{"uin":"TATHLIP23179V012223","name":"Tata AIG Elder Care","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223","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-senior","category_name":"Senior citizen health","irdai_type":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"Tata AIG Elder Care is an indemnity health policy for people aged 61 and above with no maximum entry age, sum insured of Rs 5, 10 or 25 lakh, terms of 1, 2 or 3 years and individual or 2-member floater cover. Every claim carries a mandatory 20% co-payment (waivable with an add-on), pre-existing diseases wait 24 months, cataract and joint replacement are capped by zone and sum insured, and it adds home nursing, compassionate care and home physiotherapy after hospitalisation.","analysis":{"state":"extracted","analysed_at":"2026-10-19 17:40:48.718096+00","note":"Every stated fact carries a verbatim quote found in the cited clause."},"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":"No named plans. The policy is sold on an individual or family floater basis (maximum 2 members), which are cover types, not plans (see family_floater). Sub-limits for cataract and joint replacement vary by premium zone (A, B, C) and sum insured.","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":"cross-checked","value":"The policy is issued for 1, 2 or 3 years.","display":"1, 2 or 3 years","note":"Long-term discount on premium: 5% for a 2 year term, 10% for a 3 year term (prospectus).","quote":"The policy will be issued for a period 1/2/3 years. ... 10% long term discount on premium in case insured opts policy term of 3 years ... 5% long term discount on premium in case insured opts policy term of 2 years","sources":[{"clause":"1","heading":"Suitability","page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1070#c-1"},{"clause":"3","heading":"Discounts on premium","page":2,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1070#c-3"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"cross-checked","value":"Planned hospitalisation: at least 48 hours before admission. Emergency hospitalisation: within 24 hours of admission. Reimbursement claims: inform within 7 days of completing treatment.","display":"48 hours before planned admission; within 24 hours of emergency admission","note":"Prospectus and CIS: send the signed claim form and documents within 15 days of the occurrence of the incident. The wording asks for documents within 15 days of the insurer's request or of discharge.","quote":"If any treatment for which a claim may be made and that treatment requires planned Hospitalisation: | At least 48 hours prior to the Insured Person’s admission. ... Within 24 hours of the Insured Person’s ... emergency admission to Hospital ... Our TPA/We must be informed within 7 days of completion of such treatment, consultation or procedure using the Claim Intimation Form. ... Please send the duly signed claim form and all the information/documents mentioned therein to our TPA/Us within 15 days of the occurrence of the Incident.","sources":[{"clause":"24","heading":"Premium Refund in case of demise of the Insured Person","page":31,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-24-2"},{"clause":"11(c)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1070#c-11-c"}],"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":"cross-checked","value":["Claim form, duly completed and signed","Original bills (pharmacy, consultation, diagnostic) and receipts or prescriptions","Medical reports, case histories, investigation reports, indoor case papers, discharge summaries","Precise diagnosis of the treatment","Detailed list of services and treatments with unit prices","Prescriptions naming the insured, with drug prices and payment receipts","Pre and post investigation, treatment and follow-up records","Treating doctor's certificate on missing information","Copy of settlement letter from other insurer or TPA","Stickers and invoice of implants","MLC and FIR copies for accident claims","NEFT bank details and KYC (ID/address proof, photograph)","Legal heir/succession certificate, if required","Post-mortem report, where applicable"],"display":"Claim form, original bills, medical reports and discharge summary, prescriptions, implant invoices, MLC/FIR for accidents, NEFT and KYC","note":"Wording asks for documents within 15 days of the request or of discharge; delay is condoned if not reasonably possible.","quote":"Our claim form, duly completed and signed for on behalf of the Insured Person. ... Original Bills (pharmacy purchase bill, consultation bill, diagnostic bill) ... All medical reports, case histories, investigation reports, indoor case papers/ treatment papers (in reimbursement cases, if available), discharge summaries. ... A precise diagnosis of the treatment for which a claim is made. ... A detailed list of the individual medical services and treatments provided and a unit price for each ... Prescriptions that name the Insured Person and in the case of drugs: the drugs prescribed, their price and a receipt for payment. ... All pre and post investigation, treatment and follow up (consultation) records ... Treating doctor’s certificate regarding missing information in case histories ... Copy of settlement letter from other insurance company or TPA. ... Stickers and invoice of implants used during surgery. ... Copy of MLC (Medico legal case) records, if carried out and FIR (First information report), if registered, in case of claims arising out of an accident ... currently mandatory NEFT (to enable direct credit of claim amount in bank account) and KYC (recent ID/Address proof and photograph) requirements. ... Legal heir/succession certificate, if required ... PM report (wherever