Tata AIG Insurance offers two different versions of health insurance: MediCare plans and Wellsurance plans. The MediCare plans are more traditional comprehensive health insurance plans, while the Wellsurance plans are tailored to suit specific coverages, like the needs of families or those with a critical illness. Tata AIG's plans provide COVID-19 coverage, lifetime renewability, and even dental coverage. Plus, they offer restoration of your sum insured amount up to 100%, but their policies are a bit more expensive than the market average for medical insurance in India.
The company's excellent claim settlement metrics set them apart from their competitors. As one of just two insurers we studied to boast both an optimal claim settlement rate and incurred claims ratio, Tata AIG excels at settling claims quickly, accurately, and to the satisfaction of their policyholders.
|Summary of Tata AIG Health Insurance|
|Policies start 33% more expensive than market average.|
|2 different policy categories to suit specific needs.|
|Optimal 96% claim settlement rate and 78% ICR|
Tata AIG Health Insurance Plan Benefits and Exclusions
Tata AIG offers health insurance plans that are not designed for consumers on a budget. Policies start 33% more expensive than the market average for medical insurance in India, but great features are included to make Tata AIG's coverage among the best in our study. They provide coverage for COVID-19 treatment, automatically restore your sum insured amount up to 100% if you meet or exceed it during a single policy term, and all plans come with lifetime renewability; so you can continue to extend and renew your health coverage for as long as you need. The company also includes dental coverage, an extremely unique feature among the health insurance policies we studied.
Tata AIG's policies are segmented into two different groups: MediCare policies and Wellsurance policies.
MediCare policies are the standard, more commonly-enrolled health insurance plans, and through Tata AIG, consumers have access to three different levels of MediCare insurance coverage. The lowest and cheapest version of MediCare plan is the MediCare Protect policy. It includes all base-level coverages, like in-patient treatment and 540 different day care procedures, but excludes more enhanced features, such as global coverage and vaccination coverage.
The simply named MediCare policy is the middle-tier of coverage. It provides slightly enhanced coverages, like a daily cash allowance and the option to receive a second medical opinion, but still excludes features like OPD treatment and dental coverage. Sum insured amounts range from Rs. 3 lakhs to Rs. 20 lakhs.
Finally, Tata AIG's MediCare Premier policy provides the highest level of coverage and the highest sum insured amounts to go along with it. Sum insured amounts range from Rs. 5 lakhs to Rs. 50 lakhs, some of the highest offered by any insurer in our study - most top-level plans max-out around Rs. 25 lakhs. Some unique features specific to the Premier policy include dental treatment, a prolonged hospitalisation benefit which provides coverage for stays over 10 days, and newborn baby coverage, so this policy is especially effective for expectant mothers and growing families.
|Emergency Air Ambulance||Excluded||Excluded||Included|
|Day Care Procedures||Included||Included||Included|
|Accidental Death Benefits||Optional||Optional||Included|
|First Year Vaccinations||Excluded||Excluded||Included|
|OPD Treatment & Dental||Excluded||Excluded||Included|
|Pre-hospitalisation||30 days||60 days||60 days|
|Post-hospitalisation||60 days||90 days||90 days|
|Newborn Baby Cover||Excluded||Excluded||Included|
|Ambulance Coverage||Rs. 1,000||Rs. 3,000||Rs. 5,000|
|Prolonged Hospitalisation Benefit||Excluded||Excluded||Included|
Tata AIG also provides a MediCare Top-Up plan called MediCare Plus. The Plus plan is designed as an economical and affordable supplement to the other MediCare policies, and provides coverages such as lifelong renewal, global health coverage, consumables benefit, and a cumulative no claims bonus.
The second group of policies is called Wellsurance, and these plans are more tailored to consumers with specific needs and medical requirements. There are three main versions of Tata AIG's Wellsurance coverage: Wellsurance Family, Wellsurance Woman, and Wellsurance Executive.
Wellsurance Family covers not only your immediate family, but your children's education and your parents' medical expenses as well. With the family plan, critical illness coverage is included, as are in-hospital benefits for bother accidents and sickness.
