1 Crore Health Insurance

With the rising likelihood of critical diseases, health insurance with a lesser sum insured may not be adequate in the event of terminal or critical sickness. With the growing incidence of life-threatening illnesses in India, a 1 crore insurance coverage has become nothing short of a necessity.

"1 crore" is a term used in India to refer to a sum insured of 10 million rupees, equivalent to 100 lakh rupees. Therefore, a 1 CR medical Insurance plan is a health insurance policy that provides coverage of up to 1 crore rupees for medical expenses incurred by the policyholder.

This type of Health Insurance policy is designed to offer high coverage to individuals and their families for medical treatments and hospitalisation expenses. It may cover hospitalisation, surgeries, medical tests, doctor consultations, and other healthcare-related expenses.

A 1 crore health insurance policy can be purchased as an individual or family floater covering multiple family members. The premium for such policies may be higher than that for lower coverage policies. Still, they offer higher financial protection and peace of mind in the event of unexpected medical emergencies or health issues.

To understand how this works, let us understand this with an example:

1. Rahul, a 40 year old software engineer, chooses a TATA AIG Health Insurance policy with a ₹1 Crore sum insured to protect his family.

2. Rahul pays his yearly premium on time, which keeps his full ₹1 Crore coverage active throughout the policy term.

3. During the year, Rahul can utilise benefits such as cashless check-ups, preventive healthcare services, and tax savings under Section 80D.

4. Later, Rahul experiences a sudden health issue and needs urgent hospitalisation. He immediately raises a claim through TATA AIG.

5. Rahul visits a network hospital and receives treatment without paying out of pocket. TATA AIG settles the hospital bills directly.

Also Read: 10 Lakh Health Insurance: Types, Benefits, Eligibility & More

Rising Healthcare Expenses

Medical treatments in India are becoming costly every year. Emergency hospitalisation, complex surgeries, and advanced therapies can quickly increase expenses. A ₹1 crore Health Insurance plan provides a strong financial cushion against these growing costs.

Wide and Comprehensive Coverage

A high sum insured offers extensive medical care, including major surgeries, hospitalisation, diagnostics, and post-treatment recovery expenses. There can be significant coverage, ensuring your focus stays on healing, not bills.

Critical Illness Protection

Treatments for conditions like cancer, cardiac illness, or kidney failure require long-term care and significant funds. Our ₹1 crore health insurance plan covers up to 100 critical illnesses, making high-quality treatment affordable.

Restore Benefit

If you exhaust your sum insured amount, we will restore an extra amount equal to your base cover once in the same year. You can use it for related issues after 45 days.

Family-Wide Security

Family floater plans allow you to cover multiple members under a single ₹1 crore policy. This delivers broad protection for your loved ones and preserves your savings for other life goals.

Extra Wellness Benefits

High-coverage plans often include annual health check-ups, wellness programmes, and fitness incentives. This encourages a proactive approach to healthcare and long-term well-being.

Tax Savings

The 1 crore health insurance premium that you pay is eligible for tax deductions under Section 80D.

Protection Against Future Inflation

Healthcare costs continue to surge. Opting for high coverage today protects you from rising medical inflation and future treatment expenses.

Lifelong Renewal

Enjoy lifelong renewability with our ₹1 Crore health insurance plan, ensuring continuous protection when your policy stays active.

Global Cover

You can receive treatment abroad for planned hospitalisation if the diagnosis is done in India. When you opt for our plans offering coverage of ₹1 crore, you are also eligible for coverage of reasonable visa expenses for medical travel.

Wide Hospital Network

You can receive treatment at over 12,000+ network hospitals across India. This provides you with high-quality care and faster cashless claims with lesser documentation across the country.

Organ Donor Expenses

You can get cover for medical and surgical expenses related to the organ donor when the insured undergoes an organ transplant.

Home Care Treatment Cover

We will take care of the medical costs for certain treatments you need to undergo at home, such as home dialysis, home chemotherapy, etc. We also cover pre- and post- hospitalisation costs for the domiciliary treatment.

High End Diagnostics Cover

Our ₹1 crore plans, such as the MediCare Premier plan, also cover the costs of high-end diagnostic tests up to the SI on an OPD basis that are part of the treatment. It includes tests like brain perfusion imaging, CT-guided biopsy, CT urography, DSA, liver biopsy and more.