applicable)","sources":[{"clause":"24(a)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-24-a-2"},{"clause":"24(b)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-24-b-2"},{"clause":"24(c)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-24-c-2"},{"clause":"24(d)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-24-d-2"},{"clause":"24(e)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-24-e-2"},{"clause":"24(f)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-24-f-2"},{"clause":"24(g)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-24-g-2"},{"clause":"24(h)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-24-h"},{"clause":"24(i)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-24-i-2"},{"clause":"24(j)","heading":null,"page":34,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-24-j"},{"clause":"24(k)","heading":null,"page":34,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-24-k"},{"clause":"24(l)","heading":null,"page":34,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-24-l"},{"clause":"24(m)","heading":null,"page":34,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-24-m"},{"clause":"24(n)","heading":null,"page":34,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-24-n"}],"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":"cross-checked","value":"Settled or rejected within 15 days of the last necessary document; within 45 days where an investigation is needed. Delay attracts interest at 2% above the bank rate.","display":"15 days from the last necessary document (45 days if investigated)","note":"Prospectus clause 11(e) repeats the 15 and 45 day rule, but its reimbursement procedure (11(c)) says: 'On receipt of the complete set of claim documents, We will send the payment for the admissible amount, along with a settlement statement within 30 days.' The wording and the prospectus's own settlement clause give 15 days, so this is an inconsistency inside the prospectus, not a conflict between documents.","quote":"The Company shall settle or reject a claim, as the case may be, within 15 days from the date of receipt of last necessary document. ... the Company shall be liable to pay interest to the policyholder from the date of receipt of last necessary document to the date of payment of claim at a rate 2% above the bank rate. ... In such cases, the Company shall settle or reject the claim within 45 days from the date of receipt of last necessary document. ... On receipt of the complete set of claim documents, We will send the payment for the admissible amount, along with a settlement statement within 30 days.","sources":[{"clause":"3(i)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-3-i"},{"clause":"3(ii)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-3-ii"},{"clause":"3(iii)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-3-iii"},{"clause":"11(c)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1070#c-11-c"}],"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":"cross-checked","value":["Pre-existing diseases until 24 months of continuous coverage","Listed conditions and surgeries until 24 months/36 months of continuous coverage","Any illness within 30 days from the first policy commencement date, except accidents","Admission primarily for diagnostics and evaluation","Rest cure, rehabilitation and respite care","Cosmetic or plastic surgery","Alcoholism, drug or substance abuse","Unproven treatments","Maternity","Hazardous or adventure sports","Alcoholic pancreatitis","Dental treatment or surgery of any kind","Sleep-apnoea","War or any act of war","Intentional self-injury or attempted suicide"],"display":"PED (24 months), specified illnesses (24/36 months), first 30 days, plus standard and product-specific exclusions such as dental treatment, sleep-apnoea and alcoholic pancreatitis","note":"Hazardous sports excluded only when participating as a professional. Cosmetic surgery allowed for reconstruction after accident, burns or cancer.","quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 24 months of continuous coverage ... Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months/36 months (as applicable), of continuous coverage ... Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident ... Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded. ... Rest cure, rehabilitation and respite care ... Expenses for cosmetic or plastic surgery ... Treatment for, Alcoholism, drug or substance abuse ... Unproven treatments ... Maternity ... Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports ... Alcoholic pancreatitis ... Dental treatment or surgery of any kind ... Sleep-apnoea ... War or any act of war ... Intentional self-injury or attempted suicide while sane or insane.","sources":[{"clause":"14","heading":null,"page":18,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-2"},{"clause":"14(XVII)(d)(ii)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-xvii-d-ii"},{"clause":"14(XVII)(d)(iii)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-xvii-d-iii"},{"clause":"14(XVII)(d)(iv)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-xvii-d-iv"},{"clause":null,"heading":"3. Non-Medical Exclusions","page":23,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-3-non-medical-exclusions"},{"clause":"14(XVII)(b)(i)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-xvii-b-i"},{"clause":"14(XVII)(b)(ii)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-xvii-b-ii"},{"clause":"14(XVII)(b)(iii)","heading":"Excluded Providers","page":23,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-xvii-b-iii"}],"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":"cross-checked","value":"Call 022 6489 8282 or 1800 267 1955 (senior citizens) or e-mail customersupport@tataaig.com; escalate to manager.customersupport@tataaig.com, then the Head of Customer Services at head.customerservices@tataaig.com; then the Insurance Ombudsman or the Bima Bharosa portal.","display":"Customer support, then manager.customersupport@tataaig.com, then head.customerservices@tataaig.com","note":"Prospectus and CIS give different phone numbers: 1800-266-7780 / 1800 22 9966 (senior citizens) or 022-66939500.","quote":"If you’re not satisfied and wish to lodge a complaint, please call our 24/7 Customer Support No. 022 6489 8282 or 1800 267 1955 (For