Tata AIG Health Insurance

About TATA AIG Health Insurance

Tata AIG Insurance Company is a joint venture between the Tata Group and American International Group (AIG). The insurance company began its operations in 2001 and it has made a mark in the industry with its products and services in its 19 years of operation. It offers an extensive range of products addressed towards the individual as well as business insurance needs.

TATA AIG offers multiple health insurance plans to deal with different needs of the policyholders. It aims to create better tomorrow for its customers by providing trustworthy and innovative medical insurance solutions to secure their families.

Highlights of TATA AIG Health Insurance

Branches	152
Network hospitals	4000+
Claim Ratio	78%
Waiting period	4 years

Table Data updated on 25-03-2020

Types of TATA AIG Health Insurance Plans

1. Tata AIG Medicare (UIN: TATHLIP18004V011819)

Tata AIG Medicare is a simple and comprehensive health insurance plan which is available at an affordable price. It is designed by keeping different medical emergencies in mind.

Key Features

• Global Cover: Apart from the coverage in India, the plan will also cover the medical expenses of the policyholder incurred outside India, up to the sum insured limit. This benefit is available for those who are travelling abroad to avail of the required treatment.
• Bariatric Surgery Cover: The plan offers coverage against expenses occurring due to bariatric surgery in case the policyholder fulfils conditions as mentioned in the policy document.
• Sum insured Restore Benefit: If the policyholder has used the complete sum insured (including cumulative bonus) during the policy tenure, an additional amount equal to the sum insured will be restored in the policy. The same can also be used after 45 days from the date of discharge of the earlier claim.
• Consumables Benefit: The plan will pay for the expenses associated with the consumables that are listed in items for which additional cover may be offered by the company under ‘Guidelines on Standardization in Health Insurance 2016’, which are consumed during hospitalisation.
• Cumulative Bonus: On every claim-free year, the insured will avail a cumulative bonus of up to 50%. The account of cumulative bonus would decrease by 50% in the following year.

Eligibility

2. Medicare Premier Health Insurance (UIN No.: TATHLIP18005V011819)

Medicare Premier Health Insurance is a comprehensive yet affordable health insurance plan that stands with the financial support to deal with the unwanted medical emergencies of your life. The plan offers global cover in the hour of need. It is available on an individual and family floater basis.

Key Features

• Sum Insured Restore Benefit: If the insured utilized the entire sum assured along with the cumulative bonus, an amount equivalent to the base sum insured will be added to the plan during the chosen policy tenure. The benefit cannot be carried forward to further renewals.
• High-end Diagnostics: The plan will provide coverage to the insured for the listed diagnostic tests on an OPD basis in case of requiring treatment subject to Rs. 25,000 (annually) per policy.
• Emergency Air Ambulance Cover: The plan will also pay for the ambulance transportation of the policyholder in an airplane or helicopter up to Rs. 500,000.
• Maternity Cover: The plan will also pay for the maternity cover maximum up to Rs. 50,000 per policy. There will be a waiting period of 4 years under this plan subject to IRDAI portability guidelines.
• Organ Donor Cover: It will cover the medical and surgical expenses of the organ donor for harvesting the organ where the policyholder is the recipient.

Eligibility

3. Tata AIG MediCare Protect Health Insurance Policy (UIN: TATHLIP18007V011819)

Tata AIG MediCare Protect Health plan will assist the insured with helpful financial support to deal with medical bills and associated expenses during any medical emergency,

Key Features

• Daycare Procedures: The plan allows the insured to get coverage against 540+ Daycare procedures due to illness/disease/injury treatment taken at a hospital or a daycare center during the policy tenure.
• Restore Benefit: The plan automatically restores the sum insured (100%) for you and your family members.
• Cumulative Bonus: Like other plans, it also offers a cumulative bonus up to a maximum of 100% without a break. In the case where the insured files any claim, the cumulative bonus would get reduced by 10% in the following year.
• Consumables Benefit: The plan offers coverage against expenses incurred for consumables that are consumed during the hospitalisation period directly related to the policyholder’s medical or surgical treatment of disease/illness/injury.
• In-patient Treatment: The plan offers coverage against hospitalization and treatment of disease/illness/injury (during the policy tenure) that requires the policyholder to get admitted to the hospital as an inpatient. Medical expenses associated with hospitalization would be payable.

Eligibility

4. Wellsurance Executive Policy (UIN: TATHLIP10001010910)

Wellsurance Executive Policy is a health insurance plan designed to offer cover against specific and unique requirements of insured people. The plan offers a complete cover to the insured at an affordable price.

Key Features

Hospitalisation Cover: The plan offers the desired coverage against specified hospitalisation cost in a case where the insured person is hospitalized for the treatment of injury/sickness.

