{"uin":"TATHLIP26052V052526","name":"TATA AIG MediCare Premier","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526","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":"New","kind":"product","status":"active","approved_on":"2018-11-04","withdrawn_on":null,"summary":"TATA AIG MediCare Premier is a health indemnity policy with individual and family floater coverage options and policy terms of 1, 2 or 3 years. It has 30 days initial waiting, 24 months PED and specific disease waiting, global planned hospitalisation where applicable, restore benefit once in a policy year, and sum insured options from Rs. 5 Lacs to Rs. 300 Lacs.","analysis":{"state":"machine","analysed_at":"2026-10-19 22:46:16.714328+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":"quote-verified","value":["Individual","Family floater"],"display":"Individual/Family floater","note":"These are coverage options, not named plan tiers.","quote":"Coverage Options | Individual/Family floater","sources":[{"clause":"1","heading":"Suitability","page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16840#c-1"}],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"Policy term is 1 Year/ 2 Years/ 3 Years.","display":"1 Year/ 2 Years/ 3 Years","note":null,"quote":"Policy Term | 1 Year/ 2 Years/ 3 Years","sources":[{"clause":"1","heading":"Suitability","page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16840#c-1"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"quote-verified","value":"For planned hospitalisation, the designated TPA or insurer must be informed at least 48 hours before hospitalisation or treatment. For emergency hospitalisation, they must be informed no later than 24 hours from the start of hospitalisation or treatment.","display":"Planned: at least 48 hours prior; emergency: no later than 24 hours","note":null,"quote":"For any emergency Hospitalisation, our designated TPA/We must be informed no later than 24 hours of the start of Your hospitalization/ treatment. ... For any planned hospitalization, our designated TPA/We must be informed atleast 48 hours prior to the start of your hospitalization/treatment.","sources":[{"clause":"Excl18(II)(b)","heading":null,"page":50,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-b-4"},{"clause":"Excl18(II)(c)","heading":null,"page":50,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-c-2"}],"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":["Our claim form, duly completed and signed","Original Bills (pharmacy purchase bill, consultation bill, diagnostic bill) and any attachments thereto like receipts or prescriptions","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","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","Regulatory requirements as amended from time to time, currently mandatory NEFT and KYC requirements","Legal heir/succession certificate, if required","PM report (wherever applicable)"],"display":"Claim form, original bills and receipts, medical reports/case papers/discharge summaries, diagnosis, service list, prescriptions, investigation and follow-up records, and other claim-specific documents","note":"The company may call for additional documents wherever required.","quote":"Our claim form, duly completed and signed for on behalf of the Insured Person. ... Original Bills (pharmacy purchase bill, consultation bill, diagnostic bill) and any attachments thereto like receipts or prescriptions in support of any amount claimed which will then become Our property. ... 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 in case not available in the submitted hospital bill. ... Prescriptions that name the Insured Person and in the case of drugs: the drugs prescribed, their price and a receipt for payment. In case of pre/post hospitalization claim Prescriptions must be submitted with the corresponding Doctor/hospital invoice. ... All pre and post investigation, treatment and follow up (consultation) records pertaining to the present ailment for which claim is being made, if and where applicable. ... Treating doctor’s certificate regarding missing information in case histories e.g. Circumstance of injury and Alcohol or drug influence at the time of accident, if available ... 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 and available with the claimant. ... Regulatory requirements as amended from time to time, 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":"Excl18(II)(a)","heading":null,"page":51,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-a-5"},{"clause":"Excl18(II)(b)","heading":null,"page":51,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-b-5"},{"clause":"Excl18(II)(c)","heading":null,"page":51,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-c-3"},{"clause":"Excl18(II)(d)","heading":null,"page":51,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-d-2"},{"clause":"Excl18(II)(e)","heading":null,"page":51,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-e-2"},{"clause":"Excl18(II)(f)","heading":null,"page":51,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-f-2"},{"clause":"Excl18(II)(g)","heading":null,"page":51,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-g-2"},{"clause":"Excl18(II)(h)","heading":null,"page":51,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-h-2"},{"clause":"Excl18(II)(i)","heading":null,"page":51,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-i-2"},{"clause":"Excl18(II)(j)","heading":null,"page":51,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-j-2"},{"clause":"Excl18(II)(k)","heading":null,"page":51,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-k"},{"clause":"Excl18(II)(l)","heading":null,"page":51,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-l"},{"clause":"Excl18(II)(m)","heading":null,"page":51,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-m"},{"clause":"Excl18(II)(n)","heading":null,"page":51,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-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":"quote-verified","value":"The company shall settle or reject a claim within 15 days from receipt of the last necessary document. If investigation is required, it must be