Tata AIG Wellsurance Family Policy
Tata AIG is a collaborative venture between the Indian firm Tata Group and the American International Group (AIG). The company started with humble means and is a famed private insurance company brand today. Amongst its wide range of coverage offered through various policies, health insurance products of the insurer are the most sought after ones. One such policy is TATA AIG Wellsurance Family Policy.
What is TATA AIG Wellsurance Family Policy?
TATA AIG Wellsurance Family Policy offered by TATA AIG the family of the insured. This way, the policy scheme enables you to have a sense of security for your entire family and lets you unwind. Certain accessory plans along with it add more value to this scheme.
Features of the TATA AIG Wellsurance Policy
Some of the salient features of this policy are mentioned below:
- The company with daily cash benefit option will reimburse the expenses and bills pertaining to hospitalization- in a situation where a family member of the insured is admitted to the hospital owing to illness, if the amount spent by him/her goes up to the first 90 days.
- ICU Expense- if any family member is admitted to the ICU, the insured will get daily benefits subject to certain deductibles and a limit capped on daily cash benefits.
- Ambulance Expenses- Expenses pertaining to the ambulance and medical transportation are also looked after. This covers the transportation of a patient when he has met with an accident and taking him back to his house after recovery.
- Value Added Services- apart from the coverages, there are other services like queries related to health and access to health portals and wellness offers. There is a provision where you can receive newsletters, when you subscribe to different health plans.
Benefits of TATA AIG Wellsurance Family Plan
You will be insured against 11 critical diseases. If the user suffers from any of those listed, the sum insured is paid in a lump sum. The sum insured depends on the variant of the policy that you have chosen.
- In case a patient is admitted, the insurance provider pays daily benefits to the insured in the hospital.
- In the case of ICU admission, the daily cash benefit is increased.
- Up to a specified threshold, ambulance costs are also covered.
- If the duration of hospitalization increases for 5 or more days, a lump sum amount is paid for recovery purposes to the patient.
- In case of disability or sudden death, the insurer looks after the education needs of the dependent ward.
- There are miscellaneous services where you can seek professional help from the portals and subscribe to newsletters from them to stay updated.
Inclusions of the TATA AIG Wellsurance Family Plan
The expenses that are covered under this TATA AIG health insurance plan are:
- Coverage for Critical Illnesses- There is a provision for lump-sum payment in case a person is detected with a specified illness during the period in which the policy is functional. The disease can only be covered if it is diagnosed after 90 days of the beginning of the policy and continues thereafter for at least 30 days.
However, the number of times the person is afflicted won’t matter as the insurer will only pay a lump-sum amount once a year. The customer needs to get the policy renewed after a year or so.
- Accidental Coverage- Daily benefits in cash is provided to patients who are taken to the hospital after having met with an accident, subject to certain deductibles. The procedure of the hospitalization should not be arbitrary and medically required. There should be a doctor’s prescription affiliated with all other documents.
- Hospitalization Cover for a Disease- Daily cash benefit is available to patients who are suffering from a disease and are admitted to a hospital within the boundary of India with a waiting time allotted of 90 days. The hospitalization should happen only when a medical practitioner prescribes it.
- The insurer provides the benefits only once during the first hospitalization. The insurer also pays a daily sum for patients admitted to the ICU or the cash requirements of the hospital.
- Education Coverage- This can be claimed when the policyholder becomes completely disabled or meets with an unforeseen death. The insurer will make sure that he pays the money that is scheduled in the policy.
- Post-illness Benefits- The insurer also pays a decent amount during the recovery period of a patient after he/she has been discharged from the hospital. This is only applicable if the patient was admitted to the hospital for at least 5 subsequent nights.
Exclusions of the TATA AIG Wellsurance Family Plan
Health insurance plan of TATA AIG Insurance Company doesn’t cover the insured for the following:
- Pre-existed illnesses are not covered before 4 years of the commencement of the policy.
- Medical attention caused due to drug or alcohol abuse is not covered.
- Injuries caused by self-harm is also not covered under this policy.
- Any serious illness that was diagnosed before the waiting period of 90 days will not be included.
- Programs related to alternate forms of medicines like homoeopathy, naturopathy, and Ayurveda will not be accepted.
- Diseases like HIV, STDs, and complications arising out of pregnancy and childbirth are not included.
- Congenital diseases and abnormalities are also not looked after.
- Disorders of the mind like anxiety, depression, and stress-related issues are also not covered.
