{"uin":"TATHLIA25039V012425","name":"Flexi Shield (UIN: )","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425","insurer":{"slug":"tata-aig-general-insurance","name":"Tata AIG General Insurance Company Limited","url":"https://indiainsurances.com/insurer/tata-aig-general-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"Flexi Shield is a health rider package that can only be opted along with a base Policy and cannot be bought separately. Its rider options include emergency air ambulance, waiting-period modifications, hospital cash, wellness rewards and global emergency hospitalization.","analysis":{"state":"machine","analysed_at":"2026-10-19 22:52:16.566841+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"not-stated","value":null,"display":null,"note":"The documents list riders/benefits, not named plan variants.","quote":null,"sources":[],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"not-stated","value":null,"display":null,"note":"The rider documents refer to the base Policy and Policy Schedule, but do not state a standalone policy term for this rider package.","quote":null,"sources":[],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"quote-verified","value":["Duly completed claim form","Nominee-attested copy of Death Certificate","Nominee-attested copy of Post Mortem Report, wherever applicable and conducted","Nominee-attested copy of Death Summary or all Medical records, if treated in hospital","Nominee-attested copy of news paper cutting, if any.","Nominee-attested copy of KYC documents with NEFT details of nominee and CKYC form (attached)","Competent medical authority / Doctor like Civil Surgeon, confirming the Disability percentage / period and prognosis for Permanent Total Disability","Self-attested copy of FIR, if filed / Police Panchnama, if conducted","Self-attested copy of Discharge Summary or all Medical records Self-attested copy of news paper cutting, if any.","Self-attested copy of KYC documents with NEFT details of nominee and KYC form"],"display":"Duly completed claim form; Death Certificate; Post Mortem Report; medical records; news paper cutting; KYC/NEFT; disability certificate; FIR/Police Panchnama.","note":"These claim document lists are printed for the Accidental Death Benefit Rider and Permanent Total Disability Benefit Rider.","quote":"Claim Documentation:\na) Duly completed claim form\nb) Nominee-attested copy of Death Certificate\nc) Nominee-attested copy of Post Mortem Report, wherever applicable and conducted ... e) Nominee-attested copy of Death Summary or all Medical records, if treated in hospital\nf) Nominee-attested copy of news paper cutting, if any.\ng) Nominee-attested copy of KYC documents with NEFT details of nominee and CKYC form (attached) ... Claim Documentation:\na) completed claim form\nb) Competent medical authority / Doctor like Civil Surgeon, confirming the Disability percentage / period and prognosis for Permanent Total Disability\nc) Self-attested copy of FIR, if filed / Police Panchnama, if conducted\nd) Self-attested copy of Discharge Summary or all Medical records Self-attested copy of news paper cutting, if any.\ne) Self-attested copy of KYC documents with NEFT details of nominee and KYC form","sources":[{"clause":null,"heading":"R35. Accidental Death Benefit Rider","page":23,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-r35-accidental-death-benefit-rider"},{"clause":"Section 3(II)(g)(v)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-section-3-ii-g-v"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"quote-verified","value":["where the insured person is under the influence of intoxicating liquor or drugs or other intoxicants, except where the insured person is not directly responsible for the injury / accident though under influence of intoxication","Insured Person committing or attempting to commit an illegal activity or violation of law","An accident that do not occur within the policy period","Ionising radiation or contamination by radioactivity from any nuclear waste from combustion of nuclear fuel","Asbestosis or other related sickness or disease resulting from the existence, production, handling, processing, manufacture, sale, distribution of asbestos or other products thereof.","Participation in any Professional Sports which remunerates in excess of 50% of the Insured Person‘s annual income as a means of their livelihood","Whilst engaging in Adventure Sports","Whilst engaging in aviation or ballooning","Any planned treatment or where the Insured Person is travelling for the purpose of obtaining treatment.","Treatment towards Oncological (Cancer) diseases.","Any claim under this benefit due to the pregnancy of the Insured Person including resulting childbirth, miscarriage, abortion or complication of any of these.","Stem cell implantation/Surgery, harvesting, storage or any kind of treatment using stem cells."],"display":"Main exclusions include intoxication, illegal activity, accidents outside the policy period, nuclear radiation, asbestosis, professional or adventure sports, aviation or ballooning, planned overseas treatment, cancer treatment under global emergency cover, pregnancy-related claims and stem cell treatment.","note":"These are rider-specific exclusions. General exclusions of the base Policy are not printed in these rider documents.","quote":"where the insured person is under