be within India and in Indian Rupees only.","sources":[{"clause":"7","heading":"Territorial Jurisdiction and Territorial Limit","page":16,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-7-6"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":"At inception only, not on renewal or porting. Refund less medical examination and stamp duty charges. CIS says 'up to 30 days from the first inception of policy'.","quote":"The Insured Person shall be allowed a 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":"9","heading":"Free Look Period","page":15,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-9-4"},{"clause":null,"heading":null,"page":1,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/302#c-s1"}],"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":"The Grace Period definition says fifteen days where premium payment mode is monthly and thirty days in all other cases.","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.","sources":[{"clause":"3(iii)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-3-iii"},{"clause":"12","heading":"Grace Period","page":2,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-12"}],"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":"18 to 65 years.","display":"18 to 65 years","note":"From the prospectus; the wording does not state entry ages.","quote":"What is the entry age eligibility under the policy? 18 Years to 65 Years","sources":[{"clause":null,"heading":null,"page":1,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/301#c-s1"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"not-stated","value":null,"display":null,"note":"The cancellation clause mentions full premium at inception and premium received on instalment basis, but no payment frequencies are listed.","quote":null,"sources":[],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"not-stated","value":null,"display":null,"note":"No optional covers are mentioned.","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":"cross-checked","value":"No cover during a grace period for which no premium is received, except that cover continues during the grace period when premium is paid in instalments.","display":"Not covered, unless premium is paid in instalments","note":"From the Grace Period definition.","quote":"Coverage need not be available during the period for which no premium is received. ... Provided the insurers shall offer coverage during the grace period, if the premium is paid in instalments during the Policy Period.","sources":[{"clause":"12","heading":"Grace Period","page":2,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-12"}],"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-applicable","value":null,"display":null,"note":"The policy only arranges wellness, tele consultation, lab test and diet services on a cashless basis through the Service Provider's app; it pays no hospitalisation or treatment bills, so this cannot apply.","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-applicable","value":null,"display":null,"note":"The policy only arranges wellness, tele consultation, lab test and diet services on a cashless basis through the Service Provider's app; it pays no hospitalisation or treatment bills, so this cannot apply.","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-applicable","value":null,"display":null,"note":"The policy only arranges wellness, tele consultation, lab test and diet services on a cashless basis through the Service Provider's app; it pays no hospitalisation or treatment bills, so this cannot apply.","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-applicable","value":null,"display":null,"note":"The policy only arranges wellness, tele consultation, lab test and diet services on a cashless basis through the Service Provider's app; it pays no hospitalisation or treatment bills, so this cannot apply.","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":"CIS: 'The policy will pay as per the limits specified in the Certificate of Insurance.' Services are cashless through the Service Provider.","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":"CIS: 'The policy will pay as per the limits specified in the Certificate of Insurance.'","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-applicable","value":null,"display":null,"note":"The policy only arranges listed wellness services (annual health check-up, tele consultations, lab test profiles, diet consultations and digital tools) on a cashless basis; it pays no hospital or treatment bills. The CIS says 'The policy will pay as per the limits specified in the Certificate of Insurance.'","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-applicable","value":null,"display":null,"note":"The policy only arranges wellness, tele consultation, lab test and diet services on a cashless basis through the Service Provider's app; it pays no hospitalisation or treatment bills, so this cannot apply.","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-applicable","value":null,"display":null,"note":"The policy only arranges wellness, tele consultation, lab test and diet services on a cashless basis through the Service Provider's app; it pays no hospitalisation or treatment bills, so this cannot apply.","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-applicable","value":null,"display":null,"note":"The policy only arranges wellness, tele consultation, lab test and diet services on a cashless basis through the Service Provider's app; it pays no hospitalisation or treatment bills, so this cannot apply.","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-applicable","value":null,"display":null,"note":"The policy only arranges wellness, tele consultation, lab test and diet services on a cashless basis through the Service Provider's app; it pays no hospitalisation or treatment bills, so this cannot apply.","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-applicable","value":null,"display":null,"note":"The policy only arranges wellness, tele consultation, lab test and diet services on a cashless basis through the Service Provider's app; it pays no hospitalisation or treatment bills, so this cannot apply.","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-applicable","value":null,"display":null,"note":"The policy only arranges wellness, tele consultation, lab test and diet services on a cashless basis through the Service Provider's app; it pays no hospitalisation or treatment bills, so this cannot apply.","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-applicable","value":null,"display":null,"note":"The policy only arranges wellness, tele consultation, lab test and diet services on a cashless basis through the Service Provider's app; it pays no hospitalisation or treatment bills, so this cannot apply.","quote":null,"sources":[],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"not-applicable","value":null,"display":null,"note":"The policy only arranges wellness, tele consultation, lab test and diet services on a cashless basis through the Service Provider's app; it pays no hospitalisation or treatment bills, so this cannot apply.","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-applicable","value":null,"display":null,"note":"Benefits are fixed service counts per Policy Year (sessions, tests, scans) and no hospitalisation sum insured is paid out, so there is nothing to restore.","quote":null,"sources":[],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"not-stated","value":null,"display":null,"note":"No bonus is described. The withdrawal clause mentions cumulative bonus only