A PROJECT REPORT ON HEALTH INSURANCE AT TATA AIG

CHAPTER -1

INTRODUCTION

1.1 Introduction

Health insurance is one of the ways that people in various countries finance their medical needs. It is
estimated that out-of-pocket expenditure of over 15–20 % of total health expenditure or 40 % of
household net income of subsistence needs can lead to financial catastrophe. When people on low
incomes with no financial risk protection fall ill, they face a dilemma: they can use health services and
suffer further impoverishment in paying for them, or they can forego services, remain ill, and risk
being unable to work or function. Variation in financing and organization structures in various
countries notwithstanding, there is now nearly a unanimous commitment to assuring universal access
to medically necessary care in high-income countries. Internationally, health insurance serves to
improve service utilization and protect households against impoverishment from out-of-pocket
expenditures.

Analysis of how health insurance schemes function in a particular country, especially in relation to
other funding aspects and health outcomes, can provide a glimpse of the performance of the whole
healthcare system. Health insurance (sometimes called health coverage) pays for some or all of the
cost of the health services you receive, like doctors' visits, hospital stays, and visits to the emergency
room. ... You will generally pay a premium, a monthly fixed payment to the insurance company. You
may have to pay a deductible. Its mentioned how the pooling of resources helpful during calamities
like floods, fire, and epidemics. The health insurance concept was first suggested in the year 1694 by
Hugh the Elder Chamberlen from Peter Chamberlen family. As a result, "Accident Assurance" began
to be available in the 19th Century. Congress has seen a renewed interest in the market for private
health insurance since the passage of the Patient Protection and Affordable Care Act (ACA; P.L. 111-
148, as amended). This report provides an overview of private-sector (as opposed to government-
provided) health insurance.

It serves as an introduction to health insurance from the point of view of many consumers under the
age of 65. No background in health insurance is assumed, and all terms are defined in the body of the
report. A consumer may find the purchase of health care inherently different from some other
purchases. Health care can be expensive, and many relevant details concerning future health care may
not be known when the consumer is choosing an insurance plan, including when over the course of a
year (if at all) health care will be purchased, which services will be needed, and the costs of those
services. These characteristics of purchasing health care decrease the consumer’s ability to plan
financially and increase the consumer’s exposure financial risk also unpredictability inherent in
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paying for health services. An employed consumer may obtain health insurance from his or her
employer if health insurance is offered by the employer (known as employer-sponsored insurance, or
ESI) as a fringe benefit. All consumers may purchase health insurance directly (perhaps through an
insurance agent or broker) from private insurance firms. In addition, all consumers may obtain health
insurance through insurance exchanges, or marketplaces. Exchanges facilitate transactions between
buyers and sellers of insurance but are not insurers.

Health insurance plans can differ across many dimensions, including coverage, costs, flexibility in
choosing providers, special features, and generosity. Two specific health insurance plan types that
may be of interest to Congress are consumer-directed health care (CDHC) and value-based insurance
design (VBID). Both these plan types have the potential to lower aggregate health care (however
measured) by providing incentives for consumers to seek less care, or less expensive care. Which
health insurance plan a consumer chooses depends on a number of factors, including the expected
health of those covered by the plan, the price of the plan and of the medical services it provides, the
consumer’s income, and the prices of the other goods and services the consumer wishes to purchase.
In addition, because some health insurance plans are tied to employment, the consumer’s status as an
employee also influences (and is influenced by) his or her choice of health insurance. This section of
the report covers the differences between a consumer’s purchase of health care and his or her
purchase of other goods and services. For example, budgeting for health care expenses may be more
difficult than budgeting for other services. The purchase of health insurance reduces the risks and
unpredictability inherent in a consumer’s health care expenses. The consumer pays for a health
insurance policy and then is subsequently (partly) reimbursed for his or her future expenditures on
health care.

The purchase of health insurance reduces the risks and unpredictability inherent in a consumer’s cost
of health care. Typically, a consumer selects a particular health insurance plan just before the start of
the health insurance plan year and then pays a monthly premium to the health insurer.5 In return, if
the consumer receives health care over the course of the year, the health insurer may pay some (or all)
of the costs, depending on the details of the plan. For example, if the consumer does use health care,
he or she often has to pay something out of his or her own pocket. The level of outof-pocket (OOP)
expenses varies across health insurance plans. Although health insurance may never make health care
free of charge for the consumer, it often results in lower OOP expenses, especially when evaluated
over the entire term of the plan. Not all holders of health insurance end up using health care over the
year. However, when considered over a multiyear period, health insurance may help a consumer
manage the risk associated with a large potential financial loss from health care costs. Insurers are
also sometimes referred to as insurance firms and insurance carriers

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A premium is the price of a health insurance plan. The term (length) of many health insurance policies
is one year. Insurers also manage risk when providing health coverage to consumers to assure that
their businesses are profitable. One type of risk management involves having a mix of consumers with
different health statuses enrolled in each insurance product.

The healthier consumers will be lower-cost enrollees, and the less-healthy consumers will be
highercost enrollees. Were it permitted by federal and state law, an insurer would prefer to cover only
the healthy. Health insurance helps lessen the costs of medical expenses in the event of an illness or
accident and for preventive medicine such as routine medical tests, checkups and screening tests. In
our introductory module, we will learn about the basics of health insurance including the formation of
an insurance policy, the validity of coverage, the duration of health insurance coverage, modification,
renewal and policy cancellation. Health insurance policies are full of terms such as deductibles, co-
payments, and co-insurance.

Let’s look at what these terms mean. Other than for preventative services, a policyholder must first
pay a deductible before the insurance plan pays any benefits. After she pays the deductible, she’ll pay
a copayment or coinsurance for covered services.The insurer pays the rest. Generally, plans with
lower monthly premiums have higher deductibles.A plan with a higher monthly premium may have a
lower deductible or even no deductible .A copyment, or co-pay, is an out-of-pocket fixed amount paid
for a covered health care service after paying the deductible. For example, a plan may have an
allowable cost for a doctor’s office visit of $100. The co-payment for a doctor visit may be $20. For
each visit, the insured pays $20 and the insurance company will pay the rest.Co-insurance, featured by
some health insurance plans, is the percentage of costs of a covered health care service that is paid by
the insured after the deductible. Let’s take, for example, a person who had a surgery that costs
$10,000 allowable under the plan, with a $1,000 deductible and 20 percent co-insurance. The
policyholder would first pay a $1,000 deductible. She would have to pay coinsurance of 20 percent of
the remaining balance after the deductible, or $1,800. She would have total out-of-pocket costs of
$2,800 for the $10,000 surgery, including a $1,000 deductible and $1,800 co-insurance. Many plans
also have limits on co-insurance after reaching a certain level. As with the deductible, a plan with low
monthly premiums generally has higher co-insurance. Health insurance or medical insurance (also
known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk
of a person incurring medical expenses. As with other types of insurance is risk among many
individuals. By estimating the overall risk of health risk and health system expenses over the risk
pool, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to
provide the money to pay for the health care benefits specified in the insurance agreement.

1.2 SELECTION AND RELEVANCE OF THE PROBLEM

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[1] The benefit is administered by a central organization, such as a government agency, private
business, or not-for-profit entity. According to the Health Insurance Association of America, health
insurance is defined as "coverage that provides for the payments of benefits as a result of sickness or
injury. It includes insurance for losses from accident, medical expense, disability, or accidental death
and dismemberment". A contract between an insurance provider

(e.g. an insurance company or a government) and an individual or his/her sponsor (that is an employer
or a community organization). The contract can be renewable ( annually, monthly) or lifelong in the
case of private insurance.

[2] It can also be mandatory for all citizens in the case of national plans. The type and amount of
health care costs that will be covered by the health insurance provider are specified in writing, in a
member contract or "Evidence of Coverage" booklet for private insurance, or in a national [health
policy] for public insurance. In the U.S., there are two types of health insurance - tax payer-funded
and private-fund ed.

[3] An example of a private-funded insurance plan is an employer-sponsored self-funded ERISA plan.

The company generally advertises that they have one of the big insurance companies. However, in an
ERISA case, that insurance company "doesn't engage in the act of insurance", they just administer it.
Therefore, ERISA plans are not subject to state laws. ERISA plans are governed by federal law under
the jurisdiction of the US Department of Labor (USDOL). The specific benefits or coverage details
are found in the Summary Plan Description (SPD). An appeal must go through the insurance
company, then to the Employer's Plan Fiduciary. If still required, the Fiduciary's decision can be
brought to the USDOL to review for ERISA compliance, and then file a lawsuit in federal court.

How many accident you need to realise that you need Health Cover?

It takes just one visit to a hospital to make us realize how vulnerable we are, every passing second.
For the rich as well as poor, male as well as female and young as well as old, being diagnosed with an
illness and having the need to be hospitalized can be a tough ordeal. Heart problems, diabetes, stroke,
renal failure, cancer – the list of lifestyle diseases just seem to get longer and more common these
days. Thankfully there are more speciality hospitals and specialist doctors – but all that comes at a
cost. The super rich can afford such costs, but what about an average middle-class person.

For an illness that requires hospitalization/ surgery, costs can easily run into five-digit bills. A Health
insurance policy can cover such expenses to a large extent. Read why Health Insurance is more
important these days compared to old days Health is a human right, which has also been accepted in
the constitution. Its accessibility and affordability has to be insured. While the wellto-do segment of
the population both in rural & urban areas have acceptability and affordability towards medical care,
at the same time cannot be said about the people who belong to poor segment of the society. It is well

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known that more than 75% of the population utilizes private sectors for medical care unfortunately
medical care becoming costlier day by day and it has become almost out of reach of the poor people.
Today there is need for injection of substantial resources in the health sectors to ensure affordability
of medical care to all. Health insurance is an important option, which needs to be considered by the
policy makers and planners. As mentioned earlier, the cost of Health Insurance depends on the sum
assured , age, current health condition and your previous medical history. Higher the sum assured,
higher the premium. So what is the ideal health insurance cover requirement? There is no standard
answer or thumb rule for this. If we agree that health insurance is important, one has to look at his/ her
own lifestyle, health condition, age/ life stage, family history of illnesses and affordability. Keep in
mind that most insurance companies limit the sum assured to a maximum of 5 lakhs. Also note that
many health insurance policies provide additional benefits‖ such as daily allowance, ambulance
charges, etc. for hospitalization. Not only are such benefits‖ superfluous, they tend to drive the
premiums higher. So it is best to avoid such plans and stick to something basic and simple. Health
insurance is a form of group insurance, where individuals pay premiums or taxes in order to help
protect themselves from high or unexpected healthcare expenses. Health insurance works by
estimating the overall "risk" of healthcare expenses and developing a routine finance structure (such
as a monthly premium, or annual tax) that will ensure that money is available to pay for the healthcare
benefits specified in the insurance agreement. The healthcare benefit is administered by a central
organization, which is most often either a government agency, or a private or notfor-profit entity
operating a health plan.

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1.3 HISTORICAL BACKGROUND OF THE PROBLEM

The concept of health insurance was proposed in 1694 by Hugh the Elder Chamberlen from the Peter
Chamberlin family. In the late 19th century, "accident insurance" began to be available, which
operated much like modern disability insurance. This payment model continued until the start of the
20th century in some jurisdictions (like California), where all laws regulating health insurance
actually referred to disability insurance. Patients were expected to pay all other health care costs out
of their own pockets, under what is known as the fee-for-service business model. During the middle to
late 20th century, traditional disability insurance evolved into modern health insurance programs.
Today, most comprehensive private health insurance programs cover the cost of routine, preventive,
and emergency health care procedures, and also most prescription drugs, but this was not always the
case. Insurance may be described as a social device to reduce or eliminate risk of life and property.

Under the plan of insurance, a large number of people associate themselves by sharing risk, attached
to individual insurance plan that exclusively covers healthcare costs and is called Health Insurance.
Since the past two decades, there has been a phenomenal surge in acceleration of healthcare costs.
This has compelled individuals to have a re-look on their actual monthly expenditures, spending
patterns and simultaneously allocate a proportion of their income towards personal healthcare. This
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has resulted in individuals availing healthcare insurance coverage not only for themselves but also for
their family members including their dependants. In short, healthcare insurance provides a cushion
against medical emergencies.

The concept of insurance is closely concerned with security. Insurance acts as a shield against risks
and unforeseen circumstances. In general, by and large, Some major health insurance companies in
India include National Insurance Company, New India Assurance, United India Insurance, ICICI
Lombard, Tata AIG, Royal Sundaram, Star Allied Health Insurance, HDFC standard life, Bajaj
Allianz Apollo, AG Health Insurance Company among others.

India‘s fast growing demand for affordable health cover is attracting greater business attention, with
both life and non-life insurance companies now entering the market with innovative new protection
and savings medical insurance products. This intense competition for health insurance customers has
only intensified in recent months, with the introduction of new savings linked and investment-oriented
health insurance schemes by some of the country ‘s largest insurance groups.

India‘s insurance sector first opened up to private and international investors in 2001. Over the past
ten years coverage rates across the populous South Asian country have doubled and the domestic
insurance industry has overtaken several more developed financial markets in the process. The overall
number of insurance policies sold has increased several times over, and combined premium income is
now projected to reach between US$350 to US$400 billion by 2020. Health insurance, in particular,
has become as one of the country ‘s fastest growing insurance lines, accounting for almost a third of
new written premiums last year. Sales of medical insurance products have been driven by three key
factors: a low penetration rate of about 5 percent at present, surging treatment costs, and a lack of
other social safety options across most of India.

With total expenditure on healthcare, through both Indian government schemes and private sector
activity, expected to exceed US$200 billion by 2015, even more significant opportunities for the
country‘s health insurance sector will likely emerge. Over the next three years, health insurance has
the potential to become an INR300 billion market (US$6 billion), according to industry observers.
The introduction and increased proliferation of private sector players in India‘s health insurance sector
has worked to both develop innovative new coverage products and increase service standards for
clients in the domestic market Of particular note has been how the entrance of several major life
insurance brands, including Life Insurance Corporation of India, Aviva Life Insurance and Max Life
Insurance, has affected the market recently. These life insurers offer largely savings-based health
plans that provide lump sum compensation to clients in case of a critical illness or other malady
specifically defined by a specific policy. These longterm products have tenures that can last up to 20
years. When the policy expires, customers are entitled to receive the fund value. Normally this is not a
cashless process as payment is reimbursed on submission of medical bills. Most of these health
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insurance plans sold by life insurance companies are unit-linked insurance products (Ulips), whereby
returns are determined by the performance of the stock market.

While life insurer health plans are tied to equity returns, medical insurance policies sold through non-
life companies tend to provide cashless hospitalization cover for policyholders in the event of an
illness or accident. These plans, with premiums reviewed and renewed annually, also offer customers
a variety of additional valueadded benefits such as hospital cash allowance, home nursing allowance
and recovery grants. Some insurance companies offer these outpatient services as add-on covers with
their hospitalization plans, while others provide discounts through certain affiliated hospital networks.
These products have so far proven to be the most popular in India.

Health insurance policies sold through non-life and dedicated medical insurers currently dominate the
market, accounting for roughly INR100-120 billion (US$1.9-2.3billion) of the country‘s INR150
billion (US$3 billion) health insurance sector. It is expected that increased intra-market competition
going forward will enable successful insurers to meet the country‘s changing healthcare needs.
Despite the positive growth indicators, India‘s health insurance market still has many problems to
contend with in order to match its true potential going forward. The most important challenge for
insurers remains the low level of awareness concerning the value of obtaining adequate coverage as a
valuable savings and investment tool across much of the country.

This problem is slowly being addressed as more insurers develop their product and distribution
platforms to reach previously untapped regions and client bases with more innovative and affordable
coverage products, including micro insurance and local bank.

Indian consumers already aware and enrolled in health insurance schemes, the industry faces the
continuing challenge of keeping them happy. Customer satisfaction levels for health insurance in
India have consistently ranked below comparable levels elsewhere, with critics frequently citing the
low coverage of plans in terms of both the diseases and number of hospitals covered. Unlike other
homogenous general insurance products, premiums for medical plans are based on the health of an
individual policyholder and this hadlead to confusion and fraud in the Indian market and increased
policy cancellations from customers who do not find any value in their health insurance policies. The
Insurance Regulatory Authority of India (IRDA) has come to the forefront in tackling these service
standard issues recently. Speaking at the first meeting of the India Health Insurance Forum in
Hyderabad last Thursday, IRDA chairman J Harinarayan said the industry must now work to improve
communication with its customers, particularly with regard to health insurance policy documentation,
as a third of all consumer complaints this year have been directed towards health insurers. According
to IRDA data, of the 92,898 complaints levied at the non-life sector so far in 2012, 38,891, or 37.5
percent have been focused on health insurance issues.

