Tata AIG MediCare Premier UIN No.: TATHLIP24159V042324
Tata AIG General Insurance Company Limited
REG-IMP-V1-300924 Page 1 of 49
TATA AIG General Insurance Company
Limited
Tata AIG MediCare Premier Policy Wordings
Tata AIG General Insurance Company Limited (We, Our or Us) will provide the insurance cover, described
in this Policy and any endorsements thereto, for the Insured Period, as defined in the Policy schedule.
The insurance cover provided under this Policy is only with respect to such and so many of the benefits
upto the Sum Insured as mentioned in the Policy Schedule. Commencement of risk cover under the
policy is subject to receipt of premium by us.
The statements and declarations contained in the Proposal signed by the Policyholder (You) and/or
medical reports shall be the basis of this Policy and are deemed to be incorporated herein. The insurance
cover is governed by and subject to, the terms, conditions and exclusions of this Policy.
Tata AIG MediCare Premier UIN No.: TATHLIP24159V042324
Tata AIG General Insurance Company Limited
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TATA AIG General Insurance Company
Limited
Preamble
While the policy is in force, if the Insured Person contracts any disease or suffers from any illness or
sustains bodily injury through accident and if such event requires the insured Person to incur expenses
for Medically Necessary Treatment, We will indemnify You for the amount of such Reasonable and
Customary Charges or compensate to the extent agreed, upto the limits mentioned, subject to terms
and conditions of the Policy. Each Benefit is subject to its Sum Insured, but Our liability to make payment
in respect of any and all Benefits shall be limited to the Sum Insured unless expressly stated to the
contrary.
In case of family floater policy, the sum insured for all or any of the benefits shall be on a per policy per
year basis unless explicitly stated to the contrary. In case of an individual policy, the sum insured for all
or any of the benefits shall be on a per insured per year basis unless explicitly stated to the contrary.
The said Medically Necessary Treatment must be on the advice of a qualified Medical Practitioner.
Section 1 – General Definitions
The terms defined below and at other junctures in the Policy Wording have the meanings ascribed to
them wherever they appear in this Policy and, where appropriate, references to the singular include
references to the plural; references to the male include the female and third gender, references to any
statutory enactment include subsequent changes to the same:
i. Standard Definitions
1. Accident
An accident means sudden, unforeseen and involuntary event caused by external, visible and violent
means.
2. Any one illness
Any one illness means continuous period of illness and includes relapse within 45 days from the date of
last consultation with the Hospital/Nursing Home where treatment was taken.
3. AYUSH Day Care Centre
AYUSH Day Care Centre means and includes Community Health Centre (CHC), Primary Health Centre
(PHC), Dispensary, Clinic, Polyclinic or any such health centre which is registered with the local
authorities, wherever applicable and having facilities for carrying out treatment procedures and
medical or surgical/para-surgical interventions or both under the supervision of registered AYUSH
Medical Practitioner (s) on day care basis without in-patient services and must comply with all the
following criterion:
i. Having qualified registered AYUSH Medical Practitioner(s) in charge;
ii. Having dedicated AYUSH therapy sections as required and/or has equipped operation theatre
where surgical procedures are to be carried out;
Tata AIG MediCare Premier UIN No.: TATHLIP24159V042324
Tata AIG General Insurance Company Limited
REG-IMP-V1-300924 Page 3 of 49
TATA AIG General Insurance Company
Limited
iii. Maintaining daily records of the patients and making them accessible to the insurance
company’s authorized representative.
4. AYUSH Hospital
An AYUSH Hospital is a healthcare facility wherein medical/surgical/para-surgical treatment
procedures and interventions are carried out by AYUSH Medical Practitioner(s) comprising of any of
the following:
a. Central or State Government AYUSH Hospital or
b. Teaching hospital attached to AYUSH college recognized by the Central Government/ Central
Council of Indian Medicine/ Central Council for Homeopathy, or
c. AYUSH Hospital, standalone or co-located with in-patient healthcare facility of any recognized
system of medicine, registered with the local authorities, wherever applicable, and is under the
supervision of a qualified registered AYUSH Medical Practitioner and must comply with all the
following criterion:
i. Having atleast 5 in-patient beds;
ii. Having qualified AYUSH Medical Practitioner round the clock;
iii. Having dedicated AYUSH therapy sections as required and/or has equipped operation
theatre where surgical procedures are to be carried out
Maintaining daily records of the patients and making them accessible to the insurance company's
authorized representative.
5. AYUSH Treatment
AYUSH treatment refers to the medical and / or hospitalization treatments given under Ayurveda,
Yoga and Naturopathy, Unani, Siddha and Homeopathy systems.
6. Break in policy
Break in policy means the period of gap that occurs at the end of the existing policy term/installment
premium due date, when the premium due for renewal on a given policy or installment premium due is
not paid on or before the premium renewal date or grace period.
7. Cashless facility
Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs
of treatment undergone by the insured in accordance with the policy terms and conditions, are directly
made to the network provider by the insurer to the extent pre-authorization is approved.
8. Condition Precedent
Condition Precedent means a policy term or condition upon which the Insurer's liability under the
policy is conditional upon.
9. Congenital Anomaly:
Congenital Anomaly means a condition which is present since birth, and which is abnormal with
reference to form, structure or position.
a) Internal Congenital Anomaly
Congenital anomaly which is not in the visible and accessible parts of the body.
b) External Congenital Anomaly
Congenital anomaly which is in the visible and accessible parts of the body
Tata AIG MediCare Premier UIN No.: TATHLIP24159V042324
Tata AIG General Insurance Company Limited
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TATA AIG General Insurance Company
Limited
10. Cumulative Bonus
Cumulative Bonus means any increase or addition in the Sum Insured granted by the insurer without an
associated increase in premium.
11. Day Care Centre
A day care centre means any institution established for day care treatment of illness and/or injuries or
a medical setup with a hospital and which has been registered with the local authorities, wherever
applicable, and is under supervision of a registered and qualified medical practitioner AND must comply
with all minimum criterion as under –
i. has qualified nursing staff under its employment;
ii. has qualified medical practitioner/s in charge;
iii. has fully equipped operation theatre of its own where surgical procedures are carried out;
iv. maintains daily records of patients and will make these accessible to the insurance company’s
authorized personnel.
12. Day Care Treatment
Day care treatment means medical treatment, and/or surgical procedure which is:
i. undertaken under General or Local Anesthesia in a hospital/day care centre in less than 24 hrs
because of technological advancement, and
ii. which would have otherwise required hospitalization of more than 24 hours.
Treatment normally taken on an out-patient basis is not included in the scope of this definition
13. Dental Treatment
Dental treatment means a treatment related to teeth or structures supporting teeth including
examinations, fillings (where appropriate), crowns, extractions and surgery.
14. Domiciliary Hospitalization
Domiciliary hospitalization means medical treatment for an illness/disease/injury which in the normal
course would require care and treatment at a hospital but is actually taken while confined at home
under any of the following circumstances:
i. the condition of the patient is such that he/she is not in a condition to be removed to a hospital,
or
ii. the patient takes treatment at home on account of non-availability of room in a hospital.
15. Grace Period
“Grace period” means the specified period of time, immediately following the premium due date during
which premium payment can be made to renew or continue a policy in force without loss of continuity
benefits pertaining to waiting periods and coverage of pre-existing diseases. For single premium
payment policies, coverage is not available during the period for which no premium is received.
However, If the premium is paid in instalments during the policy period, coverage will be available during
the grace period, within the policy period. The grace period for payment of the premium shall be: fifteen
days where premium payment mode is monthly and thirty days in all other cases.
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Tata AIG General Insurance Company Limited
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TATA AIG General Insurance Company
Limited
16. Hospital
A hospital means any institution established for in-patient care and day care treatment of illness and/or
injuries and which has been registered as a hospital with the local authorities under Clinical
Establishments (Registration and Regulation) Act 2010 or under enactments specified under the
Schedule of Section 56(1) and the said act Or complies with all minimum criteria as under:
i. has qualified nursing staff under its employment round the clock;
ii. has at least 10 in-patient beds in towns having a population of less than 10,00,000 and at least
15 in-patient beds in all other places;
iii. has qualified medical practitioner(s) in charge round the clock;
iv. has a fully equipped operation theatre of its own where surgical procedures are carried out;
v. maintains daily records of patients and makes these accessible to the insurance company’s
authorized personnel;
17. Hospitalization
Hospitalization means admission in a Hospital for a minimum period of 24 consecutive ‘In-patient Care’
hours except for specified procedures/ treatments, where such admission could be for a period of less
than 24 consecutive hours.
18. Illness
Illness means a sickness or a disease or pathological condition leading to the impairment of normal
physiological function and requires medical treatment.
(a) Acute condition
Acute condition is a disease, illness or injury that is likely to respond quickly to treatment which aims to
return the person to his or her state of health immediately before suffering the disease/ illness/ injury
which leads to full recovery
(b) Chronic condition
A chronic condition is defined as a disease, illness, or injury that has one or more of the following
characteristics:
i. it needs ongoing or long-term monitoring through consultations, examinations, check-ups, and /or
tests
ii. it needs ongoing or long-term control or relief of symptoms
iii. it requires rehabilitation for the patient or for the patient to be specially trained to cope with it
iv. it continues indefinitely
v. it recurs or is likely to recur
19. Injury
Injury means accidental physical bodily harm excluding illness or disease solely and directly caused by
external, violent, visible and evident means which is verified and certified by a Medical Practitioner.
20. Inpatient Care
Inpatient care means treatment for which the insured person has to stay in a hospital for
more than 24 hours for a covered event.
Tata AIG MediCare Premier UIN No.: TATHLIP24159V042324
Tata AIG General Insurance Company Limited
REG-IMP-V1-300924 Page 6 of 49
TATA AIG General Insurance Company
Limited
21. Maternity expenses
Maternity expenses means;
a. medical treatment expenses traceable to childbirth (including complicated deliveries and
caesarean sections incurred during hospitalization);
b. expenses towards lawful medical termination of pregnancy during the policy period.
22. Medical Advice
Medical Advice means any consultation or advice from a Medical Practitioner including the issuance of
any prescription or follow-up prescription.
23. Medical Expenses:
Medical Expenses means those expenses that an Insured Person has necessarily and actually incurred
for medical treatment on account of Illness or Accident on the advice of a Medical Practitioner, as long
as these are no more than would have been payable if the Insured Person had not been insured and no
more than other hospitals or doctors in the same locality would have charged for the same medical
treatment.
24. Medical Practitioner
Medical Practitioner means a person who holds a valid registration from the Medical Council of any
State or Medical Council of India or Council for Indian Medicine or for Homeopathy set up by the
Government of India or a State Government and is thereby entitled to practice medicine within its
jurisdiction; and is acting within its scope and jurisdiction of license.
25. Medically Necessary Treatment
Medically necessary treatment means any treatment, tests, medication, or stay in hospital or part of a
stay in hospital which:
i. is required for the medical management of the illness or injury suffered by the insured;
ii. must not exceed the level of care necessary to provide safe, adequate and appropriate medical
care in scope, duration, or intensity;
iii. must have been prescribed by a medical practitioner;
iv. must conform to the professional standards widely accepted in international medical practice or
by the medical community in India.
26. Migration
“Migration” means a facility provided to policyholders (including all members under family cover and
group policies), to transfer the credits gained for pre-existing diseases and specific waiting periods from
one health insurance policy to another with the same insurer.
27. Network Provider
Network Provider means hospitals or health care providers enlisted by an insurer, TPA or jointly by an
Insurer and TPA to provide medical services to an insured by a cashless facility.
The updated list of Network Provider is available on Our website (www.tataaig.com).
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Tata AIG General Insurance Company Limited
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TATA AIG General Insurance Company
Limited
28. New Born Baby
Newborn baby means baby born during the Policy Period and is aged upto 90 days
29. Notification of Claim:
Notification of claim means the process of intimating a claim to the insurer or TPA through any of
the recognized modes of communication
30. OPD treatment
OPD treatment means the one in which the Insured visits a clinic / hospital or associated facility like a
consultation room for diagnosis and treatment based on the advice of a Medical Practitioner. The
Insured is not admitted as a day care or in-patient.
