New India Insurance Plans

New India Mediclaim Health Insurance

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New India Mediclaim is a Policy specially designed to cover Hospitalisation expenses. One is covered for any Hospitalisation during the period of Insurance for any Illness or Injury admissible under the policy. Hospitalisation should be for more than 24 hours except for specified / listed procedures requiring less than 24 hours Hospitalisation.

Key features of New India Mediclaim Insurance plan

  • Room Rent: Covered upto 1% of Sum Insured daily limit /NIL on Premier plan.
  • Co - pay: Option of Copay upto 20% on certain mediclaim plans.
  • Restoration Benefit: NIL Restoration benefit.

New India Health Insurance Review

New India Assurance Health Insurance
New India Assurance Insurance sum insured
2 lacs − 100 lacs options available
Incurred Claims Ratio *
New India Insurance tenure options
1 year
Claims Settlement Ratio **
List of network hospitals
3,000+ hospitals
Number of policies issued *
Maximum family floater coverage
Self, Spouse + dependent (children + parent)
Number of lives covered *
* As per IRDAI report for 2018-19   |   ** As per NL25 data published on the Insurance Company website

Overview of New India Mediclaim Policy

  • Eligibility
  • Features
  • Benefits
  • How to buy
  • Claims procedure
  • Exclusions

Who can buy New India Mediclaim Health Insurance?

  • All the persons proposed for this Insurance should be between the age of 18 years and 65 years.
  • Children between the age of 3 months and 18 years are covered provided one or both parents are covered concurrently.
  • Children between 18 years to 25 years can be covered provided they are financially dependent on the parents and one or both parents are covered simultaneously.

Eligibility of New India Mediclaim Health Insurance for Family Members

  • Proposer
  • Proposer’s Spouse
  • Proposer’s Children
  • Proposer’s Parents

Salient Features of New India Mediclaim Health Insurance

Some of the key salient features of New India Mediclaim Health Insurance include:
  • No Zonewise Premium rating – rating only based on age and sum insured
  • Lifelong Renewal subject to there not being a break in the renewal of the policy
  • Pre Acceptance Medical Check up only for insureds beyond 50 years of age
  • No Loading for Adverse Claims Experience
  • No Loading for Diabetes & Hypertension
  • Policy covers 139 Day Care Treatments
  • Free Look Period of 15 days