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If one-third of complaints are from the health side, I will conclude that the nature of communication
on health insurance policies and the understanding of the policy by the consumer are areas of concern.
Probably, the lack of clarity is reflected in the increasing number of complaints, IRDA chairman J
Harinarayan said, adding that ―good communication is the responsibility of the insurance company
and not of the policy holder. An insurance policy, as a contingent contract, has to be specific and
unambiguous.

With a reach of just about 2% of the country‘s 1.2 billion population, India offers a huge potential in
health insurance market. There are over 30 health insurance products in the category offered by both
life and non-life insurers. While ICICI Lombard, Bajaj Allianz and Reliance General are some of the
prominent general insurers in the health insurance space, Apollo DKV, Star Health & Allied
Insurance are the standalone players.

Health insurance‘s annual premium collections are over Rs 6,000 crores. Despite the high growth, the
business is a huge challenge for insurers because of the high losses over soaring medical expenses A
survey showed massive dissatisfaction with the healthcare system in India. The interesting find about
health insurance in India was how people perceived health insurance in India. It is seen as an
instrument to protect savings. It is not aimed at protecting the asset that is health. This is probably
common to developing markets, where people tend to place wealth ahead of health. On a macro level,
very few households in India have contingency plans to meet their health expenses. Health risks in
India are perceived differently than the western population. Prior planning in health issues is yet to be
a major priority The industry is also becoming techsavvy with facilities to buy certain types of
insurance products online and payment of premium through Internet.

The insurance penetration level in India is very low when compared with the global average. This has
brought about a plethora of distribution channels such as agents, brokers, bancassurance (bank
insurance model) avenues, soliciting insurance through Internet or direct mailing. Many banks,
financial institutions and insurance intermediaries saw a huge opportunity in marketing insurance
products. Insurance brokers play a vital role in bringing together insurance companies and the insured,
and their role assumes importance when a claim arises. Research includes awareness of health
insurance , preference of health insurance consumption pattern ,new services offered by insurance
sectors, claim settlement procedure, and major issues of health insurance.

Health insurance policy does not always cover every possible health problem someone might
encounter in the future. There are certain terms and conditions agreed to by the insured (person who is
taking the plan), and the insurer (entity that is providing the plan) and the entire procedure happens
according to what has been agreed to in the contract . The best time to avail a health insurance plan is
when the insured is still in a good physical condition. The normal logic among young people is that
since they are rarely afflicted by physical ailments they do not need such a plan. In reality people can
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fall prey to a disease or other physical problem at any time - nobody can be absolutely sure of a life
fully free of such issues. Normally as someone gets older the problems increase and the possibilities
of some majordisease are always there. A problem with trying to get a medical insurance during old
age is that since there are more chances of a medical condition the premium is often high or the
insurer is not ready to cover the individual in question. Congress has seen a renewed interest in
questions related to the market for private health insurance since the passage of the Patient Protection
and Affordable Care Act (ACA; P.L. 111- 148, as amended). Recent health insurance marketplace
changes include a different way to purchase health insurance (exchanges) and a new system of
categorizing the generosity of plans’ health coverage based on the names of various metals (e.g.,
bronze and silver)

1. Some consumers may face different choices of health insurance plans than in the past. Not all
consumers are comfortable with the various concepts governing which health insurance plan
might be best for them. This report provides an overview of private-sector (as opposed to
government-provided) health insurance.It serves as an introduction to health insurance from
the point of view of consumers under the age of 65 who purchase a health insurance plan.
2. No background in health insurance is assumed, and all terms are defined. The report
therefore can be viewed as an introduction to the more comprehensive discussion of health
insurance found in the Congressional Research Service (CRS) health insurance primer. Health
insurance plans can differ in terms of their coverage of consumers and services, their costs to
the consumers (and consumers’ dependents or employers, if relevant), special features, and
generosity, among other properties.
3. The percentage of India's national budget allocated to the health sector remains one of the
lowest in the world, and healthcare expenditures are largely outof-pocket (OOP). Currently,
efforts are being made to expand health insurance coverage as one means of addressing health
disparity and reducing catastrophic health costs. In this review, we document reasons for
rising interest in health insurance and summarize the country's history of insurance projects to
date. We note that most of these projects focus on in-patient hospital costs, not the larger
burden of out-patient costs. We briefly highlight some of the more popular forms that
government, private, and community-based insurance schemes have taken and the results of
quantitative research conducted to assess their reach and cost-effectiveness. We argue that
ethnographic case studies could add much to existing health service and policy research, and
provide a better understanding of the life cycle and impact of insurance programs on both
insurance holders and healthcare providers. Drawing on preliminary fieldwork in South India
and recognizing the need for a broad-based implementation science perspective (studying up,
down and sideways), we identify six key topics demanding more in-depth research, among
others:

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(1) public awareness and understanding of insurance;

(2) misunderstanding of insurance and how this influences health care utilization;

(3) differences in behavior patterns in cash and cashless insurance systems;

(4) impact of insurance on quality of care and doctor-patient relations;

(5) (mis)trust in health insurance schemes; and

(6) health insurance coverage of chronic illnesses, rehabilitation and OOP expenses.

In recent years, health planners in India have advocated for the expansion of health insurance as
an essential component of the country's healthcare reform and poverty reduction agenda (Planning
Commission and United Nations 2011; Reddy 2012; Forgia and Nagpal 2012).

One of the most ambitious plans in Indian healthcare reform has been a call for ‘universal
healthcare for all by 2020’ (Reddy et al. 2011b), now extended to year 2022 (Devadasan et al.
2014). Reaching this goal would include implementing universal health insurance, which been
seen as a potential way of reducing health disparities and OOP health expenditure (Bennett,
Ozawa, and Rao 2010; Reddy et al. 2011b; Reddy 2012). Currently, numerous public, private, and
community-based insurance schemes have come to coexist and even merge with each other, a
situation that is hardly surprising in a country as diverse as India.

The newest draft of National Health Policy (NHP) was revealed inDecember 2014, promising
‘universal ability of free, comprehensive primary healthcare services as an entitlement’ (Sharma
2015, 317). However, some have already pointed out that NHP overemphasizes the role of the
private sector in healthcare delivery and financing, and view the proposed plan as a step away
from universal health coverage (Sharma 2015).What forces have brought health insurance to the
attention of Indian policy-makers? In sum, they include

(1) high burden of ill health;

(2) low public spending on healthcare,

(3) high private (especially OOP) healthcare expenditure;

(4) limited coverage by the existing health insurance schemes.

India is currently going through a stage of health transition characterized by high burdens of ill
health caused by nutritional deficiencies, infectious disease, and non-communicable disease
(NCD), which are a long-term sequela of poverty, as well as an outcome of defective
modernization associated with such trends as high tobacco use, overconsumption of high caloric

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fat-rich diets, and low levels of exercise among the more affluent. The latter factors contribute to
rising rates of cardiovascular disease, diabetes, and cancer (Reddy et al. 2005).

1 The lion's share of health problems, however, lies with the impoverished 75% of India's
population who live on less than $2 a day (Subramanian et al. 2013).Within this population, rates
of mortality and morbidity are uneven and subject to factors including gender, caste,
socioeconomic status, and education, all of which have a significant impact on health risks and
access to healthcare (Duggal 2007; Subramanian et al. 2008).Despite a significant demand for
community-based health services, national public spending on healthcare in India remains quite
low

2 This has led to substantial private spending on health, especially in terms of OOP expenditure
on medicines (Dror, van Putten-Rademaker, and Koren 2008; Shahrawat and Rao 2012; Karan,
Selvaraj, and Mahal 2014). There are significant differences between India's states in the amount,
distribution, use, and effect of public spending in healthcare, but even in states that spend more on
healthcare OOP expenses remain high.

3 On the providers’ side, low public healthcare spending has had a negative impact on the quality
of care delivered at primary health centers and district level hospitals (Rao and Choudhury 2012).
On the other hand, the private sector has been thriving, providing 80% of outpatient and 60% of
inpatient care (Sharma 2015). Even the poorest and least educated people in both rural and urban
settings consult private practitioners more than government practitioners and spend about twice as
much on treatment from them than from government practitioners (Bhatia and Cleland 2001;
Devadasan et al. 2006; Purohit and Siddiqui 1994; Madhukumar, Sudeepa, and Gaikwad
2012).Health-related debt has pushed many low and middle-income households into poverty. It
has been estimated that OOP expenses are directly responsible for the deepening of poverty in
both rural and urban areas, pushing between 32 million and 39 million Indians into poverty every
year (van Doorslaer et al. 2007; Shahrawat and Rao 2012; Balarajan, Selvaraj, and Subramanian
2011; Berman, Ahuja, and Bhandari 2010). Households with elderly and chronically ill members
are especially susceptible to impoverishment due to health expenditure (Mohanty et al. 2014).In
Kerala, for example, the loss of household income per illness episode has been estimated to be
over four times greater for the poor elderly in comparison with the rich elderly households
(Mukherjee and Levesque 2012). Hospitalization is often presumed to be the most important
cause of health related impoverishment in India, but research has revealed that drug expenditure is
actually the largest component of OOP payments, accounting for 61% to 88% of the total OOP
spending (Garg and Karan 2009; Peters et al. 2002; Roy and Hill Howard 2007; Shahrawat and
Rao 2012). Contributing to this expenditure is liberal prescription of drugs by practitioners
(Nichter 1996; Porter and Grills 2015) and widespread over-the-counter medication use by both

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the poor and middle class (Basak and Sathyanarayana 2010; Ghosh 2011; Kamat and Nichter
1998).

4 It hasbeen argued that universal health coverage (UHC) implementers should focus explicitly on
medicines as one of the most important drivers of quality, safety, equity and cost of care (Wagner,
Quick and Ross-Degnan 2014; Bigdeli et al. 2015).In the field of public health and health policy
making it has been suggested that health insurance could provide an important safety net for low
to middle income citizens by reducing emergency healthcare expenses for all social classes
(Reshmi et al. 2007; Kasirajan 2012).

Yet up until fairly recently only a small percentage of India's population has been insured. The
Employees’ State Insurance Scheme (ESIS, introduced in 1948) and the Central Government
Health Scheme (CGHS, introduced in 1954) cover only about 10% of India's population working
as public employees (Shiva Kumar et al. 2011; Selvaraj and Karan 2012). During the last several
years, private insurance companies have started offering health insurance next to life and property
insurance, and a number of community-based schemes have been implemented, although the
actual impact of many of them is not yet known.At national and state levels, there is much debate
about how best to proceed as a means of providing some level of coverage to as many people in
India as possible. While some policy makers have called for insurance coverage in cases of
catastrophic medical events, others have called for broader policies to reduce OOP expenditure as
a means of preventing those living on the margin from falling into poverty (Garg and Karan 2009;
Sodhi and Rabbani 2014).

Still others have argued for the funding of more preventive and promotive health programs to
decrease the country's NCD burden (Patel et al. 2011).This paper examines challenges to
implementing health insurance in India and makes a case for anthropological studies of the social
life of insurance schemes (Dao and Nichter 2015) as a means of providing fresh insights to the
emerging interdisciplinary field of health policy and service research (Gilson et al. 2011; Mills
2012; Hafner and Shiffman 2013). Medical anthropologists and anthropologists of global health
and development have long been investigating the expansion of biomedical technologies,
including issues of access and affordability (Lock and Nguyen 2010), and of health-related
intervention programs (e.g. Pigg 2013). Health insurance as one such technology and also an
intervention is yet to be addressed properly through ethnography everywhere. In the United States
of America (USA), anthropologists have only recently been called upon to pay attention to this
topic, as health reform has become a pressing political issue (Horton et al. 2014).

1.4 DEFINATION OF RELATED ASPECTS

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Changing Lifestyle: With the ever-increasing pressures of modern-day lifestyle, the range of health-
related risks we are exposed to has significantly widened in scope. From lifestyle disorders such as
obesity and eating disorders to pollution-induced conditions such as asthma, there is no dearth of
ailments that can lead to high medical expenses.

In addition to physical illnesses, the constant stress of today's competitive world has led to a
substantial rise in mental health issues, which is why it is critical to buy an adequate health insurance
plan for yourself and your family.

Rising Medical Costs: In recent years, the medical inflation in India has not only kept pace with its
retail counterpart but exceeded it by leaps and bounds. The cost of medicines, medical examinations,
hospitalisation, and surgeries are consistently on the rise. It makes more sense to pay the basic health
insurance premium and get insured than shelling out those exorbitant health expenses from your own
pocket. Therefore, it is critical to get yourself insured with a health insurance plan to help you stay
financially secure during and in the wake of a medical emergency.

COVID-19 Cover: The state of the world over the better part of the past two years is nothing short of
unprecedented. With the multifaceted impact of the ongoing global COVID-19 pandemic, it is more
crucial than perhaps ever before to buy a suitable health insurance plan. The Tata AIG health
insurance benefits include a cover for Coronavirus.

Tax Benefits: Not only does health insurance safeguard you from the financial ramifications of a
medical crisis but it also provides you significant tax benefits. Whilst the premiums paid for health
insurance plans for senior citizens are eligible for tax deduction to the extent of ₹50,000, those for
individuals below the age of 60 years have a tax deduction ceiling of ₹25,000 under Section 80D of
the Income Tax Act, 1961.

Includes a Cover for Pre-existing Diseases: Most health insurance plans comprise a cover for
preexisting illnesses; however, this cover usually gets activated after the expiration of a waiting
period. Therefore, if you want immediate cover for a pre-existing illness, you must select a health
insurance plan with a short waiting period.

The Tata AIG health insurance benefits include a cover for pre-existing illnesses after the expiration
of three years of the plan's tenure.

Provides Cashless Treatment: With the facility of cashless medical insurance, the process of handling
a medical emergency has become somewhat easier. With our network of 7,200+ hospitals across the
nation, you can access cashless treatment without having to file a health insurance claim and wait for
the reimbursement of your bills.

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Covers Ambulance Expenses: With regard to ambulance expenses, the Tata AIG health insurance
plans have got you covered. Therefore, you need not worry at all should you need emergency transit
to a hospital. We are available to provide the required assistance to you 24x7x365. You can reach out
to us on 1800-266-7780. We are also a WhatsApp text away at +91-9136160375.

Covers Pre-hospitalisation and Post-hospitalisation Expenses: A health insurance plan covers the
medical expenses incurred due by you in the wake of pre-hospitalisation and post-hospitalisation.
Once you are insured under the Tata AIG MediCare and MediCare Protect Health Insurance Plans,
your predetermined sum insured covers the medical bills generated 30 to 60 days before your
hospitalisation and 60 to 90 days following your discharge from the hospital.

The exact coverage shall vary depending on your choice of health insurance plan variant and the
premium paid.

Provides the Option of Additional Sum Insured: One of the most important health insurance benefits
of a Tata AIG health insurance plan is that you can earn a cumulative 'No-claim Bonus' for every
claim-free year, which entails an enhancement in the sum insured under your health insurance plan
without any corresponding rise in your health insurance premium. Under our MediCare health
insurance plans and variants, you can get a 10 to 100 per cent additional sum insured for each policy
year without a health insurance claim as a 'No-claim Bonus'. At Tata AIG, we have a wide variety of
health insurance plans to cater to your varied health insurance requirements also people can buy
health insurance online through which there are many benefits of buying online health insurance. The
earlier in life you take valuable and far-sighted decisions, the better placed you are to handle any
contingencies, and buying health insurance is no exception to this principle. There are several
advantages of buying a health insurance plan at a young age, some of which have been discussed
below.

1.5 CHARACTERISTICS

Fewer Health Concerns: It is a truth universally acknowledged that one's age and health are inversely
proportional to each other. Therefore, the younger you are, the lower is your likelihood of the
occurrence of any major illness. You can invest in a health insurance plan in your youth and reap the
benefits should you ever need to.

Higher Coverage At A Lower Premium: At a relatively young age, you are less vulnerable to any
adverse health-related risks and ailments, thereby making you a low-risk customer for us. Therefore,
you can easily get a high sum insured for your health insurance plan at a relatively low premium.

