Health Assurance

Temporary total disability (optional)

• In the unfortunate case of temporary total disability, 1% of temporary total disability sum insured is payable per week. This weekly pay out shall be made for a maximum of 100 continuous weeks.

Accident hospitalization (optional)

• In case of hospitalization due to an accident, medical expenses incurred towards such hospitalization shall be payable up to 2% of accident care sum insured. This benefit shall be available for hospitalization in India only.

Policy benefit options

You can choose any of the following benefit options. Option once chosen cannot be changed later during the lifetime of the policy.

• Benefit Option 1: Sum insured payable as lump sum
• Benefit Option 2: Sum insured payable as lump sum plus additional 10% of the sum insured payable each year for subsequent 5 years.

Tax benefit

• A Max Bupa health insurance policy can help you save tax under Section 80D of the Income Tax Act. These benefits are subject to change in tax laws. You may consult your tax advisor for more in-depth advice pertaining to your personal finances.

Free look period

• Your complete satisfaction is important to us. If you’re unsatisfied with your policy, you have a 15-day free look period during which you can cancel your policy simply by stating your reason. The free look period will be 30 days if the policy is purchased through distance marketing mode and policy tenure is 3 years.

Critical illnesses covered

• Cancer of specified severity
• Open Chest CABG
• Myocardial infarction (first heart attack of specific severity)
• Open heart replacement or repair of heart valves
• Stroke resulting in permanent symptoms
• Permanent paralysis of limbs
• Coma of specified severity
• Kidney failure requiring regular dialysis
• Major organ/bone marrow transplant 
• Motor neurone disease with permanent symptoms
• Multiple sclerosis with persisting symptoms
• End stage liver disease
• End-stage lung disease
• Third degree burns
• Loss of speech
• Deafness
• Aplastic anaemia
• Bacterial meningitis
• Fulminant viral hepatitis
• Muscular dystrophy

Eligibility

Health Assurance gives you the flexibility to choose from 3 covers. These can be bought individually, or can be clubbed together to give a fixed benefit that not only protects your lifestyle, but also helps you meet your expenses.

• AccidentCare Cover
• Criticare Cover
• HospiCash Cover

You can opt for any of the below 6 combinations:

• Criticare + AccidentCare + HospiCash
• Critcare + AccidentCare
• Criticare + HospiCash
• AccidentCare + HospiCash
• Criticare Only
• AccidentCare only

I. AccidentCare

An accident can exhaust the savings of a lifetime and even cause irreversible disability and loss of income. Our AccidentCare Insurance Plan provides cover not just in the case of accidental death but also for permanent total or partial disability, along with a host of other benefits.

Coverage - individual and family coverage

Sum insured: Rs 5 lakhs to Rs. 5 crore.

If you are claiming your insurance as an individual, you are entitled to 100% of the sum insured promised.

When you are claiming your sum insured on a family plan that covers yourself, a spouse and up to 2 children, you are entitled to 100% of the amount, your spouse is entitled to 50% or Rs. 10 lakhs (whichever is lower), and your children are entitled to 20% of the amount or Rs. 5 lakhs (whichever is lower).

Maximum Sum Insured will be 12/15 times of annual income for salaried/ self-employed respectively.

Eligibility Criteria

AccidentCare: Coverage available for adults and children. Entry age for adults is 18 years to 65 years and entry age for children is 2 years to 21 years (dependent children)

Permanent Exclusions

• Suicide or self-inflicted injury, whether the insured person is medically sane or insane.
• Treatment for any injury or illness resulting directly or indirectly from nuclear, radiological emissions, war or war like situations (whether war is declared or not), rebellion (act of armed resistance to an established government or leader), acts of terrorism.
• Service in the armed forces, or any police organization, of any country at war or at peace or service in any force of an international body or participation in any of the naval, military or air force operation during peace time.
• Any change of profession after inception of the Policy which results in the enhancement of our risk, if not accepted and endorsed by us on the Schedule of Insurance Certificate.
• Committing an assault, a criminal offence or any breach of law with criminal intent.
• Taking or absorbing, accidentally or otherwise, any intoxicating liquor, drug, narcotic, medicine, sedative or poison, except as prescribed by a medical practitioner other than the policyholder or an insured person.
• Participation in aviation/ marine including crew other than as a passenger in an aircraft/ water craft that is authorized by the relevant regulations to carry such passengers between established airports or ports
• Including but not limited to engaging in or taking part in professional/ adventure sports or any hazardous pursuits, such as speed contest or racing of any kind (other than on foot), bungee jumping, parasailing, ballooning, parachuting, skydiving, paragliding, hang gliding, mountain or rock climbing necessitating the use of guides or ropes, potholing, abseiling, deep sea diving using hard helmet and breathing apparatus, polo, snow and ice sports, hunting, etc.;
• Body or mental infirmity or any disease except where such condition arises directly as a correspondence of an accident during the policy period. However, this exclusion is not applicable to claims made under the PPD benefit
• Any costs or expenses specified in the list of expenses generally excluded at Annexure II of policy document. This is applicable only for accident hospitalization benefit.

