Tata AIG Mediplus Top-up Plan

Brief Overview

Tata AIG General Insurance Company is a collaboration between the Tata Group and the American Insurance Group. Ever since its establishment in the year 2001, Tata AIG has launched various insurance plans and products in the market. With 200 branches and a workforce of over 6,000 employees and over 40,000 licensed agents, the company surely has built a vast and strong network throughout the length and breadth of the country. The company is gradually increasing its online presence and in the past few years, most of the insurance plans and procedures are carried out digitally.

Tata AIG has also made a name for itself in the health insurance sector. The plans are customer-centric and offer a lot of features and benefits. One such plan is the Tata AIG Mediplus Top-Up Plan. As the name suggests, this is a top-up plan that helps you enhance the cover of your existing health insurance plan. 

A deductible is a cost-sharing that you do with the company. It is your share of the amount that you need to pay before your health insurance plan pays up for the expenses. In simple words, the insurance company will pay the claim amount only when the amount exceeds the deductible. A cost-effective plan, it helps you increase the sum assured in the base policy by paying a much lower price. 

Best Features of Tata AIG Mediplus Top-up Plan

Some of the best features of this plan are: 

1. The plan is a top-up plan that helps you increase the limit of your current health insurance plan at an affordable rate
2. The policy covers people in the age group of 91 days to 65 years
3. Apart from yourself, you can cover your spouse, up to 3 dependent children and dependent parents
4. Under this policy, the cover is on individual sum assured basis and the policy can be issued on a family floater and/or individual basis
5. The company would pay the medical expenses only when they exceed the Deductible
6. The company offers discounts in premiums under specific conditions

Benefits of Tata AIG Mediplus Top-up Plan

1. Covers Everyone
   The policy can cover up to 7 family members including you, spouse, 3 children and your parents. From a 91-day-old baby to 65 years old everyone will be covered.
2. Ambulance Charges
   For the transportation of the insured member ambulance charges up to INR 2,000 will be covered.
3. Tax Benefits
   Under this health insurance plan, you can claim a tax exemption of up to INR 25,000 when you insure yourself/ husband/ wife/ children. You can claim INR 30,000 for senior citizen parents.
4. In-Patient Dental Treatments
   Any dental treatments that you are required to have due to an accidental injury or illness will be covered.
5. Pre and Post-Hospitalisation 
   Your medical expenses will not finish with your hospitalisation. The plan would cover pre and post hospitalisation expenses for 60 days and 90 days respectively.
6. Discounts
   You can get the following discounts on your premium:
   • 10% family discount if 2 or more people covered under the same policy
   • If you pay 2 years premium together, you can get a 7.5% discount
7. Day-Care Procedures
   Day-care procedures are the treatments that do not require hospitalisation of more than 24 hours. There are 140 day-care procedures that will be covered under this plan.
8. Organ Transplant
   You can receive a cover for in-patient expenses that are incurred by the donor at the time of organ harvesting and also the expenses incurred by the organ recipient.
9. Domiciliary Treatment
   When you undergo medical treatment at home, that would otherwise have required hospitalisation, your treatment would be covered. Keep in mind that domiciliary care can be claimed only when it is based on a physician’s advice.

Plan Details of Tata AIG Mediplus Top-up Plan

• Waiting Period
  The waiting period is as follows:
  • Accidental injuries are covered from day 1
  • 30-day waiting period for any illness related treatment
  • There is a waiting period of 48 months for all pre-existing illnesses.
  • Expenses that are related to the treatment of the listed conditions, surgeries/ treatments come with a waiting period of 24 months
• Free Look Period
  Within 15 days of the policy purchase, if you feel dissatisfied with the policy, you have the right to return it to the company. If a claim has not been made by you in these 15 days, the premium that you have paid will be refunded. However, stamp duty charges and proportionate risk amount will be deducted.

What is not Covered in Tata AIG Mediplus Top-up Plan?