Emergency Air Ambulance Cover

Get coverage for the cost of air ambulance transport by an aeroplane or helicopter in case of a medical emergency.

Dental Treatment

We will cover hospitalisation expenses for dental treatment under anaesthesia if necessary due to an accident, injury, or illness. Our plans also include OPD dental care done for select treatments.

Second Opinion & Consumables Cover

If you need a second medical opinion for any listed illnesses, and coverage for consumables used during treatment, you can get this with a TATA AIG health plan.

Preventive Health Check-ups

Receive coverage for preventive health check-ups up to 1% of the previous year’s sum insured of up to ₹10,000 once in two continuous claim-free years on a cashless basis.

Bariatric Surgery Cover

You also get coverage for medically prescribed bariatric surgery under our MediCare Premier plan, offering coverage of up to the sum insured, as per the policy terms and conditions.

Also Read: Health Insurance Plans for Family

Medicare Plus

The TATA AIG MediCare Plus plan provides you and your family with strong protection in any medical emergency with coverage of up to ₹1 crore. The comprehensive health plan helps cover essential expenses such as day-care treatments, pre- and post-hospitalisation costs, and organ transplants.

This also pays for home treatment when hospitalisation is not possible, as well as AYUSH and emergency ambulance services. With the help of this policy, you get access to more than 12,000+ hospitals in India for cashless treatment. In addition to the one crore Health Insurance cover, you also get worldwide treatment and renewal benefits like preventive health check-ups and 50% of the SI as bonus for every claim-free year up to 100%.

Medicare Select

With the TATA AIG MediCare Select, you can choose coverage from ₹5 lakh up to ₹3 crore, based on your comfort and needs. The plan covers everything from hospital stays and 540+ daycare treatments to AYUSH care and organ donor expenses.

It also covers medical costs before and after hospitalisation, and even offers daily cash if you choose shared rooms. There are benefits such as an attractive family plan, lifelong renewal, no claim-based premium discounts, long-term discounts, maternity add-on options, and flexible room and deductible choices.

Medicare Premier

For individuals and families who want complete coverage with a premium standard of care, TATA AIG MediCare Premier is the best option available. You can get essential benefits such as hospitalisation, daycare procedures, organ donor expenses, and AYUSH treatments.

Additionally, there are advanced benefits such as bariatric cover, planned treatment outside India, vaccinations
for newborns, hearing aid benefit, dental cover, maternity care, OPD and air ambulance support. You can also get wellness rewards, enjoy no-claim bonuses, and benefit from lifelong renewals.

TATA AIG Criti MediCare

TATA AIG Criti Medicare is a special plan created for people who want strong financial backing against 100 serious illnesses like cancer and life-threatening conditions. It provides flexibility to choose from various sections, like critical illness payout, cancer-focused coverage, and daily hospital cash.

This plan gives you flexible coverage with 3 plan options and optional benefits with varying SI and coverage. You can choose Critical Illness cover or a Cancer 360° (Indemnity Cover), ranging from ₹5 lakh up to ₹2 crore. If you require daily support during hospital stays, you can opt for the Hospital Cash benefit, ranging from ₹500 to ₹20,000 per day.

The plan lets you claim for critical illnesses more than once, as long as each claim is from a different category and within the policy term. There are also benefits, such as premium waivers and discounts, for long-term policies.

Also Read: Super Top Up Health Insurance Plans by TATA AIG

A ₹1 crore Health Insurance plan is the ideal option for individuals seeking substantial financial security. Here are the different groups that benefit the most from this Health Insurance:

Purchasing a health insurance of 1 crore involves considering several factors and doing the necessary calculations to determine the premium and benefits of the policy. Here are some of the key mathematical considerations when purchasing a 1 crore health plan:

• Premium Calculation: The premium for a 1 crore health insurance is calculated based on various factors, including age, medical history, lifestyle habits, family history, and the type of plan chosen (individual or family floater). A 1 crore health plan premium is typically higher than those for lower coverage policies.

• Sum Insured Calculation: A 1 crore plan provides coverage up to a maximum sum insured of 1 crore rupees. It is essential to assess your healthcare needs and expenses to determine the amount of insurance that adequately covers your medical expenses.

• Deductible Calculation: Some health insurance plans have a deductible, which is the amount the policyholder must pay before the insurance policy begins to take effect. Deductibles can affect the policy's premium, and it is important to calculate the deductible amount you can afford.