Post Hospitalization Expenses: The plan will pay a lump sum amount (after hospitalisation) under following situations-

• Postoperative physiotherapy
• Chemotherapy and/or radiation
• Kidney dialysis

Value-added Service: Apart from the basic cover, the plan will also offer additional services such as facilities (like free health line, health query, health portal, discounted services for the health and wellness) and e-newsletter under which the insured will get access to various health articles.

Minor and Major Surgical benefits: Any minor or major surgery is liable to get the cover which is essential for the treatment and not related to the pre-existing disease.

Eligibility

5. Wellsurance Family Policy (UIN: TATHLIP10004V010910)

Wellsurance Family Policy is a single health insurance policy that covers your child’s education and parent’s hospitalisation expenses. It allows the insured to protect his/her family. The plan also covers 11 specified critical illnesses.

Key Features

• Intensive Care Unit Benefits: The plan will provide a cash benefit on a daily basis while the insured is admitted to the intensive care unit in a hospital because of any injury/sickness.
• Ease of Hospitalisation: In the case where a family member is admitted in hospital due to any illness or injury, the plan will provide a daily cash benefit for up to 90 days.
• Ambulance Charges: The plan covers a specified amount towards the medical transportation fees and services for bringing the insured to the hospital due to an accident/illness. Even after getting discharged from the hospital, it will pay for the charges to take the patient back home
• Value-added Service: The plan offers a few additional services that include free health line, health queries, health portal, discounts on services associated with health and wellness and e-newsletter and complete access to health-related articles.
• Domiciliary Hospitalisations: The plan pays a lump sum amount for the recovery at home. In case the patient wants or the hospital authority asks him/her to take treatment at home (because of any genuine reason), the plan will be there to assist with the cover against such charges.

Eligibility

6. Wellsurance Woman Policy (UIN: TATHLIP10001010910)

Wellsurance Woman policy is specially designed to provide coverage to women against illnesses. The plan covers critical diseases. Along with the same, there are several additional benefits that you can get under this plan such as recuperation benefits, health lines, health and wellness discounts, cosmetic reconstructive surgery and much more.

Key Features

• Critical Illness Benefits: The plan will offer a lump sum amount to the insured in case she is diagnosed with any critical illness during the policy tenure.
• Ambulance Charges: The plan pays up to a specified amount for the medical transportation fees of the insured.
• ICU Expenses: ICU expenses related to the treatment will be liable to get the cover for 15 days.
• Cosmetic Reconstruction Surgery: The plan will pay a particular amount in the case where the surgery is conducted as a reconstructive procedure.
• Value-added Service: Additional facilities such as a health portal, free health line, health query, an e-newsletter will be provided to the policyholders.

Eligibility

7. TATA AIG Critical Illness Policy (UIN: TATHLIP05001V010405)

TATA AIG Critical Illness Policy is a health insurance plan which is designed to offer coverage against critical diseases. The policy will cover 12 specified critical diseases.

Key Features

• Comprehensive Cover: It will offer comprehensive cover in case the insured is diagnosed with heart attack, stroke, cancer, open chest CABG, organ transplant, kidney failure, bone marrow transplant, major burns, blindness, coma, multiple sclerosis, and paralysis.
• Second Opinion Cover: If the insured has any doubt regarding the treatment or diagnosis, he/she can opt for a second opinion and this insurance plan will cover the cost of the same.
• Enhance Sum Assured: During the policy tenure, if the insured feels that he/she should enhance the sum assured for wider coverage, then he/she can use the ‘sum insured enhancement’ feature at the time of renewal and get it done.
• Portability Option: The plan comes out with the portability option. Under the same, the customer is allowed to invest in the same plan and avail the huge benefit.
• Tax Benefit: You can reduce your taxable income by up to Rs. 50,000 by investing in this critical illness cover.

Eligibility

8. MediPlus – Top-up Medical Health Insurance Plan (UIN: TATHLIP14003V011314)

MediPlus is a health top-up plan under which the insured gets an extra cover to deal with medical emergencies in case the limit of the basic health insurance plan meets the threshold.

Key Features

• Daycare Procedures: The plan offers coverage of up to 140-daycare procedures that do not need hospitalisation of 24 hours.
• Dental Coverage: If you need any dental treatment owing to an accident or illness, you are liable to get the coverage under the policy.
• Ambulance Charge: Under this plan, the insured is liable to get the coverage against ambulance charges up to Rs. 2000.
• Discounts: The plan offers a discount of around 10% on insuring two or more family members under the same policy. In case you choose a 2-year policy, you can avail of another 7.5% discount.
• In-patient Treatment: The plan offers coverage against room rent, ICU, and nursing. The coverage can also extend to medicines, drugs, and consumables.
• Organ Transplant: The plan also covers in-patient expenses incurred by the organ donor in case of organ transplantation along with the costs incurred by the recipient.
• Pre and Post-hospitalisation: The policy covers the cost of medical expenses incurred 60 days prior and up to 90 days after hospitalisation.