the influence of intoxicating liquor or drugs or other intoxicants, except where the insured person is not directly responsible for the injury / accident though under influence of intoxication\n- Insured Person committing or attempting to commit an illegal activity or violation of law ... i) An accident that do not occur within the policy period ... ii) Ionising radiation or contamination by radioactivity from any nuclear waste from combustion of nuclear fuel; or the radioactive, toxic, explosive or other hazardous properties of any explosion nuclear assembly or nuclear component, thereof ... iii) Asbestosis or other related sickness or disease resulting from the existence, production, handling, processing, manufacture, sale, distribution of asbestos or other products thereof. ... iv) Participation in any Professional Sports which remunerates in excess of 50% of the Insured Person‘s annual income as a means of their livelihood ... vi. Whilst engaging in Adventure Sports, where Adventure Sports | means | Recreational\nactivities perceived as involving a high degree of risk. ... vii. Whilst engaging in aviation or ballooning, whilst mounting into, dismounting from or traveling in any balloon or aircraft other than as a passenger (fare paying or otherwise) in any duly licensed standard type of aircraft anywhere in the world ... a) Any planned treatment or where the Insured Person is travelling for the purpose of obtaining treatment. ... g) Treatment towards Oncological (Cancer) diseases.\nh) Any claim under this benefit due to the pregnancy of the Insured Person including resulting childbirth, miscarriage, abortion or complication of any of these. ... p) Stem cell implantation/Surgery, harvesting, storage or any kind of treatment using stem cells.","sources":[{"clause":null,"heading":"R6. Additional Sum Insured for Accidental Hospitalization","page":6,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-r6-additional-sum-insured-for-accidental-hospita"},{"clause":"Section 3(II)(g)(i)","heading":null,"page":24,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-section-3-ii-g-i"},{"clause":"Section 3(II)(g)(ii)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-section-3-ii-g-ii"},{"clause":"Section 3(II)(g)(iii)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-section-3-ii-g-iii"},{"clause":"Section 3(II)(g)(iv)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-section-3-ii-g-iv"},{"clause":"Section 3(II)(g)(v)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-section-3-ii-g-v"},{"clause":null,"heading":"R46. Global Cover for Emergency Hospitalization","page":32,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-r46-global-cover-for-emergency-hospitalization"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"not-stated","value":null,"display":null,"note":"The documents print customer support contact details, but not a grievance escalation route before the Insurance Ombudsman.","quote":null,"sources":[],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"not-stated","value":null,"display":null,"note":"The rider documents state rider-specific limits and refer to the base Sum Insured or Policy Schedule, but do not state the base policy sum insured options.","quote":null,"sources":[],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"not-stated","value":null,"display":null,"note":"The rider documents do not state a general initial illness waiting period for the base policy.","quote":null,"sources":[],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"not-stated","value":null,"display":null,"note":"The documents describe riders that can modify the base Policy's pre-existing disease waiting period, but the base waiting period itself is not printed.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"not-stated","value":null,"display":null,"note":"The documents describe riders that can modify the base Policy's specific disease/procedure waiting period, but the base waiting period itself is not printed.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"not-stated","value":null,"display":null,"note":"The rider documents do not print the base Policy's list of specific diseases/procedures carrying a waiting period.","quote":null,"sources":[],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"not-stated","value":null,"display":null,"note":"The documents mention portability only inside certain waiting-period riders and do not state a general right to port the policy to another insurer.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"not-stated","value":null,"display":null,"note":"The rider documents discuss cumulative bonus and some rider renewals, but do not state whether premium can be loaded at renewal because of claims.