Baroda Health Bank of Baroda Helth Insturans

Baroda Health

"Baroda Health" (Mediclaim Insurance Policy) for Bank’s Account holders.

With a view to offer value added services to our customers, we have developed a co-branded insurance product called as "BarodaHealth" (Mediclaim Insurance Policy) for Bank's Account holders w.e.f. 23rd February 2006 available at all our branches across the country.

What is Baroda Health Policy?

It is a Medical Insurance Scheme, available only to account holders of our Bank, which takes care of the hospitalization expenses incurred by the customer up to the amount of sum insured, in respect of the following eventualities.

• Any illness / disease
  
  
• Accidental injury and/ or any ailment.
  
  
• Any surgery that is required in respect of any disease or accident that has arisen during the policy period
  
  
• The minimum hospitalization should be for 24 hours

Key Benefits :

• Very low premium
  
  
• In this co-branded product, single premium (generally payable for a single person) is payable and Medical Health insurance cover is available to family of -4- (self, spouse and 2 dependent children) up to the amount insured without any additional premium.
  
  
• A member or all the members in insured family can avail hospitalization benefits during the policy period, to the extent of aggregate sum not exceeding the sum insured.
  
  
• Premium paid is eligible for Income Tax exemption under Section 80 D as per Income Tax Rules.

Salient features:

• No medical examination required for commencement of health cover.
  
  
• Pre-existing diseases also get coverage after 3 continuous claim-free policy years.
  
  
• Coverage options available: 8 slabs ranging from Rs. 50,000/- to Rs. 5,00,000/- per family of 1+3.
  
  
• Upper age limit of primary member (first named person) is allowed upto 80 years, if a person obtains the insurance cover before completion of 65 years and continue to renew the policy upto the age he wishes to or 80 years, whichever is earlier.
  
  
• The scheme is administered through Third Party Administrators (TPAs) for settlement of Hospitalization Claims under the insurance cover.
  
  
• The insured individuals get cashless hospitalization facility also in the selected hospitals through TPAs. The whole process is hassle-free and treatment upto the limit of insurance is available without any payment at the time of admission or discharge. Payment of hospital bill up to the sum insured will be taken care of by the TPA directly.

Scope of cover:

• Room, Boarding expenses as provided by the Hospital / Nursing Home.
  
  
• Nursing expenses.
  
  
• Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Fees.
  
  
• Anaesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical appliances, Medicines & Drugs, Diagnostic Materials and X-Ray, Dialysis, Chemotherapy, Radiotherapy, Cost of pacemaker, Artificial Limbs and cost of organs and similar expenses.
  
• Additional Covers

Terms and Conditions:

• This policy is available only to account holders of our Bank.
  
  
• Period of insurance cover is one year. The policy needs renewal on or before the expiry date for continuity.
  
  
• The Premium Payable (currently in force).
  
  
  Baroda Health -Premium Payable
  
  (Currently in force including the service tax @ 12.36%)
  
  

  Floater Sum Insured (INR)	Premium up to 65 years (INR)	Premium above 65 years & upto 80 years
  50,000	931	1164
  1,00,000	1748	2185
  1,50,000	2638	3298
  2,00,000	3393	4242
  2,50,000	4063	5079
  3,00,000	4734	5917
  4,00,000	5906	7382
  5,00,000	7079	8848

• The family for this purpose means self, spouse and two dependent children.
• Non-earning son / daughter is considered dependent (scholarship amount is not considered as income). However, Married daughters are not considered dependent.
  
  
• There are certain diseases / expenses which are not covered in the scheme. Kindly check the details of these Major Exclusions
  
• The insured will receive the following documents directly from the insurance co. and TPA
  

  Original Receipt (can be used as proof for claiming IT rebates U/s 80D of Income Tax Act.) Policy TPA guide book Identity Card issued by TPA

• The scheme is administered through Third Party Administrators (TPAs) for settlement of Hospitalization Claims under the insurance cover. Please check details for Claim Procedure
•  

