New India Flexi Floater Mediclaim Policy

Have a look at all the benefits and features offered by the New India Flexi Floater Mediclaim policy!

Hospital Cash Benefit:

As per the policy guidelines, the insured patient will be entitled to Hospital Cash at a rate of 0.1% of the Sum Insured (on a per-day basis). You will be entitled to the Hospital Cash benefit only if the patient has been hospitalised for over 24 hours.

Critical Care Benefit:

When an insured member finds out that he/she is suffering from any critical health condition during the policy tenure, that person is eligible to claim 10% of the Sum Insured as the Critical Care Benefit. In addition to it, he/she will be entitled to the admissible claim amount as well.

Remember that Critical Care Benefit is paid to an insured individual just once in his/her entire lifetime. Also, he or she won’t get any Critical Care Benefits if that health condition is a pre-existing disease. The payment under Critical Care Benefit is always done in addition to the Sum Insured and is not deducted from the latter.

Cumulative Bonus:

According to this feature, the Sum Insured amount will get increased by a whopping 25% after every successful renewal (given that the year has been claim-free). The maximum increase can be up to 50% of the sum insured. In case the claim has been made during the policy tenure, the cumulative bonus accrued will come down.

If you fail to renew the Mediclaim policy even after 30 days of the expiry, then you will lose the cumulative policy. Suppose you have reduced the Sum Insured during policy renewal; the cumulative bonus percentage will apply to the reduced amount.

Continuity Benefit:

Certain health conditions get covered only after the insured person has been under continuous coverage for a given time period. For instance, cataract treatment expenditure can be compensated only when the insured person is under 24 months of coverage. He should also keep renewing his policy at the right time every year. In order to get compensated against health check-ups once a year, you will have to stay under continuous coverage.

Newborn Baby Cover:

When a baby is given birth by a mother who is under Continuous Coverage for at least 24 months, that baby gets covered against any kind of injury or illness from his/her date of birth to the expiry of the Mediclaim policy. You need not have to pay any additional premium for the baby’s coverage.

However, any kind of expenditure that the baby has incurred because of pre-mature, post-natal or pe-term care does not get covered. Congenital External Anomaly also comes under the exclusion.

Treatment For Congenital Diseases:

Under the New India Flexi Floater Mediclaim policy, congenital internal diseases get covered after at least 24 months of continuous coverage. On the other hand, congenital external diseases get covered after at least 48 months of continuous coverage. There will be a limitation of up to 10% of the average sum insured in the last four years.

Specific Coverages:

• If the insured person has been affected by the consumption of depressants or drugs (prescribed by a medical expert) and his intellectual faculties have been impacted, then as per the policy, he will be entitled to a maximum of INR 25,000 for treatment of his health condition.

• The Mediclaim also covers treatment expenses associated with stress, mental illness, psychological disorders or even neurodegenerative disorders. The waiting period for such diseases is 48 months and the limit is up to 25% of the Sum Insured.

• If the insured person is under an artificial life maintenance system, for instance, a life support machine, and there is absolutely no hope of him getting better, then he is entitled to 10% of the Sum Insured for up to 15 days for every policy period.

• The policy also covers genetic disorders up to 25% of the Sum Insured. And the waiting period, in this case, is 48 months.

• Coverage is offered for complications and health conditions that might arise because of menopause, puberty etc.

• ARMD or Age-Related Macular Degeneration gets covered up to 10% of the Sum Insured and the waiting period for this health condition is 48 months.

• Conditions like Dyslexia, adult personality disorder, stammering etc., gets covered with a limit of up to 25% of the Sum Insured.

Modern Treatments Coverage:

A total of 12 modern treatments, such as Balloon Sinuplasty, Oral Chemotherapy, and Robotic surgeries, are covered under the Mediclaim policy. To know more about the limit of coverage, refer to the policy brochure.

No Proportionate Deduction:

This is one of the optional covers and is applicable for those insured persons who have Sum Insured worth INR 2 lakhs or more. By paying an additional premium for every insured individual under the policy, a proportionate deduction of the policy will be stopped for the members.

Maternity Expenses Benefit:

If your sun insured is INR 5 lakhs or more, you are eligible to get this optional cover. You need to pay an additional premium to avail of this optional cover. One needs to wait for at least 36 months after opting for this cover to avail of the compensation.

Revision in the Limit of Cataract:

For those insured persons whose Sum Insured is INR 8 lakhs or above, this optional coverage is available. On paying an extra premium, the policy agrees to pay an additional amount for Cataract treatment. The waiting period for this optional coverage is 36 months.