TATA AIG Health Insurance, TATA AIG Medical Insurance

It is rightly said 'Health is Wealth'. We are all aware that health care costs are high and getting higher. At times, unfortunately we fall prey to unanticipated accidents & illness.
The newly launched TATA AIG's MediCare plans caters to most of the needs of the mediclaim policy holders where it covers wide range of new benefits at a competetive price.
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TATA AIG Health Insurance Review

Sum Insured
3 lacs − 20 lacs options available
Tenure Options
1, 2 or 3 years options available
Claims Incurred Ratio *
78.00%
Claims Settlement Ratio **
80.61%
List of Network Hospitals
4,000+ hospitals
Number of Policies issued *
220,583
Number of Lives Covered *
2,248,000
Maximum Family Floater Coverage
Self, Spouse + 3 dependent children + 2 dependent parents
* As per IRDAI report for 2018-19   |   ** As per NL25 data published on the Insurance Company website

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What are the unique benefits of TATA AIG health insurance?

Some of the TATA AIG health insurance benefits are
  • Cashless hospitalization due to accident and sickness at 4500+ network hospitals
  • No room rent restrictions
  • Pre-existing diseases cover after 2 year waiting period.
  • Domiciliary treatment
  • 541 day care procedure
  • Family discount of up to 32% and up to 10% discount if purchased for 3 years.
  • Maternity and new born baby cover
  • Vaccination cover
  • Bariatric surgery
  • Tax benefit under section 80D
  • Renewal for life
  • Ayush benefit
  • Global cover
  • Restore benefit (for related and unrelated issues)
  • OPD cover
  • Emergency air ambulance
  • No Claim bonus
  • Good claim settlement ratio
  • Other consumable benefits

TATA AIG health insurance plans

  • Sum insured 3, 4, 5, 7.5, 10, 15, and 20 Lacs
  • Global Cover
  • 100% automatic restoration of base sum insured
  • 540+ listed Day Care Treatment covered
  • Covers treatment of Obesity and weight control
  • 50% no claim bonus on base sum insured, max up to 100%
  • Pre-existing diseases covered after 3 years
  • Sum insured 5, 10, 15, 20, 25 and 50 Lacs
  • Global Cover
  • 100% automatic restoration of base sum insured
  • Cover for Maternity and new born baby expenses
  • Covers out patient medical expenses
  • Covers treatment of Obesity and weight control
  • 50% no claim bonus on base sum insured, max up to 100%
  • Pre-existing diseases covered after 2 years
  • Sum insured 2, 3, 4, 5 Lacs
  • 100% automatic restoration of base sum insured
  • 540+ listed Day Care Treatment covered
  • 10% no claim bonus on base sum insured, max up to 100%
  • Pre-existing diseases covered after 4 years
  • Plan is available for individuals.
  • Eligible for applicants 61 yrs and above.
  • Coverage available from 2-5 lakhs.
  • Lifelong renewal provided.
  • Family discount of 5% for self and spouse and 7.5% discount for two year tenure.
  • Entry age is 18years to 65years.
  • Lifelong renewal provided.
  • Coverage available is Rs. 50,000, Rs. 75,000 and Rs. 1 lakh.
  • No medical check up required if you are taking the policy before the age of 55 years
  • Provides coverage for a set of 11 Critical Illnesses & Surgeries.
  • Entry age is 18 - 60 years.
  • The coverage can be availed on renewals till the age of 64 yrs.
  • Waiting period is 90 Days from the inception of the policy
  • This is a top-up health insurance plan
  • Entry age is 91days to 65years.
  • Lifelong renewal provided.
  • Coverage available is 5 lakhs.
  • Entry age is 6months up to 65 years.
  • No medical check up required.
  • Coverage available from Rs. 500 a day to Rs. 25,000 per day.
  • We offer life-long renewal subject to application for renewal.
  • Entry age is 6months up to 65 years.
  • No medical check up required.
  • We offer life-long renewal subject to application for renewal.
  • Grace period of 30 days to renew the policy.
  • Option to increase the sum assured at the time of renewal.
  • Principal sum will be increased by 5% (up to 25%) every year if there is no interruption in coverage.
  • Option to choose the amount of monthly income anywhere between Rs.10000 and Rs.35000, for a period of 5 to 20 years.
  • You have a period of 15 days from the date of receipt of the Policy document to review the terms and conditions of this Policy.

Wellsurance Plans (TOP-UP PLANS)

TATA AIG’s Wellsurance is an exciting add-on health insurance product which works very well in complementing existing medi-claim plan. The claims are settled on this plan simply by providing photocopies of the bills which is unique to this plan, thereby allowing the customer to use the original bills for filing claims with any other health insurance plan.
  • Plan is availbale for individuals.
  • Eligible for 18 - 65 yrs of age.
  • Policy pays benefit amount on diagnosis of any 9 critical illnesses.
  • A Unique plan for Women's.
  • Eligible for 18 - 65 yrs of age.
  • Policy pays benefit amount on diagnosis of any 11 critical illnesses.
  • Plan cover whole family.
  • Eligible for 18 - 65 yrs of age.
  • Policy pays benefit amount on diagnosis of any 11 critical illnesses.

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
  • 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.
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