Tata AIG Wellsurance Family Health Insurance
Claim Settlement | Dedicated Team |
Claim Settlement Ratio | 76.04% |
COVID-19 Cover | Yes |
Network Hospitals | 3,000+ |
Policies Sold | 2,20,583 |
Renewability | Lifelong |
About Tata AIG Wellsurance Family Health Insurance
TATA AIG’s Wellsurance Family Policy is a unique medical insurance plan which combines critical illness and hospital cash benefits along with other coverage benefits. The plan is a combination of fixed benefit and indemnity coverage as some benefits are paid as fixed benefits while some are paid at actuals. The main coverage under the plan is for specified critical illnesses. If the insured is diagnosed with any of the covered illness, the sum insured is paid in a lump sum. Besides critical illnesses, the plan also pays a daily benefit in case of hospitalisation.
The plan is available in three variants: Classic, Supreme and Elite with the sum insured of Rs. 2 Lakh, Rs. 3 Lakh, and Rs. 4 Lakh respectively. The sum insured is paid in case of critical illness claim and for other claims, the limit of coverage is specified in each variant of the plan.
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Key Inclusions and Exclusions of the Plan
What's Included
- Coverage against 11 critical illnesses
- Ambulance costs are paid for transporting the insured to the hospital
- A lump sum convalescence benefit is paid if the insured is hospitalised for five or more days
- Education benefit is available in case of accidental death or disablement
- A daily benefit is paid in case of hospitalisation due to sickness or accident
What's Not Included
- Pre-existing illnesses are not covered within the first 4 years of the plan
- Critical illnesses are not covered within the first 90 days of the plan
- AYUSH treatments and other non-allopathic treatments are not covered
- Medical expenses incurred due to alcohol or drug abuse are not covered
- Mental or psychiatric disorders are not covered
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Major Attractions
The coverage benefits of the plan are its major attractions which include the following –
- 11 critical illnesses are covered under the plan. If the insured suffers from any of the covered illness, the critical illness sum insured is paid at once. The sum insured for critical illness coverage ranges from Rs. 2 Lakh to Rs. 4 Lakh depending on the plan variant
- In case of hospitalisation, whether due to accidents or sickness, the plan pays a specified daily benefit for each day that the insured is admitted to the hospital
- In case the insured is admitted in the ICU, an increased daily benefit is paid for each day
- Ambulance costs are covered up to specified limits
- In case hospitalisation exceeds 5 continuous days, a lump sum convalescence benefit is paid under the plan
- In case of accidental death or permanent total disability suffered by the insured, a lump sum education benefit is paid to meet the education costs of the dependent child
- There are various value-added benefits too which include health line, health portal, e-newsletters, health query and discounts on health and wellness related services
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What’s More?
Besides offering a good coverage, the plan also offers the following benefits –
- The premiums paid are allowed as a deduction up to a limit of Rs. 25,000 as per the provisions of Section 80D
- The plan allows lifelong renewability for the policyholder and his/her spouse
- Easy portability option is available under the plan
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Conclusion
TATA AIG’s Wellsurance Family is a good health insurance plan with unique coverage benefits which not only take care of the medical expenses but also of other non-medical expenses which cause a strain in times of emergencies. So, you can buy the plan and get yourself protected against medical emergencies.
The policy can be bought online from your own home or office. InsuranceDekho website offers you the ease of buying the policy from its portal. You can do a need analysis using the website’s analysis tools to find the most optimal coverage for your family. So, go online and buy the policy from InsuranceDekho website.
Claim Process at Tata AIG Health Insurance
FAQs on Wellsurance Family Health Insurance Plan
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Which critical illnesses are covered under the plan?
The plan covers 11 illnesses which include first heart attack, cancer, major burns, stroke, total blindness, kidney failure for which regular dialysis is required, multiple sclerosis, coma, open chest CABG, permanent paralysis of limbs and transplant of a major organ or bone marrow.
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Is there any survival period for critical illness claims?
Yes, the insured is supposed to survive for at least 30 days after the diagnosis of the illness to become eligible for critical illness claims.
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What is the limit of hospital cash benefit and for how long is the benefit paid?
The limit of hospital cash benefit is 1% of the sum insured. That means that for Classic Plan where the sum insured is Rs. 2 Lakh, hospital cash is payable @ Rs. 2000. For the other two plan variants of Supreme and Elite where the sum insured is Rs. 3 Lakh and Rs. 4 Lakh respectively, hospital cash is paid @ Rs. 3000 and Rs. 4000 respectively. Hospital cash benefit is paid for a maximum of 90 days.
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Is the benefit paid on ICU admission higher?
Yes, if the insured is admitted to the ICU, the hospital cash benefit would be higher. It would be Rs. 3000, Rs. 4500 and Rs. 6000 for the three variants of Classic, Supreme and Elite respectively.