31. Pre-Existing Disease
“Pre-existing disease (PED)” means any condition, ailment, injury or disease:
a) that is/are diagnosed by a physician not more than 36 months prior to the date of commencement of
the policy issued by the insurer; or
b) for which medical advice or treatment was recommended by, or received from, a physician, not more
than 36 months prior to the date of commencement of the policy.
32. Pre-hospitalization Medical Expenses
Pre-hospitalization Medical Expenses means medical expenses incurred during predefined number of
days preceding the hospitalization of the Insured Person, provided that:
i. Such Medical Expenses are incurred for the same condition for which the Insured Person’s
Hospitalization was required, and
ii. The In-patient Hospitalization claim for such Hospitalization is admissible by the Insurance
Company.
33. Portability
“Portability” means a facility provided to the health insurance policyholders (including all members
under family cover), to transfer the credits gained for, pre-existing diseases and specific waiting periods
from one insurer to another insurer.
34. Post-hospitalization Medical Expenses
Post-hospitalization Medical Expenses means medical expenses incurred during predefined number of
days immediately after the insured person is discharged from the hospital provided that:
i. Such Medical Expenses are for the same condition for which the insured person’s hospitalization
was required, and
ii. The inpatient hospitalization claim for such hospitalization is admissible by the insurance company
Tata AIG MediCare Premier UIN No.: TATHLIP24159V042324
Tata AIG General Insurance Company Limited
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TATA AIG General Insurance Company
Limited
35. Qualified Nurse
Qualified nurse means a person who holds a valid registration from the Nursing Council of India or the
Nursing Council of any state in India.
36. Reasonable and Customary Charges
Reasonable and Customary charges means the charges for services or supplies, which are the standard
charges for the specific provider and consistent with the prevailing charges in the geographical area for
identical or similar services, taking into account the nature of the illness / injury involved.
37. Renewal
Renewal means the terms on which the contract of insurance can be renewed on mutual consent with
a provision of grace period for treating the renewal continuous for the purpose of gaining credit for preexisting diseases, time-bound exclusions and for all waiting periods.
38. Room Rent
Room Rent means the amount charged by a Hospital towards Room and Boarding expenses and shall
include the associated medical expenses.
39. Surgery or Surgical Procedure
Surgery or Surgical Procedure means manual and / or operative procedure (s) required for treatment of
an illness or injury, correction of deformities and defects, diagnosis and cure of diseases, relief from
suffering and prolongation of life, performed in a hospital or day care centre by a medical practitioner.
40. Unproven/Experimental treatment
Unproven/Experimental treatment means the treatment including drug experimental therapy which is
not based on established medical practice in India, is treatment experimental or unproven.
ii. Specific Definitions (Definitions other than as mentioned under Section 1 (i) above)
1. Age
Means the completed age of the Insured Person on his / her most recent birthday as per the English
calendar, regardless of the actual time of birth.
2. Policy
Policy means the contract of insurance including but not limited to Policy Schedule, Endorsements and
Policy Wordings.
3. Policy period
Policy Period means the time during which this Policy is in effect. Such period commences from
Commencement Date and ends on the Expiry Date and specifically appears in the Policy Schedule.
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Tata AIG General Insurance Company Limited
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TATA AIG General Insurance Company
Limited
4. Policy Schedule
Policy Schedule means the Policy Schedule attached to and forming part of Policy
5. Policy year
Policy Year means a period of twelve months beginning from the date of commencement of the
Policy period and ending on the last day of such twelve-month period. For the purpose of
subsequent years, policy year shall mean a period of twelve months commencing from the end
of the previous policy year and lapsing on the last day of such twelve-month period, till the
Policy Expiry date
6. Shared Accommodation
Shared Accommodation means a hospital room with two or more patient beds. This definition does not
apply to ICU or ICCU.
Section 2 – Benefits
Below listed benefits are payable subject to Terms and Conditions of the policy.
The company’s maximum liability in aggregate for payment of any claim under Section B1, B2, B3, B4
and B7 shall not exceed the opted sum insured. However, any payment under cumulative bonus shall
be over and above.
The sequence of utilization of benefits for a claim shall be as per the following:
i. Sum Insured,
ii. Any accrued Cumulative Bonus, if applicable
iii. Restore benefit amount, if applicable
B1. In-Patient Treatment
We will cover for expenses for hospitalization due to disease/illness/Injury during the policy period that
requires an Insured Person’s admission in a hospital as an inpatient.
Medical expenses directly related to the hospitalization would be payable.
B2. Pre-Hospitalization expenses
We will cover for expenses for Pre-Hospitalization consultations, investigations and medicines incurred
up to 60 days before the date of admission to the hospital.
The benefit is payable if We have admitted a claim under section B1 or B4 or B6 or B31 of this policy.
B3. Post-Hospitalization expenses
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Tata AIG General Insurance Company Limited
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TATA AIG General Insurance Company
Limited
We will cover for expenses for Post-Hospitalization consultations, investigations and medicines incurred
after discharge from the hospital, upto number of days as specified in the table below.
Basic Sum insured Number of days
Up to Rs. 50 Lacs 90 days
Rs.75 Lacs to Rs.3 Crore 200 days
In case the insured person has opted sum insured Rs. 75 Lacs and above, then We will arrange up to 15
physiotherapy sessions at home within India, wherever available, within the city in which you reside
through our empanelled service provider subject to following conditions:
• This limit on physiotherapy sessions is applicable to each insured person, per posthospitalization event
• Availing the services for physiotherapy at home under this Benefit is at insured person’s sole
discretion and risk. We do not assume any liability towards quality of service rendered, any
immediate or consequential loss arising out of or in relation to these services rendered by the
empanelled service provider.
• The said physiotherapy must be advised in writing by the treating medical practitioner.
• The above services may be provided by the company /network providers or other empaneled
hospitals / service providers. Any additional expenses other than the eligible expenses shall be
borne by the insured person which shall not be covered under this policy unless specified
otherwise
• This facility may be availed through our website or our mobile application or through calling our
call centre on the toll free number specified in the policy schedule. Alternatively, details of our
empanelled service provider are available on our website (www.tataaig.com)
• In case we or the empanelled service provider fails to provide any of the services as mentioned
in this policy or is unable to implement , in whole or in part due to force majeure, non-availability
of services, change in law, rule or regulations which affects the services, or if any regulatory or
governmental agency having jurisdiction over a party takes a position which affects the services,
then the service provider services suspended, curtailed or limited performance shall not
constitute breach of contract and the company or the empanelled service provider shall have
no liability whatsoever including but not limited to any immediate or consequential loss
resulting therefrom.
The benefit is payable if We have admitted a claim under section B1 or B4 or B6 or B31 of this policy.
B4. Day Care Procedures
We will cover expenses for Day Care Treatment due to disease/illness/Injury during the policy period
taken at a hospital or a Day Care Centre.
Treatment normally taken on out-patient basis is not included in the scope of this cover.
Tata AIG MediCare Premier UIN No.: TATHLIP24159V042324
Tata AIG General Insurance Company Limited
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TATA AIG General Insurance Company
Limited
B5. Organ Donor
We will cover for Medical and surgical Expenses of the organ donor for harvesting the organ where an
Insured Person is the recipient provided that:
i. The organ donor is any person whose organ has been made available in accordance and in
compliance with The Transplantation of Human Organs (Amendment) Bill, 2011 and the organ
donated is for the use of the Insured Person, and
ii. We have accepted an inpatient Hospitalization claim for the insured member under section B1
of this policy.
B6. Domiciliary Treatment
We will cover for expenses related to Domiciliary Hospitalization of the insured person if the treatment
exceeds beyond three days. The treatment must be for management of an illness and not for enteral
feedings or end of life care.
At the time of claiming under this benefit, we shall require certification from the treating doctor fulfilling
the conditions as mentioned under the general definitions (Section 1) of this policy.
B7. Restore benefit
We will automatically restore the Basic Sum Insured if the Sum Insured and accrued Cumulative Bonus
is insufficient to pay a claim during the policy year. This benefit can be availed once during the policy
year subject to the following conditions:
a. The restored sum insured can be used for any admissible claim under Sections B1 to B4, for the
insured person(s) who have not claimed earlier under these Sections. In case the insured has
claimed under these sections, then this automatic restoration benefit is available for admissions
due to unrelated illness/diseases. However, this benefit for related illness/diseases would be
available, in case of claimed insured person(s), for admissions after 45 days from the date of
discharge of the earlier claim.
b. In case of Family Floater policy, Reinstatement of Sum Insured will be available for all Insured
Persons in the Policy on floater basis
c. For policy with Basic Sum Insured less than or Equal to Rs. 50 Lacs: This benefit shall be
applicable annually for policies with tenure of more than 1 year.
For policy with Basic Sum Insured Rs. 75 Lacs and above:
This benefit shall be applicable annually for multiyear policies. However, for single premium
multiyear policies, the insured shall have the right to utilize the available restorations anytime
during the policy period, except for the first claim, for e.g. a policy with tenure of 2 years where
Tata AIG MediCare Premier UIN No.: TATHLIP24159V042324
Tata AIG General Insurance Company Limited
REG-IMP-V1-300924 Page 12 of 49
TATA AIG General Insurance Company
Limited
entire premium is paid upfront, the insured is eligible for a total of 2 restorations anytime during
the policy period except for the first claim in each policy year.
d. The unutilized restored sum insured cannot be carried forward to the next policy year.
e. Restore will not trigger for the first claim under each policy year.
f. The maximum liability under a single claim under this benefit shall be the sum Insured.
This benefit shall not be available for section B13 and B31 of this policy.
B8. AYUSH Benefit
We will cover Medical Expenses incurred for treatment as In-Patient or Day Care Treatment in an
AYUSH Hospital/ AYUSH day care centre.
This benefit shall also cover Pre-Hospitalization medical expenses for a period of upto 60 days before
the date of admission to the AYUSH hospital/ AYUSH day care centre and Post-Hospitalization
Medical Expenses for a period upto number of days as specified in the table below, subject to AYUSH
In-Patient hospitalization or AYUSH day care treatment claim being admissible under this benefit.
Basic Sum insured Number of days
Upto Rs. 50 Lacs 90 days
Rs.75 Lacs to Rs.3 Crore 200 days
Claims under this section shall be assessed as per the applicable insurance guidelines related to AYUSH
and benchmark rates as available on Ministry of AYUSH website
(https://ayushnext.ayush.gov.in/site/insurance-guidelines-related-to-ayush).
B9. Ambulance Cover
We will cover for expenses incurred on transportation of Insured Person in a registered ambulance to a
Hospital for admission in case of an Emergency or from one hospital to another hospital for better
medical facilities and treatment, subject to limited as specified in the table below.
Basic Sum Insured Limit
Up to Rs. 50 Lacs Upto Rs. 5000 per hospitalization
Rs. 75 Lacs Upto Rs. 7500 per hospitalization
Rs. 1 Crore Upto Rs. 10000 per hospitalization
Rs. 2 Crore Upto Rs. 20000 per hospitalization
Rs. 3 Crore Upto Rs. 30000 per hospitalization
For this claim to be paid, the claim must be admissible under section B1 or B4 of this policy.
B10. Health Checkup
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We will cover for expenses for a Preventive Health Check-up upto 1% of policy sum insured subject to a
maximum limit as specified in the table below. The limit is the maximum per policy in case of floater
policy and per insured person in case of individual policy
The benefit is payable every year irrespective of claims under the policy. This benefit has a separate limit
(over and above base sum insured) and does not affect cumulative bonus.
Basic Sum Insured (Rs.) Limit
Up to Rs. 50 Lacs Upto Rs. 10000
Rs. 75 Lacs Upto Rs. 15000
Rs. 1 Crore Upto Rs. 20000
Rs. 2 Crore Upto Rs. 25000
Rs. 3 Crore Upto Rs. 25000
For the purpose of this benefit, Preventive Health Check-up means medical test(s) undertaken for
general assessment of health status and does not include any diagnostic or investigative medical tests
for evaluation of illness or a disease.
B11. Compassionate travel
a) Domestic
In the event the Insured Person is Hospitalized in India for more than Five consecutive days in a
place where no adult member of his immediate family is present, we will cover for expenses
related to a round trip economy class air ticket, or first-class railway ticket, to allow the
Immediate Family Member be at his bedside for the duration of his stay in the hospital.
