This policy provides a top-up health insurance plan that can be purchased with or without an existing base health plan. It covers expenses exceeding the sum insured of the base plan. Key features include coverage for pre-existing diseases after 12 months, maternity benefits, inpatient and daycare treatments, ambulance costs, and tax benefits. Claims are paid over the aggregate deductible amount selected, which the insured pays initially each year before insurer pays remaining claims. Optional air ambulance coverage is also available. Exclusions include experimental treatments, obesity treatment, mental illness, dental treatments, and costs not covered in the policy document.

1. EXTRA CARE PLUS
POLICY

2. WHAT IS IT?
Bajaj Allianz’s Extra Care Plus is a top-up policy that can be added to your existing health
insurance policy or can be taken even without any base health insurance. This policy
comes with a wide range of sum insured options with low premium and is of great help
when your hospital bills exceed your sum insured limit. Apart from the pocket-
friendly feature of this policy, it alters the waiting period of pre-existing diseases to 12
months and has added benefits like air ambulance and maternity complications cover.
This policy works on the basis of aggregate deductible, we only honor the claim once
you have exhausted your aggregate deductible for the rest of the policy year.

3. FEATURES
• Floater option in this policy is not just for children, spouse and proposer, it can be extended to
parents as well.
• The age range in this policy is from 91 days to 80 years.
• Extensive range of sum insured and aggregate deductible options.
• No pre-medical tests required for people up to 55 years of age (subject to no adverse health
declaration on proposal form).
• Waiting period of pre-existing diseases reduced to 12 months.
• In patient hospitalization cover.
• Pre 60 days and post hospitalization 90 days cover.
• Emergency road ambulance along with the option of air ambulance.
• Day care procedures cover as listed in the policy.
• Free health check-up.
• Maternity and its complications are covered.
• Income tax benefit under section 80 D of the IT Act.

4. COVERAGE
Medical expenses
• Expenses incurred towards room/ICU rent and nursing.
• Fees of medical practitioner, surgeon, anesthetists, nurses and specialist doctor.
• Operation theatre charges, anesthesia, surgical appliances, diagnostic tests, medicines,
blood, oxygen and cost of prosthetic and other devices or equipment if implanted
internally like pacemaker during a surgical process.
• Pre and post hospitalization expenses.
Maternity expenses
• The expenses in maternity complications will be indemnified by us over and above the
aggregate deductible limit as specified in the policy.
• Expenses towards lawful termination of pregnancy will be covered.
• Pre and post natal hospitalization expenses will be covered.

5. COVERAGE
Ambulance expenses
• Ambulance expense for taking the insured and the family to and from the hospital
will be covered up to Rupees 3000.
Organ donor expenses
• The money spent on harvesting the organ and the in house hospitalization
expenses of the insured is covered in the policy.

6. OPTIONAL COVER
Air Ambulance
• At an additional premium, Extra Care Policy will also indemnify rapid ambulance
transportation from the site of first occurrence of the illness / accident to the nearest
hospital during the policy period.
Specific Conditions Applicable to Air Ambulance Cover:
• Return transportation to the insured’s home by air ambulance is excluded.
• The air ambulance providers should have a valid license to operate by the government.
• Deductible will not be applied on the claim admissible under air ambulance cover.

7. WHAT IS AN AGGREGATE DEDUCTIBLE?
Aggregate deductible is a component under which the insured bears the claim amount up to
the aggregate deductible amount, after which the insurer pays the remaining claims during the
policy period over and above the aggregate deductible amount as listed on the policy schedule.
For example,
Sum Insured: Rs. 10 Lacs ; Aggregate Deductible Opted: Rs. 2 LacsClaim details Date of
Hospitalisation
Total Claim
Amount(in Rs.
Deductible
Utilization(in
Balance
deductible(in
Rs.)
Payable by
insured(if
any)(in Rs.)
Payable under
Extra Care
PlusPolicy(in
Claim 1 10-Aug-2017 1,50,000 1,50,000 50,000 1,50,000 0
Claim 2 10-Sep-2017 3,00,000 50,000 0 50,000 2,50,000
Claim 3 10-Oct-2017 7,50,000 0 0 0 7,50,000

8. EXCLUSIONS*
• Experimental, unproven or non-standard treatment.
• Weight management services and treatment related to weight reduction programs including
treatment of obesity & treatment arising from direct or indirect complications of obesity.
• Treatment for any mental illness or psychiatric illness, Parkinson’s disease.
• All non-medical Items as per annexure II provided in policy wordings.
• Any treatment received outside India.
• Any medical expenses for the new born baby.
• Dental treatment or surgery of any kind unless it requires hospitalization as a result of
accidental bodily injury to natural teeth.
• War, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war,
commotion, unrest, rebellion, revolution, insurrection, military or usurped power or
confiscation or nationalization or requisition of or damage by or under the order of any
government or public local authority.
• Circumcision unless required for the treatment of illness or accidental bodily injury, cosmetic
or aesthetic treatments of any description, treatment or surgery for change of life/gender.
• Any form of plastic surgery unless necessary for the treatment of cancer, burns or accidental
bodily injury.
*For complete policy terms and condition please go through the policy document.