TATA AIG Wellsurance Family Policy

Brief Overview

A joint venture between Tata Group and US-based American International Group, Tata AIG came into being in 2001, and this year the company is celebrating a very successful 20 years, in these two decades, Tata AIG has offered various insurance solutions to over 5 crore customers. The company has also gained a lot of popularity in the area of the health insurance sector as the plans it offers are unique and comprehensive. With over 6,200 hospitals in its network, the company provides cashless treatment to the policyholders all across the country.

One of the very popular health insurance policies offered by the company  is Tata AIG Wellsurance Family Policy. An all-inclusive, family floater policy, it allows you to cover yourself, your husband/ wife, your dependent children and also your dependent parents. The policy, therefore, offers you peace of mind that your entire family is covered against all medical emergencies. It also provides lump-sum benefits along with indemnity oriented claims. With a cover against 11 critical illnesses, you can deal with all kinds of medical emergencies. 

Best Features of Tata AIG Wellsurance Family Policy

Before we go into the details here are some of the best features of the AIG Wellsurance Family Policy:

• The plan provides lump-sum benefits along with indemnity oriented claims
• The plan offers 3 variants Elite, Supreme and Classic
• There are many value-added services that are offered under this plan
• 11 critical illnesses are covered
• Ambulance charges for the medical transportation of the patient are covered
• The policyholder receives a daily allowance when hospitalised because of sickness as well as injury
• The policy also offers a convalescence benefit
• A daily cash benefit is also received when the insured is in ICU
• The policy is available on lifetime renewability basis

Benefits of Tata AIG Wellsurance Family Policy

Let us take a look at the benefits that make this policy a popular one:

1. Single Policy for the Whole Family 
   Under just one policy you can cover your family including your spouse, up to 2 dependent children and dependent parents.
2. ICU Benefit
   A daily benefit is paid for each day that you are admitted in the intensive care unit in a hospital. The hospitalisation can be either due to sickness or due to an injury. This benefit is paid for a specific number of days during the policy tenure.
3. Critical Illness Benefits
   In case an insured member is diagnosed with any of the mentioned illnesses, a lump sum amount will be paid out.
   • First Heart Attack of specified severity
   • Total Blindness (Accidental or due to any sickness)
   • Cancer of specified severity
   • Multiple Sclerosis with persisting symptoms
   • Permanent Paralysis of Limbs
   • Coma of specified severity
   • Stroke resulting in permanent symptoms
   • Open Chest CABG
   • Kidney Failure that requires regular dialysis
   • Major Organ /Bone Marrow Transplant
   • Major Burns
4. In-Patient Hospitalisation Benefits
   Irrespective of the expenses that have been incurred, a specified amount will be paid for the days that the insured is hospitalised. The hospitalisation could be due to:
   • Accidental Injury
   • Sickness
5. Hospitalisation Made Easy
   In case an insured family member is hospitalised, the policy will offer a cash allowance for up to 90 days. This facility greatly helps you in managing the expenses, so that they don’t make a big hole in your pocket.
6. Ambulance Charges
   A specific amount is paid towards the transportation services used in bringing the insured member to the hospital after an accident and his return to his normal residence after discharge from the hospital.
7. Value-Added Services 
   With the Wellsurance Family policy, you get the following services:
   • Free Health Line
     You can get in touch with physicians to seek help in common health problems
   • Health Portal
     Gives you access to multiple health-related articles
   • Health Offers & Discounts 
     You can avail discounts on selected Gyms, weight management centres and spas
   • Discounted Services for Health and Wellness
     Avail discounts in health check-up packages
8. Education Benefit
   In case of death or permanent total disability of the primary insured, a lump sum amount is paid.
9. Convalescence Benefit
   A convalescence benefit is paid to the insured for his recovery at home that follows hospital discharge after 5 consecutive nights at the hospital.
10. Tax Benefits
    The premium amount that you pay towards the policy is eligible for deduction under Section 80D of the Income Tax Act.
11. Wide Network of Hospitals
    Tata AIG Wellsurance Family comes with a strong network of over 6,200 hospitals in the country. So no matter in which corner of the country you are, you would never be away from the coverage.

Plan Details of Tata AIG Wellsurance Family Policy

Free Look Period 
A period of 15 days starting from the date of purchase, the policyholder is given a free-look period to review the terms and conditions of the policy. In case of any issues, the policy can be cancelled. The premium that has been paid by you will be refunded. The stamp duty charges and the proportionate risk premium will be adjusted.

Waiting Period
The Waiting period in Tata AIG Wellsurance Family Policy is as follows:

• For all sickness-related hospitalisation, there is a waiting period of 90 days.
• For accidental injuries, there is no waiting period.
• A waiting period of 90 days and a survival period of 30 days is applicable for Critical Illness Benefit.

