New India Assurance - Senior Citizens Mediclaim 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's tailor-made plan for the senior citizen proposes a maximum coverage towards the well-being of the elderly. It covers crucial areas with lucrative benefits like no claim bonus and free health check-ups.

Highlights of Senior Citizens Mediclaim Policy

  • Offers 5% cumulative bonus for every claim free (renewal) year up to a maximum of 30%.
  • Adding spouse on the policy will provide 10% family discount on the premium. Also, opting for a voluntary deductible of Rs.10,000 will fetch another 10% rebate on the premium.
  • Migration to a Senior Citizen Mediclaim is possible for those senior citizens who already have an existing health plan.
  • Payment towards the cost of Health Check every four claim free years.
  • Income Tax Benefit for the premium paid under Section 80D of Income Tax Act.

Scope of cover

Indivdual Plan

Entry Age

For children :

Adults :

Minimum : 60

Maximum : 80

Number of Members Covered

Maximum Members : 2

Maximum Adults : 2

Maximum Children :

Sum Insured

1 lakh and 1.5 lakh


discount

Family discount

Policy Periods Available

1 year


Pre-Policy Medical Check-up

Above 60 years

Family Floater Plan

Entry Age

For children :

Adults :

Minimum : 60

Maximum : 80

Number of Members Covered

Maximum Members : 2

Maximum Adults : 2

Maximum Children :

Sum Insured

1 lakh and 1.5 lakh


discount

Family discount

Policy Periods Available

1 year


Pre-Policy Medical Check-up

Above 60 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 such procedures.

No-Claim Benefits

For every claim free year, you will earn a no claim bonus of 5% up to a maximum of 30%.

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 up to a maximum of 5% of the hospital bill.

Post Hospitalization

The insurance company will pay you for the medical expenses related to your hospitalization 60 days post hospitalization up to a maximum of 10% of the hospital bill.

Good to Have Benefits

Health Check-up

You are entitled to a health check up every four claim free years. This amount can be reimbursed up to a maximum limit of 1% of the average sum insured.

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 Rs.1,000.

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 ten days from the date of receipt of the policy document.

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
  • The overall limit should not exceed more than 25% of the sum insured

Co-Payment

For every admissible claim, the insurer has to bear a co-payment of 10%.

Sub-Limits

  • SURGEON, ANESTHETIST, MEDICAL PRACTITIONER, CONSULTANTS, SPECIALISTS FEES, NURSING EXPENSES: Overall limit 25% of sum insured
  • ANESTHESIA, BLOOD, OXYGEN, OT CHARGES, SURGICAL APPLIANCES, MEDICINES, DRUGS, DIAGNOSTIC MATERIAL & X-RAY, DIALYSIS, CHEMOTHERAPY, RADIOTHERAPY, COST OF PACEMAKER, ARTIFICIAL LIMBS, COST OF STENTS & IMPLANTS: Overall limit 50% of sum insured

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.

Add-on Covers

WAIVER OF WAITING PERIOD FOR DIABETES MELLITUS AND HYPERTENSION:

At an additional premium, you can opt to waive the usual waiting period for any illness arising out of Diabetes mellitus and Hypertension. The same can be covered from the inception of the policy.

Eligibility Criteria for New India Senior Citizen Mediclaim Policy

Product Name Senior Citizen
Minimum Age of Entry 60 years
Maximum Age of Entry 80 years
Sum Insured Rs.1 lakh to Rs.1.5 lakh
Policy Tenure 1 year
Family Definition Individual – self, spouse
Premium Calculated on Basis of Age (i.e. sum insured chosen)

Document Required Buy New India Senior Citizen Mediclaim Policy

The below documents are required to buy New India Senior Citizen Mediclaim Policy:

  • Proof of age and address and a recent photograph

Document Required For Claim Policy

The below documents are required to file New India Senior Citizen Mediclaim Policy:

  • Claim Form, duly filled up by the policyholder
  • Doctor's certificate and treatment reports
  • Bank details for transfer of the claim amount
  • Discharge summary
  • Bills and Prescriptions
  • Advance and final receipts
  • Diagnostic test reports, X Ray, scan, ECG and other films

Further documents may be called upon for by the claim processing team if requirement for the same arises.

Tax Benefits of New India - Senior Citizen Mediclaim Policy

Offers tax rebate under Section 80D of the Income Tax Act, 1961 on payment of the premium of the Senior Citizen Mediclaim Policy.

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 - Senior Citizens Mediclaim Policy

New India's Senior Citizen Mediclaim policy is a tailor-made product that covers you against medical costs due to specific critical illnesses, ailments, injuries or accidents. With useful features like a complimentary health checkup, no claim bonus and an option to include Diabetes and Hypertension from day one is what makes the policy unique. On a flip-side, a limit on the room rent and sub-limit on some of the procedures along with a co-payment clause can be a bit discouraging.

**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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