#Virukipolicy | T&C*
New India Health Insurance is a product of New India Assurance which holds an international presence in various foreign countries with headquarters in India. New India Assurance is one of the oldest insurance companies operating worldwide with products like health insurance, motor insurance, marine insurance, rural insurance, travel insurance, etc. New India Assurance has commenced its operation in 1920 and right now functioning in 28 countries such as Japan, Mauritius, Singapore, London, St. Lucia, Dominica, Myanmar, Nigeria, etc.
New India Health insurance main objective is to cover an individual or family or group from uncertain and invited medical mishappenings. New India Health insurance is available for any age between 3 months to 65 years where a dependent child, spouse, parents, daughter, son, can be included.New India Assurance has formulated a variety of health insurance plan that covers the medical costs of hospitalization, treatment of critical illnesses, doctor consultation, pharmaceuticals, Ayurveda treatment, health checkups etc.
| Number of Network Hospitals | 5884 |
| Day care Procedures/ treatments | 139 ailments |
| Portability | Yes |
| Renewability of the Policy | Lifetime |
| Discounts | Available |
| Free Look Period | 15 days |
| Grace Period | 30 days |
| Pre-Policy Medical Checkup | Not Required |
139 daycare procedures: Under New India health insurance, the policyholder can avail treatment at any medical facility for the rectification of an illness that requires less than 24 hours to get completely operated. Treatment such as Radiotherapy, Tonsillectomy, Chemotherapy, Operations On-ear, eyes, Cataract, Skin Transplantation, Angiography, etc.
Quick Claim Settlement Process: New India Assurance ensures that the customer does not confront any hassle during the process of raising a claim and settling it. The online process of submitting a claim has made the process more simple and effortless. The policyholder can easily gather information about claim status by visiting the website New India Health insurance.
No pre-policy Medical check-up: New India Health insurance does not mandate the requirement of medical examination before purchasing the policy for individuals who are less than 50 years of age. The policyholder who is above the age of 50 years may have to appear for the medical checkup.
Effective Customer Service: Customer satisfaction must for the development of the company and shows the attentiveness of the company is towards its customer claims and queries. New India Assurance with the separate team for claim, queries which resolve each and every query through toll free number and email ID. To have a direct interaction with the New India customer service team, call on 1800 209 1415.
Rating of the company: New India Assurance has been rated AAA/Stable by CRISIL. CRISIL is an organization that give honest rating to companies based on their financial accountability. This rating displays credibility of the company to honour each authorized claim with actual amount of claim arrived.
Awards and Accolades: New India Assurance have collected many awards like General Insurance company of the Year, Business Excellence Award, Innovative product Service by Golden Peacock, Best health insurer by Outlook Money.
Tax exemptions: A person purchasing New India health insurance will get tax benefits in the annual payment of the Income Tax by insured person. Exemptions up to a maximum of Rs 1.5 lakhs and minimum 25,000 thousand is granted if premiums are submitted positively with the company.
The New India health insurance premier policy that promises coverage to family members including spouse, children, dependent parents. The health policy will cover all basic as well as advance medical expenses.
What are medical cost and benefits are covered?
In-patient Treatment cost is included in the coverage that consists of following expenses
Room Rent, including boarding and nursing expenses, are fully paid equal to the actual cost.
Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses are completely paid with respect to the actual cost incurred.
Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist fees.
Anesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances, Medicines & Drugs, Dialysis, Chemotherapy, Radiotherapy, Artificial Limbs, Cost of Prosthetic devices implanted during surgical procedure like pacemaker, Relevant Laboratory/Diagnostic test, X-Ray and other medical expenses related to the treatment.
Hospital Cash which gives the privilege to insured of availing specialized treatment without any obligation to arrange payment out of pocket. On arrival of any illness, the insured will get Rs 2,000 per day under Plan A and Rs. 4,000 per day under Plan B. Also, the payment will be made for 10 days maximum and will be paid after the completion of 24 hours in a day.
Critical Care Benefit for those life insured who got detected with critical illness by a medical specialist who has confirmed the traces of disease in the body of insured. On raising a claim and acceptance of same by the company, the insured will receive Rs 2,00,000 under Plan A and Rs. 5,00,000 under Plan B. The payment made will not affect the sum insured but on the contrary will enhance the sum
Cancer
First Heart attack of specified severity
Open chest CABG
Open Heart replacement or repair of Heart Valves
Coma of specified severity
Kidney failure requiring regular dialysis
Stroke resulting in permanent symptoms
Major organ/ bone marrow transplant
Permanent paralysis of limbs
Motor neuron disease with permanent symptoms
Multiple sclerosis with persisting symptoms
Ayurvedic/Homoeopathic/ Unani treatment will be covered by New India health insurance and an amount equal to 20 % of Sum Insured is paid to the insured. The facility must be availed in the hospital or medical institute operating under the authorization and guidelines of government.
