• Tata AIG Health Insurance Claims Procedure

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    Cashless Treatment

    Customer Service

    Medical Coverage

    Claim Experience

    Tata AIG allows cashless claims and reimbursement claims on their health insurance plans. Cashless claims facility is available with the network hospitals. The Third Party Administrator has to be informed about the claim and the TPA will assist you in completing the formality regarding the claim request. If you are getting treated in a non-network hospital, then you must clear all the bills at the hospital and then claim for reimbursement. There are over 3,000+ network hospitals covered with Tata AIG.

    Incurred Claim Ratio of Tata AIG Health Insurance:

    Incurred Claims Ratio or ICR for Health Insurance companies in India is published by IRDA each year. ICR is the overall value of the claims the company has paid divided by the total sum of premiums collected during that period. The following is the incurred claim ratio for Tata AIG for the year 2014-15 and 2015-16:

    For 2015-16:

    Net Earned Premium (in lakhs INR) Net Claims Paid (in lakhs INR) Incurred Claims Ratio (Percentage)
    37258 24163 64.85

    For 2014-15:

    Net earned premium (in lakhs) Net claims paid (in lakhs) Incurred claims ratio
    35,591 24,892 69.94%

    Tata AIG has a low incurred claims ratio and thus proving that the company is making a good profit and is in a position to settle claims. Hence, the company will not load your premium as they are not incurring loss.

    Claim Procedure:

    You can make either cashless claims or you can get reimbursement.

    Cashless Claim:

    In cashless claim, you do not have to settle the bill if you are hospitalised in a network hospital on an emergency or if it is planned. Tata AIG will be represented by the Third Party Administrator and the TPA will coordinate with the hospital and settle the bill. The process for cashless claim is as follows:

    Cashless Claims Procedure:

    You may be admitted in a hospital due to emergency or it could be planned, you need not worry about paying the hospital bill. If you are planning the hospitalisation, you must contact the service provider 48 hours before the admission. Emergency admission has to be notified within 24 hours of hospitalisation. If you have been admitted in a network hospital then you can contact the TPA of Tata AIG and check if cashless claim can be made. You will then have to follow the following procedure to claim:

    • You must get admitted in a network hospital.
    • You must then contact the TPA of Tata AIG.
    • The TPA can be contact at the toll free number 1800-425-4033 or at 1800-22-9966 for senior citizen.
    • You can also fax the TPA at +91-40-23541400.
    • The address is Claims Department, Family Health Plan Ltd., Ground Floor, Srinilaya – Cyber Spazio, Road no- 2, Banjara Hills, Hyderabad – 500 034.
    • Email ID – info@fhpl.net. Website – www.fhpl.net.

    Cashless Claims Process:

    • TPA will then review the documents.
    • The confirmation will be communicated to the hospital by fax or e-mail.
    • The claim request will be communicated to you.
    • After completing the formalities, the claim will be settled as per the policy terms and conditions.

    Reimbursement of Treatment Expenses:

    You can reimburse your treatment expenses if your cashless claim does not get approved or if you are getting treated at a non-network hospital. You will however have to clear the hospital bill first. You will then have to notify the TPA within 48 hours of the admission if it is planned or within 24 hours if it is an emergency hospitalisation. The following is the procedure to file for reimbursement:

    • Clear out the bill at the non-network hospital.
    • Contact the TPA at 1800-266-7780 or 1-800-11-9966. You can also write at general.claims@tata-aig.com. Keep your contact number, policy number, name of insured, date and time of hospitalisation or loss, location and nature of loss and place and contact detail of the person information ready.
    • Collect all relevant documents and submit it to the TPA.

    Documents Required:

    While reimbursing your health insurance claim, you must submit the following documents:

    • If you want reimbursement for hospital cash or medical benefits:
      • Duly filled claim form
      • Report from the attending doctor
      • Discharge card or proof of hospitalisation that includes the treatment details
      • Prescription bills
      • X-ray reports or pathological reports, if any
    • If you want to claim for weekly benefits:
      • Duly filled claim form
      • Report from the attending doctor
      • Disability certificate, if any
      • Investigation or lab reports
      • If hospitalised, then original discharge or admission card
      • If you are employed, then employer’s leave certificate that includes your grade or designation information
      • You will have to submit your latest salary certificate
    • If you are claiming for death benefit:
      • Duly filled claim form
      • Original death certificate
      • Attending doctor’s report
      • Original or attested coroner’s report
      • Attested copy of FIR
      • Police inquest report, if applicable

    Claims Process:

    • The claim processing team will check the documents and if required ask for additional documents.
    • The claim request will be reviewed and the approval or rejection of the claim will be communicated to you.
    • The claim will be settled as per the terms and conditions of the policy
    • The approved amount will be then reimbursed to you.

