New India Mediclaim 2012 Policy

What is the Plan all About?

Mediclaim 2012 Policy covers your family members, with separate Sum Insured available for each Insured member of the policy. This policy thus takes proper care of healthcare needs of your family.

Key Features

Complete health cover for your family
Avail premium discounts on covering family members
Enjoy NCB benefit
Get tax benefits under section 80 C
Lifetime Renewability

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.
Pre hospitalization expenses are covered for 30 days before hospitalization and post hospitalization expenses covered for 60 days after hospitalization.
32 Day Care Procedures & other Surgeries/Procedures as mentioned in the policy are covered, 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.
Daily Hospital Cash is paid up to 0.1% of Sum Insured per day that cannot exceed beyond 1% of Sum Insured for any one illness.
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, you can increase the sum insured up to 3% in each policy year and a maximum of 15% NCB discount can be availed. The NCB buffer can be carried forward unless and until it is completely utilized.
Enhancement of sum insured at the time of renewal of the policy.
Ambulance Charges are paid up to 1% of sum insured in case of emergency hospitalization, ICU, or shifting from one hospital to another.
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 3 claim-free policy years. Such payment is limited to Rs 5,000 or 1% of average sum insured in those previous three years.
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.
ICU charges are capped up to 2% of sum insured per day.
Co-payment

Co-pay applies, if you take treatment in a Hospital situated outside the Area of Coverage. 80% of the admissible claim amount, or Sum Insured whichever is less will be paid.
Co-pay applies, in case the insured person is aged over 55 years at commencement of the policy, continuous coverage incepts in the policy, who does not have 4 years of continuous policy coverage, company pays 80% of the admissible claim amount, or Sum Insured whichever is less will be paid. 20% of the claim amount is to be borne by the policyholder.

For cataract, up to 20% of aggregate Sum Insured plus cumulative bonus, for each eye, subject to a maximum of Rs 24,000.

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 Cataract, Hydrocele, Hernia, Hypertension, etc. is covered after 24 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.
Congenital Disease Waiting Period: Congenital internal disease will be covered after 24 months of continuous policy coverage, if it was unknown to you or to the insured at the commencement of the policy. Congenital external disease will be covered 48 months of continuous policy coverage, but it shall be covered up to 10% of the average sum insured in the previous 4 policy years.

Who can Buy the Plan?

Factor	Minimum	Maximum
Age (as on last birthday)	Adult: 18 Years, Children: 3 Months	Adult: 65 Years, Children: 25 Years
Sum Assured	1 Lac	8 Lacs
Cover Type	Individual/Family Floater	-
Policy Tenure	1 Year	1 Year
Grace Period	30 Days	-
Free Look Period	15 Days	-
Riders	Nil	-