TATA AIG MediSenior Health Insurance

MediSenior Insurance Quotes

Coverage Amount
Age of senior member:
  years OR age
Policy Duration
Start Date
End Date

MediSenior plan eligibility

  • Available for 61 years and above
  • Buy policy for 2 years to get 7.5% discount
  • Lifelong renewal provided
  • Eligible for a tax deduction benefit upto Rs 20,000

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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Tata AIG MediSenior health insurance benefits

  • Features
  • Coverage
  • Co-Payment

Features of TATA AIG MediSenior Insurance

  • In-patient Treatment
    The Medical Expenses for: Room rent, boarding expenses, Nursing, Intensive care unit, Medical Practitioners, Anaesthesia, blood, oxygen, operation theater charges, surgical appliances, Medicines, drugs and consumables, Diagnostic procedures, The Cost of prosthetic and other devices or equipment if implanted internally during a Surgical Procedure
  • Eligibility Criteria
    • Individuals aged 61 years and above are eligible
  • Policy options
    • Individual
    • Family discount of 5% is available when self and spouse are insured under TATA AIG MediSenior plan
    • Choice of paying the premium for 1 year or 2 years
    • Discount of 7.5% is available if the premium is paid 2 years in advance
  • Sum Insured options
    • 2 lakhs, 3 lakhs, 5 lakhs
  • Pre-policy check
    • Mandatory and must be done in a diagnostic center in the network
    • Reimbursement of 50% of the expenses incurred if the proposal is accepted
    • Medical reports are valid for 90 days from the pre-policy check-up date
  • Claims Free Discount
    • Offers 5% non-cumulative discount on the premium to be paid for renewing if there are no claims in the previous years.

Coverages of TATA AIG MediSenior Health Insurance

  • In-patient Treatment: Room rent, ICU, nursing, medicines drugs and consumables
  • Pre Hospitalization: Expenses incurred up to 30 days prior to hospitalization
  • Post Hospitalization: Expenses incurred up to 60 days immediately after discharge from hospital
  • Domiciliary Treatment: Expenses incurred while getting treated at home on an advice from the attending medical practitioner which could not be transferred to hospital or due to unavailability of hospital bed
  • Emergency Ambulance: Maximum up to Rs.2,000/- per hospitalization used for ambulance service for transporting the insured to the nearest hospital offering necessary services
  • Day Care Procedures: Medical expenses incurred for any of the 140 day care procedures requiring not more than 24 hours of hospitalization
  • Organ Donor: Inpatient medical expenses incurred on the insured and the organ donor during a organ transplant surgery
  • Tax Benefit: Income Tax Benefit under section 80D
Co-payment for Accommodation Type
  • Shared Accommodation or any lower accommodation type: Insured has to pay 15% of the admissible claim amount
  • Single Occupancy or any higher accommodation type: Insured has to pay 30% of the admissible claim amount
Co-payment for Day Care Procedures
  • Insured has to pay 15% of the admissible claim amount for expenses incurred from day care procedures
Co-payment for Specific illness/surgeries
For expenses incurred from treatment of the following illnesses and Surgeries, the insured has to pay 30% of the admissible claim amount.
  1. Cataract(each eye)
  2. Hysterectomy
  3. Cholecystectomy
  4. Transurethral resection of the prostate (TURP) / Benign prostate surgery
  5. Surgery of Hernia
  6. Angiography (CT Angiogram excluded)
  7. Arthroscopy
  8. PID - Discectomy
  9. Mastectomy
  10. Joint replacement
  11. PTCA (Angioplasty)
  12. Hydrocele
  13. Major organ Transplant
  14. Coronary Artery Bypass Graft (CABG)x
Note: If a claim is accepted for any of the above mentioned surgery then no additional co-payment will be applicable on the accommodation for the same claim. No 2 different co-payment will be applicable for a single claim.

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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