Health Insurance in West Bengal

Here are some key reasons why every individual must look for the best medical insurance in West Bengal:

Changing Lifestyles: A sedentary lifestyle paired with neglecting health and busy lifestyles in West Bengal has resulted in several diseases at a younger age. This exposure to health risks has made the need for medical insurance more pronounced than ever.

Protecting Loved Ones: A health insurance plan is a crucial requirement for individuals with dependent family members as paying for the healthcare of multiple people is a significant financial commitment. So, every individual with dependents must buy the best mediclaim policy for their family in West Bengal.

Medical Inflation: Over the last few years, the cost of securing quality medical treatment has risen significantly in West Bengal. To combat this medical inflation, a health insurance policy is essential.

Securing Your Savings: A sudden illness can drain your savings. Medical insurance helps you alleviate the stress of seeking treatment.

It is also important to note that the city where you purchase your health insurance plan plays an important role in determining the cost of your insurance. This segregation is referred to as zone-based health insurance wherein healthcare in larger metropolitan cities costs more than that in smaller cities. Subsequently, this influences the cost of health insurance.

Acknowledging the varying healthcare needs of every individual, health insurance companies in West Bengal have curated diverse plans. The common ones include:

Individual Plans: It offers coverage to a single individual securing them against medical and hospitalisation costs. Premiums for individual plans depend on the age, medical history, lifestyle choices, etc.

Family Plans: It covers the entire family under a single policy. The sum assured is higher in family plans and is shared equally among the policy members. When you buy the best mediclaim policy for your family in West Bengal instead of buying an individual plan for every member, you have made a cost-effective choice.

Senior Citizens’ Plans: These insurance plans are curated for senior citizens who are above the age of 60. As older individuals are more likely to raise a claim, the premiums payable for this policy are higher.

Critical Illness Insurance: Critical illness insurance covers serious health conditions such as kidney diseases, heart attacks, cancer, paralysis, etc. by paying a lump sum amount to the insured member upon diagnosis.

Knowing the inclusions and exclusions of your medical insurance can help you plan your healthcare in a better way. Here are the common inclusions and exclusions in a health insurance plan.

Inclusions:

In-Patient Hospitalisation: If you are admitted to the hospital for at least 24 hours, your insurance will cover in-patient expenses, including room rent, ICU treatment, medicines, diagnostic tests, consultation, etc.

Pre-Existing Conditions: Coverage for pre-existing health conditions after a waiting period of 2-4 years.

Pre- and Post-Hospitalisation: Pre-hospitalisation expenses coverage for 30 to 60 days for consultation, diagnosis, medicines, etc., and post-hospitalisation expenses for 60 to 90 days for follow-up consultations, medications, physiotherapy, etc.

Daycare Treatments: Some treatments don’t need the patient to be hospitalised for more than 24 hours. Even so, your insurance will compensate for these expenses.

Annual Check-Ups: Coverage for preventive annual health checkups.

Mental Health Cover: The Insurance Regulatory and Development Authority of India (IRDAI) has made it mandatory to offer coverage for mental illnesses such as bipolar disorder, depression, dementia, etc.

AYUSH Treatment: Your health insurance policy will also provide coverage for alternative medicine treatments, collectively known as AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy)

Domiciliary Treatment: If the patient needs to receive at-home treatments in cases where hospital beds are unavailable or the insured member has a specific medical condition your insurance will compensate for them.

Exclusions:

Pre-existing conditions: There is generally a waiting period before one can raise a claim to secure treatment for pre-existing health conditions.

Cosmetic surgery: Hygiene-related therapies and cosmetic surgeries are not covered under a health insurance policy.

Dental and Auditory: Outpatient procedures such as dental and auditory treatments are not covered by insurance.

Self-inflicted injury or suicide attempt: Insurance providers will not entertain a claim if the policyholder intentionally injures themselves or attempts to commit suicide. Misuse of intoxicating substances is also not covered under insurance.

Specific illnesses: Certain illnesses such as congenital diseases or genetic disorders, STDs, infertility treatments, voluntary abortions, etc., are not covered by insurance.

It is natural to want to find the best medical insurance in West Bengal to safeguard healthcare needs and finances. However, with so many options to choose from, it can be challenging to find a suitable policy.

So, to help you pick the best health insurance for yourself and your loved ones, we have highlighted six key factors you must consider:

Policy Coverage: The best health insurance in West Bengal is one that not only offers coverage against a wide range of health concerns but also covers pre and post-hospitalization cover, ambulance charges, critical illness coverage, maternity benefits, cashless treatment, etc. If you are looking at a family plan, ensure it accommodates the healthcare needs of every member.

Flexibility: Check if your policy enables you to add a new family member to your plan with ease without losing on benefits.

Waiting Period: Typically, there is a waiting period for maternity expenses, pre-existing ailments, and specific health conditions. Ensure that you check this duration and select a policy that comes with a lower waiting period.

Co-Payment: This is a percentage of the amount that the policyholder is liable to pay from their pocket. Some policies come without a co-payment clause.

Lifetime Renewability: Health insurance gets more expensive as you grow older so look for a lifetime renewability plan.

To make it easier and more convenient for insurance seekers to find the best Mediclaim policy in West Bengal for themselves, insurance companies have enabled online insurance purchases. Here are some key reasons why it is better to buy medical insurance online:

Affordable Premiums: When you buy a health insurance policy online, you directly communicate with the insurance company thereby saving commissions to agents and the distributors. The insurer shares these savings with the customers by giving them discounted premiums.

