New India Floater Mediclaim is a Policy designed to cover Hospitalisation expenses.
Sl No | Coverage Details | Sum Insured |
---|---|---|
1. | Sum Insured options available | 2,00,000, 3,00,000, 5,00,000, 8,00,000 |
2. | Room Rent, Boarding and Nursing expenses as provided by the Hospital | Not exceeding 1.0 % of the Sum Insured per day |
3. | Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses | Not exceeding 2.0 % of the Sum Insured per day. |
4. | Surgeon, Anaesthetist, Medical Practioner, Consultant and Specialist Fees + Nursing Fees Anaesthetist, Blood, Oxygen, Operation Theatre Charges, surgical appliances, Medicines & Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Artificial Limbs, cost of prosthetic devices implanted during surgical procedure like Pacemaker, relevant laboratory diagnostic tests, etc.& similar expenses. |
Covered |
5. | Pre Hospitalisation expense – expenses incurred days prior to the date of Hospitalisation. Post Hospitalisation – expenses incurred post the date of discharge |
30 days 60 days |
6. | 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.) |
10% of Sum Insured subject to a maximum of Rs. 50,000 |
7. | Critical Care Benefit for Ist time Diagnosis of Illness **** | Up to 10% of the Sum Insured |
8. | 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. |
9. | 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. |
10. | Hospitalisation Expenses relating to Organ Transplant | Covered |
11. | AYUSH Treatment | Up to 25% of Sum Insured |
12. | Congenital Internal Diseases | Covered up to the Sum Insured provided the Insured has Continuous Coverage of twenty four months |
13. | Congenital External Diseases | Covered up to 10% of Sum Insured provided the Insured has Continuous Coverage of forty eight months. |
Eligibility Criteria | ||
1. | Entry Age / Maximum Age | 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. |
2. | Family Members Eligible |
|
Sl No | Coverage | Compensation | |
---|---|---|---|
1. | Accidental Death of | Proposer or Spouse | 100% of Sum Insured |
Proposer or Spouse | 200% of Sum Insured | ||
2. | Permanent Total Disablement of | Proposer or Spouse | 100% of Sum Insured |
Proposer or Spouse | 200% of Sum Insured | ||
3. | Loss of one limb and one eye or loss of both eyes and/or loss of both limbs of | Proposer or Spouse | 100% of Sum Insured |
Proposer or Spouse | 200% of Sum Insured | ||
4. | Loss of one limb / sight in one eye of | Proposer or Spouse | 50% of Sum Insured |
Proposer or Spouse | 100% of Sum Insured |
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. 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.
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