Ambulance charges, as well as Air Ambulance charges, are covered to facilitate the transportation of Insured Person to the nearest hospital for betterment of health condition.
OPD expenses such as dental treatment, health check-up, consultation with a Medical Practitioner, Drugs and Medicines and medical detection as suggested by the Medical Practitioner are compensated by New India Assurance according to the sum insured. An amount of Rs. 5,000 for Plan A and Rs. 10,000 for Plan B if the no claims have been made for two constant years.
Maternity expenses will be covered for a maximum of two deliveries and payment will be made if the female insured has been admitted to hospital for in-patient treatment. To avail this coverage the insured have to pay regular premiums for thirty six months. The amount reserved for Maternity expenses is Rs. 50,000 for Plan A and Rs. 1,00,000 for Plan B.
New Born Baby expenses that will include illness or injury resulting during the policy term are covered from the date of birth. This cover will remain effective till the date of maturity without any extra premium.
Medical Second opinion for major surgeries can be availed on the advice of medical expert. The company will pay up to Rs.5,000 for Plan A and up to Rs. 8,000 for Plan B.
Obesity treatments are included for insured person whose BMI is more than 35 and have other miserable medical conditions related to obesity. Other conditions may involve-
Obstructive sleep apnea, Pickwickian syndrome (obesity hypoventilation syndrome),
Coronary artery disease, left ventricular hypertrophy, coronary pulmonale, obesity-associated cardiomyopathy, accelerated atherosclerosis, and pulmonary hypertension of obesity
Treatment of cataract where the company will pay actual cost arrived on operating the disease. The actual charges up to a maximum of Rs. 75,000 in Plan A and Rs. 1,00,000 for Plan B. Insured has to constantly pay the premium and renew the policy for 36 months to avail this coverage.
Psychiatric and psychosomatic disorders are covered up to 5% of the sum Insured.
HIV/AIDS or other which are transferred sexually to insured person body will be covered. An amount equal to Rs. 2,00,000 in Plan A and Rs. 5,00,000 in Plan B is given. Insured must be submitted in a hospital for inpatient treatment to get coverage and the facility of consultation under OPD is given for Rs. 20,000 in Plan A and Rs. 50,000 in Plan B.
Treatment for infertility cases is also included and paid up to a limit of Rs. 1,00,000 for Plan A and Rs. 2,00,000 for Plan B. The treatment can also be availed on inpatient or outpatient basis and will be valid for once in the whole policy term.
Continuity Benefit will be provided to those who keep their policy running for 36 months through continuous submission of premium and subject to timely renewal
Dietician counseling is applicable to plan B and the insured will receive Rs 5000 for the consultation/ counseling taken from the dietician.
Eligibility Criteria
| Minimum Age of entry | 18 years for Adults 3 months for Children |
| Maximum Age of entry | 65 years |
| Sum Insured | Plan A: Rs 15 lakhs to Rs 25 lakhs Plan B: Rs 50 lakhs to 1 crore |
| Number members can be included | 6 members maximum (self, spouse, dependent children and parents) |
insurance to cover the hospitalization expenses that takes form during the treatment of a specific diseases/ ailments/ injury in a hospital. It not only helps during the hospitalization but also cover expenses coming after and before in-patient hospitalization.
What are medical cost and benefits are covered?
In-patient hospitalization cover for availing treatment at a hospital which continues for more than 24 hours. Cost involved are as follows
Room Rent / Boarding/ Nursing Care, RMO Charges,Fluids/Blood Transfusion/ Injection administration charges are covered upto 1% of sum insured each day.
ICU cost provided up to 2% of Sum Insured each day.
Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Fees
Anesthetist, Blood, Oxygen, Operation Theatre Charges, surgical appliances, Medicines & Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Artificial Limbs, prosthetic devices implanted during surgical procedure like Pacemaker, laboratory diagnostic tests.
Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses are included but should not exceed 2% of the Sum Insured each day.
Pre Hospitalisation expenses before the treatment of illness by a hospital doctor and reception of insured are covered up to 30 days.