Benefits of New India Mediclaim Policy

Coverage Details Sum Insured
Sum Insured options available : (Proportionate deduction on the other expenses incurred at the Hospital, with the exception of cost of medicines, if Room Rent / ICU / ICCU charges exceeds the aforesaid limit. (Waived if No proportionate deduction option is Opted)) 1,00,000 2,00,000 3,00,000 5,00,000 8,00,000 10,00,000 12,00,000 15,00,000
Room Rent, Boarding and Nursing expenses as provided by the Hospital Not exceeding 1.0 % of the Sum Insured per day
Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses Not exceeding 2.0 % of the Sum Insured per day.
Pre Hospitalisation expense – expenses incurred days prior to the date of Hospitalisation. 30 days
Post Hospitalisation – expenses incurred post the date of discharge 60 days
Cataract (The said limit shall be applicable per event for all the Policies of Our Company including Group Policies. Even if two or more Policies of New India are invoked, sublimit of the Policy chosen by Insured shall prevail and our liability is restricted to stated sublimit.) 20% of Sum Insured subject to a maximum of Rs. 50,000
Ayurvedic / Homeopathic / Unani Treatment Up to 25% of the Sum Insured
Hospital cash (This benefit will reduce the Sum Insured. This benefit is payable only if the Hospitalisation is for more than 24 hours. This benefit is applicable only if the Sum Insured of the Insured Person is more than or equal to three lakhs) Paid at the rate of 0.1% per day maximum up to 1% of Sum Insured for any one Illness.
Health Check-up: Cost of health check-up shall be reimbursed to the Insured person after every block of Three Claim Free Years. Rs. 5000 or 1% of average Sum Insured of proceeding three years whichever is less
Ambulance service will be Payment under this benefit will reduce the Sum Insured. Ambulance charges will be paid once for Any One Illness for each Insured. Payable subject to cap 1% of Sum Insured.
Reinstatement of Sum Insured This benefit is applicable only if the Sum Insured of the Insured person is more than or equal to Rs. 5 lakhs. After exhausting the Sum Insured as mentioned in the Schedule, the Sum Insured shall stand restored for the remaining Policy Period for non-related illness.
Optional Covers
No Proportionate Deduction This benefit is applicable only if the Sum Insured of the Insured person is more than or equal to Rs. 2 lakhs. On payment of additional premium, proportionate deduction clause shall stand deleted
Maternity Expenses- This benefit is applicable only if the Sum Insured of the Insured person is more than or equal to Rs. 5 lakhs.
(Includes Day 1 New Born Baby cover)
On payment of additional premium, Maternity Expenses up to 10% of the average Sum Insured shall be payable after waiting period of thirty six months.
The said limit shall be applicable per event for all the Policies of Our Company including Group Policies. Even if two or more Policies of New India are invoked, sublimit of the Policy chosen by Insured shall prevail and our liability is restricted to stated sublimit.
Revision in cataract Limit- This benefit is applicable only if the Sum Insured of the Insured person is more than or equal to Rs. 8 lakhs. On payment of additional premium, additional limit shall be as follows
Sum Insured Revised Cataract Limit
Rs. 8,00,000 Rs. 80,000
Rs. 10,00,000 Rs. 1,00,000
Rs. 12,00,000 Rs. 1,20,000
Rs. 15,00,000 Rs. 1,50,000
Voluntary Co-Pay If the Insured person opts for voluntary co-pay of 20%, a discount of 15% shall be of given on the premium payable for the Insured Person.
Congenital Internal Diseases Covered up to the Sum Insured provided the Insured has Continuous Coverage of twenty four months
Congenital External Diseases Covered up to 10% of Sum Insured provided the Insured has Continuous Coverage of thirty six months.

Benefits under New India Health Insurance plans include:

Some of the benefits under the New India Health plans are below…
  • Cashless facility – New India processes all cashless claims across 3,500 + quality hospitals in their network across India.
  • This Policy covers In–Patient Hospitalisation Expenses incurred in India. This policy will respond only when the aggregate of all Hospitalisation expenses (except Pre / Post hospitalization expenses) of one or all members of the policy, exceeds the "Threshold" stated in the policy.
  • The policy can be issued on Individual or Floater Sum Insured basis covering up to 6 members of the family. If the policy is to be issued on Individual Sum Insured basis, then separate document will be issued to each Insured.
  • Inpatient Treatment Covered expenses include: Hospital room rent, Boarding expenses and doctor fees, Operation Theatre and Intensive Care charges, Nursing expenses and Medicines that you consume during the hospital stay
  • Cumulative bonus for every two claim free years up to 100% of the base sum insured.
  • Sum Insured Restoration at No Extra Cost : This benefit recharges your exhausted health cover to treat the next hospitalization of a new illness or injury, the recharge is upto 50% of the Sum insured.
  • Cumulative Bonus @25% SI for claim free year with Max 50% of SI.
  • New Born Baby cover
  • Critical Care Benefit - 10% of the Sum Insured.
  • Midterm inclusion of newly married spouse.
  • Cataract claims, up to 10% of Sum Insured or Rs. 50,000 whichever less, for each eye.
  • Ayurvedic/Homoeopathic/ Unani treatments are covered, up to 25% of the Sum Insured
  • Ambulance Charges at the rate of 1% of the Sum Insured.
  • Hospital Cash at the rate of 0.1% Sum Insured per day, up to a maximum of 1% Sum Insured.
  • 139 Day Care procedures are covered.
  • Lifelong Renewability : New India assures you renewability for life without any extra loadings based on the claims
  • Income Tax Exemption under section 80D if the Income Tax Act.
  • Optional Covers
    • I : No Proportionate Deduction
    • II : Maternity Expenses Benefit for Sum Insured 5 Lakhs and Above (Maximum of 10% of the average SI of the Insured Person in the preceding three years)
    • III : Revision in Limit of Cataract (For 8 Lakhs & above SI revised limit for Cataract will be 10% of the Sum Insured)

How can one Buy a New India Health Insurance policy?