You Can Easily Ride Out The Waiting Period: Another advantage of buying health insurance when
you are young, say, in your twenties, is that you can easily traverse through life without having to fall

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on the wrong side of the various waiting periods of your health insurance plan. Now a days there is
AYUSH Today, people may opt for different kinds of medical treatments based on their preferences.
All Ayurveda, Yoga and naturopathy, Unani, Siddha and Homoeopathy treatments are covered under
the banner of AYUSH.

Bariatric Surgery Bariatric surgery is more commonly known as weight-loss surgery. If you are
required to undergo bariatric surgery to treat obesity or control your weight, it is covered under our
Medicare health insurance policy. Base or Indemnity Plan An indemnity plan refers to a medical
insurance policy against which the insurance-provider makes payments based on actuals. For
example, let’s say you’ve purchased a plan with a sum insured of INR 5 lakhs. You have to undergo
covered treatment and a hospital stay which costs you INR 2 lakhs. If you have an indemnity plan,
your insurance provider will reimburse you or settle the amount of 2 lakhs directly with the hospital.
Co-Pay If you’d like to lower your health insurance premium, you can opt for co-payment.

You can promise to pay a certain percentage of each claim you make against your medical insurance
policy, and your insurance provider will take care of the rest. If you’d like your insurance provider to
settle the full claim, you can opt-out of co-payment. Cumulative or No-Claim Bonus This is a little
reward that your insurance provider offers you for not making a single claim in a policy year. For
every year that you do not make a claim, your sum insured will be increased by a certain percentage.
For every consecutive claim-free year, the percentage will increase. Daycare Procedures A daycare
procedure is any treatment that requires you to be hospitalised for less than 24 hours.

For example, a single round of chemotherapy radiation or dialysis falls under daycare procedures.
Most health insurance policies offer cover for a wide variety of daycare treatments. Deductible This is
a fixed amount that the insured individual has to pay towards their medical treatments before they can
file a claim with their insurance provider. The deductible is a fixed amount and not a percentage of the
total claim amount. Let’s assume that your deductible is INR 5,000. In a policy year, you undergo
treatment worth INR 50,000. You have to pay INR 5,000 before you can make a claim for the balance
amount of INR 45,000. Dependent In certain situations, your health insurance policy will extend your
cover to certain family members, like your spouse, children or parents. These individuals who are
eligible to enjoy cover under your policy are known as dependents.

Domiciliary Treatment We understand that not everybody can make it to hospital for treatment. Any
medical treatment that you or an insured individual receives at home, under the supervision of a
trained medical professional, is known as domiciliary treatment & is available under the domiciliary
hospitalization. Free Look Period Once you purchase a health insurance plan, you don’t have to be
committed to it. You have the opportunity to cancel or change your insurance provider within a given
period. If you opt to cancel your health insurance policy within this specified time, you will not be
required to pay any penalty.
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This time is known as the free look period. Typically, it lasts for 15 days from the date the policy is
issued. Bariatric Surgery Bariatric surgery is more commonly known as weight-loss surgery. If you
are required to undergo bariatric surgery to treat obesity or control your weight, it is covered under
our Medicare health insurance policy. Base or Indemnity Plan An indemnity plan refers to a medical
insurance policy against which the insurance-provider makes payments based on actuals. For
example, let’s say you’ve purchased a plan with a sum insured of INR 5 lakhs. You have to undergo
covered treatment and a hospital stay which costs you INR 2 lakhs. If you have an indemnity plan,
your insurance provider will reimburse you or settle the amount of 2 lakhs directly with the hospital.
Co-Pay If you’d like to lower your health insurance premium, you can opt for co-payment.

You can promise to pay a certain percentage of each claim you make against your medical insurance
policy, and your insurance provider will take care of the rest. If you’d like your insurance provider to
settle the full claim, you can opt-out of co-payment. Cumulative or No-Claim Bonus This is a little
reward that your insurance provider offers you for not making a single claim in a policy year. For
every year that you do not make a claim, your sum insured will be increased by a certain percentage.
For every consecutive claim-free year, the percentage will increase.

Daycare Procedures A daycare procedure is any treatment that requires you to be hospitalised for less
than 24 hours. For example, a single round of chemotherapy radiation or dialysis falls under daycare
procedures. Most health insurance policies offer cover for a wide variety of daycare treatments.
Deductible This is a fixed amount that the insured individual has to pay towards their medical
treatments before they can file a claim with their insurance provider.

The deductible is a fixed amount and not a percentage of the total claim amount. Let’s assume that
your deductible is INR 5,000. In a policy year, you undergo treatment worth INR 50,000. You have to
pay INR 5,000 before you can make a claim for the balance amount of INR 45,000. Dependent In
certain situations, your health insurance policy will extend your cover to certain family members, like
your spouse, children or parents. These individuals who are eligible to enjoy cover under your policy
are known as dependents.

Domiciliary Treatment We understand that not everybody can make it to hospital for treatment. Any
medical treatment that you or an insured individual receives at home, under the supervision of a
trained medical professional, is known as domiciliary treatment & is available under the domiciliary
hospitalization. Free Look Period Once you purchase a health insurance plan, you don’t have to be
committed to it. You have the opportunity to cancel or change your insurance provider within a given
period. If you opt to cancel your health insurance policy within this specified time, you will not be
required to pay any penalty. This time is known as the free look period. Typically, it lasts for 15 days
from the date the policy is issued.

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Critical Illness Policy A policy for a serious, possibly terminal disease, which is strictly defined by
the insurer. Most critical illness policies provide for the payment of a lump sum benefit if the
policyholder is diagnosed as suffering from any one of the specified conditions. Cumulative Bonus
Cumulative bonus is similar to no claim discounts, the only difference being that instead of giving an
upfront discount, the health insurance company adds more benefits for the same premium paid.
Disability Insurance It is a form of insurance that pays a monthly income to the insured when he
suffers from total or partial disability caused due to either illness or injury, that affects his capacity to
work and earn Deductible Deductible is the amount of loss borne by the insured after which the
insurance kicks in. This share of expense can be a certain money amount or a percentage of the claim
amount. However, bigger the deductible, lower is the premium.

Exclusions The diseases, conditions or situations in which medical expenses are not covered by the
health insurance policy. Exclusions can be of two types –

‘Permanent’, i.e. the ones never covered and ‘First year’, which are ailments covered from second
year. Floater Policy A Family Floater Health Insurance also called the family health insurance is a
type of health insurance policy that is issued with a single sum insured covering number of
individuals.

The cover can be used by any member of the family any number of times. Sublimit It is the limitation
in an insurance policy on the amount of coverage available to cover a specific type of expenditure. It
can be in amount or percentage. Loading It is the amount a health insurance company adds to you
renewal premium if you had made any claims in the previous year.

No Claim Bonus It is a bonus or rather a discount on the Basic Premium if there is a claim-free year
in the policy. This bonus gets accumulated with each year you don’t make a claim. Overseas
Mediclaim Policy (OMP) An Overseas Mediclaim Policy is issued to persons who are undertaking
trips abroad for business, pleasure or educational purposes. Personal Accident Policy They are issued
as fixed benefit policies whereby specified sums are paid on the occurrence of specified events such
as death or disability. An unexpected illness or accident could make a dent in your bank accounts and
make your financial plans go haywire. With ever-rising costs of medical care, making health
insurance is important not only for yourself but for your loved ones as well.

As everyone is different, so are their needs. Your health insurance should be decided upon after
careful consideration like Premium Payment Terms Your financial ability to pay premium is an
important factor while deciding the extent of health insurance cover that you will need.

Not everyone can pay the premium for Rs 20 lakh cover, however, you can pay what you can afford.
A good way tocalculate that is by taking 2% of your yearly income – for example, if you earn Rs 6
lakh a year, you might be able to pay an amount of Rs 12,000 yearly which will give you a decent

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cover from today’s standard. Annual Income Percentage Annual income is directly proportionate to
the health insurance cover. Your annual income is a considering factor by the insurance providers,
while determining the maximum health insurance cover you are eligible for. Practically, you should
have health insurance cover between 50% to 100% of your annual income.

1.6 DIFFERENT CONCEPTS PERTAINING TO THE PROBLEM

A simple but helpful formula is: Health Insurance cover = 50% of Income + 100% of last 3 years’
expenses on health (hospitals) Family Medical History Family history is another factor that affects
your health insurance cover. The insurer will look at the history of health problems of your family
members in order to evaluate the risk of the insured contracting the same. Individuals falling under the
high-risk category should get a comprehensive high cover health insurance policy.

Age of the Insured Age is another important factor that will affect your health insurance coverage.
Individuals who have bought health insurance policies while young avail a discount on premium. For
example, if you start at age 25 you can buy health insurance worth Rs 5-10 lakh and then increase it
by 10-15% every year. And individuals over 45 years of age would have to pay higher premium for
health insurance coverage.

Type of Hospital The health insurance cover is also affected by the grade of hospital where you
choose to be hospitalized. The rate of same treatment differs in different hospitals. So, the amount of
health insurance cover that is needed has to be determined by calculating the expenses that might
incur from the hospital of your choice.

Tax Benefit When you avail a health insurance policy mainly for the purpose of tax benefits, then
you need not take a comprehensive health insurance cover. You can evaluate the amount of health
insurance tax benefit you wish to avail through the policy and then purchase one that meets your
requirement. The maximum limit for 80D deduction is Rs. 25, 000, and Rs. 30,000 for senior citizens.
There is so much unpredictability encompassing one's health and it is almost impossible to have any
control over health-related expenses. However, after getting insured with a suitable health insurance
plan, you can exercise some degree of control and gain some security visa-vis your and your family’s
health care expenses. Medical emergencies do not announce themselves before showing up.

No matter how careful you are and how healthy you try to be, it’s likely that you will face a health
emergency at some point in your life.

Apart from the actual, physical issue, a medical emergency could leave you with mental and financial
stress as well. That’s precisely why having a health insurance plan is so essential. With Tata AIG’s
Medicare health insurance policy, you won’t have to worry about the high medical costs associated
with getting quality treatment.

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Our policy will help look after you not just when you’re hospitalised, but for treatments required
before and after a hospital stay as well. If you happen to test positive for COVID-19, don’t worry. Our
health insurance policy will help take care of the cost of COVID-19 treatment too

At Tata AIG General Insurance Company Limited, We Don’t Just Insure, We Give You A Reason To
Keep Smiling.

1.7 ADVANTAGES AND DISADVANTAGES

Advantages of TATA AIG Health Insurance :-

There are several excellent features in Tata AIG's health insurance plans that make it a suitable choice
for your health insurance requirements. Some of the significant features of a Tata AIG health
insurance policy are as follows

Cashless Hospitalisation In India

By getting insured with Tata AIG as your partner in health insurance, you can get access to a network
of 7,200+ hospitals across India and benefit from cashless hospitalisation. There is no need to file and
follow up on medical insurance claims as we settle the medical expenses and bills directly with the
network hospitals.

Substantial Cumulative Bonus for Claim-free Years

For every policy year that does not include a health insurance claim, you can receive a cumulative
bonus between 10 to 100 per cent on the sum insured, depending on the plan that you have selected.
With this bonus, the sum insured under your health insurance plan gets increased without paying any
additional premiums.

Round The Clock Assistance

We’ve made it our mission to anticipate your every need. We put your priorities above ours, always,
and work to exceed your every expectation. We offer 24x7 customer assistance, so even if you call us
in the middle of the night with an emergency, we’ll be there for you!

A TATA Promise

The name Tata has long been associated with trust, quality, and excellent customer service. We take
our commitments very seriously and try to ensure the delivery of prompt and high-quality services to
you round the clock.

Your Safety Is Our Priority

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At Tata AIG, we place the utmost value in your trust and leave no stone unturned to ensure the
protection and privacy of your data, including your personal information and payment details. You
can be assured of a safe and transparent process at our website as well as our offices.

High Claim Settlement Ratio

With a health insurance claim settlement ratio of 94.21% during the financial year 2020-2021, we, at
Tata AIG, have reasserted our ever-growing commitment to customer service and support.
Additionally, we also offer an easy and quick claim settlement process.

Save On Taxes

It may seem frivolous, but one great reason to get a health insurance policy is to save on taxes.
Premiums that you pay to maintain a TATA AIG health insurance policy are exempt from taxes under
Section 80D of the Income Tax Act. If you’ve bought a health insurance plan for yourself, your
spouse or your kids, you can claim up to INR 25,000 per year. If you’ve bought a health insurance
plan for your parents who are over the age of 60, you can claim an additionaldeduction of INR 50,000
per year

Paperless Policies

Say goodbye to standing in long queues to buy or renew health insurance. With the Tata AIG
MediCare line of health insurance products, you can select, compare, and buy an excellent health
insurance policy by paying the premiums from the comfort of your home, office, or weekend
getaway.We take our motto of "With You Always" to heart and stay committed to providing you with
24x7x365 support in policy purchase, renewal, premium payment, claim filing, and claim tracking.
You can get your policy documents via email and WhatsApp and reach out to us should you need any
assistance.

It's Raining Discounts.

By buying a Tata AIG health insurance policy, not only do you get extensive health insurance
coverage from one of India's most trusted brands but also receive incredible discounts.

If you buy our MediCare or MediCare Protect health insurance plans for a tenure of two years, you
can get a 5% discount on the premium. Similarly, if you opt for a three-year Tata AIG MediCare or
MediCare Protect health insurance plan, you can benefit from a 10% discount on the cost of the
policy.What is more, is that should you choose our family floater health insurance plan, the higher the
number of family members added to the plan, the higher shall be the discount you get on the
premium.

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You can benefit from a 20% discount on the premium for a family floater health insurance plan for
two family members, a 28% discount for three family members, and a 32% discount for more than
three family members.

We Have A Wide-Reaching Network

Cashless claims with Tata AIG’s health insurance policy is easy. We have tied up with over 7,200+
hospitals across India, so no matter where you are, you’ll have a network hospital close by. In the
unlikely possibility that you’re unable to get to one of our network hospitals, you don’t need to break
a sweat. You can go across to any trusted healthcare facility and get the treatment you need.

Save On Taxes

When you purchase medical insurance, the premium that you pay can be deducted from your taxable
income under Section 80D of the Income Tax Act, 1961. For insured individuals below the age of 60,
you can claim a maximum deduction of INR 25,000. If you’ve purchased a policy for a parent above
the age of 60, you can claim an additional deduction of INR 50,000.

Paperless Policies

We live in a digital and fast-paced world, so we understand the need to have all your documents on-
the-go. As soon as your health insurance policy is issued, we’ll send you a soft copy. You can show
the TPA the digital copy at the hospital and we’ll get your health insurance claims process started.
You don’t have to carry around a paper or card to prove you’ve bought our health insurance policy!

A TATA Promise

Our health insurance policies come with the 150-year legacy and trust of TATA. As an insurance
company, we’ve been keeping our promise of looking after you, your health and your finances for
over 20 years! When we commit to something, we stick to it.

Safe And Secure

We value your privacy and data. Our website is a safe place for you to input your details and
complete health insurance premium payments. We promise to keep your personal and payment data
100% secure at all times. Check our health Insurance premium calculator to know your health
Insurance premium

High Claim Settlement Ratio

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Before you buy or renew your health insurance policy, we’re sure you’d like to know how likely you
are to get your settlement if you raise a valid claim. Well, we’re proud of our stats. In FY19- 20, we
settled 94.21% of all health insurance claims that came our way.

Round the Clock Assistance

We’ve made it our mission to anticipate your every need. We put your priorities above ours, always,
and work to exceed your every expectation. We offer 24x7 customer assistance, so even if you call us
in the middle of the night with an emergency, we’ll be there for you!

CHAPTER-2

RESEARCH DESIGN

2.1 INTRODUCTION

Research design is the framework of research methods and techniques chosen by a researcher to
conduct a study. The design allows researchers to sharpen the research methods suitable for the
subject matter and set up their studies for success.

Creating a research topic explains the type of research (experimental, survey research, correlational,

semi-experimental, review) and its sub-type (experimental design, research problem, descriptive case-
study). 
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There are three main types of designs for research:

 Data collection
 Measurement
 Data Analysis

The research problem an organization faces will determine the design, not vice-versa. The design
phase of a study determines which tools to use and how they are used.

