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New India Family Floater Mediclaim Policy

What is the Plan all About?

Family Floater Mediclaim Policy is designed to cover family members with one sum insured. With this policy, you can get a health cover to cater health care needs of the family.

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Key Features

  • Comprehensive family cover
  • Loyalty Discount
  • Good Health Discount
  • Enjoy tax benefits

Policy Benefits

  • In-patient hospitalization expenses, including Room Rent / Boarding/ Nursing Expenses and other expenses are covered up to 1% of sum insured per day or actual expenses incurred, whichever is less.
  • Pre hospitalization expenses are covered for 30 days before hospitalization and post hospitalization expenses covered for 60 days after hospitalization.
  • Day Care Procedures or other Surgical Operation/ procedures as specified under the policy, for which the insured person requires hospitalization for less than 24 hours.
  • ICU charges are covered, as mentioned in the policy.
  • Donor transplant expenses are covered, excluding cost of the organ.
  • Surgeon, Anesthetist, Medical Practitioner, Consultants’ Specialist fees, Operation Theatre Charges, and other medical expenses are also covered.

Value Added Benefits

  • Enhancement of sum insured can be availed at the time of renewal of the policy, but the insured has to undergo pre-acceptance health check-up and 50% cost of such health check-up will have to be borne by the insured.
  • Ambulance Charges are paid up to 1% of sum insured or actual expenses, whichever is less, in case of emergency hospitalization, ICU, or shifting from one hospital to another. These charges are paid up to a maximum of Rs 2500.
  • Ayurvedic / Homoeopathic / Unani treatment is covered up to 25% of the sum insured, if treatment is taken in any government Hospital, any institute Accredited by Quality Council of India, National Accreditation Board on Health or other hospital as specified under the policy.
  • If you claim in two policy periods, the claims shall be payable considering available sum insured in the two policy periods, including deductibles.
  • Tax Benefit under section 80D of Income Tax Act, 1961.

Sub Limits

  • Room Rent Limit: It is capped up to 1% of sum insured per day or actual expenses, whichever is less.
  • ICU charges are capped up to 2% of sum insured per day or actual expenses incurred, whichever is less.
  • 10% / 20% co-pay applies, when the insured person avails treatment in a different zone, he/she has actually opted for. The co-payment will be applicable as defined in the policy terms.
  • For cataract, the actual expenses incurred or maximum of Rs 24,000, for each eye, whichever is less.
  • Medically necessary Surgeon fee and Anesthetist fee is covered up to a maximum of 25% of sum insured. Such fee when paid in cash will be reimbursed up to a maximum of Rs 10,000.

Waiting Period Clause

  • Initial Waiting Period: Claims arising during first 30 days of the policy start date, except accidental claims.
  • Specific Waiting Period: Some treatments such as ENT Disorders, Cataract, Hernia, Hydrocele, Hypertension, etc are covered after 24 months from the inception date of the policy. Age related Osteoarthritis & Osteoporosis and Joint Replacements due to Degenerative Condition are covered after 48 months from the inception date of the policy.
  • Pre existing Disease Waiting Period: Any pre-existing disease until 48 months of continuous policy coverage, from date of inception of the first policy.

Who can Buy the Plan?

Factor Minimum Maximum
Age (as on last birthday) 18 Years 60 Years
Sum Assured 2 Lacs 5 Lacs
Cover Type Family Floater -
Policy Tenure 1 Year 1 Year
Grace Period 30 Days -
Free Look Period 15 Days -
Riders - -

Exclusions

  • Injury/illness caused by war, invasion, or act of foreign enemy
  • Circumcision, cosmetic, or aesthetic treatment
  • Vaccination and inoculation
  • Dental treatment
  • Maternity or pregnancy related expenses
  • Naturopathy Treatment
  • Genetic disorders
  • Domiciliary Hospitalization
  • Experimental and Unproven treatment,etc.
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