By entering the one-time password (“OTP”) sent by Bajaj Finance Limited (“BFL”) and/or by signing the Application Form along with General Terms and Conditions, I am expressing my interest in availing Bajaj Finserv Health EMI Network Card from Bajaj Finance Limited. I hereby confirm that I (i) am at least 18 years of age, (ii) can understand, read and access the world wide web / internet in English language, (iii) have read, understood and agree to be bound by the terms in this Form (“Application Form”). Further, I agree that my action of submission of the OTP sent by BFL, constitutes a valid acceptance by me of the terms and conditions contained herein and which shall have binding effect on me.

I (‘customer’) hereby state, confirm, and agree as under: :

• I have applied for Bajaj Finserv Health EMI Network Card (hereinafter referred as “Health EMI Card”) as specified in this application (“Application Form”), from Bajaj Finance Limited (“BFL”).
• I hereby unconditionally acknowledge and accept that:
1. The Health EMI Card may be issued by BFL either in Physical or Electronic form.
2. All particulars, information and details provided by me in relation to my application are true, correct and up to date and that I have not withheld any material information and I am obliged to keep BFL immediately updated of any change in the information provided by me in this Application Form.
3. I shall submit all documents including KYC documents in such form and manner as may be required by BFL in relation to my Application Form.
4. I authorize BFL to use my existing details and KYC documents/data for KYC compliance, if any, for this application and in case of any changes in my registered KYC or bank account details, I shall update about the same & submit the updated KYC to BFL.
5. I shall make payment of applicable fee and/or charges as specified by BFL with respect to the Health EMI Card as provided in this application form and on BFL’s website www.bajajfinserv.in
6. I shall make payment of applicable fee and/or charges as specified by BFL with respect to the Health EMI Card as provided in this application form and on BFL’s https://www.bajajfinserv.in/all-fees-and-charges-new#ec.
7. I understand that the aforesaid fees and/or charges are subject to changes and are non-refundable and non-transferable.
8. BFL has the sole and absolute discretion, without assigning any reasons to accept or reject my application.
9. I have read and understood the Master Terms and Conditions applicable to Loans for Consumer Durable, Digital, Life style products & EMI Network Cards (“Master Terms”) prescribed by BFL and available on website: https://www.bajajfinserv.in/consumer-durables_master_t-and-c_english.pdf and understand the applicability of the same for issuance and usage of Health EMI Card at Selected Business Associates as defined herein below and hereby agree to be bound by the same at all times including any additions/amendments thereto from time to time. ix. I shall keep myself updated of any revisions in the Master Terms as may be communicated by BFL through any acceptable means of communications (as defined in the Master Terms).
10. I shall keep myself updated of the list of Selected Business Associates tie-ups of BFL, as may be updated by BFL on its website https://www.bajajfinserv.in/emi-network-multispeciality from time to time.
11. The loan limit shall be assigned to me as per BFL’s sole discretion and internal policies and the same is subject to further revision at BFL’s sole discretion. BFL shall not be liable in any manner whatsoever for such revision or cancellation of limits.
12. No insolvency proceeding or suit for recovery of outstanding dues or monies and or any criminal proceedings, have been initiated and/or are pending against me and that I have never been adjudicated insolvent by court or any other authority. I have not taken any action and no other steps have been taken or legal proceeding started by or against me in any court of law and/or in any other authority for appointment of a receiver, administrator, administrative receiver, Insolvency professional, similar officer with respect to any of my assets.
13. I shall keep my credentials including the login id and password/PIN issued by BFL and/or reset by me (“Credential”) as confidential and not to share the same with any person/third party. Any use or misuse of the credentials including the transactions carried out using the credentials shall be my sole responsibility and BFL shall not be held responsible for any loss/damage incurred on account of such use or misuse.
• I authorize BFL:
1. To exchange, share or part with all information relating to this application to credit bureaus/credit reference agencies, its group companies, financial institutions, Credit Information Companies (‘CIC’), Central KYC Registry (CERSAI) or any authorized third-party agency as BFL may deem necessary or appropriate for use or processing of the said information and shall not hold BFL (or any of its group companies or its/ their agents/representatives) liable for the use/sharing of the information as stated above.
