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Bharti AXA Health Insurance

Bharti AXA General Insurance Company Ltd. (IRDA Reg. No 139) are renowned insurance vendors with a loyal fan following accumulated since the time of its inception - August 2008. Bharti Enterprises is an Indian conglomerate that is quite a stalwart in its own respect, with presence in various parts of the world.

Bharti AXA is a joint venture, and Bharti AXA health insurance plans are very popular in India.

AXA is a global name in wealth management and financial protection. A significant achievement of this brand is that Bharti AXA is known for the high quality products and customer relationship services they offer. Bharti AXA health insurance arm boasts of a simple claims process, which is one of the main reasons for customers’ gratification. They have ‘smart’ policies that claim to be smart and simple, and suit anyone just as easily.

Features of Bharti AXA Health Insurance

  • Lifelong renewable – The plan covers you for your entire lifetime and you can renew them lifelong.
  • Room Rent- The plan offers unlimited room rent on certain health plans.
  • Pre & Post hospitalization cover- The plan covers medical expenses for 30days prior to hospitalization and 60 days post hospitalization only for related medical expenses.
  • Health Check-ups – The policy offers 1% of the sum insured after every 4 claim-free years for free health check-up.
  • Pre-existing diseases- Pre-existing diseases are covered after 4 years of policy issuance.

Benefits of buying Health Insurance from Bharti AXA

  • Competitively priced products
  • Industry first services like dedicated claims handlers and 48 hour fund release
  • Offers great deductions on premium

Products offered by Bharti AXA Health Insurance

Bharti AXA SmartHealth Basic Policy

Individual Cover

As the name suggests, SmartHealth Basic offers the most basic coverage in case of hospitalization.

  • This plan offers basic health coverage of Rs.2 lakh; Rs.3 lakh and Rs.5 lakh for individuals between 2 years and 65 years can be covered under this policy.
  • Pre and post hospitalization expenses, coverage for day care procedures, no-claim bonus, daily cash, coverage for domiciliary treatment(treatment at home because of lack of accommodation),etc. are the benefits offered in this plan.
  • There is one variant of this plan available which offers wider coverage.

Family Floater

Under family floater coverage the Smart Health Plan all the family members are covered on a shared basis as follows:

  • Coverage offered in the range of Rs.2 lakh; Rs.3 lakh and Rs.5 lakh
  • A maximum of two adults including the policy holder, spouse up to age 65 years and 2 dependent children between age 3 months and 23 years can be covered under this plan.

Note: For both the individual and family floater coverage this plan has sub-limits (limits for coverage for room rent, ICU/CCU rent, etc.).

Bharti AXA SmartHealth Premium Policy

Individual Cover

The SmartHealth Premium is the advanced variant of SmartHealth Basic plan which offers additional benefits upon hospitalization.

  • This plan offers health coverage of Rs.3 lakh for individuals between age 2 years and 55 years.
  • Compared to basic plan this plan has additional benefits like pre and post hospitalization expenses coverage for a longer period, higher daily cash allowance for longer period of time, higher coverage limit for domiciliary treatment and room rent or ICU/ CCU rent,etc.
  • In addition to the basic plan this plan provides daily allowance for accompanying person.

Family Floater

The family floater option covers the entire family on a shared basis.

  • Coverage of Rs.3 lakh is available in this plan.
  • A maximum of two adults including the policy holder, spouse up to age 55 years and 2 dependent children between age 3 months and 23 years can be covered under this plan.

Note: The sub-limits applicable for both individual and family floater covers larger expenses when compared to the basic plan. Bharti AXA SmartHealth Optimum Policy

Individual Plan

The SmartHealth Optimum is the most advanced variant of SmartHealth plan which offers benefits like additional coverage upon diagnosis of critical illness and dread disease recuperation benefit along with the benefits offered in the other two variants.

  • This plan offers health coverage of Rs.4 lakh and Rs.5 lakh for individuals between 2 years and 45 years.
  • Compared to the other two variants, the benefits under this plan are larger. This plan also offers additional lump-sum expense upon diagnosis of critical illnesses.

Family Floater

All the benefits offered under SmartHealth Optimum are available on shared basis for the entire family.

  • Coverage of Rs.4 lakh and Rs.5 lakh is available under this variant.
  • A maximum of two adults including the policy holder, spouse up to age 45 years and 2 dependent children between age 3 months and 23 years can be covered under this plan.

Note: This plan does not have any sub-limits on room rent expenses.

Bharti AXA SmartHealth Critical Illness Insurance

SmartHealth Critical illness policy is a benefit plan which offers lump-sum benefit after diagnosis of critical illness.

