Tata AIG Health Insurance Plans – Features, Plans, Claims Process, Buy, Renew Policy, Quotes

Tata AIG Health Insurance

TATA AIG General Insurance Company, founded in 2001, is a collaboration between the Tata Group and American International Group (AIG). TATA AIG offers a wide range of Health Insurance Plans for Individuals, Families, Senior Citizens, and Corporate Groups. Tata AIG General Insurance had an Incurred Claim Ratio of 83.13% as of March 2024 according to IRDAI Handbook of Insurance Statistics 2023-24

What are the Key Features of Tata AIG Health Insurance Plans?

The Key Features of Tata AIG Health Insurance Plans are as follows:

1. Comprehensive Coverage: Tata AIG Health Insurance Plans provide comprehensive coverage for Hospitalisation Expenses, Pre- and Post-Hospitalisation Expenses, Daycare Procedures, organ donor expenses, AYUSH treatments (Ayurveda, Yoga, Unani, Siddha, Homeopathy) etc.
2. Wide Range of Plans: Tata AIG offers a wide range of plans to suit the different requirements of Individuals, Families, Senior Citizens.
3. Sum Insured Options: Tata AIG Health Insurance Plans offer wide coverage ranging from Rs2 lakh to Rs3 crore, depending on plan type.
4. Extensive Hospital Network: Cashless Claim Settlement at 12,000+ hospitals across India.
5. Tax Benefits: Premiums paid for Tata AIG Health Insurance Plans are eligible for deductions under Section 80D of the Income Tax Act, 1961.
6. Global Coverage: Some plans cover overseas treatments, subject to policy terms

What are different Health Insurance Plans offered by Tata AIG General Insurance Company?

Tata AIG General Insurance Company offers various health insurance plans depending on the requirement of the Insured. Some of the Health Insurance Plans offered by HDFC Ergo are listed below:

TATA AIG Medicare Premier Insurance Policy

Tata AIG Medicare Premier is a Comprehensive Health Insurance Plan that provides cover for Hospitalisation Expenses, Pre and Post-Hospitalisation Expenses, Daycare Procedures etc. The Policy also offers coverage for Maternity Expenses, High End Diagnostics and Organ Donor Expenses.

Key Features of the Tata AIG Medicare Premier Insurance Policy

1. Tata AIG Medicare Policy offers various Sum Insured Options from Rs5 Lakhs to Rs3 Crores and has a Minimum Entry Age of 91 Days and Maximum Entry Age of 65 years
2. Pre and Post-Hospitalisation Expenses coverage for 60 days - 200 days respectively
3. Global Cover for Planned Hospitalisation: The Policy provides coverage for Inpatient and Daycare Treatments availed outside India upto the Sum Insured provided that the diagnosis was made in India and the Insured travels abroad for treatment.
4. Restoration Benefit provided for Related and Unrelated Illnesses provided during the Policy Year. For Related Illnesses, hospitalisation should be 45 days after the date of discharge of the earlier claim.
5. Cumulative Bonus of 50% Base Sum Insured up to a maximum of 100% of the Base Sum Insured under the current Policy Year. If a Claim is made under the Health Insurance Policy during any Policy Year, the cumulative bonus benefit will be reduced at the same rate at which it has accrued.
6. Maternity Coverage: The Policy provides Maternity Expenses Coverage of upto Rs50,000/60,000 for Boy/Girl child for Sum Insured upto Rs50 lakhs and Rs1,00,000/Rs1,20,000 lakhs for a Boy/Girl Child for Sum Insured above Rs50 lakhs subject to a Waiting Period of 3 Years.
7. OPD Coverage: Tata AIG Medicare Premier Plan provides coverage for OPD Treatment (including Dental Treatment) with a Sub-Limit ranging from Rs5000 to Rs20000 depending on the Sum Insured chosen under the Plan. The Policy also provides coverage to the Insured for listed diagnostic tests on OPD Basis tanging from Rs25,000 to Rs50,000 depending on the Sum Insured if these tests are required as part of treatment.
8. Consumables Benefit: The Consumables Benefit Cover provides coverage for specified consumables which are consumed during the period of hospitalization.
9. Home Care Treatment Cover: The Policy provides a Home Care Treatment Cover upto the Sum Insured for Dialysis and Chemotherapy treatment taken at home
10. Waiting Period of 24 months for Specific Diseases
11. Waiting Period of 24 months for Pre-Existing Diseases
12. Waiting Period of 24 months for OPD Coverage
13. Waiting Period of 36 months for Maternity Coverage
14. The Premiums are applicable for Section 80D Deduction under the Income Tax Act, 1961
15. Lifetime Renewal

TATA AIG Medicare Select Insurance Policy

Tata AIG Medicare Select is a Health Insurance Plan that provides cover for Hospitalisation Expenses, Pre and Post-Hospitalisation Expenses, Daycare Procedures etc. Tata AIG Medicare Select Policy offers various Sum Insured Options from Rs5 Lakhs to Rs3 Crores and has a Minimum Entry Age of 0 Days and no Limit on Maximum Entry Age.