The general exclusions in Tata AIG Mediplus Top-Up Plan are listed below, for a detailed list, kindly refer to the policy document. Expenses that arise because of the following conditions are not covered:

1. Intentional self-injury
2. Suicide attempt
3. Obesity and weight control
4. Injury/ illness arising due to participation in:
   • Hazardous or Adventure Sports
   • Criminal activities
   • Any act of war/ warlike operations

Renewal Process of Tata AIG Mediplus Top-up Plan

To maintain continuity of the benefits of MediPlus Top-Up plan, you must renew it before the expiry date. Remember, the company is not under any obligation to send you a notice for renewal. After the policy term is over, you have the chance to get the renewal done with the 30-day grace period. Once the grace period is over, your policy will be terminated. Claims made during the grace period are not accepted.

For renewal of the policy, you can visit the company website and pay the premium due. If you wish to renew the policy offline, you can visit a nearby branch office. Here, you can fill in the Renewal Form and make the payment via credit/debit card or cheque. 

Tata AIG Mediplus Top-up Plan - Claim Process

In the case of hospitalisation, for intimation of claim, claim status, pre-authorisation, submission of claim etc. you need to get in touch with the company designated TPA, which is Family Health Plan Insurance TPA Ltd.  In the case of planned hospitalisation, you have to inform the company 48 hours before the admission in the hospital, and in case of an emergency, the hospitalisation reports the company within 24 hours of admission. You can get in touch with the TPA through the following modes:

1. Call them on 1800-425-4033. Senior citizens can call on 040- 23552899
2. Fax +91-40-23541400
3. Email Address: info@fhpl.net

Once the claim is registered, you can proceed with the hospitalisation. If you wish to seek a cashless treatment, you would have to get admitted to a network hospital. At a non-network hospital, you would not be able to seek cashless treatment, however, you can make a reimbursement claim for the medical expenses that you had to make due to your hospitalisation. 

• Cashless Claim 
  When you reach the hospital, you have to get your pre-authorisation form submitted at the Helpdesk or the TPA associates. A few treatment-related documents may also be required at this time. The TPA and the company will approve the cashless claim if all the paperwork is verified. The settlement of the bills is done by Tata AIG to the extent the pre-authorisation is approved. You would have to pay for the non-medical and uncovered expenses.
• Reimbursement Claim 
  In case you seek treatment at a non-network hospital, you would be eligible for reimbursement if all the criteria are fulfilled. Make sure that you inform the TPA within 7 days of the treatment or consultation. You have to fill in and submit the Claim Intimation Form within 15 days of the incident. When the TPA or the company receives all the treatment-related documents and the claim form, they will verify and then process the claim. If your claim is approved, the payment will be made within 30 days.

Points to remember when making a Claim

1. Cashless treatment can be availed only in a network hospital
2. Payment will be made in excess of the deductible and up to the limits
3. Non-medical and uncovered expenses will have to be borne by you

• Required Documents
  The documents that are required for making a claim are:
  1. Filled and signed Company Claim Form
  2. Copy of policy document
  3. Treatment-related bills
  4. Medical and diagnostic reports
  5. Discharge Summary
  6. Medical prescriptions
  7. FIR in case of accidental injury, if reported

Tata AIG Policy Network Hospitals

Tata AIG offers its customers a collaboration with around 6,200 leading hospitals all across the country. At a network hospital, the bills and claims are settled by the company and its TPA, with this facility your shoulders get burden-free. And rather than worrying about arranging the money, you can concentrate on the treatment. At a network hospital, you can be at peace and be free from any expense related anxiety. The TPA and the company executives will help you with all the procedures making the claim process smooth and simple. 

Review of Tata AIG Mediplus Top-up Plan

Today, Tata AIG is one of the most distinguished health insurance companies in the country. The credit goes to their innovative and cost-effective insurance products. Tata AIG Mediplus Top-Up Plan is a great way to enhance the coverage of your existing health insurance plan. In a simple way, it can be said that with Mediplus top-up you can supplement your primary health insurance policy. This plan comes in very handy when you have to face an expensive medical emergency. Mediplus is an affordable solution and if you fulfil certain conditions, you can also avail discounts on the premium amount. With lifelong renewability options, the plan is like a cherry on the cake, for your health insurance plan. 

TATA AIG Customer Care Details