Bharti AXA Health Insurance

Bharti AXA, known for their high quality products and customer relationship services, are health insurance providers that relieve you of all your health related worries in the times of need.

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

With plans that offer lifetime renewal benefits, room rent on certain plans and coverage of pre-existing diseases, it is clear that the company understands the importance of health and offers unique health insurance benefits to insurers.

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 Bharti AXA Health Insurance

  • Competitively priced products
  • Industry first services like dedicated claims handlers and 48 hour fund release
  • Offers great deductions on premium
  • The incurred claim settlement ratio of Bharti AXA Health Insurance for F.Y.2017-18 is 98.50%.

What is Covered Under Bharti AXA Health Insurance Plans?

Note: All information regarding inclusions/exclusions, product features and benefits have been sourced from the official website of Bharti AXA General Insurance.

Pre-existing diseases: Covered after 48 Months.
24 months for the specific diseases or illness or procedures/surgeries.
Initial waiting period: 30 days for all illnesses (not applicable on renewal or for accidents)
Maternity expenses: where maternity cover is opted, waiting period until 9 months since inception of the first Policy with the Company.
Critical Illness - 60 days waiting period and 30 days survival period.
Internal Congenital Anomalies are covered after a waiting period of 48 months.
Genetic disorders are covered after a waiting period of 48 months.
Any benefit under Critical Illness Section within 30 days from the date of inception in case of benefit plan and 60 days from the date of inception in case of reimbursement plan.
Hospitalization expenses incurred for treatment undertaken for disease or illness and/or for critical illness within 30 days of the inception date of this Policy.

What is Not Covered Under Bharti AXA Health Insurance Plans?

War (whether declared or not) and war like occurrence or invasion, acts of foreign enemies, hostilities, civil war, rebellion, revolutions, insurrections, mutiny, military or usurped power, seizure, capture, arrest, restraints and detainment of all kinds. Disease/ Illness/ Injury whilst performing duties as a serving member of a military or a police force.
Any Illness or Injury directly or indirectly resulting or arising from or occurring during commission of any breach of any law by the Insured Person with criminal intent.
Circumcision unless necessary for treatment of a disease, illness or injury not excluded hereunder, or, as may be necessitated due to an accident.
Dental treatment or surgery of any kind unless requiring hospitalization.
Birth control procedures, hormone replacement therapy, treatment arising from or traceable to pregnancy, childbirth including caesarean section and voluntary medical termination of pregnancy during the first 12 weeks from the date of conception. However, this exclusion will not apply to Ectopic Pregnancy proved by diagnostic means and certified to be life threatening by the attending Medical Practitioner.

Plans 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.).

Smart Super Health Insurance Plan

CriteriaValueClassicUber
Sum Insured (SI)5|7 lakhs10|15|20 lakhs20|30|50|60|70|80|90|100 lakhs
Room RentUpto SI. No Cap--
Pre/Post Hospitalization ExpensesUpto SI - 60 days/90 days--
Restoration of SIUpto 100% of SI--
AYUSH, Day Care, Organ Donor and Domiciliary Hospitalization ExpensesUpto SI--
Maternity BenefitsRs.35,000 - Maternity Rs.25,000 - New Born Rs.50,000 - Maternity
Rs.50,000 - New Born
For SI of Rs. 20 and 30 Lakhs - Rs.75,000 - Maternity Rs.75,000 - New Born
For rest of the SIRs.1,00,000 - Maternity
Ambulance ChargesUpto Rs. 3000/event--
Hospital Cash Allowance add-onOption of Rs.500, 1000 / dayOption of Rs.500, 1000, 2000 / day Option of Rs.500, 1000, 2000, 3000 / day
Annual Health Check-upBasicExtendedComprehensive

The two major health insurance products offered by Bharti AXA are Smart Super Health Insurance Policy and Smart Health Insurance Policy. Mentioned below are the features for the same.

Smart Health Insurance Plan

Criteria3 lakh4 lakh5 lakh
Room RentAs per the selected plan--
Pre/Post Hospitalization ExpensesUp to SI for 30 - 40 Days/60 days max--
AYUSH, Day Care, and Domiciliary Hospitalization ExpensesUpto SI 10% of the Sum Insured--
Organ Donor10% of SI15% of SI10% of SI
NCBRenewal discount of 5% upto 25%--
Health Check-upOnce in block of 4 years--
Critical Illness add-onAdditional 100% SI on hospitalisation expenses--
Hospital Cash Allowance add-onRs.250Rs.350Rs.350

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.

Bharti AXA Health Insurance Renewal Online

Bharti AXA General Insurance has provided the facility to renew the policy online directly from the website. Simply visit the online portal and select the renewal option. Next, you are required to submit the following details policy no., policy expiry date, name, email id and mobile number. Post submission, you will be redirected to the payment page to recharge the premium via net banking/credit/debit card. This is the same process for buying a new policy online.

Documents required to buy Bharti AXA Health Insurance

  • KYC - Proof of ID and Proof of Address
  • Proof of Age for self and each beneficiary
  • Medical check-up/report

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

Documents Required to Claim Bharti AXA Health Insurance

For Cashless claims policyholder can contact Bharati AXA through any of their 24x7 convenient intimation modes and notify about the claim within 48 hours of date of admission to the hospital or before discharge from the hospital, whichever is earlier.

For reimbursement claims – Claim must be intimated within 7 days from date of discharge and all original and other necessary documents along with the claim form must reach the insurer within 30 days from the date of discharge. If everything is in order, payment will be made within 21 days of receiving all documents. If claim is rejected, a letter explaining the reason for the rejection is sent.

Bharti AXA Health Insurance Premium Calculator

You can also avail the facility of an Insurance Premium Calculator free of cost form the official website of Bharti AXA General Insurance. An insurance premium calculator derives the right amount of premium on your behalf. Simply enter your basic details such as age and policy cover and the premium calculator will mention the different premium quotes applicable to you.

Bharti AXA Health Insurance Network Hospitals

You can locate your nearest Bharti AXA Health Insurance Network Hospital from the official website of Bharti AXA General Insurance. Simply select the state and city of residence and the entire list of network hospitals will be displayed. Bharati AXA has 4500+ hospitals under its network which provides cashless hospitalization benefits.

Bharti AXA Health Insurance Customer Care Support

  • For any queries, you can send an email at customer.service@bhartiaxa.com.
  • For grievances, the number is 1800-103-2292 (Toll free).
  • You can also request a callback by registering your number at the website.

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.

Frequently Asked Questions On Bharti AXA Health Insurance

Why should one buy Bharti AXA Medical Insurance Plans?

With competitively priced products and inspiring features, Bharti AXA is one of the Top Ten insurance companies in India.

How to apply for Bharti AXA Health Insurance Plans?

You can apply for Bharti AXA Health Insurance Plans directly from the website or by physically visiting the branch. Additionally, you can request a call back by registering your mobile number at the website.

How is Bharti AXA Health Insurance different from other insurance policies?

Bharti AXA health insurance plan offers unique features based on the sum insured chosen by the policyholder. There is a varied range of sum insured options available which a person can choose from.

Is Pregnancy covered as a part of Bharti AXA Health Insurance plan?

Yes, maternity benefits are provided to the mother and the new born child as per the policy variant selected.

How to Cancel Bharti AXA Health Insurance Policy?

You can cancel your Bharti AXA Health Insurance Policy by submitting the surrender application at the nearest branch and paying the cancellation charges.

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