{"uin":"TATHLIP27059V012627","name":"TATA AIG MediCare Reserve","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627","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-topup","category_name":"Top-up and super top-up","irdai_type":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"TATA AIG MediCare Reserve is an India-only top-up health policy with a Sum Insured of 5 to 500 Lacs that pays only above an Aggregate Deductible of 2 to 50 Lacs per policy year, which can be waived at renewal after five continuous policy years. Waiting periods are 30 days initial and 36 months for pre-existing diseases and listed illnesses, and Restore and No Claim Bonus apply only after the deductible is waived.","analysis":{"state":"extracted","analysed_at":"2026-10-19 17:40:49.518701+00","note":"Every stated fact carries a verbatim quote found in the cited clause."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"not-stated","value":null,"display":null,"note":"No named plans. The prospectus offers Individual, Family floater and Multi-individual cover with a chosen Sum Insured and Aggregate Deductible.","quote":null,"sources":[],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"cross-checked","value":"The policy runs for 1, 2, 3, 4 or 5 years.","display":"1, 2, 3, 4 or 5 years","note":"From the prospectus; the policy wording does not print the terms. Long term discounts apply only with single premium payment.","quote":"Policy Term | 1 Year/ 2 Years/ 3 Years / 4 Years/ 5 Years ... This discount is available only with ‘Single’ Premium Payment mode.","sources":[{"clause":"1","heading":"Suitability","page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1080#c-1"},{"clause":"7","heading":"Discounts on premium","page":4,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1080#c-7"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"conflicting","value":"Planned hospitalisation must be notified at least 48 hours before admission; emergency hospitalisation within 24 hours of admission or at discharge, whichever is earlier.","display":"48 hours before planned admission; within 24 hours of emergency admission","note":"The wording's notification table applies to every claim. Prospectus and CIS say for reimbursement: 'Intimate Us within 7 days of completion of treatment, consultation or procedure' and submit documents within 15 days. Timely intimation is a pre-condition for admission of liability but may be waived in extreme hardship.","quote":"If any treatment for which a claim may be made and that treatment requires planned Hospitalization/ Day Care Treatment/ AYUSH/ Domiciliary Treatment: | At least 48 hours prior to the Insured Person’s admission/ start of treatment. ... If any treatment for which a claim may be made and that treatment requires emergency Hospitalization/ Day Care Treatment | Within 24 hours of the Insured Person’s admission to Hospital or at the time of discharge, whichever is earlier. ... Our TPA/We must be informed within 7 days of completion of such treatment, consultation or procedure using the Claim Intimation Form. ... For Reimbursement of Claim: Intimate Us within 7 days of completion of treatment, consultation or procedure. ... Timely intimation of claim in Our prescribed format is a pre-condition for admission of liability.","sources":[{"clause":"Section 5(a)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-a"},{"clause":"13(c)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1080#c-13-c"},{"clause":"Row 4","heading":"Sum Insured (Basis) (Along with amount)","page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1081#c-row-4"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"cross-checked","value":["Claim form, duly completed and signed","Original Bills (pharmacy purchase bill, consultation bill, diagnostic bill, medical devices) and receipts or prescriptions","All medical reports, case histories, investigation reports, indoor case papers/ treatment papers, discharge summaries","A precise diagnosis of the treatment","A detailed list of the individual medical services and treatments with a unit price for each","Prescriptions that name the Insured Person","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 records and FIR in case of claims arising out of an Accident","NEFT and KYC (recent ID/Address proof and photograph)","Legal heir/succession certificate, if required","PM report (wherever applicable)","Documents validating the residential status of NRI/OCI at the time of claim"],"display":"Claim form, original bills, medical reports and discharge summary, prescriptions, implant invoices, MLC/FIR for accidents, NEFT and KYC, and others","note":"The insurer may call for additional documents. TransiCare Wallet claims also need proof of termination of the employer group policy and a declaration of unemployment.","quote":"Our claim form, duly completed and signed for on behalf of the Insured Person. ... Original Bills (pharmacy purchase bill, consultation bill, diagnostic bill, medical devices) 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, in case of claims arising out of an Accident ... currently mandatory NEFT (to enable direct credit of claim amount in bank account) and KYC (recent ID/Address proof and photograph) requirements. ... Legal heir/succession certificate, if required ... PM report (wherever applicable) ... The documents