Raheja QBE Arogya Sanjeevani Policy
Raheja QBE Arogya Sanjeevani policy is a standard product among all the health insurance companies.
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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
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Children - 3 months
Adults - 18 years
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Maximum Entry Age
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Children - 25 years
Adults - 65 years
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Plan Type
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Indemnity
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Sum Insured (Rs.)
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Rs 1 lakh – Rs 5 lakh
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Renewability
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Lifelong
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Policy Term
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1 Year
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Relationships Covered
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Self, spouse, children, parents, and parents-in-law
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Cumulative Bonus
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5% for each claim-free year
5-50%
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Co-payment
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5%
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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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Ans: Yes, you need to pay a co-pay amount equal to the 5% of the total claim amount at the time of claim settlement.
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Ans: This health scheme does not offer compensation for medical treatment taken overseas.
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Ans: Yes, Raheja QBE Arogya Sanjeevani plan offers coverage for pre-existing diseases after a waiting period four years.
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Ans: Yes, you can switch to Arogya Sanjeevani policy even if you have an existing health insurance policy.
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Ans: You can avail sum insured amount equal to what is offered in the Arogya Sanjeevani plan i.e. between Rs 1 lakh and Rs 5 lakh. If you want to increase your sum insured amount, then you would need to buy another health plan with a higher sum insured limit.