Key Features of the Tata AIG Medicare Select Insurance Policy

1. The Policy provides coverage for Hospitalisation Expenses, Pre and Post-Hospitalisation Expenses coverage for 90 days and Daycare Procedures.
2. The Policy has a Room Rent Restriction of Single Private Room
3. Restoration Benefit: The Policy provides Unlimited Restoration Benefit for Related and Unrelated Illnesses provided during the Policy Year. For Related Illnesses, hospitalisation should be 45 days after the date of discharge of the earlier claim.
4. Cumulative Bonus of 50% Base Sum Insured up to a maximum of 100% of the Base Sum Insured under the current Policy Year. If a Claim is made under the Health Insurance Policy during any Policy Year, the cumulative bonus benefit will be reduced at the same rate at which it has accrued.
5. Infinity Sum Insured: The Policy provides coverage for 1 Claim for Inpatient Treatment/Daycare Procedure where medical expenses are covered with no limit on the Sum Insured. The Infinity Sum Insured can be utilized only once during the lifetime of the Policy.
6. Consumables Benefit (Optional): The Consumables Benefit Cover provides coverage for specified consumables which are consumed during the period of hospitalization.
7. Maternity Coverage (Optional): The Policy provides Maternity Expenses Coverage of upto 10% of Policy Sum Insured subject to a maximum of Rs1 lakh subject to a Waiting Period of 2 Years. There is an option to reduce the Waiting Period for Maternity Coverage to 1 Year. In addition to maternity expenses, the Policy provides coverage for Delivery Complications and 1st Year Vaccination Expenses of a New-Born Baby.
8. Waiting Period of 24 months for Specific Diseases
9. Waiting Period of 36 months for Pre-Existing Diseases
10. Waiting Period of 24 months for Maternity Coverage. There is an option to reduce the Waiting Period for Maternity Coverage to 1 Year
11. The Premiums are applicable for Section 80D Deduction under the Income Tax Act, 1961
12. Lifetime Renewal

TATA AIG Arogya Sanjeevani Policy

The Tata AIG Arogya Sanjeevani Policy is a standard health insurance plan mandated by IRDAI providing coverage for hospitalization expenses, Pre and Post-Hospitalisation Expenses, Daycare Procedures etc. The Policy has a minimum entry age of 18 years and maximum entry age of 65 years.

Key Features of the Tata AIG Medicare Arogya Sanjeevani Insurance Policy

1. Sum insured options ranging from Rs. 50,000 to Rs. 10,00,000.
2. Pre and Post-Hospitalisation Expenses Coverage for 30 days and 60 Days
3. Room Rent Limit of 2% of Sum Insured subject to a maximum of Rs5000 per day for Normal Rooms and 5% of Sum Insured subject to a maximum of Rs10,000 per day for ICU Rooms
4. Cumulative Bonus of 5% per year for every claim free year, provided that the policy is renewed without a break every year, subject to a maximum of 50% of Sum Insured.
5. Cataract Limit of upto Rs. 40,000 per eye or 25% of Sum Insured whichever is lower
6. Co-Payment of 5% on each and every claim
7. Waiting Period of 48 months for Pre-Existing Diseases
8. Waiting Period of 24 and 48 months for Specific Diseases
9. The Premiums paid for the Policy are eligible for Section 80D Deduction under the Income Tax Act, 1961
10. Lifelong Renewal

TATA AIG Medicare Plus Super Top-Up Health Insurance Policy

Tata AIG Medicare Plus Super Top Up Policy is a Super Top-Up Health Insurance Plan which provides Health Insurance Coverage over and above an existing base Health Insurance Plan thusPlan enhances the overall Health Insurance Coverage at affordable premiums.