validating the residential status of NRI/OCI at the time of claim. ... The Company reserves the right to call for additional documents wherever required. ... We reserve the right to call for and verify supporting documents, including but not limited to a resignation letter, termination letter, or any other documentary evidence establishing unemployment status. ... submit a declaration confirming that he/she was unemployed at the time of occurrence of the claim event","sources":[{"clause":"Section 5(a)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-a-3"},{"clause":"Section 5(b)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-b-3"},{"clause":"Section 5(c)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-c-3"},{"clause":"Section 5(d)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-d-2"},{"clause":"Section 5(e)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-e-2"},{"clause":"Section 5(f)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-f-2"},{"clause":"Section 5(g)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-g-2"},{"clause":"Section 5(h)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-h"},{"clause":"Section 5(i)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-i"},{"clause":"Section 5(j)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-j"},{"clause":"Section 5(k)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-k"},{"clause":"Section 5(l)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-l"},{"clause":"Section 5(m)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-m"},{"clause":"Section 5(n)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-n"},{"clause":"Section 5(p)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-p"},{"clause":"Section 5(o)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-o"},{"clause":"Section 5(q)","heading":null,"page":35,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-q"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"cross-checked","value":"The claim is settled or rejected within 15 days from receipt of the last necessary document; delay attracts interest at 2% above the bank rate.","display":"15 days from the last necessary document","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. ... the Company shall be liable to pay interest to the policyholder from the date of receipt of last necessary document to the date of payment of claim at a rate 2% above the bank rate.","sources":[{"clause":"3","heading":"Claim Settlement (provision for Penal Interest)","page":26,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-3-3"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"cross-checked","value":["Pre-Existing Diseases until 36 months of continuous coverage","Listed conditions, surgeries/treatments until 36 months of continuous coverage","Any Illness within 30 days from the first Policy commencement date, except Accident","Investigation and evaluation","Rest cure, rehabilitation and respite care","Cosmetic or Plastic Surgery","Treatment for Alcoholism, drug or substance abuse","Sterility and Infertility","Maternity","Hazardous or Adventure Sports","Breach of law","Congenital External Diseases, defects or anomalies","All preventive care including Health Check-ups","Non payable items as mentioned in Annexure I, List I","Any claim within the deductible limit"],"display":"PED and listed illnesses for 36 months, 30-day initial wait, maternity, infertility, cosmetic surgery, preventive check-ups, claims within the deductible and others","note":null,"quote":"Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage ... Expenses related to the treatment of the listed conditions, surgeries/treatments shall be excluded until the expiry of 36 months of continuous coverage ... Expenses related to the treatment of any Illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident ... Investigation and evaluation ... Rest cure, rehabilitation and respite care ... Cosmetic or Plastic Surgery ... Treatment for Alcoholism, drug or substance abuse ... Sterility and Infertility ... Maternity ... Hazardous or Adventure Sports ... Breach of law ... Congenital External Diseases, defects or anomalies ... All preventive care including Health Check-ups ... Non payable items as mentioned in Annexure I ... Any claim within the deductible limit","sources":[{"clause":null,"heading":"A. Exclusions with waiting periods","page":20,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-a-exclusions-with-waiting-periods"},{"clause":null,"heading":"B. Medical Exclusions","page":22,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-b-medical-exclusions"},{"clause":"4","heading":"Uncontrolled Type2 Diabetes","page":22,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-4-2"},{"clause":"Excl12","heading":null,"page":23,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-excl12"},{"clause":null,"heading":"C. Non-Medical Exclusions","page":23,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-c-non-medical-exclusions"},{"clause":null,"heading":"B. Non-Medical Exclusions","page":24,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-b-non-medical-exclusions"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"cross-checked","value":"Call the 24x7 Customer Support Number 022 6489 8282 or email customersupport@tataaig.com; escalate to manager.customersupport@tataaig.com, then to the Head of Customer Services at head.customerservices@tataaig.com, before the Insurance Ombudsman.","display":"TATA AIG customer support (022 6489 8282, customersupport@tataaig.com), then manager.customersupport@tataaig.com, then head.customerservices@tataaig.com","note":"1800 267 1955 is only for senior citizen policyholders. A grievance can also be lodged on the Bima Bharosa portal.","quote":"please call Our 24*7 Customer Support Number: 022 6489 8282 / 1800 267 1955 (only for senior citizen policy holders) or email Us at customersupport@tataaig.com ... please contact Us at manager.customersupport@tataaig.com ... 