Senior Citizens) or email us at customersupport@tataaig.com. ... Escalation Level 1 ... please contact us at manager.customersupport@tataaig.com. ... Escalation Level 2 ... reach out to the Head of Customer Services at head.customerservices@tataaig.com. ... you may approach the Insurance Ombudsman of concerned jurisdiction. You can also lodge a grievance on the Bima Bharosa Grievance Redressal Portal","sources":[{"clause":"15","heading":"Redressal of Grievance","page":29,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-15-2"}],"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":"cross-checked","value":"Rs 5 lakh, Rs 10 lakh or Rs 25 lakh.","display":"Rs 5 Lacs, 10 Lacs or 25 Lacs","note":null,"quote":"Sum Insured options (Rs.) • 5 Lacs • 10 Lacs • 25 Lacs","sources":[{"clause":"5","heading":"Sum Insured options (Rs.)","page":5,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1070#c-5"}],"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":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":"Accidents covered from day one. Not applied if continuously covered for more than twelve months; applies afresh to any sum insured increase.","quote":"Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident ... This exclusion shall not, however, apply if the Insured Person has Continuous Coverage for more than twelve months.","sources":[{"clause":"14","heading":null,"page":18,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-2"}],"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":"cross-checked","value":{"unit":"months","amount":24},"display":"24 months","note":"Reduced for prior continuous cover under portability; applies afresh to any sum insured increase; PED covered after 24 months only if declared and accepted.","quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us.","sources":[{"clause":"14","heading":null,"page":18,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-2"}],"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":"cross-checked","value":{"unit":"months","amount":24},"display":"24 months","note":"36 months for joint replacement surgeries. Not applicable to claims arising due to an accident.","quote":"List of Specific conditions as furnished below are covered after a waiting period of 24 months: ... 36 months waiting period will be applicable for Joint replacement surgeries for example: Knee replacement, Hip replacement","sources":[{"clause":"14","heading":null,"page":18,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-2"}],"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":"cross-checked","value":["Tumors, Cysts, polyps including breast lumps (benign)","Polycystic ovarian disease","Fibromyoma","Adenomyosis","Endometriosis","Prolapsed Uterus","Non-infective arthritis","Gout and Rheumatism","Osteoporosis","Ligament, Tendon or Meniscal tear","Prolapsed Inter Vertebral Disc","Cholelithiasis","Pancreatitis","Fissure/fistula in anus, haemorrhoids, pilonidal sinus","Ulcer & erosion of stomach & duodenum","Gastro Esophageal Reflux Disorder (GERD)","Liver Cirrhosis","Perineal Abscesses","Perianal / Anal Abscesses","Calculus diseases of Urogenital system","Benign Hyperplasia of prostate","Varicocele","Cataract","Retinal detachment","Glaucoma","Congenital Internal Diseases","Adenoidectomy","Mastoidectomy","Tonsillectomy","Tympanoplasty","Surgery for nasal septum deviation","Nasal concha resection","Surgery for Turbinate hypertrophy","Hysterectomy","Cholecystectomy","Hernioplasty or Herniorraphy","Surgery/procedure for Benign prostate enlargement","Surgery for Hydrocele/ Rectocele","Surgery of varicose veins and varicose ulcers","Joint replacement surgeries (36 months)"],"display":"Benign tumours and cysts, cataract, glaucoma, hernia, hysterectomy, gallstones, piles and fistula, kidney stones, prostate enlargement, joint replacement and others","note":"All items 24 months except joint replacement surgeries (36 months).","quote":"I) Tumors, Cysts, polyps including breast lumps (benign) II) Polycystic ovarian disease III) Fibromyoma IV) Adenomyosis V) Endometriosis VI) Prolapsed Uterus VII) Non-infective arthritis VIII) Gout and Rheumatism IX) Osteoporosis X) Ligament, Tendon or Meniscal tear ... XI) Prolapsed Inter Vertebral Disc XII) Cholelithiasis XIII) Pancreatitis XIV) Fissure/fistula in anus, haemorrhoids, pilonidal sinus XV) Ulcer & erosion of stomach & duodenum XVI) Gastro Esophageal Reflux Disorder (GERD) XVII) Liver Cirrhosis ... Perineal Abscesses ... XIX. Perianal / Anal Abscesses ... XX. Calculus diseases of Urogenital system ... XXI. Benign Hyperplasia of prostate ... XXII. Varicocele ... Cataract ... XXIV. Retinal detachment ... XXV. Glaucoma ... XXVI. Congenital Internal Diseases ... Adenoidectomy ... Mastoidectomy ... XXIX. Tonsillectomy ... XXX. Tympanoplasty ... XXXI. Surgery for nasal septum deviation ... Nasal concha resection ... Surgery for Turbinate hypertrophy ... Hysterectomy ... XXXV. Cholecystectomy ... Hernioplasty or Herniorraphy ... Surgery/procedure for Benign prostate enlargement ... Surgery for Hydrocele/ Rectocele ... Surgery of varicose veins and varicose ulcers ... 36 months waiting period will be applicable for Joint replacement surgeries","sources":[{"clause":"14","heading":null,"page":18,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-2"}],"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":"cross-checked","value":{"unit":"years","amount":5},"display":"5 years","note":"Applies to the first policy's sum insured; for any increase, five years count from the date of enhancement.","quote":"After completion of five continuous years of coverage (including portability and migration) in health insurance policy, no policy and claim shall be contestable by the insurer on grounds of non-disclosure, misrepresentation, except on grounds of established fraud.","sources":[{"clause":"12","heading":"Moratorium Period","page":28,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-12-3"}],"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":"cross-checked","value":"Yes. Apply