The New India Assurance, the largest state-owned general insurance company in India, offers a range of insurance products in various categories. In the health insurance domain, the company has various products to provide comprehensive coverage for its customers. The Top-Up Mediclaim Policy is developed to provide extra coverage in addition to an existing health insurance plan. The insured can choose between two different threshold options and avail benefits for expenses incurred over the threshold. Coverage from this top-up policy will kick in once the medical expenses cross the threshold limit.
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**
Eligibility for New India Top-Up Mediclaim Policy
The following eligibility criteria must be met for policyholders to enroll themselves in New India Top-Up Mediclaim Policy:
The age of the proposer must be between 18 years and 65 years.
Dependent children between the age of 3 months and 18 years can avail this cover provided both their parents are concurrently covered.
A maximum of 6 family members can avail this policy cover.
Lifetime renewability option is available for people entering this policy cover.
Features of New India Top-Up Mediclaim Policy
Some of the key features of New India Top-Up Mediclaim Policy can be given as follows:
The sum insured options for this top-up policy cover ranges from Rs.5 lakh to Rs.22 lakh.
Policyholders can choose between the threshold (deductible) options of Rs.5 lakh and Rs.8 lakh.
The sum insured amount and the threshold limit can be enhanced only at the time of renewal.
Sum insured enhancement will not be available for people renewing this cover after 65 years of age.
Pre-insurance medical examination is mandatory for people entering the policy over the age of 50 years.
The medical examination taken for this policy is valid for a maximum of 30 days.
Following the acceptance of a proposal, the company will reimburse 50% of the medical examination costs.
Any pre-existing conditions will not be covered for up to 4 years of continuous policy coverage.
There is a general waiting period of 30 days before coverage can begin under this policy.
Certain conditions like cataract, hernia, congenital internal disease, hypertension, hydrocele, etc. have a waiting period of 2 years.
Joint replacement surgery, age-related osteoporosis, and osteoarthritis have a waiting period of 4 years.
Pre and post hospitalisation expenses are not covered under this top-up policy.
This policy can be ported to other insurers within the guidelines provided by the Insurance Regulatory and Development Authority of India (IRDAI).
There is a free look period of 15 days to review the terms and conditions of this cover.
Benefits of New India Top-Up Mediclaim Policy
Benefits
Extent of cover
Room rent, boarding, and nursing expenses
Up to Rs.5,000 (for threshold Rs.5 lakh) Up to Rs.8,000 (for threshold Rs.8 lakh)
Intensive care unit charges
Up to Rs.10,000 (for threshold Rs.5 lakh) Up to Rs.16,000 (for threshold Rs.8 lakh)
Hospitalisation expenses
Up to the sum insured limit
Get well benefit
Up to Rs.5,000 (for threshold Rs.5 lakh) Up to Rs.8,000 (for threshold Rs.8 lakh)
Emergency ambulance cover (for one hospitalisation)
Up to Rs.5,000 (for threshold Rs.5 lakh) Up to Rs.8,000 (for threshold Rs.8 lakh)
Hospital cash
Rs.500 (for threshold Rs.5 lakh) per day Rs.800 (for threshold Rs.8 lakh) per day
Cataract claims
Up to Rs.50,000
Day care treatment
Expenses covered for treatments like dialysis, chemotherapy, radiotherapy, eye surgery, dental surgery, etc.
AYUSH Treatment
Covered for treatments undertaken in any hospital recognized by the government
Exclusions of New India Top-Up Mediclaim Policy
The list of exclusions applicable for New India Top-Up Mediclaim Policy can be given as follows:
Pre hospitalisation and post hospitalisation expenses
Illnesses or injuries caused by war, invasion, or any warlike activities
Cosmetic or aesthetic treatments including circumcision, plastic surgery, etc.
Any kinds of dental treatment unless arising out of an accident
Expenses related to vaccination or inoculation
Convalescence, general debility, or run down condition
Expenses related to domiciliary hospitalisation
Treatment for congenital diseases, birth defects, etc.
Expenses incurred for any kinds of psychiatric or mental disorders
Injuries or illnesses caused while breaking the law with criminal intent
Any kinds of sexually transmitted diseases
Cost of medical equipment such as braces, crutches, contact lens, spectacles, hearing aids, etc.
Any kinds of unproven or experimental treatments
Expenses related to pregnancy, miscarriage, childbirth, abortion, etc.
Expenses incurred for domiciliary treatment
Any kinds of non-medical expenses incurred during a hospital stay
Expenses for treatment taken outside the country
Claim Procedure
The claims made by policyholders are settled with the help of a third-party administrator (TPA). The TPA must be informed 48 hours before a planned hospitalisation or within 48 hours of emergency hospitalisation. Cashless treatment is available subject to pre-authorisation by the TPA. The cashless claim form along with the required documents can be sent to the TPA through fax and approval can be obtained.
Reimbursement claims can be made after discharge from the hospital. In order to make the reimbursement claim, various documents like medical bills, diagnostic reports, discharge summary, physician certificate, etc. must be submitted to the TPA. Once the documents are submitted, the TPA will verify the claim and provide the reimbursement amount within a maximum of 30 days.
