Arogya Sanjeevani Health Insurance

Are you looking for an excellent health insurance plan? Then you have come to the right place! At Tata AIG, we offer medical insurance policies with extensive coverage and affordable premiums, and our Arogya Sanjeevani Health Insurance Policy could be the medical insurance plan you are looking for.

Key Highlights of Tata AIG Arogya Sanjeevani Health Insurance

  • Here are the key highlights of Tata AIG's Arogya Sanjeevani Health Insurance Plans.
  • Access to Cashless Insurance at 7,200+ Network Hospitals
  • 94.43 per cent Health Insurance Claim Settlement Ratio for FY20-21
  • 4.5/5 Customer Ratings
  • Coverage for Pre-hospitalisation, hospitalisation, and Post-Hospitalisation Expenses
  • Lifelong Renewals
  • Cumulative Bonus

UIN: TATHLIP20169V011920

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What Is Arogya Sanjeevani Policy?

Arogya is an ancient Sanskrit word that refers to a holistic approach to health, that is, a healthy mind, body, and soul. The philosophy of Arogya, or 'free from diseases', encompasses the significance of overall health and well-being in the life of any individual. Since the present times pose a wide gamut of health-related challenges to all of us, the importance of Arogya cannot be overstated.

Although you have very little control over the occurrence of diseases, infections, and accidents, you can control your level of preparedness against such threats. And to help you do that, the Insurance Regulatory and Development Authority of India (IRDAI) has launched the Arogya Sanjeevani Health Insurance Policy.

The Arogya Sanjeevani Policy is a basic health insurance plan that comprises medical insurance coverage for hospitalisation and several other medical expenses. In order to make an affordable health insurance option available for everyone, the IRDAI has directed all the leading insurance companies in India to design and offer a basic health insurance plan by the name of Arogya Sanjeevani.

The coverage for Arogya Sanjeevani plans includes pre-hospitalisation, hospitalisation, and post-hospitalisation expenses, along with the bills for doctor's consultation and nursing care. In times as unprecedented and unpredictable as the ones we find ourselves in, it is more important than ever before to have at least a basic health insurance plan.

Therefore, you must consider purchasing an Arogya Sanjeevani Policy and ensuring financial protection against basic health-related expenses. The Tata AIG Arogya Sanjeevani Health Insurance Policy is an excellent health insurance policy with several benefits. You can carry out Tata AIG Health Insurance Policy Renewal or purchase on our website and select the best medical insurance policy as per your health insurance requirements.

Reasons To Choose the Tata AIG Arogya Sanjeevani Health Insurance Policy

The Tata AIG Arogya Sanjeevani Health Insurance Policy is packed with excellent benefits and the commitment of one of India's most trusted brands. Here is why you should choose our Arogya Health Insurance Policy.

Wide Range of Benefits: The Tata AIG Arogya Sanjeevani Medical Insurance Plan provides you with a wide range of medical insurance benefits, including coverage for hospitalisation expenses, pre and post-hospitalisation expenses, cataract treatment, and AYUSH treatment.

Access to 7,200 Hospitals for Cashless Insurance: By selecting the Tata AIG Arogya Sanjeevani Health Insurance Policy, you can get access to cashless insurance at our nationwide network of partner hospitals.

One Plan for Your Entire Family: With the Tata AIG Arogya Sanjeevani Health Insurance Plan, you can cover your entire family under the umbrella of one medical insurance plan. This keeps your health insurance coverage centralised and also enables you to save in terms of money and effort.

Cumulative Bonus: For every claim-free year in your Tata AIG Arogya Sanjeevani Health Insurance Policy, you can have an enhancement in your sum insured by 5 to 50 per cent without having to pay any additional premium. However, you are eligible for this cumulative bonus only if your policy gets renewed without any break or lapse.