as a generic continuity benefit on migration.","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-applicable","value":null,"display":null,"note":"The policy only arranges wellness, tele consultation, lab test and diet services on a cashless basis through the Service Provider's app; it pays no hospitalisation or treatment bills, so this cannot apply.","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-applicable","value":null,"display":null,"note":"The policy only arranges wellness, tele consultation, lab test and diet services on a cashless basis through the Service Provider's app; it pays no hospitalisation or treatment bills, so this cannot apply.","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-applicable","value":null,"display":null,"note":"The policy only arranges wellness, tele consultation, lab test and diet services for an individual Insured Person aged 18 to 65 years on a cashless basis through the Service Provider's app; it pays no hospitalisation or childbirth bills, so newborn cover cannot apply.","quote":null,"sources":[],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"not-applicable","value":null,"display":null,"note":"The policy only arranges wellness, tele consultation, lab test and diet services on a cashless basis through the Service Provider's app; it pays no hospitalisation or treatment bills, so this cannot apply.","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":"cross-checked","value":"Yes: 1 Annual Health Check-up each Policy Year (HbA1c, Total Cholesterol, TSH, Serum Creatinine, SGOT, SGPT), cashless only at the Service Provider's network centres.","display":"Yes, 1 Annual Health Check-up each Policy Year","note":"All tests in a single appointment; unused benefit lapses at the end of the Policy Year. Separately, any 2 Lab Test Profiles per Policy Year are included.","quote":"the Insured Person shall be entitled to get 1 Annual Health Check-up during each Policy Year through the Service Provider’s designated Network Providers. ... CONDITION Test Diabetes HbA1c (%) Lipid Disorder Total Cholesterol (mg/dL) Thyroid Disorder TSH (mIU/L) Kidney Function (KFT) Serum Creatinine (mg/dL) SGOT (AST) (U/L) Liver Function (LFT) SGPT (ALT) (U/L) ... This benefit shall be available on a Cashless basis only through the network centres of our Service Provider.","sources":[{"clause":"1","heading":"Annual Health Check-up (AHC)","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-1-3"}],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"cross-checked","value":"Yes, as services only: 1 Specialist and 3 GP/Internal Medicine tele consultations, any 2 lab test profiles and 6 diet consultation sessions each Policy Year through the Service Provider's platform. In-clinic consultations and reimbursement are not covered.","display":"Tele consultations (1 specialist, 3 GP), 2 lab test profiles, 6 diet sessions a year","note":"Medicines, diagnostics or treatment advised during tele consultation are not covered. Unused sessions lapse at the end of the Policy Year. Also 4 Smart Face Scans and app features (AI models, fitness videos, step tracker, health insight).","quote":"During each Policy Year, the Insured Person shall be entitled to 1 Specialist Tele Consultation and 3 General Practitioner (GP)/Internal Medicine Tele Consultations ... In-clinic/physical consultation is not covered under this cover of Policy. ... Reimbursement of expenses incurred for teleconsultation benefit is excluded. ... medicines, diagnostics, procedures or other treatment advised during teleconsultation are not covered ... During each Policy Year, the Insured Person shall be entitled to avail any 2 Lab Test Profiles ... The Insured Person shall be entitled to 6 Diet Consultation sessions during each Policy Year ... The Insured Person may voluntarily access 4 Face Scan","sources":[{"clause":"2","heading":"Tele Consultation (Specialist and General Practitioner/Internal Medicine)","page":8,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-2-3"},{"clause":"3","heading":"Lab Test (Profile)","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-3-3"},{"clause":"4","heading":"Diet Consultations","page":9,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-4-3"},{"clause":"5","heading":"Smart Face Scan","page":10,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-5-3"}],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"not-stated","value":null,"display":null,"note":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":"cross-checked","value":"Cashless only: services are availed through the Company's and/or Service Provider's digital platform and empanelled network.","display":"Cashless only, through the app and Service Provider network","note":"Subject to availability of the network healthcare provider or service partner. Reimbursement of teleconsultation expenses is excluded.","quote":"the Insured Person(s) shall be entitled to avail the services and/or benefits expressly covered under this Policy on Cashless basis only as specified in the Schedule through the Company's and/or Service Provider's digital platform/ application.","sources":[{"clause":"Section C","heading":"SCOPE OF COVER","page":7,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-section-c"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"cross-checked","value":"The insurer arranges the benefits; they are delivered by its Service Provider (not named).","display":"Insurer's Service Provider delivers the services","note":"No TPA is named.","quote":"Our role in relation to such benefit shall, unless expressly stated otherwise in this Policy, be limited to arranging or facilitating access to the benefit through the Service Provider. The actual provision, performance and delivery of the benefit shall be undertaken by the Service Provider.","sources":[{"clause":"10(ii)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300#c-10-ii"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"cross-checked","value":false,"display":"No, individual only","note":"The wording says family members can be covered as separate individual members.","quote":"For the purpose of Individual Policy- includes the Insured Person only (Individual Membership) ... What type of plans are available? Individual Policy","sources":[{"clause":null,"heading":null,"page":1,"url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/301#c-s1"}],"law":[]}],"documents":[{"kind":"wording","label":"My Swasthya Care Policy Wordings","pages":17,"fetched_at":"2026-10-16 08:29:40.545153+00","source_url":"https://www.bajajgeneralinsurance.com/download-documents/health-insurance/wellness-plans/MY-SWASTHYA-CARE_PW.pdf","url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/300"},{"kind":"prospectus","label":"My Swasthya Care PROSPECTUS","pages":11,"fetched_at":"2026-10-16 08:29:40.545153+00","source_url":"https://www.bajajgeneralinsurance.com/download-documents/health-insurance/wellness-plans/MY-SWASTHYA-CARE_PROSPECTUS.pdf","url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/301"},{"kind":"cis","label":"My Swasthya Care CIS","pages":5,"fetched_at":"2026-10-16 08:29:40.545153+00","source_url":"https://www.bajajgeneralinsurance.com/download-documents/health-insurance/wellness-plans/MY-SWASTHYA-CARE_CIS.pdf","url":"https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627/document/302"}],"versions":[],"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":"My Swasthya Care (UIN BAJHLIP27080V012627), IndiaInsurances, https://indiainsurances.com/policy/bajaj-general-insurance/my-swasthya-care-bajhlip27080v012627"}