2.2 TITLE OF THE STUDY

A STUDY ON HEALTH INSURANCE AT TATA AIG

2.3 OBJECTIVES AND HYPOTHESSIS

Tata AIG Health Insurance offers a comprehensive health plan called the Tata AIG Medicare which
offers the option of individual health insurance or a family floater plan. Further, you can enjoy a
personal accident cover, COVID-19 hospitalisation cover, a wide network of 7200+ network cashless
hospitals, a high claim settlement ratio and 24x7 assistance.

Its a health insurance you can trust and avail comprehensive health covers starting @ Rs.15/day. So,
invest in a plan that caters to your unique requirements and provides your family members with
adequate protection.

How To Buy A Health Insurance Plan?

The first step towards buying a suitable health insurance plan is a thorough assessment of your health
insurance requirements and the sum insured you need. If you want to buy health insurance for
yourself, you can opt for an individual health insurance plan, whereas if you wish to get medical
insurance coverage for your family members, you can consider a family floater health insurance
plan.After determining who you want to bring under the coverage of the intended health insurance
plan, you must decide on the type and extent of said coverage. In this context, you must take into
account your age, medical history, pre-existing illnesses, if any, etc. before finalising the sum insured
and plan. You can opt for a critical illness cover to enhance the scope of your health insurance.
Furthermore, you can top-up your existing health insurance plan with the Tata AIG Super Top-up
Health Insurance Plan. The next step is to assess and compare health insurance plans to select the best
health insurance plan for yourself and/or your family. It is advisable to choose a medical insurance
plan that allows you to remove room rent limits, includes a cover for the AYUSH line of treatment,

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and offers relevant benefits such as a maternity cover and a critical illness cover. You must also
consider adding the relevant add-on covers at additional premiums to make your health insurance
policy more comprehensive.

You would not purchase anything that is even remotely important without adequate research, now,
would you? Then why make an exception for something as critical as health insurance?! It is
important to compare various health insurance providers and check their key result areas, including
but not limited to their claim settlement ratio, the ease of the claims process, cashless hospital
network, customer feedback and reviews, and customer support mechanism. Not only should you
research the aforementioned parameters on your own but also consult friends and family to decide
which insurer to opt for. Remember that the health insurance plan as well as the health insurance
company you select play a crucial role in financially securing you against health-related expenses.

How To Buy A New Family Health Insurance Plan?

If you are looking for a health policy for family, following the steps given below can ensure that you
purchase the right plan

Compare different plans: Compare different plans and closely look at the features and services of each
available Mediclaim for the family. Analyse the ages and health of all your family members,
including yourself and see if these features will be suitable for everyone. When you compare different
plans, look at the premium amount too. Check your budget and pick a plan that fits into it.

Pick the adequate sum insured: Since a single family health insurance plan will be covering multiple
people, it is important to pick a sum insured amount that is adequate for everyone’s needs and does
not fall short in case of an emergency. Consider the ages, lifestyles, pre-existing illnesses of all
members to decide a suitable amount. Also, make sure to keep in mind the rising costs of medical
treatments, equipment, etc., in the country and around the globe.

Pay attention to the inclusions and exclusions: Certain health insurance plans for the family may not
include all dental treatment expenses. If you pick such a plan, you may end up spending money out of
your pocket. Similarly, some plans may not offer a global cover or include experimental treatment. It
is important to thoroughly check the list of inclusions and exclusions to know what kind of claims you
can raise in the future.

Check the available riders: Riders enhance your existing family health plan by offering you increased
protection. Look at the riders that the plan offers and the cost for each and see how they can add value
to your life.

Go through the network of hospitals: Check the list and number of network hospitals included in your
medical insurance plan for the family. It can help to pick a plan with a wide number of network

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hospitals in your city of residence and across the country. Network hospitals offer cashless services
for better convenience during a hospital visit.

Check the pre-existing illness waiting period: The waiting period is the time after you purchase the
policy when you cannot raise a claim for a pre-existing diseases. All insurance family medical
insurance plans have a waiting period. Make sure you check this and pick the lowest one.

Look for discounts: If you are switching from an individual health plan to a family health plan, you
can get a discount on the premium of the new policy. Similarly, if you have an NCB from the
previous year, you can use it to get a discount for the new plan. Check if you can get a discount and
lower your premium amount.

2.4 SCOPE OF THE STUDY

After you have completed the steps given above and picked a suitable family health plan, follow the
steps given below:

Go to the Tata AIG website

Go to All Products and select Health Insurance

Select the family members that you want to secure like father, mother, son, daughter, spouse, or
yourself. You can also select the number of children.

Click on Get Plan to purchase a new family medical insurance plan.

Online Purchase of Health Insurance Plan

When you buy health insurance online, the whole process becomes easier, smoother, quicker, and
more transparent as compared to the offline mode of policy purchase. Before you know it, you can get
a health insurance premium quote, and have your health insurance policy be delivered to your email
or WhatsApp inbox. Therefore, by buying online health insurance, you save on time, money, and
effort.

With the availability of plan brochures online, you can easily check and compare various health
insurance plans, the sum insured offered, the medical expenses covered, the applicable premium and
select the one you deem most suitable for yourself.

Our team of health insurance and claims experts are available to assist you through the selection of
your health insurance plan and during the claims process. You can reach out to us via call on 1800-
266-7780, through WhatsApp at +91-9136160375, or by email.

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If you buy a health insurance plan with us online, you shall not be required to undergo a health check-
up which is generally the norm whilst purchasing health insurance offline. However, if we need
additional information on your medical history or any other personal details, one of our tele-
underwriters shall reach out to you before the issuance of your health insurance plan.

As important as it is to safeguard your health through health insurance, some thoughts must be spared
to the health of the planet that sustains us. This is why we have adopted a paperless process, which
means that you shall get a soft copy of your health insurance plan via email and, should you so wish,
over WhatsApp.

The Perfect Health Insurance Plans

At Tata AIG, we have a wide variety of health insurance plans to cater to your varied health
insurance requirements. Here is the catalogue of the varied types of health insurance coverages you
can avail of:

Individual Health Insurance

An individual health insurance policy is a plan wherein the entire sum insured provides coverage for
one individual. If you are seeking a health insurance plan for yourself or individual medical insurance
plans for your family members, you can buy our individual health insurance plans. They also
Understand That Each Individual Is Unique That’s Why We Offer Three Health Insurance Policy
Variants:

Tata AIG Medicare

This pocket-friendly policy offers you all the benefits you need to deal with medical emergencies that
come your way. TATA AIG Medicare offers benefits such as global cover and cover for bariatric
surgery as well! Depending on your needs, you can select your sum insured. We offer amounts as low
as INR 3 lakhs and as high as INR 20 lakhs under the TATA AIG Medicare health insurance plan.

Tata AIG Medicare Premier

If you’re looking for enhanced, all-rounded safety, TATA AIG MediCare Premier is the right option
for you. Along with all the cover offered by our MediCare plan, this health insurance policy also
provides cover for high-end diagnostics, OPD dental treatment, emergency air ambulance and more!
The sum insured amounts offered for TATA AIG MediCare Premier can be as low as INR 5 lakhs or
as high as INR 50 lakhs.

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Tata AIG Medicare Protect

TATA AIG MediCare Protect is the ideal plan for those concerned about the costs attached with a
stay at the hospital. This health insurance policy covers pre- and post-hospitalisation expenses,
allowing you to focus on getting better instead of stressing about hospital bills.

Family Health Insurance

A family floater health insurance plan allows you to include multiple family members under the same
health insurance plan with a single premium. It is worth noting here that under a family health
insurance plan, the sum insured is shared by all the individuals covered in the plan, thereby allowing
you to get Mediclaim for your family at a feasible premium.

A Complete Guide to Family Health Insurance In India: Your family is the most important aspect of
your life. Your loved ones are your companions in all of life’s joys and sorrows. While you work hard
to offer them different comforts and luxuries of the world, it is also crucial to ensure their well-being
and offer them financial protection from the exorbitant expenses of medical emergencies.

2.5 SIGNIFICANCE OF STUDY

What is Family Floater Health Insurance?

Family floater health insurance also called a family health insurance plan protects all members of your
family under a single health plan. Such plans provide coverage to your spouse, children, and parents
with a common premium. Family floater insurance can be customized according to the unique needs
of all your loved ones. It covers pre and post-hospitalisation expenses, critical illnesses, medical
check-ups, and a lot more. Before you get such a health insurance policy, it is advisable to know more
about a family floater and its meaning.

How Does Family Floater Health Insurance Work?

Family health insurance has a fixed insurance cover that can be used by all the people insured under
the plan. For instance, if you purchase a policy with a cover of ₹15 lakhs for a year and add your
spouse and parents to the plan, this amount can be claimed for the health expenses of your spouse,
father, mother, as well as your own. Let’s assume that your father raised a claim of ₹5 lakhs for knee
surgery. After the claim has been processed, you will be left with a cover of ₹10 lakhs for the rest of
the year that can be claimed by the remaining members of your family. Now consider another
scenario where your father’s surgery costs more and he ends up claiming the entire insurance amount
of ₹15 lakhs. In this case, the rest of the family members will not be able to make any more claims
during the year.

What is the Difference Between Individual Policy and Family Floater?

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An individual health insurance plan offers coverage to only a single person in the policy. Family
floater plans, as discussed, will cover the entire family under a single plan and premium.A lot of
people opt for separate individual covers for themselves and other members of their family. In this
case, you will need one plan for yourself, one for your spouse, one for your child, and so on. The
premium, renewal dates, claim process, etc., for all these plans will be different. This can not only be
time-consuming and confusing to keep track of but also result in higher premiums and expenses.A
family floater mediclaim policy, on the other hand, will extend financial protection to all your family
members. So, you will only have to keep track of one policy and pay a single premium.

How can You Choose the Right Family Floater Medical Insurance Policy?

Picking a family floater Mediclaim policy is simple. You can purchase a plan online with minimal
effort in a quick and seamless manner. However, there are some things that you should pay attention
to, such as:

High sum insured: The sum insured is the insurance cover of your policy. A floater policy, meaning a
family floater plan covers a number of people. Family floater plans cover a number of people.
Therefore, it is important to pick a high sum assured that is adequate to meet the needs of everyone in
your family.When you choose the sum assured, you must consider factors like the ages, health history
of each member, the general family medical history, cost of medical expenses in your city, etc. For
example, elderly people are more susceptible to falling sick. So, if you are adding your parents to your
family floater policy, you may want to consider picking a high sum assured that can cover age-related
ailments like heart and kidney issues, etc.

Pre-existing illnesses: Pre-existing illnesses are health conditions that a person may be suffering from
before buying health insurance. Some examples include diabetes, high cholesterol, etc. While a family
floater health insurance policy in India will cover pre-existing diseases, there will be a waiting period
right after you purchase the plan when you will not be able to raise a claim.Before you select a plan,
make sure to check how long this waiting period is and whether or not the pre-existing illnesses of all
the family members are covered under the plan.

Riders and benefits: Riders are add-ons that can be bought over the base health insurance plan. They
are used to enhance your coverage and can offer you increased financial protection against specific
illnesses and health concerns.Check the list of riders that a plan offers, along with the costs of each
rider. Buy the plan only if your requirements are met, and you are satisfied with the level of
protection.

Claim settlement process: A health crisis can be a trying time for the entire family. Hence, you should
pick a family floater health insurance plan with a smooth and fast claim settlement process. Some
companies demand multiple documents and bills and have a long turnaround time. This can be

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extremely stressful.So, look for an insurance provider that offers quick settlements and has a high
claim settlement ratio to reduce the chances of claim rejection.

Compare premiums: It helps to compare the premiums of different plans and pick the one that is the
most cost-effective. It can sometimes be misleading to pick a plan with a low premium sincenot all
low premium plans will offer you sufficient coverage. Likewise, a high premium plan may or may not
offer you great benefits always.So, try to evaluate the price against the features offered and then make
a decision.

Inclusion : Family floater health insurance plans can have several inclusions and exclusions. For
instance, some plans may not cover dental procedures or cosmetic issues. It helps to pick a plan that
covers a wide range of illnesses and offers flexible services.For instance, inclusions like a global
cover, maternity cover, vaccination cover, pre and post-hospitalisation medical expenses, newborn
baby cover, ambulance cover, AYUSH benefit, in-patient dental treatment, organ donor expenses, and
more can offer you better financial protection.Make sure to thoroughly check the list of inclusions and
exclusions and see how they impact you and your family.

To sum it up

Family floater health insurance is a much-needed financial tool in today’s times. Covid-19 and the
surge in medical inflation have further fortified the importance of health insurance. Follow this guide
to enjoy the best financial health coverage and live a stress-free life.However, to ensure complete
financial protection for your family members, you must be careful and select a plan that offers
comprehensive coverage.

Health Insurance Plans For Family:-

The world of health insurance plans is a diverse and vast one. There are several types of plans,
features, services, and pay-out methods that might be suited to the distinct and unique needs of every
individual. These plans are also designed keeping in mind the age and financial limitations of people
as well as their health concerns and medical requirements. Typically, health insurance plans can be
categorized into two main categories. The first is an individual health insurance plan, and the second
is a mediclaim policy for the family. Get complete coverage for your family with Tata AIG health
insurance plans for the family.

An individual health insurance policy aims at securing one person under the plan. In such plans, the
insurance coverage is extended to one person alone. For instance, if you buy an individual plan for
yourself, you will be able to raise a claim for your medical expenses like hospitalization, doctor’s
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consultation, ambulance costs, surgery costs, diagnosis costs, AYUSH treatment, and more. Now, if
you get married and have children, your existing policy will not cover them. In this case, you will
have to buy a health insurance plan for the family to cover your dependents. Individual health
insurance plans are typically ideal for youngsters who do not have any dependent family members.
However, as you age and have more responsibilities, you may find such a plan inadequate. This is
where family insurance plans come in.

Family health insurance is a type of health insurance that secures the entire family. This includes the
spouse, dependent children, and dependent parents. Such insurance plans cover all members of your
family with unified protection. There is only one premium and one insurance amount. This implies
that the insurance company does not charge you a separate premium for all members of your family.
So, you pay only one premium, and in return, the insurance company offers insurance protection to all
the individuals insured under the policy.

The sum insured of a medical policy for the family is shared between all the insured family members.
Example: Consider a scenario where you purchase a family medical insuranceplan. There are four
people insured under this plan, including you, your spouse, and your dependent children. The
insurance cover or the sum assured for this health plan is ₹8 lakhs. Now, you undergo surgery and
require an insurance claim amount of ₹2 lakhs. This money will be deducted from the sum assured
(₹8 lakhs – ₹2 lakhs), and the rest of the family will be able to claim ₹6 lakhs for their medical
expenses.Family health insurance plans are more suitable for families as they help reduce the
additional cost incurred on individual plans. They also help organize your finances greatly as you no
longer have to remember the premium payment dates or renewal dates of each individual policy.
Moreover, it becomes easy to cover dependent members who may not be able to afford a health
insurance plan on their own.

2.6 DATA COLLECTION AND TECHNIQUES AND TOOLS

Tata AIG Health Insurance Plans For Family:- If you are looking for health insurance for your family,
you can explore the following three plans:

Tata AIG Medicare: The Tata AIG Medicare medical insurance for the family offers sum assured
amounts ranging from as low as ₹3 lakhs to as high as ₹20 lakhs. This is a budgetfriendly plan that
can suit most income groups. You get all basic benefits like a global cover, consumables benefit,
bariatric surgery, daycare procedures, in-patient treatment, organ donor expenses, pre-hospitalization

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medical expenses, post-hospitalization medical expenses, daily cash for choosing shared
accommodation, ambulance cover, AYUSH benefit, Free health checkup, in-patient dental treatment,
and more. However, this family health insurance plan does not include OPD treatment, OPD dental
treatment, accidental death benefit, maternity cover, etc.

Tata AIG Medicare Protect: Tata AIG MediCare Protect is another cashless mediclaim policy for the
family. This plan is better suited for people concerned about hospitalization costs. This health
insurance policy covers pre-hospitalization medical expenses, post-hospitalization medical expenses,
consumables benefit, daycare procedures, in-patient treatment, organ donor expenses, daily cash for
choosing shared accommodation, ambulance cover, AYUSH benefit, health checkup, etc. But the plan
does not include a global cover, bariatric surgery, emergency air ambulance, highend diagnostics,
accidental death benefit, maternity cover, OPD treatment, vaccination cover, etc.