2. To seek/obtain any other information, relating to me, from any third party.
3. To procure/avail my CIBIL report and provide it to me by deducting applicable charges for the same.
4. To share certain information related to Health EMI Card, which may include my KYC and transaction details with its business associates (subject to confidentiality restrictions) for integrating the Health EMI Card usage on such business associate’s website/ wallet, etc. as may be required for facilitating my use of Health EMI Card.
• I hereby expressly consent for paying a Loan Enhancement Fee, in case where BFL allows to approve the Loan transaction amount over and above my Health EMI Card loan limit, as per its internal risk/credit policies and at its sole and absolute discretion. It is hereby clarified that payment of such fee would not enhance my overall Health EMI card loan limit. Further, I agree that payment of such fee would be added to the first EMI/monthly instalment of my Loan transaction.
• I authorize BFL to share certain information related to Health EMI Card, which may include my KYC and transaction details with its Selected Business Associates, Sourcing Partners, and/or Technology Partners (subject to confidentiality restrictions) for integrating the Health EMI Card usage on such business associate’s website/ wallet etc. as may be required for facilitating my use of Health EMI Card.
• That this Application Form, together with all its contents, may be submitted to:
1. The subsidiaries and affiliates of BFL, any service provider/third party with reference to rendering services in connection with the product(s) availed by me;
2. to any Regulator, Court, Law enforcement agency, Quasi-judicial authority etc. on a need-to-need basis.
• I hereby authorize group companies, affiliates and/or business associates of BFL and their respective representatives to send me communications regarding loans, insurance and their respective products and/or services (Collectively “Other Products”) through telephone calls/SMSs/emails/post/WhatsApp/bot/bitly, etc. including but not limited to promotional communications. I agree and understand that such Other Products if availed, are governed by their own set of terms and conditions, which shall be in addition to and not in derogation to the terms and conditions prescribed by BFL herein. I understand that I can at any time opt to withdraw my consent to receive any telecommunication.
• HEALTH EMI NETWORK CARD TERMS
1. The Health EMI Card is an Existing Membership Identification number used for authentication and is neither a credit card nor a stored value card.
2. The Health EMI Card can be used only at limited Life Care Counters (LCF) including Multi Specialty Hospitals (MSH), Non-MSH and diagnostic centres and such other counters as may be decided by BFL at its sole discretion (“Selected Business Associates”). Updated list of Selected Business Associates can be accessed through https://www.bajajfinserv.in/emi-network-multispeciality. This Health EMI Card cannot be used for purchase on e-Commerce platforms and of retail (apparel, footwear, small appliances, travel, coaching classes, hotels, eyewear, accessories etc.), consumer durables, digital, lifestyle products, etc.
3. Details of the treatments eligible for loan and benefits under the Health EMI CARD are listed on BFL Website- https://www.bajajfinserv.in/emi-network-multispeciality.
4. The Personal Guard Individual Accident Policy upto an amount of Rs.1,00,000 will be issued by M/s. Bajaj Allianz General Insurance Company (“BAGIC”) which will be valid for a period of one year from the date of issuance of the Health EMI Card. The Terms and Condition as may be prescribed by BAGIC shall be applicable to the said Personal Accident Insurance Policy. Such Terms and Conditions as listed on BAGIC website: https://www.bajajallianz.com/Corp/ health-insurance/personal-accident-insurance-ppg.jsp shall be in addition and not in derogation of the Terms and Conditions of this Application Form. Any claims pertaining to the said Personal Guard Individual Accident Policy issued by BAGIC shall be directly taken up with BAGIC.
5. BFL may at any time, at its full discretion and without assigning any reason, decide to withdraw the Health EMI Card service and/ or terminate any specific Health EMI Card and will have no liability to the Health EMI Card-holder or any other person in this regard. In the event of termination of Health EMI card/ withdrawal of Health EMI Card services, the Personal Guard Individual Accident Policy or any other facility provided with health EMI Card services shall be immediately terminated.
6. For each valid transaction initiated and approved by the BFL on the Health EMI Card, a new Loan account will be created by BFL, provided that BFL may at its sole discretion reject such transaction initiated through the Health EMI Card. Further BFL may require additional documentations from the Customer for approving the said loan transaction.
