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 (Senior Citizen)
Visit us at www.tataaig.com | IRDA of India Registration No.:108 | CIN: U85110MH2000PLC128425
UIN: TATHLIP21253V022021 | REG-IMP-V1-300924
1
TATA AIG MediCare Plus
Policy Wording
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 in excess
of Aggregate Deductible as mentioned in the Policy
Schedule. Commencement of risk cover under the
policy is subject to receipt of premium by us.
The statements contained in the Proposal signed
by the Policyholder (You) 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.
For TATA AIG General Insurance Company Limited
Authorized Signatory
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
(Senior Citizen)
Visit us at www.tataaig.com
IRDA of India Registration No.:108
CIN: U85110MH2000PLC128425
UIN: TATHLIP21253V022021
“Insurance is the subject matter of solicitation”. For more details
on risk factors, terms and conditions, please read policy document
carefully before concluding a sale.
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 (Senior Citizen)
Visit us at www.tataaig.com | IRDA of India Registration No.:108 | CIN: U85110MH2000PLC128425
UIN: TATHLIP21253V022021 | REG-IMP-V1-300924
2
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 and deductible as specified in the Policy
Schedule, but Our liability in aggregate to make
payment in respect of any and all Benefits shall
be limited to the Sum Insured and will only begin
when the deductible is exceeded.
In case of family floater policy, the sum insured
& deductible for all or any of the benefits shall
be on a per policy per year basis. In case of an
individual policy, the sum insured & deductible
for all or any of the benefits shall be on a per
insured person per year basis.
All claims under the policy benefits shall be
payable only if the aggregate of covered medical
expenses, in respect to hospitalization(s) in a
policy year is in excess of deductible specified in
the policy schedule. In case of multi-year policy
(i.e. tenure more than 1 year), such aggregate
deductible would be applicable on annual basis.
The said Medically Necessary Treatment must be
on the advice of a qualified Medical Practitioner.
Section 1 – 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
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. 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/parasurgical 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;
iii. Maintaining daily records of the
patients and making them accessible
t o t h e i n s u r a n c e c o m p a n y ’ s
authorized representative.
3. 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 colocated 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
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 (Senior Citizen)
Visit us at www.tataaig.com | IRDA of India Registration No.:108 | CIN: U85110MH2000PLC128425
UIN: TATHLIP21253V022021 | REG-IMP-V1-300924
3
equipped operation theatre
where surgical procedures are
to be carried out;
 iv. Maintaining daily records of
the patients and making them
accessible to the insurance
c o m p a n y ’ s a u t h o r i z e d
representative.
4. AYUSH Treatment
AYUSH treatment refers to the medical and
/ or hospitalization treatments given under
Ayurveda, Yoga and Naturopathy, Unani,
Siddha and Homeopathy systems.
5. 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.
6. 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.
7. 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.
8. Condition Precedent
Condition Precedent means a policy term
or condition upon which the Insurer’s
liability under the policy is conditional
upon.
9. Cumulative Bonus
Cumulative Bonus means any increase or
addition in the Sum Insured granted by the
insurer without an associated increase in
premium.
10. 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.
11. 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 outpatient basis is not included in the
scope of this definition.
12. Deductible
Deductible means a cost sharing
requirement under a health insurance
policy that provides that the insurer will
not be liable for a specified rupee amount
in case of indemnity policies and for a
specified number of days/hours in case
of hospital cash policies which will apply
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 (Senior Citizen)
Visit us at www.tataaig.com | IRDA of India Registration No.:108 | CIN: U85110MH2000PLC128425
UIN: TATHLIP21253V022021 | REG-IMP-V1-300924
4
before any benefits are payable by the
insurer.
A deductible does not reduce the Sum
Insured.
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.
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 inpatient 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 longterm monitoring through
consultations, examinations,
check-ups, and /or tests;
 ii. it needs ongoing or long-term
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 (Senior Citizen)
Visit us at www.tataaig.com | IRDA of India Registration No.:108 | CIN: U85110MH2000PLC128425
UIN: TATHLIP21253V022021 | REG-IMP-V1-300924
5
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.
