Health Guard Platinum in one table
| Insurer | Bajaj General Insurance Company Limited |
|---|---|
| Sum insured | ₹5 lakh to ₹1 crore, in tiers of 5 / 7.5 / 10 / 15 / 20 / 25 / 30 / 35 / 40 / 45 / 50 / 75 lakh and 1 crore |
Claim settlement and complaint figures are IRDAI-published and held centrally by NYVO, not taken from the insurer's marketing.
What Health Guard Platinum covers
These are the terms that decide what you are actually paid when you claim. Room rent, co-pay and restoration do more to shape a settlement than the sum insured does, and they are read from Bajaj General's own policy wording.
| Feature | This plan | What good looks like |
|---|---|---|
| Co-payment | None if you pay Zone A rates · 5% to 20% if you pay a cheaper zone's rate and treat in a costlier city | No Co-payment |
| Room Rent Limit | Any room category from ₹10 lakh cover · single private AC room at ₹5 and ₹7.5 lakh | No room rent capping |
| Disease sub-limit | Cataract 20% of sum insured per eye, max ₹1 lakh · bariatric 50%, max ₹5 lakh · ambulance ₹20,000 a year | No sub-limit |
| No Claim Bonus | Super Cumulative Bonus: 50% a year for two years, then 10% a year for five, capped at 150% | 50% each year (Minimum upto 100%) |
| Restoration Benefit | 100% of base sum insured, once a policy year, for an unrelated illness · once in a lifetime for cancer and dialysis-dependent kidney failure | 100% restoration once in a year |
| Recharge Benefit | Adds 20% of sum insured, ₹1 lakh to ₹5 lakh, once a policy year | Included |
| Pre-Hospitalization | 60 days | At least 60 days |
| Post-Hospitalization | 90 days | At least 120 days |
| Consumables | Excluded – every non-medical item on the standard list is outside the policy | Consumables covered |
| Maternity | ₹15,000 normal and ₹25,000 caesarean up to ₹7.5 lakh cover · ₹25,000 and ₹35,000 from ₹10 lakh · 72-month wait | Included |
| Day-Care Procedures | Covered up to the sum insured, from the wording's listed procedures | Covered without a capped list |
| Entry age | Adults from 18 with no upper limit · dependent children 3 months to 30 years | No maximum entry age |
Health Guard Platinum add-ons you can buy with it
Each of these costs extra and each has its own conditions. Some are genuinely worth it; several exist to patch a gap in the base plan. Ask what each one adds before it goes on your quote.
Health Guard Platinum discounts you can ask for
Published discounts on this plan. Most are applied at quote stage rather than offered, so it is worth naming the ones you qualify for. Every figure is a ceiling, not a promise - what you actually get depends on the case.
| Discount | Worth | When it applies |
|---|---|---|
| Zone discount | Up to 20% or 30% | 20% for Zone B cover and 30% for Zone C. Treat in a costlier zone afterwards and a co-payment of 5% to 20% applies to the claim. |
| Wellness discount | Up to 5% to 12.5% | 5% for meeting 4 of 8 health parameters, 7.5% for 6 and 10% for all 8, plus 2.5% more for 10,000 steps on 20 days a month. Members aged 25 and above only. |
| Room rent capping discount | Up to 8% | Accept a room limit of 1.5% of sum insured, capped at ₹7,500 a day, and the Platinum premium drops 8%. Exceed the limit and a proportionate co-payment hits the whole hospitalisation. |
| Family discount | Up to 10% or 15% | 10% for two family members on one policy, 15% for more than two. Not available on floater policies. |
| Long-term discount | Up to 4% or 8% | 4% on a two-year policy, 8% on three years. Not available if you pay in instalments. |
| Voluntary co-payment | Up to 10% or 20% | Bear 10% or 20% of every admitted claim yourself and the premium falls by the same figure. |
From the plan brochure. Applied to the base premium; the insurer's stacking rules apply.
Health Guard Platinum waiting periods: when each part of the cover starts
Waiting periods run from the day cover began, not from the day you fall ill, and they run in parallel rather than one after another.
| Initial Waiting Period | 30 days |
|---|---|
| Specific Illness | 24 months |
| Pre-Existing Disease | 36 months |
| Listed surgeries (joint replacement, spinal, nasal septum, bariatric, Parkinson's, genetic disorders) | 36 months |
| Maternity and newborn | 72 months |
The named illnesses that wait 24 months
Payable once the policy has run 24 months without a break; the wait does not apply to an accident. This list is indicative – the wording carries 27 named conditions, and a separate 36-month clock covers joint replacement, spinal surgery, bariatric surgery and genetic disorders.
Health Guard Platinum exclusions: what the plan will not pay for
Every policy carries exclusions, and they are the clauses people read for the first time at claim stage. These are the ones worth knowing before you buy.
Where Health Guard Platinum falls short
No plan is right for everyone, and a page that only lists strengths is not much use to you. These are the gaps we would raise on a call before recommending it.
Health Guard Platinum questions, answered
How does the Super Cumulative Bonus actually build up?
It is not a flat 50% a year. Health Guard Platinum adds 50% of your base sum insured in each of the first two claim-free years, then 10% a year for the next five, stopping at 150%. So ₹10 lakh becomes ₹20 lakh after two clean years, and only reaches ₹25 lakh after seven. Make a claim and the increase drops back to the previous slab, though the base sum insured itself is never cut.
Does Health Guard Platinum have a room rent limit?
It depends on your cover. From ₹10 lakh upwards you can use any room category. At ₹5 lakh and ₹7.5 lakh you are limited to a single private air-conditioned room, and if you take a better one a proportionate deduction applies to everything except pharmacy, consumables, implants, devices and diagnostics. There is a separate Bajaj add-on that waives that restriction.
Is there a co-payment on this plan?
Not if you buy at Zone A rates, which let you treat anywhere in India. Buy the cheaper Zone B cover and treat in a Zone A city and you pay 15% of the claim. On Zone C it is 20% in a Zone A city and 5% in a Zone B city. Accident admissions are exempt. The 20% and 30% zone discounts are real, but so is the bill if you travel for treatment.
Is maternity covered?
Yes, on Platinum and Gold, but the waiting period is 72 months from your first Health Guard policy. The limit is ₹15,000 for a normal delivery and ₹25,000 for a caesarean up to ₹7.5 lakh cover, rising to ₹25,000 and ₹35,000 from ₹10 lakh. Newborn cover, including complications for 90 days and mandatory vaccinations, sits inside the same limit.
Are consumables covered?
No. Every item on the standard non-medical list is excluded, and no rider in the range adds them back. These are the gloves, syringes, PPE and similar supplies that hospitals bill separately, and they are a common reason a fully settled claim still leaves a bill behind. If that matters to you, compare against plans that build a consumables benefit into the base cover.
What is the Recharge Benefit and how is it different from restoration?
They fire in different situations. Restoration only triggers once your cover and bonus are completely exhausted, and pays a fresh 100% for an unrelated illness. Recharge fires when a single claim overshoots your remaining cover and simply adds 20% of the sum insured, between ₹1 lakh and ₹5 lakh, once a year. Recharge is the one that catches the near-miss claim.
Read it from the insurer
We summarise. The policy wording is the contract, and it is the only document that settles a dispute. These links go to the insurer's own pages.
Understand the terms before you commit
A plan page tells you what this policy does. These explain why each term matters and what it costs you when it is missing.
Other Bajaj General plans we have read
Bajaj General files these separately, and the terms differ between them. If you are choosing within the range, compare the waiting periods and the exclusions rather than the sum insured.