completed within 30 days and the claim settled or rejected within 45 days from receipt of the last necessary document, with penal interest for delay.","display":"15 days from last necessary document; 45 days if investigation is required","note":null,"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. ... where the circumstances of a claim warrant an investigation in the opinion of the Company, it shall initiate and complete such investigation at the earliest, in any case not later than 30 days from the date of receipt of last necessary document. In such cases, the Company shall settle or reject the claim within 45 days from the date of receipt of last necessary document. ... In case of delay beyond stipulated 45 days, the Company shall be liable to pay interest to the policyholder at a rate 2% above the bank rate from the date of receipt of last necessary document to the date of payment of claim.","sources":[{"clause":"Excl18(b)(xiv)","heading":null,"page":40,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-b-xiv"}],"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":["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 the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage","Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 24 months","Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded","Expenses related to any admission primarily for enforced bed rest and not for receiving treatment","Expenses related to surgical treatment of obesity that does not fulfil the below conditions","Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex","Expenses for cosmetic or plastic surgery or any treatment to change appearance","Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof","Expenses related to Sterility and infertility","Expenses related to any unproven treatment, services and supplies for or in connection with any treatment","Hazardous or Adventure Sports","Breach of law","Excluded Providers","War or any act of war"],"display":"30-day illness waiting, 24-month specific disease/procedure waiting, 24-month PED waiting, diagnostics-only admissions, rest cure, obesity surgery outside conditions, change of gender, cosmetic/plastic surgery, substance abuse, infertility, unproven treatment, hazardous sports, breach of law, excluded providers and war","note":"This is a selected list of main exclusions and waiting-period exclusions, not every exclusion in the policy.","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, provided the same are covered. ... Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. ... 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. ... Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded. ... Expenses related to any admission primarily for enforced bed rest and not for receiving treatment. ... Expenses related to surgical treatment of obesity that does not fulfil the below conditions: ... Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex ... Expenses for cosmetic or plastic surgery or any treatment to change appearance ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof .(Code - Excl12) ... Expenses related to Sterility and infertility. ... Expenses related to any unproven treatment, services and supplies for or in connection with any treatment. ... Hazardous or Adventure Sports (Code Excl09) : ... Breach of law (Code Excl10): ... Excluded Providers (Code-Excl11): ... War or any act of war, invasion, act of foreign enemy, war like operations","sources":[{"clause":"41(I)(a)","heading":null,"page":34,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i-a-10"},{"clause":"41(I)(a)","heading":null,"page":34,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i-a-11"},{"clause":"41(II)","heading":null,"page":34,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-ii-2"},{"clause":"41(II)(d)(ii)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-ii-d-ii"},{"clause":"Excl18(b)(i)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-b-i"},{"clause":"Excl18(b)(ii)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-b-ii"},{"clause":"Excl18(b)(iii)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-b-iii"},{"clause":"Excl18(b)(vi)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-b-vi"}],"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":"quote-verified","value":"First complain to TATA AIG by phone or email at customersupport@tataaig.com. If unresolved, escalate to manager.customersupport@tataaig.com, then to the Head of Customer Services at head.customerservices@tataaig.com, before approaching the Insurance Ombudsman or Bima Bharosa.","display":"TATA AIG customer support, then manager.customersupport@tataaig.com, then Head of Customer Services","note":null,"quote":"If you’re not satisfied and wish to lodge a complaint, please call our 24/7 toll-free number 1800-266-7780/ 1800 22 9966 (For Senior Citizen) or 022-66939500 (toll charges apply), or email us at customersupport@tataaig.com. ... If you do not receive a response or are not satisfied with the resolution, please contact us at manager.customersupport@tataaig.com. ... If you still need assistance, reach out to the Head of Customer Services at head.customerservices@tataaig.com. ... If you're still not satisfied after this process, you may approach the Insurance Ombudsman of concerned jurisdiction.","sources":[{"clause":"Excl18(II)(b)(ii)","heading":null,"page":44,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-b-ii"}],"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":"quote-verified","value":"Sum insured options are Rs. 5 Lacs, 10 Lacs, 15 Lacs, 20 Lacs, 25 Lacs, 50 Lacs, 75 Lacs, 100 Lacs, 200 Lacs and 300 Lacs.","display":"Rs. 5 Lacs to Rs. 300 Lacs","note":null,"quote":"• 5 Lacs | • 20 Lacs | • 75 Lacs\n• 10 Lacs | • 25 Lacs | • 100 Lacs\n• 15 Lacs | • 50 Lacs | • 200 Lacs\n• 300 Lacs","sources":[{"clause":"5","heading":"Sum Insured options (Rs.)","page":7,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16840#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":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Does not apply to covered accident claims.","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, provided