TATA AIG Wellsurance Executive Health Policy

Key Features Tata AIG Wellsurance Executive Plan

• Hospitalization Expenses: Hospitalization expenses if the policyholder is hospitalized to get treatment for the illness or injury covered.
• Post-hospitalization Expenses: It includes payment of the lump sum amount in case of the following expenses:
• 3-visit of chemotherapy or radiation. It will be paid only once during the lifetime of the policyholder
• 2-visit of postoperative physiotherapy
• Kidney dialysis expenses to be paid once during the lifetime of the policyholder/insured
3. Value-added services: Facilities like free health portal, health line, health query, health and wellness discounts and e-newsletter subscription where you will have access to useful health articles and can also take experts consultation for any health-related queries.

Coverage Benefits of Tata AIG Wellsurance Executive Plan

• Critical Illness Benefits: In case there is a diagnosis of any critical illness (first time during the policy term) you will get lump sum payment shall be made to the insured. The signs and symptoms of the critical illness should appear after 90 days of the policy commencement date and a survival period of 30 days should be there from the date of diagnosis. Payment shall be made in the lump sum and only once during a policy term irrespective of the number of critical illness. Once the payment is made this benefit will be terminated. It can only be availed after renewing the policy.
• In-Hospital Benefit for Accident: This plan includes daily cash benefit for inpatient hospitalization across India due to an accident or injury (subjected to deductibles). The total benefits are subjected to the maximum in-hospitalization limits. During a hospitalization that requires ICU and regular treatment, the insurer shall pay against daily hospital cash or ICU expenses as subjected to deductibles. 
• Convalescence Benefit: The insurer pays in a lump sum to the patient for the recovery period after getting discharged from the hospital and the minimum hospitalization tenure is of 5 consecutive nights.
• In-Hospitalization Cover Benefit for Sickness: Daily cash benefit is paid on daily basis for expenses incurred during the hospitalization for treatment of any disease, illness and it is subjected to a waiting period of 90 days. Hospitalization needs to recommend by a doctor. The treatment should be recommended by a physician. The total benefits are subjected to the maximum in-hospitalization limits. During a hospitalization that requires ICU and regular treatment, the insurer shall pay against daily hospital cash or ICU expenses as subjected to deductibles
• Covers Major Surgeries: The insurer pays a lump sum amount for specific major surgeries that are not resulting due to any pre-existing condition.
• Covers Minor Surgeries: The insurer pays a lump sum amount for specific minor surgeries that are not resulting due to any pre-existing condition.
• Ambulance Expenses: The plan covers expenses incurred on the ambulance before hospitalization and after getting discharged from the hospital.

Exclusions of Tata AIG Wellsurance Executive Plan

There are a lot of expenses that this plan covers, but the following medical expenses are not covered:

• All the pre-existing illnesses will be covered after a waiting period of 4-years from the date of policy commencement
• Any sign of critical illness or disease that appeared within the waiting period of 90 days
• weight control programs, homeopath or naturopath and Ayurveda treatments
• HIV and AIDS infection, congenital anomalies or complications, childbirth or pregnancy-related treatments
• Elective, plastic or cosmetic surgery, unless it has resulted due to accidental injuries
• Stress, anxiety, mental disorders, depression, and stress
• Medical expenses resulting due to drugs and alcohol addiction
• Intentional self-injuries
• War, invasion, civil war, nuclear weapon, hostilities induced hospitalization
• Health issues, injuries and illnesses resulting due to involvement in adventure sports and hazardous activities
• For detailed benefits, limitations, terms & conditions you can refer to the policy wordings

Claim Process of Tata AIG Wellsurance Executive Plan

The procedure to file a claim is enumerated below:

• If the hospitalization is required for any illness or disease then you need to file a claim within 48 hours of taking admission in the hospital
• If it was done in an emergency then you need to file a claim within 24 hours of the hospitalization
• You also need to submit the claim form
• If all the procedures are followed and the documents are submitted then the insurer will recompense the amount/settle the claim within 30 days of submission of all the reports and any other additional information. The claim will be settled in accordance with the IRDA guidelines, 2002.

Documents Required at the Time of Claim

The documents that you need to submit are as follows:

• Claim form duly signed
• Pharmacy Bills
• Hospital Bills/Receipts
• Investigation Reports
• Operation Theatre Notes
• Hospital Discharge Summary
• A prescription from the doctor
• Claim Intimation proof