Informed Decision: Insurance seekers can analyse different plans in terms of benefits, coverage, features, premiums, claim process, renewal, etc., which helps them find the best health insurance for themselves and their loved ones.

Time-Saving: Online insurance purchase is characterised by less paperwork and a hassle-free process. You no longer need to queue up to buy a policy. This makes it time-saving.

Convenient: You can buy insurance online anytime, anywhere which is particularly beneficial with a busy routine.

Online Reviews: You can check reviews of existing customers online which can help you effectively choose the right health insurance plan.

Online Services: With online insurance purchases, you can avail of a host of services online including downloading policy documents, calculating insurance premiums using a health insurance calculator, policy renewal, raising a claim, etc.

Tata AIG offers unique benefits to health insurance plan seekers for comprehensive protection. These add-ons can help strengthen your basic health insurance:

Consumables cover: Expenses beyond hospitalisation with surgical and medical supplies coverage.

Global coverage: Option of seeking medical treatment abroad for specific medical conditions.

Maternity cover: Maternity cover (four-year waiting period) to tackle maternity expenses up to ₹50,000 per policy year and an additional ₹10,000 if the newborn is a baby girl.

Newborn cover: An additional ₹10,000 to tackle complications during delivery.

OPD cover: Medical consultation and medicine costs of up to ₹5,000 can be offset (two-year waiting period).

Seamless process: With more than 650 claim experts our claim settlement process is simple.

Automatic restoration: Automatic restoration of the sum assured to take care of medical emergencies. If you exhaust your coverage in a year, it gets replenished.

Cumulative bonus: Earn up to 50% cumulative bonus annually for claim-free years. Associated benefits include cashless treatments, tax benefits, and more, to meet specific healthcare requirements.

We strive to ensure you receive the best health insurance to secure yourself and your loved ones with features such as:

• The liberty to remove the cap on hospital room rent expenses to ensure quality treatment without the worry of additional expense.

• Financial support during pregnancy with reimbursement up to ₹50,000 (extendable by an additional ₹10,000 for newborn girls).

• Coverage for pre-hospitalisation expenses 30-60 days before admission and post-hospitalisation expenses 60-90 days after discharge.

• Coverage for pre-existing health conditions after a waiting period of two to five years.

• Cashless claim settlement at any authorised hospitals across India.

• Tax benefits under section 80D of the Income Tax Act, 1961.

• Coverage for the cost of an ambulance.

• NCB for not raising a claim during one whole policy year.

• Coverage for AYUSH treatments.

• Coverage for daycare processes that take less than 24 hours.

• COVID-19 coverage.

With online services, it is much easier to buy and renew health insurance. Let’s explore the process for each.

How to Buy Medical Insurance Online?

Visit the official Tata AIG website and select “Health Insurance.”

In the next step, select how many members you are going to buy insurance for and their respective ages.

Enter your contact details, medical history, and pre-existing illness (if applicable).

Choose an appropriate health insurance policy.

Pay for the policy online and your coverage will be issued instantaneously.

How to Renew Medical Insurance Online?

Visit the Tata AIG website, click on “Renew” and then select “Health.”

Enter your contact details, policy number, and other essential information.

Choose the policy that needs to be renewed. You can even include add-ons but this will increase your premium.

Once you pay the premium, your policy will be renewed.

Documents Required to Buy Tata AIG Health Insurance in West Bengal

A cancelled bank cheque

A signed and properly filled proposal form

Proof of identity (Aadhaar card, PAN card, passport, etc.)

Proof of address (Aadhaar card, utility bills, etc.)

Proof of income (salary slips, bank statements, etc.)

There are two kinds of claim settlement procedures: cashless claims and reimbursement claims. In the cashless process, the claims are settled directly by the insurer and the hospital and the policyholder need not pay anything. For reimbursement claims, the policyholder pays upfront and files for reimbursement later.

Cashless Claim Settlement Process:

Go to our claims page to initiate a cashless claim. You can also give us a call to start the process.

Choose a Tata AIG network hospital to receive your medical treatment. Inform us within 48 hours of hospitalisation in case of emergencies and 48 hours before admission for planned hospitalisation.

Submit the policy documents at the hospital’s insurance desk and fill out a pre-authorisation form.

Once the application is approved you are eligible to receive cashless service at the hospital.

Reimbursement Claim Settlement Process:

Visit our claims page to initiate a reimbursement claim.

Inform us about the hospital where you will be receiving your medical treatment and the dates.

After you receive your treatment, pay for the medical expenses from your pocket.

Submit the reimbursement form along with all invoices, medical bills, prescriptions, and other important documents

Once the claim and the documents are verified, the process for reimbursement is initiated

Documents Required for Reimbursement Claim

A duly signed claim form.

All medical reports and treatment details or reports.

All medical bills, including consultation bills, pharmacy receipts, prescriptions, and any other payments made towards the treatment.

A certificate from the treating doctor that clearly indicates the medical procedures undertaken.

First Information Report (FIR) in case of accidents or theft.

A clear copy of your health insurance policy.

Bank details for processing reimbursement payment.

Any other additional documentation to support your claim.

With the latest amendments by the IRDAI, now you can file cashless claims at any hospital of your choice across the country, including the state of West Bengal. Tata AIG too facilitates cashless claims for its policyholders.

Simply follow the documentation and process of getting cashless treatment at our network/non-network hospitals in West Bengal and enjoy stress-free treatments for your loved ones and yourself at a hospital of your preference with Tata AIG.