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Tata AIG General Insurance -Tata AIG MediCare
Axis Bank offers you MediCare where in you have a Health Insurance plan which allows you Medical Insurance across the globe. With an auto restore feature, it gives you a no compromise cover up to ₹20 lakhs for you and your family. You can avail cashless benefits at over 5,800+ hospitals.
Features & Benefits
Restore benefits
automatically restore the basic sum insured upon exhaustion of the sum insured and accrued cumulative bonus, during the policy period
Consumables benefit
covers expenses incurred, for specified consumables, which are consumed during the period of hospitalization directly related to the insured person's medical or surgical treatment of illness /disease/injury
Cumulative bonus
50% cumulative bonus will be applied to the sum insured for the next policy year under the policy after every claim-free policy year, provided that the policy is renewed with us and without a break. The maximum cumulative bonus shall not exceed 100% of the sum insured in any policy year.
Wellness services
facilities designed to assist in maintaining and improving good health and fitness. 8 teleconsultations (general physician) through telecommunication and digital communication technologies by a qualified medical practitioner Ambulance booking facility through our empaneled service provider that will provide a facility to book a road ambulance in India..
Required Documents for Tata AIG MediCare Policy
Such documentation will include the following:
- Our claim form, duly completed and signed for on behalf of the Insured Person. We, upon receipt of a notice of claim, will furnish your representative with such forms as we may require for filing proofs of loss or you may download the claim form from our Web site.
- Original Bills (pharmacy purchase bill, consultation bill, diagnostic bill) and any attachments thereto like receipts or prescriptions in support of any amount claimed which will then become Our property.
- All medical reports, case histories, investigation reports, indoor case papers/ treatment papers (in reimbursement cases, if available), discharge summaries.
- A precise diagnosis of the treatment for which a claim is made.
- A detailed list of the individual medical services and treatments provided and a unit price for each in case not available in the submitted hospital bill.
- Prescriptions that name the insured person and in the case of drugs: the drugs prescribed, their price and a receipt for payment. In case of pre/post hospitalisation claim, prescriptions must be submitted with all pre and post investigation, treatment and follow up (consultation) records pertaining to the present ailment for which claim is being made, if and where applicable, corresponding doctor/hospital invoice.
- All pre and post investigation, treatment and follow up (consultation) records pertaining to the present ailment for which claim is being made, if and where applicable.
- Treating doctor’s certificate regarding missing information in case histories e.g. Circumstance of injury and Alcohol or drug influence at the time of accident, if available
- Copy of settlement letter from other insurance company or TPA
- Stickers and invoice of implants used during surgery
- Copy of MLC (Medico legal case) records, if carried out and FIR (First information report) if registered, in case of claims arising out of an accident and available with the claimant.
- Regulatory requirements as amended from time to time, currently mandatory NEFT (to enable direct credit of claim amount in bank account) and KYC (recent ID/Address proof and photograph) requirements
- Legal heir/succession certificate , if required
- PM report (wherever applicable)
Note: In case you are claiming for the same event under an indemnity based policy of another insurer and are required to submit the original documents related to your treatment with that particular insurer, then you may provide us with the attested copies of such documents along with a declaration from the particular insurer specifying the availability of the original copies of the specified treatment documents with it.
We at our own expense, shall have the right and opportunity to examine insured persons through our authorised medical practitioner whose details will be notified to insured person when and as often as we may reasonably require during the pendency of a claim hereunder.
How to File a Claim Under Tata AIG MediCare Health Insurance
For any claim related assistance, notification of claim and submission of claim related documents, the insured person can contact us through:
- Take advantage of cashless hospitalisation facility across the 5,800+ strong network of hospitals.
- In case you have availed of treatment at hospitals not listed on the network, you can settle the bills at the hospital and then submit your original claim documents with required medical records to the TPA/us for reimbursement.
- For any emergency hospitalisation, please carry your cashless card and identity proof and inform the TPA /us within 24 hours after hospitalisation.
- For planned hospitalisation, kindly seek cashless authorisation from TPA/us at least 48 hours prior to the hospitalisation.
- For any claim related query, intimation of claim and submission of claim related documents, you can contact your TPA/us through:
- Please contact our designated TPA/us at least 7 days prior to an event which might give rise to a claim.
- For any emergency situations, kindly contact our TPA /us within 24 hours of the event.
Claim Procedure:
Claims under this policy will be administered In House
For Details please contact:
Name: TAGIC Health Claims
Website: www.tataaig.com
Email: healthclaimsupport@tataaig.com
Toll free:1800 266 7780 or 1800 229 966(for senior citizens)
Claims Administrator:Tata AIG General Insurance Company Limited
Address:5th and 6th Floor ,Imperial Towers,
H.No 7-1-6-617/A,GHMC No-615,616
Ameerpet, Hyderabad-500016,Telangana,
Phone-040-66864900
Eligibility and Coverage Details
Disclaimer
Diversification -
Prohibition of Rebates - Section 41 of the Insurance Act, 1938 as amended by Insurance Laws (Amendment) Act, 2015
- No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take out or renew or continue an insurance in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy, nor shall any person be taking out or renewing or continuing a policy accept any rebate, except such rebate as may be allowed in accordance with the published prospectuses or tables of the insurer. Any person making default in complying with the provisions of this section shall be liable for a penalty which may extend to ten lakh rupees.