The benefit shall be payable if an inpatient Hospitalization claim for the insured member is
admissible under section B1 of this Policy.
b) Global (Applicable for sum insured above Rs. 50 Lacs):
In the event the Insured person is hospitalized outside India and claim is admissible under
section B13 (Global cover for Planned Hospitalization) of this policy, We will cover 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.
This benefit has a separate limit (over and above base sum insured) as specified in the policy schedule
and does not affect cumulative bonus.
We shall require the following additional documents (proof of travel) supporting the claim under this
benefit: Copy of Passport (in case of Global), Boarding Pass, or Railway ticket or any other document to
show proof of travel.
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Tata AIG General Insurance Company Limited
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TATA AIG General Insurance Company
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B12. Consumables Benefit
We will pay for expenses incurred, for specified consumables listed in ‘Annexure I – List I- Optional Items’
which are consumed during the period of hospitalization directly related to the insured’s medical or
surgical treatment of illness/disease/injury. Details of Annexure I-List I-Optional items are available on
our website (www.tataaig.com)
However, the following items shall be excluded from scope of this coverage:
• Items of personal comfort, toiletries, cosmetics and convenience shall be excluded from scope
of this coverage.
• External durable devices like Bilevel Positive Airway Pressure (BIPAP) machine, Continuous
Positive Airway Pressure (CPAP) machine, Peritoneal Dialysis (PD) equipment and supplies,
Nimbus/water/air bed, dialyzer and other medical equipments.
• Any item which is neither medical consumable nor medically necessary nor prescribed by
Doctor.
For this claim to be paid, the main claim must be admissible under section B1 or B4 or B31 of this
policy.
B13. Global Cover for Planned Hospitalization
a. Global Cover for Planned Hospitalization (Medical Expenses)
We will cover for Medical Expenses of the Insured Person incurred outside India, upto the sum
insured, provided that the diagnosis was made in India and the insured travels abroad for
treatment.
The Medical Expenses payable shall be limited to Inpatient and daycare Hospitalization. Any
claim under this cover can be made only on reimbursement basis. Cashless facility may be
arranged on case to case basis. Insured person can contact us for claim assistance.
The payment of claim under this benefit will be in Indian Rupees based on the rate of exchange
published by Reserve Bank of India (RBI), as on the date of invoice and shall be used for
conversion of foreign currency into Indian Rupees for claims payment. If these rates are not
published on the date of invoice, the exchange rate next published by RBI shall be considered
for conversion.
Only the balance basic sum insured along with Cumulative Bonus can be used for this and not
the restored sum insured.
We shall require the following additional documents supporting the claim under this benefit:
• Proof of diagnosis in India
• Insured’s Passport and Visa
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b. Visa Services Fees (Applicable only for Sum Insured above Rs.50 Lacs)
We will cover for reasonable and customary expenses incurred towards obtaining visa for
medical treatment of the insured person travelling abroad upto the sum insured subject to
claim being admissible under section B13 (a – Global Cover for Planned Hospitalization
(Medical Expenses)) of this policy.
• We shall require valid receipts/bills of visa fee services supporting the claim under this
benefit.
Special condition applicable for cover B13 (a) & (b):
Please note that, B13. ‘Global Cover for Planned Hospitalization’ as a Benefit is:
a) not available under this policy and no claim shall be admissible under this section where either
the policyholder or any of the Insured Person(s) is a Foreign National or their Residence Status
at the time of proposal or anytime during the policy period/ renewal is:
• Non-Resident Indian (NRI); or
• Overseas Citizen of India (OCI)
b) not available under this Policy and no claim shall be admissible under this section, if the
Policyholder or any of the Insured Person(s), as a Resident Indian National, has agreed to opt
out of this Benefit at the time of proposal or at renewal.
If the coverage under B13. ‘Global Cover for Planned Hospitalization’ is once opted out, then neither
the policyholder nor the Insured Person can take coverage under this benefit.
You are eligible for a premium discount as specified in the prospectus in case this special condition, as
mentioned above, is applicable to You/ Insured Person(s).
B14. Bariatric Surgery Cover
We will cover for reasonable and customary expenses for Bariatric Surgery if the insured fulfills all of the
following conditions:
i. Surgery to be conducted is upon the advice of the Doctor
ii. The member has to be 18 years of age or older and
iii. Body Mass Index (BMI) greater than or equal to 40 or
iv. BMI is greater than or equal to 35 in conjunction with any of the following severe co-morbidities
following failure of less invasive methods of weight loss:
a. Obesity-related cardiomyopathy
b. Coronary heart disease
c. Severe sleep apnea
d. Uncontrolled Type2 Diabetes
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In view of this coverage getting extended, exclusion code (Code-Excl06) of this policy stands deleted.
B15. In-Patient Treatment - Dental
We will cover for medical expenses incurred towards hospitalization for dental treatment under
anesthesia necessitated due to an accident/injury/illness.
B16. Vaccination cover
We will cover for expenses related to the cost of the following vaccines only:
Basic Sum Insured Vaccines covered
Up to Rs. 50 Lacs Without any waiting period:
- Anti-rabies vaccine following an animal bite
- Typhoid vaccination
After 2 years of continuous coverage with Us:
- Human Papilloma Virus (HPV) vaccine
- Hepatitis B Vaccine
Rs. 75 Lacs to Rs. 3
Crore.
Without any waiting period:
- Anti-rabies vaccine following an animal bite
- Typhoid vaccination
After 2 years of continuous coverage with Us:
- Human Papilloma Virus (HPV) vaccine
- Hepatitis A Vaccine
- Hepatitis B Vaccine
- Tetanus, Diphtheria, Pertussis
- Pneumococcal
Expenses related to the doctor, nurse or any incidental expenses are not payable. This benefit has a
separate limit (over and above base sum insured) and does not affect cumulative bonus.
B17. Hearing Aid
We will cover for reasonable charges for a hearing aid every third year. The maximum amount payable
is 50% of actual cost or Rs. 10,000/- per policy, whichever is lower.
The items must be prescribed by a specialized Medical Practitioner as medically necessary.
This benefit has a separate limit (over and above base sum insured) and does not affect cumulative
bonus.
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B18. Daily Cash for choosing Shared Accommodation
We will pay a fixed amount per day as mentioned in the policy schedule if the Insured Person is
Hospitalized in Shared Accommodation in a Network Hospital for each continuous and completed period
of 24 hours. The benefit payable per day would be 0.25% of base sum insured and a maximum of Rs.
2000 per day.
For this claim to be paid, the main claim must be admissible under section B1 of this policy. This benefit
has a separate limit (over and above base sum insured) and does not affect cumulative bonus.
B19. Daily Cash for Accompanying an Insured Child
We will pay a fixed amount per day, as mentioned in the policy schedule, if the Insured Person
Hospitalized is a child Aged 12 years or less, for one accompanying adult for each complete period of 24
hours. The benefit payable per day would be 0.25% of base sum insured and a maximum of Rs.2000 per
day.
For this claim to be paid, the main claim must be admissible under section B1 of this policy.
This benefit has a separate limit (over and above base sum insured) and does not affect cumulative
bonus.
B20. Second Opinion
We will provide You a second opinion from Network Provider or Medical Practitioner, if an Insured
Person is diagnosed with the below mentioned Illnesses during the Policy Period. The expert opinion
would be directly sent to the Insured Person.
i. Cancer
ii. Kidney Failure
iii. Myocardial Infarction
iv. Angina
v. Coronary bypass surgery
vi. Stroke/Cerebral hemorrhage
vii. Organ failure requiring transplant
viii. Heart Valve replacement
ix. Brain tumors
This benefit can be availed by an insured person once during a Policy Year.
B21. Maternity Cover
We will cover for Maternity Expenses, upto limits as specified in the table below, per policy subject to
a waiting period of 4 years of continuous coverage under this policy .
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Basic Sum Insured Limit
Up to Rs. 50 Lacs A maximum of upto Rs 50,000/-. In case of birth of a girl child, the
maximum limit under this coverage would be upto Rs 60,000/- per
policy
Rs.75 Lacs to Rs.3 Crore A maximum of upto Rs 1,00,000/-. In case of birth of a girl child, the
maximum limit under this coverage would be upto Rs 1,20,000/- per
policy
We will not cover ectopic pregnancy under this benefit (although it shall be covered under section B1).
Expenses incurred for following shall be excluded from the scope of this coverage:
• Expenses incurred for pre/post natal care
• Pre/Post hospitalization benefit (Section B2 and B3 of this policy)
In view of this coverage getting extended, maternity exclusion code 18 stands deleted. However, no
coverage is available for voluntary termination of pregnancy during the policy period under this policy.
B22. Delivery Complications Cover
We will cover for medical expenses incurred for the medically necessary treatment of the new born
baby up to limits as specified in the table below, for complications related to delivery if claim is admitted
under the maternity benefit (B21) of this policy.
Basic Sum Insured Limit
Up to Rs.50 Lacs Upto Rs. 10000
Rs. 75 Lacs to Rs. 3 Crore Upto Rs. 25000
B23. First year Vaccinations
We will pay for vaccination expenses for up to one year after the birth of the child subject to a limit of
Rs. 10,000/- provided the child is covered with Us. In case of girl child, applicable limit under this
coverage would be Rs.15,000/-.
For the claim to be paid under this benefit, the expenses related to maternity should be admissible
under section B21 of this policy. The limit of Rs.10,000 (Rs.15,000 in case of girl child) is a lifetime limit
and not a policy limit which will be applicable for each child.
B24. Prolonged Hospitalization Benefit
We will pay a fixed amount of 1% of sum insured, in the event of insured hospitalized for a
disease/illness/injury for a continuous period exceeding 10 days.
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This benefit will be triggered provided that the hospitalization claim is accepted under section B1 of this
policy.
This benefit shall not be applicable for section B6 / B 31 of this policy.
This benefit has a separate limit (over and above base sum insured) and does not affect cumulative
bonus.
B25. High End Diagnostics
We will cover for reasonable charges incurred for the following diagnostic tests only on OPD basis if
required as part of a medically necessary treatment subject to limits as specified in the table below, per
policy year:
i. Brain Perfusion imaging
ii. Computed Tomography (CT) guided Biopsy
iii. Computed Tomography (CT) Urography
iv. Digital Subtraction Angiography (DSA)
v. Liver Biopsy
vi. Magnetic Resonance Cholangiography Scan
vii. Positron Emission Tomography Computed Tomography (PET CT)
viii. Positron emission tomography Magnetic Resonance Imaging (PET MRI)
ix. Renogram
Basic Sum Insured Limit
Up to Rs.50 Lacs Up to Rs. 25,000 per policy year
Rs. 75 Lacs to Rs. 3 Crore Up to Rs. 50,000 per policy year
This benefit has a separate limit (over and above base sum insured) and does not affect cumulative
bonus.
B26. OPD Treatment
Once the insured has completed two years of continuous coverage with Us, We will pay for expenses
related to consultations and pharmacy up to limits specified in the table below, per policy year annually
subject to policy terms and conditions.
Basic Sum Insured Limit
Up to Rs.50 Lacs Upto Rs. 5,000/-
Rs.75 Lacs Upto Rs. 7,500/-
Rs. 1 Crore Upto Rs. 10,000/-
Rs. 2 Crore Upto Rs. 15,000/-
Rs. 3 Crore Upto Rs. 20,000/-
This benefit has a separate limit (over and above base sum insured) and does not affect cumulative
bonus.
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B27. OPD Treatment - Dental
Once the Insured has completed two years of continuous coverage with Us, we will pay for expenses
related to the following dental treatments only subject to a maximum of limit specified in the table
below, per policy year annually:
- Root Canal Treatment (single or multiple sittings)
- Tooth extraction(s)
- Filling
Basic Sum Insured Limit
Up to Rs. 50 Lacs Upto Rs. 10,000/-
Rs. 75 Lacs Upto Rs. 12,500/-
Rs.1 Crore Upto Rs. 15,000/-
Rs.2 Crore Upto Rs. 20,000/-
Rs.3 Crore. Upto Rs. 25,000/-
This benefit has a separate limit (over and above base sum insured) and does not affect Cumulative
Bonus.
In view of this coverage getting extended, dental exclusion (General Exclusions ii. 1. ix) is not applicable
for this particular coverage.
B28. Emergency Air Ambulance Cover
We will pay for ambulance transportation of the Insured Person in an airplane or helicopter subject to
maximum of limit specified in the table below, for emergency life threatening health conditions which
require immediate and rapid ambulance transportation to the hospital/medical centre for further
medical management.
