Group Health Insurance Plan

Group Accident & Sickness Hospital Cash Policy

UIN: IRDA/NL-HLT/TAGI/P-P/V.I/292/13-14
With our new age lifestyles, our susceptibility to risks has increased more than ever. With the escalating medical costs the charges like Surgeon's fees, diagnostic tests etc may turn out to be very expensive. In some instances the hospitalization may be prolonged and may drain your savings. Tata AIG General Insurance Company Limited Group Accident and Sickness Hospital Cash Policy is a perfect supplement to the group health insurance policy and can be taken along with any other health insurance schemes.
 
 

Key Features

 
  • A Daily benefit for Accident & Sickness hospitalization.
  • No Pre-policy check up required.
  • Hospitalisation Cash upto 180 days in case of Accidents or Sickness
  • Tax Benefits-Get tax benefits for premium paid on policies as per section 80D of the Income Tax Act. Tax benefits are subject to changes in tax laws.
    • Flexibility in choosing options-5 different levels.
    • We offer life-long renewal subject to application for renewal and the renewal premium in full has been received by the due dates and realisation of premium, unless the Insured Person or any one acting on behalf of an Insured Person has acted in an improper, dishonest or fraudulent manner or any misrepresentation or non cooperation under or in relation to this policy or the policy poses a moral hazard.
    • 15 days Free Look period (For the new business only)
    • 30 days Grace Period (For renewals only).
    • Sum Insured Enhancement – Sum Insured can be enhanced only at the time of renewal .The Enhanced Sum Insured will have a fresh proposal status where the waiting period, deductibles and exclusions shall apply afresh.However the quantum of increase shall be as per underwriting guidelines of the company.
    • Changes will be notified to the policyholders 3 months in advance in case of revision /modification in approved product.
    • In the likelihood of this policy being withdrawn in future, we will intimate you about the same 3 months prior to expiry of the policy, You will have the option to migrate to similar product available with us at the time of renewal.

    • Please refer Policy wordings for detailed information.

 
Benefit Chart
 
 
Benefits Level 1 Level 2 Level 3 Level 4 Level 5
In Hospital Indemnity for Sickness (Per Day) 500 1000 2000 3000 5000
In Hospital Indemnity for Accidents (Per Day) 1000 2000 4000 6000 10000
Accident Medical Expense reimbursement (Upto) 5000 10000 15000 20000 25000

  • Fig in Rs. (deductible: 1 Day for In Hospital indemnity for sickness, NIL for In Hospital indemnity for Accident and 5% of benefit amount for Accident Medical expense reimbursement)
  • Coverage Period is Upto 180 Days in Accident & Sickness Hospital Cash
  • Coverage will be 100% of sum insured in case of Insured & Spouse, 50% in case of each child
  • Waiting period of 90 Days for - In Hospital indemnity for sickness.
NOTE - For Premium & group discounts, please contact TATA AIG General Insurance Company Ltd. at 24x7 Toll Free Number 1800 11 99 66 / 1800 266 77 80
Senior citizen number-1800 22 9966.
What are the benefits of Group Accident and Sickness Hospital Cash?
 
  1. In-hospital Indemnity For Sickness :Pays for Daily Benefit for each Day for Inpatient Hospitalisation due to Illness ,Disease or Sickness
  2. In-hospital Indemnity For Accidents : Pays for Daily Benefit for each Day for Inpatient Hospitalisation due to Injury or Accidents
  3. Accident Medical Expense Reimbursement: We will pay the Reasonable and Customary Charges, subject to the Deductible shown in the Policy Schedule, for Covered Medical Expenses that occurs within the Republic of India for medical services which are not due to a Pre-existing Condition up to the maximum amount and benefit period stated in the Policy Schedule for the treatment of an Injury sustained by you.
  4. 1 day deductible and 90 days waiting period for Sickness Hospital Cash
  5. Deductible of 5% of benefit amount for Accident Medical expense reimbursement
  6. Coverage will be 100% of the Coverage amount in case of Insured and Spouse, 50% in case of each child
Who should buy this insurance?
 