Post Hospitalisation cost happening after getting relief from the hospital as confirmed by the attending doctor are covered up to 60 days.
Free Health Check-up where the insured will get reimbursement of cost incurred. The condition for this benefit is that the policy is renewed for three consecutive years and no claim has been raised. The maximum amount that can be used is Rs. 5000 or 1% of average sum insured, whichever is less.
Ambulance service cost for timely transfer of insured patient to the nearby hospital and a sum equal to 1% of the sum insured is reserved.
Ayurvedic / Homeopathic / Unani Treatment can also be availed under this cover and up to 25% of the sum insured.
Daily hospital cash for utilizing the facility a bed and room while admitted into a hospital where an amount parallel to 0.1% of sum insured each day is provided. The total maximum limit should not cross 1% of sum insured for any one Illness.
Cataract claims are due respected with the payment of the sum insured equal to 20% or 50,000, as the case may be.
Add-on Covers (Riders)
Optional Cover I: For insured person whose sum insured is more than or equal to Rs. 2 lakhs and the cover will cancel all your deductions for claims made under the basic cover. Payment of extra premium must be submitted along with base premium to attach the cover.
Optional Cover II: The cover is developed for females covered under the policy can buy this optional cover for future maternity expenses occurring due to the birth of the newborn baby.
The selected sum insured must be more than or equal to Rs. 5 lakhs and additional premium is paid along with base premium. New India health insurance company guarantees to pay 10% of the sum insured on the authorization of the claim and the policy is renewed for a continuous period of thirty-six months.
Optional Cover III: The cover will reduce the limit of Cataract and is available to the insured whose sum insured is more than or equal to Rs. 8 lakhs.
Eligibility Criteria
| Minimum Age of entry | 18 years for Adults 3 months for Children |
| Maximum Age of entry | 65 years |
| Sum Insured | Rs. 1/ 2/ 3/ 5/ 8/ 10/ 12/ 15 lakhs |
| Number members can be included | 6 members maximum (self, spouse, dependent children and parents) |
The family will get the advantage of getting finest medical treatments for any specified diseases/ injury against the payment of regular premium on every renewal date. On perpetual renewals, a policyholder to enjoy the utmost benefits of the health insurance policy.
What medical costs and benefits are covered?
The in-patient hospitalization for the treatment of illness/injury provided is more than 24 hours.
Pre-hospitalization expenses for 30 days and post hospitalization expenses for 60 days are also payable.
Day-care treatment expense towards specific technologically advanced day-care treatments/ surgeries where 24-hour hospitalization is not required.
Ambulance Charges for shifting the insured from residence to hospital are covered up to the limits specified in the policy.
Ayurvedic/Homeopathic and Unani system of medicine are covered to the extent of 25% of the Sum Insured provided the treatment is taken in the Registered Hospital.
Pre-existing diseases are covered only after four years of unceasing renewals with no issuing of claim.
Pre-existing conditions like Hypertension, Diabetes, and their complications are covered after two years of continuous insurance on payment of additional premium to lessen the time limit established.
Eligibility Criteria
| Minimum Age of entry | 18 years for Adults 3 months for Children |
| Maximum Age of entry | 60 years |
| Sum Insured | Rs 2 lakhs to 5 lakhs |
| Number members can be included | 4 members maximum (self, spouse, dependent children) |
A floater health insurance policy that covers the whole family under one sum insured while covering all the medical cost specific to an illness and other additional bonuses. The unique feature of this policy is the involvement of 11 critical diseases that are commonly traced in every one of the four persons.
What medical costs and benefits are covered?
In-patient hospitalization cover for availing treatment at a hospital which continues for more than 24 hours. Cost involved are as follows-
Room Rent / Boarding/ Nursing Care, RMO Charges,Fluids/Blood Transfusion/ Injection administration charges are covered upto 1% of sum insured each day.
ICU cost provided up to 2% of Sum Insured each day.
Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Fees
Anesthetist, Blood, Oxygen, Operation Theatre Charges, surgical appliances, Medicines & Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Artificial Limbs, prosthetic devices implanted during surgical procedure like Pacemaker, laboratory diagnostic tests.
Pre-hospitalisation expenses up to 30 days before the date of actual admission to hospital for availing operation of an illness. The illness should be same as under in-patient hospitalization.
Post-hospitalisation expenses covered for a maximum of 60 days following the date of discharge as recommended by the attending medical expert.
Organ donor expenses for the process of organ transplantation of the insured person. The expenses occurring from the extraction of organ from the body of donor and in-patient treatment of donor is covered.