There are many distribution channels that distribute New India Health insurance products that include Agents, Banks and Brokers. One of the key distributors is the Web Aggregators which are online distributors of insurance and the advantage is that they offer a comparison of all insurance products to the customer, to allow them to compare the plans before opting for a health insurance plan that most suits his/her needs.
  • Step 1- Visit a product comparison website eindiainsurance to review and compare policy benefits, coverage and premium details online
  • Step 2 - Seek information and clarity on the charges, inclusions, exclusions, other terms and conditions under the policy
  • Step 3 - Fill the New India online Health Insurance proposal form stating your personal details and health profile while ensuring the information given is complete and accurate
  • Step 4 – If this is a Straight through proposal, the premium remitted online will be transferred directly to the insurance company, and the policy will be issued, dispatched and will reach you in 7 working days
  • Step 5 – For Non Straight through cases, New India will process the application forwarded to them. Based on the information provided, one may be required to undergo pre-policy tests at designated diagnostic centers or they may just levy a loading based on the health report
  • Step 6 - If the proposal is accepted, the same will be issued accordingly
  • Step 7 - The Policy Schedule, Policy Wordings, Cashless Cards and Health Guide will be sent to the insured’s mailing address mentioned on the proposal form in the prescribed Turn around time.

Claim Process

You can contact New India Insurance through:
  • 24 x 7 Toll Free : 1800-209-1415
For Cashless Hospitalisation
  • Intimate TPA in writing on detection of any Illness/Injury being suffered immediately or forty eight hours before Hospitalisation.
  • Intimate within twenty four hours from the time of Hospitalisation in case of Hospitalisation due to medical emergency.
  • Submit following supporting documents TPA relating to the claim within seven days from the date of discharge from the Hospital:
  • Bill, Receipt and Discharge certificate / card from the Hospital.
  • Cash Memos from the Hospitals (s) / Chemists (s), supported by proper prescriptions.
  • Receipt and Pathological test reports from Pathologist supported by the note from the attending Medical Practitioner / Surgeon recommending such Pathological tests / pathological.
  • Surgeon's certificate stating nature of operation performed and Surgeons' bill and receipt.
  • Attending Doctor's/ Consultant's/ Specialist's / Anesthetist's bill and receipt, and certificate regarding diagnosis.
  • 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 a claim is based and shall also give the TPA/Us such additional information and assistance as the TPA / We may require.
Any Medical Practitioner authorised by the TPA/Us shall be allowed to examine the Insured Person, at our cost, if We deem Medically Necessary in connection with any claim.

For Reimbursement Claims
In case of treatment in a non–Network Hospital, TPA will reimburse You the amount of bills subject to the conditions of the Policy. You must ensure that the Hospital where treatment is taken fulfills the conditions of definition of Hospital in the Policy. Within twenty four hours of Hospitalisation the TPA should be intimated. The following documents in original should be submitted to the TPA within seven days from the date of Discharge from the Hospital:
  • Claim Form duly filled and signed by the claimant
  • Discharge Certificate from the hospital
  • All documents pertaining to the illness starting from the date it was first detected i.e. Doctor’s consultation reports/history
  • Bills, Receipts, Cash Memos from hospital supported by proper prescription
  • Receipt and diagnostic test report supported by a note from the attending medical practitioner/surgeon justifying such diagnostics.
  • Surgeon’s certificate stating the nature of the operation performed and surgeon’s bill and receipt
  • Attending doctor’s / consultant’s / specialist’s / anesthetist’s bill and receipt, and certificate regarding diagnosis
  • Details of previous policies if the details are not already with TPA or any other information needed by the TPA for considering the claim.