The Key Features of Arogya Sanjeevani Health Insurance By Tata AIG

Here are the main features of the Tata AIG Arogya Sanjeevani Scheme:

Benefits Galore: With the selection of our Arogya health insurance, you get access to several benefits, including in-patient hospitalisation cover, AYUSH cover, coverage for specific surgical procedures, etc. You can check your Arogya Sanjeevani Policy Details to know about the entire range of covers available under this plan.

Wide Network of Hospitals: To make your health insurance claims experience easier and smoother and be of aid to you in times of great difficulty, we have partnered with more than 7,200 hospitals across India. Filing cashless claims is a hassle-free process that can be completed online.

Lifelong Renewals: At Tata AIG, we are true to our promise of 'With You Always'. You can, therefore, be assured of lifelong renewals of your Arogya Insurance as long as you uphold your Arogya Sanjeevani Policy Premium payment obligations on a timely basis.

Cumulative Bonus: If you do not file a health insurance claim on your Arogya health insurance during a policy year, you become eligible for an increase in the sum insured under your policy. We offer a 5 to 50 per cent enhancement in your sum insured for every claim-free policy year.

Tax Benefits: Under Section 80D of the Income Tax Act, 1961, you can claim a tax deduction of ₹25,000 on the premiums paid towards your Arogya insurance plan. This sum increases to ₹50,000 if the premium is being paid for a policy benefitting a senior citizen.

Flexible Frequency of Premium Payment: You can choose to make your Arogya Sanjeevani Policy Premium payment on a yearly, half-yearly, quarterly, or monthly basis as per your convenience. This flexibility can help you manage your financial obligations better.

Benefits of Arogya Sanjeevani Health Insurance By Tata AIG

The Tata AIG Arogya Sanjeevani Policy has no dearth of benefits. By choosing our Arogya Sanjeevani plan, you get the following benefits: Health Insurance With a TATA Promise: At Tata AIG, we have a relentless commitment to upholding the highest standards in product and service delivery. The world-renowned TATA promise is a matter of immense privilege as well as responsibility for us, and we are dedicated to fulfilling it every step of the way through our customer engagement. Health Insurance You Can Keep Renewing: We offer lifetime renewals on our Tata AIG Arogya Sanjeevani Health Insurance Policy, which means that you do not have to worry about having to find a new health insurance policy after attaining a certain age.

Health Insurance For Your Entire Family: With the Tata AIG Arogya Sanjeevani Health Policy, you can get excellent medical insurance coverage not only for yourself but also for your family members. There is an option to add your parents, legally wedded spouse, children, and parents-in-law under the ambit of the plan. Therefore, you can have one centralised health insurance plan for your whole family.

Health Insurance at Feasible Premiums: Our Arogya Sanjeevani Policy is available at a cost-effective premium, which means that your Arogya Sanjeevani Policy Premium is unlikely to put a huge dent in your financial obligations. Health Insurance With Excellent Coverage: The Tata AIG Arogya Sanjeevani Health Insurance Policy enables you to have coverage for daycare procedures, ambulance expenses, hospitalisation expenses, pre-hospitalisation expenses, and post-hospitalisation expenses.

Health Insurance With Cashless Claims: If you select a Tata AIG Arogya Sanjeevani health insurance plan, you can avail of cashless insurance at more than 7,200 hospitals across the country. The flexibility of being free from cumbersome claims processes can lend a substantial helping hand in your speedy recovery.

What Is Included In Your Tata AIG Arogya Sanjeevani Health Insurance?

It is incredibly important to understand what is covered by your Tata AIG Arogya Sanjeevani Health Insurance. Here are the inclusions in your Arogya Sanjeevani Policy.

Coverage for Hospitalisation Expenses: With the Tata AIG Arogya Sanjeevani Health Insurance Policy, you get the benefit of a cover for your hospitalisation expenses, subject to the ceiling of your sum insured and the applicable cumulative bonus. This cover includes, amongst others, the following expenses.