Wellsurance Woman policy covers simple illnesses and critical emergencies, and has terrific coverage benefits that are specifically designed for women. This plan also includes coverage for ICU charges for up to 15 days and uniquely covers cosmetic reconstruction surgery, as long as the surgery is designed to improve bodily functions, correct a significant deformity, or fix an injury resulting from an accident.
Finally, Wellsurance Executive is for more critical diseases that may not be covered or may not fit under the maximum sum insured amount of other comprehensive health insurance policies. The Executive plan covers kidney dialysis, chemotherapy or radiation therapy, and post-operative physiotherapy. It also includes features like major and minor surgical benefits, which covers surgeries that do not stem from pre-existing conditions, but rather are a medical necessity.
Before opting into any of Tata AIG's health insurance plans, consumers should be aware of their list of exclusions, in case there are any that are mandatory for your lifestyle. Tata AIG does not cover:
- Sterility or fertility treatment
- Laser treatment
- Hearing aids
- Private nursing
- Long-term care
- Plastic surgery
In addition to strong medical plans, Tata AIG provides excellent claim settlement rates. Their 96% claim settlement rate is the second-best among the insurers we analysed, and it gives policyholders the confidence that their health insurance claims will be settled in a timely manner. Tata AIG's incurred claims ratio (ICR) is also firmly in the desired range for an Indian health insurance company. The optimal range is between 75-90%, and Tata AIG's 78% ICR indicates a healthy ability to settle claims against annual premium collection.
|Tata AIG||Market Average|
|Claim Settlement Rate||96%||91%|
|PolicyBazaar Reviews||4.7 (3 reviews)||4.1 (49 reviews)|
One drawback of Tata AIG's medical insurance is their slightly below-average network list of hospitals. They have just about 400 fewer than average, so there are many other competing insurers with a shorter list, but policyholders in rural areas outside of the city may have difficulty finding a hospital in a convenient location.
Policy Annual Premium Cost and Comparison
Tata AIG's insurance plans are more expensive than the average health insurer in India, with many plans nearing 30% more expensive than the competition. Consumers on a budget can choose to opt for the MediCare Protect policy, which is the base model and cheapest option under Tata AIG's MediCare coverage.
Annual premium costs will increase as you opt for higher levels of health insurance coverage, like what's provided by the MediCare Standard plan and the MediCare Premier plan.
Claim Submission and Settlement Process
Tata AIG's claim settlement process is just as great as their claim settlement rates. They're one of just two health insurers in our study to have both an optimal claim settlement rate and incurred claims ratio, so you can expect your claims to be finalized quickly, accurately, and with few obstacles along the way.
Claims are easily submitted on Tata AIG's website. Simply navigate to their claims portal, click the submit button, and fill out all required fields and information. While your claim is being evaluated by Tata AIG, you can use their claim tracking tool to receive updates on the progress of your submission. Also on Tata AIG's website, you can use the network hospital list tool, which will locate nearby in-network and cashless medical facilities that accept Tata AIG insurance.
Tata AIG accepts both cashless and reimbursement claims. Using the cashless method, you must be treated at a network hospital. If your procedure is planned, you must submit your claim at least 48 hours in advance, but if it's an emergency, you must submit a claim within 24 hours of the event. The reimbursement claim method allows policyholders to use any hospital, even if it's out-of-network. However, the drawback of this method is that you'll be responsible for all costs up-front, and will rely on Tata AIG to settle your claim and pay you back for covered expenses.
How to Apply or Renew
To apply for any of Tata AIG's health insurance policies, simply navigate to their website, select the policy that fits your needs and your budget best, and fill in all the information that's required of you. The process is simple, quick, and easy online, as Tata AIG provides a step-by-step questionnaire to help you build the perfect plan. You can even build plans for your parents, children, or your spouse.
Renewing your medical insurance policy is just as easy, if not easier, than buying a new plan, and can be done right on Tata AIG's website. Instead of selecting "Get Plan", click "Renew". From there, enter your current plan information and proceed to the renewal application in minutes.