Key Features of the Tata AIG Medicare Plus Super Top-Up Health Insurance Policy

1. Sum Insured options range from Rs3 Lakhs to Rs1 Crore with Deductible options ranging from Rs2 lakhs to Rs20 lakhs.
2. Pre and Post-Hospitalisation Expenses coverage for 60 days - 90 days respectively
3. 540 Daycare Procedures are covered under the Policy
4. The policy provides coverage (Optional Cover) for treatments availed outside India upto the Sum Insured provided that the diagnosis was made in India and the Insured travels abroad for treatment.
5. Cumulative Bonus of 50% Base Sum Insured up to a maximum of 100% of the Base Sum Insured under the current Policy Year. If a Claim is made under the Health Insurance Policy during any Policy Year, the cumulative bonus benefit will be reduced at the same rate at which it has accrued
6. Waiting Period of 24 months for Specific Diseases
7. Waiting Period of 36 months for Pre-Existing Diseases
8. Premiums paid for the policy are eligible for tax deduction under Section 80D of the Income Tax Act.
9. Lifelong Renewal

TATA AIG Criti Medicare Insurance Policy (Smart Century Premier Plan)

The Tata AIG Criti Medicare Policy (Smart Century Premier Plan) is a Critical Illness Insurance Policy which provides comprehensive coverage against 100 critical illnesses and related expenses. The Policy pays a lumpsum amount on diagnosis of covered critical illness during policy period.

Key Features and Benefits of the Tata AIG Criti Medicare Insurance Policy

1. The Plan offers coverage under 3 Main Sections: Critical Illness, Cancer 360 Degree Indemnity Cover and Hospital Cash Cover.
2. Under the Critical Illness Cover, the Policy pays a Lumpsum Amount on the diagnosis of any of the listed critical illnesses. The Smart Cancer Care Cover under the Critical Illness Cover provides a specified percentage of Sum Insured as a Lumpsum Payment if the Insured is diagnosed from Cancer. This benefit is over and above Critical Illness Sum Insured. The Sum Insured for Critical Illness Cover ranges from Rs5 lakhs to Rs2 Crores.
3. The Cancer 360 Degree Indemnity Cover provides coverage for Hospitalisation Expenses and Daycare Treatment of Cancer upto the Sum Insured. The Cover also provides coverage for Chemotherapy and Radiotherapy, Advanced Treatments and High End Diagnostics upto Rs25000 per Policy Year on OPD Basis. Additionally, The Cancer 360 Degree Cover also covers Hospitalisation Expenses and Daycare Treatment Expenses incurred outside India (abroad) on reimbursement basis, provided that the diagnosis was made in India. The Sum Insured for Cancer 360 Degree Cover ranges from Rs5 lakhs to Rs2 Crores.
4. The Hospital Cash Cover provides a fixed Daily Cash Benefit for each continuous and completed 24 hours of hospitalization for medically necessary treatment. The Sum Insured for Critical Illness Cover ranges from Rs500 per day to Rs20,000 per day.
5. The Policy has a Waiting Period of 90 Days for Critical Illness Cover and Cancer 360 Degree Cover and a Waiting Period of 30 Days for Hospital Cash Benefit Cover
6. The Insured can choose a Survival Period of 0/7/15 days.
7. Waiting Period of 36 months for Pre-Existing Diseases
8. Premiums paid are eligible for tax deductions under Section 80D of Income Tax Act
9. Lifelong Renewal

TATA AIG Elder Care Health Insurance Policy

Tata AIG Elder Care policy is a Senior Citizen Health Insurance Policy with an entry age of 61 years to 85 years. The Policy provides cover for Hospitalization Expenses, Day Care Procedures, Pre and Post-Hospitalization Expenses, Ambulance Charges etc.

Key Features and Benefits of the Tata AIG Elder Care Health Insurance Policy

1. The Policy offers Sum Insured Options of Rs5 Lakhs, Rs10 Lakhs and Rs25 Lakhs
2. The Policy has a Room Rent Restriction of a Single Private Room and a Co-Payment of 20% of Claim Amount applies to each and every claim. The Co-Payment can be waived off by opting for the ‘Waiver of Co-Payment’ Add-On Cover
3. Cumulative Bonus of 10% Base Sum Insured up to a maximum of 100% of the Base Sum Insured for each Claim Free year under the Policy.
4. Pre and Post-Hospitalisation Expenses coverage for 30 days - 60 days respectively
5. The Policy provides coverage for 10 Home Physiotherapy sessions after a hospitalization claim under Joint replacement surgery, stroke or paralysis
6. Tata AIG Elder Care Policy provides coverage for Home Treatment for Specific Conditions upto 10% of the Policy Sum Insured
7. The Policy provides coverage for High End Diagnostics on OPD Basis subject to a maximum of Rs20,000 per Policy Year
8. Sub-Limits applicable on Cataracts and Joint Replacement surgeries
9. Waiting Period of 24 months for Pre-Existing Diseases
10. Waiting Period of 24 months for Specific Diseases and 36 months for Joint replacement surgeries/Hip Replacement Surgeries
11. Lifelong Renewal

What is the Health Insurance Claim Settlement Process with Tata AIG General Insurance Company?

