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    MediCare Premier Health Insurance

    When thinking of health, DON'T Compromise!

    Being the risk experts, we know there can be no compromise in the matters of health and making sure that starts with a robust insurance plan. Choosing the right mix of features and coverage levels is essential to get everything you would need in an ideal health insurance plan. Tata AIG Medicare Premier is a simplified and comprehensive Health Insurance plan. The product is designed keeping in mind the important role that your health insurance plays considering the cost of medical emergencies. Tata AIG General Insurance has been accredited with IAAA rating by ICRA for highest claims paying ability. With a legacy built on trust, rest assured that we will not compromise on your health insurance and neither should you! Think Ahead.

     

    UIN: TATHLIP18005V011819

     

    ADVT: TAGIC/WebApp/TGMCPRE/Nov 18/8 Ver 1 / All 1290

     

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    Or You Can Contact Us on Our Toll Free No: 1800 266 1363

    • Features that make it the #RightInsurance

      • Global Cover: Covers Medical Expenses related to Inpatient & Day Care Hospitalization of the Insured Person incurred outside India, provided that the diagnosis was made in India.

      • Consumables benefit: Covers expenses incurred, for consumables which are consumed during the period of hospitalization directly related to the insured person's medical or surgical treatment of illness/disease/injury.

      • Bariatric Surgery: Covers expenses incurred for Bariatric Surgery for treatment of Obesity and weight control.

      • Restore Benefits: It automatically restores your sum insured to 100% for you and your family members.

      • Emergency Air Ambulance: Covers expense for ambulance transportation by airplane or helicopter for emergency life threatening health conditions, which require immediate ambulance transportation to the hospital/medical centre for upto Rs. 5 lacs.

      • Day Care Procedures: Covers expenses for 540+ Day Care Treatment due to disease/illness/Injury during the policy period taken at a hospital or a Day Care Centre.

      • In-Patient Treatment: Covers expenses for hospitalization due to disease/illness/Injury during the policy period that requires an Insured Person’s admission in a hospital as an inpatient.

        Medical expenses directly related to the hospitalization would be payable.

      • High End Diagnostics: Covers the insured person for the listed diagnostic tests on OPD basis if required as part of a treatment subject to Rs. 25,000 per policy year annually.

      • Accidental Death Benefit: Covers 100% of sum insured in the event of death of insured person due to accident. This benefit is not applicable for dependent children covered in the policy.

      • Maternity Cover: Covers maternity expenses – up to a maximum of Rs. 50,000/- per policy subject to a waiting period of 4 years of continuous coverage under this policy subject to IRDAI portability guidelines. (in case of birth of girl child cover would be for Rs. 60,000) per policy. No limit on number of delivery events.

      • First year Vaccinations: Covers vaccination expenses for up to one year after the birth of the child subject to a limit of Rs.10,000/- (in case of girl child cover would be for Rs. 15,000) provided the child is covered with us.

      • Organ Donor: Covers Medical and surgical Expenses of the organ donor for harvesting the organ where an Insured Person is the recipient.

      • Vaccination Cover: Covers expenses related to Human Papilloma Virus (HPV) vaccine & Hepatitis B Vaccine after 2 years of continuous coverage and Anti-rabies vaccine & Typhoid vaccination without any waiting period.

      • Compassionate Travel: Covers expenses up to Rs. 20,000 related to a round trip economy class air ticket, or first-class railway ticket, to allow the Immediate Family Member to be at insured person's bedside during his stay in the hospital.

      • OPD Dental Treatment: Once the Insured has completed two years of continuous coverage with Us, we will pay for expenses related to the following dental treatments only subject to a maximum of Rs.10,000 per policy year annually:

         

        • Root Canal Treatment (single or multiple sittings)
        • Tooth extraction(s)
        • Filling

         

        This benefit has a separate limit (over and above base sum insured) and does not affect Cumulative Bonus

      • Pre-Hospitalization: Medical Expenses incurred in 60 days before the date of admission to the hospital.

      • Post-Hospitalization: Medical Expenses incurred in 90 days after the date of discharge from the hospital.

      • Daily Cash for choosing Shared Accommodation: A fixed amount per day will be paid as mentioned in the policy schedule if the Insured Person is hospitalized in Shared Accommodation in a Network Hospital for each continuous and completed period of 24 hours. Coverage limit 0.25% of base sum insured and max. Rs. 2000 per day.

      • Daily cash for accompanying an insured child: A fixed amount per day will be paid, as mentioned in the schedule, if the Insured Person Hospitalized is a child Aged 12 years or less, for one accompanying adult for each complete period of 24 hours. Coverage limit 0.25% of base sum insured and max. Rs. 2000 per day.

      • OPD Treatment: Once the insured has completed two years of continuous coverage with us, we will pay for expenses related to consultations and pharmacy subject to Rs. 5000 per policy year annually subject to policy terms and conditions.

      • Second Opinion: A second opinion from Network Provider or Medical Practitioner will be provided, if an Insured Person is diagnosed with the mentioned Illnesses during the Policy Period.