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"quote-verified","value":["where the insured person is under the influence of intoxicating liquor or drugs or other intoxicants, except where the insured person is not directly responsible for the injury / accident though under influence of intoxication","Insured Person committing or attempting to commit an illegal activity or violation of law","An accident that do not occur within the policy period","Ionising radiation or contamination by radioactivity from any nuclear waste from combustion of nuclear fuel","Asbestosis or other related sickness or disease resulting from the existence, production, handling, processing, manufacture, sale, distribution of asbestos or other products thereof.","Participation in any Professional Sports which remunerates in excess of 50% of the Insured Person‘s annual income as a means of their livelihood","Whilst engaging in Adventure Sports","Whilst engaging in aviation or ballooning","infections (except pyogenic infections which shall occur through an Accidental cut or wound) or any other kind of Disease","Any planned treatment or where the Insured Person is travelling for the purpose of obtaining treatment.","Treatment or part of treatment for any condition which is not life threatening in nature and can be safely postponed till the Insured Person’s return to India.","Where the Insured Person is travelling against the advice of a Physician/Medical Practitioner","Where the Insured Person is operating or learning to operate any aircraft","Any treatment of orthopaedic diseases or conditions except for fractures, dislocations and / or Injuries suffered during the Policy Period.","Treatment towards Oncological (Cancer) diseases.","Any claim under this benefit due to the pregnancy of the Insured Person including resulting childbirth, miscarriage, abortion or complication of any of these.","In case of any territorial restriction laid by the Government of India, We will not pay the expenses incurred for such hospitalization.","Expenses incurred in connection with weak, strained, or flat feet, corns, calluses, or toenails.","Surgical treatment undertaken for correction of Deviated nasal septum, including sub mucous resection and/or other surgical correction thereof, except as the result of Accident.","Child care including general medical examination and immunizations.","Any expenses incurred in India unless specifically covered elsewhere in the Policy.","Bone marrow transplants in blood disorders.","Stem cell implantation/Surgery, harvesting, storage or any kind of treatment using stem cells."],"display":"Rider-specific permanent exclusions include intoxication, illegal activity, nuclear radiation, asbestosis, professional or adventure sports, aviation or ballooning, disease/infections for PTD, planned or postponable overseas treatment, cancer, pregnancy, specified overseas territorial and treatment exclusions, bone marrow transplants in blood disorders and stem cell treatment.","note":"The standard IRDAI Excl04 to Excl18 exclusions of the base policy are not printed in these rider documents.","quote":"where the insured person is under the influence of intoxicating liquor or drugs or other intoxicants, except where the insured person is not directly responsible for the injury / accident though under influence of intoxication\n- Insured Person committing or attempting to commit an illegal activity or violation of law ... i) An accident that do not occur within the policy period ... ii) Ionising radiation or contamination by radioactivity from any nuclear waste from combustion of nuclear fuel; or the radioactive, toxic, explosive or other hazardous properties of any explosion nuclear assembly or nuclear component, thereof ... iii) Asbestosis or other related sickness or disease resulting from the existence, production, handling, processing, manufacture, sale, distribution of asbestos or other products thereof. ... iv) Participation in any Professional Sports which remunerates in excess of 50% of the Insured Person‘s annual income as a means of their livelihood ... vi. Whilst engaging in Adventure Sports, where Adventure Sports | means | Recreational\nactivities perceived as involving a high degree of risk. ... vii. Whilst engaging in aviation or ballooning, whilst mounting into, dismounting from or traveling in any balloon or aircraft other than as a passenger (fare paying or otherwise) in any duly licensed standard type of aircraft anywhere in the world\nviii. infections (except pyogenic infections which shall occur through an Accidental cut or wound) or any other kind of Disease;\nix. Insured Person committing or attempting to commit an illegal activity or violation of law ... a) Any planned treatment or where the Insured Person is travelling for the purpose of obtaining treatment. ... b) Treatment or part of treatment for any condition which is not life threatening in nature and can be safely postponed till the Insured Person’s return to India.\nc) Where the Insured Person is travelling against the advice of a Physician/Medical Practitioner or receiving or on a waiting list for receiving specified medical treatment or has received a terminal prognosis for a medical condition. ... e) Where the Insured Person is operating or learning to operate any aircraft, or performing duties as a member of the crew on any aircraft or the Scheduled Airline.\nf) Any treatment of orthopaedic diseases or conditions except for fractures, dislocations and / or Injuries suffered during the Policy Period.\ng) Treatment towards Oncological (Cancer) diseases.\nh) Any claim under this benefit due to the pregnancy of the Insured Person including resulting childbirth, miscarriage, abortion or complication of any of these. ... j) In case of any territorial restriction laid by the Government of India, We will not pay the expenses incurred for such hospitalization.\nk) Expenses incurred in connection with weak, strained, or flat feet, corns, calluses, or toenails.