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New India Assurance - Mediclaim 2012 Policy

New India Assurance Co Ltd. is a Government multinational general insurance company having its headquarters in Mumbai and a global presence in more than 27 countries. Sir Dorabji Tata founded the company in 1919 and since then it has been ruling the market in the non-life insurance business.

New India Assurance's Mediclaim 2012 Policy is intended to shield people against the whopping hospitalization costs. This plan is an excellent product with notable features like no maximum entry age limit, high cumulative bonus. Compared to Mediclaim 2007, this revised version is packed with valuable benefits and worth considering.

Highlights of Senior Citizens Mediclaim Policy

  • Available for persons between the age of 18 and 65 years
  • Liability cover for Cataract claims up to 10% of Sum Insured or Rs.50,000 whichever less, for each eye
  • Pre-acceptance medical check required only for those above the age of 50
  • Cover for Ayurvedic/Homoeopathic/Unani treatment
  • Coverage for Congenital (External) Diseases from the 5th year up to 10% of the Sum Insured
  • Income Tax Benefit for the premium paid under Section 80D of Income Tax Act.

Scope of cover

Indivdual Plan

Entry Age

For children : 91 days

Adults :

Minimum : 18

Maximum : 60

Number of Members Covered

Maximum Members : 4

Maximum Adults : 2

Maximum Children : 2

Sum Insured

1 lakh - 8 Lakh


discount

Family Discount

Policy Periods Available

1 year


Pre-Policy Medical Check-up

Above 50 years

Family Floater Plan

Entry Age

For children : 91 days

Adults :

Minimum : 18

Maximum : 60

Number of Members Covered

Maximum Members : 6

Maximum Adults : 4

Maximum Children : 2

Sum Insured

1 lakh - 8 Lakh


discount

Family Discount

Policy Periods Available

1 year


Pre-Policy Medical Check-up

Above 50 years

Important Features

Day Care Treatments

Due to scientific progress, some procedures/treatments do not require you to be hospitalized for a minimum of 24 hours to raise a claim. This plan covers 32 such procedures.

    No-Claim Benefits

    For every claim free year, based on the age and the sum insured, the discount offered on the premium varies between 2% up to a maximum of 15%.

      Organ Donor Cover

      If you ever have to opt for organ donation, the hospitalization expenses (excluding the cost of the organ) on the procedure for the donor will be covered up to the sum insured.

        Pre Hospitalization

        The insurance company will compensate you for the medical expenses related to your hospitalization 30 days before the hospitalization.

          Post Hospitalization

          The insurance company will pay you for the medical expenses related to your hospitalization 60 days post hospitalization.

            Good to Have Benefits

            Daily Hospitalization Allowance

            Benefit of Hospital Cash at the rate of 0.1% of Sum Insured per day of Hospitalization for every admissible claim and for each member.

              Health Check-up

              At every third renewal, a compensation towards the health checkup is provided up to Rs.5,000 or 1% of the average Sum Insured; whichever is lower.

                Non- Allopathic Treatment Expense Cover

                You can claim for any treatment sought through alternate medicine like Ayurveda, Unani or Homeopathy up to a maximum of 25% of the sum insured. This claim will be honored as per the policy terms only if you seek the stated treatment in a Government Hospital or any institute duly recognized by the Government or any other governing body.

                  Emergency Ambulance

                  This plan provides ambulance cover for up to 1% of the sum insured.

                    Value Adds

                    FREE LOOK PERIOD

                    For any reason, should you decide not to proceed with the policy, you can return the same and request for a refund within fifteen days from the date of receipt of the policy document.

                      Critical Illness Cover

                      During the policy term, if the insured member is diagnosed with any of the 11 specified critical illnesses, the insurance company will pay a lump sum of 10% of sum insured as an additional benefit.

                        Terms & Conditions

                        Room Rent / Room Category

                        You can claim for the hospitalization basis the following limits:

                        • Room rent/boarding/nursing expenses up to a maximum of 1% of sum insured per day
                        • ICU charges up to 2% of sum insured per day

                          Co-Payment

                          For every admissible claim, the insurer has to bear a co-payment of 20% if he/she seeks the treatment in any hospital that is outside the Zone he has paid the premium. Similarly, If anyone buys the policy at the age of 55 years, he will have to bear a 20% Copay on admissible claim amount.

                            Sub-Limits

                            CATARACT CLAIMS: For cataract claims, your compensation will be restricted to 10% of sum insured or Rs.50,000 whichever less, for each eye.

                              Waiting Period

                              Cooling Off Period

                              A 30 days cooling off period for all claims except any arising out of accidental injuries.

                                Specific Illnesses

                                The policy covers some specific diseases/treatments only after 18 or 24 months. These include Stone in Gall Bladder & Bile duct, Cataract, Hysterectomy, Myomectomy for Fibroids, and so forth.

                                  Pre-Existing Illnesses

                                  You can claim for any pre-existing conditions after a waiting period of 48 months from the policy start date.

                                    Permanent Exclusions

                                      The Plan will not cover any liabilities towards the treatments of following conditions-

                                      • Whose signs or symptoms first occur within 30 days of the policy period
                                      • Attempted suicide
                                      • Use of alcohol or drug
                                      • AIDS
                                      • Pregnancy, childbirth, miscarriage, and abortion
                                      • Infertility and in vitro fertilization.
                                      • Vaccination & Inoculation
                                      • Hospitalization out of war, riot, strike and nuclear weapons

                                      Note: The complete list of what is omitted from the scope of coverage forms a part of the policy wordings. Kindly refer the same for additional reference.

                                    Review of New India Assurance - Medclaim 2012 Policy

                                    New India’s Mediclaim 2012 policy is an excellent investment to safeguard your family against the rising hospitalization costs. With valuable benefits like no claim bonus and a health check up at the end of every three claim free years, the policy is well-designed to tackle most of the expenses. However, a limit on the room rent and co-pay of 20% is something you need to think before you buy.

                                    **Reviews and ratings are based only on Benefits and Conditions. Things like Claim Settlement Ratio, Hospital Network have not been covered under product ratings. These are covered under Company ratings.

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