The Medical Evacuation should be prescribed by a Medical Practitioner and should be Medically
Necessary.
This benefit shall only be payable if We have accepted an inpatient Hospitalization claim for the Insured
member under section B1 of this policy.
Basic Sum Insured Limit
Up to Rs.50 Lacs Up to Rs. 500,000
Rs.75 Lacs to Rs. 3 Crore Up to Rs. 500,000 for Non Network;
Upto Sum Insured for Network Provider
This benefit has a separate limit (over and above base sum insured) and does not affect Cumulative
Bonus.
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B29. Accidental Death Benefit
If an Insured Person suffers an accident during the policy period and this is the sole and direct cause of
his death within 365 days from the date of accident, then We will pay a fixed amount of 100% of the
base Sum Insured, maximum up to Rs 50 Lacs.
This benefit is not applicable for dependent children covered in the policy.
B30. Cumulative Bonus
i. 50% cumulative bonus will be applied on the Sum Insured for next policy year under the Policy
after every claim free Policy Year, provided that the Policy is renewed with Us and without a
break. The maximum cumulative bonus shall not exceed 100% of the Sum Insured in any Policy
Year.
ii. If a Cumulative Bonus has been applied and a claim is made, then in the subsequent Policy Year
We will automatically decrease the Cumulative Bonus by 50% of the Sum Insured in that
following Policy Year. There will be no impact on the Inpatient Sum Insured, only the accrued
Cumulative Bonus will be decreased.
iii. In policies with a tenure of more than one year, the above guidelines of Cumulative Bonus shall
be applicable post completion of each policy year
iv. In relation to a Family Floater, the Cumulative Bonus so applied will only be available in respect
of those Insured Persons who were Insured Persons in the claim free Policy Year and continue
to be Insured Persons in the subsequent Policy Year.
v. For purpose of computation of Cumulative Bonus, the percentage (%) of Cumulative Bonus will
be applied on the base Sum Insured only. Restored sum insured will not be taken into
consideration.
vi. Cumulative Bonus shall be provided only if No Claim Discount has not been availed for the claim
free previous Policy Year.
B31. Home Care Treatment Cover (Applicable only for Sum Insured Rs.75 Lacs and above)
We will cover for reasonable and customary medical expenses incurred for treatment taken at home,
which are “Equivalent Medical charges” as defined in this policy, for below specified conditions/illness
upto the sum insured (excluding accrued cumulative bonus) for the Insured Person’s medically
necessary treatment at home. Restore benefit sum insured is not applicable for this benefit.
Home Care Treatment means treatment availed by the Insured Person at home for below listed
conditions/ illness/ procedures, which in normal course would require hospitalization of more than 24
hours or would have been admissible under Day Care Procedures but is actually taken at home
provided that:
a. The medical practitioner advices the insured person to undergo treatment at home.
b. There is a continuous active line of treatment with monitoring of the health status by a medical
practitioner for each day through the duration of the home care treatment.
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c. Daily monitoring chart including records of treatment administered duly signed by the treating
doctor is maintained
d. Home care treatment is availed in India.
e. Home treatment services may be provided through network service provider/ empanelled
service provider in select cities for select treatment procedures only. Please contact us or visit
our website (www.tataaig.com) for updated list of treatment procedures and cities where home
treatment service is provided
f. Insured shall be permitted to avail the services as prescribed by the medical practitioner.
g. In case the insured intends to avail the services of non-network provider, claim shall be subject
to reimbursement, a prior approval from the insurer needs to be taken before availing such
services from a registered home care provider. Insurer shall respond to approval request within
4 working hours of receiving the last necessary requirement.
Specified conditions/ illness covered under Home care treatment:
a. Dialysis at home
b. Chemotherapy at home
c. Pandemic Care at home for a maximum period of 15 days and maximum upto 25% of the base
sum insured excluding cumulative bonus (Pandemic as defined and declared by World Health
Organization (WHO) or any equivalent healthcare authority)
In this benefit, the following shall be covered if prescribed by the treating medical practitioner and is
related to treatment covered under the policy,
a. Diagnostic tests undergone at home or at diagnostics center
b. Medicines prescribed in writing
c. Consultation charges of the medical practitioner
d. Nursing charges related to medical staff
e. Medical procedures limited to parenteral administration of medicines
f. Including but not limited to cost of Pulse Oximeter, Oxygen cylinder and nebulizer wherever
applicable
For the purpose of this cover, “Equivalent Medical charges” shall mean the charges for services or
supplies, which are the standard/equivalent charges for the specific provider and not more than the
prevailing charges in the geographical area for identical or similar services taken on inpatient/day care
basis, considering the nature of the illness / injury involved.
B32. Wellness Services
We / our Empanelled Service Provider will provide below mentioned wellness services designed
to assist insured persons in maintaining and improving good health and fitness. These Wellness
Services will be available for the insured person during the policy period and as specified in the
Policy schedule.
i. Teleconsultation - General
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We /our empanelled Service Provider will arrange for teleconsultations upon insured
person’s request through telecommunications and digital communication technologies for
insured person’s health related complaints or preventive health care by a qualified Medical
Practitioner/ Health Care Professional, as per the limit specified in your Policy Schedule.
This service can only be availed subject to condition below:
- Consultation will be provided through various specified modes of communication
(including but not limited to) like audio, video, online portal, chat, digital
customer application or any other digital mode.
ii. Teleconsultation - Speciality
We /Our empanelled Service Provider will arrange for teleconsultations upon insured
person’s request through telecommunications and digital communication technologies for
insured person’s health related complaints or preventive health care by a qualified &
specialist Medical Practitioner/ Health Care Professional, as per the limit/speciality
specified in your Policy Schedule.
This service can only be availed subject to conditions below:
- Consultation will be provided through various specified modes of communication
(including but not limited to) like audio, video, online portal, chat, digital
customer application or any other digital mode.
iii. Ambulance Booking facility
We / Our empanelled Service Provider will provide a facility to book a road ambulance in
India, for transportation of an Insured Person to a Hospital for admission or from one
hospital to another hospital for better medical facilities and treatment.
This booking service can be availed at Our Network subject to the transportation of the
Insured Person will be offered to the nearest Hospital
iv. Emergency - Help me feature
In case of an emergency, insured person will have an option to share his/her location with
the ‘designated caregiver’ through our customer application provided the insured person has
registered on our App.
The app will trigger a message and call to the designated caregiver informing about the
emergency and sharing the location of the Insured Person.
For the purpose of this benefit, ‘designated caregiver’ shall mean that individual who has
been specified as a caregiver at the time of registration in the customer App.
Please note
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- This service will be available subject to suitable infrastructure, connectivity, device
restrictions and device functionality.
v. Redeemable voucher/Discount on services
We / our empanelled service provider will provide redeemable vouchers/ discount (as
approved by the regulator from time to time) on certain specified products/ services to
promote wellness and fitness of the insured person.
vi. Health Condition Management
We / our empanelled service provider will provide consultative services related to health
conditions/ illnesses with the objective of maintaining good health and improving it through
various health condition management programmes including but not limited to nutrition
management, weight management, chronic condition management, stress management,
health coach (as approved by the regulator from time to time) and offered by us.
Consultative services will be provided through various specified modes of communication
(including but not limited to) audio, video, online portal, chat, digital customer application
or any other digital mode.
Definition:
For the purpose of section B 32 of this policy, a Health Care Professional is a person who holds
a valid qualification from regulatory body as set up by the Government of India or a State
Government or any other relevant authority and is engaged in actions with an objective of
maintaining and improving individual’s good health.
B33. Wellness Program
We / our empanelled service provider will provide a wellness program designed to promote
wellness and fitness amongst the insured persons. This wellness program is structured to reward
the insured person in the form of measurable wellness score for the prescribed physical
efforts/fitness activity undertaken by such insured person during the policy period. This is a
voluntary program available for insured with age above 18 years, at the start of the policy year.
It is advisable to the insured person to consult his/her physician before starting any physical
exercise/ activity.
It is a pre-condition for enrolment under this wellness programme, that the insured person
should have undergone the health risk assessment as specified below and depending on the
outcome from health risk assessment, the wellness reward and its scoring should be
administered. The earnings under the wellness program is linked to your wellness category and
shall be valid for one year from the date of credit of daily score in insured person’s wellness
account, provided the policy is renewed within the grace period. Daily score will be credited
after the completion of a healthy day.
For the purpose of understanding if the daily score is credited on 1st Jan 2024 it will be valid up
to 31st Dec 2024.
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i) Health risk assessment
We / our empanelled service provider will provide a health risk assessment (HRA) questionnaire,
which is an online tool for evaluation of status of health and quality of the insured person’s life.
This tool helps insured persons to review their lifestyle practises which may impact their health
status.
To undertake the health risk assessment, you can log into your account on our customer
application. This can be undertaken once a policy year.
On completion of the health risk assessment and based on the insured person’s assessment
results, we / our empanelled service provider will identify the wellness category in which the
insured person falls in.
Wellness categories for this purpose are defined as below:
• Green – low risk for developing lifestyle disease as compared to peers in the same age
and gender group.
• Yellow – moderate risk for developing lifestyle disease as compared to peers in the same
age and gender group.
• Red – higher risk for developing lifestyle disease as compared to peers in the same age
and gender group.
The overall wellness category is valid till the expiry of the policy year in which the insured
undergoes the assessment and will be updated based on HRA results of subsequent assessment
undergone by the insured person in each consecutive policy year, subject to renewal of the
policy within the grace period. In the event of a long-term policy (greater than 1 year) the
insured has to undergo HRA in each policy year to be eligible for wellness rewards. If the insured
does not undergo assessment in the consecutive policy year, henceforth no rewards will be
earned for any physical activity undertaken. However, earned rewards will be carried forward
till its validity and will be available for utilization.
ii) Wellness Rewards
Mechanism to earn Wellness Reward:
We will encourage physical exercise and fitness and recognise the effort by rewarding the
insured person on daily basis for each healthy day.
A healthy day can be earned by undertaking below activity on a calendar day:
1. Recording 10, 000 steps / day#
in the activity tracking apps or fitness tracker devices
as prescribed by the company or our empanelled service provider: or
2. Burning 500 calories or more in a day through activity as measured by fitness tracker
devices.
The company may at its discretion change the above criteria and the same would be mentioned
in the policy schedule/ customer application.
Wellness reward will be earned depending on the wellness category of the insured person and
as per the grid below:
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Wellness category
Green Yellow Red
Rewards per Healthy Day 10 7 5
Note:
− HRA registration will be allowed anytime during the policy year and healthy activities will be
tracked throughout the policy year, however, for each policy year, activities completed in
first 300 days of the policy year will be considered for reward in the same year, activities
completed on or after 301st day of the policy year will be carried forward to the next policy
year and will be available for utilization in the next year provided the policy has been inforce
or renewed with us without any break within the grace period.
− In case of individual policy, each insured person would be tracked separately and shall earn
wellness reward based on one’s own individual performance/physical activity as per the grid
above
− In case of family floater policy, each insured person, with age above 18 years, at the start of
the policy year, would be tracked separately and shall earn wellness reward based on one’s
own individual performance/physical activity as per the grid above. In order to compute the
wellness reward for such policies, average of individual performance rewards would be
considered for computation of wellness reward.
−
# The company may also use alternative measurement criteria in lieu of steps and calories
burnt and the same shall be mentioned on the policy schedule
− Data entered manually in the fitness tracking apps or devices will not be considered for
tracking healthy day
− Calories burnt during basic metabolism shall not be considered for tracking healthy day (here
basic metabolism refers to activities done while at rest to maintain vital functions such as
breathing and keeping warm etc.)
−
−
Mechanism to Utilise Wellness Reward:
Wellness Reward accumulated through fitness activities can be converted into monetary value
as per method defined below and can be utilized towards the payment of services/items under
below categories, available through our Network/ empanelled service provider:
▪ OPD consultation/ treatment
▪ Pharmaceuticals
▪ Health-check-ups/ diagnostics
▪ Health Supplements
▪ Coverage of cost of treatment of any admissible claim in respect of non-payable items that
are specified under the terms and conditions of the base policy
▪ Or any other items as prescribed by the company or our empanelled service provider as
approved by the Regulator as a redeemable item from time to time.
