Compare Tata AIG Medicare Health Insurance

TATA AIG Health Insurance Highlights

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 | ** As per NL25 data published on the Insurance Company website.

Compare Medicare Health Insurance Benefits

Plans	TATA AIG Medicare Protect	TATA AIG Medicare	TATA AIG Medicare Premier
Sum Insured	2 lakhs, 3 lakhs, 4 lakhs, 5 lakhs	3 lakhs, 4 lakhs, 5 lakhs, 7.5 lakhs, 10 lakhs, 15 lakhs, 20 lakhs	5 lakhs, 10 lakhs, 15 lakhs, 20 lakhs, 25 lakhs, 50 lakhs
Pre-Hospitalization expenses	30 days before the date of admission to the hospital	60 days before the date of admission to the hospital	60 days before the date of admission to the hospital
Post-Hospitalization expenses	60 days after discharge from the hospital	90 days after discharge from the hospital	90 days after discharge from the hospital
Day Care Procedures	540+ listed Day Care Treatment covered	540+ listed Day Care Treatment covered	540+ listed Day Care Treatment covered
Ambulance Cover	1000	3000	5000
Health Checkup	Up to 1% of sum insured per policy and more than one insured can utilize the amount. The benefit is payable after every 3 continuous claim free policy years.	Up to 1% of sum insured and maximum of Rs.10,000/- per policy and more than one insured can utilize the amount. The benefit is payable after every 2 continuous claim free	Up to 1% of sum insured and maximum of Rs.10,000/- per policy and more than one insured can utilize the amount.
Cumulative Bonus	10% on base sum insured for every claim free year and up to 100%. Reduced by 10% and up to 100% in case of claim.	50% on base sum insured for every claim free year and up to 100%. Reduced by 50% and up to 100% in case of claim.	50% on base sum insured for every claim free year and up to 100%. Reduced by 50% and up to 100% in case of claim.
Co-pay	10% for higher room	optional	No Co-pay
Compassionate Travel	Max 20,000pa, more than 5 days of hospitalisation	Max 20,000pa, more than 5 days of hospitalisation	Max 20,000pa, more than 5 days of hospitalisation
Accidental Cover	optional	optional	Inbuilt, upto Sum Insured
Hearing Aid	NIL	10,000, every third year	10,000, every third year
Daily cash for choosing shared accomodation	NIL	If the insured is hospitalized in shared accommodation in a network hospital for more than 24 hours. Then the company pays 0.25% of base sum insured and maximum of Rs.2,000/- per day.	If the insured is hospitalized in shared accommodation in a network hospital for more than 24 hours. Then the company pays 0.25% of base sum insured and maximum of Rs.2,000/- per day.
Daily cash for accompanying an insured child		If an insured child aged 12 years or less is hospitalized. The company pays 0.25% of base sum insured and maximum of Rs.2,000/- per day for one accompanying adult for 24 hours.	If an insured child aged 12 years or less is hospitalized. The company pays 0.25% of base sum insured and maximum of Rs.2,000/- per day for one accompanying adult for 24 hours.
Maternity Expenses Cover	NIL	NIL	Up to Rs.50,000/- (Rs.60,000/- in case of girl child) per policy. Waiting period 4 years.
New born baby cover	NIL	NIL	If a claim is admitted under the maternity benefit, then the company covers for medical expenses incurred on the treatment of new born baby up to Rs.10,000/- for complications related to delivery.
Waiting Period for pre-existing diseases	48 months	36 months	24 months
OPD Dental	NIL	NIL	10,000
OPD	NIL	NIL	5000
High end diagnostics	NIL	NIL	25,000
Vaccination Cover	NIL	5000	Up to Sum Insured

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

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.