    This Insurance Company has not partnered with BankBazaar.com. For more details, please visit its website/branch office. The trademarks, logos and other subject matters of intellectual property belong to their respective owners.

    GST rate of 18% applicable for all financial services effective July 1, 2017.

    Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.

    Tata AIG Health Insurance Claims Procedure Reviews

  • Page 1 of 4 1 2 3 4
    • Tata AIG Health Insurance
      "Excellent Insurance Policy"
      0.5 5.0/5 "Blown Away!"
      They are very customer friendly people. I have a very good claim experience with them. It is very friendly claim experience and cashless mediclaim. Almost most of the hospital has been covered in the city where I'm living in. There is a sufficient amount of Coverage. If I'm not claiming the policy in this year. Next year i will get extra 50000 as add on in my claim amount.
      Was this review helpful? 0
      , nasik
      Reviewed on May 24, 2018
    • Tata AIG Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have my health insured with TATA AIG from last 2-3 years and it is a good insurance policy to use. I have not claimed anything so far from this insurance policy. I am not aware of the premium amount as my company pays it. I have a coverage value of Rs 4 lakhs for this insurance.
      Was this review helpful? 0
      , mumbai
      Reviewed on May 09, 2018
    • Tata AIG Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have my health insured with TATA AIA insurance from last 1 month, the premium amount of this insurance is Rs 33000 which has to be paid every year. I do not have claim experience so far with this insurance and i have a coverage of Rs 60 lakhs for this insurance.
      Was this review helpful? 0
      , kolkata
      Reviewed on Apr 16, 2018
    • Tata AIG Health Insurance
      "Good health insurance policy"
      0.5 5.0/5 "Blown Away!"
      I have got the health insurance policy from TATA AIG around a year ago. The customer support is good with the TATA AIG and they give good responses to the customs. This policy covers 3members in my family and I pay the premium amount of Rs,11,000 ti renew the policy every year.
      Was this review helpful? 0
      , kolkata
      Reviewed on Apr 12, 2018
    • Tata AIG Health Insurance
      "Good service"
      0.5 5.0/5 "Blown Away!"
      I have taken a Health insurance with TATA Aig, the insurance was taken since 2008,I have no claim experience with them but 100% covered as cashless treatment.I pay a premium amount of 600 per month.The policy coverage amount three lakhs.customer service i good.
      Was this review helpful? 0
      , mumbai
      Reviewed on Mar 02, 2018
    • Tata AIG Health Insurance
      "Not satisfied with the insurance policy"
      0.5 1.0/5 "Really Bad"
      Without my knowledge the health insurance with TATA AIG GENERAL INSURANCE got opened and took a premium of 5000. The executive informed me after one year the premium amount will be credited back to my account if i have not availed any claim. But till now i have not got the amount and later i closed the insurance.
      Was this review helpful? 0
      , bangalore
      Reviewed on Dec 09, 2017
    • Tata AIG Health Insurance
      "GOOD SERVICE"
      0.5 4.0/5 "Great!"
      I dont have much experience with TATA health insurance service the payment was easy process the premium amount was 8k per year the benefits not gone through the customer service was good the offers are good with TATA for my health insurance service,it was a good service from TATA for my health insurance service.
      Was this review helpful? 0
      , bangalore
      Reviewed on Nov 21, 2017
    • Tata AIG Health Insurance
      "Good service"
      0.5 4.0/5 "Great!"
      I have accidental coverage with TATA AIG general insurance policy. I got this policy around 3 years ago. I have the medical claim Up to 10lakhs with TATA AIG accidental coverage insurance policy . This policy covers only myself. I have paid Rs,2000 to renew the policy last year.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Nov 17, 2017
    • Tata AIG Health Insurance
      "Good"
      0.5 4.0/5 "Great!"
      I am having the health insurance policy with the TATA AIG general insurance company and I have not faced any claims with them till now. Everything is perfect one with the Tata AIG general insurance company.
      Was this review helpful? 0
      , kolkata
      Reviewed on Nov 13, 2017
    • Tata AIG Health Insurance
      "Worst service"
      0.5 1.0/5 "Really Bad"
      I have cancelled the TATA AIG health insurance policy , because the executives are not customer centric.I have informed the executives saying that I am not interested to go with this policy but they have debited the amount from my credit card and I have asked them refund the amount in time , but they are too much of time to refund the debited amount.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Oct 31, 2017
