New India Assurance Health Insurance

• This New India Assurance plan will be in force for each and every hospitalization after the limits has been exceeded by the previous hospitalization expenses subject to the Sum Insured as mentioned in the plan.
• The maximum liability of the company towards all the members is the Sum Insured.
• The insured person has an option to recover the expense from any other company or this policy, but not both, if there is any expense which has been incurred over and above the limits.
• Under this New India Health Insurance plan, the Sum Insured is available over and above any reimbursement received from any other company if such amount exceeds the limits.

The Sum Insured Under New India Health Insurance available are:

New India Health Insurance Eligibility

The proposer has to be aged between 18-65 years and other members 3 months – 65 years. Children between 3 months till 18 years are covered under this New India Assurance plan, provided their parents are also covered simultaneously. Children between 18 years till 25 years are also covered provided their parents are also covered simultaneously and they are financially dependants on their parents except for unmarried daughter and where the child is mentally handicapped.

Health Check up will be required for person above 50 years of age under

• Persons above 50 years of age Or
• Persons with Adverse Medical / Claims history.

Tenure of the Plan

The policy is only for a period of one year.

Coverage under New India Assurance Health Insurance

The Hospitalization expenses include:

• Room rent, boarding and nursing expenses incurred in actual with a maximum amount of Rs 5000 per day for Rs 500000 Threshold and Rs 8000 per day for Rs 800000 Threshold.
• Specialists Fee, Consultants, Surgeon, Medical Practitioner, and Anesthetist fees.
• IICCU/ ICU expenses incurred in actual with a maximum of Rs 10000 per day for Rs 500000 Threshold and Rs 16000 per day for Rs 800000 Threshold.
• Oxygen, Surgical Appliances, Medicines & Drugs, Blood, Anesthesia, OT Charges, Chemotherapy, Radiotherapy, Artificial Limbs, Cost of Prosthetic devices implanted during surgical operation like pacemaker, related test, X-Ray and other expenses.
• Under this New India Assurance Plan, get Well Benefit of Rs 5000 for Rs 500000 Threshold and Rs 8000 per day for Rs 800000 Threshold will be paid for any one illness. This is applicable for only for the first four admissible claims under the plan. However, this facility will result in decrease in sum insured.
• Donor’s hospitalization expenses.
• Ambulance service expenses of Rs 5000 for Rs 500000 Threshold and Rs 8000 per day for Rs 800000 Threshold.
• Hospital Cash benefit under this plan of Rs 500 per day for Rs 500000 Threshold and Rs 800 per day for Rs 800000 Threshold.
• Cataract operation coverage under this plan will be maximum upto Rs 50000/-.
• AYUSH treatments are also payable under this plan.

• Room and Nursing Charge: 1% of Sum Insured per day.
• Specialists Fee, Consultants, Surgeon, Medical Practitioner, and Anesthetist fees.
• Oxygen, Surgical Appliances, Medicines & Drugs, Blood, Anesthesia, OT Charges, Chemotherapy, Radiotherapy, Artificial Limbs, Cost of Prosthetic devices implanted during surgical operation like pacemaker, related test, X-Ray and other expenses.
• Organ Donor hospitalization expenses.
• Specified day care procedures.
• Cataract operation coverage under this New India Assurance plan will be maximum upto Rs 50000/-.
• AYUSH treatments are also payable under this plan.
• 11 critical illnesses as specified 10% of sum insured.

Eligibility

This New India Assurance Health Insurance plan can be availed by individuals who are aged between 18-65 years. Children between 18 years till 25 years are also covered provided their parents are also covered simultaneously and they are financially dependants on their parents except for unmarried daughter and where the child is mentally handicapped. Health Check up will be required for person above 50 years of age, however 50% of the health check up costs will be reimbursed if the policy is approved by the company.

Tenure of the Plan

This New India Assurance policy is only for a period of one year.

