TATA AIG Wellsurance Executive Health Policy

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Introduction/Overview

Tata AIG Wellsurance Executive Health Insurance policy is specifically designed to cover unforeseen medical expenses of busy executives. It pays for critical illnesses, surgeries, miscellaneous hospital expenses, benefits like daily hospital cash, convalescence etc.

Wellsurance Executive is a unique combination of health insurance and wellness program. In addition to the above mentioned Insurance benefits it also offers a host value added services like Health Line & health query, Health & wellness discounts on selected diagnostic centers, gymnasiums and spas, Health portal, response to your Health queries by experts and regular health newsletters. It is beyond health insurance

Key Features

Benefit amount on diagnosis of any of 9 critical illnesses
Cashless Hospitalization at 3000+ hospitals in India
Benefit amount for specified major & minor surgical procedures
Higher Hospital Cash for ICU/ICCU admissions
Daily Hospital Cash benefit
Convalescence benefit for post hospitalization treatment
Income Tax benefit under Section 80D

Benefits

	Benefits	Classic	Supreme	Elite
i>	Diagnosed Critical Illness ( waiting period 90 days, survival period 30 days)
i>	Cancer of specified severity	300000	500000	750000
ii>	First Heart Attack of specified severity	300000	500000	750000
iii>	Stroke resulting in permanent symptoms	300000	500000	750000
iv>	Kidney Failure requiring regular Dialysis	300000	500000	750000
v>	Coma of specified severity	300000	500000	750000
vi>	Total Blindness	300000	500000	750000
vii>	Permanent Paralysis Of Limbs	300000	500000	750000
viii>	Multiple Sclerosis with persisting symptoms	300000	500000	750000
ix>	Major Burns	300000	500000	750000
2	Hospitalisation:
a	Hospitalisation Miscellaneous
	Nursing services - Max upto 90 days	750	1000	1250
	Physician’s visit - Max upto 90 days	750	1000	1250
	Investigation- MRI	2500	3500	3500
	Investigation- CT scan or Doppler study	1250	1750	1750
	Physiotherapy( while hospital confined) max upto 30 days	750	1000	1250
	Investigation- lab test, and or x-ray and or ECG	350	500	750
b	Operation charges
	Anaesthetist’s fees	2500	5000	7500
c	Major surgeries
1	CABG- coronary artery bypass grafting	100000	150000	200000
2	Angioplasty -PTCA( percutaniuos transluminal coronery angioplasty)	100000	150000	200000
3	Brain surgery including Craniotomy, tumor removal and intercranial drainage	100000	150000	200000
4	Post traumatic surgery ( skull fracture, pelvis fracture, complicated fracture )	50000	75000	100000
	Skull fracture
	Traumatic amputation of upper and /or lower limb
	Pelvis / Hip Fracture
	Compound communicated fracture of any part where ORIF is required
5	Bone marrow transplant	100000	150000	200000
6	Major organ transplant ( Heart, Lung, Liver, Pancreas	100000	150000	200000
7	Knee replacement	75000	125000	150000
	Traumatic / septic arthritis
	Severe irreparable knee injury
8	Hip replacement	75000	125000	150000
	Traumatic hip injury- both partial and total
9	Spinal surgeries	40000	75000	100000
	Traumatic spinal injuries
10	Enucleation	40000	60000	75000
	Malignant tumor of eye ball
	Severe trauma to eye ball
	Odentogenic cyst
11	Heart valve replacement	100000	150000	200000
12	Pacemaker implant	75000	100000	125000
13	Knee ligament surgery - trauma related	75000	125000	150000
d	Minor Surgeries
1	Appendectomy	10000	10000	15000
2	Cholecystectomy/ Removal of Gall Stone	15000	20000	20000
3	Removal of kidney stones	10000	10000	15000
4	Hernia repair	15000	20000	20000
5	Haemorrhoids	10000	10000	15000
6	Biopsy of growth	15000	20000	20000
3	Outpatient
	Post operative Physiotherapy eligibility Min 2 visits	3500	5000	7000
	Chemotheraphy and/or radiation eligibility Min 3 visits	150000	250000	300000
	Kidney Dialysis	150000	200000	250000
4	Ambulance Charges
	while admitting and while discharging from the Hospital	2000	2000	2000
5	Hospital Cash ( Max 90 days ) (Per Day)	2000	3000	4000
6	ICU Benefit - Max 15 days per policy year (Per Day)	3000	4500	6000
7	Convalescence Benefit( payable after continuous Hospitalization for 5 days)	1500	2500	4000

Details About Premium

Annual premium in Rupees

Policy Details

Coverage type: Individual

Grace period: 30 days for renewing the Policy. However, coverage would not be available for the period for which no premium has been received.

Policy termination: 15 days prior to the expiry of the policy

No Claim Period: 90 days from inception of the policy or 120 days for major surgeries

Additional Features Or Riders

Discounts on selected health check up packages at network hospitals
Discounts at select gyms, spas, weight management centers and skin care
Ambulance benefit is paid as a lump sum amount during hospitalisation
Access to exclusive health and wellness related articles
Free Health Helpline

Exclusions

Pre existing diseases will not be covered for the first 4 policy years given there has been continuous renewal from the policy start date
Treatment done in the first 30 days from the commencement of the policy, unless the treatment is done as a result of accident or emergency. This is referred to as a waiting period.
Any illness or disease contracted due to intake of alcohol/drugs or other addictive substances will not be covered.
The waiting period for specific conditions will be 24 months Any pre-existing condition will be covered after a waiting period of 48 months
Any treatment which begins during waiting periods except Accident related / War / Intentional self injury or attempted suicide / Abuse of drugs and alcohol and nicotine addiction / Treatment of Obesity / Sleep Apnoea / Maternity / Psychiatric or mental disorders / Congenital diseases / Conditions related to or arising out of HIV/AIDS / Intentionally self-inflicted Injury or illness.
Professional Sports, Hazardous Activities

Documents Required

Policyholder has to fill up an ‘Application form/ proposal form’ with accurate medical history along with the address proof. Medical examination may be required in some cases, based on the sum assured and the age of the person.

Eligibility

Entry age for the policyholder, spouse and parents is 18 years to 65 years with lifetime renewal option.

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