TATA AIG Health Insurance Plans

TATA AIG Critical Illness Insurance

Tata AIG Critical Illness insurance quotes

 Plan type
 
 Coverage type
 Coverage amount
 Coverage City
Date of Birth
  OR age      years
Policy duration
Start Date
End Date

Critical Illness health insurance features

Medical emergencies can hit us when least anticipated and force to pay medical bills. There is health insurance coverage always at your side to pay medical bills and save you and your entire family from financial loss. You need a proper mediclaim insurance coverage which will not have sub limits and capping on certain diseases under sum assured or premium loading on renewals.

TATA AIG Health Insurance Review

TATA AIG Health Insurance
TATA AIG Health Insurance sum insured
3 lacs − 20 lacs options available
Incurred Claims Ratio *
78.00%
TATA AIG Health Insurance tenure options
1, 2 or 3 years options available
Claims Settlement Ratio **
80.61%
List of network hospitals
4,000+ hospitals
Number of policies issued *
220,583
Maximum family floater coverage
Self, Spouse + 3 dependent children + 2 dependent parents
Number of lives covered *
2,248,000
* As per IRDAI report for 2018-19   |   ** As per NL25 data published on the Insurance Company website

What is Criticare?

  • CritiCare is a Critical Illness insurance policy, which provides coverage for a set of 11 Critical Illnesses & Surgeries.
  • It pays out a lumpsum benefit equal to the coverage level (Sum Assured) you have purchased, upon the diagnosis of any of these illness.
  • You are not required to undergo any medical check up in order to subscribe to the same.
  • It is an annually renewable plan and you are not required to undergo any medical check up in order to subscribe to the same.
    Please note that the policy does not cover any pre-existing medical conditions (Refer Policy wordings for more information)

Tata AIG Critical Illness Insurance benefits

  • Key Features
  • Key Benefits
  • Tax Benefit
  • Exclusions

Features of Tata AIG Critical Illness Insurance

  • Room Rent:NIL Room Rent restrictions
  • Co-pay : NIL co-pay for all treatment
  • Restoration Benefit :NIL Restoration Benefit
Sum Assured Six levels of cover available
* Rs 2,50,000 * Rs 7,50,000
* Rs 3,50,000 * Rs 10,00,000
* Rs 5,00,000 * Rs 15,00,000
Age Entry age: 18 - 60 years
The coverage can be availed on renewals till the age of 64 yrs.
Waiting Period 90 Days from the inception of the policy
Survival Period 30 days from the diagnosis of illness/performance of surgery.

Benefits of Tata AIG Critical Illness insurance

The Critical illness benefit covers any of the following illnesses / surgeries upon diagnosis.
  1. First Heart attack
  2. Cancer (excluding skin cancer)
  3. Coronary artery Bypass Surgery
  4. Kidney failure
  5. Major Organ Transplant
  6. Total blindness
  7. Coma
  8. Major Burns
  9. Multiple Sclerosis
  10. Paralysis
  11. Stroke
Sum Insured :

The plan pays one lumpsum benefit if you are diagnosed to be suffering from any of the covered illnesses / surgeries and if it is the first incidence. This lumpsum benefit is payable only once under this plan after which the coverage ends. A waiting period of 90 days from the inception of the policy is applicable i.e. The benefit is payable only in respect of illnesses first diagnosed / surgeries conducted after 90 days from the inception of the policy. A survival period of 30 days is also applicable i.e., the sum insured is payable only upon the insured surviving 30 days from the diagnosis of the illness / performance of the surgery. The lump sum benefit for Major Organ Transplant is offered, upon undergoing the actual Transplant procedure as a recipient for the organ from a valid donor. And, after the completion of 90 days waiting period and 30 days survival period.

Tata AIG General Insurance Company’s will arrange to transfer your medical reports and diagnosis to a special panel of doctors in the USA who will review your case and give an independent opinion on the diagnosis and the line of treatment. The benefit is available only if the diagnoses pertains to one of the 11 covered Critical Illnesses / Surgeries in the plan. The premium paid under CritiCare is exempt from income tax under Sec 80D of the Income Tax Act.

