TATA AIG Health Insurance Plans

TATA AIG Health Insurance

Buy TATA AIG Health Insurance ( Covers Covid19 Travel insurance for Coronavirus Covid )
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Tata AIG General Insurance Company Limited is an Indian General Insurance company and a joint venture between the Tata Group and American International Group, one of the global leader in General Insurance based out of the USA. Tata Group holds a 51 percent stake in the insurance venture with AIG holding the balance of 49 percent. Tata AIG General Insurance Company Limited celebrated 18 years of service this year (2018) since it commenced operations in India on January 22, 2001. Tata AIG General Insurance Company Limited has an asset base of approximate INR 10,050 crs. (as of 31st March 2019).
   Plans include global Covid-19 coverage  

TATA AIG Health Insurance Review

TATA AIG Health Insurance
Travel insurance for Coronavirus Covid Covers Covid19 Medical Expenses
TATA AIG Health Insurance sum insured
3 lacs − 20 lacs options available
Incurred Claims Ratio *
71.00%
TATA AIG Health Insurance tenure options
1, 2 or 3 years options available
Claims Settlement Ratio **
70.07%
List of network hospitals
7,200+ hospitals
Number of policies issued *
266,237
Maximum family floater coverage
Self, Spouse + 3 dependent children + 2 dependent parents
Number of lives covered *
4,194,204
* As per IRDAI report for 2020-21   |   ** As per NL25 data published on the Insurance Company website

Tata AIG Health insurance - Overview

With more than 200 offices spread across India, the Company has a robust multi-channel distribution network and also has a workforce of over 5,000 employees, including 550+ claim experts and a dedicated Customer Service & Operations & Claims team comprising of 450 team members, operating from various offices across India, consistently delivering superior service experiences powered by the latest innovations in technology.
Tata AIG offer their health insurance customers quality treatment at more than 4,000+ leading hospitals across the country. With an incurred claims ratio of 78%, they covered 22.48 lac lives (as per IRDA data for 2018-19) and also had a satisafctory 80.61% Claims settlement ratio(as per NL25 information declared on the company website).
As a saying goes, health is wealth! Good health is always important to pursue your interests and achieve your goals. However life is unpredictable and unfortunately poor health can land you in hospitals. The health care costs today is getting more expensive and you need adequate insurance coverage from reputed insurance companies like tata AIG health insurance.

Tata AIG Mediclaim Insurance Online

There are specially designed plans offered by Tata AIG health insurance for parents and elderly or senior citizens. Customers can get information regarding Tata AIG health insurance and the corresponding network of hospitals and choose the right plan to suit their individual requirements.
If you are living outside India with your parents living in India you can get quotes online and facilitate the purchase of Tata AIG health insurance for your parents remotely. You can complete a simple online application and get free quotes of Tata AIG health insurance. The Tata AIG health insurance claim form is also available online for customers. Contact our insurance experts for more details on tata health insurance.
If you are living outside India with your parents living in India you can get quotes online and facilitate the purchase of Tata AIG health insurance for your parents remotely. You can complete a simple online application and get free quotes of Tata AIG health insurance. The Tata AIG health insurance claim form is also available online for customers. Contact our insurance experts for more details on tata health insurance.

