New India Assurance Tertiary Care Insurance (Individual)
Considering the rising demand for disease or a group of diseases-specific health insurance, the public sector insurance giant New India Assurance Health Insurance Co. Ltd. has introduced the New India Assurance Tertiary Care Insurance (Individual) policy with standout features. This New India Assurance health insurance offers coverage for nine major ailments with reimbursement for treatment expenses incurred in any hospital in India. The policy covers the listed major ailments and the Modern Treatment, apart from expenses for essential Life Support Equipment and Genetic Disorders, with limits specified in the policy schedule.
The minimum eligibility conditions to buy this policy are:
Minimum Entry Age
Child: 3 months (provided one or both parent is covered concurrently)
Others: 5 years
Maximum Entry Age
Child: 5 years
Adult: 75 years
The Number of people covered:
Cover on an Individual basis with family cover for the spouse, dependent children, and dependent parents.
Resident Indian Citizens
Considering the severity of the listed diseases, the primary coverage in the policy includes:
- In-patient Hospitalization: The policy delivers a comprehensive cover for all medical expenses subject to a minimum stay of 24 hours or more.
- Pre and Post Hospitalization Expenses Cover: The cover is for 30 days and 60 days, respectively, for all incurred medical expenses.
- Day Care Treatment Expenses Cover: Procedures and surgeries in a hospital which need admission only for a few hours are covered under the policy.
- Domiciliary Hospitalization: The expenses are fully covered for domiciliary hospitalization within India.
Inclusions of the Plan
The list of inclusions under this policy considers the following:
- Covered Diseases: The policy covers nine severe illnesses for hospitalization. The insured must consult the policy document for the detailed list with all its variations. The listed diseases are:
Nephritis and Kidney Failure needing transplantation and dialysis
Malignancy diagnosed through Histopathological Report.
Total Joint Replacements
- Modern Treatments: Several technologically advanced available medical procedures are covered in the policy with limits specified for each.
- Genetic Disorders: The cover is up to 25% of the sum insured after a wait of 24/48 months.
- Artificial Life Maintenance: The cover for life support is up to 10% of the sum insured for a maximum of 15 days for all the listed illnesses.
- Other Expenses: The policy also covers the cost of Pacemaker, Organ, Artificial Limbs, and Ambulance for emergency evacuation.
Exclusions of the Plan
Individuals, who intend to buy New India Assurance Health Insurance, need to go through the detailed list of exclusions as mentioned in the policy document. Some of them are:
- Waiting Period:
- The initial waiting period applicable to the covered illnesses is 30 days from policy inception.
- The period applied to pre-existing diseases is a straight 48 months.
- Specific diseases are imposed with a waiting period of varying durations, best ascertained through the policy document.
- Permanent Exclusions: The elaborate list for denial of coverage is available in the policy document. The insured must check them for clarity.
Features & Benefits of the Plan
Looking up the range of options is essential to buy New India Assurance Tertiary Care Insurance (Individual).
- Sum Insured: The insured has a choice of the sum insured in a range from Rs 50, 000 to Rs 5 Lakh in multiples of Rs 50,000.
- Cumulative Bonus: The sum insured enhances by 5% for every claim-free year, subject to an accumulation of a maximum of 10 years.
- Health Check-up: The health check-up cost will be borne by the insurer up to 1% of the sum insured. The facility is available once in a block of 4 consecutive claim-free years.
- Tax Benefits: The premium paid for the policy is tax-exempt as per the current tax laws.
Cancellation Terms of the Policy
The insured has the liberty to cancel the policy at any time, provided there is no pending claim on the cancellation date. The insurer refunds the premium at the applicable short period rate.
Ans: Yes, for internal anomalies after the expiry of 24-month wait, and external abnormalities only after the expiry of the 48-month wait.
Ans: The cover is limited to 10% of the average sum insured during the preceding four years.
Ans: The insured can renew the policy with a grace period of 30 days from the policy expiry date, during which the cover is temporarily withdrawn.
Ans: The only mode of claim settlement applied to the policy is reimbursement with a notice served within seven days of hospitalization.
Ans: The insured can save on the inclusion of the family members in the policy but not on the online New India Assurance Tertiary Care Insurance (Individual) purchase.
Written By: PolicyBazaar - Updated: 25 February 2021