    • Tata AIG Health Insurance
      "Reasonable"
      0.5 3.0/5 "Satisfactory"
      I do have health insurance policy with the Tata AIG general insurance company and I dont have any claim experience with them . Response is an average one for me like I was not assisted in a proper way and it is very easy to update the information.
      Was this review helpful? 0
      , coimbatore
      Reviewed on Sep 02, 2017
    • Tata AIG Health Insurance
      "Health insurance is too good"
      0.5 3.0/5 "Satisfactory"
      TATA AIG health insurance is very good but there is some scope for improvement when tit comes to customer service. When I call the customer care they are dealing in responding, so I have canceled the plan and I shifted to ICICI LOMBARD. Premuim is 1600 and it is too low
      Was this review helpful? 0
      , satara
      Reviewed on Aug 23, 2017
    • Tata AIG Health Insurance
      "Good health policy"
      0.5 4.0/5 "Great!"
      I got a health insurance policy with TATA AIG for past 2 years. The customer service is good with TATA. I never had any claim experience so far. The medical coverage and the cashless treatment is good with TATA AIG. I pay the premium of Rs.7000 in a year to renew the policy . This policy covers 4 people in my family including me.
      Was this review helpful? 0
      , sonepat
      Reviewed on Jul 18, 2017
    • Tata AIG Health Insurance
      "Good Service"
      0.5 4.0/5 "Great!"
      I have taken a health insurance policy. For myself I got this policy around three years ago. I pay the premium of 3839 . I have no idea of the coverage every years I get as a refund 4000 from the insurance company If I don't claim anything Customer service and other things are really hassle free from I pay the premium as cash
      Was this review helpful? 0
      , ludhiana
      Reviewed on Jul 04, 2017
    • Tata AIG Health Insurance
      "Good Health Coverage"
      0.5 4.0/5 "Great!"
      I am making the premium of around 3000 per year, They gave me the medical coverage for everything except pregnancy and delivery wont cover. For small illness, accidents and cancer it has a coverage. Overall they offered me the medical coverage of Rs.3 lakhs per annum.
      Was this review helpful? 1
      , sangli
      Reviewed on May 11, 2017
    • Tata AIG Health Insurance
      "Very good"
      0.5 5.0/5 "Blown Away!"
      As of now, I have health insurance policy with the TATA AIG general insurance company. Claims are really good with them and on every year, I have claimed around one lakh of Rupees. Premium is around 600 Rupees more per annum and it provides coverage for my full nuclear family. I experienced cashless treatment facilities and it depends on hospitals terms and conditions.
      Was this review helpful? 1
      , mumbai
      Reviewed on Mar 20, 2017
    • Tata AIG Health Insurance
      "Health insurance is very good"
      0.5 4.0/5 "Great!"
      TATA AIG health insurance is very good and it helps me to run my family they are easily reachable it is very much useful for every one. I am holding this health insurance for about 3 months. I am supposed to pay a premium of 27000 once in every 6 months.
      Was this review helpful? 0
      , bangalore
      Reviewed on Jan 16, 2017
    • Tata AIG Health Insurance
      "Health insurance"
      0.5 3.0/5 "Satisfactory"
      TATA AIG health insurance is fine, since I had not used I dont have experienced much, I am holding this health insurance for a period of 2years no drawback nor any challenges . Noting particular about this health insurance . I normally make the payment on a yearly basis
      Was this review helpful? 0
      , vadodara
      Reviewed on Dec 23, 2016
    • Tata AIG Health Insurance
      "Not customer oriented"
      0.5 1.5/5 "Bad"
      TATA AIG policy is very much aggressive at the time of selling the policy. After selling the policy they were not providing any sort of information about the further updates or about the policy. They will only call for making the premium payment not for servicing. Bottom line, they are business oriented.
      Was this review helpful? 1
      , chennai
      Reviewed on Dec 07, 2016
    • Tata AIG Health Insurance
      "Very fast services"
      0.5 5.0/5 "Blown Away!"
      TATA AIG provides me a health insurance benefit. Being a corporate insurance, I do not have to do much. I only have to submit the bills with the proper documents attached and the process for it is very fast. I get my reimbursement on time. The coverage is for my family and myself. I have not used the cashless facility yet.
      Was this review helpful? 1
      , jabalpur
      Reviewed on Oct 17, 2016
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