Grievance Redressal Procedure
- As per Regulation 17 of IRDA of India (Protection of Policy holders Interests) Regulation, 2017.
Section 64 VB of the Insurance Act 1938
- Commencement of risk cover under the policy is subject to receipt of premium by Tata AIG General Insurance Company Limited.
- Insurance is the subject matter of the solicitation. For more details on risk factors and terms and conditions, please read the sales brochure & Policy Wordings carefully before concluding a sale. The benefits and features of the products and services are purely indicative in nature. The purchase of a Tata AIG insurance product by Axis Bank’s customers is purely on a voluntary basis. For clarifications, customers can call on 1800 201 2009 or write to insurance@axisbank.com. Axis Bank is a Licensed Corporate Agent (CA license no. CA0069 CIN: L65110GJ1993PLC020769) of Tata AIG General Insurance Company Limited (IRDA registration no.108, CIN: U85110MH2000PLC128425). The insurance products are underwritten by Tata AIG General Insurance Company Limited (‘Tata AIG’), having its registered office at Peninsula Business Park, Tower A, 15th Floor, G.K Marg, Lower Parel, Mumbai 400 013. This information is given by Axis Bank Limited (‘Axis Bank’) whose registered office is at ‘TRISHUL’, Third Floor, Opp. Samartheshwar Temple, Nr. Law Garden, Ellisbridge, Ahmedabad 380006.
- UIN :- TATHLIP21224V022021
Frequently Asked Questions
A pre-policy check-up at our network is required. The medical reports are valid for a period of 90 days from the date of the pre-policy check-up. The company may conduct Tele Mer/video, Mer/pre-policy check-ups based on age/sum insured medical declaration or any other underwriting criteria. In case of an adverse medical declaration, we may call for additional medical tests. We may conduct medical tests at diagnostic centers based on medical disclosure wherever applicable. At least 50% of the pre-policy medical check-up cost would be borne by Tata AIG in case a pre-policy check-up (PPC) is conducted and the proposal is accepted.
Medical exclusions:
- Congenital external diseases, defects, or anomalies
- Alcoholic pancreatitis
Non-medical exclusions:
- Intentional self-injury or attempted suicide while sane or insane
- Any insured person attempting to commit a breach of law with criminal intent
- Expenses for treatment rendered by a medical practitioner which is outside his discipline
Please refer to policy wordings for a complete list of benefits and exclusions.
- Policy coverage starts 30 days from the first inception of the policy (except for accidents)
- Any listed illness/treatments will be covered after a waiting period of 24 months
- Any pre-existing condition will be covered after a waiting period of 24 months
The premium amount paid under this policy qualifies for deduction under 80d of the Income Tax Act. This benefit is not applicable for the premium amount paid towards accidental death benefit if opted and for the premium paid in cash/ or by demand draft. Tax benefits are subject to changes in income tax law.
- Intimation & Assistance: Please contact us at least 48 hours prior to an event which might give rise to a claim. For any emergency situations, kindly contact us within 24 hours of the event.
- Claim-Related Information: For any claim-related query, intimation of claim, and submission of claim-related documents, you can contact us through:
Name: TAGIC Health Claims
Email: healthclaimsupport@tataaig.com
Toll-Free: 1800 266 7780 or 1800 229 966 (For Senior Citizens)
Website: www.tataaig.com
Submit Claim:
Tata AIG General Insurance Company Limited,
5th and 6th Floor, Imperial Towers,
H. No 7-1-6-617/A, GHMC No - 615,616,
Ameerpet, Hyderabad – 500016, Telangana
Phone: 040-66864900
For a list of network hospitals, please visit the website.
- Minimum entry age - 91 days and maximum entry age - 65 years
- Policy tenure options-1/2/3 years
- Covers up to 7 members (self, spouse, up to 3 dependent children, and parents/parents-in-law)
- You have a period of 15 days from the date of receipt of the policy document to review the policy terms/conditions. In case of any policy-related objections, you have the option to cancel the policy, and the premium will be refunded as per the free-look regulation laid down by IRDAI
- We may apply risk loading based on an individual's health status.
- There will be no premium refund in case of cancellation due to non-disclosure of material facts,
- Misrepresentation or fraud.
- A grace period of 30 days from the policy expiry is available. Coverage is not available during the grace period.
- Sum insured can be enhanced only at the time of renewal subject to our underwriting guidelines
- In case you want to port your policy to us, apply at least 45 days prior to the policy renewal date and IRDAI portability guidelines shall apply.
- The company, as per the IRDAI process, may revise or modify the terms of the policy including the premium rates or product withdrawal. The policyholder shall be notified three months before the changes are effected.
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