21. Intensive Care Unit
Intensive care unit means an identified
section, ward or wing of a hospital which
is under the constant supervision of
a dedicated medical practitioner(s),
and which is specially equipped for the
continuous monitoring and treatment of
patients who are in a critical condition,
or require life support facilities and
where the level of care and supervision
is considerably more sophisticated and
intensive than in the ordinary and other
wards.
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. i s r e q u i r e d f o r t h e m e d i c a l
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).
28. 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.
29. OPD treatment
OPD treatment means the one in which
the Insured visits a clinic / hospital or
associated facility like a consultation room
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 (Senior Citizen)
Visit us at www.tataaig.com | IRDA of India Registration No.:108 | CIN: U85110MH2000PLC128425
UIN: TATHLIP21253V022021 | REG-IMP-V1-300924
6
for diagnosis and treatment based on
the advice of a Medical Practitioner. The
Insured is not admitted as a day care or
in-patient.
30. 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.
31. 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.
32. 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.
33. 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.
34. 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.
35. 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.
36. 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.
37. Room Rent
Room Rent means the amount charged
by a Hospital towards Room and Boarding
expenses and shall include the associated
medical expenses.
38. 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.
39. 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
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 (Senior Citizen)
Visit us at www.tataaig.com | IRDA of India Registration No.:108 | CIN: U85110MH2000PLC128425
UIN: TATHLIP21253V022021 | REG-IMP-V1-300924
7
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 , Policy Wordings and Riders.
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.
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 twelvemonth period, till the Policy Expiry date.
Section 2 – Benefits
The following benefits are payable subject to
Terms and Conditions of the policy:
B1. In-Patient Treatment
W e w i l l c o v e r f o r e x p e n s e s f o r
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 PreH o s p i t a l i z a t i o n c o n s u l t a t i o n s ,
investigations and medicines incurred
upto 60 days before the date of admission
to the hospital.
The benefit is payable if We have admitted
a claim under B1 or B4 or B6.
B3. Post-Hospitalization expenses
We will cover for expenses for PostH o s p i t a l i z a t i o n c o n s u l t a t i o n s ,
investigations and medicines incurred upto
90 days after discharge from the hospital.
The benefit is payable if We have admitted
a claim under B1 or B4 or B6.
B4. Day Care Procedures
We will cover expenses for listed Day Care
Treatment due to disease/illness/Injury
during the policy period taken at a hospital
or a Day Care Centre. The list of such day
care procedures covered is available on
our website (www.tataaig.com).
Treatment normally taken on out-patient
basis is not included in the scope of this
cover.
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 In Patient
Hospitalization Treatment (section
B1).
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
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 (Senior Citizen)
Visit us at www.tataaig.com | IRDA of India Registration No.:108 | CIN: U85110MH2000PLC128425
UIN: TATHLIP21253V022021 | REG-IMP-V1-300924
8
(Section 1) of this Policy.
B7. 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 PreHospitalization 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 90 days,
subject to AYUSH In-Patient hospitalization
or AYUSH day care treatment claim being
admissible under this benefit.
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).
 B8. 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
Rs. 3000 per Hospitalization.
For this claim to be paid, the claim must be
admissible under section B1 or B4 of this
policy.
 B9. Health Checkup
We will cover for expenses for a Preventive
Health Check-up upto 1% of previous
sum insured subject to a maximum of
Rs. 10,000/- per policy. The limit is the
maximum per policy and more than one
insured can utilize the amount.
The benefit is payable once after block
of every two continuous claim free policy
years with us. This benefit has a separate
limit (over and above base sum insured)
and does not affect cumulative bonus.
Deductible shall not be applicable for this
benefit.
B10. Consumables Benefit
We will pay for expenses incurred,
for specified consumables listed in
‘Annexure I – List I as 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 a 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 of this policy.
B11. 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.
B12. 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
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 (Senior Citizen)
Visit us at www.tataaig.com | IRDA of India Registration No.:108 | CIN: U85110MH2000PLC128425
UIN: TATHLIP21253V022021 | REG-IMP-V1-300924
9
Person once during a Policy Year.
B13. Global Cover (Optional Cover)
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 only on reimbursement
basis. Cashless facility may be arranged
on case to case basis. Insured person can
contact us for any claim assistance.