Exclusions under all New India Health Plans

What are excluded under this policy? No claim will be payable under this Policy for the following; however kindly refer the policy wordings with the policy kit for the complete list of exclusions:
  • Treatment of any Pre–Existing Condition/Disease, until forty eight months of Continuous Coverage of such Insured Person have elapsed, from the Date of inception of his/her first Policy with Us as mentioned in the Schedule.
  • Any Illness contracted by the Insured person (except Injury) during the first 30 days of the commencement date of this Policy. This exclusion shall not however, apply if the Insured person has Continuous Coverage for more than twelve months.
  • Unless the Insured Person has Continuous Coverage in excess of twenty four months with Us, expenses on treatment of the following Illnesses are not payable:
    • All internal and external benign tumors, cysts, polyps of any kind, including benign breast lumps
    • Benign ear, nose, throat disorders
    • Benign prostate hypertrophy
    • Cataract and age related eye ailments
    • Gastric/ Duodenal Ulcer
    • Gout and Rheumatism
    • Hernia of all types
    • Hydrocele
    • Infective Arthritis
    • Piles, Fissures and Fistula in anus
    • Pilonidal sinus, Sinusitis and related disorders
    • Prolapse inter Vertebral Disc and Spinal Diseases unless arising from Accident
    • Skin Disorders
    • Stone in Gall Bladder and Bile duct, excluding malignancy
    • Stones in Urinary system
    • Varicose Veins and Varicose Ulcers
    • Renal Failure
  • Unless the Insured Person has Continuous Coverage in excess of forty eight months with Us, the expenses related to treatment of
    • Joint Replacement due to Degenerative Condition,
    • Age–related Osteoarthritis & Osteoporosis are not payable
  • Injury / Illness directly or indirectly caused by or arising from or attributable to War, invasion, Act of Foreign enemy, War like operations (whether war be declared or not), nuclear weapon/ ionising radiation, contamination by Radioactive material, nuclear fuel or nuclear waste or from the combustion of nuclear fuel.
  • No Coverage for
    • Circumcision unless Medically Necessary for treatment of an Illness not excluded hereunder or as may be necessitated due to an Accident
    • Change of life/sex change or cosmetic or aesthetic treatment (except for burns/Injury) of any description such as correction of eyesight, etc
    • Plastic Surgery other than as may be necessitated due to an Accident or as a part of any Illness.
    • Vaccination and/or inoculation.
    • Cost of braces, equipment or external prosthetic devices, non–durable implants, eyeglasses, Cost of spectacles and contact lenses, hearing aids including cochlear implants, durable medical equipment.
    • Dental treatment or Surgery of any kind unless necessitated by Accident and requiring Hospitalisation.
    • Convalescence, general debility, ’Run–down’ condition or rest cure, obesity treatment and its complications, treatment relating to all psychiatric and psychosomatic disorders, infertility, sterility, Venereal disease, intentional self–Injury and Illness or Injury caused by the use of intoxicating drugs/alcohol.
    • Congenital Internal and External Disease or Defects or anomalies.
    • Bodily Injury due to willful or deliberate exposure to danger (except in an attempt to save human life), intentional self–inflicted Injury, attempted suicide, Illness arising out of non–adherence to medical advice.
    • Treatment of any Bodily Injury or Illness sustained whilst or as a result of active participation in any hazardous sports of any kind.
    • Treatment of any Injury or Illness sustained whilst or as a result of participating in any criminal act.
    • Sexually Transmitted Diseases, any condition directly or indirectly caused to or associated with Human T–Cell Lymphotropic Virus Type III (HTLB – III) or lymphadenopathy Associated Virus (LAV) or the Mutants Derivative or Variation Deficiency Syndrome or any syndrome or condition of a similar kind commonly referred to as AIDS.
    • Charges incurred at Hospital primarily for diagnosis, x–ray or Laboratory examinations or other diagnostic studies not consistent with or incidental to the diagnosis and treatment of positive existence or presence of any Illness or Injury for which confinement is required at a Hospital
    • Maternity Expenses, except abdominal operation for extra uterine pregnancy (Ectopic Pregnancy), which is proved by submission of Ultra Sonographic Report and Certification by Gynaecologist that it is life threatening one if left untreated.
NEW INDIA ASSURANCE CO. LTD, founded by Sir Dorabji Tata in 1919, a Multinational General Insurance Company, today operates in 28 countries and headquartered at Mumbai, India. Their global business crossed ₹26607 crores (India business crossed ₹23,910 crores) as onMarch 2019.

