Health Insurance 931 views February 16, 2021

Tata AIA Life Insurance Vital Care Pro Plan is a non-linked non-participating health insurance plan which provides a lump sum to the insured upon diagnosis of any of the 15 critical illnesses as specified in the plan. We will talk about such illnesses later. At first, you can check out the key features of this plan at a glance.

  1. Lump sum up to INR 60 lakh
  2. No medical examination required
  3. A monthly payout on diagnosis of critical illness for up to 10 years
  4. Floater option to Cover your spouse

Read this page further and know about the above-mentioned features in detail.

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Tata AIA Life Insurance Vital Care Pro Plan Options

You need to choose from the following while purchasing the Tata AIA Life Insurance Vital Care Pro Plan.

Individual LifeJoint Life
Pro CarePro Care PlusDuo CareDuo Care Plus
100% basic sum assured is paid to the insured if he/she survives for 30 days from the date of diagnosis of critical illness or the date of surgery.100% basic sum assured is paid in lump sum immediately and 1/120th of the basic sum assured will be payable in installments up to 120 months, provided the insured has survived for 30 days from the date of diagnosis of critical illness or the date of surgery.100% basic sum assured becomes payable if any of the insured members survive for 30 days from the date of diagnosis of critical illness or the date of surgery.100% basic sum assured is payable in lump sum immediately plus 1/120th of the basic sum assured will be payable in installments up to 120 months if any of the insured members have survived for 30 days from the date of diagnosis of critical illness or the date of surgery.

Note:– In Joint Life, if any one of the insured members dies before any Critical Illness claim, the policy will continue on surviving life for the remaining policy term. But the premiums will be changed to the individual premium rate.

Eligibility for Tata AIA Life Insurance Vital Care Pro Plan

To purchase this health insurance plan from Tata AIA, you need to meet the following –

  1. Minimum age required at entry – 18-65 years
  2. Maximum age allowed at maturity – 85 years

Note:- In the case of joint life, the maximum age at maturity will apply as per the older applicant.

Covered Critical Illnesses & Surgeries Under Tata AIA Life Insurance Vital Care Pro Plan

The sum insured for the plan shall be payable for any of the following critical illness or surgeries:-

  1. Cancer of Specified Severity
  2. Coma of Specified Severity
  3. Open Chest Coronary Artery Bypass Surgery
  4. Kidney Failure Requiring Regular Dialysis
  5. First Heart Attack of Specified Severity
  6. Stroke Resulting in Permanent Symptoms
  7. Permanent Paralysis of Limbs
  8. Open Heart Replacement Or Repair Of Heart Valves
  9. Major Organ or Bone Marrow Transplant
  10. Motor Neurone Disease With Permanent Symptoms
  11. Multiple Sclerosis With Persisting Symptoms
  12. Benign Brain Tumour
  13. Parkinson’s Disease
  14. Surgery to the Aorta
  15. Alzheimer’s Disease / Irreversible Organic Degenerative Brain Disorders

The above-mentioned critical illness or surgeries shall be admissible for claim under Tata AIA Life Insurance Vital Care Pro Plan if you submit proof of occurrence of the insured event, such as:

  1. Confirmation of the illness or surgery from an appropriate specialist medical practitioner. The concerned practitioner shouldn’t be the policy owner or the relatives of life assured or his/her spouse.
  2. Confirmatory investigations proceed including, but not limited to, clinical, radiological, histological and laboratory evidence.
  3. If a surgical procedure is going to be performed on the insured person, the procedure must be the usual treatment for the condition and should be medically necessary.