If insured get detected with cataract, the New India assurance is responsible to pay 10% of the sum insured or Rs. 50,000 whichever less, for the treatment of each affected eye. The claim is payable only when the policy is renewed on the due date without any respite.
Hospital Cash availability offered as 0.1% of Sum Insured per day of hospitalisation. The hospitalization must be for more than 24 hours.
Ambulance service for transferring the patient from home to hospital or from one hospital to another hospital for quality treatment from a medical professional. The company will pay sum insured equal to 1% of the Sum Insured.
Ayurvedic, Homeopathic and Unani based treatment are covered and a maximum of 25% of the sum Insured is granted for the treatment. The treating institution/ organization should be licensed/ accredited by Quality Council Of India under Indian government
Cancer of Specified severity
First Heart attack of specified severity
Open chest CABG
Open Heart replacement or repair of Heart valve
Coma of specified severity
Kidney failure requiring regular dialysis
Stroke resulting in permanent symptoms
Major organ / bone marrow transplant
Permanent paralysis of limbs
Motor neurone disease with permanent symptoms
Multiple sclerosis with persisting symptoms
Enhancement of sum insured whose age is more than 50 years and the increase is upto Rs 15 lakhs. The insured should not suffer from any illness like chronic Illness or critical illness.
Eligibility Criteria
| Minimum Age of entry | 18 years for Adults 3 months for Children |
| Maximum Age of entry | 65 years |
| Sum Insured | Rs 2, 3, 5, 8, 10, 12 and 15 Lakhs |
| Number members can be included | 6 members maximum (self, spouse, dependent child and dependent parents) |
A girl specific health insurance plan that gives advance health protection from medical emergencies to girl proposer as well her family. The policy will cover all the basic hospitalization costs related to treatment of illness/ personal accident/ critical illness.
What medical costs and benefits are covered?
Room Rent / Boarding/ Nursing Expenses and other associated expenses will receive 1% of the sum insured on a daily basis during the in-patient treatment process.
Nursing Care, RMO Charges, Fluids/Blood Transfusion/ Injection administration charges
ICU limit up to 2% of Sum Insured per day.
Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Fees
Anesthetist, Blood, Oxygen, Operation Theatre Charges, surgical appliances, Medicines & Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Artificial Limbs, cost of prosthetic devices implanted during surgical procedure like Pacemaker, relevant laboratory diagnostic tests
Organ transplantation cost which covers organ donor in-patient treatment for extraction of the organ where cost of organ is not covered.
For cataract claims, the liability of the company will be restricted to 10% of the sum insured or Rs. 50000 whichever less, for each eye
Critical Illness coverage is given for insured who get diagnosed with any of the diseases pointed below. The company will pay 10% of the sum insured as extra amount in addition to admissible amount under New India Health insurance
Cancer
First Heart attack of specified severity
Open chest CABG
Open Heart replacement or repair of Heart Valves
Coma of specified severity
Kidney failure requiring regular dialysis
Stroke resulting in permanent symptoms
Major organ/ bone marrow transplant
Permanent paralysis of limbs
Motor neuron disease with permanent symptoms
Multiple sclerosis with persisting symptoms
Daily Hospital Cash available at the rate of 0.1% of sum insured for each day of hospitalization. For availing this benefit, the claim must be admissible by New India Assurance.
Eligibility Criteria
| Minimum Age of entry | 18 years for Adult Girl 3 months for dependent children |
| Maximum Age of entry | 65 years |
| Sum Insured | Rs 2/ 3/ 5/ 8 lakh |
| Number members can be included | 4 members maximum (self, spouse, dependent child) |
A health insurance plan that provides high coverage for each admissible claim of hospitalization or other medical facilities along with extended coverage for family members.
What medical costs and benefits are covered?
Room Rent, boarding and nursing expenses actually incurred subject to a cap of Rs. 5000 per day for Rs. 5,00,000 Threshold and Rs. 8000 per day for Rs. 8,00,000 Threshold.
Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses which are actually occurred. The maximum coverage awarded will be Rs. 10,000 per day for Rs. 5 lakhs of threshold and Rs. 16000 per day for Rs. 8 lakhs of threshold.
Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist fees.
Anaesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances, Medicines & Drugs, Dialysis, Chemotherapy, Radiotherapy, Artificial Limbs, Cost of Prosthetic devices implanted during surgical procedure like pacemaker, Relevant Laboratory/Diagnostic test, XRay and other medical expenses related to the treatment. Reimbursement / payment of Room, boarding and nursing expenses incurred at
AYUSH treatments are payable provided the treatment has been undergone in a government hospital or in any institute recognized by government and/or accredited by Quality Council of India/National Accreditation Board on Health.
