New India Assurance Janata Mediclaim Policy

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Introduction:

This mediclaim policy is available for the persons between 18 years to 60 years. Children between 3 months to 18 years are covered provided their parents should be covered under the same policy. Persons beyond the age of 60 years are covered only if they are covered with the same insurance company from past years.

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Key Features

It covers pre hospitalization charges up to 30 days and post hospitalization charges up to 60 days subject to 10% maximum of hospital bills.

Ambulance charges are covered up to actual expenses or Rs 1000 whichever is less.

The total amount payable under this policy will not exceed sum insured in any case.

Cost of treatment taken in general ward is limited up to actual expense or Rs 450 per day, whichever is less.

Benefits

Discount will be given provided covering your family under this policy.

Discount in premiums will be given in case renewals are done with good claim history.

Cost of health checkup will be incurred by the insurance company after 4 continuous claim free years.

Details about Premium

Premium in this policy depends on the age of the proposer. There are basically two sum insured slabs available under this policy- Rs 50,000 and Rs 75,000.

Sum insured

3 months to 5 years

6 years to 35 years

36 years to 40 years

41years to 45 years

46 years to 50 years

51 years to 55 years

56 years to 60 years

61 years to 65 years

66 years to 70 years

50,000

750

700

800

1100

1400

1550

1800

2050

2300

75,000

1125

1050

1200

1650

2100

2350

2700

3050

3450

 

Policy Details

Minimum sum insured: 50,000

Maximum sum insured: 75,000

Cumulative bonus: Under this policy, for every claim free year sum insured will be increased by 5% at each renewal and maximum bonus that is applicable is 30%.

Free look period:

Free look period of this policy is 15 days to review the terms and conditions of the policy and if the proposer is not satisfied with the policy, he can return the policy during free look period.

Period of policy:

This mediclaim policy is issued for one year and after every one year the policy holder has to renew the policy with the same company to avail benefits like cumulative bonus as per terms and conditions.

Policyholder can only port his policy to some other company as per IRDA guidelines.

Amount payable:

Company in no case will be liable to pay an amount exceeding the sum insured promised to the insured.

Additional Riders or Features

To avail the cashless claim facility the insured has to get treatment from the agreed list of network hospitals.

Insured can cover his /her family members under this policy.

Documents Required

To avail the mediclaim policy, the proposer has to sign a proposal form and insurance company can ask the proposer to submit the medical history from listed doctors.The insurance company has all the rights to reject the proposal form in case of misrepresentation or extreme medical condition.

Eligibility criteria

Persons in the age group of 18 years to 60 years can avail this policy and children in the age group of 3 months to 18 years can be covered provided parents are covered under the same policy.

Inclusions

Day care treatments are covered up to specified limits.

Ayurvedic treatments are covered up to 25% of sum insured provided it is required for any injury or illness.

ICU expenses are covered under this policy.

Surgeon, Anesthetist, Medical Practitioner, Consultants’ Specialist fees are covered.

Exclusion

Dental treatment is not covered except if it is arises out of any accident.

Cosmetic surgeries are not covered except arising out of accident.

Pre –existing diseases are not covered for 48 months from the date of commencement of policy.