New India Mediclaim 2007 Policy

What is the Plan all About?

Getting medical treatment for any member of the family always threatens your monthly budget. Choosing a right health insurance plan would be the wise option. Mediclaim 2007 Policy covers hospitalization expenses of you and your family.

Key Features

Get the family health cover
Discount in premium upon choosing family cover
Get Loyalty Discount
Avail Good Health Discount
Avail Cumulative Bonus
Cost of Health Check up is reimbursed

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

Under No Claim Bonus discount, the sum insured will be increased by 5% at the renewal of each claim free policy year, subject to a maximum of 15% NCB benefit.
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.
Cost of medical check up is reimbursed once after every 4 claim-free policy years. Such payment is limited to 1% of average sum insured excluding cumulative bonus.
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 been 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)	Adult: 18 Years, Children: 3 Months	Adult: 60 Years, Children: 18 Years
Sum Assured	-	-
Cover Type	Individual/Family Floater	-
Policy Tenure	-	-
Grace Period	30 Days	-
Free Look Period	15 Days	-
Riders	-	-