Hospital cash paid as Rs. 500 per day for Rs. 5,00,000 threshold and Rs. 800 per day for Rs. 8,00,000 threshold. The number of days allowed to avail this benefit are 10 days for listed Illnesses/ ailments.
Cover the treatment of Cataract for each eye whose cost should not go beyond Rs.50,000.
Organ transplantation cost which covers organ donor in-patient treatment for extraction of the organ where cost of organ is not covered.
Eligibility Criteria
| Minimum Age of entry | 18 years for Adults 3 months for Children |
| Maximum Age of entry | 65 years |
| Sum Insured | Rs 5/ 10/ 15 lakhs for threshold of Rs 5 lakhs Rs 7/ 12/ 17/ 22 lakhs for threshold of Rs 8 lakhs |
| Number members can be included | 6 members maximum (self, spouse, dependent children and parents) |
This health policy is completely for the health betterment of senior citizens which are often neglected during the time of coverage due to their age. This plan will cover medical expenses of the person above 60 years and ensure their safety from uninvited medical emergencies.
What medical costs and benefits are covered?
Room charges up to 1% of sum insured per day and Intensive care unit (ICU) charges up to 2% of sum insured per day. This will include nursing care, RMO charges, IV fluids / blood transfusion / injection administration charges.
Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Fees. The insured is guaranteed a payment of 25% of the sum insured plus cumulative bonus buffer on happening of any illness.
Anesthesia, Blood, Oxygen, OT charges, Surgical appliances (any disposable surgical consumables), Medicines, drugs, Diagnostic material & X-Ray, Dialysis, Chemotherapy, Radiotherapy, Artificial limbs and implants other than Orthopedic. A maximum coverage equal to 50% of the sum insured is offered.
Attendant Charges is also covered where the insured will receive Rs. 5000, Rs. 7000 and Rs, 10,000 per hospitalization according to sum insured chosen (Rs 2, 3 and 5 Lakhs). The maximum amount offered per day is Rs. 800 or actual cost, whichever is less.
Ambulance services in case of emergency cases where the patient needs immediate medical attention and an amount equal to 1% of the sum insured per hospitalization is paid by the company. This facility can be availed for transfer of insured from one hospital to another for better treatment or for admission to ICU/ emergency ward from home/ any location.
Organ Transplantation cost will be covered which include Hospitalisation cost (excluding cost of organ) on the treatment of donor for extraction of organ and transplanting the organ in the recipient body. This will not cover the expenses of the organ donated.
Enhancement of the sum insured preceding the renewal on the consent of the company in written and the maximum increase can be up to Rs 5 lakhs.
Eligibility Criteria
| Minimum Age of entry | 60 years |
| Maximum Age of entry | 80 years |
| Sum Insured | Rs 2/ 3/ 5 lakhs |
| Number members can be included | 2 members maximum (self, spouse) |
The senior citizen ranging between 60 years to 80 years can easily purchase this policy and can get uninterrupted coverage for medical cost incurred for any listed diseases/ injury/ accident.
What medical costs and benefits are covered?
In Patient Hospitalization for any illness as listed by the New India Assurance where related medical expenditure will be paid by the company.
Coverage for pre-existing diseases which is carried by the insured before purchasing the policy and the company promises to cover it after passing of 4 years of health policy.
Free Health checkup facility if the policy is renewed without any delay for three years and
Common diseases like Hypertension, Diabetes mellitus are also given due coverage if a claim is made.
Cataract with imported foldable lens, Hysterectomy, Appendicectomy, Angiography, Tonsillectomy, Tympanoplasty, Kidney stone/lithotripsy and other included diseases are given proportionate amount of sum insured.
Treatment taken under Ayurvedic/ Homeopathic/ Unani are given due coverage if the institution is recognized by Quality Council Of India / National Accreditation Board on Healthcare. The insured will get 25% of the sum insured as an agreed amount for the treatment.
Eligibility Criteria
| Minimum Age of entry | 60 years for Adults |
| Maximum Age of entry | 80 years |
| SSum Insured | Rs 1 lakhs to Rs 1.5 lakhs |
| Number members can be included | 1 member |
This will cover all the medical expenses that are necessary for the treatment of a disease/ injury. From hospitalization to recovery of a disease, this cover is uniquely structured for completing every need of the customer.
