TATA AIG Health Insurance

Tata AIG General Insurance Company Limited is an Indian General Insurance company and a joint venture between the Tata Group and American International Group, one of the global leader in General Insurance based out of the USA. Tata Group holds a 51 percent stake in the insurance venture with AIG holding the balance of 49 percent. Tata AIG General Insurance Company Limited celebrated 18 years of service this year (2018) since it commenced operations in India on January 22, 2001. Tata AIG General Insurance Company Limited has an asset base of approximate INR 10,050 crs. (as of 31st March 2019).

TATA AIG Health Insurance sum insured
3 lacs − 20 lacs options available

TATA AIG Health Insurance tenure options
1, 2 or 3 years options available

List of network hospitals
4,000+ hospitals

Maximum family floater coverage
Self, Spouse + 3 dependent children + 2 dependent parents

Incurred Claims Ratio *
78.00%

Claims Settlement Ratio **
80.61%

Number of policies issued *
220,583

Number of lives covered *
2,248,000

* As per IRDAI report for 2018-19 | ** As per NL25 data published on the Insurance Company website

TATA AIG Health Insurance – Overview

Tata AIG Health insurance – Overview

With more than 200 offices spread across India, the Company has a robust multi-channel distribution network and also has a workforce of over 5,000 employees, including 550+ claim experts and a dedicated Customer Service & Operations & Claims team comprising of 450 team members, operating from various offices across India, consistently delivering superior service experiences powered by the latest innovations in technology.
Tata AIG offer their health insurance customers quality treatment at more than 4,000+ leading hospitals across the country. With an incurred claims ratio of 78%, they covered 22.48 lac lives (as per IRDA data for 2018-19) and also had a satisafctory 80.61% Claims settlement ratio(as per NL25 information declared on the company website).
As a saying goes, health is wealth! Good health is always important to pursue your interests and achieve your goals. However life is unpredictable and unfortunately poor health can land you in hospitals. The health care costs today is getting more expensive and you need adequate insurance coverage from reputed insurance companies like tata AIG health insurance.

Tata AIG Mediclaim Insurance Online

There are specially designed plans offered by Tata AIG health insurance for parents and elderly or senior citizens. Customers can get information regarding Tata AIG health insurance and the corresponding network of hospitals and choose the right plan to suit their individual requirements.
If you are living outside India with your parents living in India you can get quotes online and facilitate the purchase of Tata AIG health insurance for your parents remotely. You can complete a simple online application and get free quotes of Tata AIG health insurance. The Tata AIG health insurance claim form is also available online for customers. Contact our insurance experts for more details on tata health insurance.
If you are living outside India with your parents living in India you can get quotes online and facilitate the purchase of Tata AIG health insurance for your parents remotely. You can complete a simple online application and get free quotes of Tata AIG health insurance. The Tata AIG health insurance claim form is also available online for customers. Contact our insurance experts for more details on tata health insurance.

Tata AIG health insurance benefits

Benefits under SBI General Health Insurance plans include :

  • Cashless facility – SBI General processes all cashless claims across 6000 + quality hospitals in their network across India
  • Hospitalisation expenses : Coverage for room rental expenses up to the sum insured for most of their plans. Pre and post hospitalisation expenses are covered up to the sum insured, 30/60 days prior and 60/90 days post hospitalisation depending on the plan opted for
  • Inpatient Treatment Covered expenses include: Hospital room rent, Boarding expenses and doctor fees, Operation Theatre and Intensive Care charges, Nursing expenses and Medicines that you consume during the hospital stay
  • Health Check up : Policy provides health check-up as per the applicable plan as specified in the Product Benefits Table, once every 4 claim free years.
  • Lifelong Renewability : SBI General assures you renewability for life without any extra loadings based on the claims
  • 142 Day Care procedures covered
  • No medical check-up if proposer doesn’t have any medical history up to 45 years of age
  • No Claims Bonus available at 10% increase after every claim free year upto maximum of 50% of Basic Sum insured
  • Income Tax Exemption under section 80D if the Income Tax Act.

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
    • info@fhpl.net
    • seniorcitizensdesk@fhpl.net (for Senior Citizens)
  • 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.

Exclusions under the Tata AIG’s Health Products

The following are the key Medical and Non Medical Exclusions under Tata AIG’s Health insurance Plans. Please go through the Terms and Conditions of the policy for the complete list of the exclusions: Medical Exclusions:

  • “AIDS” (Acquired Immune Deficiency Syndrome) and/or infection with HIV (Human immunodeficiency virus) including but not limited to conditions related to or arising out of HIV/AIDS such as ARC (AIDS related complex), Lymphomas in brain, Kaposi’s sarcoma, tuberculosis.
  • The abuse or the consequences of the abuse of intoxicants or hallucinogenic substances such as intoxicating drugs and alcohol, including smoking cessation programs and the treatment of nicotine addiction or any other substance abuse treatment or services, or supplies.
  • Treatment of Obesity and any weight control program subject to cover under benefit bariatric surgery.
  • Psychiatric, mental disorders (including mental health treatments); Parkinsons and Alzheimer’s disease;
  • Congenital external diseases, defects or anomalies;
  • Stem cell implantation or surgery; or growth hormone therapy;
  • Sleep-apnea
  • Charges related to peritoneal dialysis (CAPD), including supplies
  • Admission primarily for diagnostic and evaluation purposes only.
  • Venereal disease, sexually transmitted disease or illness;
  • Sterility, treatment whether to effect or to treat infertility; any fertility, sub-fertility or assisted conception procedure; surrogate or vicarious pregnancy; birth control, contraceptive supplies or services including complications arising due to supplying services.
  • Laser treatment for correction of eye due to refractive error;
  • Aesthetic or change-of-life treatments of any description such as sex transformation operations, treatments to do or undo changes in appearance or carried out in childhood or at any other times driven by cultural habits, fashion or the like or any procedures which improve physical appearance.
  • Plastic surgery or cosmetic surgery unless necessary as a part of medically necessary treatment certified by the attending Medical Practitioner for reconstruction following an Accident, Cancer or Burns.
  • All preventive care, vaccination including inoculation and immunisations (except in case of post- bite treatment and other vaccines explicitly covered);