They have been market leaders in India in Non-Life business for more than 40 years and they are the only direct insurer in India rated A-(Excellent) by AM BEST Company since 2007. They have also been rated AAA/Stable by CRISIL since 2014, indicating that the Company has the highest degree of Financial Strength to honour its Policyholder's obligations.

Their Indian operations span across all territories through 2395 offices, including 476 DOs, 595 BOs, 26 DABs and 1257 Micro Offices. We have 16795 employees as on 31st December 2019, providing insurance services to our customers. We have over 250 products.

New India offers their health insurance customers the option of availing quality treatment at more than 3,000+ leading hospitals across the country. With an incurred claims ratio of 103%, they also covered 875.61 lac lives during the same year 2018-19, as per the data provided by IRDAI.

Awards Won by New India in the recent past:


Why Should One insure themselves through New India Health Insurance plans?

  • New India is the largest Non Life (General) Insurance company in India and has been continuously growing year on year and currently enjoys an almost 15% market share.
  • Largest number of Offices - In India and Abroad Trained and technically qualified staff 2221 fully computerised offices across India.
  • "A-" (Excellent) rating by A.M.Best & Co (Europe) First domestic company to be rated by an International Rating Agency Rating based upon following factors:
    • Superior capital position
    • Strong operating performance
    • Strong market position
    • Only company to develop significant International operations, long record of successful trading outside India.
  • New India are Pioneers with many firsts in the industry
    • First company to set up an Aviation Insurance Department in 1946.
    • First company to handle the Hull Insurance requirements of the Indian Shipping Fleet.
    • First company to establish its own Training School.
    • First company to introduce the concept of 'Model Office Training'.
  • Cashless Hospitalization Across the Large Network With More Than 3,000+ Hospitals in India for their insured customers offering Transparent and Trusted claims service
  • Wide Range Of Health Insurance Products From Individual Plans to Family Floater Schemes with Sum Insureds ranging from ₹2 lacs to ₹100 lacs
  • World class Customer Centric Support through its 24X7 service centre known for transparency and ease

New India Insurance is today one of the fastest growing insurance players in India with a lot of focus on both retail and group insurance products. Today the New India health insurance premium is one of the most competitive in the market across all their plans apart from being competitive in their benefit structure. They are also one of the players who have built a strong hospital network across India with a current strength of 5,000+. Most of the customer’s New India health insurance reviews have been positively influencing the growth of their business year on year. One can also follow the New India health insurance renewal link on eindiainsurance for renewal of their existing policies and if one needs to file a claim, all they need to do is to fill in the New India health insurance claim form available on the same website.

New India Assurance health insurance products

New India Premier is a Policy designed to cover Hospitalisation expenses of the Persons who would like to be covered under this Policy.
Senior citizen residing in India and aged between 60 and 80 years.

New India Assurance Family Floater health insurance offers comprehensive and best health insurance coverage for Indians aged from 18 years to 60 years.
Available as indidivial or family health insurance up to 6 members in the family.

This policy is designed to the parents with only girl children. This insurance is available to persons between the age of 18 years and 65 years.
All the persons proposed for this Insurance should be between the age of 18 years and 65 years.