• Co-payment Calculation: Some health insurance policies require a co-payment, which is a percentage of the medical expenses that the policyholder must pay out of pocket. Co-payments can affect the policy premium, and it is essential to calculate the co-payment amount you can afford.

• Tax Benefit Calculation: Premiums paid for a 1 crore insurance are eligible for tax deductions under Section 80D of the Income Tax Act, 1961. Calculating the tax benefit you can avail of is important based on the premium paid for the policy.

Before purchasing any health insurance policy, it is important to carefully review the terms and conditions, including coverage limits, exclusions, deductibles, and other details. By doing the necessary calculations and understanding the benefits and costs of the policy, you can make an informed decision about purchasing a 1 crore health plan.

• Gender: Premiums for men and women differ significantly. This is because most health risks vary between genders.
• Age: Younger people always have to pay lower premiums because they tend to face much less health issues. As they grow older, the probability of health issues increases, which in turn increases the premium.
• Policy Duration: There is a difference between short-term and long-term policy premiums. Having a long-term policy (such as 2 or 3 years) may offer better discounts compared to renewing annually.
• Type of Plan You Choose: Whether you opt for an individual plan or a family floater one, as well as the add-on benefits you select, will influence the premium cost. Higher coverage and extra features will result in a higher 1 cr health insurance premium.
• Your Health and Medical History: If you have existing health issues and certain lifestyle habits, it can increase your premium. Similarly, if there is a history of chronic illnesses in your family, it may result in a higher premium.
• Number of Family Members: Adding more family members to your plan gives everyone protection, but it also increases the cost.
• Sum Insured: A higher coverage amount provides more security, but it also increases the premium.
• Occupation: The nature of your work and related risks impact premium charges. For example, if you work in a factory with a high risk of injury, your premium will be higher.

When applying for a ₹1 cr health insurance policy, you will need to provide certain documents to verify your identity, health history, and eligibility. Here are some of the most important documents you must provide:

• Address proof documents such as Voter ID, Passport, Utility Bills, Rent Agreement, or Aadhaar Card.
• Identity proof documents such as PAN Card, Passport, Driving Licence, or Aadhaar Card.
• If you require higher coverage, such as ₹1 crore, you must provide income proof documents, including bank statements, salary slips, Income Tax Returns, or Form 16.
• Age proof such as a Passport, School Leaving Certificate, Aadhaar Card, or Birth Certificate.
• If you have an existing policy, you will also need to provide your previous policy documents and a record of your renewal history.
• Provide medical records, such as existing prescriptions, medical test reports, and a past health history, if the insurer requests them.

• Step 1: Navigate to the TATA AIG Health Insurance page.
• Step 2: Select the members you want to insure and click on “Get Price.”
• Step 3: Fill in the basic details, such as email ID, mobile number, PIN code, and date of birth, then click “See Plan.”
• Step 4: Browse through the available health insurance plans, compare benefits, and review policy details. Select the option that best suits your needs.
• Step 5: Enter ₹1 crore in the sum insured section and desired policy tenure.
• Step 6: Submit all the necessary documentation mentioned above. Check the premium breakdown and proceed to make the payment online to complete your policy purchase.

Key Inclusions in the 1 Crore Mediclaim Policy

• AYUSH Treatment Cover: Treatments like Naturopathy, Yoga, Ayurveda, Siddha, Homoeopathy, and Unani are also included in the policy.
• Pre and Post-hospitalisation Expenses Cover: It covers the costs of tests, doctor visits, and medications before admission and after discharge. The number of days will be mentioned in your plan.
• COVID-19 Cover: If there are any hospitalisation and treatment costs due to COVID-19, they are covered as per the policy terms.
• Daycare Surgery: Smaller procedures, such as cataract surgery or tonsil removal, that do not require a full day in the hospital, are also covered.
• Hospitalisation Expenses Coverage: The policy covers your hospital bills if you fall ill or are injured and require any medical care.
• Existing Diseases Cover: If you are seeking treatment for an existing health condition, your coverage will begin after a waiting period of 24-36 months.
• Ambulance Services Cover: These plans cover emergency ambulance trips and transfers to another hospital for medical care.
• Global Cover: If you are diagnosed in India but require treatment overseas, the policy provides coverage. Your claims will be reimbursed, and if you visit a network hospital, cashless payment is possible. For higher sum-insured plans such as the ₹1 crore insurance, visa costs may also be supported.
• Preventive Health Check-ups: There are plans that offer regular preventive check-ups to help you identify and prevent potential health conditions.
• Homecare Treatments: If treatment at home becomes medically necessary, those expenses are covered too. These treatments can be home-based dialysis, chemotherapy, nursing care, or injections.
• OPD Dental Care: Depending on your policy terms and selected add-ons, we cover selected OPD dental procedures related to Root Canal treatment, tooth extraction(s) or filling.
• Infertility Treatment Cover: IVF and other fertility treatments can be covered with the optional add-on of EmpowerHer.