Tata AIG health insurance benefits

  • Key features
  • Key reasons
  • How to buy?
  • Claims
  • Exclusion

Key Features of Tata AIG Health Plans

  • Room Rent : No Room Rent Restrictions
  • Co-pay : NIL co-pay for all treatment
  • Restoration : Upto 100% of Base SI per year for unrelated illnesses
Some of the key features under the Tata AIG health insurance plans include :
  • Higher sum insured options in MediCare (upto ₹20 Lacs) and MediCare Premier (upto ₹50 Lacs)
  • No room rent restrictions in MediCare Premier / MediCare
  • In case of MediCare, two variants for accommodation cover – Single Private room/ Shared
  • Restore Benefit (for related as well as unrelated illnesses)
  • Longer tenure upto 3 years
  • Consumables Benefit available
  • Higher Cumulative Bonus than most plans in the India market
  • Optional PA cover for MediCare Protect and MediCare
  • Tata AIG is equipped to offer quality health care with our strong network of 4000+ hospitals across India.
  • Lifelong renewal: Lifelong renewal for your policy provided premium is paid without any break. Premiums will be basis the age, sum insured and plan with no extra loading
  • Global Cover: Insured can be covered for Medical Expenses incurred outside India, upto the sum insured provided that the diagnosis was made in India and the insured travels abroad for treatment.
  • Process
    • Uniform PPC grids
    • Simpler & Reduced medical questions in Proposal Form
    • Tele Underwriting – Medical Examination Report over the telephone
  • Claims
    • Plan for in house servicing of claims

Why Should One insure themselves through Tata AIG Health Insurance?

Some of the key reasons to trust Tata AIG with your Health Insurance policy are as follows:
  • One of the leading brands in India across all products including Health Insurance – know for transparency and integrity
  • Cashless claims facility at over 4,000+ hospitals across the country
  • State of the art 24*7 call centre for assistance and claims settlement across all product lines
  • Catering to needs as per a developing Indian Health market in terms of Benefits / Sum Insured Options
  • Maximum coverage at affordable premium rates backed up from superior claims and customer support.

How can one Buy a Tata AIG Health policy?

There are many distribution channels that distribute Tata AIG Health insurance products that include Agents, Banks and Brokers. One of the key distributors is the Web Aggregators which are online distributors of insurance and the advantage is that they offer a comparison of all insurance products to the customer, to allow them to compare the plans before opting for a health insurance plan that most suits his/her needs.
  • Step 1- Visit a product comparison website like https://www.eindiainsurance.com/ to review and compare policy benefits, coverage and premium details online
  • Step 2 - Seek information and clarity on the charges, inclusions, exclusions, other terms and conditions under the policy
  • Step 3 - Fill the Tata AIG online Health Insurance proposal form stating your personal details and health profile while ensuring the information given is complete and accurate
  • Step 4 – If this is a Straight through proposal, the premium remitted online will be transferred directly to the insurance company, and the policy will be issued, dispatched and will reach you in 7 working days
  • Step 5 – For Non Straight through cases, Tata AIG will process the application forwarded to them. Based on the information provided, one may be required to undergo pre-policy tests at designated diagnostic centers or they may just levy a loading based on the health report
  • Step 6 - If the proposal is accepted, the same will be issued accordingly
  • Step 7 - The Policy Schedule, Policy Wordings, Cashless Cards and Health Guide will be sent to the insured’s mailing address mentioned on the proposal form in the prescribed Turn around time