Tata AIG Medicare Premier: If you are looking for the best medical insurance for your family with
enhanced features and wholesome protection, the Tata AIG MediCare Premier is what you can select.
This plan offers sum assured amounts of as high as ₹50 lakhs. However, you can also pick lower
amounts starting from ₹5 lakhs. Moreover, the plan offers benefits like a global cover, consumables
benefit, bariatric surgery, daycare procedures, in-patient treatment, organ donor expenses, pre-
hospitalization medical expenses, post-hospitalization medical expenses, daily cash for choosing
shared accommodation, ambulance cover, AYUSH benefit, health check-up, in-patient dental
treatment, bariatric surgery, emergency air ambulance, high-end diagnostics, accidental death benefit,
maternity cover, OPD treatment, vaccination cover, etc.Tata AIG offers ideal family health insurance
plans for varied needs, budgets and health conditions. To enjoy all benefits and features, make sure to
pick a plan that is suited to your needs. Why Should You Buy A Family Health Insurance Plan? Here
are some ways in which a mediclaim policy for the family can help you:

Health insurance covers all medical expenses: Mediclaim for the family covers all kinds of medical
expenses, right from basic health check-ups to major surgeries. It also covers unexpected expenses
like emergency air ambulance costs, AYUSH benefits, and more. So, you stay protected from all
possible costs. Health insurance covers the cost of hospitalization: Hospitalization can lead to high-
value bills that can be hard to cover on a salary. A cashless mediclaim policy for the family helps
cover hospital charges in a seamless manner. Health insurance offers quality medical attention:
Family insurance plans ensure that you receive quality medical attention without compromising on
anything. When money is no longer an issue, you can seek the best medical treatment and recover
quickly.

Health insurance covers ICU charges: Not only does the best medical insurance for families cover
general hospitalization expenses, but also ICU charges.

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Health insurance covers preventive health check-ups: Family medical insurance plans cover the
expenses of preventive health check-ups. These routine check-ups contribute to better overall health
and help you catch a medical problem in its nascent stage. Health insurance covers ambulance costs:
Additional and unexpected costs like ambulance charges can also be covered with a good family
floater insurance plan.

Health insurance helps you beat inflation: Medical inflation can make it hard to plan or save for your
future health expenses. However, the best medical policy for the family offers high sum assured
amounts to counter the rising costs.

Health insurance covers daycare procedures: Daycare procedures are also covered in health insurance.
So, you do not necessarily have to be admitted to a hospital to make a claim.

Health insurance lets you save tax: The tax deductions under Section 80D of the Income Tax Act,
1961, enhance your savings.

Health insurance covers AYUSH treatments: The best cashless mediclaim policies for families in
India cover alternative treatments like Ayurveda, Yoga, Naturopathy, Unani, Siddha, SowaRigpa, and
Homoeopathy.

Health insurance reduces costs: You can avail of discounts like the No Claim Bonus (NCB) to reduce
the overall costs incurred on purchasing a plan.

Health insurance offers peace of mind: One family health insurance policy can cover multiple people
at the same time. Such comprehensive security offers you peace of mind and lets you live stress-free.
Benefits Of Buying Health Insurance Plans For Family Here are some benefits of buying a medical
policy for the family.

Tax benefits: Health insurance income tax deduction can help you save money. You can claim a tax
deduction of up to ₹25,000 (under the age of 60) or ₹50,000 (over the age of 60) under Section 80D
of the Income Tax Act, 1961 for a policy for yourself, your spouse, or your children. You can claim
another tax benefit of up to ₹50,000 if you’ve bought a health insurance plan for your parents, taking
the total allowed health insurance tax deduction limit to ₹1 lakh. To know more, check our resource
on Tax Benefits with Health Insurance.

Peace of mind: Since a single policy covers all your loved ones, you have nothing to worry about. A
family health plan helps you protect your peace of mind by protecting all members of your family.

Preventive health insurance check-up: The best mediclaim policy for family offers coverage for
preventive health check-ups. This helps you detect a disease in its nascent stage and get the right
treatment in time. Medical check-ups also help you stay fit by motivating you to adopt a healthier
lifestyle in general.
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Comprehensive coverage: You get comprehensive coverage with a health policy for the family. These
plans take care of diverse expenses like pre and post-hospitalization, ambulance costs, organ donation,
AYUSH treatments, and more.

Affordable premium: The best family health insurance policy can offer you cost-effective premiums
that are light on the pocket but heavy in features and benefits. This lets you secure your loved ones
without hampering your present lifestyle and other future financial goals.

Discounting: Compared to individual health plans, health insurance plans for the family help you save
money. You pay one premium as opposed to several. The money spent is greatly reduced, and there
are no comprises on the benefits. So, if you want to save some money, you should consider
purchasing the best family health insurance.

Individual Vs Family Health Insurance Comparison:- The difference between an individual health
insurance plan and a health insurance plan for the family is simple. An individual health plan covers
an individual or a single person, and a family health insurance plan covers an entire family. For
instance, the former will cover only your medicalexpenses. However, the latter will also cover the
medical expenses of your spouse, dependent children, and dependent parents. Another difference that
lies between the two plans is in the premium and the sum assured. In an individual plan, the premium
you pay is used to secure you alone. The sum insured can also only be claimed by you (the insured)
and nobody else. You do not share this plan with anybody. Contrarily, in the case of family medical
insurance plans, the insurance coverage can be claimed by all the people insured in the plan.
However, there is only one premium. Not every insured person is asked to pay the premium
separately, but they all enjoy umbrella coverage.

Lastly, when you raise a claim for an individual health insurance plan, you can claim up to the sum
insured for your policy for yourself. For instance, if you have a health plan of ₹5 lakh and raise a
claim for ₹1 lakh, you would still have Rs. 4 lakh left to claim. In the case of a family health plan, the
insurance cover would be used by everyone. For instance, consider a scenario where you have a
health plan that is being shared by you, your spouse, and your parents. The sum insured of your policy
is ₹15 lakhs. If you raise a claim for ₹2 lakhs, the remaining ₹13 lakhs can then be used by any other
insured person.

The premiums for individual health plans are decided based on the individual’s age, health history,
lifestyle habits, occupation, etc. On the other hand, the premiums for health insurance plans for family
are decided on the basis of every insured person’s age, health history, lifestyle habits, occupation, etc.

Eligibility Criteria For Buying Health Insurance:- Before you buy a health insurance plan, you must
meet its eligibility criteria. Here are some factors that play a role here:

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• Age: The age of the insured is one of the primary factors that an insurance company considers
before selling a health insurance plan. Age plays a crucial role in the health and well-being of a person
and is, therefore, an important parameter in eligibility for health insurance. Typically, health insurance
can be bought for dependent children below the age of 18. Individuals over 18 are considered adults
and can therefore buy a different cover for themselves. In the case of senior citizens, the maximum
age can range between 60 and 65 years. Make sure that you check the eligibility criteria of the family
health plan and see if all your family members can be added to it or not.

• Previous medical conditions / pre-existing illnesses: The insurance company may request you to
undergo a medical test to determine if you have any pre-existing illnesses, such as hypertension,
diabetes, thyroid, etc. Pre-existing illnesses are generally not covered during the waiting period of the
policy. This implies that you would not be able to raise a claim to cover a medical expense arising out
of an illness that you had before buying the health plan.

In some cases, the insurance company can also request you to submit a self-declaration of your pre-
existing illnesses. It is important for the insurance provider to know if you have any preexisting
illnesses as it helps them assess the right premium and sum assured for your policy.

Super Top-Up Health Insurance

With the Tata AIG Super Top Up Health Insurance Plan termed MediCare Plus, you can enhance the
coverage and add into the sum insured provided by your existing individual medical insurance plan or
that of the health insurance plan for your family. Our super top-up plan, MediCare Plus, is a pocket-
friendly health companion you can always rely on. MediCare plus offers additional health benefits
over and above your regular health insurance plan. Super top-up plans are crucial as they provide you
with coverage after you’ve maxed out the claims against your regular health insurance policy. But that
isn’t the only reason why they’re a good idea.

When you make claims against your base health insurance policy, each claim amount needs to be
more than the deductible amount. With our MediCare Plus health insurance policy, you can benefit
from aggregate deductibles. This means that the total amount of all the claims you make in a policy
year should be more than the deductible amount. On the other hand, base health insurance policies
have a deductible against every claim you make. As you opt for MediCare Plus as your super top-up
health insurance plan, you can also enjoy these amazing benefits:

Health Cover

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Our super top-up health insurance policy will help you take care of the cost of various healthcare
treatments. Our plans come without sub-limits unless they’re explicitly mentioned in your health
insurance policy documents.

Cashless Claims

TATA AIG has over 7,200 network hospitals, so you can enjoy cashless claims at most facilities.

Age No Bar

We offer life-long renewals with MediCare Plus! So, whether your 60, 70 or 80, you can continue to
pay your premiums on time and enjoy additional health cover.

Consumables Benefit

Under the Consumables Benefit we’ll cover the cost of consumables that you need during your
hospitalisation that are directly related to a covered treatment.

Cumulative Bonus

For every year that you go without a claim, we’ll provide you with a bonus by bumping up your sum
insured the following year. We start with a 50% bonus and increase it each year, up to a maximum of
100% of the sum insured amount.

Tax Deductions

Under Section 80D of the Income Tax Act, 1961, you can claim deductions up to INR 75,000 for the
premiums paid towards the upkeep of health insurance policies for yourself, your spouse, your
children and your parents above the age of 60. To understand health insurance tax benefits, we've
curated an indepth guide to help you save on taxes by the purchase of a health insurance plan

Optional Global Cover

If you’d ever like to seek treatment abroad, this optional cover is great for you. With this cover, we’ll
help you take care of the cost of treatments abroad for a disease or illness that was diagnosed in India
and for which you’ve specifically travelled for the purpose of treatment.

How Does Super Top Up Health Insurance Work?

We can truly understand the importance of having super top-up health insurance by looking at an
example.

Let’s say Mr. Kumar has a base health insurance policy from his company that offers him a sum
insured of INR 5 lakhs. He meets with a terrible accident and is admitted in the hospital for treatment.
At the end of his hospitalization, the claim amount is a total of INR 7 lakhs. Mr. Kumar’s health

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insurance policy will pay the claim amount of INR 5 lakhs, but Mr. Kumar would have to pay the
remaining amount of INR 2 lakhs. If Mr. Kumar has a super top-up health policy that offers cover for
INR 10 lakhs, his super top-up policy will cover the balance amount of INR 2 lakhs.

You can also use super top-up health insurance plans in isolation. If we continue with the above
example, let’s say Mr. Kumar paid the pending amount of INR 2 lakhs from his own pocket. For the
rest of the year, he has a few other health issues and makes claims against his policy. Let’s see how
this plan helps Mr. Kumar if we assume his top-up plan offers cover of INR 10 lakhs and has a
deductible of INR 2 lakhs. The first claim he makes against the super top-up policy is for INR 4 lakhs.
He pays the deductible of INR 2 lakhs and the policy covers the rest. The next time, he has to make a
claim for INR 3 lakhs. This time, he doesn’t have to pay any deductible and the full amount is settled
by the health insurance provider. Finally, Mr. Kumar makes another claim for INR 2 lakhs. Once
again, he doesn’t have to pay any deductible and the full amount is provided by the insurance
provider.

Why Should I Buy TATA AIG’s Super Top Up Health Insurance ?

Paying premiums for the upkeep of a single health insurance policy may seem like enough. Shelling
out more money for additional cover under a super top-up plan may appear to be unnecessary. But,
life is unpredictable and rising medical costs could end up costing us our savings. Here’s a look at
some important reasons why you need to have super top-up health insurance:

Medical Inflation

Medical inflation is rising almost twice as fast as regular inflation. Basically, healthcare costs are
growing at an alarming rate, making it difficult for many people to afford good healthcare. A super
top-up plan will help alleviate the trouble of dealing with high medical costs.

Higher Cover

The main reason super top-ups plans are offered is to increase your health insurance cover. These
plans allow you to enjoy higher sum insured amounts at fairly affordable rates.

Pocket-Friendly

Since super top-up plans work as additional cover to your existing health insurance policy, they’re
quite affordable. This means you can get higher cover for pocket-friendly premium amounts. This is
especially important if you’re purchasing the plan for your parents as premiums for senior citizens are
often quite high.

Your Friend in Times of Need

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After experiencing what the world looks like in a pandemic, we’re sure you want to do whatever you
can to get the best healthcare you need in an emergency. With a super top-up health insurance plan,
you don’t have to worry too much about the cost. You can get the care you need and leave the bills to
us.

More Benefits

If you’re covered under a group health insurance policy, chances are you might not get cover for
AYUSH treatments or other critical illnesses. With a super top-up plan, you can get the cover you
want for a fraction of the cost.

Who should but a Super Top-Up Health Insurance Plan

The Corporate Policy Holder: If you’re covered under a group insurance policy, you may not have
adequate cover. Sure, your regular policy will take care of the small stuff, but if anything bigger
comes your way, you need a super top-up plan in your corner. The policy will boost your sum insured
without burning a hole in your pocket.

The Elderly:

As you grow older, your health insurance premiums are likely to increase. If you’re purchasing health
insurance for your parents for the first time, their premiums will be much higher than yours, even if
you’re opting for the same sum insured. So, you can opt for a policy that offers lower cover and then
increase their overall health cover with a super top-up plan instead. It’s lighter on your pocket and
makes sure your parents have the kind of cover they need.

The Limited Coverage Policy Holder:

There are many people who purchase fairly basic health insurance policies since they’re affordable.
These plans may cover only basic hospitalization expenses. If you’ve purchased such a plan but want
better cover, you can opt for a super top-up instead of switching to a comprehensive health insurance
policy. You’ll get similar benefits for a far more pocket-friendly price tag.

Critical Illness Health Insurance

Whilst a basic health insurance plan provides you financial protection against any regular diseases
and injuries, they do not usually cover the expenses related to critical illnesses, such as cancer,
cardiovascular diseases, and renal failure. Therefore, you can buy the Tata AIG Critical Illness Health
Insurance Plan to get coverage for critical illness.

What is A Critical Illness Insurance Cover?

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There are many things in life you simply have minimal control over, and your health is certainly one
of those things. Although it is impossible to exert full control over your health, present and future
alike, you can take a significant stride towards doing so by investing in a suitable health insurance
policy.

With the selection of the Tata AIG health insurance plan, you can benefit from extensive coverage
against a wide gamut of illnesses and medical emergencies, including accidents. Our plans have been
designed to offer you the maximum protection possible at a feasible price.However, even if you
choose the best medical policy in line with your health insurance requirements, you may end up
facing a dearth of adequate coverage should you get diagnosed with a critical illness.

A basic health insurance policy does not encompass coverage for critical ailments such as cancer,
cardiac stroke, and paralysis, to name a few.Therefore, it is prudent to opt for a critical illness health
insurance plan. Our critical illness cover enhances the scope of your health insurance policy and
provides you coverage against critical illnesses such as cancer, kidney failure, blindness, and coma.
By purchasing a critical illness plan with Tata AIG, you do not have to worry about your medical bills
upon being diagnosed with any of the critical ailments covered under the plan.In order to have
sufficient protection against critical illnesses, you must consider buying a critical illness insurance
policy. The best critical illness insurance plan for you is one that offers optimal coverage without
putting a huge dent in your pockets, and the Tata AIG critical illness health insurance plan ticks all
those boxes.

Why Should You Buy A Critical Illness Cover Even If You Already Have a Mediclaim Plan?

It is true that one can never quite have enough health insurance. Such is the unpredictability of health-
related issues that irrespective of the amount of advance planning and careful preparation you have in
place, you are still vulnerable to an incredible number of ailments, not to mention accidents. It is,
therefore, wise to have a suitable health insurance policy to provide you with financial protection
against such ailments. However, since medical inflation is consistently on the rise, a basic health
insurance plan may not suffice to ensure sufficient medical coverage for you. This is why it is prudent
to purchase a critical illness insurance policy.

Here are some reasons why you should opt for a critical health insurance policy. Coverage Against
Critical IllnessesBy buying a critical illness cover, you can easily enhance the coverage provided by
your existing health insurance policy.