\nl) Surgical treatment undertaken for correction of Deviated nasal septum, including sub mucous resection and/or other surgical correction thereof, except as the result of Accident.\nm) Child care including general medical examination and immunizations.\nn) Any expenses incurred in India unless specifically covered elsewhere in the Policy.\no) Bone marrow transplants in blood disorders.\np) Stem cell implantation/Surgery, harvesting, storage or any kind of treatment using stem cells.","sources":[{"clause":null,"heading":"R6. Additional Sum Insured for Accidental Hospitalization","page":6,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-r6-additional-sum-insured-for-accidental-hospita"},{"clause":"Section 3(II)(g)(i)","heading":null,"page":24,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-section-3-ii-g-i"},{"clause":"Section 3(II)(g)(ii)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-section-3-ii-g-ii"},{"clause":"Section 3(II)(g)(iii)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-section-3-ii-g-iii"},{"clause":"Section 3(II)(g)(iv)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-section-3-ii-g-iv"},{"clause":"Section 3(II)(g)(v)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-section-3-ii-g-v"},{"clause":null,"heading":"R46. Global Cover for Emergency Hospitalization","page":32,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-r46-global-cover-for-emergency-hospitalization"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"not-stated","value":null,"display":null,"note":"The documents do not state the refund if the policyholder cancels during the year.","quote":null,"sources":[],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"quote-verified","value":"The rider coverage is restricted to India unless the respective rider cover specifies otherwise. Specific riders include worldwide or outside-India benefits such as International Second Opinion and Global Cover for Emergency Hospitalization.","display":"India, unless specified otherwise in the respective Rider cover.","note":null,"quote":"The scope of coverage under these Riders are restricted to the geography of India, unless specified otherwise in the respective Rider cover. ... We will provide You at your request a second medical opinion from Our Network Provider/ empanelled service provider or Medical Practitioner located worldwide outside India ... while the Insured Person is travelling outside India and suffers an Injury or is diagnosed with an Illness leading to an Emergency condition that require Medically Necessary Hospitalization in Emergency Care outside India","sources":[{"clause":"Section 1","heading":"Preamble","page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-section-1"},{"clause":null,"heading":"R3. International Second Opinion","page":3,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-r3-international-second-opinion"},{"clause":null,"heading":"R46. Global Cover for Emergency Hospitalization","page":32,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-r46-global-cover-for-emergency-hospitalization"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"quote-verified","value":{"unit":"days","amount":15},"display":"15 days for monthly instalments and 30 days in all other cases; Limited Payment Facility has 15 days.","note":"This is stated for the Instalment Facility and Limited Payment Facility riders. For end-of-policy renewal, the printed grace period is 30 days.","quote":"The grace period for payment of the premium during the Policy Period, for instalment premium shall be: fifteen days where premium payment mode is monthly and thirty days in all other cases (Annually (for multi-year policy)/ Half-yearly / quarterly) ... The grace period for payment of the premium during the Policy Period, for limited payment facility shall be fifteen days. ... At the end of the policy period - the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy.","sources":[{"clause":null,"heading":"R30. Instalment Facility","page":20,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-r30-instalment-facility"},{"clause":null,"heading":"R31. Limited Payment Facility","page":21,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-r31-limited-payment-facility"},{"clause":"Section 3(II)(b)(ii)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-section-3-ii-b-ii"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"not-stated","value":null,"display":null,"note":"The prospectus says entry age limits are as per the base Policy; it does not print the youngest and oldest entry ages.","quote":null,"sources":[],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"quote-verified","value":["Monthly","Quarterly","Half-Yearly","Annual (in case of multi year Policy)","2/3/6/12 monthly Instalments"],"display":"Monthly/Quarterly/Half-Yearly/Annual (in case of multi year Policy); Limited Payment Facility 2/3/6/12 monthly Instalments.","note":"These options are stated in the prospectus benefit table for the Instalment Facility and Limited Payment Facility riders.","quote":"Instalment Facility | Monthly/Quarterly/Half-Yearly/Annual (in case of multi year Policy) ... Limited Payment Facility | 2/3/6/12 monthly Instalments","sources":[{"clause":null,"heading":"Benefit Table","page":32,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16850#c-benefit-table"}],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"For