      • Domiciliary Treatment: Covers for expenses related to Domiciliary Hospitalization of the insured person if the treatment exceeds beyond three days. The treatment must be for management of an illness and not for enteral feedings or end of life care.

      • New Born Baby Cover: Covers medical expenses incurred for the medically necessary treatment of the new born baby up to Rs.10, 000 for complications related to delivery. This benefit will trigger only in case where we have admitted the maternity claim.

      • Ambulance cover:  For utilizing ambulance service for transporting insured person to hospital in case of an emergency, coverage limit (Rs.5000).

      • Prolonged hospitalization Benefit: Pays a fixed amount of 1% of sum insured, in the event of insured hospitalized for a disease/illness/injury for a continuous period exceeding 10 days.

      • AYUSH benefit: Medical Expenses incurred for In-patient treatment taken under Ayurveda, Unani, Sidha or Homeopathy.

      • Health Checkup: Expenses for a Preventive Health Check-up up to 1% of policy sum insured subject to a maximum of Rs. 10,000/- per policy

      • In-patient Dental Treatment: Covers expenses incurred towards hospitalization for dental treatment under anesthesia necessitated due to an accident/injury/illness.

      • Hearing Aid: Covers reasonable charges for a hearing aid every third year. The maximum payable is 50% of actual cost or Rs. 10,000/- per policy, whichever is lower. 

      • 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.

         

        For complete list of detailed benefits, please refer policy wordings.

    • Benefits to make the policy stronger

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      • Tax Benefit: The premium amount paid under this policy qualifies for deduction under 80D of Income Tax (Amendment) Act, 1986. This benefit is not applicable for premium amount paid towards accidental death benefit and for premium paid in cash/ or by demand draft. Tax benefits are subject to changes in Income Tax Law.

      • Settlement of your claims: We settle your claims hassle-free and quickly so that you can focus on quality and timely recovery rather than managing the funding of the treatment, subject to submission of all required documents.

      • Network of hospitals: We are equipped to offer you quality health care in your city with our strong network of hospitals across India. Kindly carry original photo identity proof along with cashless card to avail cashless hospitalization in network hospitals.

      • Lifelong Renewal: We offer you a lifelong renewal for your policy provided premium is paid without any break Your premiums will be basis the age and coverage. Your renewal premium will be basis your revised age band and there will be no extra loading's based on your individual claim.

      • Optional Two/ three years Term: The longer term option of two/ three years policy is more convenient and economical as we offer a discount* on the premium

         

         

        For complete list of detailed benefits, please refer policy wordings

    • Situations where your policy won’t work

      This policy will not apply if:

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      • Medical  Exclusions:

        • Conditions related to or arising out of HIV or AIDS
        • Abuse of intoxicants or hallucinogenic substances such as intoxicating drugs and alcohol
        • Congenital External Diseases, defects or anomalies
      • Non-Medical Exclusions:

        • War or any act of war, act of foreign enemy or war like operations.
        • Intentional self-injury or attempted suicide while sane or insane.
        • Any Insured Person attempting to commit a breach of law with criminal intent.
      • Waiting Period:

        • Policy coverage starts 30 days from the first inception of the policy (except accident).
        • Any listed illnesses/treatments will be covered after a waiting period of 24 months.
        • Any pre-existing condition will be covered after a waiting period of 24 months.
      • Claim Procedure:

        • Claims under this policy will be administered by a specified Third Party Administrator (TPA) duly licensed by IRDAI.
        • Intimation & Assistance: Please contact our designated TPA/Us atleast 48 hours prior to an event
        • which might give rise to a claim. For any emergency situations, kindly contact our TPA within 24 hours of the event.

        Claim Related Information: For any claim related query, intimation of claim and submission of

         

        Claim related documents, You can contact TPA through:

        Name of TPA: Family Health Plan Insurance TPA Ltd (FHPL)

        Email:             info@fhpl.net, seniorcitizensdesk@fhpl.net (for Senior Citizens)

        Toll Free:        1800-425-4033, 040- 23552899 (for Senior Citizens)

        Fax:                +91 40 23541400 Website: www.fhpl.net

        Submit claim:  Claims Department, Family Health Plan Insurance (TPA) Ltd,

                              Srinilaya – Cyber Spazio, Suite # 101,102,109 & 110, Ground Floor,

                              Road No. 2, Banjara Hills, Hyderabad, 500 034

         

        Please refer to policy wordings for complete list of Benefits and Exclusions.





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    2008, Tata AIG General Insurance Company Limited, all rights reserved.

    Registered Office : Peninsula Business Park, Tower A, 15thFloor, G.K.Marg, Lower Parel, Mumbai-400 013, Maharashtra, India. CINNumber : U85110MH2000PLC128425.

    Registered with IRDA of India Regn. No. 108. Insurance is the subject matter of the solicitation.

    For more details on benefits, exclusions, limitations, terms and conditions, please read sales brochure/policy wording carefully before concluding a sale.

    Toll Free Number : 1800 266 7780 / 1800 22 9966 (only for senior citizen policy holders). Email Id –customersupport@tataaig.com. Fax Number – 022 66938170