Main Highlight of the plan
This policy offers both hospitalization benefit and wellness benefits like discounts and offers on gyms, diagnostic centers, etc.
This policy offers double claim benefit under which an individual can claim twice for same illness from a different insurer.
This plan offers lump sum amount in case of hospitalization or diagnosis of critical illnesses.
Scope of cover
Coverage: Benefits & Features
Most Important
ROOM RENT/ ROOM CATEGORY
This plan has limit of ICU room expenses. The ICU room expenses for a maximum of 15 days are covered in this plan.
For Classic plan expenses up to INR 3000 per day are covered.
For Supreme plan expenses up to INR 4500 per day are covered.
For Elite plan expenses up to INR 6000 per day are covered.
CO-PAYMENT
This plan does not have co-payment clause.
NO-CLAIM BENEFITS
This plan does not offer no-claim benefits.
Good to have
PRE/POST HOSPITALIZATION
90 days of post hospitalization (nursing services and physician's visit) are provided in this plan.
RESTORE BENEFITS
This plan does not offer restore benefit.
HEALTH CHECK-UP
This plan offers health check-up benefit.
Value Adds
AMBULANCE CHARGES
This plan provides lump sum ambulance charges of INR 2000 while admitting and discharge from the hospital.
EYE COVER
This plan does not cover expenses for eye treatments.
DOMICILIARY HOSPITALIZATION
This plan does not offer coverage for domiciliary hospitalization treatments.
OUTPATIENT BENEFITS
This plan covers expenses on physiotherapy (minimum of 2 visits), chemotherapy (minimum 3 visits) and kidney dialysis under outpatient benefits.
Note: The benefit for kidney dialysis and chemotherapy are provided only once in lifetime.
CRITICAL ILLNESS COVERAGE
This plan offers fixed benefit for some of the listed critical illness. Please refer the policy document for the list of these illnesses.
ALTERNATIVE PRACTICE
This plan does not cover non-allopathic treatments.
DENTAL COVER
This plan does not cover expenses on dental treatments.
DAILY CASH
This plan provides daily cash allowance of-
INR 2000 for Classic variant.
INR 3000 for Supreme variant.
INR 4000 for Elite variant.
Note: Deductible of 1 day is applicable in this plan.
ORGAN DONOR COVER
This plan does not offer coverage for organ donor expenses.
CONVALESCENCE BENEFIT
This plan offers convalescence benefit in the range of INR 1500 to INR 4000 after 5 days of continuous hospitalization.
MATERNITY COVER
This plan does not cover maternity expenses.
Exclusions
Waiting period of 4 years is applicable for pre-existing diseases.
Waiting period for critical diseases is 90 days with a survival period of 30 days. Please refer the Tata Aig Health Insurance policy document for the list of illnesses included under critical illness category.
Waiting period of 90 is applicable for minor surgeries. Please refer the policy document for the list of surgeries included under minor surgeries category.
Waiting period of 120 days is applicable for major surgeries. Please refer the policy document for the list of surgeries included under major surgeries category.
PERMANENT EXCLUSIONS
Cosmetic surgery, Lasik eye treatments, drugs or alcohol abuse, genetic disorders, self inflicted injuries, war related injuries, etc are some of the permanent exclusions. For the detailed list of please refer the policy document.