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. ... You can also lodge a grievance on the Bima Bharosa Grievance Redressal Portal","sources":[{"clause":"15","heading":"Redressal of Grievance","page":29,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-15-2"},{"clause":null,"heading":"Escalation Level 1","page":30,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-escalation-level-1"},{"clause":null,"heading":"Escalation Level 2","page":30,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-escalation-level-2"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"cross-checked","value":"Sum Insured of 5, 7.5, 10, 15, 20, 25, 50, 75, 100, 200, 300 or 500 Lacs.","display":"5, 7.5, 10, 15, 20, 25, 50, 75, 100, 200, 300 or 500 Lacs","note":"From the prospectus. Each is chosen with an Aggregate Deductible of 2 to 50 Lacs.","quote":"• 5 Lacs | • 20 Lacs | • 100 Lacs ... • 7.5 Lacs | • 25 Lacs | • 200 Lacs ... • 10 Lacs | • 50 Lacs | • 300 Lacs ... • 15 Lacs | • 75 Lacs | • 500 Lacs","sources":[{"clause":"2","heading":"Sum Insured options (in ₹)","page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1080#c-2"}],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":"Does not apply if the Insured Person has continuous coverage for more than twelve months; applies to any enhanced Sum Insured.","quote":"Expenses related to the treatment of any Illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident ... This exclusion shall not, however, apply if the Insured Person has Continuous Coverage for more than twelve months. ... The within referred waiting period is made applicable to the enhanced Sum Insured","sources":[{"clause":null,"heading":"A. Exclusions with waiting periods","page":20,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-a-exclusions-with-waiting-periods"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"cross-checked","value":{"unit":"months","amount":36},"display":"36 months","note":"Applies afresh to any Sum Insured increase; reduced by prior continuous cover under portability.","quote":"Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first Policy with Us. ... In case of enhancement of Sum Insured the exclusion shall apply afresh to the extent of Sum Insured increase. ... waiting period for the same would be reduced to the extent of prior coverage.","sources":[{"clause":null,"heading":"A. Exclusions with waiting periods","page":20,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-a-exclusions-with-waiting-periods"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"cross-checked","value":{"unit":"months","amount":36},"display":"36 months","note":"Single tier. Not applicable to accident claims; applies afresh to any Sum Insured increase.","quote":"Expenses related to the treatment of the listed conditions, surgeries/treatments shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first Policy with Us. This exclusion shall not be applicable for claims arising due to an Accident. ... In case of enhancement of Sum Insured, the exclusion shall apply afresh to the extent of Sum Insured increase.","sources":[{"clause":null,"heading":"A. Exclusions with waiting periods","page":20,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-a-exclusions-with-waiting-periods"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"cross-checked","value":["Tumors, Cysts, polyps including breast lumps (benign)","Polycystic ovarian disease","Fibromyoma","Adenomyosis","Endometriosis","Prolapsed Uterus","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 (for example: Knee replacement, Hip 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":"Tumors and cysts, gynaecological conditions, arthritis, spinal disc disease, gallstones, piles and fistula, kidney stones, cataract, ENT surgeries, hysterectomy, joint replacement, hernia, and others","note":null,"quote":"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 (for example: Knee replacement, Hip 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","sources":[{"clause":null,"heading":"A. Exclusions with waiting periods","page":20,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-a-exclusions-with-waiting-periods"}],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"cross-checked","value":{"unit":"years","amount":5},"display":"5 years (five continuous years)","note":"Applies to the Sum Insured of the first policy; enhanced Sum Insured has its own five years from the enhancement.","quote":"After completion of five continuous years of coverage (including Portability and Migration) in health insurance Policy, no Policy and claim shall be contestable by the Insurer on grounds of non-disclosure, misrepresentation, except on grounds of established fraud.","sources":[{"clause":"12","heading":"Moratorium