Claim Settlement Ratio 94.21%
Claim Settlement Facility 100%
Network Hospitals 7200
COVID-19 Cover Yes
Incurred Claim Ratio 60.68%
The policy restores 100% of the basic sum insured upon the exhaustion of the basic sum insured and the cumulative bonus during the policy period. The restoration benefit can be availed only once during the policy period. The restored sum insured can be utilized only for the unrelated illness for which the basic sum insured is utilized and exhausted. In case of family floater policy, reinstatement of sum insured done can be utilized by all the insured persons in the policy on floater basis. The unutilized sum insured cannot be carried forward to the next policy year.
TATA AIG health insurance policy covers the medical expenses incurred for bariatric surgery for treatment of Obesity and Weight control. The surgery has to be conducted only on the advice of the doctor. The BMI requirements have to be satisfied to undergo the bariatric surgery under this section.
The policy covers medical expenses related to inpatient and day care hospitalization of the insured customer incurred outside India. For this condition to be fulfilled the diagnosis of the illness has to happen in India and the treatment can be taken within India or abroad. The medical expenses shall be settled on reimbursement basis and cashless would be arranged on a case to case basis. It is important to note that only the basic sum insured and the no claim bonus can be utilized under this section and not the reinstated sum insured.
The policy provides for 50% cumulative bonus for every claim free year up to a maximum of 100%. The cumulative bonus would be provided only for a claim free year. In case of claim during any policy year, the cumulative bonus would be reduced by the same percentage by which it was increased. In case of floater policies the cumulative bonus will only be applicable only to those insured persons who did not make a claim during the policy period.