Note:
− Wellness Reward can be converted into a monetary value after every Healthy Day, during
the Cover Period
− Monetary value of the Wellness score earned is equivalent to the:
Wellness score earned X (Per year Policy Premium without Taxes/ 10,000).
o In case of policy with tenure more than one year, ‘per year policy Premium without
Taxes’ = (Total Policy premium without tax, for the tenure/ policy tenure).
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o In case of family floater policy, reward will be calculated on average premium per
person which is equivalent to the Total Policy premium without tax/ number of
Insured persons covered in the policy on floater basis
Illustration
Age of the Insured Person (Years) 40
Sum Insured opted under the Policy (Rs.) 5 Lacs
Plan Type Individual
Policy Tenure (years) 1
Total number of members covered under the policy 1
Net Premium paid (without Tax) 7931
Wellness Category (post Health Risk Assessment) Green
Healthy Day Wellness
Reward
earned
(per day)
Wellness
Reward
converted to
Monetary
Value
(per day)
Wellness Reward
credited after
Healthy Day
Wellness Reward valid up to
365 days (provided the
policy is active and insured
is covered)
1 to 300 day 10 7.931 Date of credit of
Wellness score
365 days from the Date of
credit of Wellness score
301 day
onwards
10 7.931 Date of Policy
Anniversary - in
case of Multi year
policy
Date of renewal - in
case of 1 yr policy
365 days from:
- Date of Policy
Anniversary - in case of
Multi year policy
- Date of renewal - in case
of 1 yr policy, as
applicable
Maximum Total in a Policy
Year
2894.82
Steps to register for Wellness Program and earn & spend Wellness Rewards
Step 1. Register yourself on customer application
• The insured person will download Tata AIG customer application on your device and complete
registration process by providing policy and insured person’s details.
Step 2. Complete health risk assessment
• Submit response to the online health questionnaire on your device.
• On completion of the health risk assessment, a Wellness category will be assigned to the
insured person for the policy year and will be updated based on the latest health risk
assessment in next policy year.
Step 3. Comply with mechanism to earn Wellness Rewards
• We will track the physical exercise and fitness activities completed by the insured person,
through the customer app.
• Activities completed on a calendar day will be considered as a Healthy Day and reward will be
credited to insured person’s wellness account.
Step 4. Convert Healthy Day into monetary value and spend
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• Insured person will have an option to convert the accumulated rewards into the monetary value
and spend it on items/ services offered under the policy
• The unutilized rewards will be carried forward to next Policy year till this policy is renewed with
us within grace period and is inforce subject to validity period of the reward point)
Disclaimer (applicable to section B32 & B33)
1. Availing the services under this benefit is purely upon the Insured’s sole discretion and risk.
2. For services that are provided through empanelled Service Providers, we are acting as a
facilitator; hence would not be liable for any incremental costs or the services. Any additional
services availed, or expenses incurred on such services or benefits which are other than those
covered under this policy and explicitly excluded by this policy schedule, shall not be covered
under this policy and all expenses incurred shall be borne by the insured person.
3. We shall not be responsible for or liable for, any actions, claims, demands, losses, damages,
costs, charges and expenses which insured person claims to have suffered, sustained or
incurred, by way of and / or on account of the benefit. We shall not be liable for any deficiency
or discrepancy in the services provided by empanelled service provider/network provider under
this policy.
4. Insured person may consult any medical professional at any network provider/empanelled
service provider at its sole discretion. The cost of service arising out of insured person choice of
medical professional at any network provider/emplaned service provider shall be completely
borne by the insured person unless covered otherwise. However, the services under this policy
should not be construed to constitute medical advice and/or substitute the insured person's
visit/ consultation to an independent medical practitioner/healthcare professional
5. The medical practitioner may suggest/recommend/prescribe over the counter medications
based on the information provided, if required on a case-to-case basis. Provided that any
recommendation under this policy shall not be valid for any medico legal purposes.
6. The insured person is free to choose whether or not to act on the recommendation after seeking
consultation.
7. Any advice, recommendations or suggestions made by any medical professional shall be solely
based on the information and documentation provided by the insured person to such medical
professional. We shall not be liable towards any loss or damage (immediate or consequential)
arising out of or in relation to any opinion, advice, prescription, actual or alleged errors,
omissions and representations made by the medical professional from whom we have availed
services or taken benefit or for any consequence of any act or omission in reliance thereon.
8. We at our discretion may provide discounts on any of the above services
9. Any discount offered under redeemable voucher/discount on services by our empanelled
service providers are subject to modification or withdrawal. We do not assume any liability
towards the quantum of discount, quality of product/services and timeline within which the
product/service is rendered.
10. For Ambulance Booking facility–
a. These services are provided through our empanelled service provider in select cities.
Please contact us / refer to our digital customer application for more details on this
service.
b. We do not assume any liability towards quality and turnaround times of service
rendered, any loss or damage arising out of or in relation to these services rendered by
the empanelled service provider.
c. This facility may be availed through Our digital customer application or through calling
Our call centre on the tollfree number specified in the Policy Schedule.
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11. Above mentioned services are non-portable, annual contracts, independent of policy contract
and not lifelong renewable. The Services provided may be added / deleted / modified at our
discretion and the same shall be notified to the policyholders in advance prior to change
effective date.
12. Provision of these services is subject to availability as per the duration specified by Us/the
empanelled service provider. Details are available on our website (www.tataaig.com)
13. Any service availed by the Insured Person under this Benefit will not impact Cumulative Bonus
if applicable.
14. We reserve the right to change any service provider during the currency of the policy or at
renewal. The same shall be intimated to the insured atleast 15 days prior to the effective date
of change. During such change, all the credits earned by the insured person shall be transferred
to the new service provider.
15. In case we or the assistance service provider fails to provide any of the services as mentioned in
this policy or is unable to implement, in whole or in part due to force majeure, non-availability
of services, change in law, rule or regulations which affects the services, or if any regulatory or
governmental agency having jurisdiction over a party takes a position which affects the services ,
then the assistance services’ suspended, curtailed or limited performance shall not constitute
breach of contract and the company or the assistance service provider shall have no liability
whatsoever including but not limited to any loss or damage resulting therefrom.
Section 3 –Exclusions
General Exclusions
We will neither be liable nor make any payment for any claim in respect of any Insured Person which is
caused by, arising from or in any way attributable to any of the following exclusions, unless expressly
stated to the contrary in this Policy.
i. Standard Exclusions
1. Exclusions with waiting periods
i. 30 Days Waiting Period (Code-Excl03):
a. Expenses related to the treatment of any illness within 30 days from the first policy
commencement date shall be excluded except claims arising due to an accident,
provided the same are covered.
b. This exclusion shall not, however, apply if the Insured Person has Continuous
Coverage for more than twelve months.
c. The within referred waiting period is made applicable to the enhanced sum insured in
the event of granting higher sum insured subsequently.
ii. Specified Disease/Procedure Waiting Period (Code-Excl02):
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a. Expenses related to the treatment of the listed Conditions, surgeries/treatments shall
be excluded until the expiry of 24 months of continuous coverage after the date of
inception of the first policy with us. This exclusion shall not be applicable for claims
arising due to an accident.
b. In case of enhancement of sum insured the exclusion shall apply afresh to the extent of
sum insured increase.
c. If any of the specified disease/procedure falls under the waiting period specified for preExisting diseases, then the longer of the two waiting periods shall apply.
d. The waiting period for listed conditions shall apply even if contracted after the policy or
declared and accepted without a specific exclusion.
e. If the Insured Person is continuously covered without any break as defined under the
applicable norms on portability stipulated by IRDAI, then waiting period for the same
would be reduced to the extent of prior coverage.
f. List of Specific Diseases/procedures as furnished below:
I. Tumors, Cysts, polyps including breast lumps (benign)
II. Polycystic ovarian disease
III. Fibromyoma
IV. Adenomyosis
V. Endometriosis
VI. Prolapsed Uterus
VII. Non-infective arthritis
VIII. Gout and Rheumatism
IX. Osteoporosis
X. Ligament, Tendon or Meniscal tear
XI. Prolapsed Inter Vertebral Disc
XII. Cholelithiasis
XIII. Pancreatitis
XIV. Fissure/fistula in anus, haemorrhoids, pilonidal sinus
XV. Ulcer & erosion of stomach & duodenum
XVI. Gastro Esophageal Reflux Disorder (GERD)
XVII. Liver Cirrhosis
XVIII. Perineal Abscesses
XIX. Perianal / Anal Abscesses
XX. Calculus diseases of Urogenital system Example: Kidney stone, Urinary bladder stone.
XXI. Benign Hyperplasia of prostate
XXII. Varicocele
XXIII. Cataract
XXIV. Retinal detachment
XXV. Glaucoma
XXVI. Congenital Internal Diseases
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The following treatments are covered after a waiting period of two years irrespective of the
illness for which it is done:
XXVII. Adenoidectomy
XXVIII. Mastoidectomy
XXIX. Tonsillectomy
XXX. Tympanoplasty
XXXI. Surgery for nasal septum deviation
XXXII. Nasal concha resection
XXXIII. Surgery for Turbinate hypertrophy
XXXIV. Hysterectomy
XXXV. Joint replacement surgeries Eg: Knee replacement, Hip replacement
XXXVI. Cholecystectomy
XXXVII. Hernioplasty or Herniorraphy
XXXVIII. Surgery/procedure for Benign prostate enlargement
XXXIX. Surgery for Hydrocele/ Rectocele
XL. Surgery of varicose veins and varicose ulcers
iii. Pre-existing Diseases Waiting Period (Code-Excl01)
a. Expenses related to the treatment of a pre-existing Disease (PED) and its direct
complications shall be excluded until the expiry of 24 months of continuous coverage
after the date of inception of the first policy with us.
b. In case of enhancement of sum insured the exclusion shall apply afresh to the extent of
sum insured increase.
c. If the Insured Person is continuously covered without any break as defined under the
portability norms of the extant IRDAI (Health Insurance) Regulations, then waiting
period for the same would be reduced to the extent of prior coverage.
d. Coverage under the policy after the expiry of 24 months for any pre-existing disease is
subject to the same being declared at the time of application and accepted by us.
2. Medical Exclusions
i. Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences
thereof .(Code-Excl12)
ii. Expenses related to surgical treatment of obesity that does not fulfil the below conditions (CodeExcl06):
a. Surgery to be conducted is upon the advice of the Doctor
b. The surgery/Procedure conducted should be supported by clinical protocols
c. The member has to be 18 years of age or older and
d. Body Mass Index (BMI);
i. greater than or equal to 40 or
ii. greater than or equal to 35 in conjunction with any of the following severe comorbidities following failure of less invasive methods of weight loss:
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1. Obesity-related cardiomyopathy
2. Coronary heart disease
3. Severe Sleep Apnea
4. Uncontrolled Type2 Diabetes
iii. Investigation and evaluation (Code-Excl04):
a. Expenses related to any admission primarily for diagnostics and evaluation purposes
only are excluded.
b. Any diagnostic expenses which are not related or not incidental to the current diagnosis
and treatment are excluded.
iv. Expenses related to Sterility and infertility (Code-Excl17). This includes:
i. Any type of contraception, sterilization
ii. Assisted Reproduction services including artificial insemination and advanced
reproductive technologies such as IVF, ZIFT, GIFT, ICSI
iii. Gestational Surrogacy
iv. Reversal of sterilization
v. Refractive error (Code -Excl15): Expenses related to the treatment for correction of eye sight
due to refractive error less than 7.5 dioptres.
vi. Change-of-Gender treatments (Code- Excl 07): Expenses related to any treatment, including
surgical management, to change characteristics of the body to those of the opposite sex
vii. Cosmetic or Plastic Surgery (Code – Excl08) : Expenses for cosmetic or plastic surgery or any
treatment to change appearance unless for reconstruction following an Accident, Burn(s) or
Cancer or as part of medically necessary treatment to remove a direct and immediate health
risk to the insured. For this to be considered a medical necessity, it must be certified by the
attending Medical Practitioner.
viii. Rest cure, rehabilitation and respite care (Code-Excl05):
a. Expenses related to any admission primarily for enforced bed rest and not for receiving
treatment. This also includes:
i. Custodial care either at home or in a nursing facility for personal care such as help
with activities of daily living such as bathing, dressing, moving around either by
skilled nurses or assistant or non-skilled persons.
