TATA AIG Wellsurance Family Health Policy

Key Features of TATA AIG Wellsurance Family Insurance Plan

• Hospitalization Expenses: In case any of your family members are admitted in the hospital the insurer will recompense the expenses incurred on the treatment if the injury or illness, with daily cash allowance up to a maximum of 90 days.
• ICU Expense Cover: Daily benefit is provided in case you are admitted in the ICU in a hospital. It is subjected to deductibles and the limit is as specified by the insurer.
• Ambulance Charges: The insurer pays off a specified amount incurred towards medical transportation. Ambulance charges for bringing the insured member to the hospital after an accident and taking back home after discharged are covered in this plan.
• Value Added Service: You can avail free services on their health portal, seek health queries, and avail health and wellness discounts. You will also get e-newsletter where you can subscribe to various health policies articles and seek consultation from the experts.

Coverage Provided In TATA AIG Wellsurance Family Insurance Plan

• Critical Illness Cover: Lump sum payment shall be provided if the insured person is diagnosed with specified critical illnesses for the first time during the policy period. The symptoms of the illness should appear post 90 days of the policy inception date and 30 days of survival period is required from the diagnosis of the illness.
• Irrespective of the number of critical illnesses, the insurer will only pay once during a policy term in lump sum amount. To avail the benefits you need to renew the policy in the subsequent year.
• In-Hospitalization cover for Accident: Daily compensation is provided for each day in case of inpatient hospitalization within India due to an injury or accident subject to the deductibles as per the policy terms and conditions. The hospitalization should be medically required and recommended by a doctor.
• During the period of hospitalization requiring regular and ICU hospitalization, the insurer shall pay against ICU expenses or daily hospital cash as per the applicable limit and deductibles that are applicable.  
• In-Hospital Cover for a Disease: Daily compensation is provided for each day in case of inpatient hospitalization within India due to a health emergency subjected to a waiting period of 90 days and deductibles. The hospitalization should be medically required and recommended by a doctor.
• The benefits are provided only once during a policy period. During the period of hospitalization requiring regular and ICU hospitalization, the insurer shall pay against ICU expenses or daily hospital cash as per the applicable limit and deductibles that are applicable. 
• Education Benefit: If the policyholder suffers permanent total disabilities and accidental death then the insurer will pay off the sum insured as per the policy schedule
• Convalescence Benefits: The insurer pays off a lump sum amount equal to the sum insured amount, for the period of home recovery at home, after getting discharged. Hospitalization should be for a minimum of 5 continuous nights in the hospital.

Exclusions of TATA AIG Wellsurance Family Insurance Plan

• Pre-existing illnesses are not covered until the completion of a waiting period of 4-consecutive years from the policy commencement date.
• Medical emergencies resulting due to the overdose of alcohol or drugs
• Self-inflicted injuries are also not recompensed
• Any critical illness that has been diagnosed within or prior to the waiting period of 90 days
• Any homeopathy, Ayurveda, weight control programs and naturopathy treatments
• AIDS, STDs, HIV infection, childbirth, and pregnancy complications are not recompensed
• Congenital complications and anomalies are not covered
• Any mental disorder, anxiety, nervous disorders, depression or stress or related illnesses
• War, invasion, nuclear weapons, civil war, induced hospitalization are not covered
• professional sports injuries and hazardous activities induced illness
• Cosmetic or plastic surgeries are not covered unless it is an accidental case

For more details please refer to the policy wordings

Claim Process of Tata AIG Wellsurance Executive Plan

The procedure to file a health claim with Tata AIG is enumerated below:

• For any disease and illness related hospitalization, you need to lodge a claim at least 48 hours after the hospital admission
• If there was an emergency then register your claim within 24 hours of getting hospitalized
• Also, furnish your claim form
• If all the documents are submitted timely and the procedure is followed then the insurance company will pay-off the claim amount within 30 days of report submission. All the claims shall be settled in as per the IRDA guidelines.

Documents Required at the Time of Claim

The documents that you need to submit are enumerated below:

• Pharmacy Bills
• Claim form duly signed
• Hospital receipts/bills
• Operation theatre notes
• Medical investigation reports
• The discharge summary from the hospital
• Doctor’s prescription
• Claim Intimation proof