Non-Medical Exclusions:

  • War or any act of war, invasion, act of foreign enemy, war like operations (whether war be declared or not or caused during service in the armed forces of any country), civil war, public defence, rebellion, revolution, insurrection, military or usurped acts, nuclear weapons/materials, chemical and biological weapons, ionising radiation.
  • Any Insured Person’s participation or involvement in naval, military or air force operation, racing, diving, aviation, scuba diving, parachuting, hang-gliding, rock or mountain climbing.
  • Intentional self-injury or attempted suicide while sane or insane.
  • Charges incurred at a Hospital primarily for diagnostic, X-ray or laboratory examinations not consistent with or incidental to the diagnosis and treatment of the positive existence or presence of any Illness or Injury, for which confinement is required at a Hospital.
  • Items of personal comfort and convenience like television (wherever specifically charged for), charges for access to telephone and telephone calls, internet, foodstuffs (except patient’s diet), cosmetics, hygiene articles, body care products and bath additive, barber or beauty service, guest service as well as similar incidental services and supplies.
  • Doctor’s fees charged by the Medical Practitioner sharing the same residence as an Insured Person or who is an immediate relative of an Insured Person’s family.
  • Provision or fitting of hearing aids, spectacles or contact lenses including optometric therapy unless explicitly stated and covered in the policy.
  • Any treatment and associated expenses for alopecia, baldness, wigs, or toupees, medical supplies including elastic stockings, diabetic test strips, and similar products.
  • Crutches or any other external appliance and/or device used for diagnosis or treatment (except when used intra-operatively and explicitly stated and covered in the policy).
  • Any claim incurred after date of proposal and before issuance of policy where there is change in health status of the member and the same is not communicated to us.
  • All expenses incurred by the Policyholder/ Insured Person at the Hospital or any institution about which the Company has expressly notified that the Claim incurred at such Hospital/institution shall not be payable (except reimbursement claims related to accidents and life threatening conditions). The updated list of such Hospitals can be obtained through the Company’s website or Call Center.

List of TATA AIG health insurance policies

Medicare Insurance

Key Features:

  • Room Rent: Shared Accommodation(with 10% co-pay)/ Single Private A/c Room .
  • Co-pay : NIL co-pay for all treatment .
  • Restoration Benefit :Upto 100% of Base SI per year for all illnesses.
Medicare Premier

Key Features:

  • Room Rent: NIL Room Rent restrictions.
  • Co-pay : NIL co-pay for all treatment .
  • Restoration Benefit :Upto 100% of Base SI per year for all illnesses.
Medicare Protect

Key Features:

  • Room Rent: Shared Accommodation / 10% co pay for higher Room category.
  • Co-pay : NIL co-pay for all treatment .
  • Restoration Benefit :Upto 100% of Base SI per year for all illnesses.
Critical Illness Plan

Key Features:

  • Room Rent: NIL Room Rent restrictions.
  • Co-pay : NIL co-pay for all treatment .
  • Restoration Benefit :NIL Restoration Benefit.
MediPlus Insurance

Key Features:

  • Room Rent: NIL Room Rent restrictions.
  • Co-pay : NIL co-pay for all treatment .
  • Restoration Benefit :NIL Restoration Benefit.
MediSenior Insurance

Key Features:

  • Room Rent:Copay of 15%-Shared Accommodation/30% -Single Accommodation.
  • Co-pay : 15% for Daycare Procedures / 30% for Specified Illnesses.
  • Restoration Benefit :NIL Restoration Benefit.
MediRaksha Insurance
(Covers emergencies and illnesses, hospitalization and surgical treatments)

Key Features:

  • Room Rent:Restricted to 1% of Sum Insured.
  • Co-pay : Co-pay of 15% for all treatments.
  • Restoration Benefit :NIL Restoration Benefit.
Group Hospital Cash insurance
(policy and can be taken along with any other health insurance schemes)

Key Features:

  • A daily benefit hospitalization expenses for accident and sickness.
  • Pre-policy check-up is not required under this policy.
  • Hospitalization cash up to 180 can be used for expenses in case of accidents or sickness.
Individual Hospital Cash insurance
(A Daily benefit hospitalization for Accident & Sickness)

Key Features:

  • A Daily benefit hospitalization for Accident & Sickness.
  • No Pre-policy check up required
  • Hospitalisation Cash upto 180 days in case of Accidents or Sickness
Secured Future Insurance Plan(IPA plan)

Key Features:

  • Guaranteed monthly income.
  • Medical test is not necessary.
  • Terrorism included.
Accident Guard Insurance(IPA plan)

Key Features:

  • Loan Shield: We will pay the outstanding loan amount in case of accidental death of the primary insured up to 25% of the sum insured or actual loan amount whichever is lesser.
  • Air Ambulance: Covers Utilization of Air Ambulance service for transporting insured person to hospital in case of an Accident Upto ₹5 lacs per year or actual whichever is lower per Insured.
Arogya Sanjeevani

Key Features:

  • The Policy covers Hospitalisation Expenses for In-Patient Care or Day Care Treatment incurred for treatment of an Illness contracted/ Injury sustained during the Policy Period.
Corona Kavach health insurance

Key Features:

  • Policy can be availed by persons between the age of 18 years up to 65 years, as Proposer. Proposer with higher age can obtain policy for family, without covering self.