to the new insurer at least 30 days, but not earlier than 60 days, before renewal; accrued continuity benefits (waiting periods, PED, moratorium, no claim bonus) carry over.","display":"Yes, apply 30 to 60 days before renewal with waiting-period credit","note":"Migration to another Tata AIG product also allowed, applying at least 30 days before renewal.","quote":"The insured person will have the option to port the policy to other insurers by applying to such insurer to port the entire policy along with all the members of the family, if any, at least 30 days before, but not earlier than 60 days from the policy renewal date ... the proposed insured person will get the accrued continuity benefits to the extent of the Sum Insured, No Claim Bonus, specific waiting periods, waiting period for pre-existing disease , Moratorium period etc","sources":[{"clause":"9","heading":"Portability","page":27,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-9-3"}],"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":"cross-checked","value":true,"display":"Yes, no exit age","note":"Renewal can be refused on established fraud, non-disclosure or misrepresentation.","quote":"We will be offering continuous renewal with no exit age subject to regular premium payment ... Lifelong renewal: We offer you a lifelong renewal for your policy provided premium is paid without any break.","sources":[{"clause":"18","heading":"Insured Person","page":30,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-18-2"},{"clause":"2(iii)","heading":"Lifelong renewal","page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1070#c-2-iii"}],"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":"cross-checked","value":"No. No loading applies on renewals based on individual claims experience; renewal premium depends on age.","display":"No claim-based loading at renewal","note":"A medical risk loading (up to 100% per condition, 150% overall) may be applied at underwriting and continues on renewals.","quote":"vi. No loading shall apply on renewals based on individual claims experience. ... Your renewal premium will be basis your age on renewal and there will be no extra loadings based on your individual claim.","sources":[{"clause":"10(b)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-10-b"},{"clause":"2(iii)","heading":"Lifelong renewal","page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1070#c-2-iii"}],"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":"cross-checked","value":["Investigation and evaluation (Code- Excl 04)","Rest cure, rehabilitation and respite care (Code- Excl 05)","Obesity/ Weight Control (Code- Excl 06)","Change-of-Gender treatments: Code- Excl07","Cosmetic or Plastic Surgery (Code- Excl 08)","Hazardous or Adventure Sports (Code- Excl 09)","Breach of law (Code- Excl 10)","Excluded Providers: (Code-Excl 11)","Alcoholism, drug or substance abuse or any addictive condition (Code- Excl 12)","Treatments in heath hydros, nature cure clinics, spas or admission for domestic reasons (Code- Excl13)","Dietary supplements bought without prescription, unless prescribed in a hospitalisation or day care claim (Code-Excl14)","Refractive error less than 7.5 dioptres (Code- Excl 15)","Unproven treatments (Code- Excl 16)","Sterility and Infertility (Code- Excl 17)","Maternity (Code - Excl 18)","Alcoholic pancreatitis","Congenital External Diseases, defects or anomalies","Stem cell therapy (except hematopoietic stem cells for bone marrow transplant)","Growth Hormone Therapy","Sleep-apnoea","Admission primarily for intra-articular or intra-lesional injections, IVIG infusion or supplementary medications like Zolendronic Acid","Venereal disease, sexually transmitted disease or illness","All preventive care, vaccination and immunisations (except post-bite treatment and vaccines explicitly covered)","Dental treatment or surgery of any kind","Any existing disease mentioned as Permanent exclusion in the Policy Schedule","War, invasion, nuclear weapons/materials, chemical and biological weapons, ionising radiation","Naval, military or air force operations","Intentional self-injury or attempted suicide","Items of personal comfort and convenience","Treatment by a Medical Practitioner outside his discipline","Fees of a doctor sharing the insured's residence or an immediate relative","Hearing aids, spectacles or contact lenses","Alopecia, baldness, wigs or toupees, elastic stockings, diabetic test strips","Treatment not part of Reasonable and Customary charges or not medically necessary; drugs without prescription","Crutches or any other external appliance","Illness or change in health after the proposal and before commencement not communicated and accepted"],"display":"Standard exclusions (Excl 04 to Excl 18) plus alcoholic pancreatitis, external congenital diseases, sleep-apnoea, growth hormone therapy, dental treatment, preventive care, war and others","note":"Hazardous sports excluded only when taking part as a professional. Cosmetic surgery is paid for reconstruction after an accident, burns or cancer. The CIS prints the same list in summary.","quote":"Investigation and evaluation (Code- Excl 04) ... Rest cure, rehabilitation and respite care (Code- Excl 05) ... Obesity/ Weight Control (Code- Excl 06) ... Change-of-Gender treatments: Code- Excl07 ... Cosmetic or Plastic Surgery (Code- Excl 08) ... Hazardous or Adventure Sports (Code- Excl 09) ... Breach of law (Code- Excl 10) ... Excluded Providers: (Code-Excl 11) ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof (Code- Excl 12) ... Treatments received in heath hydros, nature cure clinics, spas or similar establishments or private beds registered as a nursing home attached to such establishments or where admission is arranged wholly or partly for domestic reasons. (Code- Excl13) ... Dietary supplements and substances that can be purchased without prescription ... unless prescribed by a medical practitioner as part of hospitalization claim or day care procedure. (Code-Excl14) ... Refractive