Other Benefits of Tata AIA Life Insurance Vital Care Pro Plan

Under this Tata AIA insurance policy, other than the above-mentioned benefits, you will also be entitled to the following:-

  1. The minimum premium amount for this health insurance plan is INR 3,600
  2. The basic sum insured for individual and joint life ranges from INR 5 lakh to INR 20 lakh for simplified issuance. And under this, no medicals are required.
  3. The basic sum insured for individual and joint life ranges from INR 20.01 lakh to INR 60 lakh for a fully underwritten issuance.
  4. Flexible policy term – 10 years, 15 years, 20 years, 25 years and 30 years
  5. Premium payment term will be the same as your chosen policy term
  6. Premium rates are guaranteed for the first 15 policy years and thereafter the company will review the premium rates based on the critical illnesses after getting approval from the Insurance Regulatory and Development Authority of India (IRDAI).
  7. Flexible premium payment modes such as yearly, half-yearly, quarterly and monthly
  8. A grace period of 15 (monthly) and 30 days (yearly, half-yearly, quarterly), so you can pay your premiums without any late payment charges
  9. In case your Tata AIA Life Insurance Vital Care Pro Plan lapses because of non-payment of premium, you can revive the policy within 2 years from the date of the first unpaid premium.
  10. Any critical illness claim shall be admissible under Tata AIA Life Insurance Vital Care Pro Plan after the expiry of a 90-day waiting period. This period shall start from the date of commencement or reinstatement, whichever is later.
  11. You’ll also get a free look period of 15 days (offline) and 30 days (distance marketing mode) starting from the date of receipt of the policy. During this period, you can review the terms and conditions of the Tata AIA Life Insurance Vital Care Pro Plan and can return the same if not agreeable. And if you cancel your policy during the free look period, you’ll be entitled to a refund of the paid premiums less proportionate risk premium, stamp duty and medical examination charges, if any.

Exclusions from Tata AIA Life Insurance Vital Care Pro Plan

Tata AIA won’t be liable for the medical expenses of critical illnesses or surgeries if they are caused due to the following:-

  1. Any critical illness that occurs within 90 days of policy issuance reinstatement date
  2. Any condition, ailment or injury which were diagnosed within 48 months before the purchase of this plan
  3. STD and its related complications, AIDS or HIV
  4. Failure to seek medical advice or treatment
  5. Self-inflicted injuries or suicide
  6. Abuse of intoxicating drugs, alcohol or such other solvent
  7. War
  8. Breach of law
  9. Accidental physical injury or illness due to participation in hazardous sports/pastimes
  10. Radioactive contamination caused by the nuclear accident
  11. Critical illness diagnosis and treatment outside India. However, this will not apply in the following countries:- Canada, Dubai, Hong Kong, Japan, Malaysia, New Zealand, Singapore, Switzerland, USA, and countries of the European Union.
  12. Tumors showing the malignant changes of carcinoma in situ
  13. Tumors that are histologically described as premalignant or non-invasive like carcinoma in situ of breasts, Cervical dysplasia CIN‐1, CIN ‐2 & CIN‐3
  14. Any skin cancer other than invasive malignant melanoma
  15. All tumors of the prostate if not histologically classified as having a Gleason score > 6 or having progressed to at least clinical TNM classification T2N0M0
  16. Papillary microcarcinoma of the thyroid < 1 cm in diameter
  17. Chronic lymphocyctic leukaemia < RAI stage 3
  18. Microcarcinoma of the bladder
  19. All tumors in the presence of HIV infection
  20. Coma due to drug and alcohol abuse
  21. Angioplasty and any other intra‐arterial procedures
  22. Any key‐hole or laser surgery
  23. Non‐ST‐segment elevation myocardial infarction with an elevation of Troponin I or T;
  24. Other acute coronary syndromes
  25. Any type of angina pectoris
  26. Transient ischemic attacks
  27. Traumatic injury of the brain
  28. The vascular disease affecting only the eye/optic nerve/vestibular functions
  29. Other stem‐cell transplants where only islets of Langerhans are transplanted
  30. Neurological damage such as SLE and HIV
  31. Cysts, granulomas, vascular malformations, hematomas, tumors of the pituitary gland, spine, tumors of the acoustic nerve. Calcification, meningiomas.
  32. Drug‐induced or toxic causes of Parkinson’s Disease
  33. Non‐organic diseases like neurosis and psychiatric illnesses
  34. Alcohol‐related brain damage
  35. Surgery performed using minimally invasive or intra‐arterial techniques

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