What medical costs and benefits are covered?
Inpatient hospitalization expense coverage for the rectification of diseases that take more than 24 hours and requires proper hospital room to carry out the operations. Cashless facility can be availed for in-patient treatment through obtaining permission from TPA.
Pre-hospitalization expenses for 30 days are eligible to get reimbursement from the company.
Post hospitalization expenses for 60 days after the discharge is allotted from treating hospital are payable.
Day-care treatment costs are covered for the illnesses mentioned in the policy wordings under day care procedures. Due to medical advancement, the doctors/ researchers are now able to treat an illness within 24 hour.
Ambulance Charges for transferring the insured to the nearest medical facility/ hospital from home is also available up to a specified limit.
Ayurvedic, Homeopathic and Unani based treatment are covered and a maximum of 25% of the sum Insured is granted for the treatment. The institution or organization must be recognized by Quality Council Of India / National Accreditation Board on Health.
Pre-existing diseases are covered based on constant renewals without any gap.
If the insured carries a pre-existing conditions like Hypertension, Diabetes, Cholesterol and its complications during the purchase of policy will be covered. However, additional premium must be submitted and policy is renewed for two years perpetually.
Organ transplantation cost which covers organ donor in-patient treatment for extraction of the organ where cost of organ is not covered.
Eligibility Criteria
| Minimum Age of entry | 18 years for Adults 3 months for Children |
| Maximum Age of entry | 60 years |
| Sum Insured | Rs 50,000 to Rs 75,000 |
| Number members can be included | 6 members maximum (self, spouse, dependent child and parents) |
The policy mainly focuses on providing insurance services to groups that consists of various families.This health insurance plan has the capacity to attend 100 families at the same time and the insured should cover all the eligible members in the family under one group. The group policy must be issued to an institution/ organization/ mentioning the names of insured members included.
What are medical cost and benefits are covered?
In-patient hospitalization costs will be covered up to limit of sum insured and the following expenses will be under coverage.
The Room, Boarding Expenses availed at the time of treatment by treating Hospital
Nursing Expenses and Intensive Care Unit expenses
Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist Fees
Anesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances, Medicines & Drugs, Diagnostic Materials and X-Ray, Dialysis,
Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs & Cost of Organs and other related costs.
Any injuries/ death arising from uncertain accidents to the head of family that is visible on the body are covered. The death will be covered if the accident has happened within a period of 6 months and the New India Assurance will provide Rs 25,000 for the loss.
Disability benefit applicable to the earning head of the family ho is being hospitalized for the treatment of illness/ diseases/ injuries. Daily cash of Rs. 50/- is given for a maximum period of 15 days in a policy period and a time excess of 3 days is compensated.
Eligibility Criteria
| Minimum Age of entry | 18 years for Adults 3 months for Children |
| Maximum Age of entry | 65 years |
| Sum Insured | Rs 30,000 per person or family |
| Number members can be included | 6 members maximum (self, spouse, dependent children and parents) |
New India formulated this insurance policy for the weaker population of the society who does not have funds to pay the costly premium of the health insurance policy. This insurance will cover all medical expenses such as pre and post hospitalization, cashless treatment, health checkups, doctor consultation, etc.
What are medical cost and benefits are covered?
In-patient hospitalization expenses are covered for a particular illness and will include cost such as-
Room, and boarding expenses
Nursing expenses and ICU facility
Surgeon, anaesthetist, medical practitioner, consultants, specialist fees
Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines & drugs, diagnostic materials and x-ray, dialysis
Chemotherapy, radiotherapy, cost of pacemaker, artificial limbs & cost of organs and similar expenses
Daycare treatment are covered that neither require long hours of medical supervision nor any separate rooms for operation. Treatment such as cataracts, ear surgery, tonsils, Fistulectomy, Angiography, Angioplasty etc.
Pre-hospitalization expenses coming before the admission to a hospital for treatment are included. Expenses 30 days prior to hospitalization are reimbursed by New India Assurance.
Post-hospitalization expenses coverage for 60 days maximum immediately happening after the treating hospital issued the discharge letter/ note
OPD treatment expenses are covered if a medical expert has recommended the treatment as compulsory for the betterment of insured person.
