Health Insurance in Shimla

Shimla is known for its weather. The cold winters and mild summers contribute to many health issues, such as respiratory problems and joint pain. Further, medical treatment costs are very high in India, including Shimla.

Without an adequate health insurance plan, individuals need to drain their savings on medical expenses incurred. Further, without a proper medical insurance plan, individuals cannot get access to the best healthcare facilities as treatment costs are high in such facilities.

That is why having the best mediclaim policy in Shimla is crucial to secure against various unforeseen medical situations.

There are various types of health insurance available in the market depending on the person's specific medical need. Some of the best mediclaim policies in Shimla offered by Tata AIG are:**

Individual Health Insurance Plan: This health insurance plan is purchased by an individual to cover their medical expenses. The entire sum insured of the plan provides coverage to the insured person during the policy tenure.

Family Health Insurance Plan: Tata AIG offers best mediclaim policies for families in Shimla. The family health insurance plan provides coverage to all family members listed under the policy. Individuals can add their parents, spouse, and children to the family floater health insurance.

Senior Citizen Health Insurance Plan: This is a specifically designed health insurance for senior citizens, considering their health care needs. This plan includes pre-existing diseases and age-related illnesses.

Critical Illness Health Insurance Plan: This is another health insurance plan offered by Tata AIG that covers various critical illnesses, such as cancer, heart problems, etc.

Super Top-Up Health Insurance: With MediCare Plus or Super Top-Up Health Insurance plan offered by Tata AIG, policyholders can enhance the medical coverage and sum insured in addition to regular health insurance plans.

The health insurance in Shimla comes with various inclusions and exclusions, which are mentioned below:**

Medical Insurance Inclusions

Some of the standard health insurance inclusions are:

Hospitalisation Expenses: Under this, the health insurance plan covers the hospitalisation expenses incurred by the policyholder for the treatment of medical illness and injury covered under the plan.

Maternity Cover: At Tata AIG, we offer maternity cover with a health insurance plan where all maternity related hospitalisation charges, emergency ambulance charges, etc., are covered.

Daycare Procedures: The health insurance plan also offers coverage for daycare treatment and procedures that do not require hospital stay for more than 24 hours.

Pre-existing Disease: The health insurance plan also offers coverage for pre-existing disease such as thyroid, diabetes, heart disease, etc.

Medical Insurance Exclusions

The standard health insurance plan exclusions that insurance providers do not cover are:

Cosmetic Surgery: The health insurance plan does not cover expenses incurred during plastic and cosmetic surgery for beauty enhancement.

Self-Inflicted Injuries: The injuries or illnesses that are self-inflicted are not covered under the health insurance plan.

Obesity Treatments: Expenses incurred for treating obesity and other issues related to weight gain are not covered under the health insurance plan.

Rehabilitation Treatment: Any kind of medical expenses incurred for rehabilitation treatment for substance abuse such as alcohol, drugs, etc are not covered under health insurance plan.

There are various health insurance companies available in Shimla. However, choosing the best health insurance provider can be daunting. Various factors need to be considered while selecting the best mediclaim policy in Shimla.

Sum Insured: The very first thing to look for while choosing the best health insurance in Shimla is a sum insured. The sum insured is the maximum amount an insurance provider will cover for the medical expenses incurred during the policy tenure.

Individuals need to assess the sum insured by considering various factors such as pre-existing medical conditions, number of insured members, etc. It is suitable to choose the plan that offers adequate coverage for the policy tenure.

Claim Settlement Ratio: Another crucial thing to look for while choosing a health insurance company in Shimla is its claim settlement ratio, which is the ratio of approved claims to received claims. A company with a high CSR generally offers hassle-free claim settlement services.

Add-ons and Riders: Another factor to consider while choosing a health insurance plan is the availability of add-ons and riders. These are voluntary offerings that enhance the medical coverage of policyholders.

Waiting Period: The waiting period is another crucial thing to look for while investing in a medical insurance plan. Every medical insurance plan comes with a waiting period, such as the initial waiting period, the pre-existing illness waiting period, and more. It is best to check the waiting period of the policy before making a purchase.

You can purchase health insurance in Shimla online and offline. However, there are various perks of purchasing best medical insurance in Shimla online which are listed below:**

Convenience: One of the primary benefits of purchasing health insurance online is convenience. You can purchase a health insurance plan from the comfort of their homes by visiting the Tata AIG website.