error (Code- Excl 15): Expenses related to the treatment for correction of eye sight due to refractive error less than 7.5 dioptres. ... Unproven treatments (Code- Excl 16) ... Sterility and Infertility (Code- Excl 17) ... Maternity (Code - Excl 18) ... Alcoholic pancreatitis ... Congenital External Diseases, defects or anomalies ... Stem cell therapy; however, hematopoietic stem cells for bone marrow transplant for haematological conditions will be covered ... Growth Hormone Therapy ... Sleep-apnoea ... Admission primarily for administration of Intra-articular or intra-lesional injections or Intravenous immunoglobulin infusion or supplementary medications like Zolendronic Acid ... Venereal disease, sexually transmitted disease or illness ... All preventive care, vaccination including inoculation and immunisations (except in case of post- bite treatment and other vaccines explicitly covered) ... Dental treatment or surgery of any kind ... Any existing disease specifically mentioned as Permanent exclusion in the Policy Schedule. ... War or any act of war, invasion, act of foreign enemy ... nuclear weapons/materials, chemical and biological weapons, ionising radiation. ... Any Insured Person’s participation or involvement in naval, military or air force operation. ... Intentional self-injury or attempted suicide while sane or insane. ... Items of personal comfort and convenience ... Treatment rendered by a Medical Practitioner which is outside his discipline. ... Doctor’s fees charged by the Medical Practitioner sharing the same residence as an Insured Person or who is an immediate relative of an Insured Person's family. ... Provision or fitting of hearing aids, spectacles or contact lenses ... Any treatment and associated expenses for alopecia, baldness, wigs, or toupees, medical supplies including elastic stockings, diabetic test strips, and similar products. ... Any treatment or part of a treatment that is not a part of ‘Reasonable and Customary charges’, not medically necessary; drugs or treatments which are not supported by a prescription. ... Crutches or any other external appliance ... Any illness diagnosed or injury sustained or where there is change in health status of the member after date of proposal and before commencement of policy and the same is not communicated and accepted by us.","sources":[{"clause":"14","heading":null,"page":18,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-2"},{"clause":"14(XVII)(d)(ii)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-xvii-d-ii"},{"clause":"14(XVII)(d)(iv)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-xvii-d-iv"},{"clause":"14(XVII)(b)(i)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-xvii-b-i"},{"clause":"14(XVII)(b)(ii)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-xvii-b-ii"},{"clause":"14(XVII)(b)(iii)","heading":"Excluded Providers","page":23,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-xvii-b-iii"},{"clause":"14(XVII)(b)(iv)","heading":null,"page":24,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-xvii-b-iv"},{"clause":"14(XVII)(b)(v)","heading":null,"page":24,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-xvii-b-v"},{"clause":"14(XVII)(b)(vi)","heading":null,"page":24,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-xvii-b-vi"},{"clause":"14(XVII)(b)(vii)","heading":null,"page":24,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-xvii-b-vii"},{"clause":"14(XVII)(b)(viii)","heading":null,"page":24,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-xvii-b-viii"},{"clause":"14(XVII)(b)(ix)","heading":null,"page":24,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-xvii-b-ix"},{"clause":"14(XVII)(b)(x)","heading":null,"page":24,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-xvii-b-x"},{"clause":"14(XVII)(b)(xi)","heading":null,"page":24,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-xvii-b-xi"}],"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":"cross-checked","value":"You may cancel with 7 days written notice and get a proportionate refund for the unexpired period; no refund if any claim has been admitted or lodged or any benefit availed. No refund if the insurer cancels for fraud or non-disclosure.","display":"Proportionate refund for the unexpired period; none if a claim was lodged or a benefit availed","note":"Insurer may cancel on established fraud, misrepresentation or non-disclosure with 15 days' written notice.","quote":"The policyholder may cancel this policy by giving 7 days written notice and in such an event, the company shall refund proportionate premium for unexpired policy period. No refunds of premium shall be made in respect of Cancellation where, any claim has been admitted or has been lodged or any benefit under this Policy has been availed by the Insured Person. ... There would be no refund of premium on cancellation on grounds of established fraud, misrepresentation or non-disclosure of material facts.","sources":[{"clause":"7","heading":"Cancellation","page":26,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-7-3"}],"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":"cross-checked","value":"India only.","display":"India only","note":null,"quote":"This Policy only covers medical treatment taken within India, and payments under this Policy shall only be made in Indian Rupees within India.","sources":[{"clause":"24(c)","heading":null,"page":34,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-24-c-3"}],"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":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":"Refund less proportionate risk premium, medical examination expenses and stamp duty, if no claim was made.","quote":"The insured person shall be provided a free look period of thirty days beginning from the date of receipt of the policy document","sources":[{"clause":"14","heading":"Free look period","page":29,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-3"}],"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":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":"15 