New India Global Mediclaim policy

New India Global Mediclaim policy benefits

• Eligibility criteria of new India Global Mediclaim policy

  • All the persons proposed for this Insurance should be between the age of 18 years and 65 years.
  • The persons beyond 65 years can continue their Insurance provided they are Insured under the Policy with us without any break.
  • The policy can be issued to Indian citizens residing in India alone. Cover is not allowed to NRIs, OCIs, PIOs or foreign nationals residing in India for employment.

  Pre-Policy Medical Tests

  100% pre-policy medical tests mandatory for all proposals.

  Age (last birthday)	Medical tests
  >18 – 45 years	MER, RUA, ECG, CTMT, LFT, CBC with ESR, Lipid Profile, FBS, HbA1c, HIV, HbsAg, SCreat, USG Abdomen & Pelvis, 2d Echo
  >45 years	MER, RUA, ECG, CTMT, LFT, CBC with ESR, Lipid Profile, FBS, HbA1c, HIV, HbsAg, CXR, USG Abdomen & Pelvis, 2d Echo, PSA(for males age 55 yrs above only), PAP smear (for females only), SCreat

  Note:Underwriter at his/her discretion may request for any medicals tests and/or pastmedical reports and/or any additional information from the life in case of any adversedisclosures made in the proposal form on a case-to-case basis. The acceptance orrejection of a case would depend purely upon the scrutiny by medical underwritingteam through the details furnished in the proposal form and/or pre-policy medical testresults and/or past medical records (if any). A risk loading of upto 100% may beimposed based on the Medical reports of the Insured. The cost of this check-up will be borne by the proposer. But if the proposal is accepted,then 50% of the cost of this check-up will be reimbursed to the proposer.

  Plan Options

  The maximum Sum Insured allowed on an individual life is:
  • Plan A : USD 0.5 million (USD 1 million Lifetime) [Asia Treatment Plan]
  • Plan B : USD 1 million (USD 2 million Lifetime) [Worldwide Treatment Plan]

  Note: WLMC (World Leading Medical Centre) – Named centres will be used for offering this treatment

• Coverages of new India Global Mediclaim policy

  The treatments covered are:
  • Cancer surgery: Primary treatment of any newly diagnosed Cancer which is diagnosed to be atStage II or above (as defined by AJCC cancer staging manual) and primarytreatment of up to 2 confirmed relapses. Relapse will be preceded by a phase whereInsured will be declared to be apparently free of disease which will be after Insured hascompleted standard protocol based treatment for that Cancer. Cancer includes Leukaemia, Lymphoma and Sarcoma. Chronic Leukaemia needs to be Rai Stage II orabove & Lymphoma needs to be Ann Arbor stage II or above.
    • All non-melanoma skin cancers are excluded.
    • Primary treatment is defined as curative surgery and immediate chemo andradiotherapy.
    • Diagnostic procedures; preparatory pre surgical radio and chemotherapy; ongoingcycles of radio or chemo therapy and long term pain, and management taken inIndia are not covered.
  • Neurosurgery:
    • Surgery to intra cranial structures including the brain, requiring general
    • Anaesthesia and a craniotomy.
    • Keyhole surgery is included.
  • Coronary Artery Bypass Graft (CABG)Surgery: The actual undergoing of heart surgery to correct blockage or narrowing in one or morecoronary artery(s), by coronary artery bypass grafting done via a sternotomy cuttingthrough the breast bone) or minimally invasive keyhole coronary artery bypassprocedures.
    • Angioplasty and/or any other intra-arterial procedures are excluded.
  • Heart Valve Surgery:
    • Open heart or endoscopic heart surgery to replace or repair one or more heart valves.
    • All intra-arterial catheter procedures are excluded.
  • Living Organ Donor Transplant:
    • Surgical transplant of a kidney, pulmonary lobe, segment of liver or section ofpancreas from a living human donor due to irreversible organ failure.
    • The expenses incurred for the donor travel and accommodation will be covered.
  • Bone Marrow Transplant:
    • Surgical transplant of Bone Marrow as a recipient. Bone Marrow can originatefrom the insured (autologous) or a compatible living donor.
  • Additional Covers under this Plan
  • Medical Second Opinion
  • Admittance in World Leading Medical Centre (WLMC) only. This plan covers treatmentonly outside India (treatment abroad in WLMCs
  • Includes following services:
    • Travel Cost up to USD 3,000 per person per annum.
    • Travel cost of one companion will also be covered (the limits in point (a) aboveapply)
    • Actual Cost of Airport pick-up
    • Accommodation up to USD 330 per day ; maximum of 30 days per Policy period.
    • Translation assistance
    • Repatriation of mortal remains – limit of up to USD 15,000 per insured
    • The expenses incurred for the donor, including travel and accommodation, will be covered