Key Exclusions in the 1 Crore Mediclaim Policy

• Illnesses from Radiation: If there are illnesses or injuries caused by radiation exposure, nuclear events, or related hazards, these are not covered in the policy.
• Cosmetic Surgery Expenses: Cosmetic surgeries or beauty-enhancement treatments are also not included. However, if a procedure becomes necessary due to an accident or medical reason, it may be covered by the policy.
• Suicide or Self-inflicted Injuries: If any treatment is needed because of attempted suicide or intentional self-harm, it is not covered under the policy.

Please Note: All inclusions and exclusions vary by the plan, riders added and policy wordings. Always review the document to get complete clarity.

Cashless Claim Process for Planned (Non-Emergency) Treatment

• Step 1: Submit your cashless claim form via email at least 48 hours before the admission. You may also need to send a written intimation.
• Step 2: Once we verify your request, we will send you a confirmation letter and inform the hospital.
• Step 3: Bring your health card to the hospital and submit the confirmation letter to the hospital desk on the day of admission.

Cashless Claim Process for Emergency Treatment

• Step 1: Submit the cashless claim form within 24 hours of admission, along with the following documents such as a photo ID and address proof, a policy copy and insurance card, and a CKYC form.
• Step 2: Once your application is verified, we will send an authorisation letter to the hospital and settle bills directly.

Claim Process for Reimbursements

• Step 1: Submit the reimbursement forms along with the original bills, discharge papers, medical reports, FIR (in cases of accidents) and bank details.
• Step 2: We will verify all your documents and application, and send the eligible amount to your bank account.

Several factors must be considered when purchasing medical insurance with a higher sum insured. Here are some key ones:

• Premiums: A higher sum insured typically means higher premiums. You need to ensure that you can afford the premiums and that they fit your budget.
• Co-payments: Some policies come with co-payments, meaning you must pay a percentage of the total bill. Ensure you understand the co-payments and how they work.
• Deductibles: Some policies come with deductibles, meaning you must pay a certain amount before the insurance kicks in. Ensure you understand the deductibles and how they work.
• Network Of Hospitals: Ensure the policy covers hospitals you trust and can conveniently access. Also, check if the policy has tie-ups with hospitals abroad, if that is something you need.
• Pre-Existing Conditions: If you have any pre-existing conditions, ensure the policy covers them. Some policies have waiting periods before pre-existing conditions are covered.
• Exclusions: Check the policy's list of exclusions to ensure no surprises. For example, some policies may not cover certain treatments or procedures.
• Claim Settlement Process: Check the claim settlement process and the company's track record for settling claims. You want to ensure you are not stuck with a lengthy and complicated process in a medical emergency.
• Riders: Some policies offer additional riders, such as critical illness or personal accident cover. Consider whether these riders would be useful to you and if they are worth the additional cost.
• Renewal Process: Review the policy's renewal process to determine if there are any penalties or restrictions associated with renewing the policy.

High medical inflation and the advancements in the medical sector have made it essential to have robust health insurance. And, the ₹1 crore Health Insurance plan is precisely the plan you need. It protects you from the steep bills and helps you with long-term treatments. However, you must choose a policy not only based on the sum assured but also on whether it aligns with your family's needs, lifestyle, and financial situation.

Adding health insurance to your portfolio further prepares your finances and offers complete protection against future uncertainties. Investing in the best Health Insurance today leads to peace of mind tomorrow. Having the right medical insurance plan from TATA AIG helps you not worry about bills.

Choose smart with TATA AIG’s ₹1 Crore health plan. With the plan’s extensive benefits, you can get access to a wide hospital network, global treatment options, and a seamless claims experience. TATA AIG helps you stay ready for life’s unexpected moments. Contact us to buy Health Insurance and protect your family’s future.