Bajaj Allianz Silver Health - For Senior citizens

Exclusions valid for the first 30 Days

• 30 days waiting period applicable.( Disease contracted during the first 30 days from the commencement of the policy is excluded)

Exclusions valid for the 1 year

• Without derogation from above pre-existing exclusion during the first year of operation of the insurance cover any Medical Expenses incurred on treatment of the following diseases :
  • Cataract
  • Benign prostatic hypertrophy
  • Prolapse of genitourinary/intraabdominal organs
  • Hernia of all types
  • Hydrocele
  • Fistulae
  • Hemorrhoids
  • Fissure in anus
  • Dysfunctional uterine bleeding, fibromyoma, endometrioisis ,hysterectomy
  • Stones in the urinary and biliary systems
  • Surgery on ears
  • Surgery on skin/internal tumours/cysts/nodules/polyps
  • Treatment for benign tumors or malignant conditions or for organomegaly
  • Surgery on joints
  • Treatment for prolapsed intervetebral discs
  • Surgery for gastric or duodenal ulcers

In case of enhancement of Sum Insured the waiting periods 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 Health Policy without break in cover.

Exclusions valid for the first 2 years

• Pre-existing illnesses is covered from the second year of the policy.

1. This exclusion shall cease to apply if this Policy is the renewal without break of a Silver Health Policy held with Bajaj Allianz for a continuous period of one year, and shall also not apply on subsequent renewals effected on the same basis.
2. In case of enhancement of Sum Insured 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 Health Policy without break in cover.

Exclusions valid for the first 4 years

• Joint replacement surgery (other than due to accidents)-a waiting period of 4 years before it is covered.

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.
• Cosmetic or aesthetic treatments of any type, plastic surgery (unless necessary for the treatment of Illness or accidental Bodily Injury).
• The cost of spectacles, contact lenses, and hearing aids, crutches, artificial limbs, dentures, artificial teeth, and all other external appliances and/or devices whether for diagnosis or treatment.
• 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
• Venereal diseases or any sexually transmitted disease or sickness
• Intentional self-injuries (including but not limited to the use or misuse any intoxicating drugs or alcohol)
• Treatment arising from or traceable to pregnancy (whether uterine or extra uterine) and childbirth including caesarian section, and/or any treatment related to pre and post-natal care.
• Any treatment towards infertility, sub-fertility or assisted conception procedure or sterilization procedure.
• Any condition directly or indirectly caused by HIV (Human Immuno deficiency virus) or associated with Human T-Cell 3 Lymphotropic Virus type III (IITLB-III) or Lymphadinopathy Associated Virus (LAV) or the Mutants Derivative or Variations Deficiency Syndrome 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.
• Vaccination or inoculation unless forming a part of post bite treatment
• 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, including but not limited to chelation therapy
• Surgery to correct deviated septum and hypertrophied turbinates
• 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.
• Treatment for any mental illness or psychiatric illness.
• Weight management services and treatment related to weight reduction programmes including treatment of obesity.