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They reject all claims without proper reason. I personally experienced it. My claim of hospital bill was rejected giving any wrong reason. I urge all people, never take any policy of apollo munich. claim ID: 948912 case ID:5208987. Anyone can check my claim. Fraud apollo munich company, Playing with people money.
I have taken the health insurance policy with the STAR HEALTH & ALLIED INSURANCE where i been using the policy since from last few years. The premium i have paid is 11K for this policy, the medical coverage is for 2L 50K for this policy where the coverage is for self.
I have been using the health insurance policy with the ROYAL SUNDARAM GENERAL INSURANCE since from last 4-5 years where i had claim once with this policy. The medical coverage is for 4L for complete family. The premium is nominal with this insurance policy.
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6
DR AMIT KUMAR TIWARI
, bilaspur
Reviewed on Jan 29, 2019
The reason for taking the HDFC ERGO GENERAL INSURANCE health insurance is because i wanted to enhance the medical coverage of this policy. It is a top up plan where i the coverage is for 6L for family. It also includes the pre existing disease coverage.
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1
DR AMIT KUMAR TIWARI
, bilaspur
Reviewed on Jan 29, 2019
The reason for taking the health insurance policy with the NATIONAL INSURANCE is because the service is very good. The premium is nominal also the medical coverage what they have offered is 1L for self coverage. It has the disease coverage also the accidental coverage.
The reason for taking the health insurance policy with the HDFC ERGO GENERAL INSURANCE is because i am an existing customer of life insurance with this HDFC. I had no claim experience with this policy but the medical coverage is for 5L for self.
I am using with the health insurance policy with the BAJAJ ALLIANZ GENERAL INSURANCE from last two years which is a corporate policy where i had no claim experience but the premium i am paying for yearly where half of the amount has been paid by the company. The medical coverage they are providing is for 2L for family.
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1
KARTHIK RAMESH
, kumarakom
Reviewed on Jan 27, 2019
The premium is nominal when compared to the other health insurances with the APOLLO MUNICH so i have taken this health insurance policy. The claim settlement is very good and the customer service is very helpful. I had no claim experience but the medical coverage is for 10L with this policy.
I have been using the health insurance policy with the ICICI LOMBARD GENERAL INSURANCE since from last 10 years where i have paid the premium for 7 years. The customer support is very helpful for getting the claim where i got 60K of claim with this policy. Medical coverage is for 5L for family.
The benefits are good with the UNIVERSAL SOMPO GENERAL INSURANCE health insurance so i have taken this insurance. I had no claim experience with this insurance policy but the premium is nominal and the medical coverage is for 10L and the policy coverage is family.
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0
TAUSEEF ALI SAYYED
, mumbai
Reviewed on Jan 23, 2019
It is the better plan when compared to the others so i have taken the health insurance policy with the HDFC ERGO GENERAL INSURANCE. Premium is nominal and also the medical coverage is satisfactory which gives the medical coverage is for family.
I have taken the HDFC ERGO GENERAL INSURANCE health insurance policy with the where i have paid the premium 4187 and the medical coverage is satisfactory with this policy. I had no claim experience with this policy. I have not got the soft copy as well as the hard copy.
The service is better than others so i have taken this HDFC ERGO GENERAL INSURANCE health insurance policy. I had no claim experience but the medical coverage is for 3L for self. I have not received the soft copy and the hard copy. There is no proper customer followup. The premium i have paid is 8,035.
There is no particular reason for taking the health insurance policy with the CIGNA TTK HEALTH INSURANCE but i had no claim experience with this policy also the medical coverage is satisfactory but i have no idea. Policy coverage is for self.
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2
PAVAN MANIKANTA
, nellore
Reviewed on Jan 23, 2019
I have taken the health insurance policy with the BAJAJ ALLIANZ GENERAL INSURANCE wheeler i have been using it since from last few months where i have paid the premium which is nominal also the medical coverage is for 5L which covers self and my mother.
The reason for taking the STAR HEALTH & ALLIED INSURANCE health insurance policy is because friends suggested. The medical coverage is for 5K where it gives the coverage for 2 persons. It also includes the critical illness, disease coverage.
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4
MAHIPATHI JAYALAKSHMI
, guntur
Reviewed on Jan 22, 2019
I have been using the health insurance policy with the APOLLO MUNICH where i am using it from last few months. I have experienced with no claim experience but the medical coverage they have offered is satisfactory. It gives the coverage for family.
There is no particular reason for taking the health insurance policy with the BHARTI AXA GENERAL INSURANCE where i had no claim experience. The premium i have paid is 3.5k also the medical coverage is for 2L for self. The policy coverage is satisfactory.
I have taken the health insurance policy with the NATIONAL INSURANCE where i ma holding it since from many years but i have no claim experience. The premium is satisfactory and the medical coverage is for 5L for complete family. It includes the illness, disease coverage.
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1
MUKESH SHUKLA A
, faridabad
Reviewed on Jan 22, 2019
I am holding the corporate health insurance policy with the NATIONAL INSURANCE where i am using it since fro last 12 years and i had claim for 3-4 times it includes the cashless also the reimbursement. The medical coverage is for 10L for family.