TATA AIG Health Insurance Claim Settlement Process – Cashless Claim Settlement

To avail Cashless Claim Settlement under the Tata AIG Health Insurance Policy, the Policyholder must follow the steps listed below:

1. Locate the nearest network hospital covered by the Tata AIG Health Insurance Policy to avail treatment
2. Inform the Insurance Company about the hospitalization before 3-4 days in case of a planned hospitalization and within 4-5 hours in case of an emergency
3. Show the Health Card issued by the Insurance Company to the Insurance desk at the hospital
4. Fill the Pre-Authorization Claim Form provided by the hospital
5. The Hospital sends the Pre-Authorization Claim Form to TATA AIG General Insurance Company for Claim Settlement
6. The Company inspects the details and informs the Insured about the approval or rejection of the Claim
7. Once the Claim gets approved, the hospital sends the expenses and receipts to the Insurer and the hospital gets reimbursed for the treatment expenses directly by TATA AIG General Insurance Company. The advantage of cashless claim settlement is that the Policyholder does not need pay any amount from his own pocket.

TATA AIG Health Insurance Claim Settlement Process – Reimbursement Claim Settlement

If the Policyholder chooses a non-network hospital, he will have to opt for Reimbursement Claim Settlement. The Reimbursement Claim Settlement is listed below:

1. Inform TATA AIG about hospitalisation within 24 hours of admission. The Company will provide the Policyholder with a Claim Intimation Number after the claim is raised so that the Claim Status can be tracked.
2. Make the payment to the hospital for the medical expenses incurred and keep original copies of all the Invoices.
3. Submit the required documents to TATA AIG General Insurance Company
4. The Insurance Company will verify the Claim Details, ask for additional documents if required and will approve or reject the Claim.
5. The approved Claim Amount gets credited directly to the Bank Account of the Insured

What are the documents Required for a Reimbursement Claim under a Health Insurance Policy?

The Insured needs to submit the following documents to TATA AIG General Insurance Company to avail Reimbursement Claim Settlement under the Policy:

1. ID Proof, Policy Health Card and Address Proof
2. Duly Filled and Signed Claim Form
3. Pathology Reports
4. Medicine Prescriptions and Pharmacy Bills
5. Pre and Post-Hospitalisation Bills
6. Hospital Bills
7. Discharge Summary

How to Buy a Tata AIG Health Insurance Policy?

The steps to buy a Tata AIG Health Insurance Policy with Qian are as follows:

1. Go to Qian Insurance Broking website <www.qian.co.in> and click on the Health Insurance icon
2. Fill the ‘Get a Free Quote Form’ by submitting your Name, Email ID and Mobile Number
3. An Expert Health Insurance Executive would reach out to you within 15 mins and take the relevant details like the People to be Insured and their Date of Births, Details of Pre-Existing Diseases, Sum Insured and Policy Features required and Premium Budget.
4. The executive will suggest multiple plans from Tata AIG based on your requirements and budget.
5. Finalise the Plan and submit necessary documents such as ID proof, Address Proof etc.
6. Pay the premium using net banking, UPI, credit/debit card or wallet.
7. The policy will be emailed to your registered email ID.

How to Renew Tata AIG Health Insurance Policy?

The Process to renew Tata AIG Health Insurance Policy with Qian is as follows:

1. Contact Qian Insurance Broking or visit the nearest branch office of the Company.
2. Provide relevant details along with the details of Policy
3. The Qian Insurance Team will assist you with renewal quotes and to submit relevant documents.
4. Pay the premium via cash, cheque or demand draft.
5. The Policy will be mailed to your address within 2 days

Get Best Quotes for Tata AIG Health Insurance Policies with Qian!

TATA AIG Health Insurance is a credible health insurer with a wide array of plans, vast hospital network, and a smooth claims experience. Qian is a licensed Insurance Broker with Tata AIG General Insurance Company. We can assist you with all Health Insurance Policies as well as Claim Settlement with Tata AIG. Get a Quote for Tata AIG’s Health Insurance Policy from Qian.

You can reach out to us via email at insurance@qian.co.in or call us on 022-35134695. We would be glad to assist you