the same are covered.","sources":[{"clause":"41(I)(a)","heading":null,"page":34,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i-a-10"}],"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":"quote-verified","value":{"unit":"months","amount":24},"display":"24 months","note":"Coverage after 24 months is subject to declaration at application and acceptance by the insurer.","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":"41(II)","heading":null,"page":34,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-ii-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":"quote-verified","value":{"unit":"months","amount":24},"display":"24 months","note":"Does not apply to claims arising due to an accident.","quote":"Expenses related to the treatment of the listed Conditions, surgeries/treatments 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":"41(I)(a)","heading":null,"page":34,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i-a-11"}],"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":"quote-verified","value":["Tumors, Cysts, polyps including breast lumps (benign)","Polycystic ovarian disease","Fibromyoma","Adenomyosis","Endometriosis","Prolapsed Uterus","Gout and Rheumatism","Rheumatoid arthritis","Non-infective arthritis","Ligament, Tendon or Meniscal tear","Prolapsed Inter-Vertebral Disc","Spinal Diseases including spondylitis/spondylosis unless arising from Accident","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","Osteoarthritis and osteoporosis","Systemic connective tissue disorders, inflammatory polyarthropathies","Adenoidectomy","Mastoidectomy","Tonsillectomy","Tympanoplasty","Surgery for nasal septum deviation and Nasal concha resection","Surgery for Turbinate hypertrophy","Hysterectomy","Joint replacement","Cholecystectomy","Hernioplasty or Herniorraphy","Surgery/procedure for Benign prostate enlargement","Surgery for Hydrocele/ Rectocele/Spermatocele","Surgery of varicose veins and varicose ulcers","Obesity / Weight control procedures including Gastric bypass surgeries"],"display":"Listed specific diseases and procedures including tumours/cysts/polyps, cataract, joint replacement, hernia surgery, varicose veins surgery and obesity/weight control procedures","note":null,"quote":"List of Specific Diseases/procedures as furnished below:\nI. Tumors, Cysts, polyps including breast lumps (benign) (Arbud, Granthi, including arbud in Sthana) ... II) Polycystic ovarian disease (garbhashaya granthi), Fibromyoma {Aartav dushti (Sowmya arbudham)}, Adenomyosis, Endometriosis (Udavarthani yoni vyaazpt) III. Prolapsed Uterus (Yoni bhramsha)\nIV. Gout and Rheumatism, (Vaathraktha and Aamvaat / Aadhya vata), Rheumatoid arthritis, Non-infective arthritis (Sandhi shool {Dhatukshay janya or Avrodhjanya, both, Sandhigata vata, Vata roga})\nV. Ligament, Tendon or Meniscal tear (Sira, kandara, maamsgat vaat janya shool, sandhi shola)\nVI. Prolapsed Inter-Vertebral Disc (Katishool, Greevashool, Grudhrasi vata) and Spinal Diseases including spondylitis/spondylosis unless arising from Accident\nVII. Cholelithiasis (yakrut roga)\nVIII. Pancreatitis\nIX. Fissure/fistula in anus, haemorrhoids, pilonidal sinus (Arsha, Parikartika, bhagandar, gudagat vranshoth, nadi vrana)\nX. Ulcer & erosion of stomach & duodenum\nXI. Gastro Esophageal Reflux Disorder (GERD) (Parinamshool, annadravakhya shool, Amlapitta, Grahani)\nXII. Liver Cirrhosis\nXIII. Perineal Abscesses (bhagandhara)\nXIV. Perianal / Anal Abscesses\nXV. Calculus diseases of Urogenital system Example: Kidney stone, Urinary bladder stone (Ashmari of all types)\nXVI. Benign Hyperplasia of prostate (Asththila vruddhi)\nXVII. Varicocele (Vruddhi, Vrushanshoth) XVIII. Cataract (avrana Shukla), Retinal detachment, Glaucoma (abhishyandha)\nXIX. Congenital Internal Diseases\nXX. Osteoarthritis and osteoporosis (Asthikshay/ asti gata vata)\nXXI. Systemic connective tissue disorders, inflammatory polyarthropathies\nList of procedure/surgeries/treatments:\nXXII. Adenoidectomy XXIII. Mastoidectomy\nXXIV. Tonsillectomy\nXXV. Tympanoplasty\nXXVI. Surgery for nasal septum deviation and Nasal concha resection XXVII. Surgery | for\nTurbinate hypertrophy XXVIII. Hysterectomy\nXXIX. Joint replacement (for example: Knee replacement, Hip replacement) XXX. Cholecystectomy\nXXXI. Hernioplasty or Herniorraphy XXXII. Surgery/procedure for Benign prostate enlargement XXXIII. Surgery for Hydrocele/ Rectocele/Spermatocele XXXIV. Surgery of varicose veins and varicose ulcers\nXXXV. Obesity / Weight control procedures including Gastric bypass surgeries","sources":[{"clause":"41(I)(f)","heading":null,"page":34,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i-f-4"},{"clause":"41(II)","heading":null,"page":34,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-ii-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":"quote-verified","value":{"unit":"years","amount":5},"display":"five continuous years","note":"For enhanced sum insured, five continuous years apply from the date of enhancement only on the enhanced limits.","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. This continuous period of five years is called as moratorium period.","sources":[{"clause":"Excl18(II)(b)(ii)","heading":null,"page":44,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-b-ii"}],"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":"quote-verified","value":"The insured person can port the entire policy to another insurer, with all family members if any, by applying at least 30 days before and not earlier than 60 days from the renewal date. Continuity benefits can transfer for sum insured, no claim bonus, specific waiting periods, PED waiting period and moratorium period, as applicable.","display":"Allowed; apply at least 30 days before, but not earlier than 60 days from, renewal date","note":null,"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 as per IRDAI guidelines. ... 