  • Room Rent
  • Nursing Expenses
  • Intensive Care UNIT Charges
  • Intensive Cardiac Care Unit Charges
  • The Fees paid to Surgeons, Anesthetist, Medical Practitioners, and Consultant
  • Operation Theatre Charges
  • The Expenses for Medicines
  • The Cost of Diagnostics
  • The Cost of Daycare Treatments
  • The Cost of Dental Treatment Rendered Necessary By a Surgery or Disease
  • The Expenses for the Treatment of Cataracts subject to the sub-limits mentioned in the policy
  • Coverage for Ambulance Expenses

Coverage for AYUSH Treatment: Your Tata AIG Arogya insurance encompasses a cover for the in-patient treatments conducted under the Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medical treatment. This cover is subject to the sum insured in your Arogya Sanjeevani plan. You can receive this treatment at any AYUSH hospital.

Coverage for Cataract Treatment: Your Tata AIG Arogya Sanjeevani Health Insurance Policy includes a cover for Cataract Treatment. This cover is limited to 25 per cent of the sum insured or ₹40,000, whichever is lower and is applicable for Cataract Treatment for each eye in one policy year.

Coverage for Pre-hospitalisation Expenses: With our Arogya Sanjeevani Health Insurance Policy, you can also benefit from a pre-hospitalisation cover of 30 days. This cover is applicable for the medical expenses incurred due to a condition or disease for which in-patient hospitalisation subsequently takes place.

Coverage for Post-Hospitalisation Expenses: In addition to hospitalisation and pre-hospitalisation cover, the Tata AIG Arogya Sanjeevani Policy also provides you with a cover for post-hospitalisation expenses for a period of 60 days following discharge from a hospital for an admissible disease or condition (as mentioned in the policy).

Coverage for Specified Surgical Procedures: Your Tata AIG Arogya Sanjeevani Policy covers a specific list of medical procedures, either as in-patient treatment or daycare procedures. For these procedures, you are eligible for coverage up to 50 per cent of the sum insured under your policy. Here is the list of the specific medical procedures covered under your Arogya Sanjeevani Health Insurance Policy.

  • Uterine Artery Embolization and HIFU (High intensity focused ultrasound)
  • Balloon Sinoplasty
  • Deep Brain Stimulation
  • Oral Chemotherapy
  • lmmunotherapy - Monoclonal Antibody to be given as an injection
  • Intra Vitreal Injections
  • Robotic Surgeries
  • Stereotactic Radio Surgeries
  • Bronchial Thermoplasty
  • Vaporisation of the Prostate (Green laser treatment or holmium laser treatment)
  • ION M - (Intra Operative Neuro Monitoring)

Stem Cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered

Coverage for More Medical Expenses: The Tata AIG Arogya Sanjeevani Health Insurance Policy also has coverage for some other medical expenses, which are mentioned in Lists II to IV of Annexure A to the policy document. These include the expenses that are to be categorised under room charges, procedure charges, and cost of treatment, respectively.

Enhancement of Sum Insured: For each year that you do not file a health insurance policy claim on your Arogya insurance with us, you can get a 5 to 50 per cent enhancement in your sum insured under the policy. However, if you wish to be eligible for this benefit, you must ensure the timely renewal of your Arogya Sanjeevani Health Insurance Policy.

For a deeper understanding of the coverage of your Tata AIG Arogya Sanjeevani Health Insurance Policy, it is advisable to refer to the policy wordings.

Who is Eligible For Arogya Sanjeevani Health Insurance?

Before selecting our Arogya Sanjeevani Policy, you must ascertain whether you are eligible for it. Here are the eligibility criteria for the Tata AIG Arogya Sanjeevani Health Insurance Policy.

Age: If you fall within the age group of 18 to 65 years, you can enrol in our Arogya Health Insurance plan as Proposer. However, if you are older than 65 years but wish to purchase the Arogya Sanjeevani plan for your family members, you can do so. In such a case, you cannot be covered by the benefits of the plan.