Exclusions under the Critical Illness Health product

This entire Policy does not provide benefits for any loss resulting in whole or in part from, or expenses incurred, directly or indirectly in respect of:
  1. Any Pre-existing Condition * Acquired Immune Deficiency Syndrome (AIDS) * Human Immune deficiency Virus (HIV) infection * Suicide * Serving in any branch of the Military or Armed Forces of any country, whether in peace or War, * participation in an actual or attempted felony, riot, crime, misdemeanour, operating or learning to operate any aircraft, or performing duties as a member of the crew on any aircraft; War, civil war, invasion, insurrection, Act of Terrorism;,* Under the influence of drugs or alcohol and more.
  2. Is caused by osteoporosis (porosity and brittleness of the bones due to loss of protein from the bones matrix) or pathological fracture (any fracture in an area where pre-existing Disease has caused the weakening of the bone) if osteoporosis or bone Disease diagnosed prior to the Policy Effective Date.
  3. Congenital anomalies and conditions arising out of or resulting there from; or Confinement in a Hospital which is not Medically Necessary.
  4. Any Illness, sickness or disease , other than specified as Critical Illness, as mentioned in the policy schedule, or
  5. Any Critical Illness of which, the signs or symptoms first occurred prior to or within Ninety (90) days following the Policy Issue Date or the last Commencement Date, whichever is later, or
  6. Any Critical Illness resulting from a physical or mental condition which existed before the Policy Issue Date or the last Commencement Date which was not disclosed , or
  7. Any Critical Illness based on a Diagnosis made by the Insured or his/her Immediate Family Member or anyone who is living in the same household as the Insured or by a herbalists, acupuncturist or other non-traditional health care provider; and
  8. Cosmetic or plastic surgery or any elective surgery or cosmetic procedure that improves physical appearance, surgical and non-surgical treatment of obesity (including morbid obesity) and weight control programs, or treatment of an optional nature;
  9. Special nursing care, routine health checks or convalescence, Custodial Care, general debility, lethargy, rest cure
  10. Any investigation(s) or treatments not directly related to a Covered Illness or Covered Injury or the conditions or diagnosis necessitating hospital admission

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.

Tata AIG Health Insurance FAQ’s

Your coverage amount depends on your lifestyle, medical background, pre-existing diseases, members of your family, annual income, residential address and age.

Under the Tata AIG Medicare Health insurance policy, the sum insured ranges from ₹2 lacs to a maximum SI of ₹50 lacs. One can decide on the SI based on their age, lifestyle, family history and number of dependents.

While applying for a health insurance plan with Tata AIG, the following documents will be required to be submitted as part of KYC (Know Your Customer) process.

  • Age proof: Birth certificate, Passport, Driver’s License, Voter ID card.
  • ID proof: Driving license, Passport, PAN card, Aadhaar card.
  • Address proof: Electricity bill, Telephone bill, Ration card, Passport, Aadhaar card.
For senior citizens, a medical check-up is required prior to buying insurance.

Yes, you can cancel your Health Insurance policy. We provide a free look period of 15 days from the date of policy issuance within that you can cancel the policy and avail a refund if you are not satisfied with it. However, your refund will be adjusted against any expenses incurred such as underwriting costs, medical check-ups and so on. If the policy is to be cancelled after this 15 day period, there is a slab based refund that Tata AIG will provide to the insured.

Customer Infomation Sheet

Review TATA AIG health insurance - Critical Illness Customer Infomation Sheet to understand coverage details.


Know more »

Proposal form

Fill the online TATA AIG health insurance - Critical Illness proposal form.


Know more »

Policy wordings

Review TATA AIG health insurance - Critical Illness policy wordings which explains the terms and conditions.

Know more »

Get quotes for TATA AIG health insurance!

Review and compare the best health insurance.
Compare health insurance quotes
Find the best TATA AIG health insurance

India health insurance blogs and articles

health insurance India
Tips for buying best mediclaim insurance

India health insurance tips and tricks to choose the best medical insurance in India Click here to read more

Top reasons for health insurance claims rejection

Find out the different reasons why a medical insurance claim is rejected, Cashless hospitalization, Reimbursement. Click here to read more

India health insurance coverage, factors and premium calculator

Factors for medical insurance in India, How much is the premium and the coverage offered by India health insurance plans..Click here to read more

TATA AIG health insurance useful links

How to buy online?

You can buy insurance online by using a credit/debit card, direct funds transfer using NEFT or RTGS or by using a cheque

Know more »

Network hospitals

TATA AIG Network hospitals list. Cashless & Hassle-free direct claim settlement with us at 4000+ Hospitals

Know more »

Compare health plans

Compare Indian health insurance policies, Health insurance India comparison


Know more »

Health insurance benefits

Insurance customers can quickly compare the details of benefits offered under Indian mediclaim insurance policies.

Know more »

Insurance Claims

In case of a claim or reimbursement of treatment expenses, notify Tata AIG by contacting them.


Know more »

Health insurance FAQ

FAQ related to Indian health insurance. Get answers for any health insurance questions


Know more »

Search TATA AIG health insurance

Keep in touch

  • Address

    InstantCover Insurance Web Aggregator Private limited
    710, 6th B Cross, 16th Main Road, Koramangala 3rd Block, Bangalore - 560 034.

  • +91-(80)-41744345
  • Send an email
CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2022
-

ONLINE CHAT