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Extra Care Standard Exclusion

Extra Care - Floater Policy(upto 3 Children)

Exclusions valid for the first 30 Days

  • Any Medical Expenses incurred for Any illness diagnosed or diagnosable within 30 days of the commencement of the Policy Period except those incurred as a result of accidental Bodily Injury.

Exclusions valid for the first 4 years

  • Pre-existing diseases covered after 4 years
    1. In case of change in plan from a lower deductible plan to higher deductible plan this Exclusion shall apply afresh only to the extent of the amount by which the limit of indemnity has been increased (i.e. enhanced sum insured) if the policy is a renewal of Extra Care Policy without break in cover.
  • Any Medical Expenses incurred during the first four consecutive annual periods during which You/your family member(s) named in the schedule have the benefit of an Extra Care policy with Bajaj Allainz in connection with joint replacement surgery unless such joint replacement surgery is necessitated by accidental Bodily Injury. In case of change in plan from a lower deductible plan to higher deductible plan this Exclusion shall apply afresh only to the extent of the amount by which the limit of indemnity has been increased (i.e. enhanced sum insured) if the policy is a renewal of Extra Care Policy without break in cover.

Permanent Exclusions

  • War, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, commotion, unrest,rebellion, revolution, insurrection, military or usurped power or confiscation or nationalisation or requisition of or damage by or under the order of any government or public local authority.
  • Circumcision unless required for the treatment of illness or accidental bodily injury, laser treatment for correction of eye sight due to refractive error, cosmetic or aesthetic treatments of any description, treatment or surgery for change of life/gender.
  • Any form of plastic surgery (unless necessary for the treatment of cancer ,burns or accidental Bodily Injury ).
  • The cost of spectacles, contact lenses, hearing aids, crutches, artificial limbs, dentures, artificial teeth and all other external 3 appliances and/or devices whether for diagnosis or treatment except for intrinsic fixtures used for orthopedic treatments such as plating , K-wires etc.
  • External medical equipment of any kind used at home as post hospitalisation care including cost of instrument used in the treatment of Sleep Apnoea Syndrome (C.P.A.P), Continuous Peritoneal Ambulatory Dialysis (C.P.A.D) and Oxygen concentrator for Bronchial Asthmatic condition.
  • Dental treatment or surgery of any kind unless requiring hospitalisation and as a result of accidental Bodily Injury to natural teeth.
  • Convalescence, general debility, rest cure, congenital diseases or defects or anomalies.
  • Intentional self-injury (including but not limited to the use or misuse of any intoxicating drugs or alcohol)
  • Ailments requiring treatment due to use or abuse of any substance, drug or alcohol and treatment for de-addiction.
  • Any condition directly or indirectly caused by or associated with Human Immunodeficiency Virus or Variant/mutant
  • viruses and or any syndrome or condition of a similar kind commonly referred to as AIDS.
  • Medical Expenses relating to any hospitalisation primarily and specifically for diagnostic, X-ray or laboratory examinations and investigations.
  • Any claim directly or indirectly caused by or contributed to by nuclear weapons and/or materials.
  • Treatment arising from or traceable to pregnancy and childbirth including caesarian section, and/or any treatment related to pre and postnatal care.( ectopic pregnancy is covered under the policy )
  • Vaccination or inoculation unless forming a part of post bite treatment.
  • Any fertility, sub fertility, impotence or assisted conception operation or sterilization procedure.
  • Vitamins, tonics, nutritional supplements unless forming part of the treatment for injury or disease as certified by the attending Doctor
  • Experimental, unproven or non-standard treatment.
  • Surgery to correct Deviated Nasal Septum and hypertrophied turbinate.
  • Treatment for any other system other than modern medicine (also known as Allopathy)
  • Expenses related to donor screening, treatment, including surgery to remove organs from a donor in the case of transplant surgery.
  • Venereal disease or any sexually transmitted disease or sickness.
  • Weight management services and treatment related to weight reduction programmes including treatment of obesity.
  • Treatment for any mental illness or psychiatric illness.