Period","page":29,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-12-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"cross-checked","value":"Yes. Apply to the new insurer at least 30 days before, but not earlier than 60 days from, the renewal date; accrued continuity benefits for waiting periods, No Claim Bonus and Moratorium period carry over.","display":"Yes, apply 30 to 60 days before renewal; waiting-period credit carries over","note":"After porting in, Waiver of Aggregate Deductible needs 5 continuous years under this policy. Migration within TATA AIG is allowed only to similar (top-up) products, or to a base product one year after the deductible waiver.","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 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 ... after porting into this product, the option of Waiver of Aggregate Deductible under benefit B11 will be available after completion of 5 continuous years under this Policy. ... Migration, wherever permitted, shall be allowed only within similar health insurance product categories offered by Us, such as Top-up to Top-up products. On completion of one year of coverage after availing the waiver of the Aggregate Deductible option, the Policyholder shall have the option to migrate to a suitable base product offered by Us","sources":[{"clause":"9","heading":"Portability","page":28,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-9-2"},{"clause":"8","heading":"Migration","page":27,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-8-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"cross-checked","value":true,"display":"Yes, no maximum cover ceasing age","note":"From the prospectus. The wording says the policy shall ordinarily be renewable except for established fraud, non-disclosure or misrepresentation.","quote":"We offer you a lifelong renewal for your policy provided premium is paid without any break. ... There is no maximum cover ceasing age under this policy. ... The Policy shall ordinarily be renewable except on grounds of established fraud, non-disclosure or misrepresentation by the Insured Person.","sources":[{"clause":"4(III)","heading":"Lifelong renewal","page":2,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1080#c-4-iii"},{"clause":"1","heading":"Suitability","page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1080#c-1"},{"clause":"10","heading":"Renewal of Policy","page":28,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-10-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"cross-checked","value":"No. No loading applies on renewals based on individual claims experience.","display":"No","note":"A risk loading may apply from the start, based on underwriting of the proposal, and continues at renewals.","quote":"No loading shall apply on Renewals based on individual claims experience. ... We may apply a risk loading on the premium payable (based upon the declarations made in the proposal and the health status of the persons proposed for insurance). ... These loadings are applied from Commencement Date of the Policy including subsequent Renewal(s) with Us","sources":[{"clause":"10(b)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-10-b"},{"clause":"18","heading":"Loadings","page":30,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-18-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"cross-checked","value":["Investigation and evaluation","Rest cure, rehabilitation and respite care","Obesity/ Weight Control (unless conditions met)","Change-of-Gender treatments","Cosmetic or Plastic Surgery","Hazardous or Adventure Sports","Breach of law","Excluded Providers","Treatment for Alcoholism, drug or substance abuse or any addictive condition","Treatments received in health hydros, nature cure clinics, spas","Dietary supplements and substances that can be purchased without prescription","Refractive error less than 7.5 dioptres","Unproven treatments","Sterility and Infertility","Maternity","Alcoholic pancreatitis or Alcoholic liver disease","Congenital External Diseases, defects or anomalies","Stem cell therapy (except hematopoietic stem cells for bone marrow transplant)","Growth Hormone Therapy","Sleep-apnoea and Sleeping disorder","Admission primarily for administration of immunoglobulin infusion or supplementary medications","Venereal disease, sexually transmitted disease","All preventive care including Health Check-ups, vaccination","Cost of dentures, dental implants and braces; Dental Treatment unless after an Accident","Any form of Non-Allopathic treatment (except AYUSH Benefit)","Any existing disease specifically mentioned as Permanent exclusion in the Policy Schedule","Non payable items as mentioned in Annexure I, List I","War or any act of war","Nuclear, chemical or biological attack or weapons","Participation in armed forces","Intentional self-Injury or attempted suicide","Under the influence of intoxicating liquor or drugs","Items of personal comfort and convenience","Hearing aids, spectacles or contact lenses","Alopecia, baldness, wigs or toupees","Any external appliance and/or device used for diagnosis or treatment except when used intra-operatively","Any claim within the deductible limit"],"display":"Standard IRDAI exclusions plus stem cell therapy (with exceptions), growth hormone therapy, sleep apnoea, preventive care, dental, non-allopathic