• Baroda Health - Claim Procedure

  Hospital Claims will be settled by the TPA (Third Party Administrators). The details of the claim procedure for emergency / planned hospitalization and the contact phone nos. of TPA’s will be given in the TPA guidebook which the insured will receive directly. The guidebook provides all the details and procedure with regard to lodgment of insurance claim. Insured person as well as his family is eligible either for the cashless treatment and / or reimbursement of claims. Cashless hospitalization service is available through the networked Hospitals / Nursing Homes and is subject to pre admission authorization. The TPA shall, upon getting the related medical information from the insured persons / network hospital, verify that the person is eligible to claim under the policy and after satisfying itself will issue a pre-authorization letter/ guarantee of payment letter to the Hospital / Nursing Home mentioning the sum guaranteed as payable, also the ailment for which the person is seeking to be admitted as a patient.  The TPA reserves the right to deny pre-authorization in case the insured person is unable to provide the relevant medical details as required by the TPA. The TPA will also inform to the insured person that denial of Cashless Access is in no way construed to be denial of treatment.  The insured person may obtain the treatment as per his/her treating doctors advice and later on submit the full claim papers to the TPA for reimbursement.    In the event of any claim to be lodged under the policy, the customer should submit the claim papers as under be directly to the TPA “Third Party Administrators” in accordance with the guidelines incorporated in the guide book. Claim form Discharge Summary Prescription with bills Test Reports Certificate in respect of date of admission and discharge, discharge card etc. Any other documents required by TPA / NICL. The customer should send all claim papers in ORIGINAL In case of any query raised by TPA, it may be responded immediately so that the claim may be settled within reasonable time. The TPA may repudiate the claim, giving reasons, if not covered under the terms of the policy. The insured person shall have right of appeal to the insurance company if he/she feels that the claim is payable. The insurance company’s decision in this regard will be final and binding on TPA.

• The detailed Terms and Conditions as per the insuring company, which policy holder will receive along with the policy documents.
  

How to Apply:

The process is simple. Bank’s customers can download the proposal form, fill up and submit along with the cheque for premium amount to our nearest branch. The cheque should be drawn in favour of ‘National Insurance Co. Ltd.’ For any further details or assistance, please visit our nearest branch.

Disclaimer:
Insurance is the subject matter of solicitation. Bank of Baroda is the Certified Corporate Agent for National Insurance Co. Ltd. and nothing contained on the Website shall constitute or be deemed to constitute an advice, an offer to purchase or an invitation or solicitation to undertake any activity or enter into any transaction relating to the Gen. Insurance Products. Participation by Bank of Baroda customers shall be purely on voluntary basis. The contract of Insurance is between National Insurance Company Ltd.  and the insured, and not between Bank of Baroda and the insured.

Baroda Health - Major Exclusions

Benefits for pre existing diseases will not be available for any condition(s) as defined in the policy until 36 months of continuous Coverage has elapsed since issue of the first policy. Any hospitalization expenses incurred in the first 30 days from the first commencement date of Insurance cover except in case of Injury arising out of accident. During the 1st year of operation of insurance cover the expenses on treatment of diseases such as Cataract, Benign, Prostatic Hypertrophy, and Hysterectomy for Hemorrhagic, or Fibromyoma, Hernia, Hydrocele, congenital internal disease, Fistula in anus, Piles, Sinusitis and related disorders are not payable.These diseases, if pre-existing, will be covered only as per provisions mentioned as above. Circumcision, vaccination or inoculation or change of life or cosmetic or aesthetic treatment of any description, plastic surgery other than as may be necessitated due to an accident or as apart of any illness. Cost of spectacles and contact lenses, hearing aids. Dental treatment or surgery of any kind unless requiring hospitalisation. Convalescence, general debility, run-down condition or rest cure, congenital external disease or defects or anomalies, Sterility, Infertility, Venereal disease, intentional self injury and use of intoxication drugs/alcohol, AIDS. Charges incurred at Hospital or Nursing Home primarily for diagnosis purpose. Expenses on vitamins and tonics unless forming part of treatment for injury or diseases as certified by the attending physician. Treatment arising from or traceable to pregnancy (including voluntary termination of pregnancy) and child birth (including Caesarean Section) and allied maternity benefits. Naturopathy Treatment. The benefits like Cumulative Bonus, health check up including continuity accrued under the previous Policy / Policies, issued by any other Insurance Company shall not be available under this Policy.