Health Insurance, India

Owned by Tejaswini Wandhare
Last updated: Dec 10, 2024 by Tejaswini Wandhare
4 min read

1. Introduction

This guide is designed to help you understand the benefits of health insurance. Whether you’re new to the company or exploring more about your coverage, this handbook will outline everything you need to make the most of your benefits.

2. Dependent Coverage

Coverage is available for team members, their spouses, and dependent children up to 25 years of age. You may also choose optional coverage for parents.

3. Health Insurance Plan Overview

The health insurance plan provides comprehensive coverage, including preventive, urgent, and emergency care, to support you and your family’s health.

The plan includes Pre and Post Hospitalization Coverage, Day Care Treatment, Ambulance Charges, Room Rent, Maternity benefits, Pre-existing diseases, Lasik Surgery, Pre and post-natal Expenses, New Born Baby cover, and much more, giving you flexibility in choosing your care.

4. Yearly Engagement Campaigns

Our health plan includes yearly engagement campaigns on topics like Positive Parenting, Lifestyle Management, Mental Wellness, Know your Heart, Diet & Nutrition Management, Financial Wellness, Stress Management, Desktop Ergonomics, Respiratory issues, How to Boost your Immunity and more. These can be accessed via Visit App. Check more on this in the document attached below:

5. Additional Benefits

  • Doctor On Call: Free Unlimited consultations with Specialist doctors, financial advisors & psychologists

  • Discounted medicines

  • Lab tests

  • Calorie Counter

  • Nutrition Tracker

  • Sleep tracker and many more

6. Midterm endorsement

  • Addition: newly married spouse, newborn child

  • Deletion: separated spouse, deceased family members

  • New joiners addition

We request that you inform people@axelerant.com within 15 days of either of the above scenarios and update the “Dependents” details section on ZOHO people.

Any other mid-term endorsements cannot be added as per the guidelines of Aditya Birla Health Insurance.

7. Team members guide

8. Making a Claim

When you use your health insurance, claims are often processed directly by the healthcare provider. For out-of-network services, you may need to submit a claim yourself.

Step 1: Claim Intimation to Policy Bazaar Team

In case of emergency hospitalisation, call and inform us within 24 hours of your admission. However, if your hospitalization is planned, kindly inform us 48 hours prior to your admission by calling us.

Step 2: Initiating the process for Pre- Authorization

A Pre-Authorization form will be available at the hospital’s Insurance/TPA desk.

Please fill out the first section of the form by providing your details and handing over the signed pre-authorisation form to the hospital's insurance/TPA desk so they can fill out the balance details.

Step 3: Processing a request for Pre- Authorization

Policy Bazaar’s in-house medical team will review the case and documents submitted by the hospital. If your request for Pre-Authorization is approved, you and the hospital will be duly informed by us.

In case of any information deficiency or further information requirement, we will regularly inform you and the hospital to ensure resolution as soon as possible.

  1. Claim Intimation

  1. Claim Processing

  1. Approval TAT

  1. Claim Intimation

  1. Claim Processing

  1. Approval TAT

Documents Required

Intimate claim request to:

2 Hours - Pre Authorization,

  1. Prescription

Email id :

cashlessclaims@policybazaar.com

4 Hours-Final Authorization

  1. KYC

 

 

  1. E-cards

 

 

Reimbursement of Treatment Expenses:

Step 1: Claim Intimation

Claim intimation should be given within 48 hours of admission or before discharge from the hospital. Documents need to be submitted within 30 days from the date of discharge from the hospital.

Step 2: Claim Initiation –

Initiating the claim process (Also applicable for/Post Hospitalization claims) The completed and duly signed claim form has to be sent to us along with the documents mentioned in the Team member's guide.

  1. Claim Intimation

  1. Claim Processing

  1. Claim Settlement TAT

  1. Claim Intimation

  1. Claim Processing

  1. Claim Settlement TAT

Documents Required

Intimate claim request:

15-21 working days

  1. Prescription

Upload your documents on the visit app.

Intimate Policybazaar team once you have uploaded your documents on the visit app.

 

  1. KYC

 

 

  1. Discharge Summary

 

 

  1. Hospital Final Bill

 

 

  1. Bank Details

 

 

  1. Claim Form - A&B&C

 

 

9. Claims Form

10. List of Day Care Treatments covered

13. Network Hospital list

14. Non Payable Items

15. Visit App Claim Process

16. Matrix for Cashless & Reimbursement Claims

The toll-free number for cashless and reimbursement claims: 1800-309-4876

17. Orientation Session recording for reference

 

Escalation Matrix

Level 1: Executive - cashlessclaims@policybazaar.com
Level 2: Mr. Kumaresh- Kannankumaresh@policybazaar.com
Level 3: Miss Ritu- ritunayak@policybazaar.com