treatment, claims within the deductible and others","note":null,"quote":"Investigation and evaluation ... Rest cure, rehabilitation and respite care ... Obesity/ Weight Control ... Change-of-Gender treatments ... Cosmetic or Plastic Surgery ... Hazardous or Adventure Sports ... Breach of law ... Excluded Providers ... Treatment for Alcoholism, drug or substance abuse or any addictive condition ... Treatments received in health hydros, nature cure clinics, spas ... Dietary supplements and substances that can be purchased without prescription ... refractive error less than 7.5 dioptres ... Unproven treatments ... Sterility and Infertility ... Maternity ... Alcoholic pancreatitis or Alcoholic liver disease ... Congenital External Diseases, defects or anomalies ... Stem cell therapy; however, hematopoietic stem cells for bone marrow transplant for haematological conditions will be covered ... Growth Hormone Therapy ... Sleep-apnoea and Sleeping disorder ... Admission primarily for administration (via any form or mode) of immunoglobulin infusion or supplementary medications ... Venereal disease, sexually transmitted disease ... All preventive care including Health Check-ups, vaccination ... Cost of dentures, dental implants and braces; Dental Treatment or Dental Surgery of any kind unless incidental to an admissible Hospitalization claim where the cause of admission is Accident ... Any form of Non-Allopathic treatment (except AYUSH Benefit) ... Any existing disease specifically mentioned as Permanent exclusion in the Policy Schedule ... Non payable items as mentioned in Annexure I ... War or any act of war ... Nuclear, chemical or biological attack or weapons ... participation or involvement in armed forces ... Intentional self-Injury or attempted suicide ... under the influence of intoxicating liquor or drugs ... Items of personal comfort and convenience ... Hearing aids, spectacles or contact lenses ... alopecia, baldness, wigs or toupees ... Any external appliance and/or device used for diagnosis or treatment except when used intra-operatively ... Any claim within the deductible limit","sources":[{"clause":null,"heading":"B. Medical Exclusions","page":22,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-b-medical-exclusions"},{"clause":"4","heading":"Uncontrolled Type2 Diabetes","page":22,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-4-2"},{"clause":"Excl12","heading":null,"page":23,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-excl12"},{"clause":null,"heading":"C. Non-Medical Exclusions","page":23,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-c-non-medical-exclusions"},{"clause":null,"heading":"B. Non-Medical Exclusions","page":24,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-b-non-medical-exclusions"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"cross-checked","value":"On 7 days written notice the insurer refunds proportionate premium for the unexpired policy period; no refund if any claim has been admitted or lodged or any benefit availed.","display":"Proportionate premium for the unexpired period; nothing if a claim was made","note":"No refund on cancellation by the insurer for established fraud, misrepresentation or non-disclosure. If an instalment is missed, limited premium paying term policies get a pro rata refund after administrative costs, subject to no claims (prospectus).","quote":"The policyholder may cancel this Policy by giving 7 days written notice and in such an event, the Company shall refund proportionate premium for unexpired Policy Period. No refunds of premium shall be made in respect of Cancellation where any claim has been admitted or has been lodged or any benefit under this Policy has been availed by the Insured Person. ... There would be no refund of premium on cancellation on grounds of established fraud, misrepresentation, non-disclosure of material facts. ... in case of Limited Premium paying term mode, premium will be refunded on pro rata basis after deducting administrative costs (if any), subject to no claims under the Policy.","sources":[{"clause":"7","heading":"Cancellation","page":27,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-7-2"},{"clause":null,"heading":"Loading %","page":18,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1080#c-loading"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"cross-checked","value":"India only.","display":"India only","note":"The optional Inbound Emergency Hospitalization cover is for NRI/OCI insured persons on a trip to India.","quote":"All benefits under this Policy are restricted to the geography of India. ... This Policy only covers claims incurred within India, and payments under this Policy shall only be made in Indian Rupees within India. ... whilst on a trip to India","sources":[{"clause":"Section 2","heading":"Benefits","page":11,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-2"},{"clause":"Section 5(b)","heading":null,"page":36,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-b-4"},{"clause":"2(xiv)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-2-xiv"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":"Refund less proportionate risk premium, medical examination expenses and stamp duty, if no claim was made.","quote":"The insured person shall be provided a free look period of thirty days beginning from