Individual Accident & Sickness Hospital Cash Policy
Tata AIG General Insurance Company Limited Individual Accident and Sickness Hospital Cash is a perfect supplement for an individual’s health insurance policy and can be taken along with any other health insurance schemes.
- A Daily benefit hospitalization for Accident & Sickness.
- 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.
- Free Look Period –You have a period of 15 days from the date of receipt of the Policy document to review the terms and conditions of this Policy. If You have any objections to any of the terms and conditions, You have the option of cancelling the Policy stating the reasons for cancellation and You will be refunded the premium paid by You after adjusting the amounts spent on stamp duty charges and proportionate risk premium. You can cancel Your Policy only if You have not made any claims under the Policy. All Your rights under this Policy will immediately stand extinguished on the free look cancellation of the Policy. Free look provision is not applicable and available at the time of renewal of the Policy.
- Grace Period of 30 days for renewing the Policy is provided under this Policy. However, coverage would not be available for the period for which no premium has been received
- 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.
- Any revision / modification in the product will be done with the approval of the Insurance Regulatory and Development Authority and will be intimated to you atleast 3 months in advance
- In the likelihood of this policy being withdrawn in future, we will intimate you about the same 3 months priorto expiry of the policy. You will have the option to migrate to similar health insurance policy available with us at the time of renewal with all the accrued continuity benefits provided the policy has been maintained without a break as per portability guidelines issued by IRDA.We will offer the Insured Person an option to migrate to similar health insurance Policy with Us provided that:
Insured Person has been insured with Us underthis Policy as a dependant.
This option for migration to similar Indemnity health insurance policy shall be exercised by the Insured Person only when he / she is at the end of specified exit age, and certainly at the time of renewal only.
Insured Person will be offered continuity of coverage & suitable credits , if any , for all the previous policy years, provided the policy has been maintained without a break.
Please refer Policy wordings for detailed information.
- In-hospital Indemnity For Accidents : Pays for Daily Benefit for each Day for Inpatient Hospitalisation due to Injury or Accidents upto 180 days.
- In-hospital Indemnity For Sickness : Pays for Daily Benefit for each Day for Inpatient Hospitalisation due to Illness ,Disease or Sickness upto 180 days.
- Accident Medical Expense Reimbursement: We will pay the Reasonable 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.
- 1 day deductible and 90 days waiting period for under Hospital Indemnity for Sickness
- Deductible of 5% of benefit amount under Accident Medical expense reimbursement
- Coverage will be 100% of the Coverage amount in case of Insured and Spouse, 50% in case of each child
- Entry age between the age from 6 months upto 65 years
You can give us your details in the “Have us call you” form and we will get in touch with you shortly.
- any Pre-existing Condition, any complication arising from it or
- 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
- 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
- being under the influence of drugs, alcohol, or other intoxicants or hallucinogens unless properly prescribed by a Physician and taken as prescribed; or
- participation in an actual or attempted felony, riot, crime, misdemeanor, (excluding traffic violations) or civil commotion; or
- operating or learning to operate any aircraft, or performing duties as a member of the crew on any aircraft; or Scheduled Aircraft.; or
- 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
- 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
- the intentional use of military force to intercept, prevent, or mitigate any known or suspected Terrorist Act; or
- ionising radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste from burning nuclear fuel; or
- the radioactive, toxic, explosive or other dangerous properties of any explosive nuclear equipment or any part of that equipment; or
- congenital anomalies or any complications or conditions arising therefrom; or
- 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.
- any loss resulting directly or indirectly, contributed or aggravated or prolonged by childbirth or from pregnancy, or
- 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
- 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
- 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;
- Any medical treatment taken outside of India.
- Any non medical treatment(list enclosed- Annexure I).
- Call us at our 24 X 7 Toll Free number 1800 266 7780 / 1800 22 9966 (Only for Senior Citizens)
- Alternatively you can SMS “CLAIMS” to 5616181
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