Tata AIG Health Insurance Claim Settlement

TATA AIG has put in place a customer-friendly claim settlement process. You can quickly register a claim and get it settled regardless of the TATA AIG health insurance policy you have. TATA AIG provides quick and easy claim settlement with a team of professional claim settlement professionals. 

TATA AIG General Insurance Company’s health claim settlement ratio is 96 per cent, which gives customers adequate trust to buy health insurance from them. In the insurance market, TATA AIG General Insurance is a well-known name. For nearly two decades, the insurer has remained active in the market. The insurance firm has earned the trust of millions of clients thanks to its excellent service and products.

TATA AIG Health insurance

The TATA Group and AIG have partnered to form TATA AIG General Insurance Company Limited. TATA AIG General Insurance has been in the insurance business for nearly two decades, having first opened its doors on January 22, 2001. With its extensive range of products and unmatched services, the company has become a household name for insurance needs over the years.

TATA AIG General Insurance offers a variety of health insurance policies for individuals, families, women, and older citizens, as well as plans for specific diseases and critical illnesses. To provide a quick, efficient, and hassle-free claim settlement procedure for its consumers, the insurer maintains partnerships with over 3,000 hospitals in its network of cashless hospitals.

TATA AIG Health Insurance Claim Process

The health insurance claim process is a method in which a policyholder submits a request for reimbursement from the insurance provider for medical expenses incurred. A health insurance claim can be submitted in one of two ways: cashless or reimbursement.

Claim Process for Cashless Treatment

If you are hospitalised in a network hospital, you do not have to pay a single penny to settle the bill in cashless claims. TATA AIG responses to cashless claims in less than 4 hours. These benefits are available at TATA AIG’s more than 3,000 network hospitals.

• To begin, locate a TATA AIG network hospital in the city where you wish to receive cashless services. 
• In the case of emergency hospitalisation, notify the TPA within 24 hours, and 48 hours before admission in the case of a planned hospitalisation. 
• Carry your TATA AIG cashless card and one photo ID proof with you when you go to the hospital. 
• Show the cashless card and ID proof to the hospital’s insurance desk.
• Fill out the pre-authorization request form at the hospital and return it to them. 
• The network hospital delivers the pre-authorization request form to TATA AIG after verifying your identity. 
• The insurance company then sends the confirmation to the hospital and the policyholder through fax or email.
• The hospital costs are cleared by the insurer once the formalities are completed and the claim is granted according to the terms and conditions.

Reimbursement Treatment

If your request for a cashless claim was denied or you had treatment at a non-network hospital, don’t worry. You still have the option of filing a claim for reimbursement of your expenses. For the reimbursement claim, follow the steps below:

• After the treatment, pay the non-network hospital’s medical bills. 
• Make contact with the TPA and keep the policy information handy. Collect important documentation and submit it to the TPA. 
• Your files will be examined. 
• If necessary, you may be asked to provide more documentation. 
• The claim will be resolved in accordance with the policy’s terms and conditions.
• Once approved, the amount will be reimbursed to you.

Documents Required for Filing a Claim

In the case of hospital cash or medical benefits:

• Duly filled and signed the claim form 
• Report from the consulting doctor 
• Doctor’s prescription and bills 
• X-ray and pathological reports 
• Discharge report including the treatment details

In case of weekly benefits:

• Duly filled and signed claim form 
• Diagnostic lab reports 
• Report from the consulting doctor 
• Disability certificate, if any 
• Original discharge report at the time of hospitalization 
• For salaried employees a leaving certificate from the employer mentioning the designation
• Latest salary certificate

Tata AIG Health Insurance Claim Settlement Ratio

The Claim Settlement Ratio is a percentage of the total number of health insurance claims received by an insurance provider during a financial year divided by the number of claims settled. For the last two years, below are the data for TATA AIG Health Insurance’s health insurance Claim Settlement Ratio:

• FY 2018-2019 – 78.93%
• FY 2019-2020 – 76.04 %

Reviews and Ratings

The policy has an impressive rating of 4.6/5 based on 39 reviews from Policy Bazaar. Insurance Dekho has given the policy a rating of 4.4/5 based on 53 reviews. 

Sherya – As per my experience, TATA AIG is one of the best health companies to rely on. I am so glad that I choose this insurance company for protecting my and my family s healthcare needs.
Ila Kapoor – I bought this policy because my sister referred this company to me. Honestly, I am very much satisfied with the services. Good Company.