This policy is designed to provide cheap medical insurance to poorer sections of society Premium upto Rs.10000/- qualifies for tax benefit under Sec 80D of the Income Tax Act.
Policy can be availed by persons between the age of 18 years and 65years.

This Policy is designed to give You, protection against unforeseen expenses towards treatment of Cancer.
Entry age – Day 18 to 65 years. Policy period – 3 1/2 months (105 days), 6 1/2 ( 195 days), 9 1/2 months(285 days).

New India Health Insurance FAQ’s

The term Pre–existing condition/disease is defined in the Policy as Any condition, ailment or Injury or related condition(s) for which there were signs or symptoms, and/or were diagnosed, and/or for which medical advice / treatment was received within forty eight months prior to the first policy issued by Us and renewed continuously thereafter. If You had:
  • Signs or symptoms, or
  • Been diagnosed or received Medical Advice, or
  • Been Treated for any condition or disease within forty eight months prior to the commencement of the first policy with us,
Such a condition or disease shall be considered as Pre–existing. Any Hospitalisation arising out of such pre–existing disease or condition is not covered under the Policy until forty eight months of Continuous Coverage have elapsed for the Insured Person.

Pre–acceptance medical check–up is required for all the members entering after the age of 50 years. A person also needs to undergo this pre–acceptance medical check–up if he has an adverse medical history or if the health condition of the person/s to be Insured is such that the office in–charge feels that he / she be subjected to a medical examination. The cost of this check–up will be borne by the proposer. But if the proposal is accepted, then 50% of the cost of this check–up will be reimbursed to the proposer.Pre–acceptance medical check–up shall be conducted at designated centers authorized by Us.

Yes. Unless the Insured Person is Hospitalised for a condition warranting Hospitalisation, no claim is payable under the Policy. The Policy does not cover outpatient treatments.

Yes, the Policy covers treatment and/or services rendered only in India.

The Policy is valid during the Period of Insurance stated in the Schedule attached to the Policy. It is usually valid for a period of one year from the date of beginning of insurance.

Yes. If Your Policy is renewed within thirty days of the expiry of the previous Policy, then the Continuity Benefits would not be affected. But even if You renew Your Policy within thirty days of expiry of previous Policy, any disease contracted or injuries sustained or Hospitalisation commencing during the break in insurance is not covered. Therefore it is in Your own interest to see that You renew the Policy before it expires.

We may agree for a request for increase in Sum Insured at the time of renewal. But We are not obliged to agree to this request, if we feel the Person is not in good health. Moreover, for persons aged over 60, such a request could entail subjecting the Person for Medical Examination and other Medical tests. (In case the risk is accepted, 50% of the reasonable cost of Medical Examination would be reimbursed).

Enhancement of Sum Insured is subject to the limits mentioned below:
  • Age <= 50 years Up to Sum Insured of 15 lakhs without Medical Examination
  • Age 51–60 Years By two slabs without Medical Examination
  • Age 61 – 65 Years By one slab with Medical Examination
Enhancement of Sum Insured will not be considered for:
  • Any Insured Person over 65 years of age.
  • Any Insured Person who had undergone more than one Hospitalisation in the preceding two years.
  • Any Insured Person suffering from one or more of the following Illnesses / Conditions: Any chronic Illness, Any recurring Illness, Any Critical Illness

No. Your Policy can be renewed, as long as You pay the Renewal Premium before the date of expiry of the Policy. There is an age limit for taking a fresh Policy, but there is no age limit for renewal. However, if You do not renew Your Policy before the date of expiry or within thirty days of the date of expiry, the Policy may not be renewed, and only a fresh Policy could be issued, subject to Our underwriting rules. In such cases, it is possible that a fresh Policy could not be issued by Us. It is therefore in Your interest to ensure that Your Policy is renewed before expiry.

