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Tata AIG MediCare Premier

Axis bank offers you Medicare Premier 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 50 Lacs for you and your family. You can avail cashless benefits at over 5800+ hospitals.

  • No Medical Tests

  • Tax Benefit

  • High Sum Insured

  • Global Cover

covers medical expenses related to inpatient & day care hospitalization of the insured person incurred outside India, provided that the diagnosis was made in India.
Expenses incurred towards obtaining a visa for medical treatment are also covered.

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.

automatically restore the basic sum insured if the sum insured and accrued cumulative bonus is insufficient to pay a claim during the policy year. For single premium multi-year policies, the insured can utilize a maximum of up to 3x restore in a policy year. I.e., can utilize the available restorations anytime during the policy period, except for the first claim, e.g., a policy with tenure of 3 years, the insured is eligible for a total of 3 restorations anytime during the policy period and 2 restorations for a 2 years policy. *

covers the expense of ambulance transportation by airplane or helicopter for emergency life-threatening health conditions, which require immediate ambulance transportation to the hospital/medical center for further medical management.

provides wellness services designed to assist insured persons in maintaining and improving good health and fitness.

  • unlimited teleconsultation - general/ specialty
  • ambulance booking facility
  • health condition management
  • emergency help me feature
  • redeemable voucher/discount on services (vouchers for fitness centers & activities, discounts on pharmacy & diagnostics, etc.)

provides a wellness program designed to promote wellness and fitness amongst the insured persons through:

  • health risk assessment
  • wellness rewards
  • rewards accumulated through fitness activities can be utilized towards the payment of services/items under the below categories:
  • OPD consultation/treatment
  • health-check-ups/diagnostics
  • health supplements
  • pharmaceuticals

covers expenses incurred for treatment taken at home for dialysis/chemotherapy/pandemic care at home.

Coverages-

  1. In-patient treatment
    Covers expenses for hospitalization due to disease/illness/injury during the policy period that requires an insured person's admission to a hospital as an inpatient
  2. High-end diagnostics
    Covers the insured person for the listed diagnostic provided in the policy wordings on an OPD basis if required as part of a treatment
  3. Accidental death benefit
    Covers 100% of the base sum insured, a maximum of up to 50 lakhs in the event of death of an insured person due to an accident. This benefit is not applicable to dependent children covered in the policy
  4. Maternity cover
    We will cover maternity expenses, up to limits as specified in the benefit table, per policy subject to a waiting period of 4 years of continuous coverage under this policy.
  5. First-year vaccinations
    Covers vaccination expenses for up to one year after the birth of the child provided the child is covered by us
  6. Organ donor
    Covers medical and surgical expenses of the organ donor for harvesting the organ where an insured person is the recipient
  7. Compassionate travel
    Domestic- Covers expenses related to a round-trip economy class air ticket, or first-class railway ticket, to allow the immediate family member to be at the insured person's bedside during his stay in the hospital in India
    Global*- Covers expenses related to round trip economy class air ticket, to allow the immediate family member to accompany the insured person for the purpose of planned treatment outside India.
  8. OPD dental treatment
    Covers expenses related to the root canal, filling, and tooth extractions over and above the sum insured. Does not impact the cumulative bonus.
  9. Home physiotherapy*
    As a part of post-hospitalization expenses cover, 15 physiotherapy sessions arranged at home by our empaneled service providers within India


Eligibility and Coverage Details
Family DefinitionSelf + Spouse + 2 kids
Entry age (Adult)18 yrs to 65 yrs
Entry age (Child)90 days to 25yrs
Policy tenureAnnual (1yr, 2yr, 3yr)
Sum insured (Individual & floater basis)INR 5 Lakhs, 10 Lakhs, 15 Lakhs, 20 Lakhs, 25 Lakhs, 50 Lakhs, 75 Lakhs, 1 Crore, 2 Crore, 3 Crore
Pre-Post hospitalization60 days pre-hospitalization and 90 days post-hospitalization for SI up to 50L, 200 days for above 50L.
Day care treatmentCovered up to the sum insured
Domiciliary treatmentCovered (shall not be applicable for Global Cover)
Pre-existing & specific illness waiting periodCovered after a waiting period of 2 and 3 years respectively
Initial waiting period30 days (except in the case of accident cover which is from day 1)
Health check-upUp to 1% of the previous sum insured subject to a maximum of Rs.10,000/- per policy
Compassionate travelCovers expenses up to 20,000 to allow the immediate family member to be at the insured person's bedside during his stay in the hospital
Restore benefitAutomatically restore the basic sum insured upon exhaustion of the sum insured and accrued cumulative bonus, during the policy period. This benefit can be availed once during the policy period
Ambulance coverUp to Rs.3000 per hospitalization
AyushCovers on an in-patient basis hospitalization treatment
Premier Exclusive Benefits
Opd treatmentPost 2 years of the waiting period, expenses related to consultations and pharmacy up to limits are covered
Global cover for planned hospitalizationCover for medical expenses of the insured person incurred outside India, up to the sum insured, provided that the diagnosis was made in India and the insured travels abroad for treatment
Maternity coverCover for maternity expenses, up to limits, per policy subject to a waiting period of 4 years of continuous coverage
Emergency air ambulance coverPay for ambulance transportation of the insured person in an airplane or helicopter
Prolonged hospitalizationWill pay a fixed amount of 1% of the sum insured, in the event of the insured being hospitalized for a disease/illness/injury for a continuous period exceeding 10 days
Wellness serviceI. Unlimited teleconsultation general
ii. Unlimited teleconsultation-specialist
iii. Health condition management
a. Diet & weight management program
b. Stress management program
iv. Redeemable voucher/discount on services
v. Ambulance booking facility
vi. Emergency help me feature
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
  • Maternity will be covered after a waiting period of 48 months of continuous coverage under this policy with us
  • OPD treatment & OPD treatment-dental will be covered after a waiting period of 24 months of continuous coverage under this policy.
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.

Terms and Conditions
  • 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.

Disclaimer

Prohibition of Rebates

Section 41 of the Insurance Act, 1938 as amended by the 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 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 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 a default in complying with the provisions of this section shall be liable for a penalty which may extend to ten lakh rupees.

Section 64 VB 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 benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

IRDAI registration number: IRDA of India Registration No.: 108
UIN: Tata AIG MediCare UIN- TATHLIP24159V042324
CIN: U85110MH2000PLC128425
Address: Peninsula Business Park, Tower A, 15th Floor, G. K. Marg, Lower Parel, Mumbai- 400013, Maharashtra, India | 24x7 Toll Free No. 1800 266 7780 or 1800 22 9966 (Senior Citizen) Email: customersupport@tataaig.com | Visit us at www.tataaig.com