Quick Buying Process: Another benefit of purchasing a health insurance plan online from the Tata AIG website is a quick buying process. Individuals can buy a policy online in a couple of minutes.

Customisation Flexibility: With a unique list of add-ons available, individuals can customise their medical insurance plan based on their healthcare needs.

Paperless Process: By purchasing health insurance online, you do not need to submit any physical documentation. The entire process is digital without any physical paperwork.

When it comes to health insurance companies in Shimla, Tata AIG is a well-known insurance provider that has been in the market for over 20 years. Some of the prominent reasons for choosing a medical insurance plan from Tata AIG are:**

Affordable Plans: One significant benefit of purchasing a medical insurance plan from Tata AIG is cost-effective premiums. We have different health insurance plans available to cater to the specific needs of different age groups within their budget.

Extensive Coverage: Tata AIG's health insurance plans offer extensive coverage to individuals, including ambulance coverage, daycare procedures, AYUSH cover, and more.

Tax Benefits: Another reason to purchase medical insurance from Tata AIG is to get a tax deduction under Section 80D.

Cashless Claims: In medical emergencies, Tata AIG ensures that the policyholder receives cashless claim benefits in healthcare facilities of their choice.

High Claim Settlement Ratio: At Tata AIG, we have a claim settlement ratio of 96.70% during the financial year 2023-2024.

The process of buying and renewing a health insurance plan from Tata AIG is easy. Below are **Step-by-Step procedures for the same:

How to Buy Tata AIG's Health Insurance in Shimla?

Step 1: To buy a health insurance plan, visit the official Tata AIG website.

Step 2: Next, go to the "All Products" section.

Step 3: Now, under "Health Insurance", click on suitable health insurance plans.

Step 4: Now, choose the number of members you want to add under the plan and click on the "Get Price" button.

Step 5: Next, enter the birthdate of the applicant. Then, enter the mobile number, email address, and PIN code.

Step 6: After entering the details, click on the "See Plan" option.

Step 7: As per the details, various plans will appear. Choose the suitable health insurance plans.

Step 8: Include add-ons as per the requirement and click on the "Continue" button.

Step 9: A premium quote will appear on the screen. If a plan meets your requirements, make a payment using your preferred online mode.

Step 10: Upon a successful payment, the health insurance policy will be sent to the registered email address.

How to Renew Tata AIG's Health Insurance in Shimla?

Step 1: To do a health insurance plan renewal in Shimla, open the official Tata AIG website.

Step 2: Next, click on the "Renewal" tab.

Step 3: Now, choose the "Health Insurance"option.

Step 4: Enter the policy number and then click on the "Renew" button

Step 5: Review the existing health insurance policy and add or remove add-ons as needed. Then click on the "Continue" button.

Step 6: The revised premium quotation will appear on the screen. Select your preferred mode of payment and make the payment.

Step 7: After a payment confirmation, a renewed health insurance policy will be sent via email address.

Policyholders have two options for health insurance plan claims in Shimla. Below, we have discussed both procedures in detail.

How to File a Reimbursement Claim?

Step 1: Visit our Claims Process page.

Step 2: Click on “Initiate Claim” and choose the "Health" option.

Step 3: Use your registered mobile number to log into the system.

Step 4: Provide the required personal information, select the claim type as “Reimbursement”, and submit.

Step 5: Upload a few necessary documents, such as lab reports, doctors’ prescriptions, hospital bills, discharge summaries, etc., and submit the request.

Step 6: We verify the details thoroughly and reimburse the amount based on your policy terms and the sum insured.

How to File a Cashless Claim?

Step 1: Visit the Tata AIG Claims Process page.

Step 2: Find and click on the 'Initiate Claim' option. Select "Health".

Step 3: Log in to your account using your registered mobile number.

Step 4: Enter a few personal details as needed, select the claim type as “Cashless Claim”, and submit.

Step 5: We will verify your claim, and once it is approved, you can directly go to one of the authorised hospitals. We will settle the bill directly.

The new IRDAI guidelines allow individuals to receive cashless treatment benefits in any hospital in Shimla. Earlier, cashless claim benefits were restricted to network hospitals.

However, with the new guidelines, Tata AIG policyholders can receive cashless treatment benefits in the hospital of their choice. This means the policyholder does not have to pay anything for medical treatment. The medical bills are settled directly by Tata AIG.