New India Assurance Group Mediclaim Policy Introduction
New India Assurance Group Mediclaim Policy is a health insurance policy which was designed by New India Assurance Company Ltd. New India Assurance Group Mediclaim Policy covers Medical expenses incurred by you for the treatment of any Illness or Disease or Injury during Policy period. New India Assurance Group Mediclaim Policy provides the cover for any group which may include group of employees or group of family members etc. Low Claim Discount is available under New India Assurance Group Mediclaim Policy.
New India Assurance Group Mediclaim Policy Terms and Eligibility conditions
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New India Assurance Group Mediclaim Policy Review and Features
- Low Claim Discount: It will be allowed on the renewal premium, if the incurred claims of the group in the preceding 3 completed policy years, excluding the policy year immediately preceding the renewal is as shown under,
Incurred Claim Ratio Discount (%) Not Exceeding 60% 5 Not Exceeding 50% 15 Not Exceeding 40% 25 Not Exceeding 30% 35 Not Exceeding 25% 40 - High Claim Loading: Premium for renewal of the policy will be loaded, if the incurred claim ratio of the group for 3 years, excluding the policy year immediately preceding the date of renewal exceeds 70%. Loading will be as per scale shown below.
Incurred Claim Ratio Loading Between 70% & 100% 25% Between 101% & 125% 55% Between 126% & 150% 90% Between 151% & 175% 120% Between 176% & 200% 150% Over 200% Cover to be reviewed
New India Assurance Group Mediclaim Inclusions / Coverages
- Room Rent or Boarding or Nursing Expenses and other expenses – 1% of sum insured (SI) per day.
- ICU (Intensive Care Unit) – 2% of Sum Insured (SI) per day.
- Medical Practitioner, Surgeon, Anaesthetist, Specialists, Consultants Fees.
- Operation Theatre Charges, Anaesthesia, Oxygen, Blood, Medicines & Drugs, Surgical Appliances, etc.
- Hospitalization Expenses incurred on the organ donor (excluding cost of organ).
- For cataract claims – Actual or Rs. 24,000/- whichever is less, for each eye.
- Ambulance charges – 1% of SI (Sum Insured) or actual whichever is less.
- Ayurvedic or Homoeopathic or Unani treatment – 25% of the Sum Insured.
- Pre-hospitalization expenses – 30 days prior to the hospitalization.
- Post-hospitalization expenses – 60 days after discharge from the hospital.
- Maternity Expenses Benefit Extension: This is an Optional Cover which can be obtained by paying extra 20% premium of total basic premium for all the insured persons in the group under the New India Assurance Group Mediclaim Policy.
New India Assurance Group Mediclaim Exclusions / Non-Coverages
- Pre-existing diseases – covered after the waiting period of 4 years.
- In this policy, during the first 30 days of the commencement date, nothing will be payable.
- 2 (two) years waiting period for diseases like Hypertension, Diabetes Mellitus, Any Skin disorder etc.
- 4 (four) years waiting period for Age related Osteoarthritis & Osteoporosis and Joint Replacements due to Degenerative Condition.
- Domiciliary Hospitalisation, unproven treatments, Naturopathy Treatment etc.
- Dental treatment of any kind except in case of an Accident.
- Vaccination or inoculation, plastic surgery unless required for Injury due to accident.
- HIV/AIDS, War invasion, War like operations, Act of foreign enemy, Nuclear weapons, ionizing radiation etc.
- Maternity Expenses, pregnancy, abortion, miscarriage and other related problems (when New India Assurance Group Mediclaim Policy includes Maternity Expenses Benefit Extension, this exclusion is deleted).
For complete list of New India Assurance Group Mediclaim policy Inclusions and Exclusions, please refer New India Group Mediclaim policy document attached below.
New India Assurance Group Mediclaim Policy Customer Care
For any information or doubts or queries regarding New India Assurance Group Mediclaim policy call Toll Free number : 1800-209-1415.
You can also contact The New India Assurance Co. Ltd. through E-Mail: health.ho@newindia.co.in
Postal Address:
The New India Assurance Co. Ltd.,
87, M.G.Road, Fort,
Mumbai – 400 001.
New India Assurance Group Mediclaim Policy Proposal Form
To buy New India Assurance Group Mediclaim policy you need to fill the proposal form with complete and accurate information and you have to submit it to The New India Assurance Office.
Download New India Assurance Group Mediclaim Proposal Form
New India Assurance Family Floater Mediclaim Policy Claim Form
New India Assurance Group Mediclaim Claim Form is to submitted to The New India Assurance Office or TPA during claim settlement. It is to be filled accurately and completely.
Download New India Assurance Group Mediclaim Policy Claim Form
New India Assurance Group Mediclaim Premium Calculator
You can calculate the premium using New India Assurance Group Mediclaim Premium calculator. Personal details, Policy period, No. of members, Age and Sum assured and other details are required to calculate the premium.
New India Assurance Group Mediclaim Premium Rates
Premium payable under this New India Assurance Group Mediclaim Premium policy shall be paid inadvance. Premium will be charged depending on the Zone [ZONE-I (MUMBAI), ZONE-II (DELHI AND BANGALORE) AND ZONE-III (REST OF INDIA)] in which the insured undertakes treatment.
New India Assurance Group Mediclaim Policy FAQ’s
Can I Cancel the New India Assurance Family Floater Mediclaim Policy?
- Company may cancel your policy on grounds of misrepresentation, fraud etc. by sending you 15 days notice.
- You (The Insured person) may cancel the policy at any time during the policy period. In such case the New India Assurance company shall refund the premium, provided no claim has occurred till the cancellation date.
Period on Risk Premium to be Charged Up to 1 month 1/4th of annual rate Up to 3 months half of the annual rate Up to 6 months 3/4th of annual rate Exceeding 6 months full annual rate
What are the special conditions applicable for Maternity Benefit?
- 9 months waiting period is applicable for payment of any claim relating to caesarean section or normal delivery.
- Claims regarding delivery for only first 2 children will be considered.
- Insured person would not be eligible for this benefit, if he is already having 2 or more living children.
- Pre-natal and post-natal expenses are excluded unless admitted in Hospital or Nursing home for treatment.
New India Assurance Group Mediclaim Forms and Documents
New India Assurance Group Mediclaim Policy Details