Tata AIA Life Health Insurance Plans

Not always. For younger individuals (below 45 years), a pre-policy medical check is often waived. They can proceed straight to buying their health insurance plan. 

The only exception is if they suffer from a pre-existing illness. In this case, they will be required to present their past medical reports and undergo a medical screening to assess their current health status.  

The 4 most purchased types of health insurance plans in India are individual health insurance, family health insurance, group health insurance and senior citizen health insurance.

Yes, you can buy more than one health insurance plan. For enhanced benefits, you can buy a traditional health insurance plan coupled with a fixed-benefit health plan such as our Tata AIA Life Insurance Pro-Fit.If you require more medical coverage, we recommend looking into 6add-on covers or top-up plans as they are less expensive than buying a separate policy. 

Yes, you do not have to be an Indian citizen to buy health insurance. Foreign nationals and NRIs residing in India are eligible to buy health insurance subject to the insurer's terms and conditions. 

No, individuals already diagnosed with cancer cannot get insured under a new health plan unless it is a group health insurance policy under an employer. 

Hence, we recommend buying and maintaining a health policy that offers cancer or critical illness coverage if you think you may be liable to develop any type of cancer in the future. 

While there is no standard coverage amount for health insurance, there are two broadly accepted rules:

First, your health coverage should be at least 50% of your annual income.

Second, your health insurance should cover the total cost of a coronary artery bypass graft in a hospital of your choice. Most personal finance experts recommend at least ₹5 lakhs of health coverage.

Today, a 5 lakh MediClaim policy may only be enough to cover one person living in a Tier-3 city. This is because medical expenses can get extremely expensive in Tier 1 and 2 cities. Moreover, factors like medical inflation can exacerbate this issue as well.  

We recommend getting a policy with a minimum sum insured of ₹10 lakhs if you live in a Tier 1 or 2 city. If you are a senior citizen or want to insure your whole family, you will need to opt for a sum insured much higher than ₹10 lakhs.    

Generally, basic plans will only cover hospitalisation expenses and pre-existing diseases (after a waiting period). If you need critical illness insurance, we recommend looking for plans that offer 6add-on critical illness cover or built-in critical illness coverage. 

Generally, only home isolations under the prescription of a doctor or certified healthcare professional through in-person or telemedicine consultations are covered by health insurance plans subject to the policy's terms and conditions.

The waiting period in health insurance is a time frame within which you will not receive coverage even if your policy tenure has been initiated. Most health insurance policies have a waiting period of 30 days, after which they will receive coverage.

For existing diseases (pre-disclosed), the waiting period may vary from 2-4 years. It means that the insured will not get coverage for a disease that they already had before buying the health insurance coverage.

The waiting period will also vary for different add-on covers. For example, the waiting period for critical illness is usually 90 - 180 days, and maternity covers have a waiting period of 2 - 4 years.

The 30-day waiting period under health insurance is only waived for emergency medical procedures that occur due to accidents.

In health insurance, a pre-existing disease (PED) is a health condition or illness you already would have been diagnosed with before buying the health insurance plan. These can be ailments like asthma, diabetes, high blood pressure, etc.

Insurers also consider pregnancy to be a pre-existing condition and severe cases of physical injury are also considered PEDs by some insurers under specific plans.  

Generally, no, they are considered cosmetic procedures and are not covered under basic health insurance plans. Most insurers will only cover dental treatments or surgery if the damage to your teeth was the result of an accident or insured illness.

However, some health insurance plans offer coverage for dental treatments under an add-on cover. 

Generally, no, insurers have a general/overall waiting period of 30 days before you can file any medical insurance claims. This waiting period is only waived in the case of accidents and other medical emergencies.

The first thing you can do is contact us, find out the reason for your claim refusal and file a complaint under our grievance redressal mechanism. 

If this does not work, you can always approach the IRDAI's Grievance Redressal Cell under their Consumer Affairs Department. You can call their toll-free number – 155255 (or) 1800 4254 732 or send them an email at [email protected].

If you wish to get treated at a non-network hospital, you can file for cashless claims or reimbursement claims. You need to inform and follow the process for cashless claims. For reimbursement claims, first, you will need to get treated at the hospital , pay for your treatment expenses, and then contact us to initiate your claims process. 

Make sure you maintain any and all receipts/bills relating to your treatment, as you will need to submit them to us during your claims process.

A No Claim Bonus or No Claim Discount in health insurance is a percentage discount that is applied to your overall premium amount on renewal in the next policy year if you have not filed any claims in the previous policy year.

This discount can be accrued for consecutive policy years if you have not filed any claims in those years. Depending on the insurer (if they allow NCB transfers), it can also be transferred to a different policy when switching insurance providers.

After your health insurance claim with Tata AIA has been filed and settled, your policy coverage (sum insured) will be reduced by your claim amount. For example, if you have a policy with a sum insured of ₹5 lakhs and raise a claim for ₹3 lakhs. 

Your health policy coverage will be ₹2 lakhs after your insurer files and settles the claim. 

In cases where you exhaust the full amount, you will not be able to raise any more claims for the remaining policy year until renewal where your sum insured gets replenished/re-instated.

Generally, no, insurers have a general/overall waiting period of 30 days before you can file any medical insurance claims. This waiting period is only waived in the case of accidents and other medical emergencies.  

The first thing you can do is contact us, find out the reason for your claim refusal and file a complaint under our grievance redressal mechanism. 

If this does not work, you can always approach the IRDAI's Grievance Redressal Cell under their Consumer Affairs Department. You can call their toll-free number – 155255 (or) 1800 4254 732 or send them an email at [email protected].

If you wish to get treated at a non-network hospital, you can file for cashless claims or reimbursement claims. You need to inform and follow the process for cashless claims. For reimbursement claims, first, you will need to get treated at the hospital , pay for your treatment expenses, and then contact us to initiate your claims process. 

Make sure you maintain any and all receipts/bills relating to your treatment, as you will need to submit them to us during your claims process. 

A No Claim Bonus or No Claim Discount in health insurance is a percentage discount that is applied to your overall premium amount on renewal in the next policy year if you have not filed any claims in the previous policy year.

This discount can be accrued for consecutive policy years if you have not filed any claims in those years. Depending on the insurer (if they allow NCB transfers), it can also be transferred to a different policy when switching insurance providers. 

After your health insurance claim with Tata AIA has been filed and settled, your policy coverage (sum insured) will be reduced by your claim amount. For example, if you have a policy with a sum insured of ₹5 lakhs and raise a claim for ₹3 lakhs. 

Your health policy coverage will be ₹2 lakhs after your insurer files and settles the claim. 

In cases where you exhaust the full amount, you will not be able to raise any more claims for the remaining policy year until renewal where your sum insured gets replenished/re-instated.