New India Assurance Mediclaim Policy

New India Assurance Mediclaim Policy: Key Highlights

Scope of Coverage Offered

The policy provides an eclectic coverage to the insured to opt for hospitalization anywhere in India. The base coverage in the New India Assurance Mediclaim Policy Health Insurance is described below.

• In-Patient Hospitalization Cover: The insurer promises to indemnify all medical expenses incurred during hospital treatment with a minimum 24-hour stay.
• Pre and Post Hospitalization Expenses Cover: The indemnity extends to the incurred expenses associated with hospitalization before and after the discharge.
• Daycare Hospitalization Cover: The policy covers the cost of 139 daycare procedures and surgeries requiring less than 24 hours of hospital stay.
• Organ Transplant Cover:  Indemnity for an organ transplant is available subject to the stipulations in the policy schedule.
• Alternative Treatment Cover: The insured is free to opt for AYUSH treatment in any Government Hospital or recognized institute. The cover amount is limited to 25% of the sum insured.

Inclusions of the Plan

Apart from the basic coverage, the policy also includes the following expenses:

• Accommodation Limits: The room rent cover should not exceed 1% of the sum insured, while 2% for the ICU.
• Ambulance Cover: It is limited to 1% of the sum insured.
• Cataract Surgery: The insurer pays for the surgery for each eye up to 20%of the sum insured or Rs 50,000, whichever is lower.
• Hospital Cash:  The insured is paid at the rate of 0.1% of the sum insured per day of hospitalization, subject to 1% of the sum insured in total.
• Optional Cover:
• No Proportionate deduction.
• Maternity Expenses Benefit.
• Revision of Cataract Limit.
• Voluntary Co-pay.  

Exclusions of the Plan

Thorough knowledge of what is not covered in the policy is essential to buy New India Assurance Health Insurance, directly impacting the insured's claim settlement experience. The exclusions in this policy are in two categories – Waiting Period and Permanent Exclusions.

• The waiting period denotes the defined time for the commencement of cover. Accordingly, the cover for pre-existing diseases starts after the expiry of 48 months, specific listed diseases after 24 months, and 30 days for all ailments, except accidental injury from the policy inception date.
• Permanent exclusions, on the other hand, signify the conditions for the onset of the disease and injury for which the insurer is not liable. The list is elaborate, and it is sensible for the insured to consult the policy document for detail.

Features & Benefits of the New India Assurance Mediclaim Policy

The influencing factors to buy New India Assurance Mediclaim Policy are described below:

• Sum Insured: The insured can choose from Rs 1, 2, 3, 5, 8, 10, 12, and 15 Lakh. The sum insured bands of Rs 4/ 6, and 7 Lakhs are not offered for new policies but open for renewal. The insured will be covered under a single dedicated sum insured.
• Policy Term: It is one year with lifelong renewal after 65 years of age for uninterrupted coverage policies.
• Cumulative Bonus: The enhancement rate for a claim-free year is 25% of the sum insured, subject to a maximum of 50%.
• Health Check-up: The insured is entitled to the facility once for every three claim-free years.
• Tax Benefit: The premium is tax-exempt under Section 80D of the Income Tax Act, 1961.

Eligibility Criteria

One will have to be aware of the following eligibility conditions to buy this policy:

Cancellation Rules of the Policy

The insurer may cancel the policy with a 15-day written notice on the grounds of moral turpitude or non-cooperation. The insured can cancel the policy within the 15-day free-look period to receive a refund as per the insurer's short period rate.