As a result, not only will you have adequate financial protection againstcommon ailments but also
against severe ones such as cancer, cardiovascular diseases, renal failure, etc. The Security of Your
SavingsIn the absence of a critical illness cover, you will have to foot the burden of extensive medical
bills arising out of the treatment required for critical illnesses. This would entail you delving into your

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savings or being forced to resort to debt, none of which are sound options for the financial safety of
your future. Since your savings are sacrosanct, you must not let them be exhausted by the financial
impact of a critical illness diagnosis, and a critical illness insurance policy helps you do that. Features
That Make Critical Illness Insurance the

RightInsurance:- We offer one of the best critical illness covers in India. There are many features of
our critical illness insurance policy that make it the #RightInsurance for you. Here are some of the
features of our the Tata AIG Critical Illness Insurance in India: No Money Worries, No Stress: By
buying the Tata AIG critical illness cover, you can bid adieu to your financial worries and stress about
your medical expenses for critical ailments. We provide the lump-sum payment of your entire sum
assured under our critical illness cover policy.

Our Checklist for Critical Ailments: With the Tata AIG critical insurance policy, you get coverage for
the following critical ailments.

• Heart Attack

• Cancer

• Stroke

• Open Chest CABG

• Kidney Failure

• Organ Transplant

• Bone Marrow Transplant

• Blindness

• Coma

• Major Burns

• Multiple Sclerosis

• Paralysis

Go for A Second Opinion: Should you be harbouring any doubts about your initial diagnosis of a
critical illness, you can go ahead and seek a second opinion. And don't worry about the bills. We've
got your back!

Enhance Your Sum Assured: If you wish to enhance the sum assured under your critical illness cover,
you can do so whilst renewing the policy.

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Hassle-free Experience: With the advent of digitalisation, everything about your insurance experience
has been streamlined, right from the purchase of a health insurance policy or a life insurance policy
with a critical illness cover to its renewal and filing a health insurance claim. You can carry out all of
the above tasks on our website through a hassle-free process.

Monthly Income: The lump-sum payment of the sum assured under your critical illness cover can
help compensate for the loss of your monthly income due to your inability to work full time following
the diagnosis of a critical illness. This way, you and your family can be spared any financial crisis in
the wake of such a diagnosis.

What Are The Critical Illnesses Conditions Covered Under a Critical Illness Insurance Policy? It is
important to have clarity on what is included in your critical illness cover. Similarly, you must also be
aware of the exclusions from your critical illness health insurance plan. Here's a glimpse at the
inclusions and the exclusions for a critical illness insurance policy. Inclusions Under the Tata AIG
Critical Illness Cover-Critical Illness BenefitsHere is the list of critical illnesses for insurance that are
covered by the Tata AIG Critical Illness Cover.

• First heart attack - of specified severity

• Cancer - of specified severity

• Stroke resulting in Permanent Symptoms

• Open Chest CABG

• Kidney Failure requiring regular Dialysis

• Major Organ / Bone Marrow Transplant

• Total Blindness

• Coma of specified severity

• Major Burns

• Multiple Sclerosis with persisting symptoms

• Permanent paralysis of limbs Second Opinion Benefit:

You can avail of the second opinion benefit under your critical illness health insurance policy only if
the said policy is in force and you have been diagnosed with one of the 11 illnesses from the above
critical illness list. Tax Benefits Of A Critical Illness Insurance Cover:- The premium paid towards a
critical illness insurance plan qualifies for tax deduction under Section 80D of the Income Tax Act,
1961. The tax deduction you get depends on the age group you are in. Here is a quick glimpse of the
tax benefits of a critical illness insurance cover.
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The Age of the Assessee Beneficiaries of Critical Illness Cover Maximum Permissible Tax
Deduction Below 60 years Self, Spouse, Dependent Children, and Parents ₹25,000 for the premium
paid for the self, spouse, and dependent children And ₹25,000 for the premium paid for parents under
the age of 60 years and ₹50,000 for the premium paid for parents over the age of 60 years Above 60
years Self, Spouse, Dependent Children, and Parents ₹50,000 for the premium paid for the self,
spouse, and dependent children And ₹50,000 for the premium paid for parents over the age of 60
years

Personal Accident Insurance Policy Should an accident, unfortunately, lead to a permanent disability
or death, the Tata AIG Personal Accident Insurance Policy can prove to be of great assistance to you
and your family. Under this plan, you or your beneficiary (in the event of your demise in the wake of
an accident) shall receive financial support. Corporate Health Insurance It is a well known fact that an
employee values a health insurance cover and its benefits. It is viewed by the employee as the second
best thing next to monetary compensation, and gives the employer the added advantage of being able
to employ and retain the best in the business.

Tata AIG General Insurance Company Limited helps you cover your employee’s health insurance at a
low and affordable price and are of great help in instances of hospitalization, disability and even
unfortunate death resulting from accidents. What's important, it involves no major costs for your
organization, but goes a long way in cementing their belief in you. Group Personal Accident
Insurance Your Employees Are Your Greatest Asset. To Demonstrate That You Value Them You
Want To Help Them And Their Loved Ones In Case Of Misfortune.

To Cater To This Large Human Pool Tata AIG General Insurance Company Limited Provides Tailor
Made Options To Suit Your Needs. With The Tata AIG General Insurance Company Limited Group
Personal Accident(GPA) Policy You Can Offer Benefits Like Accidental Death Cover, Disability
Cover, Children’s Education Allowance And More. A Few Of Our Esteemed Clients Include Infosys,
IBM Group, Essar Group, Accenture, Oracle Financial Software Services And Many More Things to
look for when buying corporate health & accident Insurance:-

• Named/Un-Named policy options

• 24x7 worldwide cover

• um Insured based on Salary or Category

• Tailor-made policy with choice of benefits

• Endorsements/ amendments/ additions to existing insurance

• Daily cash benefits if hospitalized

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Are You Looking For An Excellent Health Insurance Plan?

Then You Have Come To The Right Place! At Tata AIG, We Offer Medical Insurance Policies With
Extensive Coverage And Affordable Premiums, And Our Arogya Sanjeevani Health Insurance Policy
Could Be The Medical Insurance Plan You Are Looking For.

What Is Arogya Sanjeevani Policy?

Arogya is an ancient Sanskrit word that refers to a holistic approach to health, that is, a healthy mind,
body, and soul. The philosophy of Arogya, or 'free from diseases', encompasses the significance of
overall health and well-being in the life of any individual. Since the present times pose a wide gamut
of health-related challenges to all of us, the importance of Arogya cannot be overstated.Although you
have very little control over the occurrence of diseases, infections, and accidents, you can control your
level of preparedness against such threats. And to help you do that, the Insurance Regulatory and
Development Authority of India (IRDAI) has launched the Arogya Sanjeevani Health Insurance
Policy.The Arogya Sanjeevani Policy is a basic health insurance plan that comprises medical
insurance coverage for hospitalisation and several other medical expenses.

In order to make an affordable health insurance option available for everyone, the IRDAI has directed
all the leading insurance companies in India to design and offer a basic health insurance plan by the
name of Arogya Sanjeevani.

The coverage for Arogya Sanjeevani plans includes pre-hospitalisation, hospitalisation, and post-
hospitalisation expenses, along with the bills for doctor's consultation and nursing care. In times as
unprecedented and unpredictable as the ones we find ourselves in, it is more important than ever
before to have at least a basic health insurance plan.

Therefore, you must consider purchasing an Arogya Sanjeevani Policy and ensuring financial
protection against basic health-related expenses. The Tata AIG Arogya Sanjeevani Health Insurance
Policy is an excellent health insurance policy with several benefits. You can carry out Tata AIG
Health Insurance Policy Renewal or purchase on our website and select the best medical insurance
policy as per your health insurance requirements. Reasons To Choose the Tata AIG Arogya
Sanjeevani Health Insurance Policy:- The Tata AIG Arogya Sanjeevani Health Insurance Policy is
packed with excellent benefits and the commitment of one of India's most trusted brands. Here is why
you should choose our Arogya Health Insurance Policy

Wide Range of Benefits: The Tata AIG Arogya Sanjeevani Medical Insurance Plan provides you with
a wide range of medical insurance benefits, including coverage for hospitalisation expenses, pre and
post-hospitalisation expenses, cataract treatment, and AYUSH treatment. Access to 7,200 Hospitals
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Cashless Insurance: By selecting the Tata AIG Arogya Sanjeevani Health Insurance Policy, you can
get access to cashless insurance at our nationwide network of partner hospitals.

One Plan for Your Entire Family: With the Tata AIG Arogya Sanjeevani Health Insurance Plan, you
can cover your entire family under the umbrella of one medical insurance plan. This keeps your health
insurance coverage centralised and also enables you to save in terms of money and effort.

Cumulative Bonus: For every claim-free year in your Tata AIG Arogya Sanjeevani Health Insurance
Policy, you can have an enhancement in your sum insured by 5 to 50 per cent without having to pay
any additional premium. However, you are eligible for this cumulative bonus only if your policy gets
renewed without any break or lapse. The Key Features of Arogya Sanjeevani Health Insurance By
Tata AIG:- Here are the main features of the Tata AIG Arogya Sanjeevani Scheme:

Benefits Galore: With the selection of our Arogya health insurance, you get access to several benefits,
including inpatient hospitalisation cover, AYUSH cover, coverage for specific surgical procedures,
etc. You can check your Arogya Sanjeevani Policy Details to know about the entire range of covers
available under this plan. Wide Network of Hospitals: To make your health insurance claims
experience easier and smoother and be of aid to you in times of great difficulty, we have partnered
with more than 7,200 hospitals across India. Filing cashless claims is a hassle-free process that can be
completed online.

Lifelong Renewals: At Tata AIG, we are true to our promise of 'With You Always'. You can,
therefore, be assured of lifelong renewals of your Arogya Insurance as long as you uphold your
Arogya Sanjeevani Policy Premium payment obligations on a timely basis.

Cumulative Bonus: If you do not file a health insurance claim on your Arogya health insurance during
a policy year, you become eligible for an increase in the sum insured under your policy. We offer a 5
to 50 per cent enhancement in your sum insured for every claim-free policy year.

Tax Benefits: Under Section 80D of the Income Tax Act, 1961, you can claim a tax deduction of
₹25,000 on the premiums paid towards your Arogya insurance plan. This sum increases to ₹50,000 if
the premium is being paid for a policy benefitting a senior citizen.

Flexible Frequency of Premium Payment: You can choose to make your Arogya Sanjeevani Policy
Premium payment on a yearly, half-yearly, quarterly, or monthly basis as per your convenience. This
flexibility can help you manage your financial obligations better.

What Is Included In Your Tata AIG Arogya Sanjeevani Health Insurance?

It is incredibly important to understand what is covered by your Tata AIG Arogya Sanjeevani Health
Insurance. Here are the inclusions in your Arogya Sanjeevani Policy.

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Coverage for Hospitalisation Expenses: With the Tata AIG Arogya Sanjeevani Health Insurance
Policy, you get the benefit of a cover for your hospitalisation expenses, subject to the ceiling of your
sum insured and the applicable cumulative bonus.

This cover includes, amongst others, the following expenses.

• Room Rent

• Nursing Expenses

• Intensive Care UNIT Charges

• Intensive Cardiac Care Unit Charges

• The Fees paid to Surgeons, Anesthetist, Medical Practitioners, and Consultant

• Operation Theatre Charges

• The Expenses for Medicines

• The Cost of Diagnostics

• The Cost of Daycare Treatments

• The Cost of Dental Treatment Rendered Necessary By a Surgery or Disease

• The Expenses for the Treatment of Cataracts subject to the sub-limits mentioned in the policy

• Coverage for Ambulance Expenses Coverage for AYUSH Treatment: Your Tata AIG Arogya
insurance encompasses a cover for the in-patient treatments conducted under the Ayurveda, Yoga and
Naturopathy, Unani, Siddha and Homeopathy systems of medical treatment. This cover is subject to
the sum insured in your Arogya Sanjeevani plan. You can receive this treatment at any AYUSH
hospital.

Coverage for Cataract Treatment: Your Tata AIG Arogya Sanjeevani Health Insurance Policy
includes a cover for Cataract Treatment. This cover is limited to 25 per cent of the sum insured or
₹40,000, whichever is lower and is applicable for Cataract Treatment for each eye in one policy year.
Coverage for Pre-hospitalisation Expenses: With our Arogya Sanjeevani Health Insurance Policy, you
can also benefit from a pre-hospitalisation cover of 30 days. This cover is applicable for the medical
expenses incurred due to a condition or disease for which in-patient hospitalisation subsequently takes
place.

Coverage for Post-Hospitalisation Expenses: In addition to hospitalisation and prehospitalisation

cover, the Tata AIG Arogya Sanjeevani Policy also provides you with a cover for post-hospitalisation
expenses for a period of 60 days following discharge from a hospital for an admissible disease or

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condition (as mentioned in the policy). Coverage for Specified Surgical Procedures: Your Tata AIG
Arogya Sanjeevani Policy covers a specific list of medical procedures, either as in-patient treatment or
daycare procedures. For these procedures, you are eligible for coverage up to 50 per cent of the sum
insured under your policy. Here is the list of the specific medical procedures covered under your
Arogya Sanjeevani Health Insurance Policy.

• Uterine Artery Embolization and HIFU (High intensity focused ultrasound)

• Balloon Sinoplasty

• Deep Brain Stimulation

• Oral Chemotherapy

• lmmunotherapy - Monoclonal Antibody to be given as an injection

• Intra Vitreal Injections

• Robotic Surgeries

• Stereotactic Radio Surgeries

• Bronchial Thermoplasty

• Vaporisation of the Prostate (Green laser treatment or holmium laser treatment)

• ION M - (Intra Operative Neuro Monitoring) Stem Cell therapy: Hematopoietic stem cells for bone
marrow transplant for haematological conditions to be covered Coverage for More Medical Expenses:
The Tata AIG Arogya Sanjeevani Health Insurance Policy also has coverage for some other medical
expenses, which are mentioned in Lists II to IV of Annexure A to the policy document. These include
the expenses that are to be categorised under room charges, procedure charges, and cost of treatment,
respectively.

Enhancement of Sum Insured: For each year that you do not file a health insurance policy claim on
your Arogya insurance with us, you can get a 5 to 50 per cent enhancement in your sum insured under
the policy. However, if you wish to be eligible for this benefit, you must ensure the timely renewal of
your Arogya Sanjeevani Health Insurance Policy.

Who is Eligible For Arogya Sanjeevani Health Insurance?

Before selecting our Arogya Sanjeevani Policy, you must ascertain whether you are eligible for it.
Here are the eligibility criteria for the Tata AIG Arogya Sanjeevani Health Insurance Policy. Age: If
you fall within the age group of 18 to 65 years, you can enrol in our Arogya Health Insurance plan as
Proposer. However, if you are older than 65 years but wish to purchase the Arogya Sanjeevani plan

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for your family members, you can do so. In such a case, you cannot be covered by the benefits of the
plan.

Who Can Be Covered?:

You can bring the following family members under the umbrella of the coverage of a Tata AIG
Arogya Sanjeevani Health Insurance Policy.

• Legally Wedded Spouse

• Parents

• Parents-in-law

• Dependent Children (Natural as well as legally adopted) between the ages of 3 months and 25 years
It is important to note here that if your child is a financially independent adult, they shall not be
eligible for coverage in the Tata AIG Arogya Sanjeevani Policy upon subsequent renewals
Coronavirus Health Insurance The latest addition to our health insurance benefits is the Coronavirus
Protection which has been designed keeping in mind the various medical and financial challenges
caused by the ongoing global pandemic.

When you buy our health insurance plans, the sum insured covers the COVID19-related medical
expenses.The COVID-19 pandemic has torn millions of lives across the globe

• Vaporisation of the Prostate (Green laser treatment or holmium laser treatment)

• ION M - (Intra Operative Neuro Monitoring) Stem Cell therapy: Hematopoietic stem cells for bone
marrow transplant for haematological conditions to be covered Coverage for More Medical Expenses:
The Tata AIG Arogya Sanjeevani Health Insurance Policy also has coverage for some other medical
expenses, which are mentioned in Lists II to IV of Annexure A to the policy document. These include
the expenses that are to be categorised under room charges, procedure charges, and cost of treatment,
respectively.