The payment of any claim under this
benefit will be in Indian Rupees based
on the rate of exchange as on the date
of invoice, published by Reserve Bank of
India (RBI) 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.
We shall require the following additional
documents of the insured person for
supporting the claim under this benefit:
• Proof of diagnosis in India
• Insured’s Passport and Visa
B14. 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. Cumulative Bonus shall not be
applicable for newly added members
in the year of addition.
vi. For purpose of computation of
Cumulative Bonus, the percentage
(%) of Cumulative Bonus will be
applied on the Inpatient Sum Insured
only.
vii. Cumulative Bonus shall be provided
only if No Claim Discount has not
been availed for the claim free
previous Policy Year.
Section 3 – 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. Pre-existing Diseases Waiting
Period (Code- Excl 01):
a. Expenses related to the
treatment of a pre-existing
Disease (PED) and its direct
complications shall be excluded
until the expiry of 36 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
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 (Senior Citizen)
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10
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 36 months for any
pre-existing disease is subject
to the same being declared
at the time of application and
accepted by us.
ii. Specified Disease/Procedure
Waiting Period (Code- Excl 02):
a. Expenses related to the
t r e a t m e n t o f t h e l i s t e d
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
pre-Existing 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 (due to
injury or otherwise)
 XI. Prolapsed Inter Vertebral
Disc (due to injury or
otherwise)
 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
U r o g e n i t a l s y s t e m
Example: Kidney stone,
Urinary bladder stone.
XXI. Benign Hyperplasia of
prostate
 XXII. Varicocele
 XXIII. Cataract
 XXIV. Retinal detachment
 XXV. Glaucoma
 XXVI. C o n g e n i t a l I n t e r n a l
Diseases
 The following treatments are covered
after a waiting period of two years
irrespective of the illness for which it
is done:
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 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. H e r n i o p l a s t y o r
Herniorraphy
XXXVIII. S u r g e r y / p r o c e d u r e
for Benign prostate
enlargement
XXXIX. Surgery for Hydrocele/
Rectocele
 XL. Surgery of varicose veins
and varicose ulcers
iii. 30 Days Waiting Period (Code- Excl 03):
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.
2. Medical Exclusions
i. Investigation and evaluation
(Code- Excl 04):
a. Expenses related to any
a d m i s s i o n p r i m a r i l y f o r
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.
ii. Rest cure, rehabilitation and
respite care (Code- Excl 05):
 a. Expenses related to any
a d m i s s i o n p r i m a r i l y f o r
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 nonskilled persons.
ii. Any services for people
who are terminally ill to
address physical, social,
emotional and spiritual
needs.
iii. Obesity/ Weight Control (CodeExcl 06)
Expenses related to surgical
treatment of obesity that does not
fulfil the below conditions:
a. Surgery to be conducted is upon
the advice of the Doctor;
b. T h e s u r g e r y / P r o c e d u r e
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
co-morbidities following
failure of less invasive
methods of weight loss:
1. O b e s i t y - r e l a t e d
cardiomyopathy
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2. C o r o n a r y h e a r t
disease
3. Severe Sleep Apnea
4. Uncontrolled Type2
Diabetes
 iv. 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.
 v. Cosmetic or Plastic Surgery (CodeExcl 08):
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.
 vi. Treatment for, Alcoholism, drug or
substance abuse or any addictive
condition and consequences thereof.
(Code- Excl 12)
 vii. 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)
viii. 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)
 ix. Refractive error (Code- Excl 15):
Expenses related to the treatment
for correction of eye sight due to
refractive error less than 7.5 dioptres
 x. Unproven treatments (Code- Excl
16):
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.
 xi. Sterility and Infertility (Code- Excl
17):
Expenses related to Sterility and
infertility. 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
xii. Maternity (Code - Excl 18) :
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.
