Tata AIG Medicare Premier In-depth Review

Tata AIG is a reputed name in the health insurance industry because of many reasons. It comes from the house of Tatas, offers comprehensive and efficient health insurance products to protect you and your family in case of any medical emergency and enjoys a good name in terms of customer service.

So is Tata AIG Medicare Premier a good health insurance plan for you?

Should you consider buying it for yourself and your family? 

Let’s find out.

A Health Cover Like No Other

Tata AIG Medicare Premier is a unique health insurance plan which covers benefits which are not usually not covered under other regular health plans. These are all inbuilt features so you don’t have to pay any extra premium for them.

Here are those benefits:

Global Cover: Yes, you enjoy global medical cover upto sum insured without any capping or geographical limit for any planned hospitalisation provided the diagnosis has happened in India. 

OPD Benefits: You have inbuilt OPD treatments and OPD dental treatments which can be availed after a waiting period of 24 months. In other health insurance plans, OPD benefits usually come at an extra cost.

Maternity Cover: Tata AIG Medicare Premier health insurance plan also provides maternity cover for any female insured person after a waiting period of 48 months.

Ambulance Cover: You also get cover for road ambulance and emergency air ambulance.

Daily Cash: You can get daily cash benefits if you choose to stay in a shared accommodation.

Main Benefits of Tata AIG Medicare Premier 

Tata AIG Medicare Premier covers all the base health insurance benefits quite well. It has no sub-limits or copays on any treatment which ensures that your hospital bill is never spilled onto you.

Inpatient Hospitalisation and Daycare Expenses: This plan covers all inpatient hospitalisation and daycare treatment expenses at actuals without any sub-limit. There is neither any sort of room rent capping and hence you can choose the best room available without any worry.

Consumable Benefits: This health plan covers the cost of all consumables directly related to your treatment in the hospital. This is a great benefit as you don’t have to pay for the cost of consumables out of your own pocket. 

Pre and Post Hospitalisation Expenses: Pre and post hospitalisation expenses are covered at actuals for 60 and 90 days respectively. 60 and 90 days are a bit less compared to other health insurance products in the market. However, the good part is that these expenses are covered at actuals without any sub-limits.

Cumulative Bonus: You get 50% cumulative bonus for every claim free year upto a maximum of 100% of sum insured. But your cumulative bonus reduces by 50% of the sum insured if you make a claim in any policy year.

Restore Benefits: One time restoration benefit is available under the policy in any policy year. If you exhaust your health cover in any policy year, you get a one time refill from the insurer. However, refill applies to the same illness for the same person only after a gap of 45 days from the previous claim.

Other Benefits: Other benefits which include AYUSH Benefit, Domiciliary Treatment and Organ Donor Expenses and Bariatric Surgery are also available at actuals. The plan also offers annual preventive health checkup upto Rs. 10000 which is good. 

Policy Conditions

You can choose from a wide range of sums insured ranging from Rs. 5 Lakh to Rs. 3 Crore under TATA AIG Premier. 

Maximum age at entry in the plan is only 65 years. However, lifelong renewals are available. The cover is also available on family floater basis where upto 7 members including upto 3 dependent children can be included.

You can choose your policy tenure as 1, 2 or 3 years depending on your convenience. 

Tata AIG Medicare Premier comes with zone wise premiums. However, you can take the treatment anywhere in India without having to make any copayment. 

The plan imposes a waiting period of 24 months on pre-existing conditions which is normal. But you do not have any option to reduce this waiting period if you wish to.

Drawbacks of Tata AIG Medicare Premier

TATA AIG Medicare Premier plan offers small no claim bonus benefit which reduces when you make a claim in any policy year. Restoration benefit is available only one time in a policy year. Multiple restorations are not available even at an extra cost. There is also no way to reduce waiting periods on pre-existing illnesses to get instant cover. This health insurance plan is expensive compared to health plans offered by stand alone health insurance companies. 

About Tata AIG General Insurance

Tata AIG General Insurance is a very reputed brand name in the general insurance space in India. The company is a joint venture between Tata Group and American International Group (AIG) and started its operations in 2001. 

Tata AIG brings with it the promise of TATA to protect you and your family in case of adversities. The company boasts of having a great team to service the customers and settle their claims. Tata AIG’s claim settlement ratio by number of policies for the FY 2023-24 is 96.67% while its last 3 years’ average claim settlement ratio is 98%. Its last 3 years’ average claim settlement ratio by amount of claim settled is 96.5%. These numbers reflect how efficient and customer focussed its claim settlement process is.

If we look at the incurred claim ratio of TATA AIG – the last 3 years’ average stands at 73.33% which is great. However, its last 3 years average combined ratio stands at 109% which could have been better.

In terms of number of claim complaints, TATA AIG does fairly well. Its last year’s volume of claim complaints is 12.11. This means that the company receives 12.11 complaints per 10000 claims registered which is ok. Its last 3 years’ average volume of claim complaints is 10.8.

Is Tata AIG Medicare Premier good for you?

Tata AIG Medicare Premier comes from the house of Tata. Hence you get a sense of trust and security of the Tata promise. Tata AIG also tries to keep this promise by performing well in terms of claim settlement. The plan covers all base benefits at actuals. So you don’t have to pay anything out of your pocket when a claim arises. There are also other amazing benefits like global cover, OPD cover, dental cover and maternity benefit which are inbuilt in the plan. 

The underwriting is strict and age at entry is capped at 65. So anyone with a major health issue or pre-existing condition is not likely to get the cover. Premiums for TATA AIG Premier plan are on the higher side compared to health insurance plans offered by stand alone health insurance companies. 

So if you are young and healthy, want a robust health insurance policy with some amazing features and premium pricing is not a problem for you, Tata AIG Medicare Premier is a great health insurance plan for you.