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New India Mediclaim Policy

New India Mediclaim is a dedicated insurance Policy that covers Hospitalisation expenses. In short, it is a type of health insurance policy that provides coverage for medical expenses, including hospital and hospitalization bills incurred due to illness or injury. All applicants for this insurance must be between the ages of 18 and 65. If one or both parents are concurrently covered, children between the ages of 3 months and 18 are covered. If both parents are covered at the same time and the child is between the ages of 18 and 25, they are eligible for coverage. The major highlight of choosing the policy is that Lifelong renewal is available. Let’s know more about the policy.

Eligibility Criteria

Here are the eligibility criteria for the New India Mediclaim Insurance Plan.

ParametersDetails
Age

Minimum- 18 Years

Maximum- 65 Years

Sum InsuredRs. 1,2, 3, 5, 8, 10, 12, and 15 Lakhs (4,6,7 Lakh Sum Insured bands are only available for renewals)
Members CoveredProposer, Proposer’s Spouse, Proposer’s Children, Proposer’s Parents, Proposer’s Brother/Sister, Proposer’s Ward, Employers can cover their Employees
Policy period1 Year

Coverage Details

Here are the coverage details for the New India Mediclaim Insurance Plan.

ParametersDetails
Cumulative Bonus@25% SI for claim free year with Max 50% of SI
Health Check UpEvery 3 claim-free years
CataractUp to 20% of the Sum Insured or Rs. 50,000
Ayurvedic / Homeopathic / Unani treatmentsUp to 25% of the Sum Insured
Ambulance ChargesRate of 1% of the Sum Insured
Hospital CashRate of 0.1% Sum Insured per day, up to a maximum of 1% Sum Insured
Day Care procedures139 Day Care procedures are covered under this policy

Key Features and Benefits of Considering the New India Mediclaim Policy

Here are the salient features and benefits of choosing the New India Mediclaim Insurance Plan.

  • Dental Treatment (Inpatient): The plan will pay for medical costs related to dental work done under anaesthesia that is required because of an accident, injury, or sickness that necessitates hospitalisation as part of inpatient treatment.
  • Treatments Under Ayurvedic, Homoeopathic, and Unani Systems: Expenses for Ayurvedic, Homoeopathic, and Unani Treatment are allowable up to 25% of the Sum Insured provided the treatment for Illness or Injury is taken in a government hospital or any institute recognised by the government and/or accredited by the Quality Council of India / National Accreditation Board on Health, excluding facilities for spas, massages, and health rejuvenation procedures.
  • Hospital Cash: The plan will pay Hospital Cash at a rate of 0.1% of the Sum Insured for each day of hospitalisation that is permissible under the Policy for those Insured Persons whose Sum Insured is greater than or equal to Rs. three lakhs.
  • Health Check-Up: After a block of every three claim-free years, the insured person is entitled to reimbursement for the cost of a medical check-up. Such payment shall not exceed Rs. 5,000 or 1% of the Insured Person’s average Sum Insured during the three years prior, whichever is less. Only once every three years is this benefit available.
  • Payment Of Ambulance Charges: The plan will cover any reasonable and medically necessary ambulance fees up to 1% of the insured amount for each insured event that you incur when moving an insured person to the hospital for admission to the emergency room or intensive care unit (ICU) or from one hospital to another for better medical facilities.
  • Medical Expenses for Organ Transplant: If the treatment requires an organ transplant for the insured person, the plan will also cover hospitalisation costs (excluding the cost of the organ), as long as their liability for costs incurred on both the donor and the insured recipient does not exceed the sum of the insured amount and any cumulative bonuses received by the insured person who will be receiving the organ.
  • Free Look Period: Following receipt of the policy document, the insured person has fifteen days to evaluate the terms and conditions and return the document if they are not satisfactory.

Exclusions Under the New India Mediclaim Insurance Policy

Pre-Existing Diseases:

  • Until the end of 48 months of uninterrupted coverage following the date of the start of the first policy with the company, costs associated with the medical management of a pre-existing disease (PED) and its direct complications must be excluded.
  • If the Sum Insured is increased, the exclusion will once again apply to the total amount of the increase in the Sum Insured.
  • The waiting period for the same benefit would be decreased to the extent of prior insurance if the insured person maintains uninterrupted coverage without interruption under the portability criteria of the current IRDAI (Health Insurance) Regulations.
  • Pre-existing conditions must be disclosed and approved at the time of application for any pre-existing conditions to be covered under the policy after the first 48 months have passed.

Specific Waiting Period:

  • The costs of the procedures, treatments, and conditions indicated below will not be covered up to ninety days, 24 months, 36 months, or 48 months of uninterrupted coverage, as applicable, from the start date of the initial insurance with the insurer. Claims resulting from accidents are not subject to this restriction.
  • If the amount insured is increased, the exclusion will reapply to the extent of the increase.
  • The larger of the two waiting periods will be used if any of the specified diseases or procedures fall under the pre existing disease waiting period.
  • If the mentioned circumstances are contracted after the policy is issued or if they are stated and accepted without a particular exclusion, the waiting period will still be in effect.
  • The waiting period would be shortened to the level of prior coverage if the insured person maintains continuous coverage without a break as indicated by the applicable portability rules established by IRDAI.

Investigation & Evaluation:

  • Costs associated with any admission, mostly for testing and evaluation.
  • Any diagnostic costs that are not incidental to the current diagnosis and therapy or that are unrelated to it.

Premium Illustration of the New India Mediclaim Policy

Let’s take Mr. Umesh Thakur, a software designer from Bangalore who works for a corporation, as a case study. He was hoping to get a specialised health plan that would protect him against medical emergencies due to the high expense of medical care. He also does not want to take any chances because he is the family’s sole provider and medical costs are rising. He considered several options before settling on the New India Mediclaim Plan.

