New India Top-Up Mediclaim Policy

What is the Plan all About?

New India Top-up Mediclaim Policy is designed to cover in-patient hospitalization expenses. It is a top up policy which is in addition to a health policy.

Key Features

Provides additional health cover after threshold
Individual or family can be covered
Enjoy enhancement of sum insured and threshold
Avail Get Well Benefit
AYUSH treatment is covered
Avail tax benefits

Policy Benefits

In-patient hospitalization expenses, including Room Rent / Boarding/ Nursing Expenses actually incurred are covered up to Rs 5,000 per day and Rs 8,000 per day for threshold of Rs 5 Lacs & Rs. 8 Lacs respectively.

74 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.
Intensive Care Unit / Intensive Cardiac Care Unit expenses actually incurred are covered up to Rs 10,000 per day and Rs 16,000 per day for Rs 5 Lacs Threshold and Rs 8 Lacs Threshold respectively.
Daily Hospital Cash is paid at the rate of Rs 500 per and Rs 800 per day for Rs 5 Lacs Threshold and Rs 8 Lacs Threshold respectively. This daily allowance is paid up to the maximum for 10 days for any one illness.
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.
Get Well Benefit of Rs 5,000 and Rs 8,000 for threshold of Rs 5 Lacs & Rs. 8 Lacs respectively. This benefit will be paid for any one illness and is payable for the first four admissible claims. This benefit further reduces the Sum Insured.

Value Added Benefits

Enhancement of sum insured and threshold can be availed at the time of renewal of the policy, subject to fulfillment of the criteria as mentioned in the policy.
Ambulance Charges actually incurred are paid up to Rs 5,000 and Rs 8,000 for threshold of Rs 5 Lacs & Rs. 8 Lacs respectively, in case of emergency hospitalization, ICU, or shifting from one hospital to another.

AYUSH treatment is covered, 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, after considering the threshold for each policy period.
Payment of claims within thirty days of the receipt of the last necessary document. In case of extraordinary delay, the claim will be paid at 2% above the rate of interest paid by nationalized banks on savings bank account.
Tax Benefit under section 80D of Income Tax Act, 1961.

Sub Limits

Room Rent Limit: It is capped up to Rs 5,000 per day and Rs 8,000 per day for threshold of Rs 5 Lacs & Rs. 8 Lacs respectively.
For cataract, maximum of Rs 50,000 for each eye is payable.

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 Replacement 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)	Proposer: 18 Years, Other Members: 3 Months, Children: 3 Months	Proposer: 65 Years, Other Members: 65 Years, Children: 25 Years
Sum Assured	5 Lacs	22 Lacs
Threshold	5 Lacs	8 Lacs
Cover Type	Individual/Family Floater Top-up	-
Policy Tenure	1 Year	1 Year
Grace Period	30 Days	-
Free Look Period	15 Days	-
Riders	Nil	-