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Home » Blog » General Insurance » New India Assurance Top Up Mediclaim Policy

New India Assurance Top Up Mediclaim Policy

April 1, 2016 By policydunia

4.2/5 - (5 votes)

New India Assurance Top Up Mediclaim Image

Policy Highlights

  • 1 New India Assurance Top Up Mediclaim Policy Introduction
  • 2 New India Assurance Top Up Mediclaim Policy Eligibility Conditions
  • 3 New India Assurance Top Up Mediclaim Policy Review and Features
  • 4 New India Assurance Top Up Mediclaim Policy Coverages
  • 5 New India Assurance Top Up Mediclaim Policy Exclusions
  • 6 New India Assurance Top Up Mediclaim Policy Customer Care
  • 7 New India Assurance Top Up Mediclaim Proposal Form
  • 8 New India Assurance Top Up Mediclaim Policy Claim Form
  • 9 Claims Adjudication:
  • 10 New India Assurance Top Up Mediclaim Premium Calculator
  • 11 New India Assurance Mediclaim Top Up policy Premium Rates
  • 12 New India Assurance Top Up Mediclaim Policy FAQ’s
  • 13 New India Assurance Top Up Mediclaim Forms and Documents

New India Assurance Top Up Mediclaim Policy Introduction

New India Assurance Top Up Mediclaim Policy is Health Insurance Policy which was designed by The New India Assurance Co. Ltd. You or any insured person in family may undergo hospitalization during policy period for illness or injury or disease. The New India Assurance Top Up Mediclaim Policy covers such medical expenses incurred during In-patient treatment in India. New India Assurance Top Up Mediclaim Policy covers medical expenses only when the aggregate of all medical expenses, exceeds the “Threshold” stated in the New India Top Up Mediclaim policy.

New India Assurance Top Up Mediclaim Policy Eligibility Conditions

Entry Age of Proposer:
  • Minimum: 18 years
  • Maximum: 65 years
Entry Age of Other Members:
  • Minimum: 3 months
  • Maximum: 65 years
Policy Period:
  • 1 Year
Renewal till age:
  • Lifelong
Grace Period:
  • 30 days for renewal.
Policy Type:
  • Individual / Family Floater
Members covered under Family Floater:
  • Self, Spouse, dependent Children and dependent Parents.
Pre-policy health checkup:
  • Required for persons of age group 50 years and above.

Sum Assured:

The Sum Insured available under New India Assurance Top Up Mediclaim Policy are,

Coverage Type Sum Insured Threshold
A 5,00,000 5,00,000
B 10,00,000 5,00,000
C 15,00,000 5,00,000
D 7,00,000 8,00,000
E 12,00,000 8,00,000
F 17,00,000 8,00,000
G 22,00,000 8,00,000

New India Assurance Top Up Mediclaim Policy Review and Features

  • New India Assurance Top Up Mediclaim Policy covers In-patient hospitalization expenses.
  • This policy covers expenses for each and every hospitalization after the Threshold has been exceeded by previous medical expenses subject to the Sum Insured stated in the Policy.
  • Sum Assured is the maximum liability of the New India company for all members of the policy.
  • In case there is any expense in excess of Threshold, receivable from other entity, you have an option to recover it from either that entity or New India Assurance Top Up Mediclaim policy, but not both.
  • Avail Tax benefit under Section 80 D as per provision of Income Tax rules. For information bout Tax on Insurance Policies, refer www.taxqueries.in.

New India Assurance Top Up Mediclaim Policy Coverages

  • In-Patient treatment:
    • Room Rent, boarding expenses and nursing expenses – Rs. 5,000/- per day for Rs. 5,00,000/- Threshold & Rs. 8,000/- per day for Rs. 8,00,000/- Threshold.
    • ICU/ICCU – Rs. 10,000/- per day for Rs. 5 lakhs Threshold and Rs. 16,000/- per day for Rs. 8 lakhs Threshold.
    • Surgeon, Medical Practitioner, Anaesthetist, Specialists, Consultants Fees.
    • Anaesthesia, Oxygen, Blood, Operation Theatre Charges, Medicines & Drugs, Surgical Appliances, etc.
  • Hospitalization Expenses incurred on the organ donor (excluding cost of organ).
  • Get Well Benefit – Rs. 5,000/- for Rs. 5 lakhs Threshold and Rs. 8,000/- for Rs. 8 lakhs Threshold, will be paid for Any One Illness.
  • Ambulance Charges – Rs. 5,000/- for Rs. 5 lakhs Threshold and Rs. 8,000/- for Rs. 8 lakhs Threshold.
  • Hospital Cash – Rs. 500/- per day for Rs. 5 lakhs Threshold and Rs. 800/- per day for Rs. 8 lakhs Threshold; For maximum of 10 days for Any One Illness.
  • Payment relating to Cataract for each eye shall not exceed Rs. 50000.
  • AYUSH Treatments.

For complete information about New India Assurance Top Up Mediclaim policy Inclusions, please refer New India Assurance Top Up Mediclaim policy document.

New India Assurance Top Up Mediclaim Policy Exclusions

  • 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.
  • Pre hospitalization and Post Hospitalization medical expenses.
  • Domiciliary Hospitalization, Treatment taken outside India, Experimental Treatment, Genetic disorders etc.
  • Dental treatment of any kind except in case of an Accident.
  • Vaccination or inoculation, cosmetic treatment, plastic surgery unless required for Injury or Illness treatment.
  • 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.