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 from the Existing Insurer to the Acquiring Insurer in the previous policy, as applicable.","sources":[{"clause":"Excl18(II)","heading":null,"page":42,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii"}],"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":"quote-verified","value":true,"display":"Yes, continuous renewal with no exit age","note":null,"quote":"We will be offering continuous renewal with no exit age subject to regular premium payment and compliance with all provisions and terms & conditions of this policy by the Insured Person.","sources":[{"clause":"Excl18(II)(b)(iii)","heading":null,"page":46,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-b-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":"quote-verified","value":"No loading shall apply on renewals based on individual claims experience.","display":"No loading on renewals based on individual claims experience","note":null,"quote":"No loading shall apply on renewals based on individual claims experience","sources":[{"clause":"Excl18(II)(b)","heading":null,"page":44,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-b"}],"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":["Investigation and evaluation (Code-Excl04)","Rest cure, rehabilitation and respite care (Code-Excl05)","Obesity/ Weight Control (Code – Excl 06)","Change-of-Gender treatments (Code- Excl 07)","Cosmetic or Plastic Surgery (Code – Excl08)","Hazardous or Adventure Sports (Code Excl09)","Breach of law (Code Excl10)","Excluded Providers (Code-Excl11)","Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof .(Code - Excl12)","Treatments received in heath hydros, nature cure clinics, spas or similar establishments","Dietary supplements and substances that can be purchased without prescription","Refractive error (Code- Excl 15)","Unproven treatments (Code-Excl16)","Sterility and infertility (Code-Excl17)","Maternity (Code - Excl18)","Alcoholic pancreatitis","Congenital External Diseases, defects or anomalies","Stem cell therapy","Growth hormone therapy","Sleep-apnoea"],"display":"Standard permanent exclusions Excl04 to Excl18 plus product-specific exclusions including alcoholic pancreatitis, congenital external diseases, stem cell therapy, growth hormone therapy and sleep-apnoea","note":"Bariatric surgery is covered under benefit B14 when the listed conditions are met; maternity exclusion is modified by the maternity cover after its waiting period.","quote":"Investigation and evaluation (Code-Excl04): ... Rest cure, rehabilitation and respite care (Code-Excl05): ... Obesity/ Weight Control (Code – Excl 06) ... Change-of-Gender treatments (Code- Excl 07) ... Cosmetic or Plastic Surgery (Code – Excl08): ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof .(Code - Excl12) ... Treatments received in heath hydros, nature cure clinics, spas or similar establishments ... Dietary supplements and substances that can be purchased without prescription ... Refractive error (Code- Excl 15): ... Unproven treatments (Code-Excl16): ... Sterility and infertility (Code-Excl17). ... Maternity (Code - ... Excl18 ... Hazardous or Adventure Sports (Code Excl09) : ... Breach of law (Code Excl10): ... Excluded Providers (Code-Excl11): ... Alcoholic pancreatitis\nii. Congenital External Diseases, defects or anomalies;\niii. Stem cell therapy ; however hematopoietic stem cells for bone marrow transplant for haematological conditions will be covered under benefit B1 or B4 of this policy; ... Growth hormone therapy; ... Sleep-apnoea","sources":[{"clause":"41(II)","heading":null,"page":34,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-ii-2"},{"clause":"41(II)(d)(ii)","heading":null,"page":37,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-ii-d-ii"},{"clause":"41(II)(d)(iii)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-ii-d-iii"},{"clause":"Excl18","heading":null,"page":38,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18"},{"clause":"Excl18(b)(i)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-b-i"},{"clause":"Excl18(b)(ii)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-b-ii"},{"clause":"Excl18(b)(iii)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-b-iii"},{"clause":"Excl18(b)(iv)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-b-iv"},{"clause":"Excl18(b)(v)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-b-v"}],"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":"quote-verified","value":"The policyholder may cancel by giving 7 days written notice and the company will refund proportionate premium for the unexpired policy period. No premium refund is made where any claim has been admitted or lodged or any policy benefit has been availed.","display":"Proportionate premium for unexpired policy period, after 7 days written notice; no refund if a claim is admitted/lodged or a benefit availed","note":null,"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 the 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.","sources":[{"clause":"Excl18(I)","heading":null,"page":42,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-i"}],"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 policy covers claims incurred within India, except Global Cover for Planned Hospitalization wherever applicable. Global Cover pays medical expenses incurred outside India up to the sum insured when the diagnosis was made in India and the insured travels abroad for treatment.","display":"India, except Global Cover for Planned Hospitalization wherever applicable","note":"Global Cover for Planned Hospitalization is not available in the policy for NRI/OCI/foreign national status or if opted out as stated in the policy.","quote":"This Policy only covers claims incurred within India (except in case of benefit B13-Global cover for Planned Hospitalization, wherever applicable), and payments under this Policy shall only be made in Indian Rupees within India. ... We will cover for Medical Expenses of the Insured Person incurred outside India, upto the sum insured, provided that the diagnosis was made in India and the insured travels abroad for treatment.","sources":[{"clause":"Excl18(II)(o)(ii)","heading":null,"page":52,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-o-ii"},{"clause":"41(I)(a)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i-a-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":"quote-verified","value":{"unit":"days","amount":30},"display":"thirty