Tata AIG health insurance claims

Claim Related Information:
For any claim related query, intimation of claim and submission of claim related documents, you can contact Your TPA through:
  • Name of TPA : Family Health Plan Insurance TPA Ltd (FHPL)
  • Website : www.fhpl.net
  • Email
    • info@fhpl.net
    • seniorcitizensdesk@fhpl.net (for Senior Citizens)
  • Toll Free
    • 1800-425-4033
    • 040- 23552899 (for Senior Citizens)
  • Fax : +91-40-23541400
  • Submit claim
    • Claims Department, Family Health Plan Insurance (TPA) Ltd, Srinilaya – Cyber Spazio Suite # 101,102,109 & 110, Ground Floor, Road No. 2, Banjara Hills, Hyderabad, 500 034.
Procedure for Reimbursement of Medical Expenses
  • The TPA (Third Party Administrator) must be informed no later than 7 days of completion of such treatment, consultation or procedure using the Claim Intimation Form.
  • Please send the duly signed claim form and all the information/documents mentioned therein to your designated TPA within 15 days of the occurrence of the Incident. Please refer to claim form for complete documentation.
  • If there is any deficiency in the documents/information submitted by the insured, the TPA will send the deficiency letter within 7 days of receipt of the claim documents.
  • On receipt of the complete set of claim documents, Tata AIG will send the payment for the admissible amount, along with a settlement statement within 30 days.
  • The payment will be sent in the name of the proposer.
(Note: Payment will only be made for items covered under your policy and upto the limits therein.)
Procedure to avail Cashless Treatment
  • For any emergency Hospitalisation, the designated TPA must be informed no later than 24 hours after hospitalization.
  • For any planned hospitalization, kindly seek cashless authorization from the designated TPA atleast 48 hours prior to the hospitalization.
  • TPA will check your coverage as per the eligibility and send an authorization letter to the provider. In case there is any deficiency in the documents sent, the same shall be communicated to the hospital within 6 hours of receipt of documents.
  • Please pay the non-medical and expenses not covered to the hospital prior to the discharge.
  • In case the ailment /treatment is not covered under the policy a rejection letter would be sent to the provider within 6 hours.
(Note: n Insured person is entitled for cashless coverage only in our empanelled hospitals.)
Grievance Redressal Procedure
Tata AIG is committed to extend the best possible services to the insured. However, if you are not satisfied with our services and wish to lodge a complaint, please call our 24X7 Toll free number 1800266-7780 or 022-66939500 (toll number) or 1800 22 9966 (For Senior Citizens) or you may email to the customer service desk at customersupport@tataaig.com.
After examining the issue and subsequent closure, Tata AIG will send our response within 10 days from the date of receipt of the complaint by them. In case the resolution is likely to take a longer time, we will inform you of the same through an interim reply.
Escalation Level 1
In case you do not receive a resolution within 10 days or if the resolution still does not meet your expectations, you can write to manager.customersupport@tataaig.com . After analysing the matter internally and subsequent closure, we will send our response within a period of 8 days from the date of receipt at this email id.
Escalation Level 2
In case you do not receive a resolution within 8 days or if the resolution still does not meet your expectations, you can write to Head - Customer Services at head.customerservices@tataaig.com . After examining the matter, we will send you our final response within 7 days from the date of receipt of your complaint on this email id.

Exclusions under the Tata AIG’s Health Products

The following are the key Medical and Non Medical Exclusions under Tata AIG’s Health insurance Plans. Please go through the Terms and Conditions of the policy for the complete list of the exclusions: Medical Exclusions:
  • “AIDS” (Acquired Immune Deficiency Syndrome) and/or infection with HIV (Human immunodeficiency virus) including but not limited to conditions related to or arising out of HIV/AIDS such as ARC (AIDS related complex), Lymphomas in brain, Kaposi’s sarcoma, tuberculosis.
  • The abuse or the consequences of the abuse of intoxicants or hallucinogenic substances such as intoxicating drugs and alcohol, including smoking cessation programs and the treatment of nicotine addiction or any other substance abuse treatment or services, or supplies.
  • Treatment of Obesity and any weight control program subject to cover under benefit bariatric surgery.
  • Psychiatric, mental disorders (including mental health treatments); Parkinsons and Alzheimer’s disease;
  • Congenital external diseases, defects or anomalies;
  • Stem cell implantation or surgery; or growth hormone therapy;
  • Sleep-apnea
  • Charges related to peritoneal dialysis (CAPD), including supplies
  • Admission primarily for diagnostic and evaluation purposes only.
  • Venereal disease, sexually transmitted disease or illness;
  • Sterility, treatment whether to effect or to treat infertility; any fertility, sub-fertility or assisted conception procedure; surrogate or vicarious pregnancy; birth control, contraceptive supplies or services including complications arising due to supplying services.
  • Laser treatment for correction of eye due to refractive error;
  • Aesthetic or change-of-life treatments of any description such as sex transformation operations, treatments to do or undo changes in appearance or carried out in childhood or at any other times driven by cultural habits, fashion or the like or any procedures which improve physical appearance.
  • Plastic surgery or cosmetic surgery unless necessary as a part of medically necessary treatment certified by the attending Medical Practitioner for reconstruction following an Accident, Cancer or Burns.
  • All preventive care, vaccination including inoculation and immunisations (except in case of post- bite treatment and other vaccines explicitly covered);

