TATA AIA Life - Group Sampoorna Raksha

About Plan

Consistent lifestyle and financial security for self and family is what we all aspire for. But, how do we ensure both, in a life that is so uncertain Children's education, Home loan, Family's health and much more -we need to ensure that our family is not deprived of anything even in our absence. Tata AIA Life Insurance Group Sampoorna Raksha offers you the opportunity to cover a host of life s uncertainties - Death, Terminal Illness, Total Permanent Disability, Accidental Death, Cancer and Critical Illness. Should any of these eventualities come across, we will ensure the financial security by protecting the lives of your customers and employees, the most critical asset of an organization. A simple Life Insurance cover at an affordable rates for your customers.

Features

1. Provides comprehensive cover against Death, Illness or Disability
2. Flexibility to choose benefit options along with Death Benefit
- Cancer, Critical Illness, Terminal Illness, Total Permanent Disability and Accidental Death Benefit
3. Choose between Level or Reducing cover
4. Choice of Single Life and Joint Life coverage
5. Moratorium period of 1 month to 84 months with or without interest payment
6. Flexible Policy Term from 1 month to 40 years
7. Convenient premium payment option - Yearly Renewable, Single Pay and Limited/Regular
8. Lower premium rates for female lives except for Yearly Renewable
9. You may be eligible for tax benefits, as per applicable tax laws

Benefits

Type of Cover There are two types of cover available under the Product:
1) Level Coverage: The Sum Assured will remain unchanged throughout the term
2) Reducing Coverage: If the Sum Assured is linked to a loan, the Sum Assured will decreases in line with the loan repayment schedule. The reduction in Sum Assured shall be as per the interest rate considered at the time of risk commencement for the member. The loan interest should lie in the range of 0% to 36%.
If the Sum Assured is not linked to the loan then only Level coverage is available. Both the types of cover and the available benefit options must be chosen at inception and cannot be changed thereafter. If the Sum Assured is linked to a loan, it should not exceed the loan amount.
Optional Benefits One or more of the below benefit options can be chosen by the Master Policyholder/Insured Member with the above type of Cover.
i) Cancer Protect (Additional) - (Minor 25% and Major 100%) - Benefit term will be equal to the Policy Term/ Coverage Term or 7/10 years whichever is lower
ii) Critical Illness (Accelerated / Additional) - Benefit term will be equal to the Policy Term/ Coverage term or 7/10 years whichever is lower
iii) Accidental Death Benefit (Additional Benefit)
iv) Total and Permanent Disability (Accelerated)
v) Terminal Illness (Accelerated)

Entry Age Details

Minimum - 14 years
Maximum - 84 years

Maturity Age Details

Minimum Maturity Age: 18 years. Maximum Maturity Age depends on the Premium Payment Term(PPT)

Premium payment mode

Yearly Renewable/ Single / Annual / Half-yearly / Quarterly / Monthly

Sum Assured Details

Minimum - Rs.5,000 (Under Base Death Benefit and Each Optional Benefit)
Maximum - No Limits (Based on Board Approved Underwriting Policy

Death Benefits

Upon death of an Insured Member during the Coverage Term provided the coverage is in force, the Sum Assured shall be payable.

Maturity Benefits

If the Insured Member has opted for return of premium, We shall pay the premiums received for Insured Member s coverage, after deduction of the applicable taxes, cesses and levies, at Maturity. The return of premium option is available as below:
a) Policy Term 10 years with return of premium option for base Death Benefit; or
b) Policy Term greater than or equal to 15 years with return of premium option for Benefit Option/s
There is no Maturity Benefit for other options under this plan.

Survival Benefit

There is no Survival Benefit under this plan.

Tax Benefits

Premiums paid under this plan may be eligible for tax benefits under Section 80C of the Income Tax Act, 1961 and are subject to modifications made thereto from time to time. Moreover, Life Insurance proceeds enjoy tax benefits as per Section 10(10D) of the said Act. Income Tax benefits may be available as per the prevailing income tax laws, subject to fulfillment of conditions stipulated therein. Income Tax laws are subject to change from time to time. Tata AIA Life Insurance Company Ltd. does not assume responsibility on tax implication mentioned anywhere in this document. Please consult your own tax consultant to know the tax benefits available to you.

Free Look Period

The Policyholder/ Insured Member has a free look period of 15 days from the date of receipt of the Policy Document/ Certificate of Insurance to review the terms and conditions of the Policy Document/ Certificate of Insurance and if the Policyholder/ Insured Member disagree to any of those terms or conditions, they has the option to return the Policy Document/Certificate of Insurance to the Company for cancellation, stating the reasons for objection.