Entry age from 6 months up to 65 years.
How can I buy this insurance?
 
You can give us your details in the “Have us call you” form and we will get in touch with you shortly.
What is not covered under Group Accident and Sickness Hospital Cash?
 
This entire Policy does not provide benefits for any loss resulting in whole or in part from, or expenses incurred, directly or indirectly in respect of:
  1. any Pre-existing Condition, any complication arising from it or
  2. suicide, attempted suicide (whether sane or insane) or intentionally self-inflicted Injury or illness, or sexually transmitted conditions, mental or nervous disorder, anxiety, stress or depression, Acquired Immune Deficiency Syndrome (AIDS), Human Immune-deficiency Virus (HIV) infection; or
  3. serving in any branch of the Military or Armed Forces of any country, whether in peace or War, and in such an event We, upon written notification by the Policyholder, shall return the pro rata premium for any such Insured Period of service under the circumstances described in a Hazard; or
  4. being under the influence of drugs, alcohol, or other intoxicants or hallucinogens unless properly prescribed by a Physician and taken as prescribed; or
  5. participation in an actual or attempted felony, riot, crime, misdemeanor, (excluding traffic violations) or civil commotion; or
  6. operating or learning to operate any aircraft, or performing duties as a member of the crew on any aircraft; or Scheduled Aircraft.; or
  7. War, civil war, invasion, insurrection, revolution, act of foreign enemy, hostilities (whether War be declared or not), rebellion, mutiny, use of military power or usurpation of government or military power; or
  8. any loss, damage cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any Act of Terrorism regardless of any other cause or event contributing concurrently or in any other sequence to the loss.The warranty also excludes loss, damage, cost or expenses of whatsoever nature directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to action taken in respect of any act of terrorism.If the Company alleges that by reason of this Exclusion, any loss, damage, cost or expenses is not covered by this insurance the burden of proving the contrary shall be upon the Insured. ;or
  9. the intentional use of military force to intercept, prevent, or mitigate any known or suspected Terrorist Act; or
  10. ionising radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste from burning nuclear fuel; or
  11. the radioactive, toxic, explosive or other dangerous properties of any explosive nuclear equipment or any part of that equipment; or
  12. congenital anomalies or any complications or conditions arising therefrom; or
  13. participation in winter sports, skydiving/parachuting, hang gliding, bungee jumping, scuba diving, mountain climbing (where ropes or guides are customarily used), riding or driving in races or rallies using a motorized vehicle or bicycle, caving or pot-holing, hunting or equestrian activities, skin diving or other underwater activity, rafting or canoeing involving white water rapids, yachting or boating outside coastal waters (2 miles), participation in any Professional Sport, any bodily contact sport or any other hazardous or potentially dangerous sport for which you are trained or untrained;or
  14. any loss resulting directly or indirectly, contributed or aggravated or prolonged by childbirth or from pregnancy, or
  15. for any loss of which a contributing cause was Your actual or attempted commission of, or willful participation in, an illegal act or any violation or attempted violation of the law or Your resistance to arrest; or
  16. if You are admitted to a Hospital within 90 days immediately following the Effective Date of Coverage stated in the Schedule, unless hospitalization is caused by Injury
  17. If You are admitted to a Hospital during the first 3 months immediately following the Policy Effective Date as a result of cataract(s), benign prostatic hypertrophy, hysterectomy for menorrhagia or fibromyoma, hernia, hydrocele, fistula in anus, piles, sinusits and related disorders;
  18. Any non medical expenses (list enclosed in policy wordings – Annexure I)
How can I file a Claim?
 
  • Call us at our 24 X 7 Toll Free number 1800 266 7780
  • Alternatively you can SMS “CLAIMS” to 5616181
    Click here to know more about our Claims Service
View and Download Policy Wordings
 
Click here to View and Download Policy Wordings
 
Buy Service
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It will override my registry on the DNCR.

Call us on our 24x7 Toll Free helpline 1800-266-7780
OR
SMS `TAG` to 5616181
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