• Tata AIG Mediplus Health Insurance Plan

    Health Insurance
    • Enjoy options to cover yourself, your spouse, kids and even your parents
    • Enjoy access to 10,000+ hospitals for cashless treatment
    • Reduce your taxable income by up to Rs. 50,000 deduction under section 80D**

    Tata AIG is a general insurance company that provides different types of insurance service. The company has a range of health insurance products suitable for people with differing requirements. Mediplus is a top-up plan offered by Tata AIG. This is a policy that offers extra coverage in addition to an existing health insurance policy. Customers can choose their deductible option based on the health insurance cover they already have. For instance, if the deductible chosen by a customer under Mediplus is Rs.2 lakh, this cover will begin only if the medical expenses exceed Rs.2 lakh. This policy comes in flexible options and affordable premium charges.

    Eligibility for Tata AIG Mediplus

    The eligibility criteria outlined by the company for enrolling in this medical insurance policy can be listed as follows:

    • The proposer of this policy must be between 18 years and 65 years.
    • Dependent children can be covered from the age of 91 days provided that their parents are also covered.
    • There is no exit age for this cover, and it can be renewed on a lifetime basis.
    • The proposer can take this cover for the whole family (up to 7 members) including spouse, dependent children, and dependent parents.

    Features of Tata AIG Mediplus

    The key features of Tata AIG Mediplus can be listed as follows:

    • This top-up policy is available in various deductible options ranging from Rs.1 lakh to Rs.5 lakh.
    • The premium charges for this policy vary based on the age of the insured and the deductible amount chosen.
    • A premium discount of 10% is available with this policy cover if 2 or more family members are enrolled in this policy.
    • An additional discount of 7.5% is available if premium charges are paid for 2 years.
    • Pre-insurance medical examination is required for this policy cover. The company will reimburse 50% of the examination costs upon acceptance of the proposal.
    • There is a general waiting period of 30 days from the date of inception of this policy cover.
    • All pre-existing diseases can be covered after four years of continuous policy coverage.
    • The company may apply premium risk loading based on the health status and other declarations made by the insured. The maximum risk loading shall not exceed 150% under this policy cover.
    • Pre-hospitalisation medical expenses are covered for up to 60 days prior to the date of admission in a hospital.
    • Post hospitalisation medical expenses are covered for up to 90 days after discharge from a hospital.
    • This policy can be ported to another insurance service provider in the market. The company must be notified at least 45 days before renewal in order to make the transfer.
    • There is a free look period of 15 days for customers to review the terms of the policy.
    • Customers who subscribe to this cover are eligible for income tax benefit for the premium amount paid.

    Benefits of Tata AIG Mediplus

    The range of benefits offered by this medical insurance policy cover can be given in the following table:

    In patient hospitalisation Covered up to the sum insured limit
    Domiciliary treatment Available if a patient is unable to get treatment in a hospital
    Day care treatment Available for up to 140 day care procedures that do not require 24-hour hospitalisation
    Ambulance cover Up to Rs.2,000 per hospitalisation
    Organ donor cover Expenses covered for both recipient (the insured) and donor
    Dental treatment Covered for dental treatment arising out of accidents or illnesses

    Exclusions of Tata AIG Mediplus

    The exclusions listed under Tata AIG Mediplus top-up policy can be listed as follows:

    • Intentional self-injuries or attempted suicide
    • Injuries or illnesses arising out of drug or alcohol abuse
    • Any conditions related to sexually transmitted diseases, HIV, or AIDS
    • Injuries or illnesses arising out of war or warlike activities
    • Injuries or illnesses arising out of exposure to toxic or radioactive substances
    • Treatment for congenital anomalies
    • Expenses related to pregnancy or related treatments

    Claim Procedure

    The company provides quick and hassle-free claim settlement to ensure that policyholders focus on recovery rather than worrying about the funding requirements. To provide reimbursement for the medical expenses, the company requires a list of documents from the insured along with the claim form. Some of these documents include discharge report, original bills, diagnostic reports, prescriptions, etc. In case of cashless treatment, the insured must provide a photo identity proof along with the cashless card. Once the documents are submitted, the company will verify the validity of the claim and settle the claim amount.

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