Enhancement of Sum Insured: For each year that you do not file a health insurance policy claim on
your Arogya insurance with us, you can get a 5 to 50 per cent enhancement in your sum insured under
the policy. However, if you wish to be eligible for this benefit, you must ensure the timely renewal of
your Arogya Sanjeevani Health Insurance Policy.

Who is Eligible For Arogya Sanjeevani Health Insurance?

Before selecting our Arogya Sanjeevani Policy, you must ascertain whether you are eligible for it.
Here are the eligibility criteria for the Tata AIG Arogya Sanjeevani Health Insurance Policy.

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Age: If you fall within the age group of 18 to 65 years, you can enrol in our Arogya Health Insurance
plan as Proposer. However, if you are older than 65 years but wish to purchase the Arogya Sanjeevani
plan for your family members, you can do so. In such a case, you cannot be covered by the benefits of
the plan.

Who Can Be Covered?:

You can bring the following family members under the umbrella of the coverage of a Tata AIG
Arogya Sanjeevani Health Insurance Policy.

• Legally Wedded Spouse

• Parents

• Parents-in-law

• Dependent Children (Natural as well as legally adopted) between the ages of 3 months and 25 years

It is important to note here that if your child is a financially independent adult, they shall not be
eligible for coverage in the Tata AIG Arogya Sanjeevani Policy upon subsequent renewals

Coronavirus Health Insurance

The latest addition to our health insurance benefits is the Coronavirus Protection which has been
designed keeping in mind the various medical and financial challenges caused by the ongoing global
pandemic. When you buy our health insurance plans, the sum insured covers the COVID19-related
medical expenses.The COVID-19 pandemic has torn millions of lives across the globeIf you are
wondering whether you need COVID-19 insurance, wonder no more. No one is beyond the wingspan
of this brutal virus, and the only thing we can do is take all the necessary precautionary measures and
invest in a COVID-19 insurance policy. There are several reasons why you need a Corona Kavach,
some of which have been discussed below.It Covers The Cost of the Treatment For Covid-19: The
Tata AIG Corona Kavach Policy covers the cost of your medical treatment following a COVID-19
diagnosis, including hospitalisation, if necessary, and post-hospitalisation expenses.

With the high cost of ICU beds and their ever-rising demand in the wake of the pandemic, you
absolutely must have ample financial protection to be able to bear the burden of the associated
medical expenses. Therefore, you must invest in a Corona Kavach Policy online at the earliest.It
Offers Sufficient Insurance At Feasible Premiums: With our health insurance policies starting at just
₹15 per day, you can get comprehensive health insurance coverage at feasible rates. The Corona
Kavach Policy Premium is minimal, but the benefits of this cover are anything but.It Protects Your
Savings: The sudden diagnosis of COVID-19 and the cost of the treatment that is required for you to
recover from the infection can put a severe dent in your meticulously accumulated savings. This can

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have far-reaching consequences for your and your family's financial plans and future. In order to
prevent that from happening, you must purchase a Corona Kavach Policy now.

Who Needs Corona Kavach Insurance?

Since coronavirus is an air-borne infection, all of us need covid insurance. The virus does not
discriminate on the basis of age, gender, socio-economic status, or the condition of your health. From
a pregnant woman to an infant, from a healthy 25-year-old to a 55-year old with Asthma, everyone is
vulnerable to viral infection. However, COVID-19 affects us all in varying degrees, depending on a
variety of factors, including our immunity levels, pre-existing illnesses or lack thereof, and our overall
medical condition. One thing that is certain is that it weakens the body and exacerbates any existing
ailment. Therefore, it is incredibly important to follow all the health and safety guidelines released by
the government and health authorities. It is equally important to buy a COVID-19 insurance plan so as
to have adequate financial protection in the unfortunate event of you contracting the virus. This is why
you must not think twice before purchasing a Covid Kavach Policy. Not only must you purchase
COVID-19 insurance for yourself but also for your family. This is where a Tata AIG Family Floater
Health Insurance Plan can be handy since it provides coverage to several members of a family under
one plan. Whether you opt for our Individual Health Insurance Plan or our Family Floater Health
Insurance Plan, you shall benefit from a Corona Kavach Insurance cover.

Esurance Executive Policy Trying To Keep Up With Increasing Work Pressure Can Take Toll On
Your Health But Keeping Your Unique Requirements In Mind, We Offer A Health Insurance Product
That Protects You All Round With Minimum Fuss And Maximum Gain.

Reasons why this is the #RightInsurance There’s nothing like staying protected through life’s journey.
For your benefit: Hospitalisation: Specified hospitalisation benefit shall be provided if the insured
person is hospitalized for the treatment of injury/sickness. Post Hospitalization Expenses: Pays
lumpsum amount after hospitalisation under following circumstances only

• Post operative physiotherapy-eligibility: Minimum of 2 visits.

• Chemotherapy and/or radiation-eligibility: Minimum of 3 visits. Payable once during the lifetime of
the insured.

• Kidney dialysis Payable once during the lifetime of the insured. Value added service: Facilities like
free health line, health portal, health query, discounted services for the health and wellness and e-
news letter will be provided to the insured where he will get access to various health articles and will
be able to raise queries and get them answered by experts. Wellsurance Woman Policy Don’t Let
Your Own Health Slip Up While You Carry The Weight Of The Whole Family On Your Shoulders.
So, We Give You A Plan That Takes Care Of Everything For You, From A Simple Illness To A
Critical Emergency.
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Features that make it #RightInsurance :- With these superb features, you don’t have to worry about
small health glitches! Let’s take a look:

Ambulance Charges: Pays upto the specified amount towards the medical transportation fees and
services incurred for bringing the insured to the hospital following an accident and returning to the
normal place of residence after being discharged from the hospital.

ICU charges: For 15 days are included in our hospitalisation benefit. So, don’t stress about daily
expenses when you’re admitted to the Intensive care unit.

Cosmetic Reconstruction Surgery: Pays the specified amount if the surgery is conducted as a
reconstructive procedure on structures of the body for the purpose of the restoring/improving bodily
function or correcting significant deformity resulting from accidental injury as covered under the
hazard, subject to the maximum shown in the policy schedule.

Value added service: Facilities like free health line, health portal, health query, discounted services for
the health and wellness and e-news letter will be provided to the insured where he will get access to
various health articles and will be able to raise queries and get them answered by experts.

Health Insurance Premium Calculator

Buying a health insurance policy is an imperative need of the present. However, before you buy your
health plan, check the policy documents carefully and know your premiums.Tata AIG offers a free
online health insurance premium calculator to help you precisely determine the premiums for your
health insurance plan.

Health Insurance Calculator Overview

Your health is priceless. And, today, given the rising health risks, it is critical that people of ages,
income groups and genders invest in a comprehensive health insurance plan. A sound health plan
from Tata AIG can provide you with financial support during tough times and ensure you get the best
treatment possible without burdening your family with medical expenses.If you are wondering how
much will a health insurance policy cost, you can instantly calculate health insurance premiums
through the Tata AIG health insurance premium calculator. A health insurance premium calculator is
an online free tool that allows you to calculate your health insurance premiums per the inputs
provided.Online health insurance calculators are free, easy to use, and help you make an informed
decision when buying a health cover.

What Is A Health Insurance Calculator?

A health insurance policy is an affordable medium to financially protect yourself and your family
from unexpected medical expenses. Today, there are several types of health insurance plans available

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in the market. You can choose a mediclaim policy that best meets your needs. However, before you
buy a health insurance plan, it is important to know the amount an insurer will charge you for
providing the agreed health insurance coverage. This pre-determined sum of money that you are
required to pay to the insurance company to avail coverage and benefits under the health insurance
plan is known as a health insurance premium.

Generally, you pay premiums monthly, quarterly, semi-annually or annually during the policy tenure.
In return for the health insurance premiums paid, the insurance company is liable to pay for your
eligible medical expenses, hospitalisation bills and other policy benefits. As a wise investor, you can
ascertain the premium due for your chosen health insurance policy using the Tata AIG online health
insurance calculator. Using a mediclaim calculator will help you determine the total cost of buying
health insurance and accordingly, pick the right plan and sum assured for you and your family’s
needs.

A mediclaim policy calculator is an effective, easy and time-saving tool. You can generate your health
insurance premium effortlessly by entering your details, such as name, gender, age, members to be
insured, etc. Required Information For The Premium Calculation:- All health insurance premium
calculators in India, including the Tata AIG health insurance premium calculator, require you to input
only basic personal details, such as:

• Name, age, gender, city, email, contact details, etc.

• Lifestyle habits such as smoking, drinking, consuming tobacco, etc.

• Medical history such as existing diseases like diabetes, etc.

• Policy type and tenure

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CHAPTER-3

COMPANY PROFILE

Tata AIG General Insurance Company Limited is a joint venture company between Tata Group and
American International Group (AIG).

Tata AIG General Insurance Company Limited celebrates 20 years of service as on 2020, since it
commenced operations in India on January 22, 2001. The Company has grown strongly to emerge as
the preferred private general insurance company in India with several pioneering firsts to its
credit.Driven by a mission to create better tomorrows for Customers by delivering trustworthy and
innovative risk solutions, Tata AIG’s broad portfolio of protection covers are backed by years of
professional expertise in product offerings, exceptional service capabilities and seamless claims
process … management.

The Company offers a wide range of general insurance covers for businesses and individuals
including a comprehensive range of general insurance products for Liability, Marine Cargo, Personal
Accident, Travel, Rural-Agriculture Insurance, Extended Warranty etc. Tata AIG General Insurance
Company Limited has an asset base of approximate INR 10,050 crs. (as of 31st March 2019). With
200 offices spread across India, the Company has a robust multi-channel distribution network of
40,000+ licensed agents and 437+ licensed brokers.

The Company has a workforce of over 6,000 employees, including 550+ claim experts and a
dedicated Customer Service & Operations team (as of March 2019), consistently delivering superior
service experiences powered by the latest innovations in technology. Tata AIG General Insurance
Company Limited (We, Our or Us) will provide the insurance described in this Policy and any
endorsements thereto for the Insured Period as defined in this Policy, to the Insured Persons detailed
in the Policy Schedule and in reliance upon the statements contained in the Proposal and Declaration
Form filled and signed by the Policyholder, which shall be the basis of this Policy and are deemed to
be incorporated herein in return for the payment of the requisite premium when due, and compliance
with all applicable provisions of this Policy. The insurance provided under this Policy is only with
respect to such and so many of the benefits upto the Sum Insured set in the Policy Schedule subject to
the terms and conditions contained in this policy.

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This Policy will only be in force if the Policy Schedule is signed by a person We have authorized. The
times may have changed but the old adage 'health is wealth' still holds true, perhaps more today than
ever before. With the certain degree of uncertainty that surrounds one's health, it is important to
exercise some level of control to prepare for health-related expenses.

That is where medical insurance comes in! A health insurance policy is a product that protects you
against the financial implications of a wide variety of health-related expenses, ranging from those
caused by minor illnesses and injuries to critical diseases.

Therefore, health insurance plans and the sum insured serve as a protective financial shield for you
should you be faced with a major medical expense. Selecting a suitable medical insurance is difficult
yet incredibly important for you to have a sufficient degree of preparedness against any sudden and, in
some cases, expected medical expenses. Imagine a scenario wherein you are diagnosed with a serious
medical condition that requires consistent treatment, hospitalisation, and/or surgery. In such a
situation, you would not want to let your medical bills dig a massive hole in your savings or be faced
with a financial crisis to pay said bills,

will you? Hence it is pivotal to buy a suitable health insurance plan, choose the right sum insured,
pay the applicable premium and get insured at the earliest, and we can help you with that. Selecting a
health insurance plan is not as easy as buying groceries or even big consumer items such as
refrigerators and washing machines. This decision entails a substantial degree of analysis and the
careful consideration of various factors, including your health insurance requirements, the sum
insured and the amount you can shell out on health insurance premiums. Why Do I Need Health
Insurance? There is so much unpredictability encompassing one's health and it is almost impossible to
have any control over health-related expenses. However, after getting insured with a suitable health
insurance plan, you can exercise some degree of control and gain some security vis-a-vis your and
your family’s health care expenses. The question 'why you need health insurance' can be answered in
countless ways, and here are a few of them.

Tata AIG General Insurance Company Limited (Tata AIG General) is a business collaboration of
the Tata Group and American International Group, Inc. (AIG). This joint venture has started its
operations in India from 22 January 2001. The company provides corporate and personal insurance
services and automotive insurance as well.

The organization offers general insurance. The commercial sector

covers Energy, Marine, Property and specialized Financial covers. The consumer insurance service
offers a variety of general Insurance products such as insurance for Automobiles, personal accident,
casualty, home, health and travel.

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The company has made the availability for its services from end-to-end channels of distribution like
agents, banks (through bancassurance tie ups), brokers and direct channels like tele-marketing,
e-commerce, website, etc.

In 2019,Indian Bank had joined hands with company to offer the latter’s diverse range of general
insurance policies for the benefit of the bank’s customers by way of protection, wealth creation and
savings and as per the agreement Tata AIG General Insurance will work with the bank for sales
training, product support and ensuring smooth operational processes.

In 2020, the company had launched Tata AIG Tara, which is an insurance service through WhatsApp
and with the help of artificial intelligence this initiative will offer customers a variety of solutions to
their policy related queries in a timely, efficient and precise way. This will help customers to access
their policies in a virtual form, avail policy documents, request and receive renewal details, make
premium payment online, seek support on claims, locate network hospitals and garages, make
changes in address or any other personal details and can be used as a forum to buy a health or motor
policy of their choice.

The headquarters is in Mumbai. The company is active in more than 160 locations.

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Type Joint venture 3.1

Industry Financial services

Founded 2001

Headquarters Mumbai, India

Key people Neelesh Garg (MD & CEO)[1]

Products Health insurance

Travel insurance
Vehicle insurance

Revenue  ₹9,942.81 crore (US$1.2 billion) (2023) [2]

Operating income  ₹738.27 crore (US$92 million) (2023) [2]

Net income  ₹553.05 crore (US$69 million) (2023) [2]

Parent Tata Sons (74%)

American International Group (26%)

Website www.tataaig.com

COMPANY PROFILE

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In 2020,the company had launched new policy called 'AutoSafe',which offers usage-based insurance
cover to private car owners which will help reduce the overall premium payout. [4] The app helps
policyholders by saving on premium amount by providing an option to select the kilometers-driven,
promoting safe driving and works as anti-theft device as it comes with a GPS-based tracking facility
and uses telematics-based next-generation application system and as a device to track the usage of the
car and decide on the premium amount.[4] The app helps in tracking the distance covered by the
vehicle, speed and other driving related features and also offers extra kilometers running for efficient
driving practices at the time of the renewal and is available on all policies offered on personal
accidental cover to the tune of Rs 15 lakh for owner and driver. [4] The app will help Policyholders to
benefit from flexible kilometre-based premium as it will promote savings and policyholders can
choose between 2,500, 5,000, 7500, 10,000, 15,000 and 20,000 km and if all the kilometres is
exhausted within the policy time period it has a option of top-up km between 500 and 1,500 km. The
device is GPS-enabled which is linked to the mobile app which will help in recording all information,
tracking the distance travelled and generates reports about vehicle condition or driving habits of the
policyholder and is fitted or linked to the car as the insurance policy becomes valid and must be held
during the valid period of the policy and comes with motion sensor and generates fuel based saving
reports in addition to monitoring hard-braking, night time driving and acceleration apart from
guarding against fuel slippage and dangerous driving habits.

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In 2021,company launched Tata AIA Life Fortune Guarantee Plus, a flexible, non-linked, non-
participating savings plan which offers policy holders guaranteed long-term income along with
comprehensive protection cover and in addition to long-term guaranteed income for future financial
needs, the plan also covers health protection in the event of the policyholder getting diagnosed with a
Critical diseases. This scheme offers two income options – Regular Income or Regular Income with
an inbuilt Critical Illness benefit wherein all future premiums stand waived if the insured is diagnosed
with a Critical Illness during the premium payment term and guaranteed minimum income will
commence which frees the policyholder on worrying about his income and focus on his health
recovery. The policyholder also has the option to choose the income frequency between monthly or
annual payout options and as per the terms of the policy the guaranteed income starts from the 6th
Policy year for a period ranging from 20 to 45 years and they can select a premium payment term
between 5-12 years, and the single premium payment option offers the freedom to go for Joint Life
coverage which ensures that policy continues even if one of the two passes away. Additionally it
offers an benefit of inbuilt Return of Premium benefit which allows the policyholder to get the total
premiums paid (excluding loading for modal premiums and discount) after the duration of income
Period.