the date of receipt of the policy document ... subject to deduction of proportionate risk premium for the period of cover and the expenses, if any, incurred by Us on medical examination of the proposer and stamp duty charges","sources":[{"clause":"14","heading":"Free look period","page":29,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-14-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days (15 days for monthly instalments)","note":null,"quote":"The Grace Period for payment of the premium during the Policy Period, for instalment premium shall be fifteen days where premium payment mode is monthly and thirty days in all other cases ... Single premium payment mode Policy can be renewed within the Grace Period of 30 days","sources":[{"clause":"10(iv)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-10-iv"},{"clause":"10(iii)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-10-iii"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"cross-checked","value":"Children from 0 days to 25 years; adults from 18 to 55 years.","display":"Child 0 days to 25 years; adult 18 to 55 years","note":"From the prospectus. Children aged 0 days to 5 years can be insured only when a parent is also insured. The proposer must be 18 or above.","quote":"Entry Age: Minimum | Child- 0 days ... Adult- 18 years ... Entry Age: Maximum | Child- 25 years Adult- 55 Years ... Dependent children between 0 days and 5 years can be insured only when either of the parent is getting insured. ... Age of Proposer | 18 years or above","sources":[{"clause":"1","heading":"Suitability","page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1080#c-1"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"cross-checked","value":["Annual","Half-Yearly","Quarterly","Monthly","Limited Premium paying term","Single"],"display":"Annual, half-yearly, quarterly, monthly, limited premium paying term or single","note":"Instalment loadings by policy tenure: monthly 5.00% to 13.00%, quarterly 4.00% to 12.00%, half-yearly 2.50% to 11.00% (prospectus).","quote":"Monthly/Quarterly/Half-Yearly/Annual and Limited Premium paying term instalment option would be allowed ... This discount is available only with ‘Single’ Premium Payment mode. ... Monthly | 5.00% | 9.00% | 13.00% ... Quarterly | 4.00% | 8.00% | 12.00% ... Half-Yearly | 2.50% | 7.00% | 11.00%","sources":[{"clause":"23","heading":"Premium Rates","page":18,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1080#c-23"},{"clause":"7","heading":"Discounts on premium","page":4,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1080#c-7"},{"clause":null,"heading":"Loading %","page":18,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1080#c-loading"}],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"cross-checked","value":["Consumables Benefit","TransiCare Wallet","Inbound Emergency Hospitalization (NRI/OCI)","Room Category Select"],"display":"Consumables Benefit, TransiCare Wallet, Inbound Emergency Hospitalization, Room Category Select","note":"Optional covers can be opted only at first inception. TransiCare Wallet and Inbound Emergency Hospitalization are up to Rs. 3,00,000 each and end once the deductible is waived. A higher-zone upgrade on payment of extra premium is also offered.","quote":"C1 Consumables Benefit ... C2 TransiCare Wallet ... C3 Inbound Emergency Hospitalization (Applicable for Non-Resident Indian (NRI) or Overseas Citizen of India (OCI) Insured Person(s)) ... C4 Room Category Select ... The Optional Cover(s) can only be opted only at the first inception of the Policy ... TransiCare Wallet | Available, Upto Rs. 3,00,000, over and above the base Sum Insured ... Inbound Emergency Hospitalization | Available, Upto Rs. 3,00,000, over and above the base Sum Insured ... The TransiCare Wallet will not be available in the Policy after the insured has opted for waiver of Aggregate Deductible. ... The Inbound Emergency Hospitalization will not be available in the Policy after the insured has opted for waiver of Aggregate Deductible. ... opt to pay an additional premium equivalent to the premium applicable for the higher Zone","sources":[{"clause":null,"heading":"C1 Consumables Benefit","page":17,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-c1-consumables-benefit"},{"clause":null,"heading":"C2 TransiCare Wallet","page":18,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-c2-transicare-wallet"},{"clause":"2(xiv)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-2-xiv"},{"clause":null,"heading":"C4 Room Category Select","page":19,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-c4-room-category-select"},{"clause":null,"heading":"Optional Covers","page":17,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-optional-covers"},{"clause":null,"heading":"Optional Covers","page":22,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1080#c-optional-covers"},{"clause":"23","heading":"Co-Payment for Treatment in Higher Zone","page":32,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-23-2"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"cross-checked","value":"For instalment premiums within the policy period, cover continues during the grace period; at renewal (end of the policy period) there is no cover during the grace period.","display":"Yes for instalments within the policy period; no during the renewal grace