TATA AIG Critical Illness Health Insurance, Critical Illness Health Insurance Plan

Critical Illness provides coverage for set of 11 critical illnesses and surgeries. The Plan pays out a lump sum benefit equal to the coverage level you have purchased, upon diagnosis of any of these illnesses or performance of a covered surgical procedure. Thus, We ensure that your savings are protected in the eventuality of a critical illness.

Critical Illness insurance plan key features

  • Available for 18 years to 65 years of age
  • Provides coverage for a set of 11 Critical Illnesses & Surgeries.
  • The policy will be issued for a 1 year.
  • The policy can be issued to an individual.
  • Lifelong renewal provided
  • Benefits are covered under section 80D of Income Tax Act 1961

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 *
Claims Settlement Ratio **
List of Network Hospitals
4,000+ hospitals
Number of Policies issued *
Number of Lives Covered *
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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Critical Illness Health Insurance plan details

  • Annual Premium
  • Features
  • Coverages
  • Benefits
  • Exclusions

Annual Premium Table (in INR)

Coverage Limit 1,00,000 2,50,000 3,50,000 5,00,000 7,50,000 10,00,000 15,00,000
18 - 24 383 957 1,300 1,817 2,640 3,444 4,993
25 - 29 516 1,291 1,754 2,454 3,564 4,649 6,741
30 - 34 697 1,743 2,368 3,312 4,812 6,276 9,100
35 - 39 1,011 2,528 3,433 4,802 6,977 9,100 1,3195
40 - 44 1,820 4,551 6,179 8,646 12,558 16,381 23,752
45 - 49 3,186 7,963 10,813 15,129 21,978 28,666 41,566
50 - 54 5,096 12,741 17,302 24,206 35,164 45,865 66,506
55 - 59 8,154 20,385 27,683 38,731 56,261 73,385 1,06,408
60 - 65 15,818 39,546 55,364 79,091 1,18,637 1,58,183 2,37,274
66 & above 15,818 39,546 55,364 79,091 1,18,637 1,58,183 2,37,274

Features of Tata AIG Critical Illness Insurance

  • Critical Illness Benefit – Covers listed 11 critical illnesses. It pays out a lumpsum benefit equal to the coverage level (Sum Assured) you have purchased, upon the diagnosis of any of these illness.
  • Second opinion - The second opinion benefit is valid only if your Critical Illness Insurance Policy is in force and the Insured Person has been diagnosed with any one of the 11 Covered Critical Illnesses defined in this policy.
  • Sum Insured Enhancement – Sum Insured can be enhanced only at the time of renewal .The Enhanced Sum Insured will have a fresh proposal status where the waiting period and exclusions shall apply afresh.

Coverages of Tata AIG Critical Illness Insurance

Policy covers 11 critical illnesses
  • First Heart Attack
  • Cancer
  • Stroke
  • Coronary Artery Bypass Graft
  • Kidney Failure Requiring Dialysis
  • Major Organ and Bone Marrow Transplant
  • Loss of sight
  • Coma
  • Severe Burns
  • Multiple Sclerosis
  • Paralysis

Benefits of Tata AIG Critical Illness insurance plan

  • First Heart Attack-of specified severity
  • Cancer of specified severity
  • Stroke resulting in Permanent Symptoms
  • Open Chest CABG
  • Kidney Failure Requiring Regular Dialysis
  • Major Organ / Bone Marrow Transplant
  • Total Blindness
  • Coma of specified severity
  • Major Burns
  • Multiple Sclerosis with persisting symptoms
  • Permanent Paralysis of Limb

Exclusions of Tata AIG Critical Illness insurance policy

Any treatment which begins during waiting periods except
  • Any Pre-existing Condition, any complication arising from it, or
  • Any Illness, sickness or disease , other than specified as Critical Illness
  • Any Critical Illness of which, the signs or symptoms first occurred prior to or within Ninety (90) days.
  • self-inflicted Injury or illness, or sexually transmitted conditions, mental or nervous disorder, anxiety, stress or depression, AIDS, HIV infection, suicide not covered
  • War, civil war, invasion, insurrection, revolution, act of foreign enemy, hostilities ....
  • Ionising radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste from burning nuclear fuel
  • The radioactive, toxic, explosive or other dangerous properties of any explosive nuclear equipment or any part of that equipment

Note: Please refer to policy wordings for the list of exclusions.
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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 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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