Tata Neu | Super Top-Up health insurance

Plan Summary

This Health Insurance policy is underwritten and serviced by TATA AIG General Insurance Company Limited.

Policy Conditions & Benefits Summary

Cover type Individual (1A), Family Floater (2A,2A+1C,2A+2C,1A+1C,1A+2C)

Family definition Self, Spouse, Up to 2 Dependent Children
Entry age - Min Adult: 18 years; Child: 91 days
Entry age - Max Adult: 65 years; Child: 24 years
Exit age Lifelong2
Pre-Policy Medical check-up (PPMC) No, Good health declaration basis
Premium paying frequency 1 year
Claims Payout Cashless (7,200+ network hospital), Reimbursement
Claim Servicing Tata AIG - In-house

Key Coverages i.e. What am I covered for:

Sum Insured options ₹ 10-20-50-100 lakhs
Annual Aggregate Deductible options ₹ 2-3-5-10 lakhs
Limit on Room Rent / Room Category No restriction/limit, Covered up to Sum Insured
Limit on ICU charges No restriction/limit, Covered up to Sum Insured
Limit on Treatment / Illness / Surgery / No restriction/limit, Covered up to Sum Insured
Medical Condition
In-patient Treatment Covered up to Sum Insured
Day Care Procedures Covered up to Sum Insured
Domiciliary Treatment Covered up to Sum Insured
Organ Donor expenses Covered up to Sum Insured
Ayush Covered up to Sum Insured
Modern treatment Covered up to Sum Insured
Ambulance Road: ₹ 3,000 per event
Family Transportation Benefit ₹ 2,000 per event
Pre-hospitalization expenses 60 days
Post-hospitalization expenses 90 days
Waiting Period
Accidental hospitalization Covered from Day 1
Hospitalization other than Accident 30 days
Pre-existing diseases 2 years
Specified diseases & procedures 2 years
(as defined in Group MediCare product)
Other key terms:

Key Exclusion i.e. • Maternity expenses i.e. medical expenses related to

delivery and childbirth
What are the major exclusions in the • Birth control procedures, contraceptive supplies or
policy services
• Sterility and infertility treatment
• Change-of-gender treatment
• Cosmetic surgery unless as part of eligible medically
necessary treatment
• Weight control surgery unless medically necessary.
• Alcoholism, drug or substance abuse treatment
• Cost of treatment as a result of intentional self-injury,
suicide or attempted suicide while sane or insane
• Dietary supplements and substances unless as part of
eligible medically necessary treatment
• Expenses related to any unproven treatment. Unproven
treatments are that lack significant medical
documentation to support their effectiveness
• Please find the full list of inclusions and exclusions in the
policy wordings of the Tata AIG - Group MediCare plan
Renewal Conditions • The Policy shall ordinarily be renewable except on
grounds of fraud, misrepresentation by the insured
person.
a. Request for renewal along with requisite premium
shall be received by the Company before the end of
the policy period.
b. At the end of the policy period, the policy shall
terminate and can be renewed within the Grace
Period of 30 days to maintain continuity of benefits
without Break in Policy.
• Coverage is not available during the grace period.
Free Look Period • The Free Look Period shall be applicable on new individual
health insurance policies and not on renewals or at the
time of porting/migrating the policy.
• The insured person shall be allowed free look period of
fifteen days from date of receipt of the policy document
to review the terms and conditions of the policy, and to
return the same if not acceptable.
• If the insured has not made any claim during the Free
Look Period, the insured shall be entitled to
a. a refund of the premium paid less any expenses
incurred by the Company on medical examination of
the insured person and the stamp duty charges or
b. where the risk has already commenced and the
option of return of the policy is exercised by the
insured person, a deduction towards the
proportionate risk premium for period of cover or
c. Where only a part of the insurance coverage has
commenced, such proportionate premium
commensurate with the insurance coverage during
such period
 Cancellation • The Policyholder may cancel this policy by giving 15 days
written notice and in such an event, the Company shall
refund premium for the unexpired policy period as
defined in the Policy
• The Company may cancel the Policy at any time on
grounds of mis- representation, non-disclosure of material
facts, fraud by the Insured Person by giving 15 days
written notice. There would be no refund of premium on
cancellation on grounds of mis-representation, non-
disclosure of material facts or fraud.
How to Claim • In case of any hospitalization or an event which might give
rise to a claim, please contact us at 1800-266-7780 &
1800-229-966 (for Senior Citizens)

Note:
1. The Information must be read in conjunction with the policy document. In case of any conflict, the terms
and conditions mentioned in the policy document shall prevail.
2. Certificate can be renewed for the lifetime subject to master policy is renewed with Tata Digital Private
Limited & insured person continues to be member of Tata Digital Private Limited

Tata AIG - Group MediCare - Policy wording: https://www.tataaig.com/s3/Group_Medi_Care_6c57b64356.pdf

Insurer Name: TATA AIG General Insurance Company Limited

IRDAI Registration Number: 108
Product Name: Group MediCare
Product UIN: TATHLGP21248V022021
Group Master Policy Holder: Tata Digital Private Limited