New India Premier Mediclaim Policy
New India Premier Mediclaim Policy is a comprehensive health insurance offered under New India Assurance Health insurance. This policy can be availed as individual and family floater basis. The policy covers the insured for unforeseen hospital expenses, in-patient expenses including intensive care units and other critical care benefits to provide the insured with complete medical protection.
The minimum eligibility criteria to buy this policy are:
Minimum Entry Age
18years (18-25 years must be dependent on parents)
3 months to 18 years (one of the parents must be covered already)
Maximum Entry Age
Can continue beyond if they do not break the renewal process
Number of people covered
Individuals can buy New India Premier Mediclaim Policy for themselves or their family members. The Policy covers all hospitalization expenses under 2 base plans:
- Plan A- Coverage for Rs 15,00, 000 & Rs 25,00,000
- Plan B – Coverage for Rs 50, 00,000 & Rs 1 crore.
Further coverage details are as follows:
- Inpatient Treatment Cover -Room rent, boarding, nurse expenses are all covered. The intensive care unit or ICU, intensive cardiac care unit ICCU are also incurred.
- Pre-hospitalization Cover- Pre-hospital medical expenses are covered for 60 days.
- Post-hospitalization Cover- Coverage for 90 days after the hospital discharge will be paid for the same condition for which hospitalization was there.
- Organ Donor Cover- All expenses of the hospital that are incurred for the donor regarding organ transplant. The cost of the organ is excluded.
- Daycare Treatment Cover-139 day care procedures are covered in the Policy.
- AYUSH Treatment- If in cases of Ayurvedic, homeopathic, Unani treatment, the individual is given 20% of the sum insured. This is provided only if the treatment takes place in a government or recognized or medical board accredited hospital.
Inclusions of the Policy
Individuals can buy the New India Assurance Health Insurance to get the below-mentioned benefits in addition to the above mentioned basic coverages:
- Emergency Ambulance Cover-The Policy will pay for any ambulance services, including air ambulance, up to Rs 1 lakh, for transporting any insured person for better medical facilities from one hospital to another.
- Hospital Cash Allowance-The Policy promises a cash payment of Rs 2000 per day for Plan A and Rs 4000 per day for Plan B for hospitalization for more than 24 hours.
- Maternity and Newborn Coverage- This coverage will be provided to the insured mother upon hospitalization when she has been in continuous coverage for at least 36 months under the plan. The expenses incurred towards maternity are Rs 50,000 for Plan A and Rs 1, 00,000 for Plan B.
- Critical Illness Benefit- If during the individual's period of insurance, the insured gets diagnosed with any listed critical illness, the Policy will pay the person Rs 2,00,000 under plan A and Rs 5,00,000 under Plan B. This amount is only paid to the insured once in a lifetime with no pre-existing diseases.
Exclusions of the Policy
Some cases of hospitalizations are not covered under the New India Premier Mediclaim Policy. Coverage will not be provided under the following cases as listed in the policy exclusions:
- Pre-existing condition or disease
- Listed disease diagnosed before the 24 months waiting period
- Listed disease diagnosed before the 36 months waiting period
- Injuries due to war, invasion, nuclear weapon, radiation
- Cost of external prosthetic devices, braces, equipment or nondurable implants
- Cost of spectacles, eyeglasses, contact lenses, hearing aids, etc.
*The complete list of exclusions is available in detail in the policy document.
Features & Benefits of the New India Premier Mediclaim Policy
Out of the many benefits and features of the New India Premier Mediclaim Policy, Some of them are listed below:
- All hospital expenses, including room rents and ambulance fees are covered.
- OPD treatment cover is available.
- The Policy has a new India baby care that covers any expenses incurred in connection with the delivery of any such newborn baby from birth until the expiry of this Policy.
- Infertility treatment is also covered, subjected to a limit of Rs 1, 00,000 for plan A and Rs 2, 00,000 for Plan B.
- It also covers treatment for STDs, or any condition caused due to human T cell lymphocytic virus type III. The limits are Rs 2, 00,000 for Plan A and Rs 5, 00,000 for Plan B.
- This premium paid under this Policy is eligible for tax savings under Section 80D of the Income Tax Act 1961.
Cancellation Terms of the Policy
New India Premier Mediclaim Policy has a free 15-days look up period in which the policyholder can go through the policy documents. If he/she finds it unsatisfactory, the same can be returned to the insurer.
The insurer can also cancel the Policy on the grounds of fraud and misrepresentation of personal or medical facts by the policyholder by giving prior written notice.
Ans: Yes, the Policy will cover up to 5% of the insured sum for any insured individual, admitted as an inpatient, in all psychiatric and psychosomatic disorders.
Ans: Yes, the insured can seek a medical second opinion in case of major surgeries, with an amount payable up to Rs 5000 for Plan A and up to Rs 8000 for Plan B.
Ans: Yes, cataract is treated. The expenses that are incurred for the treatment of cataract are:
- Plan A: Actual charges up to a maximum of Rs 75,000
- Plan B: Actual charges up to a maximum of Rs 1,00,000
Ans: If it is a new insurance policy, then the claim cannot be made for the first 30 days, except for accidental hospitalizations.
Ans: Such treatments are only covered under Plan B up to a max of Rs 5 lakh for specified respiratory and cardiovascular co-morbidities.
Written By: PolicyBazaar - Updated: 25 February 2021