II. Criticare

Acquiring critical illness such as cancer, stroke, kidney failure or lung disease is a life changing event which can disrupt dreams and goals for family and wipe out savings. Prepare for any critical illnesses with Max Bupa, and get the help you need to get back on your feet when your body lets you down

Coverage - individual and family Coverage

Sum Insured: Rs. 3 lakhs to Rs. 2 crore

Coverage available for spouse as well. Family combinations: 1 Adult or 2 Adults.

Maximum sum insured will be 12/15 times of annual income for salaried/self-employed respectively.

Eligibility Criteria

CritiCare: Coverage available only for adults. Entry age is 18 years to 65 years

PERMANENT EXCLUSIONS

• Acquired Immune Deficiency Syndrome (AIDS), AIDS-related complex or infection by Human Immunodeficiency Virus (HIV)
• The insured persons attempted suicide or self-inflicted injuries while sane or insane
• Narcotics used by the insured person unless taken as prescribed by a medical practitioner, or the insured person’s abuse of drugs and/or consumption of alcohol
• The directions, advice and guidance of the treating medical practitioner shall be strictly followed. We shall not be obliged to make any payment that arises out of wilful failure to comply with such directions, advice or guidance
• Treatment for any injury or illness resulting directly or indirectly from nuclear, radiological emissions, war or war like situations (whether war is declared or not), rebellion (act of armed resistance to an established government or leader), acts of terrorism
• Taking part in any naval, military or air force operation during peace time
• Participation in aviation/ marine activities including crew other than as a passenger in an aircraft/ water craft that is authorized by the relevant regulations to carry such passengers between established airports or ports
• Including but not limited to engaging in or taking part in professional/adventure sports or any hazardous pursuits, such as speed contest or racing of any kind (other than on foot), bungee jumping, parasailing, ballooning, parachuting, skydiving, paragliding, hang gliding, mountain or rock climbing necessitating the use of guides or ropes, potholing, abseiling, deep sea diving using hard helmet and breathing apparatus, polo, snow and ice sports, hunting, etc.
• Participation by the insured person in a criminal or a breach of law with criminal intent

III. HospiCash

This benefit provides daily cash allowance for other miscellaneous expenses when the insured person is in hospital.

Coverage - individual and family Coverage

Features

Hospital cash coverage may be availed by an individual or by a family of up to 4 members (self, spouse and up to 2 children). In case of family option, the sum insured shall get assigned for all the insured persons in the following manner:

• Self (Insured 1) - 100% of chosen Daily HospiCash Benefit limit;
• Spouse - 100% of chosen Daily HospiCash Benefit limit;
• Child 1 - 50% of chosen Daily HospiCash Benefit limit
• Child 2 - 50% of chosen Daily HospiCash Benefit limit

If an insured person is hospitalised, solely and directly due to an injury arising from an accident or due to an illness, then we will pay the daily allowance for each continuous and completed period of 24 hours of hospitalisation provided that:

• We shall not be liable to make any payment for hospitalisation and/ or treatment and/ or treatment following diagnosis which occurs within 30 days from the date of commencement of the Policy, unless such hospitalisation is required solely and directly due to an accident;
• We shall not be liable to make payment of the daily allowance under this benefit for more than 45 days for an insured person in a policy year, including all days of admission to the intensive care unit. This is applicable for both individual and family option.

If an insured person is required to be admitted to the intensive care unit of a hospital solely and directly due to an injury arising from an accident or due to an illness, then we will pay twice the daily allowance for each continuous and completed period of 24 hours of admission in the intensive care unit for a maximum of 7 days for an insured person in a policy year.

