Prospectus
1. Suitability:
a. This policy covers persons in the age group 5 years onwards (Dependent children between 91 days and 5
years can be insured only when both parents are getting insured). The maximum entry age is 65 years.
b. There is no maximum cover ceasing age under this policy.
c. The policy will be issued for a period 1/2/3 years.
d. This policy can be issued to an individual and/or family.
e. The family includes spouse and economically dependent children and parents/parents-in-law.
f. The policy o ers coverage on family oater basis.
g. Maximum 7 members of a family are covered in one Individual Plan Policy (Self, spouse, 3 dependent
children, 2 parents and 2 parent-in-laws ).
h. Maximum 7 members are covered in one Family Floater Plan policy (Self, spouse, 3 dependent children
(Up to the age of 25 Years), 2 parents and 2 parent-in-laws). In case of family oater, where age of the
dependent child is crossing 25 years, the child can be covered under a separate policy with eligible
continuity bene�t.
2. Key Bene�ts:
a. Range of bene�ts: Indemnity based health insurance cover with range of bene�ts without any sub-limit
unless otherwise mentioned.
b. Network of hospitals: We are equipped to o er you quality health care with our strong network of
7000+ hospitals across India.
c. Lifelong renewal: We o er you a lifelong renewal for your policy provided premium is paid without any
break.
d. Global Cover for Planned Hospitalization: We will cover Medical Expenses of the Insured Person
incurred outside India upto the sum insured provided that the diagnosis was made in India and the
insured travels abroad for treatment. In case the Insured Person has opted for Sum Insured above Rs. 50
Lacs, then reasonable and customary expenses incurred towards obtaining visa for medical treatment of
the insured person will be covered.
e. Bariatric Surgery Cover - We will Cover reasonable and customary expenses for Bariatric surgery if the
insured ful�lls conditions as listed in the policy.
f. Sum Insured Restore Bene�t: If Your Sum Insured including cumulative bonus is insu cient to pay
a claim during a policy year, an additional amount equivalent to the base Sum Insured will be restored
once during the policy year and can also be used for admissions due to related illness/diseases after 45
days from the date of discharge of the earlier claim. This bene�t cannot be carried forward to subsequent
renewals.
g. High End Diagnostics - We will pay the insured for the listed diagnostic tests on OPD basis if required as
part of a treatment subject to coverage sum insured.
h. Emergency Air Ambulance Cover - We will pay for ambulance transportation of the insured person in
an airplane or helicopter subject to coverage sum insured.
i. Maternity Cover - We will cover Maternity Expenses subject to coverage sum insured.
1
Tata AIG General Insurance Company Limited
Registered O�ce: Peninsula Business Park, Tower A, 15th Floor, G. K. Marg, Lower Parel, Mumbai- 400013, Maharashtra, India
24x7 Toll Free No. 1800 266 7780 or 1800 22 9966 (Senior Citizen) • Email: customersupport@tataaig.com • Website: www.tataaig.com
IRDA of India Registration No.: 108 • CIN: U85110MH2000PLC128425 • Tata AIG MediCare Premier UIN: TATHLIP23167V032223
j. Consumables Bene�t - We will pay for expenses incurred, for speci�ed consumables which are listed in
‘annexure 1 – List 1 as optional items’ under ‘Guidelines on Standardization in Health Insurance, 2016’ &
its amendments, which are consumed during the period of hospitalization directly related to the insured’s
medical or surgical treatment of illness/disease/injury. Details of Annexure I-List I-Optional items are
available on our website (www.tataaig.com).
k. Cumulative bonus: 50% increase in cumulative bonus for every claim free year. In the case a claim is
made during the policy year, the cumulative bonus would reduce by 50% in the following year.
l. Home Care Treatment Cover (Applicable only for Sum Insured `75 Lakhs and above) - We will
cover for reasonable and customary medical expenses incurred for treatment taken at home for below
speci�ed conditions/ illness:
• Dialysis at home
• Chemotherapy at home
• Pandemic Care at home for a maximum period of 15 days and maximum upto 25% of the base sum
insured excluding cumulative bonus
m. Wellness Services - We / our Empanelled Service Provider will provide below mentioned wellness
services:
a. Teleconsultation - General
b. Teleconsultation – Specialty
c. Ambulance Booking facility
d. Emergency Help me feature
e. Redeemable voucher/Discount on services
f. Health Condition Management
n. Wellness Program - We / our empanelled service provider will provide a wellness program designed to
promote wellness and �tness amongst the insured persons through:
a. Health risk assessment
b. Wellness Rewards: Wellness Reward accumulated through �tness activities can be converted into
monetary value and can be utilized towards the payment of services/items under below categories,
available through our Network/ empanelled service provider:
• OPD consultation/ treatment
• Pharmaceuticals
• Health-check-ups/ diagnostics
• Health Supplements
• Coverage of cost of treatment of any admissible claim in respect of non-payable items that are
speci�ed under the terms and conditions of the base policy
o. Tax Bene�t: The premium amount paid under this policy quali�es for deduction under Section 80D of
the Income Tax Act.
3. Discounts on premium:
a. 10% long term discount on premium in case insured opts policy term of 3 years
b. 5% long term discount on premium in case insured opts policy term of 2 years
2
Tata AIG General Insurance Company Limited
Registered O�ce: Peninsula Business Park, Tower A, 15th Floor, G. K. Marg, Lower Parel, Mumbai- 400013, Maharashtra, India
24x7 Toll Free No. 1800 266 7780 or 1800 22 9966 (Senior Citizen) • Email: customersupport@tataaig.com • Website: www.tataaig.com
IRDA of India Registration No.: 108 • CIN: U85110MH2000PLC128425 • Tata AIG MediCare Premier UIN: TATHLIP23167V032223