Grace Period

A Grace Period of fifteen (15) days for monthly mode and thirty (30) days for all other modes, from the due date will be allowed for payment of each subsequent premium. The coverage will remain in force during this period. In case premium in respect of Insured Member is collected by Master Policyholder within Grace Period but is not remitted to the Company for some reason, then on expiry of Grace Period, risk cover will continue in respect of those members. If the full premium for the first 2 years of coverage remains unpaid at the end of their Grace Period for Limited / Regular Pay 5 years, the Coverage shall lapse from the due date of the first unpaid premium. If any claim occurs during the Grace Period, any due premium (without interest) for the policy year in which claim occurs, of the Certificate of Insurance, shall be deducted from the claim proceeds payable for the Covered Member.

Surrender Details

The cover can be surrendered either by the Master Policyholder or Insured Member. Surrender Value shall be acquired during the Policy Term/ Member Coverage Term basis the Premium Payment Term as defined below.
1. In case of Single Premium policies, surrender value shall be payable at any point during the Member Coverage Term for both with and without Return of Premium Option.
2. In case of Limited Pay option, the surrender benefit will be available if at least two full years premiums are paid, in case of both with and without Return of Premium Option.
3. In case of Regular Pay option, the surrender benefit will be available if at least two full years premiums are paid, in case of With Return of Premium Option
By Insured Member - In case of Regular Premium or Limited Premium option, the surrender benefit will be available if at least two full years premiums are paid.
By Master Policyholder - In case of Regular Premium or Limited Premium option, the Policy can be surrendered by the Master Policyholder by giving a written intimation to the Company. In such cases, post surrender new enrolments will cease and the existing insured members shall continue to be covered under the Policy as an individual coverage on same terms and condition as those of the group Policy or avail surrender benefit and terminate the insurance cover.

Revival Details

For Single Pay: There is no revival option for Single Premium.
For Limited / Regular Pay years: If a premium is in default beyond the Grace Period and subject to the Policy/Certificate of Insurance not having been surrendered, it may be revived, in accordance with prevailing Underwriting Guidelines duly approved by the Board within five years after the due date of the first unpaid premium and before the end of the Coverage Term subject to:
(i) Insurance cover has not been surrendered;
(ii) A written application for revival is received from the Insured Member by the Company, together with evidence of insurability of the Insured Member, and
(iii) Payment of all overdue premiums with applicable interest charged by the Company to revive this cover

Claim & Solvency Ratio

Claim Ratio	Solvency Ratio
99% (2023-24)	2% (March 2024)

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Frequently Asked Questions About Insurance

Health

Life

Auto

Home

What is health insurance? +

Health insurance is a type of coverage that pays for medical and surgical expenses incurred by the insured. It may also provide coverage for other types of health-related costs, such as prescription drugs, mental health services, and preventive care.

Why do I need health insurance? +

Health insurance helps protect you from high medical costs. It provides access to medical care when you need it, helping to pay for doctor visits, hospital stays, surgeries, prescription medications, and other health-related services.

What is a premium? +

A premium is the amount you pay for your health insurance every month. Depending on your plan, the premium may vary based on factors like age, location, and level of coverage.

What is a deductible? +

A deductible is the amount of money you must pay out-of-pocket before your health insurance starts covering your medical expenses. For example, if you have a deductible of $1,000, you must pay $1,000 out-of-pocket before your insurance starts covering your medical bills.

What are copayments and coinsurance? +

Copayment (copay): A fixed amount you pay for a covered health care service, typically when you get the service. Coinsurance: The percentage of the cost you pay for covered health services after you've paid your deductible. For example, if your coinsurance is 20%, you pay 20% of the bill, and the insurance company pays the remaining 80%.

What is an out-of-pocket maximum? +

The out-of-pocket maximum is the maximum amount you can spend on your health insurance. If you exceed this amount, your insurance company will pay 100% of your medical expenses.

What is the difference between in-network and out-of-network providers? +

In-network providers: Health care providers that have a contract with your health insurance plan to provide services at negotiated rates. Out-of-network providers: Providers that don't have a contract with your insurance plan. Services from these providers may cost more or not be covered at all.

What is a Special Enrollment Period (SEP)? +

The Special Enrollment Period (SEP) is a special time during the year when you can sign up for or make changes to your health insurance plan. If you miss this period, you may have to wait until the next one unless you qualify for a Special Enrollment Period (e.g., due to a life event like marriage or having a baby).

Can I keep my doctor with health insurance? +

If you have a preferred doctor, it’s important to check if they are in-network with your insurance plan. If they are not in-network, you may need to pay more out-of-pocket, or you may have to switch to another doctor who is in-network.

What is a Health Savings Account (HSA)? +

A tax-advantaged account for people with high-deductible health plans (HDHPs). The funds roll over from year to year and can be used for qualifying medical expenses.

What is a Flexible Spending Account (FSA)? +

A tax-advantaged account for people with low-deductible health plans (LDHPs). The funds roll over from year to year and can be used for qualifying medical expenses.