Who Can Be Covered?: You can bring the following family members under the umbrella of the coverage of a Tata AIG Arogya Sanjeevani Health Insurance Policy.

  • Legally Wedded Spouse
  • Parents
  • Parents-in-law
  • Dependent Children (Natural as well as legally adopted) between the ages of 3 months and 25 years

It is important to note here that if your child is a financially independent adult, they shall not be eligible for coverage in the Tata AIG Arogya Sanjeevani Policy upon subsequent renewals

Explore Our Simple and Hassle-free Claims Process

At Tata AIG, we have a simple and seamless claims process to make the claims experience as hassle-free as possible for you. If you choose to receive treatment at one of our network hospitals in India, you can benefit from cashless claims. However, if you choose a non-network hospital, there is no need to worry. You can file a reimbursement claim with us.

Here is how you can file a cashless claim and a reimbursement claim with us for your Arogya Sanjeevani Health Insurance Policy.

Cashless Claims for Treatment at a Network Hospital: If you receive medical treatment at one of our 7,200+ network hospitals across the country, you can file a cashless insurance claim with us under your Arogya Sanjeevani plan within 24 hours of being hospitalised. If the hospitalisation is pre-planned, you must inform us at least 48 hours prior to your admission to the hospital.

  • Once we have received your claim form, we shall issue a Claim Intimation / Reference Number to you. Here are the documents required to be submitted for a cashless claim.
  • A copy of your health insurance policy
  • Your photo identity card and address proof
  • Your insurance card
  • A duly filled CKYC form (only required if the claim is in excess of ₹1 lakh)

After the receipt of the aforementioned documents, we will issue an authorisation letter to the concerned network hospital and settle your hospitalisation bill with them. All you need to worry about is your recovery!

Reimbursement Claims for Treatment at a Non-network Hospital: If you receive treatment at a hospital outside our network of partner hospitals, you have to pay the bills for the hospitalisation expenses yourself and subsequently file a reimbursement claim with us. You can submit your Arogya Insurance reimbursement claim with us accompanied by the following documents.

  • Your photo identity proof
  • A Medical Practitioner's prescription as proof of your hospital admission
  • The original hospital bills with bifurcation for various expenses
  • The relevant payment receipts
  • Documentary evidence containing your discharge summary and complete medical history
  • The necessary diagnostic test reports
  • OT Notes or Surgeon's Certificate (in case of surgeries)
  • A copy of the First Information Report (in case of accidents and if otherwise applicable)
  • Legal heir/succession certificate (if applicable)
  • A duly filled CKYC form (only required if the claim is in excess of ₹1 lakh)
  • Your NEFT details for the reimbursement

Once we have received the documents mentioned above, along with your health insurance claim form, we will verify all the documents and settle the claim within fifteen to thirty days, depending on the type of the claim (hospitalisation claim or post-hospitalisation claim). You can submit your Arogya Sanjeevani Health Insurance Claim at the Tata AIG claims page.

What's More?

In addition to our Arogya Sanjeevani Health Insurance Plan, you can peruse our other excellent health insurance plans, which are as follows:

The Tata AIG MediCare Health Insurance Plan for Individual Health Insurance, Family Health Insurance, and Personal Accident Insurance

The Tata AIG MediCare Plus Health Insurance Plan for Super Top-up Health Insurance

The Tata AIG Coronavirus Health Insurance, also known as the Tata AIG Corona Kavach Plan

Get Answers To The Common Questions

If you have any questions or doubts about the Tata AIG Arogya Sanjeevani Health Insurance Policy, we have got you covered. Here are the most frequently asked questions about Arogya Sanjeevani.

General Questions:

What is the sum insured available under Arogya Sanjeevani? Under the Arogya Sanjeevani Health Insurance Policy, you can opt for a sum insured between ₹1 lakhs and ₹5 lakhs.

What is the policy tenure of Arogya Sanjeevani? The Tata AIG Arogya Sanjeevani Insurance Policy has an initial tenure of one year. However, you can subsequently renew this policy on a lifelong renewal basis.