We may refuse to renew the Policy only on rare occasions such as fraud, misrepresentation or suppression or non–cooperation being committed by You or any one acting on Your behalf in obtaining insurance or subsequently in relation thereto. If We discontinue selling this Policy, it might not be possible to renew this Policy on the same terms and conditions. In such a case You shall however have the option for renewal under any similar Policy being issued by the Company, provided the benefits payable shall be subject to the terms contained in such other Policy.

In case of revision or modification or withdrawal of the Policy a notice will be provided to You 90 days before such revision or modification or withdrawal. Renewal can also be refused if the Policy is not renewed before expiry of the Policy or within the Grace Period.

Claims for Illnesses cannot be made during the first thirty days of a fresh Insurance policy. However, claims for Hospitalization due to accidents occurring during the first thirty days are payable. There are certain treatments where the waiting period is two years or four years.

Third Party Administrator (TPA) is a service provider to facilitate service to You for providing Cashless facility for all hospitalizations that come under the scope of Your policy. The TPA also settles reimbursement claims within the scope of the Policy.

Cashless hospitalization is service provided by the TPA on Our behalf whereby you are not required to settle the hospitalization expenses at the time of discharge from hospital. The settlement is done directly by the TPA on Our behalf. However those expenses which are not admissible under the Policy would not be paid, and You would have to pay such inadmissible expenses to the Hospital. Cashless facility is available only in Networked Hospitals. Prior approval is required from the TPA before the patient is admitted into the Network Hospital. The list of Network Hospitals can also be obtained from the TPA or from their website. You will have full freedom to choose the hospitals from the Network Hospitals and avail Cashless facility on production of proof of Insurance and Your identity, subject to the claim being admissible. The TPA might not agree to provide Cashless facility at a Hospital which is not a Network Hospital. In such cases You may avail treatment at any Hospital of Your choice and seek reimbursement of the claim subject to the terms and conditions of the Policy. In cases where the admissibility of the claim could not be determined with the available documents, even if the treatment is at a Network Hospital, the TPA may refuse to provide Cashless facility. Such refusal may not necessarily mean denial of the claim. You may seek reimbursement of the expenses incurred by producing all relevant documents and the TPA may pay the claim, if it is admissible under the terms and conditions of the Policy.

Yes it is possible to shift to another hospital for reasons of requirement of better medical procedure. However, this will be evaluated by the TPA on the merits of the case and as per policy terms and conditions.

The Policy allows reimbursement of medical expenses incurred before and after admissible Hospitalisation up to a certain number of days. For reimbursement, send all bills in original with supporting documents along with a copy of the discharge summary and a copy of the authorization letter to your TPA. The bills must be sent to the TPA within 7 days from the date of completion of treatment. You must also provide the TPA with additional information and assistance as may be required by the company/TPA in dealing with the claim.

No payment shall be made for any Hospitalisation expenses incurred, unless they form part of the Hospital Bill. However, the bills raised by Surgeon, Anaesthetist directly and not included in the Hospital Bill shall be paid provided a numbered Bill is produced in support thereof, for an amount not exceeding Rs. Ten thousand, where such payment is made in cash and for an amount not exceeding Rs. Twenty thousand, where such payment is made by cheque.

If treatment involves Organ Transplant to Insured Person, then We will also pay Hospitalisation Expenses (excluding cost of organ) incurred on the donor, provided Our liability towards expenses incurred on the donor and the insured recipient shall not exceed the aggregate of the Sum Insured and Cumulative Bonus Buffer, if any, of the Insured Person receiving the organ.

A New Born Baby is covered for any Illness or Injury from the date of birth till the expiry of this Policy, within the terms of this Policy. Any expense incurred towards post natal care, pre–term or pre–mature care or any such expense incurred in connection with delivery of such New Born Baby would not be covered. Congenital External Anomaly of the New Born Baby is also not covered under the policy. No coverage for the New Born Baby would be available during subsequent renewals unless the child is declared for insurance and covered as an Insured Person.