3. Non-Medical Exclusions
i. Hazardous or Adventure Sports
(Code- Excl 09):
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, deepsea diving.
ii. Breach of law (Code- Excl 10):
Expenses for treatment directly
arising from or consequent upon
any Insured Person committing or
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 (Senior Citizen)
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attempting to commit a breach of law
with criminal intent.
iii. Excluded Providers (Code-Excl 11):
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 (i)
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. A d m i s s i o n p r i m a r i l y f o r
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;
 ix. Dental treatment or surgery
of any kind unless as a result
of Accidental Bodily Injury to
natural teeth and also requiring
hospitalization & any dental
treatment other than 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, civil
war, public defence, rebellion,
revolution, insurrection,
military or usurped acts, nuclear
weapons/materials, chemical
and biological weapons, ionising
radiation.
 ii. A n y I n s u r e d P e r s o n ’ 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.
viii. Any treatment and associated
e x p e n s e s f o r a l o p e c i a ,
baldness, wigs, or toupees,
medical supplies including
elastic stockings, diabetic test
strips, and similar products.
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 (Senior Citizen)
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 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 intraoperatively 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.
xii. Any claim within the deductible
limit as specified in the policy
schedule.
Section 4 – General Terms and Clauses
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.
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).
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
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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 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 nondisclosure of material facts by the
insured person by giving 15 days’
written notice. There would be no
refund of premium on cancellation on
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
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16
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.
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.
 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
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17
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
of coverage (including portability and
migration) in health insurance policy, no
policy and claim shall be contestable by
the insurer on grounds of non-disclosure,
misrepresentation, except on grounds of
established fraud. This continuous period
of five years is called as moratorium period.
The moratorium would be applicable
for the sums insured of the first policy.
Wherever the sum insured is enhanced,
completion of five continuous years
would be applicable from the date of
enhancement of sums insured only on the
enhanced limits.
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
affected.
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
 i. 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 customersupport@tataaig.
com. After investigating the matter
internally and subsequent closure, We will
send Our response within the stipulated
TAT as prescribed by the Regulator of the
complaint by the Company or its office in
Mumbai. 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 HYPERLINK “mailto:manager.
<PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>” manager.
<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 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
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 (Senior Citizen)
Visit us at www.tataaig.com | IRDA of India Registration No.:108 | CIN: U85110MH2000PLC128425
UIN: TATHLIP21253V022021 | REG-IMP-V1-300924
18
Ombudsman Scheme
Grievances may also be lodged on the
Bima Bharosa Grievance Redressal Portal
of IRDAI (https://bimabharosa.irdai.gov.in/)
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/
Policy Certificate/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. 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.
 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. T h i s P o l i c y , i t s S c h e d u l e ,
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
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 (Senior Citizen)
Visit us at www.tataaig.com | IRDA of India Registration No.:108 | CIN: U85110MH2000PLC128425
UIN: TATHLIP21253V022021 | REG-IMP-V1-300924
19
in any part of this Policy or of the
Schedule shall bear such meaning
wherever it may appear.
21. Sum Insured Enhancement and Change
in deductible
 i. Sum Insured and/or Deductible
can be changed only at the time
of renewal subject to underwriting
guidelines of the company.
ii. In case of increase in the Sum Insured
waiting period and exclusions will
apply afresh in relation to the amount
by which the Sum Insured has been
enhanced. For claims arising in
respect of accident, injury or illness
contracted or suffered during a
preceding Policy period, liability of
the Company shall be only to the
extent of the Sum Insured under the
Policy in force at the time when it was
contracted or suffered.
22. Change of Policyholder
The change of Policyholder is permitted
only at the time of renewal.
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.
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.
Failure to furnish such intimation 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 of such
delay within such time. The Company may relax these timelines only in special circumstances
and for the reasons beyond the control of the insured.
*TPA as mentioned in the policy schedule
23. 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.
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.
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 (Senior Citizen)
Visit us at www.tataaig.com | IRDA of India Registration No.:108 | CIN: U85110MH2000PLC128425
UIN: TATHLIP21253V022021 | REG-IMP-V1-300924
20
2. Cashless Service
T r e a t m e n t ,
C o n s u l t a t i o n o r
Procedure:
T r e a t m e n t ,
C o n s u l t a t i o n o r
Procedure Taken at:
Cashless Service is
Available:
We must be given
notice that the Insured
Person wishes to
take advantage of
the cashless service
accompanied by full
particulars:
I f a n y p l a n n e d
t r e a t m e n t ,
c o n s u l t a t i o n o r
procedure for which
a claim may be made:
Network Hospital W e w i l l p r o v i d e
cashless service by
making payment to
the extent of Our
liability directly to the
Network Hospital.