days","note":null,"quote":"The insured person shall be provided a free look period of thirty days beginning from the date of receipt of the policy document, whether received electronically or otherwise, to review the terms and conditions of the policy, and to return the same if not acceptable.","sources":[{"clause":"Excl18(II)(b)(ii)","heading":null,"page":44,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-b-ii"}],"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":30},"display":"thirty days; fifteen days where premium payment mode is monthly","note":"Monthly premium mode has 15 days; all other cases have 30 days.","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":"16","heading":"Grace Period","page":5,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-16"}],"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":"quote-verified","value":"Minimum entry age is Child- 91 days and Adult- 18 years. Maximum entry age is Child- 25 years and Adult- 65 years.","display":"Child: 91 days to 25 years; Adult: 18 years to 65 years","note":"Dependent children between 91 days and 5 years can be insured only when both parents are insured.","quote":"Entry Age: Minimum | Child- 91 days Dependent children between 91 days and 5 years can be insured only when both parents are getting insured. Adult- 18 years\nEntry Age: Maximum | Child- 25 years Adult- 65 years","sources":[{"clause":"1","heading":"Suitability","page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16840#c-1"}],"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","Limited Premium paying term"],"display":"Monthly/Quarterly/Half-Yearly/Annual/Limited Premium paying term","note":null,"quote":"Monthly/Quarterly/Half-Yearly/Annual/Limited Premium paying term instalment option would be allowed","sources":[{"clause":"20(e)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16840#c-20-e"}],"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 during the policy period, coverage is available from the instalment premium due date until the company receives premium within the grace period. At the end of the policy period, coverage is not available during the grace period after the policy period.","display":"Covered during instalment grace within policy period; not covered after policy-period end","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. ... 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. Coverage is not available during the grace period after the end of the policy period.","sources":[{"clause":"Excl18(II)(a)","heading":null,"page":44,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-a"},{"clause":"Excl18(II)(b)","heading":null,"page":44,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-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. If you take a costlier room, other bills can be cut in proportion.","status":"quote-verified","value":"No specific room rent rupee limit is stated in the extracted policy clauses; in-patient treatment is payable up to the sum insured and the prospectus describes benefits without any sub-limit unless otherwise mentioned.","display":"No specific room rent limit stated; in-patient treatment up to Sum Insured","note":"Room rent is not separately capped in the cited benefit table.","quote":"Indemnity based health insurance cover with range of benefits without any sub-limit unless otherwise mentioned. ... In-Patient Treatment | Upto Sum Insured","sources":[{"clause":"2","heading":"Key Benefits","page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16840#c-2"},{"clause":"24","heading":"Section 41 of Insurance Act1938 (Prohibition of Rebates), as amended by","page":22,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16840#c-24"}],"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":"quote-verified","value":{"unit":"days","amount":60},"display":"upto 60 days","note":"Payable if a claim is admitted under section B1, B4, B6 or B31.","quote":"We will cover for expenses for Pre-Hospitalization consultations, investigations and medicines incurred upto 60 days before the date of admission to the hospital.","sources":[{"clause":"41(I)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i"}],"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":"quote-verified","value":{"unit":"days","amount":90},"display":"90 days; 200 days for Rs.75 Lacs to Rs.3 Crore","note":"Post-hospitalisation cover is 90 days for basic sum insured up to Rs. 50 Lacs and 200 days for Rs.75 Lacs to Rs.3 Crore.","quote":"Basic Sum insured | Number of days\nUpto Rs. 50 Lacs | 90 days\nRs.75 Lacs to Rs.3 Crore | 200 days","sources":[{"clause":"41(I)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i"}],"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":"quote-verified","value":"Day Care Treatment due to disease, illness or injury is covered when taken at a hospital or Day Care Centre. Treatment normally taken on an out-patient basis is not included.","display":"Covered for Day Care Treatment at a hospital or Day Care Centre","note":null,"quote":"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. Treatment normally taken on out-patient basis is not included in the scope of this cover.","sources":[{"clause":"41(I)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i"}],"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":"quote-verified","value":"Domiciliary Hospitalization expenses are covered if treatment exceeds beyond three days, is for management of an illness, and is not for enteral feedings or end of life care.","display":"Covered if Domiciliary Hospitalization exceeds beyond three days","note":"Doctor certification fulfilling the policy definition is required at claim.","quote":"We will cover for expenses related to Domiciliary Hospitalization of the insured person if the treatment exceeds beyond three days. The treatment must be for management of an illness and not for enteral feedings or end of life care.","sources":[{"clause":"41(ii)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-ii"}],"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":"quote-verified","value":"Modern