Sum Insured and Premium

There are basically 4 types of plans or sum insured categories which are Rs 2 lakhs, Rs 3 lakhs, Rs 5 lakhs and Rs 8 lakhs. The Premium payable is based on the following criteria:

• Premium from Primary Member Premium Table.
• Premium for the additional Member who needs to be covered under the plan from Additional Member Premium Table
• Basis: Family Floater: i.e, the sum insured will apply to all the insured members
• ( minimum 2 and maximum 6 which includes proposer, spouse, dependent children, dependant parents upto 60 years).
• Sum Insured
• Zone- Under Zone there are 3 zones which are namely Greater Mumbai, Delhi NCR, Rest Of India.

• Room and Nursing Charge: 1% of Sum Insured per day.
• Specialists Fee, Consultants, Surgeon, Medical Practitioner, and Anesthetist fees.
• Oxygen, Surgical Appliances, Medicines & Drugs, Blood, Anesthesia, OT Charges, Chemotherapy, Radiotherapy, Artificial Limbs, Cost of Prosthetic devices implanted during surgical operation like pacemaker, related test, X-Ray and other expenses.
• Organ Donor hospitalization expenses.
• Specified day care procedures.
• Cataract operation coverage under this policy will be maximum upto Rs 50000/- or 10% of Sum Insured whichever is less.
• AYUSH treatments are also payable under this policy to the tune of 25% of the sum insured.
• Outpatient treatments are excluded.
• 11 critical illnesses as specified 10% of sum insured.
• Congenital diseases (not pre existing) are also covered but subject to waiting periods as specified for internal or external issues.

The following Personal Accident Plans are also covered:

Eligibility

The uniqueness of this New India Assurance policy is the parents can take this plan only with daughters. This can be availed by individuals who are aged between 18-65 years. Daughters between 3 months till 18 years are covered under this plan provided their parents are also covered simultaneously. Children between 18 years till 25 years are also covered provided their parents are also covered simultaneously and they are financially dependants on their parents except for unmarried daughter and where the child is mentally handicapped.

Tenure of the Plan

The policy is only for a period of one year.

Sum Insured and Premium

There are basically 4 types of New India Assurance plans or sum insured categories which are Rs 2 lakhs, Rs 3 lakhs, Rs 5 lakhs and Rs 8 lakhs. The New India Health Insurance Premium payable is based on the following criteria:

• Premium from Primary Member Premium Table ranges from Rs 1860 to Rs 38550.
• Premium for the additional 2 Daughter who can to be covered under the plan from Additional Member Premium Table ranges from Rs 250 – Rs 25040.
• Basis: Family Floater: i.e, the sum insured will apply to all the insured members
  (includes proposer, spouse, 2 dependent daughters).
• Sum Insured
• Zone- under Zone there are 3 zones which are namely Greater Mumbai, Delhi NCR, Rest Of India.
• Premiums for covered Daughters are 50% lower than that of the additional members.
• Premium loading is applicable upon renewal for members above 65 years which is 2% every year.

Eligibility

This can be availed by individuals who are aged between 18-65 years. Children between 18 years till 25 years are also covered provided one of their parents are also covered simultaneously and they are financially dependants on their parents.

Premium

Family members can be covered in one policy with separate Sum Insured for each Insured Person and one will get Family Discount of 10% on the total premium amount payable. And 11-%-18% discount for New India Assurance plans on family floater basis, minimum two and maximum four additional members. The members of the family include the Proposer, Proposer’s Spouse, Proposer’s Children, and Proposer’s Parents.

No Claim Bonus is awarded after every claim free year to the tune of 2%-15% for members upto 60 years and 11%-18% for family floater plans.

Sum Insured

The sum insured is from Rs 1 lakh to Rs 8 lakhs, maximum limit is Rs 3 lakhs for individuals aged above 55 years. Sum Insured can be enhanced while renewing, however the same will depend on the company’s decision for insured members upto 65 years. Also Sum Insured can be enhanced when one wants to transfer from Mediclaim 2007 plan to Mediclaim 2012.

• Reimbursement of Repatriation / Transport expenses due to termination of contract of employment.
• Hospitalization Cover.
• Maternity benefit upto Rs 20000/- as in patient in India.

Eligibility

This policy can be availed by individuals who are Indian Citizens and are aged between 18-60 years havin a valid visa staying abroad for the purpose of employment only for the period of cover as mentioned in the policy.