Eligibility Criteria
| Minimum Age of entry | 18 years for Adults 3 months for Children |
| Maximum Age of entry | 70 years |
| Sum Insured | Rs 5000 per person in a policy |
| Number members can be included | 6 members maximum (self, spouse, dependent children and parents) |
This New India Health insurance is based on a membership basis taken with the Indian Cancer Society. This society is responsible in making the cancer insurance available to life remembered that neither require long hours of medical supervision nor any separate rooms for operation. Treatment such as cataracts, ear surgery, tonsils, Fistulectomy, Angiography, Angioplasty eered that neither require long hours of medical supervision nor any separate rooms for operation. Treatment such as cataracts, ear surgery, tonsils, Fistulectomy, Angiography, Angioplasty es, well-wisher ordinary members, corporate members life members, well-wisher ordinary members, corporate members.
What medical costs and benefits are covered?
All the cost that is related to the treatment of cancer are included-
Diagnosis of disease
Biopsy
Surgeries, hospitalization, and rehabilitation
Chemotherapy, radiotherapy for cancer treatment
Cumulative discount of up to 50% of the sum insured is awarded to the insured is no claim has been made during a policy year.
Free cancer checkup facility to the insured and his/ her spouse by the Indian Cancer Society.
Health check-ups with up to 50% of discount on every visit to the doctor after availing the free service of health checkup.
Allopathic treatment availed at any government managed and regulated institution is covered and expenses are paid on a reimbursement basis.
Dependent child inclusion is also available on payment of additional premium with the basic premium.
Eligibility Criteria
| Minimum Age of entry | 18 years for Adults 3 months for Children |
| Maximum Age of entry | 65 years |
| Sum Insured | 50,000 to Rs 2 lakhs |
| Number members can be included | 2 members maximum (self and spouse) |
This family mediclaim policy is applicable to all the family members including self, spouse, children and parents who are dependent on the insured for income. Also, this gives the benefit of enormous discounts on the premium on including more than 2 or 3 members and opting higher sum insured value in the policy.
What medical costs and benefits are covered?
Inpatient Treatment expenses that majorly covers all the cost of rectifying a/ an diseases/ accident/ injury during the admission to the hospital. This will involve-
Room, Boarding Expenses for carrying on an operation
Nursing Expenses
Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist Fees
Anesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances, Medicines & Drugs, Diagnostic Materials and X-Ray, Dialysis.
Chemotherapy, Radiotherapy, Cost of Pacemaker, ArtificialLimbs & Cost of Organs and similar expenses
Before hospitalization expenses are covered for the same illness for which inpatient treatment has been taken in a network or non-network hospital. The medical cost appearing 30 days before the actual hospitalization is reimbursed.
After hospitalization expenses will get reimbursed if the expenses are relevant to the illness/ injury for which the in-patient hospitalization has been availed. Post-hospitalization cost is covered for a maximum of 60 days beginning after the discharge is allocated to the insured patient.
No Claim Discount is granted if the insured doesn’t apply for any claim throughout the policy year and the health insurance policy is regularly renewed with New India. A maximum of 15% discount can be earned on the premium paid annually in a policy term.
Cumulative bonus buffer is like supplements the total sum insured when present coverage is insufficient as compared to the amount of hospitalization/ medical expense during the policy year. For instance, Raj has sum insured of Rs 2 lakhs and the cumulative bonus buffer amount to Rs 30000. The total expense amount comes at 2.5 lakhs which is more than the sum insured but due to presence bonus buffer the company will give Rs 2,30,000 as admissible claim amount. after i
Continuity Benefit is allowed to the policyholder for being regular in submission of premiums on every renewal date for months minimum. This will provide access to medical benefits such as treatment in cataract, cost of health checkup, cumulative bonus buffer and No Claim Discount without any delay due to late submission.
Eligibility Criteria
| Minimum Age of entry | 18 years for Adults 3 months for Children |
| Maximum Age of entry | 60 years |
| Sum Insured | Rs 1 lakh to Rs 8 lakhs For proposer above 55 years: Rs 1 lakh to 3 lakhs |
| Number members can be included | 4 members maximum (self, spouse, dependent children and parents) |
Intimation Process
For Planned Hospitalization: The TPA or insurance provider must be informed within 48 hours before the hospitalization for accident/ illness as investigated by the attending medical doctor.
For Emergency/Unplanned Hospitalization: The TPA or the insurance provider should be supplied with proper information of the emergency medical event within 24 hours after the hospitalization took place for an illness/ accident/ injury.
Intimate the TPA assigned for New India Health insurance policy about the kind and nature of claim. The information must be in written format furnished on the email ID.
