MPFB - 15 Feb 2024 19 50 33

MANASA
Designation
TATA AIG General Insurance Company Ltd 9391180038
manasashyamala784@gmail.c
om
Medicare Premier - Floater Basis ( 1 Year ) Date : 15-Feb-2024
Zone Zone 2
Policy Period 1 Year
Sum Insured ₹ 1,000,000.00
Gross Total Premium ₹ 66,058.00
Floater Discount 32.0 % ( - ) ₹ 21,139.00
Net Premium ₹ 44,919.00
GST 18.0 % ₹ 8,085.00
Final Payable Premium ₹ 53,004.00
Proposer Insured
Age 56 Age 48
DOB 01 Jan 1968 DOB 01 Jan 1976
Relationship SELF Relationship SPOUSE
Premium Amount ₹ 27,911.00 Premium Amount ₹ 17,963.00
Insured Insured
Age 25 Age 24
DOB 15 Feb 1999 DOB 01 Jan 2000
Relationship DAUGHTER Relationship DAUGHTER
Page 1
MANASA
Designation
om
Medicare Premier - Floater Basis ( 2 Years ) Date : 15-Feb-2024
Zone Zone 2
Policy Period 2 Years ( Save 5.0 % )
Sum Insured ₹ 1,000,000.00
Long Term Discount 5.0 % ( - ) ₹ 6,606.00
GST 18.0 % ₹ 15,362.00
Proposer Insured
Age 56 Age 48
DOB 01 Jan 1968 DOB 01 Jan 1976
Insured Insured
Age 25 Age 24
DOB 15 Feb 1999 DOB 01 Jan 2000
Page 2
MANASA
Designation
om
Medicare Premier - Floater Basis ( 3 Years ) Date : 15-Feb-2024
Zone Zone 2
Policy Period 3 Years ( Save 10.0 % )
Sum Insured ₹ 1,000,000.00
Long Term Discount 10.0 % ( - ) ₹ 19,817.00
GST 18.0 % ₹ 21,831.00
Proposer Insured
Age 56 Age 48
DOB 01 Jan 1968 DOB 01 Jan 1976
Insured Insured
Age 25 Age 24
DOB 15 Feb 1999 DOB 01 Jan 2000
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Policy Benefits & Coverages
● Floater
Coverage Type
● TATA AIG Medicare Premier is a health insurance policy offered by Tata AIG General Insurance Company
Limited. Health insurance is a type of insurance policy that covers hospitalization expenses incurred as a
result of any illness, accident, or injury. When it comes to protecting your familys health, selecting the right
Policy
Descriptions health insurance plan is crucial. With Tata AIGs MediCare Premier Plan, you can get numerous features,
benefits, and add-ons that cater to your as well as your familys medical needs. It promises to unburden
your financial stress in a medical emergency and protect your and your loved ones health.
● Self
● Spouse
● Son
● Daughter
Eligible
Members ● Father
● Mother
● Father-in-law
● Mother in-law
Zone 1 :
● Mumbai including MMR / Thane, Delhi NCR/Faridabad/ Ghaziabad, Ahmedabad, Surat and Baroda
Zone 2 :
Zone ● Hyderabad, Bengaluru, Kolkata, Indore, Chennai, Chandigarh / Mohali / Punchkula / Zirakpur, Pune / Pimpri
Chinchwad and Rajkot
Zone 3 :
● Rest of India
● Entry Age :
● For Adults – 18 Years to 65 Years and Dependent / Parent in Laws
● For children - 91 days to 25 Years and upto 3 dependent children are allowed
Eligiblities
● Minimum Person :
● 1
● Maximum Person :
● 7
● The sum insured options for this policy cover is ₹ 5,00,000 lakh, ₹ 10,00,000 lakh, ₹ 15,00,000 lakh, ₹
Sum Insured
20,00,000 lakh, ₹ 25,00,000 lakh, ₹ 50,00,000 lakh,₹ 75,00,000 lakh, ₹ 100,00,000 lakh, ₹ 200,00,000 lakh
Page 4
and ₹ 300,00,000 lakh.
● 1 Year
● 2 Years
Policy Period
● 3 Years
Renewal
● Life long renewal
Family Discount:
● 20% for 2 members.
● 28% for upto 3 members.
Discount ● 32% for more than 3 members.
Long Term Discount:

● 5% for 2 years.
● 10% for 3 years.
In-Patient Treatment :
● We will cover for expenses of hospitalization due to disease/illness/Injury
● during the policy period that requires an Insured Person’s admission in a hospital as an inpatient. Medical
expenses directly related to the hospitalization would be payable.
Pre-Hospitalization expenses :
● We will cover for expenses for Pre-Hospitalization consultations, investigations and medicines incurred up
to60 days before the date of admission to the hospital. The benefit is payable if We have admitted a claim
under this policy.
Post-Hospitalization expenses :
Policy
Coverage ● We will cover for expenses for Post-Hospitalization consultations,
● investigations and medicines incurred after discharge from the hospital, up to number of days as specified.
Day Care Procedures :

● We will cover expenses for Day Care Treatment due to disease/illness/Injury during the policy period taken
at a hospital or a Day Care Centre. Treatment normally taken on out-patient basis is not included in the
scope of this cover.
Organ Donor :
● We will cover for Medical and surgical Expenses of the organ donor for harvesting the organ where an
Insured Person is the recipient provided that:
● The organ donor is any person whose organ has been made available in accordance and in compliance with
Page 5
The Transplantation of Human Organs (Amendment) Bill, 2011 and the organ donated is for the use of the
Insured Person, and
● ii. We have accepted an inpatient Hospitalization claim for the insured member under section B1 of this
policy.
Domiciliary Treatment :
● We will cover for expenses related to Domiciliary Hospitalization of the insured person if the treatment
exceeds beyond three days. The treatment must be for management of an illness and not for enteral
feedings or end of life care. At the time of claiming under this benefit, we shall require certification from
the treating doctor fulfilling the conditions as mentioned under the general definitions (Section 1) of this
policy.
Restore benefit :
● We will automatically restore the Basic Sum Insured if the Sum Insured and accrued Cumulative Bonus is
insufficient to pay a claim during the policy year. This benefit can be availed once during the policy year.
AYUSH Benefit :
● We will cover for expenses incurred for treatment as in-patient in an Ayush Hospital.
Ambulance Cover :
● We will cover for expenses incurred on transportation of Insured Person in a
● registered ambulance to a Hospital for admission in case of an Emergency or from one hospital to another
hospital for better medical facilities and treatment.
Health Check-up :
● We will cover for expenses for a Preventive Health Check-up up to1% of policy sum insured subject to a
maximum limit as specified in the table below. The limit is the maximum per policy in case of floater policy
and per insured person in case of individual policy The benefit is payable every year irrespective of claims
under the policy. This benefit has a separate limit (over and above base sum insured) and does not affect
cumulative bonus.
In-Patient Treatment - Dental :

● We will cover for medical expenses incurred towards hospitalization for dental treatment under
Anaesthesia necessitated due to an accident/injury/illness.
Hearing Aid :
● We will cover for reasonable charges for a hearing aid every third year. The maximum amount payable is
50% of actual cost or ₹ 10,000/- per policy, whichever is lower. The items must be prescribed by a
specialized Medical Practitioner as medically necessary. This benefit has a separate limit (over and above
base sum insured) and does not affect cumulative bonus.
Daily Cash for choosing Shared Accommodation :
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● We will pay a fixed amount per day as mentioned in the policy schedule if the Insured Person is Hospitalized
in Shared Accommodation in a Network Hospital for each continuous and completed period of 24 hours.
The benefit payable per day would be 0.25% of base sum insured and a maximum of ₹ 2000 per day. For
this claim to be paid, the main claim must be admissible under section B1 of
● this policy. This benefit has a separate limit (over and above base sum insured) and does not affect
cumulative bonus.
Daily Cash for Accompanying an Insured Child :

● We will pay a fixed amount per day, as mentioned in the policy schedule, if the Insured Person Hospitalized
is a child Aged 12 years or less, for one accompanying adult for each complete period of 24 hours. The
benefit payable per day would be 0.25% of base sum insured and a maximum of ₹ 2000 per day. For this
claim to be paid, the main claim must be admissible under section B1 of this policy. This benefit has a
separate limit (over and above base sum insured) and does not affect cumulative bonus.
Second Opinion :
● We will provide You a second opinion from Network Provider or Medical Practitioner, if an Insured Person is
diagnosed with the below mentioned Illnesses during the Policy Period. The expert opinion would be
directly sent to the Insured Person.
● Cancer
● Kidney Failure
● Myocardial Infarction
● Angina
● Coronary bypass surgery
● Stroke/Cerebral haemorrhage
● Organ failure requiring transplant
● Heart Valve replacement
● Brain tumours
Maternity Cover :
● We will cover for Maternity Expenses, up to limits as specified in the table below, per policy subject to a
waiting period of 4 years of continuous coverage under this policy.
First year Vaccinations :