What is a Health Maintenance Organization (HMO)? +

An HMO is a type of health insurance plan that requires you to choose a primary care physician (PCP) and get referrals from them to see specialists. HMOs often have lower premiums and out-of-pocket costs but offer less flexibility in choosing providers.

What is a Preferred Provider Organization (PPO)? +

A PPO is a health insurance plan that offers more flexibility in choosing healthcare providers and doesn’t require referrals to see specialists. You can see any doctor, but you’ll pay less if you use in-network providers.

What is the difference between a Health Savings Account (HSA) and a Flexible Spending Account (FSA)? +

HSA: A tax-advantaged account for people with high-deductible health plans (HDHPs) The funds roll over from year to year and can be used for qualifying medical expenses. FSA: A tax-advantaged account for people with low-deductible health plans (LDHPs) The funds roll over from year to year and can be used for qualifying medical expenses.

What does the term "pre-existing condition" mean? +

A pre-existing condition is a medical condition that you had before you got your health insurance. It could include things like diabetes, high blood pressure, or heart disease.

Can I cancel my health insurance at any time? +

Yes, you can cancel your health insurance plan at any time. However, if you cancel outside the open enrollment period, you may not be able to get another plan until the next enrollment period unless you qualify for a Special Enrollment Period.

Are prescription drugs covered by health insurance? +

Many health insurance plans cover prescription medications, but the coverage may vary. Plans typically have a formulary, or list of covered drugs, and different drugs may have different levels of coverage, depending on whether they are generic, brand-name, or specialty drugs.

What is preventive care? +

Preventive care includes health services that help prevent illnesses, such as vaccinations, screenings, and annual checkups. Under the Affordable Care Act, most preventive services are covered by health insurance plans at no additional cost to the policyholder.

What should I do if my health insurance claim is denied? +

If your claim is denied, you can appeal the decision. Review the denial letter for reasons, contact your insurer for assistance, and file a written request for a hearing. If you win the appeal, you may be able to get a refund or other compensation.

How can I choose the best health insurance plan for me? +

When selecting a plan, consider factors like: Your health care needs (e.g., frequent visits, prescriptions) The plan’s network of doctors and hospitals The cost of premiums, deductibles, copays, and out-of-pocket maximums Coverage for specialized care or treatments Compare the different plans and benefits to find one that meets your needs.

What happens if I don't have health insurance? +

If you don’t have health insurance, you can still access some health care services, such as emergency care, in-network doctors, and in-network hospitals. You may be eligible for Medicaid, which provides some health care services at no cost to you.

What is life insurance? +

Life insurance is a contract between you and an insurance company, where you pay regular premiums in exchange for a lump sum payment (death benefit) to your beneficiaries upon your death.

What are the different types of life insurance? +

Term Life Insurance: Provides coverage for a specific period (e.g., 10, 20, or 30 years). If you pass away during this term, your beneficiaries receive the death benefit. It does not build cash value. Whole Life Insurance: Offers lifetime coverage with a death benefit and also builds cash value over time, which you can borrow against or use. Universal Life Insurance: A flexible policy that allows you to adjust the premiums and death benefit while also building cash value.

How much life insurance coverage do I need? +

The amount of coverage you need depends on factors like your income, debts, family needs, and long-term financial goals. A common rule is to have coverage worth 10 to 15 times your annual income, but this can vary based on your individual situation.

What is the difference between beneficiaries and policyholders? +

The policyholder is the person who owns the life insurance policy and pays the premiums, while the beneficiary is the person or group that receives the death benefit when the policyholder passes away.

Can I change my beneficiaries? +

Yes, you can change your beneficiaries at any time during the life of the policy, as long as the policy is in force and you follow the correct procedure with the insurance company.

What is the contestability period? +

The contestability period is the time during which you have the right to contest the decision of the insurer to pay the death benefit. This period varies depending on the type of life insurance policy and the insurer.

Does life insurance cover accidental death? +

Some life insurance policies include accidental death coverage, while others may require a separate rider for this benefit. Be sure to review your policy to understand what’s covered.

Can I cancel my life insurance policy at any time? +

Yes, you can cancel your life insurance policy at any time, provided you follow the correct procedure with the insurance company.

What is cash value? +

Cash value is the accumulated value of the life insurance policy that can be used to pay for expenses, such as medical bills or funeral expenses.

How do I borrow against cash value? +

You can borrow against the cash value of your life insurance policy, but it will need to be repaid, and any unpaid loan will reduce the death benefit.

What is the difference between whole life and universal life insurance? +

Whole life insurance provides coverage for a specific period (e.g., 10, 20, or 30 years) and builds cash value over time. Universal life insurance offers lifetime coverage with a death benefit and also builds cash value over time.