  • This plan offers coverage in case of critical illness in the range of Rs.2 lakh and Rs.5 lakh for individuals between age 5 years and 55 years.
  • Coverage is offered in two sections:
  • Section 1- Provides reimbursement or payment of treatment expenses along with benefits like hospital daily cash allowance, education expense of children, etc. in case of critical illness.
  • Section 2- Provides compensation equal to 100% of sum insured in case of 30 days survival post diagnosis of critical illness.

Personal Accident cover- Superior Plan

This is personal accident disability plan available online. It is available for occupation risk group 1 and occupation risk group 2 only.

  • This plan offers coverage in case of any accident it only covers individuals between age 18 years and age 65 years and in occupation Group 1 and occupation Group 2 (Group 1- administrative functions like accountants, banker, etc. Group 2- Builders sportsmen, etc.)
  • It offers benefits like:
  • Compensation in the range of Rs.10 lakh and Rs.30 lakh death due to accident.
  • Compensation in the range of and of Rs.15 lakh and Rs.45 lakh in case of permanent total disability and in the range of 2 % -75 % of principle sum insured in case of permanent partial disability.
  • Coverage for expenses medical for medical treatment post an accident, hospital cash and double indemnity in case of death due to accident are some of the additional coverage available as add-on benefit.

**SmartIndividual Personal Accident Insurance

The SmartIndividual personal accident plan is a highly customized personal accident disability plan with 7 different coverage options, offered by Bharti AXA.

  • This policy offers coverage in case of any accident for individuals between age 18 years and 70 years.
  • This plan offers a no-claim bonus for accidental death cover and permanent total or permanent partial disability cover.
  • The optional covers offered under the policy include daily cash allowance, accidental medical expenses, double indemnity for death or partial total disability and coverage for legal expenses in case of accidents.
  • There are 7 variations of this plan, individual benefits for each of them is given below.

Note: In this plan, individuals are categorized into three groups (based on the nature of the job.

Smart Individual Personal Accident Basic

This is basic of all the SmartIndividual personal accident plans. It offers compensation:

  • of Rs.2 lakh in case of death due to accident.
  • of Rs.3 lakh in case of permanent total disability .
  • equal to % of indemnity coverage (specified in the policy) for permanent partial disability .
  • equal to Rs.10,000 as education grant for dependent children up to 23 years.
  • up to 1% of accidental death sum insured to cover expenses during transportation of mortal remains.

SmartIndividual Personal Accident Regular

In addition to benefits offered under personal accident basic plan,

  • This plan provides 20% of accidental death to offer coverage for medical expense post-accident which is not provided in the basic coverage. SmartIndividual Personal Accident Standard- without medical expenses
  • This plan offers accidental death cover of Rs.5 lakh and permanent total disability cover of Rs.7,50,000
  • In addition to both of the above plans, this plan would provide benefits like legal expense cover, daily cash during hospitalization expense, coverage in case of temporary total disability, etc. are provided in this plan.

Note: This plan does not cover medical expenses.

SmartIndividual Personal Accident Standard- Covers All the Medical Expenses

  • In addition to coverage offered in the above plan this plan covers funereal expenses up to Rs.2,000 and accidental medical expenses up to 20 % of accidental death. Smart Individual Personal Accident Silver
  • This plan is available only for individuals in occupation risk Group I and Group II who have monthly income more than Rs.20,000
  • This plan covers accidental death up to Rs.10 lakh and permanent total disability up to Rs.15 lakh. In addition to other plans mentioned above this plan, offers double indemnity (double amount) benefit in case of death or permanent total disability.

SmartIndividual Personal Accident Gold

  • This plan is available only for Group I and Group II individuals having monthly income more than Rs.40, 000.
  • This plan covers accidental death up to Rs.20 lakh and permanent total disability up to Rs.30 lakh. This plan also offers double indemnity benefit in case of death or permanent total disability and has higher coverage extent for temporary total disability.

Note: This plan is applicable if the minimum monthly income is Rs. 40,000 and for occupation groups I and II.

SmartIndividual Personal Accident Superior

  • This plan gives privilege to its customers to choose the limit of coverage. As individual personal accident is available for all the three risk groups, anyone can opt this plan. Know more about SmartIndividual Personal Accident plan, contact Coverfox.

Claims Process at Bharti AXA Health Insurance

There are two ways to make claim under a Health Insurance Policy: on cashless basis and on reimbursement basis. In simple terms, for making a claim on cashless basis, the treatment must be done only at a network hospital of the insurance company servicing your policy. For availing the treatment, you would have to first seek an authorization as per the procedures laid down and in the prescribed form. In case of claims on reimbursement basis, the insurance company has to be informed as per their prescribed procedures. The policyholder has to ensure that documents such as claim form, discharge summary, prescriptions and bills to be submitted for the claim on reimbursement are obtained after hospitalization.

Bharti AXA Health Insurance has a well-defined claim processing system.