ii. Any services for people who are terminally ill to address physical, social,
emotional and spiritual needs.
ix. Unproven treatments (Code-Excl16) : Expenses related to any unproven treatment, services and
supplies for or in connection with any treatment. Unproven treatments are treatments, procedures
or supplies that lack significant medical documentation to support their effectiveness.
x. Maternity (Code - Excl18):
a. Medical treatment expenses traceable to childbirth (including complicated deliveries
and caesarean sections incurred during hospitalization) except ectopic pregnancy;
b. Expenses towards miscarriage (unless due to an accident) and lawful medical
termination of pregnancy during the policy period
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xi. Treatments received in heath hydros, nature cure clinics, spas or similar establishments or private
beds registered as a nursing home attached to such establishments or where admission is arranged
wholly or partly for domestic reasons. (Code -Excl13)
xii. Dietary supplements and substances that can be purchased without prescription, including but not
limited to Vitamins, minerals and organic substances unless prescribed by a medical practitioner as
part of hospitalization claim or day care procedure. (Code -Excl14)
3. Non-Medical Exclusions
i. Hazardous or Adventure Sports (Code Excl09) : Expenses related to any treatment necessitated
due to participation as a professional in hazardous or adventure sports, including but not limited
to, para-jumping, rock climbing, mountaineering, rafting, motor racing, horse racing or scuba
diving, hand gliding, sky diving, deep-sea diving
ii. Breach of law (Code Excl10): Expenses for treatment directly arising from or consequent upon
any Insured Person committing or attempting to commit a breach of law with criminal intent.
iii. Excluded Providers (Code-Excl11):Expenses incurred towards treatment in any hospital or by
any Medical Practitioner or any other provider specifically excluded by the Insurer and disclosed
in its website / notified to the policyholders are not admissible. However, in case of life
threatening situations or following an accident, expenses up to the stage of stabilization are
payable but not the complete claim .
ii. Specific Exclusions (Exclusions other than as mentioned under Section 3 (1, 2 & 3) above)
1. Medical Exclusions
i. Alcoholic pancreatitis
ii. Congenital External Diseases, defects or anomalies;
iii. Stem cell therapy ; however hematopoietic stem cells for bone marrow transplant for
haematological conditions will be covered under benefit B1 or B4 of this policy;
iv. Growth hormone therapy;
v. Sleep-apnoea
vi. Admission primarily for administration of Intra-articular or intra-lesional injections or
Intravenous immunoglobulin infusion or supplementary medications like Zolendronic Acid
vii. Venereal disease, sexually transmitted disease or illness;
viii. All preventive care, vaccination including inoculation and immunisations (except in case of postbite treatment and other vaccines explicitly covered);
ix. Dental treatment or surgery of any kind except as specified in ‘Inpatient Treatment – Dental’.
x. Any existing disease specifically mentioned as Permanent exclusion in the Policy Schedule
2. Non-Medical Exclusions
i. 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.
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ii. Any Insured Person’s participation or involvement in naval, military or air force operation,
iii. Intentional self-injury or attempted suicide while sane or insane.
iv. 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
v. Treatment rendered by a Medical Practitioner which is outside his discipline
vi. 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.
vii. Provision or fitting of hearing aids, spectacles or contact lenses including optometric therapy
unless explicitly stated and covered in the policy,
viii. Any treatment and associated expenses for alopecia, baldness, wigs, or toupees, medical
supplies including elastic stockings, diabetic test strips, and similar products.
ix. Any treatment or part of a treatment that is not of a reasonable charge, not medically necessary;
drugs or treatments which are not supported by a prescription.
x. 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).
xi. Any illness diagnosed or injury sustained or where there is change in health status of the
member after date of proposal and before commencement of policy and the same is not
communicated and accepted by us
Section 4 – General Terms and Clauses
i. Standard General Terms and Clauses
1. Disclosure of Information
The policy shall be void and all premium paid thereon shall be forfeited to the Company in the
event of established fraud, misrepresentation, misdescription or non-disclosure of any material
fact by the policyholder.
(Explanation: "Material facts" for the purpose of this policy shall mean all relevant information
sought by the company in the proposal form and other connected documents to enable it to
take informed decision in the context of underwriting the risk)
2. Condition Precedent to Admission of Liability
The terms and conditions of the policy must be fulfilled by the insured person for the Company
to make any payment for claim(s) arising under the policy.
3. Claim Settlement (provision for Penal Interest)
i. The Company shall settle or reject a claim, as the case may be, within 30 days from the date
of receipt of last necessary document.
ii. In the case of delay in the payment of a claim, the Company shall be liable to pay interest
to the policyholder from the date of receipt of last necessary document to the date of
payment of claim at a rate 2% above the bank rate.
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iii. However, where the circumstances of a claim warrant an investigation in the opinion of the
Company, it shall initiate and complete such investigation at the earliest, in any case not
later than 30 days from the date of receipt of last necessary document. In such cases, the
Company shall settle or reject the claim within 45 days from the date of receipt of last
necessary document.
iv. In case of delay beyond stipulated 45 days, the Company shall be liable to pay interest to
the policyholder at a rate 2% above the bank rate from the date of receipt of last necessary
document to the date of payment of claim.
(Explanation: "Bank rate" shall mean the rate fixed by the Reserve Bank of India (RBl) at the
beginning of the financial year in which claim has fallen due).The Clause shall be suitably
modified by the insurer based on the amendment(s), if any to the relevant provisions of
Protection of Policyholder's Interests Regulations, 2017)
4. Complete Discharge
Any payment to the policyholder, insured person or his/ her nominees or his/ her legal
representative or assignee or to the Hospital, as the case may be, for any benefit under the
policy shall be a valid discharge towards payment of claim by the Company to the extent of that
amount for the particular claim.
5. Multiple Policies
i. In case of multiple policies taken by an insured person during a period from one or more
insurers to indemnify treatment costs, the insured person shall have the right to require a
settlement of his/her claim in terms of any of his/her policies. In all such cases the insurer
chosen by the insured person shall be obliged to settle the claim as long as the claim is
within the limits of and according to the terms of the chosen policy.
ii. Insured person having multiple policies shall also have the right to prefer claims under this
policy for the amounts disallowed under any other policy / policies even if the sum insured
is not exhausted. Then the insurer shall independently settle the claim subject to the terms
and conditions of this policy.
iii. If the amount to be claimed exceeds the sum insured under a single policy, the insured
person shall have the right to choose insurer from whom he/she wants to claim the balance
amount and we will assist the insured person in facilitating the same.
iv. Where an insured person has policies from more than one insurer to cover the same risk on
indemnity basis, the insured person shall only be indemnified the treatment costs in
accordance with the terms and conditions of the chosen policy.
6. Fraud
If any claim made by the insured person, is in any respect fraudulent, or if any false statement,
or declaration is made or used in support thereof, or if any fraudulent means or devices are used
by the insured person or anyone acting on his/her behalf to obtain any benefit under this policy,
all benefits under this policy and the premium paid shall be forfeited.
Any amount already paid against claims made under this policy but which are found fraudulent
later shall be repaid by all recipient(s)/policyholder(s), who has made that particular claim, who
shall be jointly and severally liable for such repayment to the insurer.
For the purpose of this clause, the expression "fraud" means any of the following acts
committed by the insured person or by his agent or the hospital/doctor/any other party acting
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on behalf of the insured person, with intent to deceive the insurer or to induce the insurer to
issue an insurance policy:
a) the suggestion, as a fact of that which is not true and which the insured
person does not believe to be true;
b) the active concealment of a fact by the insured person having knowledge
or belief of the fact;
c) any other act fitted to deceive; and
d) any such act or omission as the law specially declares to be fraudulent
The Company shall not repudiate the claim and / or forfeit the policy benefits on the ground of
Fraud, if the insured person / beneficiary can prove that the misstatement was true to the best
of his knowledge and there was no deliberate intention to suppress the fact or that such
misstatement of or suppression of material fact are within the knowledge of the insurer.
7. Cancellation
I. The policyholder may cancel this policy by giving 7 days written notice and in such an
event, the Company shall refund proportionate premium for the unexpired policy
period provided no refunds of premium shall be made in respect of Cancellation where
any claim has been admitted or has been lodged or any benefit under this Policy has
been availed by the Insured Person under the Policy.
II. The Company may cancel the policy at any time on grounds of established fraud,
misrepresentation or non-disclosure of material facts by the insured person by giving
15 days' written notice. There would be no refund of premium on cancellation on
grounds of established fraud, misrepresentation or non-disclosure of material facts.
8. Migration
The insured person will have the option to migrate the policy to other health insurance
products/plans offered by the company by applying for migration of the policy at least 30 days
before the policy renewal date as per IRDAI guidelines. lf such person is presently covered and
has been continuously covered without any lapses under any health insurance product/plan
offered by the company, the insured person will get the accrued continuity benefits in waiting
periods as per IRDAI guidelines on migration.
For Detailed Guidelines on Migration, kindly refer Insurance Regulatory and Development
Authority of India (Insurance Products) Regulations, 2024 F. No. IRDAI/Reg/8/202/2024 dated
20th March, 2024 and Master Circular on IRDAI (Insurance Products) Regulations 2024- Health
Insurance Ref: IRDAI/HLT/CIR/PRO/84/5/ 2024 dated 29th May 2024 and subsequent
amendments thereof.
9. Portability
The insured person will have the option to port the policy to other insurers by applying to such
insurer to port the entire policy along with all the members of the family, if any, at least 45 days
before, but not earlier than 60 days from the policy renewal date as per IRDAI guidelines . If
such person is presently covered and has been continuously covered without any lapses under
any health insurance policy with an Indian General/Health insurer, the proposed insured person
will get the accrued continuity benefits in waiting periods as per IRDAI guidelines on portability.
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For Detailed Guidelines on Portability, kindly refer Insurance Regulatory and Development
Authority of India (Insurance Products) Regulations, 2024 F. No. IRDAI/Reg/8/202/2024 dated
20th March, 2024 and Master Circular on IRDAI (Insurance Products) Regulations 2024- Health
Insurance Ref: IRDAI/HLT/CIR/PRO/84/5/ 2024 dated 29th May 2024 and their subsequent
amendments thereof.
10. Renewal of Policy
The policy shall ordinarily be renewable except on grounds of established fraud, non-disclosure
or misrepresentation by the insured person.
i. Renewal shall not be denied on the ground that the insured person had made a claim or
claims in the preceding policy years.
ii. Request for renewal along with requisite premium shall be received by the Company before
the end of the policy period.
iii. Single premium payment mode Policy can be renewed within the Grace Period of 30 days
to maintain continuity of benefits without break in policy. Coverage is not available during
the grace period after the end of the policy period. If not renewed under the Grace Period,
the Policy shall terminate at the end of the Grace period.
iv. The grace period for payment of the premium during the Policy Period, for instalment
premium shall be fifteen days where premium payment mode is monthly.
v. Coverage during such grace period (in case of instalment premium):
a. Within the policy period - coverage will be available from the due date of instalment
premium till the date of receipt of premium by Company within the grace period.
b. At the end of the policy period - the policy shall terminate and can be renewed
within the Grace Period of 30 days to maintain continuity of benefits without break
in policy. Coverage is not available during the grace period after the end of the
policy period.
vi. The insured person will get the accrued continuity benefit in respect of the "Waiting
Periods", "Specific Waiting Periods" in the event of payment of premium within the
stipulated grace Period.
vii. No loading shall apply on renewals based on individual claims experience
11. Withdrawal of Policy
i. In the likelihood of this product being withdrawn in future, the Company will intimate the
insured person about the same 90 days prior to expiry of the policy.
ii. Insured Person will have the option to migrate to similar health insurance product available
with the Company at the time of renewal with all the accrued continuity benefits such as
cumulative bonus, waiver of waiting period as per IRDAI guidelines, provided the policy has
been maintained without a break.
12. Moratorium Period
After completion of five continuous years under the policy no look back to be applied. This
period of five years is called as moratorium period. The moratorium would be applicable for the
sums insured of the first policy and subsequently completion of five continuous years would be
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applicable from date of enhancement of sums insured only on the enhanced limits. After the
expiry of Moratorium Period no health insurance claim shall be contestable except for proven
fraud and permanent exclusions specified in the policy contract. The policies would however be
subject to all limits, sub limits, co-payments, deductibles as per the policy contract..