Non-Medical Exclusions:
  • War or any act of war, invasion, act of foreign enemy, war like operations (whether war be declared or not or caused during service in the armed forces of any country), civil war, public defence, rebellion, revolution, insurrection, military or usurped acts, nuclear weapons/materials, chemical and biological weapons, ionising radiation.
  • Any Insured Person’s participation or involvement in naval, military or air force operation, racing, diving, aviation, scuba diving, parachuting, hang-gliding, rock or mountain climbing.
  • Intentional self-injury or attempted suicide while sane or insane.
  • Charges incurred at a Hospital primarily for diagnostic, X-ray or laboratory examinations not consistent with or incidental to the diagnosis and treatment of the positive existence or presence of any Illness or Injury, for which confinement is required at a Hospital.
  • Items of personal comfort and convenience like television (wherever specifically charged for), charges for access to telephone and telephone calls, internet, foodstuffs (except patient’s diet), cosmetics, hygiene articles, body care products and bath additive, barber or beauty service, guest service as well as similar incidental services and supplies.
  • Doctor’s fees charged by the Medical Practitioner sharing the same residence as an Insured Person or who is an immediate relative of an Insured Person's family.
  • Provision or fitting of hearing aids, spectacles or contact lenses including optometric therapy unless explicitly stated and covered in the policy.
  • Any treatment and associated expenses for alopecia, baldness, wigs, or toupees, medical supplies including elastic stockings, diabetic test strips, and similar products.
  • Crutches or any other external appliance and/or device used for diagnosis or treatment (except when used intra-operatively and explicitly stated and covered in the policy).
  • Any claim incurred after date of proposal and before issuance of policy where there is change in health status of the member and the same is not communicated to us.
  • All expenses incurred by the Policyholder/ Insured Person at the Hospital or any institution about which the Company has expressly notified that the Claim incurred at such Hospital/institution shall not be payable (except reimbursement claims related to accidents and life threatening conditions). The updated list of such Hospitals can be obtained through the Company's website or Call Center.

List of TATA AIG health insurance policies

Key Features:
  • Room Rent: Shared Accommodation(with 10% co-pay)/ Single Private A/c Room .
  • Co-pay : NIL co-pay for all treatment .
  • Restoration Benefit :Upto 100% of Base SI per year for all illnesses.
Key Features:
  • Room Rent: NIL Room Rent restrictions.
  • Co-pay : NIL co-pay for all treatment .
  • Restoration Benefit :Upto 100% of Base SI per year for all illnesses.

Key Features:
  • Room Rent: Shared Accommodation / 10% co pay for higher Room category.
  • Co-pay : NIL co-pay for all treatment .
  • Restoration Benefit :Upto 100% of Base SI per year for all illnesses.
Key Features:
  • Room Rent: NIL Room Rent restrictions.
  • Co-pay : NIL co-pay for all treatment .
  • Restoration Benefit :NIL Restoration Benefit.

Individual Hospital Cash insurance

(A Daily benefit hospitalization for Accident & Sickness)
Key Features:
  • A Daily benefit hospitalization for Accident & Sickness.
  • No Pre-policy check up required
  • Hospitalisation Cash upto 180 days in case of Accidents or Sickness
Key Features:
  • Guaranteed monthly income.
  • Medical test is not necessary.
  • Terrorism included.