For complete list of New India Assurance Top Up Mediclaim policy Exclusions, please refer New India Assurance Top Up Mediclaim policy document.

New India Assurance Top Up Mediclaim Policy Customer Care

For any information or queries or doubts regarding New India Assurance Top Up Mediclaim policy call Toll Free number : 1800-209-1415.

You can also contact The New India Assurance Co. Ltd. through E-Mail : ombudsmanmumbai@gmail.com

Postal Address:

The New India Assurance Co. Ltd.,

87, M.G.Road, Fort,

Mumbai – 400 001.

New India Assurance Top Up Mediclaim Proposal Form

To buy New India Assurance Top Up 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 Top Up Mediclaim Proposal Form

New India Assurance Top Up Mediclaim Policy Claim Form

New India Assurance Top Up Mediclaim Claim Form is to submitted to The New India Assurance Office or TPA during claim settlement. It is to be filled completely and accurately.

Download New India Assurance Top Up Mediclaim Policy Claim Form

Claims Adjudication:

Any Claim which exceeds the Threshold and Insured makes a claim, it will be adjudicated as example shown below:

Claim placed by the Insured Insured having an Individual policy of Rs.8,00,000/- Insured having a Top Up of 12,00,000/- with Threshold Rs.8,00,000/-
Paticulars Charges Days Amount Sum Insured Rs.8,00,000/- Threshold Rs.8,00,000/-
Room Rent 10000 20 2 lakhs Room Rent (1% of Sum Insured) Rs.160000/- Room Rent (Maximum Rs. 8,000 for opted Threshold of Rs. 8 lakhs) Rs.160000/-
Surgeon Charges – – 4 lakhs Surgeon Charges (proportionate on SI) Rs.320000/- Surgeon Charges (proportionate on SI) Rs.320000/-
Diagnostics – – Rs.320000/- Diagnostics (proportionate on SI) Rs.256000/- Diagnostics (proportionate on SI) Rs.256000/-
Medicines – – Rs.250000/- Medicines (Actual) Rs.250000/- Medicines (Actual) Rs.250000/-
Total Cost – – Rs.1170000/- –
– Admissible Rs.986000/- Admissible Rs.986000/-
– Payable under policy Rs.8 lakhs Deductible under Top Up 8 lakhs
– Not Admissible Rs.186000/- Payable under Top Up Rs.186000/-
Insured Incurred Rs. 11,70,000/-
Total Paid under the Policy Rs. 8,00,000/- Rs. 1,86,000/-
Expense borne by Insured Rs. 1,84,000/-

New India Assurance Top Up Mediclaim Premium Calculator

You can calculate the premium using New India Assurance Top Up Mediclaim Premium calculator. Personal details, Number of members,  Policy period, Age and Sum assured and other details are required to calculate the premium.

New India Assurance Mediclaim Top Up policy Premium Rates

New India Assurance Top Up Mediclaim Policy Premium table is as shown under,

Threshold Sum Insured   Premiums at different ages
PRIMARY MEMBER
18-44 45-54 55-60 61-65
Rs.5,00,000/- Rs.5,00,000/- 1800 2900 4020 6700
Rs.10,00,000/- 2800 4500 6300 10500
Rs.15,00,000/- 3500 5600 8040 13400
Rs.8,00,000/- Rs.7,00,000/- 1600 2500 3840 6400
Rs.12,00,000/- 2300 3700 5760 9600
Rs.17,00,000/- 3000 4700 7440 12400
Rs.22,00,000/- 3600 5600 8940 14900
Threshold Sum Insured Premiums at different ages
ADDITIONAL MEMBER
0-17 18-44 45-54 55-60 61-65
Rs.5,00,000/- Rs.5,00,000/- 700 900 1450 2010 3350
Rs.10,00,000/- 1100 1400 2250 3150 5250
Rs.15,00,000/- 1400 1750 2800 4020 6700
Rs.8,00,000/- Rs.7,00,000/- 600 800 1250 1920 3200
Rs.12,00,000/- 900 1150 1850 2880 4800
Rs.17,00,000/- 1200 1500 2350 3720 6200
Rs.22,00,000/- 1400 1800 2800 4470 7450

New India Assurance Top Up Mediclaim Policy FAQ’s

At what situation New India Assurance Mediclaim Top Up Policy will get cancelled?

  • 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 term. In such case the company shall refund of premium.

What are the tests that are to be carried out as pre acceptance health checkup?

  • CBC
  • ROUTINE URINE
  • BLOOD SUGAR (FASTING & PP)
  • ECG
  • SGPT
  • X–RAY CHEST PA VIEW
  • SGOT
  • PHYSICIAN CHECK–UP
  • CHOLESTEROL
  • HDL CHOLESTEROL
  • TRIGLYCERIDES
  • EYE CHECK–UP FOR CATARACT & GLUCOMA

What expenses are to be considered for determining the Threshold?

  • Hospital Admission should have happened during the policy term.
  • You (Insured Person) should have been admitted as an inpatient.
  • Hospitalization should be for an Injury/Illness.
  • Pre and Post Hospitalization expenses are not considered.

New India Assurance Top Up Mediclaim Forms and Documents

New India Assurance Top Up Mediclaim POlicy Document

Filed Under: General Insurance, The New India Assurance Tagged With: New India Assurance Mediclaim Top Up policy, New India Assurance Top Up Mediclaim policy

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