instalment premium and limited payment facility, coverage is available within the policy period from the due date until the premium is received within the grace period. Coverage is not available during the grace period after the end of the policy period.","display":"Within the policy period coverage is available during grace; after the end of the policy period coverage is not available.","note":"This is stated for the Instalment Facility and Limited Payment Facility riders.","quote":"Within the policy period coverage will be available from the due date of instalment premium till the date of receipt of premium by Company within the grace period. ... Coverage is not available during the grace period after the end of the policy period. ... Within the policy period - coverage will be available from the due date of such premium till the date of receipt of premium by Company within the grace period. ... Coverage is not available during the grace period after the end of the policy period.","sources":[{"clause":null,"heading":"R30. Instalment Facility","page":20,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-r30-instalment-facility"},{"clause":"Section 3(II)(b)(i)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-section-3-ii-b-i"},{"clause":"Section 3(II)(b)(ii)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993#c-section-3-ii-b-ii"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for the hospital room, or the room category allowed. If you take a costlier room, other bills can be cut in proportion.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"proportionate_deduction","label":"Proportionate deduction","section":"Limits and co-pay","meaning":"If you choose a room above your limit, whether the insurer reduces associated charges (doctor fees, tests, procedures) by the same proportion.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"An amount of each claim or each year that you bear before the policy pays.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"disease_sublimits","label":"Disease or procedure sub-limits","section":"Limits and co-pay","meaning":"Caps on what is paid for named treatments (cataract, knee replacement...), even if the sum insured is higher.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"pre_hospitalisation","label":"Pre-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days before admission that are paid if related to the hospitalisation.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days after discharge that are paid if related to the hospitalisation.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital (chemotherapy, dialysis, cataract) and whether all or only listed ones are covered.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"domiciliary","label":"Treatment at home","section":"Cover","meaning":"Whether treatment at home is covered when hospital admission is not possible or a doctor advises it.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 1","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 2","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 1","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II A.I(1)","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"modern_treatments","label":"Modern treatments","section":"Cover","meaning":"Robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and the like, and any cap on them.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 2","url":"https://indiainsurances.com/law/irdai-health-mc-2024"}]},{"key":"organ_donor","label":"Organ donor expenses","section":"Cover","meaning":"Whether the donor's hospital costs for an organ transplant are paid.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"restoration","label":"Restoration of sum insured","section":"Cover","meaning":"Whether the sum insured is refilled after it is used up in a year, how much, how often, and whether it works for the same illness.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"consumables","label":"Consumables and 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Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]}],"documents":[{"kind":"wording","label":"Flexi Shield (UIN: TATHLIA25039V012425)","pages":34,"fetched_at":"2026-10-17 20:12:31+00","source_url":"https://www.tataaig.com/s3/flexi_shield_rider_policy_wordings_11_03_e451359dd4.pdf","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16993"},{"kind":"prospectus","label":"Flexi Shield (UIN: TATHLIA25039V012425)","pages":35,"fetched_at":"2026-10-17 20:07:20+00","source_url":"https://www.tataaig.com/s3/flexi_shield_04bf10bee6.pdf","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425/document/16850"}],"versions":[],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"Tata AIG General Insurance official website","url":"https://www.tataaig.com/","note":"Buy directly from the insurer."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"insurer","name":"Claims process","url":"https://www.tataaig.com/claims-process","note":null},{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"insurer","name":"Grievance redressal policy","url":"https://www.tataaig.com/grievance-redressal-policy","note":null},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"Flexi Shield (UIN: ) (UIN TATHLIA25039V012425), IndiaInsurances, https://indiainsurances.com/policy/tata-aig-general-insurance/flexi-shield-uin-tathlia25039v012425"}