Key Features:
  • Loan Shield: We will pay the outstanding loan amount in case of accidental death of the primary insured up to 25% of the sum insured or actual loan amount whichever is lesser.
  • Air Ambulance: Covers Utilization of Air Ambulance service for transporting insured person to hospital in case of an Accident Upto ₹5 lacs per year or actual whichever is lower per Insured.
Key Features:
  • The Policy covers Hospitalisation Expenses for In-Patient Care or Day Care Treatment incurred for treatment of an Illness contracted/ Injury sustained during the Policy Period.
Key Features:
  • Policy can be availed by persons between the age of 18 years up to 65 years, as Proposer. Proposer with higher age can obtain policy for family, without covering self.

Group Hospital Cash insurance

(policy and can be taken along with any other health insurance schemes)
Key Features:
  • A daily benefit hospitalization expenses for accident and sickness.
  • Pre-policy check-up is not required under this policy.
  • Hospitalization cash up to 180 can be used for expenses in case of accidents or sickness.

Tata AIG Health Insurance FAQ’s

Tata AIG has an extensive network of 4000+ network hospitals across India and this number has been growing steadily over the years. While seeking cashless settlement, one must get treated/admitted to a network hospital only. One can get the hospital in their city by reaching the Tata AIG network hospital list available on https://www.eindiainsurance.com/india-health-insurance/tata-aig-health-insurance.asp

Health Insurance is an insurance plan that provides coverage against medical expenses, following an accident or sickness to the insured and his/her family members. It also covers expenses incurred by the insured before and after hospitalisation under the pre and post hospitalisation coverage. Some of the other features include treatment for Day Care procedures, Maternity, Organ Donation, AYUSH treatment etc.

Yes, off course, Tata AIG Health offers Cashless treatment for inpatient hospitalisation across its network hospitals in India which number 4000+.Subject to the claim being admissible under the policy, Tata AIG will offer cashless settlement upto the policy limits of the insured’s policy.

Firstly Life insurance and Health Insurance are two different policies offering two different types of coverage. Most importantly, Life insurance covers the unfortunate mortality of the life assured but will not pay for medical expenses incurred by the individual if this hospitalisation occurred prior to his/her demise. Secondly Life insurance can also be used as an investment which provides both investment returns and life cover, whereas Health Insurance provides only coverage for medical treatment. It is strongly recommended that every individual has both policies, since they are complimentary in nature.

Daycare treatments are medical surgeries or treatments that can be completed in less than 24 hours and do not require the insured to be hospitalised. In such cases, even though one may be hospitalised, one doesn’t have to stay in the hospital for more than 24 hours. Since these are named procedures, only these will be covered under the policy. If one avails day care treatment without 24 hour hospitalisation for any procedure not listed by the insurance company, the same will not be covered. Tata AIG currently offers coverage for 541 named day care procedures, that are listed on the company website.

Pre hospitalisation expense is as a result of tests, medication that would have to be undertaken prior to the hospitalisation for the treatment. Similarly, post hospitalisation expenses can be for recovery and medicines that need to be taken post the hospitalisation treatment. Pre and post hospitalisation are normally covered for 60 and 90 days respectively.
  • On the advice of a physician, one gets themselves tested for symptoms etc before being hospitalised for further treatment of the illness. These medical expenses incurred before hospitalisation are called Pre hospitalisation expenses
  • Post hospitalisation expenses include all expenses or charges incurred by the insured after they are discharged from the hospital. For example, the consulting physician may prescribe certain tests to ascertain your progress or recovery after surgery.

The deductible or Co-pay is a fixed amount that the insured has to pay at the time of claim that will not be reimbursed by the insurer. At the time of settlement, Tata AIG will pay the claim amount minus the deductible.

Pre-existing diseases are those which the insured already carries before purchasing a health insurance policy. The proposer must declare any pre-existing disease/condition at the time of buying a medical insurance plan. One of the key factors to keep in mind is that the pre-existing diseases have a waiting period (which differs from company to company) and in the case of Tata AIG, it varies from 24 months to 48 months depending on the pplan opted for. Post this waiting period, one can be sure that they will be eligible to avail full benefits of your medical insurance policy.

