Raheja QBE Arogya Sanjeevani Policy

Raheja QBE Arogya Sanjeevani policy is a standard product among all the health insurance companies. It is suitable for people looking for a smaller sum insured, and comprehensive coverage benefits like hospitalization expense cover, family floater cover, coverage for modern treatments, and Ayush treatment cover. The coverage benefits and features of Arogya Sanjeevani policy by Raheja QBE are discussed below.

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Raheja QBE Arogya Sanjeevani Policy

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    Key Features of Raheja QBE Arogya Sanjeevani Policy

    The scheme not only offers coverage for accidents and illness but comes loaded with various benefits and features as given below:

    • EMI facility is provided by Raheja QBE health insurance company
    • Ayushman treatment cover is provided under the Raheja QBE Arogya Sanjeevani Scheme
    • The insurer also provides No-claim-bonus ranging from 5-50% for not filing a claim during the policy term
    • You can buy the policy on both individual and family floater basis
    • Even cataract surgery expenses are paid by Raheja QBE health insurance Company
    • The policy offers a grace period of 15-30 days as per the mode of payment

    Eligibility Criteria for Raheja QBE Arogya Sanjeevani Policy

    The following table mentions who can buy this scheme, age limit, and other parameters:

    Minimum Entry Age

    Children - 3 months

    Adults - 18 years

    Maximum Entry Age        

    Children - 25 years

    Adults - 65 years

    Plan Type

    Indemnity

    Sum Insured (Rs.)

    Rs 1 lakh – Rs 5 lakh

    Renewability

    Lifelong

    Policy Term

    1 Year

    Relationships Covered

    Self, spouse, children, parents, and parents-in-law

    Cumulative Bonus

    5% for each claim-free year

    5-50%

    Co-payment

    5%

    Raheja QBE Arogya Sanjeevani Policy Inclusions

    Raheja QBE Arogya Sanjeevani health insurance policy covers the following medical expenses during the policy term:

    • Pre & Post Hospitalization Expenses and in-patient hospitalization expenses are covered
    • COVID-19 hospitalization is covered as well
    • AYUSH treatment cover including Ayurveda, homeopathy, Siddha up to the sum insured limit
    • The policy also covers ICU (Intensive Care Unit) or ICCU (Intensive Coronary Care Unit) charges
    • Room rent charges are covered up to a limit of Rs. 5,000 on a daily basis
    • Ambulance Services are recompensed up to a maximum of Rs. 2000 per hospitalization
    • Daycare hospitalization expenses are also covered
    • The Arogya Sanjeevani insurance policy plastic surgery and dental treatment required due to an illness or injury is also covered
    • Cataract treatment cover for each eye up to a maximum of 25% of the coverage amount or up to Rs. 40,000

    Modern Treatment Cover under Raheja QBE Arogya Sanjeevani Plan

    Following new age treatment expenses up to a maximum of 50% of the coverage amount are recompensed:

    • Oral Chemotherapy
    • Intraoperative Neuromonitoring
    • Deep Brain Stimulation
    • Balloon Sinuplasty
    • Intravitreal Injections
    • Bronchial Thermoplasty
    • Uterine Artery Embolization
    • Immunotherapy - Monoclonal Antibody Injections
    • Stem Cell Therapy
    • High Intensity Focused Ultrasound
    • Robotic Surgeries
    • Stereotactic Radio Surgeries

    Exclusions of Raheja QBE Arogya Sanjeevani Policy

    Raheja QBE Arogya Sanjeevani health plan does not cover claims arising due to the following medical expenses:

    • Maternity related expenses
    • Plastic or cosmetic surgery
    • Weight control or obesity treatment
    • Rehabilitation respite care and rest cure
    • Unproven treatment
    • Any claim arising due to involvement in adventure sports or hazardous activities

    Raheja QBE Arogya Sanjeevani Policy Terms and Conditions

    • Pre-existing diseases are only covered after a waiting period of 48 months
    • There is 24 months waiting period for hernia, piles, non-effective arthritis, varicose veins, tonsillectomy, etc.
    • There is a specific waiting period of 48 months for age-related osteoporosis, joint replacement etc.

    Raheja QBE Arogya Sanjeevani Policy Renewal

    Raheja QBE Arogya Sanjeevani health plan allows lifelong renewability provision. There is 30 days of grace period for renewing this policy in case you skip the renewal date.  And it can be done in simple steps as given below:

    • Go to Policy Bazaar’s online renewal page
    • Enter your policy number and then click on submit
    • Enter all the required details and get your policy renewed instantaneously
    • It applies to the cases where a medical test is not required
    • Once the payment is done you will receive your policy documents on your registered email id and you will receive a hardcopy as well

    Raheja QBE Health Claim Process

    The procedure to claim health insurance with Raheja QBE is elucidated below-

    Raheja QBE Cashless Claim Procedure-

    • To file a claim for emergency hospitalization, notify the insurer at least 24 hours of the hospitalization
    • If it is a planned hospitalization and you want to seek cashless authorization inform their health team at least 48 hours in advance
    • Contact the insurance desk at the hospital to avail cashless treatment

    Raheja QBE Reimbursement Procedure-

    • Please fill and sign the claim form and submit it with all the documents maximum 15 days after the treatment
    • If any documents or information is missing the insurer will send you the notification within 7 days of submitting the documents
    • Once all the documents are submitted, the payment will be released in the name of the proposer (equal to the admissible amount)
    • Compensation will be equal to the coverages that you opted for ( as per the specified limits)
    • Pre and Post hospitalization claim can be submitted once the Inpatient (Cashless/Medical reimbursement) claim is settled

    Documents Required for Raheja QBE Arogya Sanjeevani Claim Process

    Here is the list of documentation that is required at the time of filing claim with Raheja QBE:

    Furnish the following documents as per the nature of the claim:

    Documents Required for Cashless Claims:

    • Unique Health Identification card number
    • All the medical/hospital records
    • KYC -, Passport size photo, ID Proof, Aadhaar card, Address Proof & Pan card

    Documents Required for Reimbursement Claims:

    • Claim form (duly filled & signed)
    • Original hospital bills and original receipts - with bill number stamped & signed by the hospital along with an itemized bill
    • Discharge summary or discharge card (in original)
    • Doctor’s prescription with medical bills and original investigation reports

    Raheja QBE Arogya Sanjeevani Policy FAQs

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