NEW MEDICLAIM POLICY 2017 IMPORTANT REVISIONS TO BE NOTED.

NEW INDIA ASSURANCE CO LTD

From 1^st August 2017, M/s. The New India Assurance Co Ltd brings in revisions in their existing Mediclaim Policy 2012 which will be applicable to all the existing and new policy holders.

Some of the important revisions are given below:-

1)   Coverage increased: - Now coverage available from Rs. 1 Lakh to Rs. 15 Lakh. Earlier coverage was up to Rs.8 lakh.

2)   Cataract expenses: - the liability for payment of any claim relating to cataract for each eye shall not exceed 20%, of sum insured subject to maximum of Rs.50000/- earlier was only Rs. 24000 per eye.

3)   TREATMENTS UNDER AYURVEDIC / HOMEOPATHIC / UNANI SYSTEMS

Expenses incurred for Ayurvedic / Homeopathic / Unani Treatment are admissible up to 25% of the Sum Insured provided the treatment for Illness or Injury is taken in a government Hospital.

4)   HOSPITAL CASH: For those Insured Persons, whose Sum Insured is more than or equal to Rs. three lakhs, we will pay Hospital Cash at the rate of 0.1% of the Sum Insured, for each day of Hospitalisation admissible under the Policy. The payment under this Clause for Any One Illness shall not exceed 1% of the Sum Insured.

5)   HEALTH CHECK-UP The Insured Person shall be entitled for reimbursement of the cost of Medical check-up at the end of a block of every three Claim Free Years. Such payment shall be restricted to Rs. 5,000 or 1% of the average Sum Insured of the Insured Person in the preceding three years, whichever is less. This benefit is available only once in three years.

6)   REINSTATEMENT OF SUM INSURED Such Reinstatement of Sum Insured shall be effected only where the Sum Insured is Rs. Five Lakhs or more and will be applicable only if the Sum Insured is exhausted due to a claim admissible under the Policy, then the Sum Insured shall be reinstated to the Sum Insured stated in the Schedule, provided our liability under the Reinstated Sum Insured shall be subject to the conditions mentioned in the policy schedule

7)   DAY ONE BABY COVER A New Born Baby is covered for any Illness or Injury from the date of birth till the expiry of this Policy, within the terms of this Policy. No subsequent coverage will be available on renewal unless specified by the parents.

8)   Congenital internal diseases covered after 24 months of continuous coverage, up to Sum Insured.

9)   Congenital external diseases covered after 36 months of continuous coverage, maximum upto 10% of Sum Insured

10)               Cumulative Bonus Buffer from Mediclaim 2012 will be carried over to New India Mediclaim Policy.

11)               Enhancement of sum insured is permitted as per slab below subject to policy terms & conditions.

Age <= 50 years	Up to Sum Insured of 15 lakhs without Medical Examination.
Age 51-60 Years	By two slabs without Medical Examination
Age 61 – 65 Years	By one slab with Medical Examination

Enhancement of Sum Insured will not be considered for:

1) Any Insured Person over 65 years of age.

2) Any Insured Person who had undergone more than one Hospitalization in the preceding two years.

  

Optional covers under the policy

—  Optional Cover 1: No Proportionate Deduction

◦       On payment of additional premium, the proportionate deduction as per the Room Rent / ICU eligibility will not be applicable.

◦       This cover is applicable only if the Sum Insured is more than or equal to 2 lakhs.

◦       This cover will not have any waiting period.

—  Optional Cover 2: Maternity Benefit

◦       On payment of additional premium, Maternity Expenses will be covered up to 10% of Sum Insured.

◦       This cover is applicable only if the Sum Insured is more than or equal to 5 lakhs.

◦      A waiting period of thirty six months is applicable, from the date of opting this cover.

—  Optional Cover 3: Revision in limit of Cataract.

◦       On payment of additional premium, an additional limit as specified in the table will be available for Cataract:

◦       Sum Insured	◦       Additional Cataract limit
◦       Rs. 8,00,000	◦       Rs. 80,000
◦       Rs. 10,00,000	◦       Rs. 1,00,000
◦       Rs. 12,00,000	◦       Rs. 1,20,000
◦       Rs. 15,00,000	◦       Rs. 1,50,000

◦       A waiting period of thirty six months is applicable, from the date of opting this cover

—  Optional Cover IV: Voluntary Co-pay

◦      If the Insured person opts for voluntary co-pay of 20%, then a discount of 15% shall be given on the premium payable.

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