Eligibility

9. TATA AIG Medisenior Plan (UIN: TATHLIP14001V011314)

Medisenior is a comprehensive health insurance plan that is an ideal option for the old age and retired people. The plan offers coverage or treatment in all hospitals across India.

Key Features

• Pre-hospitalisation and Post-hospitalization Expenses: All medical expenses that occur 30 days prior to the hospitalization and 60 days post hospitalization will be liable to get the cover.
• Daycare Procedures: The plan covers up to 140-day care procedures that do not need hospitalisation. That’s certainly a big relief!
• Other Charges: The plan offers coverage against ambulance charges up to Rs 2,000 per hospitalisation.
• Discounts: You can avail a 7.5% discount on your policy premium in case you pay two year’s premium in advance. You also get a 5% family discount on insuring 2 family members under the Medisenior policy.
• Organ Donation Expenses: The policy offers coverage against kidney and other organ transplants. It will cover the charges incurred by the donor in transplanting the organs.
• In-patient Treatment: The insured will get the coverage against hospitalisation expenses as well. Everything starting from room rent, medicines, ICU to nursing expenses, drugs, and consumables will be liable to get the cover.
• Treatment at Home: You don't have a worry in case you or your spouse needs medical treatment at home (in case of emergency). You only have to pay attention to the treatment, rest will be taken care of by the plan.

Eligibility

10. TATA AIG MediRaksha Plan (UIN: TATHLIP14002V011314)

TATA AIG MediRaksha Plan is a comprehensive health insurance plan to take care of you and your family in case of medical emergencies. It covers all illnesses, hospitalizations, and surgical treatments.

Key Features

• Wide Coverage: You can extend the cover for seven family members. It means apart from yourself, you can easily insure your parents, spouse, and three children too.
• Medical Examination: To get insured under this plan, you don't have to undergo a medical test up to the age of 55 years.
• In-patient Treatment: The plan will cover the hospitalisation expenses that occur because of illness or an accident. You get the required coverage against room rent, ICU, boarding and nursing. It also covers medicines, drugs, and other consumables.
• Organ Donor: The plan also provides coverage in case of an organ transplant – both for the organ receiver and the donor at the time of transplantation.
• Daycare Procedures: The plan will also offer coverage against 144 daycare procedures that does not require 24 hours hospitalisation.

Eligibility

What Factors Affect The Premium of TATA AIG Health Insurance Plans?

Age: The health insurance premium for young people will be less as compared to the premium of old age people. The reason behind the same is that young people are likely to have fewer health-related issues and the old age people might be suffering from one/several diseases while investing.

Pre-existing Disease: If the customer is suffering from disease while buying a health insurance plan, then the premium of the same person will be high as compared to a healthy person. Such disease will come under pre-existing diseases and will be liable to get the cover after the waiting period.

Sum Insured Amount: If the sum assured is high, its cover and the premium will be high as well. That's why it is recommended to get an adequate cover. It will be as per your requirements.

Profession: The nature of your work plays an important role in the calculation of the insurance premium. A high-risk profession will demand a high premium as compared to a low-risk profession. A person can’t be denied coverage based on the nature of his/her work but it can be a factor that could affect coverage, exclusions or even the sum insured of your policy.

What is The Right Way To Renew TATA AIG Health Insurance Plans?

• Visit the official website of TATA AIG General Insurance Company.
• Click on the tab “Renew’.
• Select ‘Health’. Submit the policy number and your phone number.
• Check and pay the premium amount.
• You will get the confirmation on your registered email id.

Claim Process of TATA AIG Health Insurance Plans

The company provides a simple claim process to assist the customer during medical emergencies. It has divided the process into two forms- Cashless and Reimbursement. Let's discuss both types of claims in detail.

Cashless: Under this form of claim settlement, the insured has the freedom to take the needful treatment at any network hospital without paying anything from his/her pocket. The best thing about this plan is that after submitting required documents along with a claim form to the insurance company or TPA present at every network hospital, the insured doesn't have to worry about making payments. The insurance company or TPA will directly deal with the bills associated with the treatment.

Note- It is important for the insured to inform the company or TPA about the hospitalisation on time (within 48 hours in case of emergency and 3 days before hospitalisation in case of a planned one).

Reimbursement: Here you need to pay all the treatment bills to the hospital. Later, you can file for reimbursement under TATA AIG health insurance. To do that, the insured must collect all bills, and prescriptions related to the treatment and submit the same along with the claim form to the insurance company or TPA The insurer will analyze your claim and might ask for additional documents (if required). If it gets approved, the company will transfer the amount directly into your account or in case of rejection, you will receive a document, email or text stating the reason for rejection.