days for monthly instalments.","quote":"The grace period for payment of the premium shall be: fifteen days where premium payment mode is monthly and thirty days in all other cases.","sources":[{"clause":"15","heading":"Grace Period","page":4,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-15"}],"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":"cross-checked","value":"From 61 years; no maximum entry age.","display":"61 years and above, no upper limit","note":"No maximum cover ceasing age.","quote":"This policy covers persons in the age group 61 years onwards. There is no maximum entry age limit.","sources":[{"clause":"1","heading":"Suitability","page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1070#c-1"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"cross-checked","value":["Full premium upfront (lump sum)","Annually","Half-Yearly","Quarterly","Monthly"],"display":"Full premium upfront, or instalments (annual, half-yearly, quarterly, monthly)","note":"Monthly instalments carry a loading of 5% (1 year), 9% (2 years) or 13% (3 years) (prospectus). Annual, half-yearly and quarterly instalments appear only in the grace period clause.","quote":"If you have opted to pay premium in full (lump sum) upfront ... fifteen days where premium payment mode is monthly and thirty days in all other cases (Annually/Half-Yearly/Quarterly/ Limited Premium Payment Term) ... Monthly instalment option would be allowed and following loadings shall be applicable:","sources":[{"clause":null,"heading":"4 (i) above)","page":29,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-4-i-above"},{"clause":"10(iv)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-10-iv"},{"clause":"20","heading":"Premium Rates & Payment Zones","page":16,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1070#c-20"}],"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":"cross-checked","value":["TATA AIG Co-payment Waiver Add on (UIN: TATHLIA24178V012324)"],"display":"Co-payment Waiver Add on (TATHLIA24178V012324)","note":"Named only in the CIS. No Claim Discount (1% renewal discount) can be chosen instead of Cumulative Bonus at no extra premium.","quote":"<<TATA AIG Co-payment Waiver Add on >> (UIN:TATHLIA24178V012324) (For applicability, terms and conditions, please refer Add On Wordings): Waiver of Co-Payment","sources":[{"clause":"Excl17","heading":null,"page":2,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1071#c-excl17"}],"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":"cross-checked","value":"For instalment premiums within the policy period, cover continues during the grace period. At the end of the policy period, there is no cover during the grace period.","display":"Instalments: covered during grace; at renewal: not covered","note":null,"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.","sources":[{"clause":"10(a)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-10-a"},{"clause":"10(b)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-10-b"}],"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.","status":"cross-checked","value":"Single private room. In a higher room category the insured bears a proportionate share of associated medical expenses (pharmacy, diagnostics, implants and consumables excepted).","display":"Up to a single private room","note":"CIS: 'Room Eligibility Up to Single private room.' Proportionate deduction applies only in hospitals with differential billing by room category.","quote":"If the Insured Person is admitted in a room which is of higher category than Single Private, then the Insured Person shall bear a rateable proportion of the total Associated Medical Expenses ... except pharmacy charges, diagnostic costs, costs of implants & medical devices and consumables expenses","sources":[{"clause":"Section 2","heading":"Benefits","page":9,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-section-2"}],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself.","status":"cross-checked","value":"20% of every admissible claim.","display":"20% on every claim","note":"Applies to in-patient, pre and post hospitalisation, day care, AYUSH, consumables, high end diagnostics and home care claims. Not applied to road ambulance claims or to cataract and joint replacement surgery (which have sub-limits). Waived if the optional Co-payment Waiver Add on (CIS) is bought.","quote":"This policy is subject to a mandatory co-payment of 20% and You shall be liable to pay 20% of the admissible claim amount of each and every claim. ... Mandatory co-payment of 20% shall not be applicable on claim incurred for these surgical procedures. ... Mandatory co-payment of 20% shall not be applicable on claim under this section. ... if this Add on is opted, then mandatory Co-payment shall not be applicable on admissible claim under the base Policy.","sources":[{"clause":null,"heading":"B8. AYUSH Benefit","page":12,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-b8-ayush-benefit"},{"clause":"14","heading":null,"page":18,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-2"},{"clause":"Excl17","heading":null,"page":2,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1071#c-excl17"}],"law":[]},{"key":"disease_sublimits","label":"Disease or procedure sub-limits","section":"Limits and co-pay","meaning":"Caps on what is paid for named treatments even if the sum insured is higher.","status":"cross-checked","value":["Cataract (per eye per insured person), per policy year: Zone A Rs. 50,000 / Rs. 75,000 / Rs. 1,00,000 (columns: the three sum insured options, lowest to highest)","Cataract: Zone B Rs. 47,500 / Rs. 70,000 / Rs. 95,000","Cataract: Zone C Rs. 40,000 / Rs. 60,000 / Rs. 80,000","Joint Replacement Surgery (per insured person), per policy year: Zone A Rs. 2,00,000 / Rs. 3,00,000 / Rs. 5,00,000","Joint Replacement Surgery: Zone B Rs. 1,90,000 / Rs. 2,85,000 / Rs. 4,75,000","Joint Replacement Surgery: Zone C Rs. 1,60,000 / Rs. 2,50,000 / Rs. 4,00,000","Home Care