What is the age criteria for enrolment in the Arogya Sanjeevani Insurance Policy? Individuals between the ages of 18 and 65 years can enrol in the Arogya Sanjeevani Health Insurance Policy as a proposer. However, individuals older than 60 years can buy the plan for their family members younger than 60 years without including themselves in the coverage.

Which familial relations are covered under the Arogya Sanjeevani Health Insurance Policy? You can bring your parents, parents-in-law, legally wedded spouse and dependent children (3 months to 25 years old) under the ambit of the Arogya Sanjeevani Insurance Policy.

Coverage-related Questions:

What is the coverage provided by the Arogya Sanjeevani Scheme? The Arogya Sanjeevani Health Insurance Policy covers, amongst other benefits, hospitalisation expenses, pre-hospitalisation expenses, post-hospitalisation expenses, expenses for daycare procedures, and an ambulance cover.

Are Maternity Expenses covered under the Tata AIG Arogya Sanjeevani Health Insurance Policy? No, maternity expenses are not covered under the Tata AIG Arogya Sanjeevani Health Insurance Policy. However, ectopic pregnancies and miscarriages resulting from accidents are exceptions to this rule.

Does the Tata AIG Arogya Sanjeevani Insurance Policy cover cosmetic surgery? No, the Tata AIG Arogya Sanjeevani Insurance Policy does not cover cosmetic or plastic surgery unless when such procedures are mandated in treatments for cancer, burns, or accidents.

What is the Waiting Period for pre-existing diseases in a Tata AIG Arogya Sanjeevani Health Insurance Policy? The Tata AIG Arogya Sanjeevani Health Insurance Policy has a waiting period of 48 months for pre-existing diseases. This means that the expenses for the treatment of such diseases are not covered for the initial 48 months of the operation of the policy.

Premium-related Questions:

Does the premium of the Tata AIG Arogya Sanjeevani Policy vary depending on the geographical location of the policyholder? No, the premium of the Tata AIG Arogya Sanjeevani Kavach Health Insurance Policy does not vary on the basis of the geographical location of the policyholder.

How much of the premium for the Arogya Sanjeevani Health Insurance Policy Qualify for Tax Benefits? Section 80D of the Income Tax Act, 1961 mandates that health insurance premiums are eligible for tax deductions to the tune of ₹25,000 for assessees below the age of 60 years and ₹50,000 for assessees above the age of 60 years. Therefore, if you are in the former age bracket, you can claim a maximum tax deduction of ₹25,000 for your

Arogya Sanjeevani Policy Premium purchased for yourself, your spouse, or your dependent children. If one or more of the beneficiaries under the policy, including your parents and parents-in-law, are older than 60 years, you can claim a further tax deduction of ₹50,000 on the premium paid for the plan.

Service-related Questions:

Can I avail Cashless Insurance for the Tata AIG Arogya Sanjeevani Health Insurance Policy? Yes, you can avail of cashless insurance for the Tata AIG Arogya Sanjeevani Policy. If you select one of our 7,200 plus network hospitals across India for treatment and/or hospitalisation, you become eligible for filing a cashless claim with us. You will not have to pay any bills for the associated expenses as we will settle those directly with the partner hospital.

What can I do if I face any issues while filing a claim for my Tata AIG Arogya Sanjeevani Health Insurance Policy? If you hit a roadblock, big or small, whilst filing your Tata AIG Arogya Sanjeevani Health Insurance Claim, we are always available to extend the necessary support to you. You can benefit from the expertise of our 650 plus claims experts and contact them through one of the following means.

What are the benefits of filing an online claim for my Tata AIG Arogya Sanjeevani Health Insurance Policy? There are several benefits of filing an online claim for your Tata AIG Arogya Sanjeevani Health Insurance Policy. By doing so, you can save on time, effort, and anxiety. Our online claims process is extremely simple, smooth, and streamlined and has been designed to make the claims experience smooth and convenient for you.