Planned Hospitalization: Intimation for hospitalization to be given 48hrs prior to hospitalization

Emergency Hospitalization: Intimation for hospitalization to be given within 24hrs from the time of hospitalization

Claim Process Contact Details:

Phone Number: 1800-103-2292 (Toll Free – 24*7 Number) or SMS – “CLAIM” to 5667700 (Registered Phone No.)

Email ID: claims@bharti-AXAgi.com or TPA

Cashless Claim

For ease of claim, we have tied up with the two main Health claims handlers- Paramount and Emeditek

Step 1: Emergency treatment at our Cashless network

  • Find the closest cashless hospital using our hospital locator.
  • Proceed to the admission with your health ID card
  • Ask the hospital to fill up the claims cashless request form and submit it to the insurance help desk at the hospital or fax it to the number indicated in the form.
  • TPA will issue an authorization letter for the coverage as per the policy to the network hospital.
  • We will settle the bill directly with the hospital.
  • If the treatment is not covered under your policy, a letter will be sent along with the reasons for rejection.

Step 2: Planned treatment at our Cashless network

  • 4 days prior to the treatment, fill up the claims cashless request form and submit it to the insurance help desk at the hospital or fax it to the number indicated in the form.
  • We will notify you and the hospital within 6 hours on receiving the request via email and SMS.
  • Proceed to the admission on the day of the treatment with your Health card ID and the confirmation letter from us.
  • We will settle directly the bill with the hospital.
  • If the treatment is not covered under your policy, a letter will be sent along with the reasons for rejection.

Step 3: If the treatment is not covered under the policy

  • You can get treatment at our network hospitals.
  • All bills are to be paid by you and original documents need to be obtained from the hospital.
  • Submit the original and necessary documents to us along with the Claim form.
  • We will review the documents and effect payment within 21 days of receiving the complete documents. If the claim is rejected, a letter will be sent along with the reasons for rejection.

Re-imbursement Claim

Step 1: Reimbursement for treatment done outside our panel

  • In the case of admission done outside our network hospital, intimate within 48 hrs of admission to the phone number provided on the claim form or mail us the details to the email id mentioned in the claim form.
  • You can then proceed with your treatment and pay the bill.
  • Get all the original documents from the hospital.

Furnish the following list of the documents to Bharti AXA – Health Claims (Head Office, Bangalore) / TPA:

  1. Claim form with duly signed by insured (Part I) and treating doctor (Part II)
  2. Original discharge summary
  3. Original final bill with receipt & detailed break up towards the final bill (item wise/cost wise)
  4. Original lab reports with advice for investigation undergone from the treating doctor (Doctor Prescription/Consultation)
  5. A letter from treating consultant stating past history if any with duration of the said ailment
  6. A letter from the treating consultant stating details of accident and initial assessment- alcohol intoxication if any, (if the case of injury or accident) with MLC COPY / FIR copy in case of RTA/any injury/assault/poisoning etc.
  7. 1st consultation paper before the admission, if any
  8. Hospital registration certificate if the hospital is in non-network/remote location
  9. A letter from insured stating reason for delay in submission of claim documents. (If delay more than 30 days after the discharge)
  10. Policy copy/Health ID card/ Health TPA ID card with ID proof & Address proof for patient & proposer
  11. Cancelled cheque for Electronic fund transfer in the name of proposer

We will review the documents and effect the payment within 21 days of receiving the complete documents. If the treatment claimed is not covered under your plan, a letter will be sent along with the reasons for rejection.

Step 2: If the treatment is not covered under the policy

  • All bills are to be paid by you and original documents need to be obtained from the hospital.
  • Submit the original and necessary documents to us along with the Claim form.

We will review the documents and effect payment within 21 days of receiving the complete documents. If the claim is rejected, a letter will be sent along with the reasons for rejection.

Claim Assistance

Cashless Hospital Network

Your health insurance at Bharti AXA offers you cashless servicing across India. Find the nearest hospital by selecting location. To download Bharti AXA General Insurance cashless hospital list across TPAs, please View Cashless Network Hospital List Download Health Insurance Cashless Claim Form: Claim Form to download Download Health Insurance Reimbursement Claim Form: Claim Form to download Download Health Insurance Pre-Authorization Form: Pre-Auth Form to download

Review of Bharti AXA Health Insurance

With competitively priced products and inspiring features, Bharti AXA is one of the Top Ten insurance companies in India. Their Triple Health Insurance Plan for Critical Illness offers coverage against as many as 13 critical illnesses.

However, a waiting period of 4 years clubbed with lack of any No Claim Bonus for claim free years is a bit impediment. Largely, if you are in quest of an insurer who believes in persistent innovation clubbed with pragmatism and professionalism, Bharti AXA undoubtedly notches some brownie points. Call Coverfox at 1800-209-9920 to help you choose the best plan for you.

Bharti Axa Health Insurance