AgeNo. of Members CoveredSum InsuredPremium Amount
30 Years1Rs. 3, 00, 000Rs. 5,085.00 (Excluding GST)
40 Years1Rs. 10, 00, 000Rs. 11,576.00 (Excluding GST)

Buying Process: How To Buy the New India Mediclaim Policy?

The main benefit of purchasing a Mediclaim policy, such as the New India Mediclaim Insurance Policy, is that it pays for hospitalisation bills as well as supplemental expenses like ambulance fees and daily cash allowances. Up until the insured amount is used up, the insured may file repeated claims. If the insured has an accident or is identified as having a serious disease, they will get a lump sum payout. If you are interested in buying the New India Mediclaim Insurance Plan, then listed below are the tips that you will need to follow.

  • Go to the New India Insurance official website.
  • The “Products section” can be found at the top of the home page in the blue banner. Just click it. Look for “Health” in the menu. Click “More” in the corner after that.
  • When you click on it, many health plans will appear in the “Health” area. Visit “New India Mediclaim Policy (Cashless Facility Available)” next. To view the plan page, click “Know More” after hovering your cursor over it.
  • The plan page will then be displayed. Then “Buy Online” will appear. Just click it. You will be prompted to enter all the necessary information on a new page, including your policy period information, date of birth, sum insured, members to add, contact information, and more. Click on two of the checks when you have correctly input all the information. Click “Calculate Premium” after that.
  • The insured amount and all of your premium information will then be displayed. Click “Save & Continue” if you are satisfied with the premium amount you need to pay.
  • After that, a registration box will show up. After clicking “Register,” provide your first and last names, birthdate, email address, mobile number, and other information. On the checkbox, click. After that, select the “Register” button.
  • You must continue with the purchasing process once your registration has been approved. You will then be prompted to submit more information on a different page, including your residence, profession, annual income, and more.
  • It will launch a payment page where you can finish the transaction with your credit/debit card, Net Banking, EMI, or UPI when you click it.
  • Click “Proceed to Pay” after that. The final stage is sending you the policy documents and a message by email and your registered mobile number.

Know The Complete Claim Process of the New India Mediclaim Insurance Plan

There are two types of health insurance claims. They are:

Reimbursement Claims:

In this kind of claim procedure, you pay the hospital the upfront cost before sending the bill to the New India insurance provider. The insurance then confirms the information provided, and if everything is accurate, they refund you for your expenses. You may submit a claim for reimbursement whether or not you received care at a network hospital.

Here is the reimbursement process. 

  • With this kind of claim procedure, you can pay the hospital’s medical bill in full upfront. Then, send the bill and any supporting documentation to the insurer, who will review everything and, if everything checks out, reimburse you for the cost in your bank account.
  • In this case, you can pay for your treatment at a network or non-network hospital and then receive a reimbursement from the insurer once you submit the bill.
  • The New India insurance company will give you many deadlines to finish the reimbursement claim. You must inform the hospital and the patient two days before admission if a patient is receiving the anticipated medical care.
  • You should tell the New India insurance company as soon as possible after being admitted to the hospital if an emergency prevented you from doing so in time. You must notify the insurer of an urgent admission to a non-network hospital within 24 hours of admission, detailing the patient’s current health state.
  • You have a third option if you are unable to follow any of the aforementioned claim procedures. You can then proceed to submit the reimbursement claim to the insurer after the hospitalised patient has been released. However, you must do this between 7 and 15 days after your hospital discharge.

Cashless Claims:

If you receive treatment at a network hospital, you can transmit the medical bill directly to the insurance provider, who will then settle the charge with the hospital after validating the information.

Here is cashless claims process:

  • The bill amount incurred is directly paid by the insurance to the hospital under a cashless Mediclaim process. However, for your claim procedure to go well, you must tell your insurer well in advance and have yourself treated at one of the insurer’s network hospitals.
  • However, a cashless plan does not indicate that the policyholder won’t have to make any out-of-pocket payments.
  • The policyholder is responsible for paying any costs that the insurance company does not cover, such as consumables.
  • If the insured has opted for a cashless hospitalisation plan, they just need to pay a predetermined amount; the insurer will cover the remaining balance.

Renew the Expired New India Mediclaim Policy

The goal of purchasing a health insurance policy is to have your family’s and your own medical needs covered. By making on-time premium payments, this is secured. You never know when you’ll have a sudden medical necessity. If you don’t renew your insurance, you won’t be able to file a claim for any shocking medical expenses that might unforeseen arrive at your door. Consequently, it’s crucial to renew your New India Mediclaim Insurance coverage. Let’s discuss the renewal steps below.

  • Go to the New India Insurance official website.
  • You will discover the “Quick Help” button at the top. Just click it. The term “Quick Renewal” will then appear. Just click it.
  • You will be required to provide your customer ID and policy number on the following page. Make sure you type the appropriate information. Click the “Proceed” button after that.
  • The insurance renewal premium will then need to be paid. At that moment, you can use a credit or debit card to renew your insurance.
  • Your registered phone number and email address will receive a message with information about your insurance when you make the payment.

Frequently Asked Questions

Yes, but only in extremely rare circumstances, such as where you or someone acting on your behalf committed fraud, misrepresentation, suppression, or non-cooperation during the application process for insurance or afterward regarding that insurance.

No. If you pay the renewal premium before the policy expiration date, you can renew your policy. Age restrictions apply when purchasing a new policy, but not while renewing an existing one.

Yes. The Continuity Benefits would not be impacted if your policy is renewed within 30 days of the preceding policy expiring. However, even if you renew your policy within 30 days of the expiration of your previous policy, any illnesses you develop, injuries you suffer, or hospitalisation that starts during the insurance gap is not covered.

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