13. Possibility of Revision of Terms of the Policy Including the Premium Rates
The Company may revise or modify the terms of the Policy including the premium rates. The
Insured Person shall be notified three months before the changes are effected.
14. Free look period
The Free Look Period shall be applicable on new individual health insurance policies and not on
renewals or at the time of porting/migrating the policy.
The insured person shall be allowed free look period of thirty days from date of receipt of the
policy document, whether received electronically or otherwise, to review the terms and
conditions of the policy, and to return the same if not acceptable.
If the insured has not made any claim during the Free Look Period, the insured shall be entitled
to a refund of the premium paid subject to deduction of proportionate risk premium for the
period of cover and the expenses, if any, incurred by Us on medical examination of the proposer
and stamp duty charges.
15. Redressal of Grievance
The Company is committed to extend the best possible services to its customers. However, if
You are not satisfied with Our services and wish to lodge a complaint, please feel free to call
Our 24X7 Toll free number <<1800-266-7780 or 022-66939500>> (tolled) or You may email to
the customer service desk at <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>. After investigating the matter
internally and subsequent closure, We will send Our response within the stipulated TAT as
prescribed by the Regulator. In case the resolution is likely to take longer time, We will inform
You of the same through an interim reply.
Escalation Level 1
For lack of a response or if the resolution still does not meet Your expectations, You can write
to <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>. After investigating the matter internally and
subsequent closure, We will send Our response within the stipulated TAT as prescribed by the
Regulator, from the date of receipt at this email id.
Escalation Level 2
For lack of a response or if the resolution still does not meet Your expectations, You can write
to the Head - Customer Services at <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS> After examining the
matter, We will send You Our final response within the stipulated TAT as prescribed by the
Regulator from the date of receipt of Your complaint on this email id. Within the stipulated TAT
as prescribed by the Regulator, from the date of lodging a complaint with Us, if You do not get
a satisfactory response from Us and You wish to pursue other avenues for redressal of
grievances, You may approach Insurance Ombudsman appointed by IRDAI under the Insurance
Ombudsman Scheme
Grievance may also be lodged on the Bima Bharosa Grievance Redressal Portal of IRDAI
(https://bimabharosa.irdai.gov.in/)
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16. Nomination
The policyholder is required at the inception of the policy to make a nomination for the purpose
of payment of claims under the policy in the event of death of the policyholder. Any change of
nomination shall be communicated to the company in writing and such change shall be effective
only when an endorsement on the policy is made. In the event of death of the policyholder, the
Company will pay the nominee {as named in the Policy Schedule /Endorsement (if any)} and in
case there is no subsisting nominee, to the legal heirs or legal representatives of the
policyholder whose discharge shall be treated as full and final discharge of its liability under the
policy.
ii. Specific terms and clauses (terms and clauses other than those mentioned under Section 4 (i)
above)
17. Premium Payment
i. Premium to be paid for the Policy Period before Policy Commencement date as opted by You in the
proposal form.
ii. If you have opted to pay premium in full (lumpsum) upfront then the entire premium for the policy
period shall be paid before the policy commencement date with an option of policy tenure 1/2/3
years.
iii. Long term premium discount of 5% and 10% is applicable for policy with tenure of 2 and 3 years
respectively.
18. Insured Person
i. Only those persons named as an Insured Person in the Schedule shall be covered under this Policy.
ii. Any person may be added during the Policy Period after his application has been accepted by Us,
additional premium has been paid and We have issued an endorsement confirming the addition of
such person as an Insured Person.
iii. We will be offering continuous renewal with no exit age subject to regular premium payment and
compliance with all provisions and terms & conditions of this policy by the Insured Person.
19. Loadings
i. We may apply a risk loading on the premium payable (based upon the declarations made in the
proposal form and the health status of the persons proposed for insurance).
ii. The maximum risk loading applicable for an individual shall not exceed 100% of premium per
diagnosis / medical condition and an overall risk loading of over 150% of premium per person.
iii. The loading shall only be applied basis an outcome of Our medical underwriting.
iv. These loadings are applied from Commencement Date of the Policy including subsequent
renewal(s) with Us or on the receipt of the request of increase in Sum Insured (for the increased
Sum Insured).
a. We will inform You about the applicable risk loading through a counter offer letter.
b. You need to revert to Us with consent and additional premium (if any), within 15 days of
the issuance of such counter offer letter.
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c. In case, you neither accept the counter offer nor revert to Us within 15 days, We shall
cancel Your application and refund the premium paid within next 10 days subject to
deduction of the Pre-Policy Check up charges, as applicable.
v. Please note that We will issue Policy only after getting Your consent.
20. Entire Contract
i. This Policy, its Schedule, endorsement(s), proposal constitutes the entire contract of insurance.
No change in this policy shall be valid unless approved by Us and such approval be endorsed
hereon.
ii. This Policy and the Schedule shall be read together as one contract and any word or expression
to which a specific meaning has been attached in any part of this Policy or of the Schedule shall
bear such meaning wherever it may appear.
21. Change of Policyholder
i. The change of Policyholder is permitted only at the time of renewal.
ii. If the Insured Person is no longer eligible on grounds of age or dependency, the insured member
will be eligible to apply for a new policy and enjoy continuity benefits upto Sum Insured.
22. Notices
i. Any notice, direction or instruction under this Policy shall be in writing and if it is to:
a. Any Insured Person, then it shall be sent to You at Your address specified in the Schedule
to this Policy and You shall act for all Insured Persons for these purposes.
b. Us, it shall be delivered to Our address specified in the Schedule to this Policy. No insurance
agents, brokers or other person or entity is authorised to receive any notice, direction or
instruction on Our behalf unless We have expressly stated to the contrary in writing.
23. Premium Payment Zone
For the purpose of premium computation, the country is divided into following three Zones and
premium payable under the policy will be computed based on the residential location/address
as provided by the proposer/insured person in the proposal form:
i. Zone A: Mumbai (including Mumbai Metropolitan Region), Delhi (including National
Capital Region, Faridabad, Ghaziabad), Ahmedabad, Surat & Baroda
ii. Zone B: Hyderabad (including Secunderabad), Bengaluru, Kolkata, Indore, Chennai,
Chandigarh (including, Mohali, Punchkula, Zirakpur), Pune (including Pimpri
Chinchwad) and Rajkot
iii. Zone C: Rest of India
Please note that the above-mentioned categorization of zones is subject to change at Our sole
discretion. Any such change made which shall impact an existing policyholder, shall be intimated
under 3 months’ notice and shall be applicable from the immediate next renewal.
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24. Premium Refund in case of demise of the Insured Person
The coverage for the Insured Person(s) shall automatically terminate in case of his/ her (Insured
Person) demise. However, the cover shall continue for the remaining Insured Persons till the end
of Policy Period. The other insured persons may also apply to renew the policy. In case, the other
insured person is minor, the policy shall be renewed only through any one of his/her natural
guardian or guardian appointed by court. All relevant particulars in respect of such person
(including his/her relationship with the insured person) must be submitted to the company along
with the application. Provided no claim has been made, and termination takes place on account of
death of the insured person, pro-rata refund of premium of the deceased insured person for the
balance period of the policy will be made.
Refund will be made to the Policy holder or the nominee in case of demise of the Policy holder. We
would require death certificate of the Deceased Insured Person for processing of the refund
amount.
Section 5 – Claims Procedure and Claims Payment
This section explains about the procedures involved to file a valid claim by the insured member and
processes related in managing the claim by TPA or Us. All the procedures and processes such as
notification of claim, availing cashless service, supporting claim documents and related claim terms of
payment are explained in this section.
1. Notification of Claim
Treatment, Consultation or Procedure: We or Our TPA* must be informed:
1 If any treatment for which a claim may be
made and that treatment requires planned
Hospitalisation:
At least 48 hours prior to the Insured
Person’s admission.
2 If any treatment for which a claim may be
made and that treatment requires emergency
Hospitalisation
Within 24 hours of the Insured Person’s
admission to Hospital.

*TPA as mentioned in the policy schedule, if any
2. Cashless Service
Treatment,
Consultation or
Procedure:
Treatment,
Consultation or
Procedure Taken at:
Cashless Service is
Available:
We must be given
notice that the
Insured Person
wishes to take
advantage of the
cashless service
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accompanied by full
particulars:
If any planned
treatment,
consultation or
procedure for which a
claim may be made:
Network Hospital We will provide
cashless service by
making payment to
the extent of Our
liability directly to
the Network
Hospital.
At least 48 hours
before the planned
treatment or
Hospitalisation
If any treatment,
consultation or
procedure for which a
claim may be made,
requiring emergency
hospitalisation
Network Hospital We will provide
cashless service by
making payment to
the extent of Our
liability directly to
the Network
Hospital.
Within 24 hours after
the treatment or
Hospitalisation
3. Procedure for Cashless Service
i. Cashless Service is only available at Network Hospitals.
ii. In order to avail of cashless treatment, the following procedure must be followed by You:
a. Prior to taking treatment and/or incurring Medical Expenses at a Network Hospital, You
must notify our designated TPA/Us and request pre-authorization.
b. For any emergency Hospitalisation, our designated TPA/We must be informed no
later than 24 hours of the start of Your hospitalization/ treatment.
c. For any planned hospitalization, our designated TPA/We must be informed atleast 48
hours prior to the start of your hospitalization/treatment.
d. Our designated TPA/We will check your coverage as per the eligibility and send an
authorization letter to the provider. You have to provide the ID card issued to You along
with any other information or documentation that is requested by the TPA/Us to the
Network Hospital.
e. In case of deficiency in the documents sent to TPA/Us for cashless authorization or the
ailment /treatment is not covered under the policy, the same shall be communicated to the
Hospital/You by TPA/Us.
f. In case the ailment /treatment is not covered under the policy or cashless is rejected due to
insufficient documents submitted, a rejection letter would be sent to the Hospital/You by
TPA/Us.
g. We/TPA will respond within TAT as prescribed by the Regulator under the Master Circular
on IRDAI (Insurance Products) Regulations 2024- Health Insurance Ref:
IRDAI/HLT/CIR/PRO/84/5/ 2024 and its subsequent amendments thereof.
h. Rejection of cashless in no way indicates rejection of the claim. You are required to submit
the claim along with required documents for us to decide on the admissibility of the claim.
i. If the cashless is approved, the original bills and evidence of treatment in respect of the
same shall be left with the Network Hospital.
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j. Pre-authorization does not guarantee that all costs and expenses will be covered. We
reserve the right to review each claim for Medical Expenses and accordingly coverage will
be determined according to the terms and conditions of this Policy.
4. Supporting Documentation & Examination
i. We or Our TPA may require documentation, medical records and information to establish the
circumstances of the claim, its quantum or Our liability for the claim within 15 days or earlier of
Our request or the Insured Person’s discharge from Hospitalization or completion of treatment.
ii. In case the delay is at Your end, failure to furnish such evidence within the time required shall
not invalidate nor reduce any claim if You can satisfy Us that it was not reasonably possible for
You to give proof within such time.
iii. We may accept claims where documents have been provided after a delayed interval only in
special circumstances and for the reasons beyond the control of the Insured Person.
iv. Such documentation will include the following:
a. Our claim form, duly completed and signed for on behalf of the Insured Person.We, upon
receipt of a notice of claim, will furnish Your representative with such forms as We may
require for filing proofs of loss or you may download the claim form from our Web site.
b. Original Bills (pharmacy purchase bill, consultation bill, diagnostic bill) and any attachments
thereto like receipts or prescriptions in support of any amount claimed which will then
become Our property.
c. All medical reports, case histories, investigation reports, indoor case papers/treatment papers
(in reimbursement cases, if available), discharge summaries.
d. A precise diagnosis of the treatment for which a claim is made.
e. A detailed list of the individual medical services and treatments provided and a unit price
for each in case not available in the submitted hospital bill.
f. Prescriptions that name the Insured Person and in the case of drugs: the drugs prescribed,
their price and a receipt for payment. In case of pre/post hospitalization claim Prescriptions
must be submitted with the corresponding Doctor/hospital invoice.
g. All pre and post investigation, treatment and follow up (consultation) records pertaining to
the present ailment for which claim is being made, if and where applicable.
h. Treating doctor’s certificate regarding missing information in case histories e.g.