Treatment (dialysis, chemotherapy, pandemic care at home): up to 10% of the sum insured"],"display":"Cataract Rs. 40,000 to Rs. 1,00,000 per eye; joint replacement Rs. 1,60,000 to Rs. 5,00,000 (by zone and sum insured); home care up to 10% of sum insured","note":"Columns are sum insured Rs5 Lacs, Rs10 Lacs and Rs25 Lacs. Zone is the premium payment zone in the schedule (Zone A: Mumbai/MMR, Delhi NCR, Ahmedabad, Surat, Baroda; Zone B: Hyderabad, Bengaluru, Kolkata, Indore, Chennai, Chandigarh tricity, Pune, Rajkot; Zone C: rest of India). Cataract and joint replacement caps include pre and post hospitalisation and carry no 20% co-payment. Home care cap excludes accrued cumulative bonus. The prospectus prints the same table.","quote":"The expenses payable during the entire policy year for following surgical procedures, either as Day Care or In-patient is limited to the amount mentioned in the table below: ... a) Cataract (per eye per insured person) ... Rs5 Lacs | Rs10 Lacs | Rs25 Lacs ... Zone A | Rs. 50,000 | Rs. 75,000 | Rs. 1,00,000 ... Zone B | Rs. 47,500 | Rs. 70,000 | Rs. 95,000 ... Zone C | Rs. 40,000 | Rs. 60,000 | Rs. 80,000 ... b) Joint Replacement Surgery (per insured person) ... Zone A | Rs. 2,00,000 | Rs. 3,00,000 | Rs. 5,00,000 ... Zone B | Rs. 1,90,000 | Rs. 2,85,000 | Rs. 4,75,000 ... Zone C | Rs. 1,60,000 | Rs. 2,50,000 | Rs. 4,00,000 ... Sub-limits will also include the expenses incurred on pre hospitalisation and post hospitalisation expenses. ... Mandatory co-payment of 20% shall not be applicable on claim incurred for these surgical procedures. ... B16. Home Care Treatment Cover We will cover for reasonable and customary medical expenses incurred for treatment taken at home ... up to 10% of the sum insured (excluding accrued cumulative bonus) ... a) Dialysis at home ... b) Chemotherapy at home ... c) Pandemic Care at home","sources":[{"clause":null,"heading":"B14. Medical Second Opinion","page":14,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-b14-medical-second-opinion"},{"clause":"Section 2(VII)(a)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-section-2-vii-a-2"},{"clause":"Section 2(VII)(b)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-section-2-vii-b-2"},{"clause":"Section 2(VII)(c)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-section-2-vii-c-2"},{"clause":"14","heading":null,"page":18,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-14-2"}],"law":[]},{"key":"pre_policy_checkup","label":"Medical tests before buying","section":"Eligibility","meaning":"Whether you need medical tests before the policy is issued.","status":"cross-checked","value":"Yes. A pre-policy check-up at the insurer's network is required (tests by age band 61-70 years and 71 years & above); Tata AIG bears at least 50% of the cost if the proposal is accepted.","display":"Yes, required at the insurer's network","note":"Reports valid 90 days. Additional tests may be called for after an adverse medical declaration.","quote":"Pre-Policy Check-up at our network is required. ... 61-70 Years | MER, CBC ESR, HbA1c, Lipid Profile, Sr. Creat, SGOT, SGPT, Urine Routine, ECG ... 71 Years & above | MER, CBC ESR, HbA1c, Lipid Profile, Sr. Creat, SGOT, SGPT, Urine Routine, 2 D Echo, USG ... *At least 50% of pre-policy medical checkup cost would be borne by Tata AIG in case where proposal is accepted.","sources":[{"clause":"19","heading":"Pre-policy medical check-up","page":15,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1070#c-19"}],"law":[]},{"key":"pre_hospitalisation","label":"Pre-hospitalisation cover","section":"Cover","meaning":"Medical costs before admission that are paid.","status":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":"90 days under the AYUSH benefit. Payable only if the in-patient or day care claim is admitted.","quote":"We will cover for expenses for Pre-Hospitalization consultations, investigations and medicines incurred upto 30 days before the date of admission to the hospital. ... This benefit shall also cover Pre-Hospitalization medical expenses for a period of upto 90 days before the date of admission to the AYUSH hospital/ AYUSH day care centre","sources":[{"clause":"Section 2","heading":"Benefits","page":9,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-section-2"},{"clause":null,"heading":"B8. AYUSH Benefit","page":12,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-b8-ayush-benefit"}],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs after discharge that are paid.","status":"cross-checked","value":{"unit":"days","amount":60},"display":"60 days","note":"90 days under the AYUSH benefit. Payable only if the in-patient or day care claim is admitted.","quote":"We will cover for expenses for Post-Hospitalization consultations, investigations and medicines incurred upto 60 days after discharge from the hospital. ... Post-Hospitalization Medical Expenses for a period upto 90 days","sources":[{"clause":"Section 2","heading":"Benefits","page":9,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-section-2"},{"clause":null,"heading":"B8. AYUSH Benefit","page":12,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-b8-ayush-benefit"}],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital.","status":"cross-checked","value":"Covered: day care treatment at a hospital or day care centre.","display":"Covered","note":"Treatment normally taken on an out-patient basis is not included.","quote":"B7. Day Care Procedures We will cover expenses for Day Care Treatment due to disease/illness/Injury during the policy period taken at a hospital or a Day Care Centre.","sources":[{"clause":null,"heading":"B6. Compassionate Care","page":11,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-b6-compassionate-care"}],"law":[]},{"key":"restoration","label":"Restoration of sum insured","section":"Cover","meaning":"Whether the sum insured is refilled after it is used up.","status":"not-stated","value":null,"display":null,"note":"The documents do not mention restoration or recharge of