Yes, a claim, which is not covered under the Policy conditions, can be rejected. In case You are not satisfied by the reasons for rejection, you can represent to Us within 15 days of such denial. If You do not receive a response to Your representation or if You are not satisfied with the response, You may write to our Grievance Cell. You also have the right to represent your case to the Insurance Ombudsman. The contact details of the office of the Insurance Ombudsman could be obtained from the IRDAI website.

Yes, You can. You will be allowed a period of fifteen days from the date of receipt of the Policy to review the terms and conditions of the Policy and to return the same if not acceptable.

If You have not made any claim during the free look period, You shall be entitled to:
  • A refund of the premium paid less any expenses incurred by Us on medical examination and the stamp duty charges or
  • where the risk has already commenced and the option of return of the policy is exercised by You, a deduction towards the proportionate risk premium for period on cover or
  • Where only a part of the risk has commenced, such proportionate risk premium commensurate with the risk covered during such period.

If you choose to cancel the policy after expiry of Free Look Period, the refund would be at our Short Period rate table given below:
  • Up to one month 1/4th of the annual rate
  • Up to three months 1/2 of the annual rate
  • Up to six months 3/4th of the annual rate
  • Exceeding six months Full annual rate

The refund would be made only if no claim has been made or paid under the Policy. We may also at any time cancel the Policy on grounds of misrepresentation, fraud, non–disclosure of material fact or non–cooperation by You by sending fifteen days’ notice in writing by Registered A/D to You at the address stated in the Policy. Even if there are several insured persons, notice will be sent to You. On such cancellation, premium corresponding to the unexpired period of Insurance will be refunded, if no claim has been made or paid under the Policy.

Yes. Payments made for health insurance in any mode other than cash are eligible for deduction from taxable income as per Section 80 D of the Income Tax Act, 1961. For details, please refer to the relevant Section of the Income Tax Act.

Your ideal sum insured or total coverage would highly depend on factors such as your current age, lifestyle, medical history, income and place of residence. Looking at the medical inflation, most of our customers prefer a health insurance policy with a sum insured of 5 lacs and above.

  • Initial Waiting Period is the cooling period applied at the start of new policy. This waiting period is not applicable for renewal policy or portability policy. Only Accidents are covered in the Intial Waiting period.
  • Pre Existing Disease waiting period is the waiting period applied for any of the existing disease customer is suffering from. It might vary from 4 years in Classic to 2 years in Elite Plan. With each policy year, the pre existing disease waiting period reduces by 1 year. Any claim related to pre existing disease hospitalization will not be covered in the policy during waiting period.

Absolutely! With employee health cover the major drawbacks come in picture when you leave your job that's when your policy goes out of action and exposes you to health risks. Your new employer may or may not cover you sufficiently. Also, having your own policy means a better buying decision and complete control to buy a cover which suits your requirement from time to time.

New India has an extensive network of 3,500+ network hospitals across India growing steadily over the years. One must get admitted to a network hospital in order to avail cashless treatment for their illness. One can get the hospital closest to them by going through the New India network hospital list available on New India Assurance Health insurance

There is no upper limit on the number of claims during the policy period. However, the total cumulative claim amount cannot exceed the Policy Sum Insured.

It refers to payment of the Medical Expenses incurred by the insured while undergoing Specified Day Care Procedures/ Treatment (as mentioned in the Day Care Surgeries list), which require less than 24 hours Hospitalization.

Co-payment is a cost-sharing requirement under a health insurance policy, where the Policy Holder / insured will bear a specified percentage of the admissible costs

A ‘Free Look Period’ is a period of 15 days from the date of receipt of the policy that a policyholder, in this case you, have to review the entire health insurance plan. If you disagree with any of the terms or conditions mentioned in the policy, you have the option of returning the policy by stating the reasons for the objection. Following this, you are entitled to a refund of the premium paid, provided no claim has been made under this mediclaim insurance policy (subject only to a deduction of the expenses incurred by the company on medical examination and the stamp duty charges). Please note that this facility is not applicable on renewal and portability cases.

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CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2022