7. BFL is not an issuer/provider of the products purchased/services availed by the Customer through the Health EMI Card. The Selected Business Associates may run different offers for Health EMI Card Customers. Such offers shall be subject to specific terms and conditions of such offers, which shall be in addition to the terms and conditions mentioned in this Application Form. Accordingly, BFL shall not be responsible for the quality or any assurances and/or representations made in relation to such products/services/offers provided by third parties. BFL shall not be liable for any delay in delivery or no-delivery of product and Services and/or with respect to the quantity, quality, conditions, fitness, suitability or otherwise whatsoever of the product/services.
8. I acknowledge that, Health EMI Card is NOT assignable to any person. I hold myself responsible for any use/misuse of the Health EMI Card, and I shall be jointly and severally responsible for any liability that is incurred by me/us.
9. In the event of an unauthorized access to or use of Health EMI Card, Health EMI Cardholder shall immediately inform BFL and call or write to BFL’s Customer and request for blocking the Health EMI Card.
10. BFL Customer Care Contact details:
1. For any grievances/queries, Customers can write to BFL at wecare@bajajfinserv.in
2. Health EMI Cardholders may also call BFL Customer Care for any grievances/queries related to Health EMI Card at 8698010101. This is not a toll-free number and normal call charges will be applicable
• CARD USAGE:-
1. The usage of Health EMI CARD at Selected Business Associates, is subject to the terms and conditions mentioned in this Application and Master Terms accessible on https://www.bajajfinserv.in/forms-centre as may be amended by BFL from time to time.
2. Terms used but not defined herein shall have the meaning ascribed to them in the Master Terms and Conditions.
3. The usage of the Card would be construed as the deemed acceptance of the Master Terms governing the usage of Health EMI Card.
4. By using the Health EMI Card, the customer may engage in the following transactions :-
1. To avail loan to pay their medical expenses on easy EMIs
2. Enquire about the available loan amount for availment of loan for the treatments that are eligible for loan under Health EMI CARD and/or apply for the same at Selected Business Associates as aforesaid
3. Use it for identification/authentication of the Existing Bajaj Member
5. To avail loan for the treatment at Selected Business Associates, Health EMI card holder will need to follow the below mentioned procedure:
1. share Health EMI Card number or registered mobile number, card validity date, name on the Health EMI Card and/or one photo identification at Merchant Counter or BFL’s branches or online platform.
2. enter his/her Transaction Code or One Time Password (OTP) received on the registered mobile number and/or the registered email id of the customer.
3. Once the Customer identity is authenticated, the Health EMI Card holder will receive a SMS providing the Commercial Terms of the proposed loan being offered (“Transaction SMS”) and containing a specific numeric code (the “Transaction Code”).
4. The customer shall convey his/her acceptance to the terms and conditions provided in the Transaction SMS by providing Transaction Code or OTP to BFL’s representative at the Selected Business Associates as specified above.
5. BFL would charge convenience/transaction/processing fees at its sole discretion on the loan availed by customer using Health EMI Card as amended from time to time and which will be communicated to the Customer through the Transaction SMS and shall be binding on the customer.
6. The NACH mandate given by Customer in favour of BFL can be used to recover all outstanding amount including fees, penalties, cost and other applicable charges in connection with the loan availed by the Customer.
7. Notwithstanding payment of instant activation fee by the Customer, this Health EMI Card cannot be used at the Selected Business Associates as aforesaid, for availing the services as stipulated herein until successful registration of the ECS/NACH mandate for the loan availed by the Customer as per this Membership Form (Ref: SFID/Case ID).
• COMMUNICATIONS RELATED TERMS AND CONDITIONS:-

• By submitting this Application Form, I hereby expressly authorise BFL, its group companies, affiliates and/or business associates and their respective representatives to send me communications regarding loans, insurance and their respective products and/or services (collectively “Other Products”) through telephone calls/SMSs/emails/post/bots/bitly etc. including but not limited to promotional communications. I agree and understand that such Other Products if availed, are governed by their own set of terms and conditions, which shall be in addition to and not in derogation to the terms and conditions prescribed by BFL herein. I understand that I can at any time opt not to receive any telecommunication

• Fees and Charges