Exclusions

Exclusions

Just as you must have clarity on what is covered by your Tata AIG Arogya Sanjeevani Policy, you must also know what is not covered by it. Here are the major exclusions from your policy.

Standard Exclusions from the Tata AIG Arogya Sanjeevani Health Insurance Plan

Exclusions for Waiting Periods for specific conditions: If you incur a medical expense for a condition for which the waiting period mentioned in the policy is yet to expire, said expenses will not be covered by the policy. This includes:

Waiting period for Pre-existing Diseases: The expenses pertaining to the treatment of pre-existing diseases are subject to a waiting period of 48 months from the inception of the policy (encompassing continuous policy coverage).

Waiting Period for Specified Conditions: The waiting period for several specified medical conditions and surgeries lasts 24 to 48 months from the beginning of the continuous coverage of the policy. The procedures with a 24-month waiting period include Benign ENT Disorders, Cataract and age-related eye ailments, Benign Prostatic Hypertrophy. The procedures with a 48-month waiting period are Age-related Osteoarthritis and Osteoporosis and the treatment for the replacement of joints (except when it's accident-induced).

First Thirty-day Waiting Period: During the initial thirty days of the term of your Arogya Health Insurance Plan, you shall not be eligible for any medical coverage except the expenses arising out of the treatment for accident-induced injuries. If, however, you have continuous coverage for a period exceeding 12 months, you shall be exempt from this waiting period.

Medical Exclusions

Expenses for Investigation and Evaluation: The expenses incurred for hospital admission for the purpose of medical evaluation or diagnostics shall be beyond the coverage of your Sanjeevani Health Care plan. Furthermore, any diagnostic expenses not related to your ongoing diagnosis or treatment shall also be excluded from your Arogya insurance policy.

Rest Cure, Rehabilitation, and Respite Care: Your Tata AIG Arogya Sanjeevani Health Insurance Policy shall not provide coverage for any expenses related to rest cure, rehabilitation, and custodial care.

Surgeries for the Treatment of Obesity: Any expenses that result from the surgical treatment of obesity shall not be covered by your Sanjeevani Medical plan unless such an expense is specifically advised by a doctor and fulfils the other conditions mentioned in the policy.

Treatments for the Change of Gender: Your Tata AIG Arogya Sanjeevani Policy shall not cover the expenses pertaining to any gender reassignment surgeries or procedures.

Cosmetic or Plastic Surgery: The expenses related to cosmetic or plastic surgery are excluded from the coverage of your Tata AIG Arogya Sanjeevani Health Insurance Policy unless such procedures are required to treat cancer, burns, or accidental injuries.

Expenses for the treatment of Alcoholism, Drug Abuse, or Substance Abuse: The expenses arising out of the treatments for addictions to alcohol or drugs is beyond the coverage of your Arogya Sanjeevani Policy. Expenses related to Maternity: Any medical expenses that are associated with childbirth and the complications thereto are excluded from your Tata AIG Arogya insurance. Ectopic pregnancies, however, are exempt from this exclusion.

Furthermore, the expenses related to the treatment for a miscarriage are also beyond the coverage of this policy unless when a miscarriage occurs due to an accident. If you engage in a legal termination of your pregnancy, any associated medical expenses shall be excluded from your Tata AIG Arogya Sanjeevani Health Insurance Policy.

Treatments received in Nature Cure Clinics or Spas Expenses for the Purchase of Over the Country Dietary Supplements Treatment for the correction of eyesight for a Refractive Error less than 7.5 dioptres Expenses for Unproven Treatments Expenses pertaining to Sterility and Infertility

Non-Medical Exclusions

Expenses arising out of the injuries sustained due to participation in a hazardous or adventure sport The expenses to treat the injuries caused by a nuclear, chemical, or biological attack For more detail on the exclusions in your Tata AIG Arogya Sanjeevani Health Insurance Policy, please refer to the policy wordings.

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