  Waiting Period

  A waiting period of 90 Days will be applicable for all the treatments mentioned above.

• Exclusions under New India Global Mediclaim Policy

  • No benefits will be payable for any condition(s) which is a direct or indirect result of any preexisting conditions unless Insured has disclosed the same in Proposal Form and We have accepted the same.
  • Any Illness or conditions where the Insured had or is aware of objective evidence related to the condition, had consultations/Investigations for it, or was diagnosed with the disease which first became apparent or commenced during the first 90 days of the commencement of this Policy.
  • AII Illnesses or conditions not specifically contemplated under Clause 3, How Much We will Reimburse, of the Policy of terms and conditions.
  • Congenital Internal Anomaly and Congenital External Anomaly.
  • Treatments and services rendered in India.
  • Any expenses for Illnesses or Injuries produced as a result of wars, Acts of Terrorism,seismic movements, commotions, floods, volcanic eruptions, as well as the direct orindirect consequences of nuclear reaction; as well as officially declared epidemics.
  • IIIness or Injury arising from the professional practice of any sport and in the keenpursuit of air activities (not related to the transport of passengers) and sub-aquaactivities, boxing, martial arts, climbing, rugby, potholing, bullfighting, motor racingincluding trials.
  • Healthcare required due to alcoholism, drug addiction and/or intoxicants caused bythe abuse of alcohol and/or the use of psychoactive, narcotic or hallucinogenic drugs.
  • Also excluded are the consequences and IIIness arising from attempted suicide andself-harm.
  • Any medical expense incurred before the issuance of the Medical Second Opinion bya World Leading Medical Centre as per MediGuide.
  • Any expense incurred in a different Hospital from the one chosen during the processof the Medical Second Opinion, unless required by the WLMC for services as definedunder the Policy.
  • AII Illness or conditions caused intentionally or fraudulently or criminal imprudence bythe Insured or resulting when committing a crime.
  • Acquired Immune Deficiency Syndrome (AIDS) or any disease secondary to or causedby AIDS, or resulting from any treatment for AIDS, including the disease known asKaposi's Sarcoma.
  • Expenses incurred in respect of confinement services, home health care or servicesprovided in a convalescence centre or institution, hospice or old people's home, evenwhere such services are required or necessary as a result of a covered Illness ormedical procedure.
  • Prosthesis, corrective devices and medical appliances which are not required intraoperatively for the covered illness.
  • AII pharmaceutical products and medicines which have not been dispensed by alicensed pharmacist or which are obtainable without a medical prescription.
  • Expenses incurred in the purchase or hire of wheelchairs, special beds, air conditioning appliances, air cleaners and any other non-medical equipment, unless for use duringthe covered hospitalization.
  • Expenses incurred by the Insured or the relatives, companions or escorts, except those expressly covered.
  • Cosmetic surgery and plastic surgery.
  • The transplant is conducted as a self-transplant with the exception of bone marrowtransplants.
  • The Insured is a donor for a third-party.Transplants from a dead donor.
  • Not customary and unreasonable charges.

  Disclaimer:“For the detailed list of exclusions under the policy, kindly refer to the same provided in your policy kit”