Products and services

 Tata AIG Car Insurance

 Tata AIG Two Wheeler Insurance
 Tata AIG Health Insurance
 Tata AIG Travel insurance
 Tata AIG Home Insurance
 Tata AIG Property Insurance
 Tata AIG Marine Insurance

3.3 VISION AND MISSION

Our Vision

To be the leader in the general insurance industry by 2025, by caring for our customers and offering
them innovative risk solutions.

To be India’s most preferred general insurance company.

By FY 2024, we will become the most aspirational indian auto brand, consistently winning,by

. Delivering superior financial retruns

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.Driving sustainable mobility solutions

. Exceeding customer expectations and creating a highly engaged work force .

Our Mission

Create better tomorrows for our customers by delivering innovative risk solutions and providing peace
of mind.

We innovate solutions with passion to enhance the quality of life .

CHAPTER-4

DATA ANALYSIS AND INTERPRETATION

4.1 INTRODUCTION

Data analysis is the process of inspecting, cleansing, transforming, and modelling data with the goal

of discovering useful information, informing conclusions, and supporting decision-making. Data
analysis has multiple facets and approaches, encompassing diverse techniques under a variety of
names, and is used in different business, science, and social science domains. In today's business

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world, data analysis plays a role in making decisions more scientific and helping businesses operate
more effectively.

Data mining is a particular data analysis technique that focuses on statistical modelling and
knowledge discovery for predictive rather than purely descriptive purposes, while business
intelligence covers data analysis that relies heavily on aggregation, focusing mainly on business
information.[4] In statistical applications, data analysis can be divided into descriptive
statistics, exploratory data analysis (EDA), and confirmatory data analysis (CDA). EDA focuses on
discovering new features in the data while CDA focuses on confirming or falsifying
existing hypotheses.

4.2 TABLE

4.3 TABLE

The Growth Ratio of health insurance schemes in India the percentage of increase and decrease, are
exhibited in Table 4.1.

Table-1.1

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Growth of Health Insurance in India (lakhs.)

S. No Year % Growth
Public Private
1. 2005-2006 12.64% 91.84%
2. 2006-2007 23.20% 77.45%
3. 2007-2008 17.48% 129.12
4. 2008-2009 58.68% 60.83%
5. 2009-2010 21.92% 38.58%
6. 2011-2012 32.91% 32.47%
7. 2012-2013 21.69% 12.46%
8. 2013-2014 34.35% 17%
9. 2014-2015 35.24% 18%
10. 2015-2016 36.21% 20%

Source: Compiled from Annual reports of IRDA of different years

From the Table 1.1 its can understand that the growth Rate of health insurance schemes that public
health insurance company has highest growth rate in 2015-16 36.21% and lowest value for 2007-
2008. The private health insurance company has highest value of 2005-2006 in 91.84% and lowest
growth rate 2012-13. Premium of health insurance schemes in India

4.4 TABLE

The Premium of health insurance schemes in India, growth rate are exhibited in Table.

Premium of health insurance schemes in India (lakhs.)

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S. No Year Premium Growth (%)

1 2005-2006 50387.87 -

3 2006-2007 57098.90 13.31%

4 2007-2008 60361.32 5.71%

5 2008-2009 79422.97 31.43%

6 2009-2010 69529.41 -12.45%

7 2010-2011 82007.05 17.94%

8 2011-2012 83174.03 1.42%

9 2012-2013 84387.09 1.45%

10 2013-2014 85022.12 0.75%

11 2014-2015 87542.21 2.96%

12 2015-2016 89635.32 2.39%

Mean 75324.39 -
Standard Deviation 13655.78 -
Co-Variance 18.12929 -

Source: Compiled from Annual reports of IRDA of different years

From the Table 1.2 its can understand that the growth Rate of Premium of Health Insurance company
has highest growth rate of 2008-09 in 31.43 % and lowest value for 2009-10 in 12.45%. The Mean
value of premium is 75324.39.

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4.5 TABLE

Claims Ratio of health insurance schemes in India

The Claims Ratio of health insurance schemes in India the percentage of increase and decrease, are
exhibited in Table .

Claims Ratio of health insurance schemes in India (lakhs.)

S. No Year Growth (%)

public Private

1 2005-2006 92.34 % 50.75%

3 2006-2007 153.89% 94.63%

4 2007-2008 157.79% 103.42%

5 2008-2009 94.84% 112.36%

6 2009-2010 85.33% 116.6%

7 2010-2011 119.85% 92.22%

8 2011-2012 106.31% 85.15%

9 2012-2013 77.08% 100.28%

10 2013-2014 79.08% 103.21%

11 2014-2015 81.20% 103.25%

12 2015-2016 81.35% 104.23%

Source: Compiled from Annual reports of IRDA of different years

From the Table 1.3 its can understand that the growth Rate of health insurance schemes that public
health insurance company has highest growth rate in 2010-11 119.85 % and lowest value for 2013.-
2014. The private health insurance company has highest value of 2008-2009 in 112.36% and lowest
growth rate 2005-06.

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Health Insurance Portfolio in India

Let us try to make projections for next 6 years. We have done this with growth rate of 12%, 20%,
30% & 60%.
4.6 TABLE

Health Insurance Portfolio

Year If Growth If Growth is 20% If Growth is If Growth is 60%

is 12% 30%

2011-12 13345 13345 13345 13345

2012-13 14946 16014 17348 21352

2013-14 16740 19217 22553 34163

2014-15 18749 23060 29319 54661

2015-16 20999 27672 38115 87458

2016-17 23519 33207 49549 139932

2017-18 26341 39848 64414 223892

Healthcare industry is growing at a tremendous pace owing to its strengthening coverage, services and
increasing expenditure by public as well private players. During 2008-20, the market is expected to
record a CAGR of 16.5 per cent.

The total industry size is expected to touch US$ 160 billion by 2017 and US$ 280 billion by 2020. As
per the Ministry of Health, development of 50 technologies has been targeted in the FY16, for the
treatment of disease like Cancer and TB.

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Level of claims of Apollo Munich health insurance

The Claims of health insurance schemes in Apollo Munich the Growth rate are exhibited in Table 1.6

4.7 TABLE

Level of claims of TATA AIG health insurance

S.No Year Claims Growth rate (%)

1 2012 2513604 -

2 2013 2619753 4.22%

3 2014 3564360 36.15%

4 2015 3652412 2.47%

5 2016 3741250 2.43%

Mean 3302422 -

Standard Deviation 684579 -

Co-Variance 20.7296 -

Source: Computed

From the Table 1.6 its can understand that the growth Rate of Premium of Apollo Munich Health
Insurance company has highest growth rate of 2013 in 25.30 % and lowest value for 2015. The Mean
value is 4995505.

CHAPTER-5

FINDINGS ,SUGGESTION,CONCLUSION

5.1 FINDINGS

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 From the Table 4.1 its can understand that the growth Rate of health insurance schemes
that public health insurance company has highest growth rate in 2015-16 36.21% and
lowest value for 2007-2008. The private health insurance company has highest value of
2005-2006 in 91.84% and lowest growth rate 2012-13.
 From the Table 1.2 its can understand that the growth Rate of Premium of Health
Insurance company has highest growth rate of 2008-09 in 31.43 % and lowest value
for 2009-10 in 12.45%. The Mean value of premium is 75324.39.
 From the Table 1.3 its can understand that the growth Rate of health insurance schemes
that public health insurance company has highest growth rate in 2010-11 119.85 % and
lowest value for 2013.-2014. The private health insurance company has highest value of
2008-2009 in 112.36% and lowest growth rate 2005-06.
 From the Table 1.5 its can understand that the growth Rate of Premium of Apollo
Munich Health Insurance company has highest growth rate of 2013 in 25.30 % and
lowest value for 2015. The Mean value of 4995505.
 From the Table 1.6 its can understand that the growth Rate of Premium of Apollo
Munich Health Insurance company has highest growth rate of 2013 in 25.30 % and
lowest value for 2015. The Mean value is 4995505.
 From the Table 1.7 its can understand that the growth Rate of Premium of Apollo
Munich Health Insurance company has highest growth rate of 2015 in 22.99% and
lowest value for 2016. The Mean value is 615654.
 From the Table 1.08 its can understand that the growth Rate of Premium of Apollo
Munich Health Insurance company has highest growth rate of 2014 in 48.14 % and
lowest value for 2016. The Mean value is 5336728.

5.2 SUGGESTIONS
• Encouraged by IRDA( Insurance Regulatory Development Authority) by providing
subsidies to increase the level of premium
• Provide financial incentives of policy holders.
• Liberal financial assistance should be available to the growers in the form premium
loans and development loans
• Provide assistance for eliminating the risk of life towards the nominees.

5.2 Conclusion

Assessment of the real world impact of health insurance requires a holistic, multi-disciplinary
analysis that captures its complexity and is sensitive to the larger social, political, and economic
context in which policy is created and introduced.

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A health policy and systems research approach promotes such ‘systems thinking’ and explores
why and how certain programs work for some, but not for others (Gilson et al. 2011; Mishra
2013). Such research must be people-centered and attentive to human agency, social relations,
cultural values, and trust (Sheikh, Ranson, and Gilson 2014). At the same time, it should also be
policy-minded and attentive to processes, structures, and power relations that constitute the field
in which a policy is both constructed and negotiated.In the case of health insurance, research
needs to take stock of those factors that lead citizens to enroll in and drop out of insurance
programs as well as to use insurance in particular ways. It should also investigate the impact of
insurance on the way healthcare is administered at multiple levels.

Medical anthropology could play a vital role in this research agenda, as is evident from a few of
the many lines of potential research proposed in this paper. Among other issues, we highlighted
the following six key areas for in-depth research:

(1) public awareness and understanding of insurance

(2) impact of misunderstanding on health seeking behavior and treatment

(3) differences in behavior patterns in cash and cashless insurance systems

(4) impact of insurance on quality of care

(5) (mis)trust in health insurance schemes

(6) health insurance coverage

especially in relation to chronic illnesses, rehabilitation and OOP expenses. These topics emerged
from our interviews time and again, and, combined with the literature review, they indicate where
most misunderstandings and tensions occur.

A better grasp of the enumerated areas could potentially lead to improvements in providing,
explaining and implementing health coverage, especially for those with limited resources. We
conclude with a call for organizational ethnographies of insurance that include what Laura Nader
(2008) has referred to as ‘up, down, and sideways’ perspectives. This refers to the study of those
in power (policy makers and influential stakeholders), those subjected to the directives of those in
power (parties charged with implementing programs downstream as well as program recipients),
and those who are motivated to frame, fund, and publicize research on insurance for a myriad of
purposes. The Committee's overarching conclusion is that insurance coverage within a family
concerns and may affect the entire family unit. The lack of insurance of any family member has
the potential to affect the financial and emotional well-being of all members of the family. Tata
AIG General Insurance Company Limited is a joint venture company between Tata Group and
American International Group (AIG).
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Tata AIG General Insurance Company Limited celebrates 20 years of service as on 2020, since it
commenced operations in India on January 22, 2001. The Company has grown strongly to emerge
as the preferred private general insurance company in India with several pioneering firsts to its
credit.Driven by a mission to create better tomorrows for Customers by delivering trustworthy
and innovative risk solutions, Tata AIG’s broad portfolio of protection covers are backed by years
of professional expertise in product offerings, exceptional service capabilities and seamless claims
process management.

The Company offers a wide range of general insurance covers for businesses and individuals
including a comprehensive range of general insurance products for Liability, Marine Cargo,
Personal Accident, Travel, Rural-Agriculture Insurance, Extended Warranty etc. Tata AIG
General Insurance Company Limited has an asset base of approximate INR 10,050 crs. (as of 31st
March 2019). With 200 offices spread across India, the Company has a robust multi-channel
distribution network of 40,000+ licensed agents and 437+ licensed brokers.

The Company has a workforce of over 6,000 employees, including 550+ claim experts and a
dedicated CustomerConclusion Assessment of the real world impact of health insurance requires a
holistic, multi-disciplinary analysis that captures its complexity and is sensitive to the larger
social, political, and economic context in which policy is created and introduced.

A health policy and systems research approach promotes such ‘systems thinking’ and explores
why and how certain programs work for some, but not for others (Gilson et al. 2011; Mishra
2013). Such research must be people-centered and attentive to human agency, social relations,
cultural values, and trust (Sheikh, Ranson, and Gilson 2014).

At the same time, it should also be policy-minded and attentive to processes, structures, and
power relations that constitute the field in which a policy is both constructed and negotiated.In the
case of health insurance, research needs to take stock of those factors that lead citizens to enroll in
and drop out of insurance programs as well as to use insurance in particular ways. It should also
investigate the impact of insurance on the way healthcare is administered at multiple levels.
Medical anthropology could play a vital role in this research agenda, as is evident from a few of
the many lines of potential research proposed in this paper. Among other issues, we highlighted
the following six key areas for in-depth research:

(1) public awareness and understanding of insurance

(2) impact of misunderstanding on health seeking behavior and treatment

(3) differences in behavior patterns in cash and cashless insurance systems

(4) impact of insurance on quality of care

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(5) (mis)trust in health insurance schemes

(6) health insurance coverage, especially in relation to chronic illnesses, rehabilitation and OOP
expenses. These topics emerged from our interviews time and again, and, combined with the
literature review, they indicate where most misunderstandings and tensions occur.

A better grasp of the enumerated areas could potentially lead to improvements in providing,
explaining and implementing health coverage, especially for those with limited resources. We
conclude with a call for organizational ethnographies of insurance that include what Laura Nader
(2008) has referred to as ‘up, down, and sideways’ perspectives. This refers to the study of those
in power (policy makers and influential stakeholders), those subjected to the directives of those in
power (parties charged with implementing programs downstream as well as program recipients),
and those who are motivated to frame, fund, and publicize research on insurance for a myriad of
purposes. The Committee's overarching conclusion is that insurance coverage within a family
concerns and may affect the entire family unit. The lack of insurance of any family member has
the potential to affect the financial and emotional well-being of all members of the family.

Tata AIG General Insurance Company Limited is a joint venture company between Tata Group
and American International Group (AIG). Tata AIG General Insurance Company Limited
celebrates 20 years of service as on 2020, since it commenced operations in India on January 22,
2001.

The Company has grown strongly to emerge as the preferred private general insurance company
in India with several pioneering firsts to its credit.Driven by a mission to create better tomorrows
for Customers by delivering trustworthy and innovative risk solutions, Tata AIG’s broad portfolio
of protection covers are backed by years of professional expertise in product offerings,
exceptional service capabilities and seamless claims process … management.

The Company offers a wide range of general insurance covers for businesses and individuals
including a comprehensive range of general insurance products for Liability, Marine Cargo,
Personal Accident, Travel, Rural-Agriculture Insurance, Extended Warranty etc. Tata AIG
General Insurance Company Limited has an asset base of approximate INR 10,050 crs. (as of 31st
March 2019). With 200 offices spread across India, the Company has a robust multi-channel
distribution network of 40,000+ licensed agents and 437+ licensed brokers. The Company has a
workforce of over 6,000 employees, including 550+ claim experts and a dedicated Customer.

BIOGRAPHY

WEBSITE:

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 A PROJECT REPORT ON HEALTH INSURANCE AT TATA AIG

1.www.tataaig.health insurance.com

2.www.google.com

QUESTIONNAIRE

Dear sir/madam ,I am kavya n pursuing B.com final year in the national college jayanagar.

As part of the project, I am conducting a survey about ‘health insurance at TATA AIG GENERAL
INSURANCE COMPANY .’

I request you to kindly fill the questionnaire below and assure you that the data generated shall be
kept confidential.

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THE NATIONAL COLLEGE OF AUTUNOMOUS JAYANAGAR
DPT.OF COMMERCE
 A PROJECT REPORT ON HEALTH INSURANCE AT TATA AIG

PERSONAL DETAILS

1.Name :

2.Gender:

3.Age:

A) 18-25

B) 25-32

C) 32-40

D) 40-48

E) 48 and above

4.What does the ‘ BRAND’ mean to you ?

5)

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THE NATIONAL COLLEGE OF AUTUNOMOUS JAYANAGAR
DPT.OF COMMERCE