Your coverage amount depends on your lifestyle, medical background, pre-existing diseases, members of your family, annual income, residential address and age.

Under the Tata AIG Medicare Health insurance policy, the sum insured ranges from ₹2 lacs to a maximum SI of ₹50 lacs. One can decide on the SI based on their age, lifestyle, family history and number of dependents.

While applying for a health insurance plan with Tata AIG, the following documents will be required to be submitted as part of KYC (Know Your Customer) process.
  • Age proof: Birth certificate, Passport, Driver’s License, Voter ID card.
  • ID proof: Driving license, Passport, PAN card, Aadhaar card.
  • Address proof: Electricity bill, Telephone bill, Ration card, Passport, Aadhaar card.
For senior citizens, a medical check-up is required prior to buying insurance.

Yes, you can cancel your Health Insurance policy. We provide a free look period of 15 days from the date of policy issuance within that you can cancel the policy and avail a refund if you are not satisfied with it. However, your refund will be adjusted against any expenses incurred such as underwriting costs, medical check-ups and so on. If the policy is to be cancelled after this 15 day period, there is a slab based refund that Tata AIG will provide to the insured.

No, the policy does not lapse, but continues to remain in force with a reduced sum insured (SI). After your claim is filed and settled, your insurance cover (SI) will be reduced by the claim amount that has already been settled to you. For example, if your policy was issued in January with a ₹5 lac coverage and if you claimed an amount of ₹2 lacs in July, then the balance SI of ₹3 lacs will be available to you between August-December during that policy year. There are some plans of Tata AIG which offer a Restore Benefit, which means that the SI gets restored back to the original SI after the claim is paid. SO in this same case, the SI available to the insured between August – December will be ₹5 lacs.

Some of the key reasons for investing in a Tata AIG Health insurance policy are:
  • Increase in Medical expenses/costs - With the healthcare industry in India witnessing double-digit medical inflation, it is getting extremely expensive to treat ailments in India for all medical conditions.
  • Health insurance coverage is more than just hospitalization - Many health insurance plans nowadays give coverage for day care procedures and OPD, cover for pre and post-hospitalisation, as well as doctor consultations, tests and medicines which are incurred during this period. There are also health plans that cover vector-borne diseases like dengue. Domiciliary treatments, Ayurveda, Unani, Siddha and Homeopathy (AYUSH) are also covered by the best health insurance plans in India.
  • Increase in the incidence of lifestyle-related illnesses - Sedentary lifestyle, unhealthy eating habits, increasing pollution and high stress levels are the growing norm day by day giving rise to chronic diseases like cancer, lung conditions and stroke, claiming younger lives.
  • Employer’s Health cover may not be sufficient - Group employer plans, rarely have sufficient coverage to meet medical expenses incurred in many cases. In the event of switching jobs or remain unemployed, an individual an remain exposed to financial risks from medical exigencies.
  • Financial Protection – Without health insurance, in the case of a medical exigency, the family can land up spending significant amounts of treatment costs from their hard earned savings. This can be avoided with a health insurance plan which will take care of these costs. The premiums paid should be regarded as an investment rather than a cost.

There is no upper limit on the number of claims during the policy period. However, the total cumulative claim amount cannot exceed the Policy Sum Insured, unless the insured has the Sum Insured Restoration benefit as part of their plan coverage.

In a cashless claim/hospitalisation, the insured/hospital intimates us regarding the hospitalization and submits a pre-authorization request. On authorization, the claim is directly settled with the network hospital and the insured is not required to pay any charges except for expenses not covered under the policy. Cashless facility can only be availed at a Tata AIG Health Insurance network hospital.

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ARTICLES

What is Health Insurance?
Health insurance is a contract between the insured and the insurance company to cover for medical emergencies that we consider ‘accidental and sudden’. The insured is expected to pay a specific premium amount regularly to utilize coverage benefits. Premiums are fixed not based on one’s income but on an assessment of risk status and coverage benefits.
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CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2025
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