Treatment Methods and Advancement in Technologies are covered as part of medically necessary treatment. The listed procedures include uterine artery embolization and HIFU, balloon sinuplasty, deep brain stimulation, oral chemotherapy, immunotherapy-monoclonal antibody injection, intra vitreal injections, robotic surgeries, stereotactic radiosurgeries, bronchial thermoplasty, prostate vaporisation, IONM and hematopoietic stem cell therapy for bone marrow transplant for haematological conditions.","display":"Covered, including robotic surgeries, oral chemotherapy, immunotherapy and listed modern treatments","note":null,"quote":"While the policy is in force, if the Insured Person contracts any disease or suffers from any illness or sustains bodily injury through accident and if such event requires the insured Person to incur expenses for Medically Necessary Treatment (including Modern Treatment Methods and Advancement in Technologies), We will indemnify You ... The following Procedures shall be considered for Modern Treatment Methods and Advancement in Technologies:\nA. Uterine Artery Embolization and HIFU B. Balloon Sinuplasty C. Deep Brain stimulation D. Oral chemotherapy E. Immunotherapy-Monoclonal Antibody to be given as injection F. Intra vitreal injections G. Robotic surgeries H. Stereotactic radiosurgeries ... I) Bronchical Thermoplasty J. Vaporisation of the prostrate (Green laser treatment or holmium laser treatment) K. IONM - (Intra Operative Neuro Monitoring) L. Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered.","sources":[{"clause":null,"heading":null,"page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-s1"},{"clause":"41","heading":"Unproven/Experimental treatment","page":9,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41"},{"clause":"41(I)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i"}],"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":"quote-verified","value":"Medical and surgical expenses of the organ donor for harvesting the organ are covered when an insured person is the recipient, the organ is made available in compliance with the Transplantation of Human Organs (Amendment) Bill, 2011, and the insurer has accepted the recipient's inpatient hospitalisation claim under B1.","display":"Covered for medical and surgical expenses of the organ donor for harvesting the organ","note":null,"quote":"We will cover for Medical and surgical Expenses of the organ donor for harvesting the organ where an Insured Person is the recipient provided that: ... The organ donor is any person whose organ has been made available in accordance and in compliance with The Transplantation of Human Organs (Amendment) Bill, 2011 and the organ donated is for the use of the Insured Person ... We have accepted an inpatient Hospitalization claim for the insured member under section B1 of this policy.","sources":[{"clause":"41(I)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i"},{"clause":"41(i)","heading":"The organ donor","page":12,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i-2"},{"clause":"41(ii)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-ii"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Road ambulance is covered for emergency transport to a hospital or transfer between hospitals, with limits from Rs. 5000 per hospitalisation up to Rs. 30000 per hospitalisation depending on sum insured. Emergency air ambulance is covered up to Rs. 500,000 for sum insured up to Rs.50 Lacs, and up to Rs. 500,000 for non-network or up to sum insured for network provider for Rs.75 Lacs to Rs. 3 Crore.","display":"Road ambulance up to Rs. 5000 to Rs. 30000 per hospitalisation; air ambulance up to Rs. 500,000 or up to Sum Insured within network","note":null,"quote":"We will cover for expenses incurred on transportation of Insured Person in a registered ambulance to a Hospital for admission in case of an Emergency or from one hospital to another hospital for better medical facilities and treatment, subject to limited as specified in the table below.\nBasic Sum Insured | Limit\nUp to Rs. 50 Lacs | Upto Rs. 5000 per hospitalization\nRs. 75 Lacs | Upto Rs. 7500 per hospitalization\nRs. 1 Crore | Upto Rs. 10000 per hospitalization\nRs. 2 Crore | Upto Rs. 20000 per hospitalization\nRs. 3 Crore | Upto Rs. 30000 per hospitalization ... We will pay for ambulance transportation of the Insured Person in an airplane or helicopter subject to maximum of limit specified in the table below, for emergency life threatening health conditions ... Basic Sum Insured | Limit\nUp to Rs.50 Lacs | Up to Rs. 500,000\nRs.75 Lacs to Rs. 3 Crore | Up to Rs. 500,000 for Non Network; Upto Sum Insured for Network Provider","sources":[{"clause":"41(I)(f)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i-f"},{"clause":"41(I)(d)(iii)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i-d-iii"}],"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":"quote-verified","value":"The policy automatically restores the Basic Sum Insured if the Sum Insured and cumulative bonus are insufficient to pay a claim during the policy year. It can be availed once during the policy year, does not trigger for the first claim, and can be used for related illness for the same claimant only for admissions after 45 days from discharge of the earlier claim.","display":"Automatic restore of Basic Sum Insured, once during the policy year","note":"Unutilized restored sum insured cannot be carried forward. For single premium multiyear policies, available restorations can be used anytime during the policy period except for the first claim in each policy year.","quote":"We will automatically restore the Basic Sum Insured if the Sum Insured and accrued Cumulative Bonus is insufficient to pay a claim during the policy year. This benefit can be availed once during the policy year ... However, this benefit for related illness/diseases would be available, in case of claimed insured person(s), for admissions after 45 days from the date of discharge of the earlier claim. ... Restore will not trigger for the first claim under each policy