● We will pay for vaccination expenses for up to one year after the birth of the child subject to a limit of ₹
10,000/- provided the child is covered with Us. In case of girl child, applicable limit under this coverage
would be ₹ 15,000/-. For the claim to be paid under this benefit, the expenses related to maternity should
be admissible under section B21 of this policy. The limit of ₹ 10,000 (₹ 15,000 in case of girl child) is a
lifetime limit and not
● a policy limit which will be applicable for each child.
Page 7
Prolonged Hospitalization Benefit :
● We will pay a fixed amount of 1% of sum insured, in the event of insured hospitalized for a
disease/illness/injury for a continuous period exceeding 10 days. This benefit will be triggered provided that
the hospitalization claim is accepted under section B1 of this policy.
OPD Treatment - Dental :

● Once the Insured has completed two years of continuous coverage with Us, we will pay for expenses
related to the following dental treatments only subject to a maximum of limit specified in the table below,
per policy year annually:
● Root Canal Treatment (single or multiple sittings)
● Tooth extraction(s)
● Filling
Emergency Air Ambulance Cover :

● We will pay for ambulance transportation of the Insured Person in an airplane or helicopter subject to
maximum of limit specified in the table below, for emergency life threatening health conditions which
require immediate and rapid ambulance transportation to the hospital/medical centre for further medical
management.
Accidental Death Benefit :

● If an Insured Person suffers an accident during the policy period and this is the sole and direct cause of his
death within 365 days from the date of accident, then We will pay a fixed amount of 100% of the base Sum
Insured, maximum up to Rs 50 Lakhs. This benefit is not applicable for dependent children covered in the
policy.
Cumulative Bonus :
● 50% cumulative bonus will be applied on the Sum Insured for next policy year under the Policy after every
claim free Policy Year, provided that the Policy is renewed with Us and without a break. The maximum
cumulative bonus shall not exceed 100% of the Sum Insured in any Policy Year.
● If a Cumulative Bonus has been applied and a claim is made, then in the subsequent Policy Year We will
automatically decrease the Cumulative Bonus by 50% of the Sum Insured in that following Policy Year.
There will be no impact on the Inpatient Sum Insured, only the accrued Cumulative Bonus will be
decreased.
● In policies with a tenure of more than one year, the above guidelines of
● Cumulative Bonus shall be applicable post completion of each policy year
● In relation to a Family Floater, the Cumulative Bonus so applied will only be available in respect of those
Insured Persons who were Insured Persons in the claim free Policy Year and continue to be Insured Persons
in the subsequent Policy Year.
● For purpose of computation of Cumulative Bonus, the percentage (%) of Cumulative Bonus will be applied
on the base Sum Insured only. Restored sum insured will not be taken into consideration.
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Note : This quotation is for your reference, subject to change at the time of purchase.
Page 9

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MANASA

Medicare Premier - Floater Basis ( 1 Year ) Date : 15-Feb-2024

Medicare Premier - Floater Basis ( 2 Years ) Date : 15-Feb-2024

Medicare Premier - Floater Basis ( 3 Years ) Date : 15-Feb-2024

● For Adults – 18 Years to 65 Years and Dependent / Parent in Laws

● 28% for upto 3 members.

Discount ● 32% for more than 3 members.

Long Term Discount:

● 10% for 3 years.

Day Care Procedures :

In-Patient Treatment - Dental :

Daily Cash for choosing Shared Accommodation :

Daily Cash for Accompanying an Insured Child :

● Coronary bypass surgery

● Organ failure requiring transplant

● Heart Valve replacement

First year Vaccinations :

● a policy limit which will be applicable for each child.

OPD Treatment - Dental :

● Root Canal Treatment (single or multiple sittings)

Emergency Air Ambulance Cover :

Accidental Death Benefit :

● Cumulative Bonus shall be applicable post completion of each policy year

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