Circumstance of injury and Alcohol or drug influence at the time of accident, if available
i. Copy of settlement letter from other insurance company or TPA
j. Stickers and invoice of implants used during surgery
k. Copy of MLC (Medico legal case) records, if carried out and FIR (First information report) if
registered, in case of claims arising out of an accident and available with the claimant.
l. Regulatory requirements as amended from time to time, currently mandatory NEFT (to
enable direct credit of claim amount in bank account) and KYC (recent ID/Address proof and
photograph) requirements
m. Legal heir/succession certificate, if required
n. PM report (wherever applicable)
o. The company reserves the right to call for additional documents wherever required.
v. Note: In case You are claiming for the same event under an indemnity-based Policy with Us and
with another Insurer and are required to submit the original documents related to Your
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treatment with that particular Insurer, then We will require the attested copies of such
documents along with a declaration from the particular Insurer specifying the availability of the
original copies of the specified treatment documents with it.
We at our own expense, shall have the right and opportunity to examine insured persons through Our
Authorised Medical Practitioner whose details will be notified to insured person when and as often as
We may reasonably require during the pendency of a claim hereunder.
5. Claims Payment
i. We shall be under no obligation to make any payment under this Policy unless We have received
all premium payments in full in time and We have been provided with the documentation and
information We or Our TPA has requested to establish the circumstances of the claim, its
quantum or Our liability for it, and unless the Insured Person has complied with his obligations
under this Policy.
ii. This Policy only covers claims incurred within India (except in case of benefit B13-Global cover
for Planned Hospitalization, wherever applicable), and payments under this Policy shall only
be made in Indian Rupees within India.
iii. Medical Expenses incurred for AYUSH treatment shall be assessed only under benefit B8 of
this policy and shall be admissible only if incurred within India.
iv. The benefits/services/claims offered/payable under this policy including but not limited to
Section B10, B32 & B33 can be availed within India only.
6. Claim procedure and management of Wellness Services & Wellness Program (Section B32 &
B33)
i. Utilise Wellness Points:
Utilisation of Wellness points is only available at network service providers. To avail products or
services, Insured Person must visit our Customer application and buy the required product/
services. On successful purchase, an amount equivalent to the monetary value of the Earned
Wellness points will be deducted from Your policy.
ii. Avail services under Benefits:
Services are only available at network. To avail the same, following procedure must be followed:
• Teleconsultation:
Insured person can gain access to tele/video/digital consultation with a general physician/
specialist/psychiatrist, using our digital customer application.
• Ambulance booking facility:
Insured person can use our digital customer application to book an ambulance. This service will
be offered on best effort basis and does not have a legal binding on us.
• Emergency - Help me feature:
In case of an emergency, insured person can use Our Customer application to alert designated
caregiver, at a push of a button. An alert message will be sent to the designated caregiver,
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informing him/her about the emergency. By opting this feature, the insured person authorizes
us/our empanelled service provider to share their geo-location with the designated caregiver.
This service will be offered on best effort basis and does not have a legal binding on us.
iii. Supporting Documentation & Examination
Insured Person or someone booking services on Your behalf shall provide Us with identification
documentation, medical records and information. We may request to establish the circumstances
of the claim.
Your claim will be processed including cashless and final bill authorization as prescribed by the
Regulator under the Master Circular on IRDAI (Insurance Products) Regulations 2024- Health
Insurance Ref: IRDAI/HLT/CIR/PRO/84/5/ 2024 and its subsequent amendments thereof.
Section 6 - Dispute Resolution
1. Dispute Resolution Clause
Any and all disputes or differences under or in relation to this Policy shall be determined by the
Indian Courts and subject to Indian law.
Annexure A
NAMES OF OMBUDSMAN AND ADDRESSES OF OMBUDSMAN CENTRES
For updated list and details of Insurance Ombudsman Offices, please visit website
http://www.cioins.co.in/ombudsman.html
Sr.No. Centre Address & Contact Jurisdiction of
Office Union
Territory, District
1 AHMEDABAD Office of the Insurance Ombudsman,
Jeevan Prakash Building, 6th floor,
Tilak Marg, Relief Road,
AHMEDABAD – 380 001.
Tel.: 079 - 25501201/02/05/06
Email: <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>
Gujarat, Dadra &
Nagar Haveli,
Daman and Diu
2 BENGALURU Office of the Insurance Ombudsman,
Jeevan Soudha Building,PID No. 57-27-N-19
Ground Floor, 19/19, 24th Main Road,
JP Nagar, Ist Phase, Bengaluru – 560 078.
Tel.: <PRESIDIO_ANONYMIZED_PHONE_NUMBER> / 26652049
Email: <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>
Karnataka
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3 BHOPAL Office of the Insurance Ombudsman,
1st floor,"Jeevan Shikha",
60-B,Hoshangabad Road, Opp. Gayatri
Mandir,
Bhopal – 462 011.
Tel.: <PRESIDIO_ANONYMIZED_PHONE_NUMBER> / 2769202
Email: <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>
Madhya Pradesh,
Chhattisgarh
4 BHUBHANESHWAR Office of the Insurance Ombudsman,
62, Forest park,
Bhubaneswar – 751 009.
Tel.: <PRESIDIO_ANONYMIZED_PHONE_NUMBER> /2596455
Email:
<PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>
Odisha
5 CHANDIGARH Office Of The Insurance Ombudsman,
Jeevan Deep Building SCO 20-27,
Ground Floor Sector- 17 A,
Chandigarh – 160 017.
Tel.: <PRESIDIO_ANONYMIZED_PHONE_NUMBER> / 2706468
Email: <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>
Punjab, Haryana
(excluding
Gurugram,
Faridabad, Sonepat
and Bahadurgarh),
Himachal Pradesh,
Union Territories of
Jammu &
Kashmir,Ladakh &
Chandigarh.
6 CHENNAI Office of the Insurance Ombudsman,
Fatima Akhtar Court, 4th Floor, 453,
Anna Salai, Teynampet,
CHENNAI – 600 018.
Tel.: <PRESIDIO_ANONYMIZED_PHONE_NUMBER> / 24333678
Email: <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>
amil Nadu,
PuducherryTown
and Karaikal (which
are part of
Puducherry)
7 DELHI Office of the Insurance Ombudsman,
2/2 A, Universal Insurance Building,
Asaf Ali Road,
New Delhi – 110 002.
Tel.: <PRESIDIO_ANONYMIZED_PHONE_NUMBER>
Email: <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>
Delhi & following
Districts of Haryana
- Gurugram,
Faridabad, Sonepat
& Bahadurgarh
8 GUWAHATI Office of the Insurance Ombudsman,
Jeevan Nivesh, 5th Floor,
Nr. Panbazar over bridge, S.S. Road,
Guwahati – 781001(ASSAM).
Tel.: <PRESIDIO_ANONYMIZED_PHONE_NUMBER> / 2602205
Email: <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>
Assam, Meghalaya,
Manipur, Mizoram,
Arunachal Pradesh,
Nagaland and
Tripura
9 HYDERABAD Office of the Insurance Ombudsman,
6-2-46, 1st floor, "Moin Court",
Lane Opp. Saleem Function Palace,
A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500
004.
Tel.: <PRESIDIO_ANONYMIZED_PHONE_NUMBER>
Email: <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>
Andhra Pradesh,
Telangana, Yanam
and part of Union
Territory of
Puducherry
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10 JAIPUR Office of the Insurance Ombudsman,
Jeevan Nidhi – II Bldg., Gr. Floor,
Bhawani Singh Marg,
Jaipur - 302 005.
Tel.: <PRESIDIO_ANONYMIZED_PHONE_NUMBER>/2740798
Email: <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>
Rajasthan
11 KOCHI Office of the Insurance Ombudsman,
10th Floor, Jeevan Prakash,LIC Building,
Opp to Maharaja's College
Ground,M.G.Road,
Kochi - 682 011.
Tel.: <PRESIDIO_ANONYMIZED_PHONE_NUMBER>
Email: <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>
Kerala,
Lakshadweep,
Mahe-a part of
Union Territory of
Puducherry
12 KOLKATA Office of the Insurance Ombudsman,
Hindustan Bldg. Annexe, 7th Floor,
4, C.R. Avenue,
KOLKATA - 700 072.
Tel.: <PRESIDIO_ANONYMIZED_PHONE_NUMBER> / 22124341
Email: <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>
West Bengal,
Sikkim, Andaman &
Nicobar Islands
13 LUCKNOW Office of the Insurance Ombudsman,
6th Floor, Jeevan Bhawan, Phase-II,
Nawal Kishore Road, Hazratganj,
Lucknow - 226 001.
Tel.: <PRESIDIO_ANONYMIZED_PHONE_NUMBER> / 3500613
Email: <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>
Districts of Uttar
Pradesh : Lalitpur,
Jhansi, Mahoba,
Hamirpur, Banda,
Chitrakoot,
Allahabad,
Mirzapur,
Sonbhabdra,
Fatehpur,
Pratapgarh,
Jaunpur,Varanasi,
Gazipur, Jalaun,
Kanpur, Lucknow,
Unnao, Sitapur,
Lakhimpur,
Bahraich, Barabanki,
Raebareli, Sravasti,
Gonda, Faizabad,
Amethi, Kaushambi,
Balrampur, Basti,
Ambedkarnagar,
Sultanpur,
Maharajgang,
Santkabirnagar,
Azamgarh,
Kushinagar,
Gorkhpur, Deoria,
Mau, Ghazipur,
Chandauli, Ballia,
Sidharathnagar
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14 MUMBAI Office of the Insurance Ombudsman,
3rd Floor, Jeevan Seva Annexe,
S. V. Road, Santacruz (W),
Mumbai - 400 054.
Tel.: 022 - 69038800/27/29/31/32/33
Email: <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>
Goa, Mumbai
Metropolitan
Region (excluding
Navi Mumbai &
Thane)
15 NOIDA Office of the Insurance Ombudsman,
Bhagwan Sahai Palace
4th Floor, Main Road, Naya Bans, Sector 15,
Distt: Gautam Buddh Nagar, U.P-201301.
Tel.: <PRESIDIO_ANONYMIZED_PHONE_NUMBER> / 2514253
Email: <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>
State of
Uttarakhand and
the following
Districts of Uttar
Pradesh: Agra,
Aligarh, Bagpat,
Bareilly, Bijnor,
Budaun,
Bulandshehar, Etah,
Kannauj, Mainpuri,
Mathura, Meerut,
Moradabad,
Muzaffarnagar,
Oraiyya, Pilibhit,
Etawah,
Farrukhabad,
Firozbad, Gautam
Buddh nagar,
Ghaziabad, Hardoi,
Shahjahanpur,
Hapur, Shamli,
Rampur, Kashganj,
Sambhal, Amroha,
Hathras,
Kanshiramnagar,
Saharanpur.
16 PATNA Office of the Insurance Ombudsman,
2nd Floor, Lalit Bhawan,
Bailey Road,
Patna 800 001.
Tel.: <PRESIDIO_ANONYMIZED_PHONE_NUMBER>
Email: <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>
Bihar, Jharkhand
17 PUNE Office of the Insurance Ombudsman,
Jeevan Darshan Bldg., 3rd Floor,
C.T.S. No.s. 195 to 198, N.C. Kelkar Road,
Narayan Peth, Pune – 411 030.
Tel.: <PRESIDIO_ANONYMIZED_PHONE_NUMBER>
Email: <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>
Maharashtra, Areas
of Navi Mumbai and
Thane (excluding
Mumbai
Metropolitan
Region)
Section 64VB of the Insurance Act, 1938 - Commencement of risk cover under the Policy is subject to
receipt of premium by Tata AIG General Insurance Company Limited.
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Prohibition of Rebates - Section 41 of the Insurance Act, 1938 as amended by Insurance Laws
(Amendment) Act, 2015.
1. 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 an 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.
2. Any person making default in complying with the provisions of this section shall be liable for a
penalty which may extend to ten lakh rupees.
Tata AIG General Insurance Company Limited
Registered Office: 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 (For Senior Citizens)
Email:<PRESIDIO_ANONYMIZED_EMAIL_ADDRESS> Website: www.tataaig.com IRDA of India Registration No: 108
CIN: U85110MH2000PLC128425

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