year.","sources":[{"clause":"41(ii)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-ii"},{"clause":"41(I)(a)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i-a"},{"clause":"41(I)(e)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i-e"}],"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":"quote-verified","value":"Two no-claim bonus options are available: Cumulative Bonus or Discount in Renewal Premium. Cumulative Bonus adds 50% of the expiring policy sum insured for each claim-free policy year, up to 100%, and reduces by 50% after a claim; the discount option gives 1% discount on renewal premium for every claim-free policy year if renewed without break.","display":"Either 50% cumulative bonus up to 100%, reduced by 50% after a claim, or 1% renewal premium discount","note":"The 1% discount detail is quoted from the prospectus because the policy wording names the option but the provided clause text does not state its rate.","quote":"Either of the two options is to be selected:\n1) Cumulative Bonus\ni. 50% cumulative bonus will be applied on the Sum Insured of the expiring Policy, on each Renewal after every claim free Policy Year, provided that the Policy is renewed with Us and without a break. The maximum cumulative bonus shall not exceed 100% of the Sum Insured in any Policy Year.\nii. 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 50% of the Sum Insured in that following Policy Year. ... Discount in Renewal Premium (No Claim Bonus)- If you choose Discount in Renewal Premium, 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":"41(I)(d)(iii)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i-d-iii"},{"clause":"6(a)","heading":null,"page":7,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16840#c-6-a-3"}],"law":[]},{"key":"consumables","label":"Consumables and non-medical items","section":"Cover","meaning":"Gloves, PPE, syringes and other items hospitals bill that standard policies exclude; whether this policy pays them.","status":"quote-verified","value":"Specified consumables listed in Annexure I – List I are covered when consumed during hospitalisation and directly related to the insured's medical or surgical treatment of illness, disease or injury. Personal comfort, toiletries, cosmetics, convenience items, external durable devices and items that are not medical consumables, medically necessary or doctor-prescribed are excluded.","display":"Specified consumables covered during hospitalisation, subject to exclusions","note":"The main claim must be admissible under section B1, B4 or B31.","quote":"We will pay for expenses incurred, for specified consumables listed in ‘Annexure I – List I- Optional Items (Consumables Benefit)’ which are consumed during the period of hospitalization directly related to the insured’s medical or surgical treatment of illness/disease/injury. ... Items of personal comfort, toiletries, cosmetics and convenience shall be excluded from scope of this coverage. ... Any item which is neither medical consumable nor medically necessary nor prescribed by Doctor.","sources":[{"clause":"41(I)(b)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i-b-2"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"quote-verified","value":"Maternity expenses are covered up to Rs 50,000 for sum insured up to Rs. 50 Lacs, increased to Rs 60,000 for birth of a girl child; and up to Rs 1,00,000 for Rs.75 Lacs to Rs.3 Crore, increased to Rs 1,20,000 for birth of a girl child. The waiting period is 3 years of continuous coverage under this policy.","display":"Covered after 3 years; up to Rs 50,000/Rs 60,000 or Rs 1,00,000/Rs 1,20,000","note":"Pre/post natal care, pre/post hospitalisation benefit, and voluntary termination of pregnancy are excluded under this benefit.","quote":"We will cover for Maternity Expenses, upto limits as specified in the table below, per policy subject to a waiting period of 3 years of continuous coverage under this policy .\nBasic Sum Insured | Limit\nUp to Rs. 50 Lacs | A maximum of upto Rs 50,000/-. In case of birth of a girl child, the maximum limit under this coverage would be upto Rs 60,000/- per policy\nRs.75 Lacs to Rs.3 Crore | A maximum of upto Rs 1,00,000/-. In case of birth of a girl child, the maximum limit under this coverage would be upto Rs 1,20,000/- per policy","sources":[{"clause":"41(I)(d)(ii)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i-d-ii"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"Delivery complications for the new born baby are covered if the maternity claim is admitted, up to Rs. 10000 for sum insured up to Rs.50 Lacs and up to Rs. 25000 for Rs. 75 Lacs to Rs. 3 Crore. First-year vaccination expenses are covered up to Rs. 10,000, or Rs.15,000 for a girl child, provided the child is covered and maternity expenses are admissible.","display":"Delivery complications up to Rs. 10000/Rs. 25000; first-year vaccinations up to Rs. 10,000 or Rs.15,000 for a girl child","note":"First-year vaccinations trigger only if maternity expenses are admissible under section B21; the vaccination limit is a lifetime limit for each child.","quote":"We will cover for medical expenses incurred for the medically necessary treatment of the new born baby upto limits as specified in the table below, for complications related to delivery if claim is admitted under the maternity benefit (B21) of this policy.