- Hospitalizations caused due to war, civil war, bombings, and nuclear weapons are also not included.
- Illness caused by harmful activities and sports-related injuries is also not covered.
- There is no provision to cover cosmetic or plastic surgeries until they are necessitated by accident.
Eligibility for Buying the TATA AIG Wellsurance Family Plan
People opting to buy the plan should be at least 18 years old and should not be more than 65 years old. Children who can be covered under the benefits of the plan have to be a minimum of 6 months of age and should not be more than 18 years of age. In the case of higher education of the dependent child, the age limit can be relaxed to 23 years of age.
How to file a Claim for TATA AIG Wellsurance Family Plan
The steps for filing a claim under Tata AIG health insurance plan are:
- For any illness or disease riddled hospitalization, the claim needs to be filed at least 48 hours after the person has been admitted.
- In case of a medical emergency, it could be sped up, and the person can make claims within 24 hours of hospitalization.
- Provide the company with the claim form. One can avail cashless claim by filling up the pre-authorisation letter and submitted to the insurer through TPA at the hospital desk.
- If all the paperwork is completed in accordance with the IRDAI guidelines and at the right time, then the company will pay you the amount within 30 days of the form submission.
Documents Needed to File a Claim
These are the papers that you need to keep ready before you file claims. These include:
- Claim form duly signed
- Bills from the chemist
- Hospital bills
- Minutes from the operation
- Medical reports
- Summary of the discharged patient given by the hospital
- The prescription of the doctor
- Intimation proof
How to Buy the TATA AIG Wellsurance Family Plan Online?
The policy can be bought online or offline. You can check out the insurers portal r directly buy it from Paisawiki.com. Here are the steps for buying the policy through Paisawiki.
- Just visit the official website of paisawiki.com and go to the ‘Health Option’ Click on the ‘Buy Plan’ option
- Provide necessary information such as age, name, members to be added, city of residence etc. and submit.
- A list of plans will appear. Select the policy that you think is the most suitable for you and select your mode of payment. The policy is available in three variants of your choice.
- You can either pay with your credit or debit card or through the Unified Payments Interface or electronic fund transfer.
- Select your mode of payment using a secured gateway. Once you are done with all the e-paperwork, the copy of the policy will be emailed and couriered.
Renewal Process of the TATA AIG Wellsurance Family Plan
These are the steps that you need to follow to renew your plan.
- Open the website of Paisawiki.com and click on ‘the renew policy tab’ one the homepage.
- The portal will open an instant new page.
- Enter your policy number or the registered mobile number.
- The page will open your existing policy, and details will be displayed.
- Calculate the premium of your policy and choose a mode of payment.
- Pay using your preferred means and save the transaction receipt.
- Once your policy is updated, you will receive a digital copy of the updated policy in your email and a hardcopy will be speed posted to you.
Ans: yes, there are a lot of added benefits like consultations with a doctor, keeping track of one's health using portals, and posting queries on them and getting newsletters.
Ans: the eleven illnesses covered are heart attacks, cancer, serious burns, blindness, kidney malfunction leading to dialysis, multiple sclerosis, coma, open chest CABG, organ or bone marrow transplant of paralysis of limbs.
Ans: The patient needs to survive at least 30 days after he/she has been diagnosed to become eligible to file claims.
Ans: the amount is capped at 1% of the total sum insured. So that entails that in a plan where the sum insured is 2 lakh, the hospital will pay the patient Rs 2000 daily for a period of 90 days.
Ans: Yes, the cash benefits attributed to patients of ICU is greater. In the classic plan where you get 2000 INR for normal admission, you will get Rs 3000 for ICU admission.
Ans: In case a patient has spent five or more days at the hospital, he is liable to be paid for recovery by the insurer. The classic plan pays the patient Rs 1500.
Ans: The education benefit entails a lump sum payment of Rs 50,000 for the dependent child under the classic variant in case the insured person dies or is rendered completely disabled.
Ans: the plan can be bought by people whose age range from 18 to 65. Children between 6-18 are also covered in the plan.
Ans: Under the plan, four individuals are covered. The four individuals are the insured person, the spouse and two children.
Ans: the insurance policies provided by them are Mediraksha, MediPlus- Top Up medical health insurance plans and Medicare health insurance.
Ans: Yes, two or more people from the same family can be covered in one plan even if they are settled in different cities of India. To ensure that the formalities are seamless, make sure that the hospital chain is the same.
Written By: Paisawiki - Updated: 21 October 2020