Tata AIG General Insurance

Tata AIG MediCare Premier

Plain-English breakdown of the plan — every field a shopper actually needs before clicking buy. Compiled from public Tata AIG brochures and policy wordings. Always confirm against the official PDF below.

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Trust at a glance

Tata AIG — IRDAI FY 2024-25

Verified

Claim Settlement Ratio: 97.07%
Incurred Claim Ratio: 76.24%
Complaints / 10,000 claims: 10
Network hospitals: 7,500

Source: IRDAI Annual Report FY 2024-25 · UIN 108PolicyPlain earns no commission · numbers shown verbatim

Plan details

Every field, in one place

Sum insured options: ₹5L · ₹7.5L · ₹10L · ₹15L · ₹20L · ₹25L · ₹50L · ₹1Cr
Pre-existing disease (PED) waiting: 36 months
Pre-existing covered: Covered after PED waiting period
Co-payment: No copay published
Room rent: Single private AC room
Restoration of sum insured: Once per policy year
No Claim Bonus (NCB): 50% per claim-free year
Cashless network: 7,500 hospitals (insurer disclosure)
Free-look cancellation window: 15 days
Premium grace days: 30 days
IRDAI UIN: Not confirmed — verify on irdai.gov.in
Last verified: 2026-06 · third party aggregator

Honesty note: MediCare has multiple variants (Plus / Protect / Premier); fields reflect Premier — the higher-tier offering.

Indicative premium

Order-of-magnitude only — NOT a quote

Age	Sum insured	Approx annual premium
35	₹10L	~₹15,000/yr
45	₹10L	~₹21,000/yr

Indicative figures vary by city, family member count, medical loading and policy term. Always confirm on the insurer's premium calculator.

Known exclusions

What this plan typically does NOT cover

Cosmetic / aesthetic surgery (non-reconstructive)
Substance abuse and self-inflicted injury
Adventure / hazardous activities
Treatment outside India unless rider opted
Experimental / unproven treatments

Known traps

The fine print that decides claim outcomes

ICU charges have a per-day sub-limit on smaller SI variants — re-confirm before claiming.
Specified-disease list (cataract, hernia, knee) has a 24-month wait separate from PED.
Single private AC room cap — proportionate deduction applies across the whole bill.
NCB capped at 100% of base SI cumulatively.
Modern treatment percentage caps on advanced procedures.

How to claim

Cashless vs reimbursement — the steps

1Notify insurer. Within 24 hours of emergency admission or 48-72 hours for planned hospitalisation. Use Tata AIG's helpline or app — keep the reference number.
2Cashless: Pre-authorisation form filled by hospital, sent to Tata AIGvia the hospital's TPA desk. Approval typically 4-6 hours during business; longer overnight. If your hospital is OUT of network (or PPN-only), you'll be on reimbursement.
3Reimbursement:Pay hospital out-of-pocket, then submit claim form + original bills + discharge summary + investigation reports + KYC. Insurer's IRDAI-mandated turnaround is 30 working days from receipt of complete documents.
4Watch for deductions. Room rent above your eligible category triggers proportionate deduction across the WHOLE bill, not just room rent. Sub-limits on cataract / modern treatment apply even when total SI is far higher.
5If denied: Ask for a written denial citing the exact clause. Internal grievance redressal first, then IRDAI Bima Bharosa or the Insurance Ombudsman.

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