the sum insured.","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":"cross-checked","value":"Cumulative bonus of 10% of the base sum insured for every claim-free year, up to 100%. After a claim, it is reduced by 10% of the sum insured in the next year. Alternatively a 1% renewal premium discount per claim-free year (No Claim Discount) can be chosen.","display":"10% a claim-free year, up to 100%; reduced by 10% after a claim","note":"Bonus is computed on the base sum insured only. Choosing No Claim Discount means no Cumulative Bonus for that year.","quote":"10% cumulative bonus will be applied on the Sum Insured for next policy year under the Policy after every claim free Policy Year, provided that the Policy is renewed with Us and without a break. The maximum accrued cumulative bonus shall not exceed 100% of the Sum Insured in any Policy Year. ... If a Cumulative Bonus has been applied and a claim is made, then in the subsequent Policy Year We will automatically decrease the Cumulative Bonus by 10% of the Sum Insured in that following Policy Year. ... Cumulative Bonus shall be provided only if No Claim Discount has not been availed for the claim free previous Policy Year. ... If you Choose No Claim Discount, We will allow 1% discount on renewal premium for every claim free Policy Year, provided that the Policy is renewed with Us without break.","sources":[{"clause":null,"heading":"B12. Consumables Benefit","page":13,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-b12-consumables-benefit"},{"clause":"2(c)","heading":null,"page":2,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1070#c-2-c"}],"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":"cross-checked","value":"Yes, at network hospitals only, with pre-authorisation.","display":"Yes, at network hospitals","note":"Prospectus mentions a network of 7000+ hospitals across India. Notify at least 48 hours before planned or within 24 hours after emergency hospitalisation.","quote":"Cashless Service is only available at Network Hospitals. ... Prior to taking treatment and/or incurring Medical Expenses at a Network Hospital, You must notify our designated TPA/Us and request pre-authorization. ... network of 7000+ hospitals across India ... At least 48 hours before the planned treatment or Hospitalisation ... Within 24 hours after the treatment or Hospitalisation","sources":[{"clause":"24","heading":"Premium Refund in case of demise of the Insured Person","page":31,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-24-2"},{"clause":"24(i)","heading":null,"page":32,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-24-i"},{"clause":"24(a)","heading":null,"page":32,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-24-a"},{"clause":"2(ii)","heading":"Network of hospitals","page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1070#c-2-ii"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"cross-checked","value":"Tata AIG itself (TAGIC Health Claims); a TPA may be named in the policy schedule.","display":"The insurer (TAGIC Health Claims)","note":null,"quote":"The final decision on all claims is taken by Tata AIG General Insurance Company Limited. ... Name | TAGIC Health Claims ... *TPA as mentioned in the policy schedule, if applicable.","sources":[{"clause":"11","heading":"Claim Procedure","page":11,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1070#c-11"},{"clause":null,"heading":"Claims Servicing Details","page":11,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1070#c-claims-servicing-details"},{"clause":"24","heading":"Premium Refund in case of demise of the Insured Person","page":31,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069#c-24-2"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"cross-checked","value":true,"display":"Yes, up to 2 members","note":"Family floater discount of 20% for 2 members (prospectus).","quote":"The policy offers coverage on family floater basis. ... Maximum 2 members are covered in one Family Floater Plan policy (Self and spouse or one set of parents/parent-in-laws/grandparents)","sources":[{"clause":"1","heading":"Suitability","page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1070#c-1"}],"law":[]}],"documents":[{"kind":"wording","label":"Tata AIG Elder Care(TATHLIP23179V012223)","pages":39,"fetched_at":"2026-10-19 17:40:48.527299+00","source_url":"https://www.tataaig.com/s3/Elder_Care_Policy_Wordings_9d18315430.pdf","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1069"},{"kind":"prospectus","label":"Tata AIG Elder Care(TATHLIP23179V012223)","pages":19,"fetched_at":"2026-10-19 17:40:48.527299+00","source_url":"https://www.tataaig.com/s3/eldercare_prospectus_b5d025637c.pdf","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1070"},{"kind":"cis","label":"Tata AIG Elder Care(TATHLIP23179V012223)","pages":6,"fetched_at":"2026-10-19 17:40:48.527299+00","source_url":"https://www.tataaig.com/s3/Tata_AIG_Elder_Care_CIS_a1c17bf958.pdf","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/1071"},{"kind":"brochure","label":"Tata AIG Elder Care","pages":10,"fetched_at":"2026-10-17 20:06:39+00","source_url":"https://www.tataaig.com/s3/tata_aig_elder_care_brochure_05_12_24_64748e0c84.pdf","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/16834"},{"kind":"premium","label":"Tata AIG Elder Care(TATHLIP23179V012223)","pages":null,"fetched_at":"2026-10-17 20:06:11+00","source_url":"https://www.tataaig.com/s3/elder_care_rate_chart_302ed17eca.pdf","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/31824"},{"kind":"proposal","label":"Tata AIG Elder Care(TATHLIP23179V012223)","pages":null,"fetched_at":"2026-10-17 20:17:57+00","source_url":"https://www.tataaig.com/s3/elder_care_proposal_form_d35a0d8615.pdf","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223/document/31883"}],"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":"Tata AIG Elder Care (UIN TATHLIP23179V012223), IndiaInsurances, https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-elder-care-tathlip23179v012223"}