period","note":null,"quote":"Within the Policy Period - coverage will be available from the due date of instalment premium till the date of receipt of premium by Company within the Grace Period. ... Coverage is not available during the Grace Period after the end of the Policy Period.","sources":[{"clause":"10(a)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-10-a"},{"clause":"10(b)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-10-b"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"The amount (per claim or per year) that must be crossed before this policy pays. Your base policy or you pay this part.","status":"cross-checked","value":"An Aggregate Deductible chosen from 2, 3, 5, 10, 15, 20, 25 or 50 Lacs applies to all claims in a policy year; it can be waived on renewal after five continuous policy years.","display":"Aggregate deductible per policy year: 2, 3, 5, 10, 15, 20, 25 or 50 Lacs","note":"Every policy has one; it can be waived on renewal after five continuous policy years with TATA AIG (no portability or migration credit), and once waived it stays off. Applies separately each policy year of a multi-year policy and on floater basis for a family floater. Not applied to Pocket Protect, TransiCare Wallet or Inbound Emergency Hospitalization.","quote":"We will not be liable for a specified amount in aggregate for all claims during the per Policy Year. ... • 2 Lacs | • 10 Lacs | • 25 Lacs ... • 3 Lacs | • 15 Lacs | • 50 Lacs ... • 5 Lacs | • 20 Lacs ... The Insured Person will have the option to waive off Aggregate Deductible on Renewal, upon completion of five continuous Policy Years ... such aggregate deductible would be applicable on annual basis and separately on each policy year ... In case of family floater Policy, the Sum Insured, Cumulative Bonus & Aggregate Deductible, shall be available for all Insured Persons on an aggregate basis ... no credit for portability/migration shall be considered while calculating the five continuous Policy Years of coverage ... the Aggregate Deductible is not applicable to the benefit payable under this benefit ... The opted Aggregate Deductible will not be applicable under this benefit.","sources":[{"clause":null,"heading":"2. Aggregate Deductible","page":8,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-2-aggregate-deductible"},{"clause":"3","heading":"Aggregate Deductible Options (in ₹)","page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1080#c-3"},{"clause":null,"heading":"B11. Waiver of Aggregate Deductible","page":15,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-b11-waiver-of-aggregate-deductible"},{"clause":"Section 2","heading":"Benefits","page":11,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-2"},{"clause":null,"heading":"B9. Pocket Protect","page":14,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-b9-pocket-protect"},{"clause":"2(ii)","heading":null,"page":18,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-2-ii"}],"law":[]},{"key":"deductible_basis","label":"Per claim or aggregate","section":"Limits and co-pay","meaning":"Top-up: deductible applies to each claim. Super top-up: to the total of all claims in the year.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"Daily room limit, if any.","status":"cross-checked","value":"Up to a Single Private Room.","display":"Up to Single Private Room","note":"No rupee limit. The wording points to the room category in the Policy Schedule; the prospectus benefit table and CIS give Single Private Room. The optional Room Category Select changes it to Shared Accommodation or Any Room (Any Room only after the deductible waiver). A higher room means proportionate deduction of associated medical expenses.","quote":"Room Category** | Single Private Room ... Room Rent, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home, up to the room category specified in the Policy Schedule. ... Room Category – Up to Single Private Room. ... Option to select Any Room or Shared Accommodation Room category | Both for ‘Shared Accomodation’ After opting waiver of aggregate deductible for ‘Any Room’ ... the Insured Person shall bear a rateable proportion of the Room Rent and the total Associated Medical Expenses","sources":[{"clause":"27(ii)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1080#c-27-ii"},{"clause":"Section 2(i)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-2-i"},{"clause":"Row 4","heading":"Sum Insured (Basis) (Along with amount)","page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1081#c-row-4"},{"clause":null,"heading":"Optional Covers","page":22,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1080#c-optional-covers"},{"clause":"Section 2(a)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-2-a"}],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"Share of each admissible claim you pay.","status":"cross-checked","value":"A co-payment of 10% (Zone B to A, Zone C to B) or 20% (Zone C to A) applies when treated in a zone higher than the one opted.","display":"10% or 20% only when treated in a higher zone than opted","note":"Not applied to emergency hospitalisation due to accidental injury. Avoided by choosing Zone A/Pan India or paying the higher zone premium.","quote":"a Co-payment as mentioned in the table below shall be applicable on the admissible claim amount. ... B | A | 10% ... C | B | 10% ... C | A | 