\nBasic Sum Insured | Limit\nUp to Rs.50 Lacs | Upto Rs. 10000\nRs. 75 Lacs to Rs. 3 Crore | Upto Rs. 25000\nB23. First year Vaccinations We will pay for vaccination expenses for up to one year after the birth of the child subject to a limit of Rs. 10,000/- provided the child is covered with Us. In case of girl child, applicable limit under this coverage would be Rs.15,000/-.","sources":[{"clause":"41(I)(d)(ii)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i-d-ii"}],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","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 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":"quote-verified","value":"Preventive health check-up is arranged on cashless basis every year irrespective of claims, up to 1% of policy sum insured and subject to maximum limits from Rs. 10000 to Rs. 25000 depending on sum insured.","display":"Every year; up to 1% of sum insured, maximum Rs. 10000 to Rs. 25000","note":"Limit is per policy for floater and per insured person for individual policy.","quote":"We/Our empanelled service provider will arrange for a Preventive Health Check-up upto 1% of policy sum insured subject to a maximum limit as specified in the table below. ... The health check-ups shall be arranged by Us on cashless basis at Our empanelled service providers or at Insured Person’s residence, as per availability. The benefit is payable every year irrespective of claims under the policy. ... Basic Sum Insured (Rs.) | Limit\nUp to Rs. 50 Lacs | Upto Rs. 10000\nRs. 75 Lacs | Upto Rs. 15000\nRs. 1 Crore | Upto Rs. 20000\nRs. 2 Crore | Upto Rs. 25000\nRs. 3 Crore | Upto Rs. 25000","sources":[{"clause":"41(I)(f)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i-f"}],"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":"quote-verified","value":"Premium is computed based on the residential address zone of the proposer or insured person. The policy divides the country into Zone A, Zone B and Zone C for premium computation; no treatment-city co-pay is stated in the extracted clauses.","display":"Premium depends on residential address zone: Zone A, Zone B or Zone C","note":"The cited clause is about premium computation by residence address, not hospital/treatment city.","quote":"For the purpose of premium computation, the country is divided into following three Zones and premium payable under this Policy will be computed based on the Zone as applicable for the ‘Address’ of the proposer/ Insured Person: ... Here ‘Address’ implies the place where the person ordinarily resides. In case proposed prospect(s) reside at multiple addresses, then address of the person residing in the highest Zone will be considered.","sources":[{"clause":"41(I)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-41-i"}],"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":"quote-verified","value":"Cashless facility is available at Network Hospitals, where the insurer pays the network provider directly to the extent pre-authorisation is approved and within policy liability.","display":"Available at Network Hospitals with pre-authorisation","note":null,"quote":"Cashless facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the network provider by the insurer to the extent pre-authorization is approved. ... Cashless Service is only available at Network Hospitals.","sources":[{"clause":"7","heading":"Cashless facility","page":3,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-7"},{"clause":"Excl18(II)(b)","heading":null,"page":47,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-b-3"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"quote-verified","value":"Claims are managed by the insurer or its designated TPA, if any, as mentioned in the policy schedule.","display":"TPA or Us; TPA as mentioned in the policy schedule, if any","note":"The prospectus also states that the final decision on claims is taken by TATA AIG General Insurance Company Limited.","quote":"This section explains about the procedures involved to file a valid claim by the insured member and processes related in managing the claim by TPA or Us. ... *TPA as mentioned in the policy schedule, if any","sources":[{"clause":"Excl18(II)(b)","heading":null,"page":47,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992#c-excl18-ii-b-3"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"quote-verified","value":true,"display":"Yes, Family floater","note":null,"quote":"Coverage Options | Individual/Family floater","sources":[{"clause":"1","heading":"Suitability","page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16840#c-1"}],"law":[]}],"documents":[{"kind":"wording","label":"TATA AIG MediCare Premier (TATHLIP26052V052526)","pages":60,"fetched_at":"2026-10-17 20:12:26+00","source_url":"https://www.tataaig.com/s3/tata_aig_medicare_premier_policy_wordings_781aa2fd94.pdf","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16992"},{"kind":"wording","label":"Tata AIG Medicare Premier (IRDAI copy)","pages":37,"fetched_at":"2026-10-20 02:36:27+00","source_url":"https://irdai.gov.in/documents/37343/931203/TATHLIP18005V011819_2018-2019.pdf/2003d209-d374-7c34-1afc-f50b2f7a2be8?version=1.1&t=1668510170858&download=true","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/28911"},{"kind":"prospectus","label":"TATA AIG MediCare Premier (TATHLIP26052V052526)","pages":24,"fetched_at":"2026-10-17 20:07:05+00","source_url":"https://www.tataaig.com/s3/03_medicare_premier_prospectus_b93b6fc6df.pdf","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16840"},{"kind":"cis","label":"TATA AIG MediCare Premier (TATHLIP26052V052526)","pages":7,"fetched_at":"2026-10-17 20:06:01+00","source_url":"https://www.tataaig.com/s3/TATA_AIG_Medicare_Premier_Customer_information_Sheet_2e2c10e8d0.pdf","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16813"},{"kind":"brochure","label":"TATA AIG MediCare Premier (TATHLIP26052V052526)","pages":9,"fetched_at":"2026-10-17 20:05:36+00","source_url":"https://www.tataaig.com/s3/medicare_premier_brochure_ab0b8e7691.pdf","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/16805"},{"kind":"premium","label":"TATA AIG MediCare Premier (TATHLIP26052V052526)","pages":null,"fetched_at":"2026-10-17 20:05:43+00","source_url":"https://www.tataaig.com/s3/TATA_Medicare_Premier_871b2dee42.pdf","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/31819"},{"kind":"proposal","label":"TATA AIG MediCare Premier (TATHLIP26052V052526)","pages":null,"fetched_at":"2026-10-17 20:17:38+00","source_url":"https://www.tataaig.com/s3/Premier_Proposal_5f2bd12e92.pdf","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526/document/31879"}],"versions":[{"uin":"TATHLIP18005V011819","version":null,"approved_on":null},{"uin":"TATHLIP26052V052526","version":null,"approved_on":null}],"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 MediCare Premier (UIN TATHLIP26052V052526), IndiaInsurances, https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-premier-tathlip26052v052526"}