At least 48 hours
before the planned
t r e a t m e n t o r
Hospitalisation
If any treatment,
c o n s u l t a t i o n o r
procedure for which
a claim may be made,
requiring emergency
hospitalisation
Network Hospital W e w i l l p r o v i d e
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. F o r a n y e m e r g e n c y
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
 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.
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 (Senior Citizen)
Visit us at www.tataaig.com | IRDA of India Registration No.:108 | CIN: U85110MH2000PLC128425
UIN: TATHLIP21253V022021 | REG-IMP-V1-300924
21
 g. 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.
 h. If the cashless is approved,
the original bills and evidence
of treatment in respect of the
same shall be left with the
Network Hospital.
 i. 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. S u p p o r t i n g D o c u m e n t a t i o n &
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
( c o n s u l t a t i o n ) r e c o r d s
pertaining to the present
ailment for which claim is being
made, if and where applicable.
 h. Treating doctor’s certificate
regarding missing information
i n c a s e h i s t o r i e s e . g .
Circumstance of injury and
Alcohol or drug influence at the
time of accident, if available.
i. Stickers and invoice of implants
used during surgery.
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 (Senior Citizen)
Visit us at www.tataaig.com | IRDA of India Registration No.:108 | CIN: U85110MH2000PLC128425
UIN: TATHLIP21253V022021 | REG-IMP-V1-300924
22
 j. 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.
k. 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.
l. Legal heir/succession certificate
, if required;
 m. PM report (wherever applicable
and conducted);
 n. If the original claim documents
mentioned above are submitted
to any other insurer, we would
require:
• Self –attested copies of the
claim documents
 • C e r t i f i c a t e / C l a i m
settlement letter from
other insurer or TPA
 v. Note: In case You are claiming for
the same event under an indemnitybased Policy with Us and with
another Insurer and are required
to submit the original documents
related to Your 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.
vi. We at our own expense, shall
have the right and opportunity to
examine insured persons through
an independent 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. Medical Expenses incurred for AYUSH
treatment shall be assessed only
under benefit B7 of this policy and
shall be admissible only if incurred
within India.^
iii. This Policy only covers medical
treatment taken within India (except
in case of benefit B13- Global cover,
if opted), and payments under this
Policy shall only be made in Indian
Rupees within India.
 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.
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 (Senior Citizen)
Visit us at www.tataaig.com | IRDA of India Registration No.:108 | CIN: U85110MH2000PLC128425
UIN: TATHLIP21253V022021 | REG-IMP-V1-300924
23
Annexure A
NAMES OF OMBUDSMAN AND ADDRESSES OF OMBUDSMAN CENTRES
SN Centre Address & Contact Jurisdiction of Office
Union Territory, District
1 Ahemdabad
Office of the Insurance Ombudsman, Jeevan
Prakash Building, 6th floor, Tilak Marg,
Relief Road, Ahemdabad – 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
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 Bhubaneswar
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>
Tamil 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
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 (Senior Citizen)
Visit us at www.tataaig.com | IRDA of India Registration No.:108 | CIN: U85110MH2000PLC128425
UIN: TATHLIP21253V022021 | REG-IMP-V1-300924
24
SN Centre Address & Contact Jurisdiction of Office
Union Territory, District
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
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
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 (Senior Citizen)
Visit us at www.tataaig.com | IRDA of India Registration No.:108 | CIN: U85110MH2000PLC128425
UIN: TATHLIP21253V022021 | REG-IMP-V1-300924
25
R1/PW/MC+/Mar 24
SN Centre Address & Contact Jurisdiction of Office
Union Territory, District
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
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
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 (Senior Citizen)
Visit us at www.tataaig.com | IRDA of India Registration No.:108 | CIN: U85110MH2000PLC128425
UIN: TATHLIP21253V022021 | REG-IMP-V1-300924
26
SN Centre Address & Contact Jurisdiction of Office
Union Territory, District
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)
For updated list and details of Insurance
Ombudsman Offices, please visit website http://
www.cioins.co.in/ombudsman.html
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.