How are life insurance premiums determined? +

Life insurance premiums are based on factors like age, health, lifestyle (e.g., smoking), coverage amount, and type of policy. Generally, younger, healthier individuals pay lower premiums.

Can I borrow money from my life insurance policy? +

If you have a whole life or universal life policy, it may build cash value over time. You can borrow against this cash value, but it will need to be repaid, and any unpaid loan will reduce the death benefit.

What happens if I stop paying my life insurance premiums? +

If you stop paying premiums, your policy may lapse. For permanent policies like whole or universal life, the cash value may cover the premiums for a time, but eventually, if premiums are not paid, the policy will end.

What is auto insurance? +

Auto insurance is a contract between you and an insurance company that provides financial protection against damage or injury caused by accidents, theft, or other incidents involving your vehicle. It covers both liability and your vehicle's repair costs depending on the type of policy.

What types of auto insurance coverage are available? +

There are several types of auto insurance coverage, including liability, collision, comprehensive, uninsured/underinsured motorist, and additional coverage like roadside assistance and collision damage waiver.

How much auto insurance do I need? +

The amount of coverage you need depends on factors such as the value of your car, your driving habits, your state's legal requirements, and whether you own or lease your vehicle. A good starting point is to meet your state's minimum required coverage, but you may want additional coverage for added protection.

Can I cancel my auto insurance policy at any time? +

Yes, you can cancel your auto insurance policy at any time, provided you follow the correct procedure with the insurance company.

What is the difference between liability and comprehensive coverage? +

Liability coverage covers the damages and injuries caused by accidents, while comprehensive coverage also covers non-accident damages, such as theft or vandalism.

How do I choose the right auto insurance policy? +

When selecting an auto insurance policy, consider factors such as the type of coverage you need, your driving habits, the value of your vehicle, and your state's legal requirements.

What factors affect my auto insurance premium? +

Several factors impact your insurance premium, including: Your driving history (accidents, tickets), The make, model, and age of your car, Your location (accident rates in your area), Your age, gender, and marital status, The level of coverage you choose, Your credit score (in some states).

What is a deductible? +

A deductible is the amount you must pay out of pocket before your insurance policy starts to cover the remaining cost of repairs or claims. For example, if you have a $500 deductible and incur $2,000 in damages, you will pay $500, and your insurer will pay the remaining $1,500.

What is the difference between comprehensive and collision coverage? +

Collision coverage pays for repairs to your vehicle after a collision with another vehicle or object, regardless of who is at fault. Comprehensive coverage covers non-collision incidents, such as theft, vandalism, or damage from natural disasters.

Can I get uninsured/underinsured motorist coverage? +

Yes, uninsured/underinsured motorist coverage is available in some states. This coverage provides financial protection for you if another driver is uninsured or underinsured.

Is auto insurance required by law? +

Yes, in most states, you are required to have a minimum level of liability insurance. Some states also require additional coverage like Personal Injury Protection (PIP) or uninsured motorist coverage. The requirements vary by state, so it’s important to check your local laws.

What happens if I don’t have auto insurance? +

If you drive without insurance, you risk facing legal penalties, fines, and the possibility of your driver's license being suspended. If you're involved in an accident, you could be held responsible for the damages.

Can I add other drivers to my auto insurance policy? +

Yes, you can add other drivers, such as family members or friends, to your policy. However, their driving record and age may affect your premium. It's important to inform your insurer about all the drivers in your household.

What should I do if I get into an accident? +

If you're in an accident, follow these steps: Ensure safety by moving to a safe location if possible. Call the police and file a report. Exchange contact and insurance information with the other driver(s). Take photos of the accident scene, vehicle damage, and injuries. Notify your insurance company about the accident as soon as possible.

What is home insurance? +

Home insurance is a contract between you and an insurance company that provides financial protection against damage or loss caused by natural disasters, theft, or other incidents.

What types of home insurance coverage are available? +

There are several types of home insurance coverage, including flood, fire, burglary, and liability. You may also have coverage for water damage, mold, and other property damage.

How much home insurance do I need? +

The amount of home insurance coverage you need depends on the value of your property, the type of coverage you want, and your insurance provider. You may also need additional coverage for water damage, mold, and other property damage.

Can I cancel my home insurance policy at any time? +

Yes, you can cancel your home insurance policy at any time, provided you follow the correct procedure with the insurance company.

What is the difference between flood and fire coverage? +

Flood coverage covers damage caused by floods, while fire coverage covers damage caused by fires.

How do I choose the right home insurance policy? +

When selecting home insurance, consider factors such as the type of coverage you need, the value of your property, and your insurance provider.

What factors affect my home insurance premium? +

Factors such as the type of coverage you need, the value of your property, and your insurance provider can significantly impact your premium.