20% ... all claims except for claims for emergency Hospitalization due to Injury arising from an Accident. ... This would entail that Co-payment for Treatment in Higher Zone would not be applicable.","sources":[{"clause":"23","heading":"Co-Payment for Treatment in Higher Zone","page":32,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-23-2"},{"clause":"22","heading":"Premium Payment Zone","page":31,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-22-2"}],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"cross-checked","value":"Yes, at the insurer's Network Providers only, with pre-authorisation.","display":"Yes, at network hospitals","note":"Notify 48 hours before planned or within 24 hours of emergency hospitalisation.","quote":"Cashless Service is only available at Our Network Provider. ... We will provide cashless service by making payment to the extent of Our liability directly to the Network Hospital.","sources":[{"clause":"Section 5(c)","heading":null,"page":34,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-c"},{"clause":"Section 5(b)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-b"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"cross-checked","value":"Claims are handled in-house by TAGIC Health Claims at TATA AIG, or by a TPA if one is named in the Policy Schedule.","display":"In-house (TAGIC Health Claims), or a TPA named in the schedule","note":null,"quote":"Name | TAGIC Health Claims ... Claims Administrator Address | TATA AIG General Insurance Company Limited ... *TPA as mentioned in the Policy Schedule, if applicable.","sources":[{"clause":null,"heading":"Claims Servicing Details","page":12,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1080#c-claims-servicing-details"},{"clause":"Section 5(a)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-5-a"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"cross-checked","value":true,"display":"Yes","note":"Self, spouse and up to 3 dependent children; floater discounts 22% to 32% (prospectus). A Multi-individual option also exists.","quote":"Coverage Options | Individual/Family floater ... In case of family floater Policy, the Sum Insured, Cumulative Bonus & Aggregate Deductible, shall be available for all Insured Persons on an aggregate basis ... Relationships covered: Self, Spouse and up to 3 dependent children. ... The Multi-individual policy covers Self, spouse, up to 3 dependent children ... 2 members | 22% ... Atleast 2 children | 32%","sources":[{"clause":"1","heading":"Suitability","page":1,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1080#c-1"},{"clause":"Section 2","heading":"Benefits","page":11,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079#c-section-2"},{"clause":"7","heading":"Discounts on premium","page":4,"url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1080#c-7"}],"law":[]}],"documents":[{"kind":"wording","label":"TATA AIG MediCare Reserve (TATHLIP27059V012627)","pages":40,"fetched_at":"2026-10-19 17:40:49.331217+00","source_url":"https://www.tataaig.com/s3/tata_aig_medicare_reserve_policy_wordings_2250e6352a.pdf","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1079"},{"kind":"prospectus","label":"TATA AIG MediCare Reserve ( TATHLIP27059V012627)","pages":23,"fetched_at":"2026-10-19 17:40:49.331217+00","source_url":"https://www.tataaig.com/s3/tata_aig_medicare_reserve_prospectus_4460ab6ce9.pdf","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1080"},{"kind":"cis","label":"TATA AIG MediCare Reserve (TATHLIP27059V012627)","pages":5,"fetched_at":"2026-10-19 17:40:49.331217+00","source_url":"https://www.tataaig.com/s3/tata_aig_medicare_reserve_customer_information_sheet_7d5853cfa7.pdf","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/1081"},{"kind":"brochure","label":"TATA AIG MediCare Reserve (TATHLIP27059V012627)","pages":8,"fetched_at":"2026-10-17 20:05:17+00","source_url":"https://www.tataaig.com/s3/tata_aig_medicare_reserve_brochures_5c31d833f9.pdf","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/16802"},{"kind":"premium","label":"TATA AIG MediCare Reserve (TATHLIP27059V012627)","pages":null,"fetched_at":"2026-10-17 20:05:20+00","source_url":"https://www.tataaig.com/s3/tata_aig_medicare_reserve_tariff_sheet_e1819b8b8e.pdf","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/31817"},{"kind":"proposal","label":"TATA AIG MediCare Reserve ( TATHLIP27059V012627))","pages":null,"fetched_at":"2026-10-17 20:17:30+00","source_url":"https://www.tataaig.com/s3/tata_aig_medicare_reserve_proposal_e9fd9c9b4c.pdf","url":"https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627/document/31877"}],"versions":[],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"Tata AIG General Insurance official website","url":"https://www.tataaig.com/","note":"Buy directly from the insurer."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"insurer","name":"Claims process","url":"https://www.tataaig.com/claims-process","note":null},{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"insurer","name":"Grievance redressal policy","url":"https://www.tataaig.com/grievance-redressal-policy","note":null},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"TATA AIG MediCare Reserve (UIN TATHLIP27059V012627), IndiaInsurances, https://indiainsurances.com/policy/tata-aig-general-insurance/tata-aig-medicare-reserve-tathlip27059v012627"}