Collect and Submit the related and important documents for the claim within a time limit of seven days applicable from the discharge date of the insured from treating Hospital.
Also, submit the claim intimation form with supporting documents.
In case of Post-Hospitalisation treatment (limited to sixty days), submit all claim documents within 7 days after completion of such treatment.
Provide TPA with authorization to obtain medical and other records from any Hospital, Laboratory or other agency.
The Insured person shall submit to the TPA all original bills, receipts and other documents upon which the claim is based and shall also give the TPA/Us such additional information and assistance as the TPA / We may require.
Any Medical Practitioner authorized by the TPA/Us shall be allowed to examine the Insured Person, at our cost, if We deem Medically Nec
Documents Required for Claim Settlement Process
Claim Form duly filled and signed by the claimant
Bill, Receipt and Discharge certificate/ card from the attending hospital.
Prescriptions papers and cash memos from the hospitals/ chemist.
Pathological test reports supported by a recommendation note by the attending Medical practitioner/pathologists.
Surgeon’s bill and receipt, certificate providing the nature of operation performed.
Treating Doctor/ Specialist/ Consultant/ Anesthetist's fee written over bills and receipts, and other certificates regarding diagnosis.
To renew the existing New India Health insurance policy, the policyholder is required to register on the website.
Go to Customer Login option displayed on the top of the website’s menu and fill in the required personal information. An OTP will be generated to the specified email ID and the same is to be filled. The registration will be completed.
Then log in to your account by submitting accurate information about policy number and requested personal details. Login can be done by clicking on “Customer Login” and change the password created during the registration process.
Login with your credentials and apply for renewal.
The payment option will pop up where the policyholder has to pay the amount of premium for the activation of the health policy.
The policy will get renewed and the payment receipt will be generated on the screen.
OR
There is another option of renewal where the insured just have to click on the ‘Quick Help option” appearing on the website’s menu bar.
Then, select “Quick Renewal Option” and fill in the Renewed Quote number, registered customer ID as written over policy document in the format reflected over the screen.
Then, proceed to pay the premium with any debit/ credit card or net banking and don’t forget to get save your payment receipt generated online. Receipt is the evidence of renewal of your health insurance policy.
Diseases contracted within 30 days of insurance.
Dental treatment except treatment arising out of an accident.
Debility and General Run Down Conditions.
Sexually transmitted diseases and HIV (AIDS) except New India Premier Policy
Cosmetic surgery/ plastic surgery
Vaccination and Inoculation
Cost of spectacles and contact lenses,
Injuries resulting from wars, Act of foreign enemy, ionizing radiation and nuclear bombing.
The exclusions are common to each but the policyholders are requested to check each and every plan specific exclusion.
1. Is there any requirement for pre-policy health check-up in New India Health Insurance?
The policyholders who are above the age of 50 years are under compulsion to take the health examination by a medical practitioner.
However, the company will reimburse the cost incurred only if the proposal of buying the policy is accepted by the New India health insurance. The person who possesses adverse medical condition is generally asked to take checkup.
2. Do I have the option to pay the premium online?
The policyholder has the option to pay online through the facility of credit and debit card or net banking. The New India Assurance accepts payment of premium either online or offline.
3. What to do if the online premium payment is made but the policy number is not allotted?
If the policy number is not generated during the process of online payment of premium, the customer/ policyholder must contact on the tech.support@newindia.co.in specifying the quote number, transaction date and additional details for further consideration.
4. Can I port my previous policy into New India Health insurance?
Yes, New India Assurance gives you the flexibility to port your previous company health insurance. All the benefits earned in the previous will be carried forward to New India Health insurance policy.
5. How we can check the status of claim?
To check the status of claim, the customer needs to write an email to nia.
(yourpolicynumber)@newindia.co.in. The insured must specify the policy number as written in the policy documents or wordings during the time of making the claim.
6. Who shall we contact for settlement of the claim in New India Health insurance?
All the health insurance claims of New India Assurance are administered by the Third Party Administrator (TPA). The policyholders can contact TPA for any kind of query regarding claim settlement process for cashless hospitalization where the insured have no obligation to submit the cash to avail treatment.
TPA is also accountable for attending reimbursement claims for any medical expenses incurred by the policyholder in past. The policyholder has to submit related proofs for fast reimbursement of medical expenses.
7. Can I change hospitals during the course of my treatment?
Yes, it is possible to shift to another Hospital for reasons of requirement of better medical treatment. However, this will be evaluated by the TPA on the merits of the case and as per Policy terms and conditions.
