• New India Assurance Mediclaim Policy

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    Health Insurance
    • Enjoy options to cover yourself, your spouse, kids and even your parents
    • Enjoy access to 10,000+ hospitals for cashless treatment
    • Reduce your taxable income by up to Rs. 50,000 deduction under section 80D**

    New India Assurance is the largest general insurance company in India. The company offers a range of insurance products in various domains including health, motor, travel, etc. In the health insurance domain, the company offers plenty of products to provide financial security against various health risks. New India Mediclaim Policy is a comprehensive medical insurance cover that offers protection against various threats. This policy can be obtained as both individual cover or family floater cover depending upon the requirements of customers.

    Eligibility for New India Mediclaim Policy

    Some of the eligibility criteria set forth by the company for subscribing to New India Mediclaim Policy can be listed as follows.

    • Anyone between the age of 18 years and 65 years can sign up this policy cover.
    • Dependent children from the age of 3 months to 18 years can avail this cover provided both their parents are simultaneously covered.
    • Lifelong renewability option is available provided that the policy is continuously renewed every year without any break.
    • If taken for the entire family, this policy cover is available for self, spouse, dependent children, and dependent parents.
    • This policy is available for a maximum of six members in a family.

    Features of New India Mediclaim Policy

    The key features of New India Mediclaim Policy outlined by the company can be listed as follows.

    • Sum insured available for this policy ranges from Rs.1 lakh to Rs.15 lakh.
    • Premium charges for this policy vary based on the age of the insured person.
    • Pre-acceptance medical examination is necessary for members enrolling in this policy after 50 years of age. However, 50% of the checkup costs will be reimbursed if the proposal is accepted.
    • This policy does not provide compensation for any outpatient treatment. Hospitalisation is necessary for making a claim.
    • The policy term is one year, and it must be renewed every year to remain active.
    • Sum insured amount can be enhanced at the time of renewal, but it will not be considered for people above 65 years of age.
    • All pre-existing diseases have a waiting period of 48 months under this policy cover.
    • Certain illnesses such as benign prostatic hypertrophy, hydrocele, ENT disorders, renal failure, stone in gall bladder, etc. have a waiting period of 24 months.
    • There is a waiting period of 30 days before any claim can be made under this policy. However, this does not apply for accidents.
    • Pre hospitalisation medical expenses are reimbursed for up to 30 days prior to the date of hospitalisation.
    • Post hospitalisation medical expenses are reimbursed for up to 60 days after discharge from the hospital.
    • Policyholders can opt for voluntary copay of 20% and get 15% discount on the premium charges.
    • After a successful claim, the exhausted sum insured amount can be reinstated provided the sum insured amount is Rs.5 lakh or more.
    • The premium charges paid for this policy are eligible for income tax relief as per Section 80D of the Income Tax Act.

    Benefits of New India Mediclaim Policy

    The range of benefits offered by New India Mediclaim Policy can be listed in the following table.

    Room rent, boarding, and nursing expenses Up to 1% of the sum insured
    Intensive care unit charges Up to 2% of the sum insured
    Hospital cash 0.1% of sum insured (for sum insured over Rs.3 lakh only) per day subject to a maximum of 1% of sum insured in total
    Medical expenses related to organ transplant Available for all hospitalisation expenses
    Cataract limit Up to 20% of the sum insured subject to a maximum of Rs.50,000 (the limit for cataract treatment can be increased with the help of an additional cover.)
    Medical check up reimbursement Up to 1% of the sum insured subject to a maximum of Rs.5,000 available for every claim-free year

    Optional Covers

    I. No proportionate deduction This is available for people who have opted for sum insured Rs.2 lakh and higher. The proportionate deduction based on room rent will be eliminated for people who opt for this cover.
    II. Maternity expenses benefit This is available for people who have opted for sum insured Rs.5 lakh and higher. There is a waiting period of 36 months for this policy to begin. Maternity expenses for up to 2 children are covered in this policy. However, pre-natal and post-natal expenses are not covered.
    III. Revision in cataract limit Under the original policy, cataract treatment expenses are capped at Rs.50,000. This limit can increased by taking this additional cover. This is applicable only for sum insured Rs.8 lakh and higher. The maximum limit available under this is Rs.1.5 lakh (for sum insured Rs.15 lakh).
    IV. Voluntary co-pay By opting for a 20% voluntary copayment, policyholders can get a 15% reduction in their premium charges

    Exclusions of New India Mediclaim Policy

    There are certain exclusions for which New India Assurance is not liable to provide any compensation to the insured. Some of these exclusions can be listed as follows.

    • Medical expenses arising out of war or warlike activities
    • Cosmetic or aesthetic treatments of all kinds
    • Any expenses related to vaccination or inoculation
    • Convalescence, general debility, or run down condition
    • Treatments related to obesity or weight loss
    • Any expenses related to congenital defects or anomalies
    • Cost of braces, spectacles, contact lens, crutches, prosthetic devices, cochlear implants, etc.
    • Injuries resulting from participation in hazardous sport activities
    • Injuries sustained while breaking the law or participating in a criminal event
    • Naturopathy and siddha treatment
    • Any expenses related to domiciliary hospitalisation
    • Any kinds of experimental or unproven treatment methods
    • Expenses related to vitamins and tonics unless forming the core part of a treatment

    Claim Procedure

    Cashless hospitalisation is available with New India Mediclaim Policy, and it can be availed only in network hospitals. The list of network hospitals can be accessed from the company’s website. This service is provided with the help of a third-party administrator (TPA). Authorisation for this facility must be obtained from the TPA before the treatment can begin.

    Policyholders can also get reimbursements for the medical treatments obtained. For reimbursement claims, the policyholder must submit all the documents related to the expenses incurred for medical treatment. All bills and related documents must be submitted within 7 days of completion of treatment. Once the documents are submitted, the company will initiate the claim proceedings. The documents will be validated and the claim amount will be disbursed to the insured.

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