Eligibility Criteria

HospiCash:Coverage available for adults and children. Entry age for adults is 18 years to 65 years and entry age for children is 1 day to 21 years (dependent children)

Permanent Exclusions

We shall not be liable to make any payment if hospitalisation or any claim under this benefit are attributable to, or based on, or arise out of, or are directly or indirectly connected to any of the following:

• Hospitalisation not in accordance with the diagnosis and treatment of the condition for which the hospital confinement was required;
• Hospitalization solely for diagnostic or observation purpose
• Treatment for weight reduction or weight improvement regardless of whether the same is caused (directly or indirectly) by a medical condition;
• Any dental care or surgery of cosmetic nature, extraction of impacted tooth/teeth, orthodontics or orthognathic surgery, or tempero-mandibular joint disorder except as necessitated by an accidental injury
• Treatment for infertility or impotency, sex change or any treatment related to it, abortion, sterilization and contraception including any complications relating thereto;
• Treatment arising from pregnancy and its complications which shall include childbirth or abortion or threatened abortion excluding ectopic pregnancy;
• Hereditary and genetic disorders: screening, counselling or treatment related to hereditary and genetic disorders;
• Hospitalisation primarily for diagnosis, X-ray examinations, general physical or medical check-up not followed by active treatment during the hospitalisation period or hospitalisation where no active treatment is given by the medical practitioner;
• Unproven/ experimental treatments/ off-label treatment;
• Alternative treatment;
• Treatment of any mental or psychiatric condition including but not limited to insanity, mental or nervous breakdown / disorder, depression, dementia, Alzheimer’s disease or rest cures;
• Admission to a nursing home or home for the care of the aged for rehabilitation, or convalescence.
• Treatment directly or indirectly arising from alcohol, drug or substance abuse and any illness or accidental injury which may be suffered after consumption of intoxicating substances, liquors or drugs;
• Treatment directly or indirectly arising from or consequent upon war (whether war be declared or not), invasion, acts of foreign enemies, hostilities, civil war, rebellion, active participation in strikes, riots or civil commotion, revolution, insurrection or military or usurped power, and full-time service in any of the armed forces;
• Acquired immune deficiency syndrome (AIDS) and all illnesses or diseases caused by or related to the Human Immuno-Deficiency Virus;
• Sexually transmitted diseases;
• Cosmetic or plastic surgery except to the extent that such surgery is necessary for the repair of damage caused solely by accidental injuries; treatment of xanthelesema, syringoma, acne and alopecia;
• Nuclear disaster, radioactive contamination and/ or release of nuclear or atomic energy;
• Treatment for accidental injury or illness caused by intentionally self-inflicted Injuries; or any attempts of suicide while sane or insane;
• Treatment for accidental injury or illness caused by violation or attempted violation of the law, or resistance to arrest;
• Including but not limited to engaging in or taking part in professional/ adventure sports or any hazardous pursuits, such as speed contest or racing of any kind (other than on foot), bungee jumping, parasailing, ballooning, parachuting, skydiving, paragliding, hang gliding, mountain or rock climbing necessitating the use of guides or ropes, potholing, abseiling, deep sea diving using hard helmet and breathing apparatus, polo, snow and ice sports, hunting, etc.;
• Circumcision unless necessary for treatment of a disease or necessitated due to an accident;
• Hospitalisation where the insured person is a donor for any organ transplant;
• Any treatment outside of Republic of India;
• Treatment to assist reproduction, including IVF treatment;
• Hormone replacement therapy;
• Puberty and menopause related disorders: treatment for any symptoms, illness, complications arising due to physiological conditions associated with puberty, menopause such as menopausal bleeding or flushing;
• Artificial Life Maintenance: Artificial life maintenance, including life support machine used to sustain a person, who has been declared brain dead, as demonstrated by:
  • Deep coma and unresponsiveness to all forms of stimulation;
  • Absent pupillary light reaction;
  • Absent oculovestibular and corneal reflexes; or
  • Complete apnea.
• Sleep disorders: Treatment for sleep apnea, snoring or any other sleep-related breathing problem;
• Treatment for developmental problems: Treatment for, or related to developmental problems, including learning difficulties (such as dyslexia), behavioural problems, including attention deficit hyperactivity disorder (ADHD)

Bank of Baroda is authorized by the Insurance Regulatory and Development Authority to act as a Corporate Agent from 01/04/2022 to 31/03/2025 for procuring or soliciting business of Life insurance, General insurance & Standalone Health insurance under Registration Code CA0004". Insurance is the subject matter of solicitation. For more details on risk factors, terms and conditions please read the sales read sales brochure carefully before concluding a sale. The purchase of Insurance products by Bank of Baroda customers is purely on a voluntary basis. The insurance products are underwritten by the respective insurance company. Bank of Baroda does not perform any insurance e-commerce activity on its website. The contract of insurance is between the insurer and the insured; and not between the Bank and the Insured.