What is not Covered in Tata AIG Wellsurance Family Policy?

The Wellsurance Family Policy offers a comprehensive cover but still, there are certain situations where your policy will not work. Listed below are some of the general exclusions in the Wellsurance Family Policy. For a more detailed list of exclusions refer to the company website:

1. Pre-existing medical conditions or any other complication that arises because a pre-existing condition will not be covered till 4 years of consecutive coverage
2. Injuries that are self-inflicted will not be covered
3. This policy doesn’t cover sexually transmitted diseases
4. Plastic/ Cosmetic surgery will not be covered unless required post-injury or accident
5. Pregnancy and related conditions will not be covered
6. Treatment required due to alcohol or drug abuse
7. Loss or injury because of war/ civil war/ revolution
8. While serving in Armed Forces

Renewal Process of Tata AIG Wellsurance Family Policy

To keep enjoying the policy benefits, you would have to renew the policy on an annual basis. The upper age limit for entry to Wellsurance Family Policy is 65 years, however, the policy comes with lifetime renewability and can be renewed even when you cross the age of 65. As a policyholder, you must ensure that you renew the policy before it hits the expiry date. Once the expiry date passes, the company will give you a 30-day grace period during which you must renew the policy. Post this period, the policy will lapse. Keep in mind is that no claims are accepted in the grace period. 

If you wish to make any changes in the sum insured, it can be done at the time of policy renewal.

Tata AIG Wellsurance Family Policy - Claim Process

Life is full of ups and downs, hospitalisation may be a planned hospitalisation or in some cases, it may be an emergency. Regardless of this, in order to make a claim smoothly, you must follow all the guidelines carefully. The first thing to be done is notifying the company. In case of planned hospitalisation, you must notify the company at least 48 hours prior to admission and in case of an emergency hospitalisation informs the company within the first 24 hours of the admission.  

The intimation can be made in a number of ways. You can write an email to general.claims@tata-aig.com OR visit the company website and register the claim online OR click https://www.tataaig.com/service/claim-register OR call the customer care 1800 266 7780 OR SMS “CLAIMS'' to 5616181 OR write to - Tata AIG General Insurance company Ltd. Health Claims Department A-501, 5th Floor, Building No. 4, Infinity Park, Gen. A. K. Vaidya Marg, Dindoshi, Malad (E), Mumbai, India - 400 097
In case you are a senior citizen who wants to raise a claim, you can call on 1800 22 9966.

1. Tata AIG Cashless Claims
   At a Tata AIG network hospital, you will have the advantage of availing cashless treatment. Submit the claim form along with the relevant medical documents with the Helpdesk at the time of admission. After an assessment by the company, approval will be given for your treatment to begin. The company will settle the final bill, however, bear in mind that you would have to pay for all the uncovered expenses on your own.
   To locate a network hospital, click https://www.tataaig.com/health-insurance and enter the Pincode of the area you wish to seek treatment in.
2. Tata AIG Reimbursement Claims
   At a non-network hospital, you would not be able to avail the cashless treatment facility, but you can get the expenditure reimbursed, provided your hospital fulfils all the required criteria. In a reimbursement claim, you pay for the hospitalisation upfront, and then you can get the amount reimbursed by the company. 
   For making a reimbursement claim, you have to submit the claim form and all the treatment-related documents. These documents must then be submitted with Tata AIG for processing. After the verification of all your documents, the reimbursement amount will be transferred to your bank account.

Required Documents for processing a claim

To make a claim, the following documents will be required:

• Company Claim Form-filled and signed
• All treatment-related bills including diagnostic bills, pharmacy bills and consultation bills
• All medical and diagnostic reports including discharge summary, investigation reports etc
• Diagnosis report by the doctor
• Medical prescriptions
• Copy of policy documents

Tata AIG Network Hospitals

A big advantage of buying a Tata AIG health insurance plan is that the company has a wide network of hospitals. With over 6,200 hospitals all over India, you never can be away from one in case of a medical emergency. When you go to a hospital that offers cashless treatment, you do have to worry about arranging for money at the last minute. As the company settles the bills with the company directly, it takes off the burden from your shoulders. You can get the best of treatment without compromising on the quality. You

Review of Tata AIG Wellsurance Family Policy

Tata AIG Wellsurance Family Policy is a health insurance policy that lets you cover your whole family under one umbrella. Along with your spouse and kids, you can also cover your parents, if they are dependent on you. It takes care of the everyday expenses that you may have to incur for each day that you or any other insured member spends at the hospital or the ICU. Other than sickness and accidental injuries, the plan also covers 11 critical diseases and would pay out a lump sum amount in case an insured member is diagnosed. 

So, if you too are looking for a health insurance policy that covers your family, Tata AIG Wellsurance Family Policy might be the right choice for you.

TATA AIG Customer Care Details