New India Janata Mediclaim Policy

Product Overview

New India Janata Mediclaim Health Insurance Plan is an inpatient hospitalization policy, along with host of other benefits like - Non-Allopathic Treatment, day care treatments, no co-payment on claim, etc.

Unique Features of New India Janata Mediclaim Policy

• There is no Co-Payment clause applicable under the policy.
• Non-Allopathic treatments like Ayurvedic, Unani and Homeopathic treatment will be covered under the policy.
• No Claim Bonus - 5% of the basic sum insured up to a maximum of 30% for each unclaimed year in case opted for.
• Under this plan any Pre-Existing Disease, Hypertension, Diabetes will be Covered after 2 years.

Critical features of New India Janata Mediclaim Policy

• Room rent:
  Limits imposed towards room and ICU rent expenses
  Treatment taken in General Ward of the Hospital/ Day Care Centre per day maximum charges Rs. 450
• Co-Pay:
  Specific % of admissible claim amount to be borne by Insured

1. Under this plan there is no Co-payment clause.
2. Certain Limitations/ Capping on the treatments. Please refer the policy wordings for detailed list.

• No Claim Bonus:
  Health Insurance policies may offer Cumulative Bonus wherein for every claim free year, the Sum Insured is increased by a certain percentage at the time of renewal
  5% of the basic sum insured up to a maximum of 30 % for each unclaimed year in case for opted for(The cumulative bonus is reduced by 5% of sum insured once a claim is made)
• Pre-Existing Diseases:
  Means any condition, ailment or injury or related condition(s) for which you had signs or symptoms, and / or were diagnosed, and / or received medical advice/ treatment, within 48 months prior to the first policy issued by the insurer

1. Under this plan any claim for pre-existing diseases shall be covered after a waiting period of 4 years.
2. Under this Plan any claim for Pre-Existing Disease for Hypertension and Diabetes will be covered after a waiting period of 2 years.

Eligibility Criteria

• Minimum Age of Entry:- Children - 3 months to 18 years/Adult-18 years
• Maximum age of Entry:- 60 years
• Sum Insured:- 50 Thousand to 75 Thousand
• Policy Tenure:- 1 year
• Family Definition:- Individual - Self, Spouse, Children, Parent.
• Premium Calculated on Basis of:- Age, (i.e. sum Insured Choosen)

Additional Discounts

• Loyalty Discount is offered on Continuous Policy Renewal
• Good Health Discount is provided for claim free renewal

Waiting Period

• Covered from Day 1:
  Accidental Injuries.
• Covered after 30 Days:
  All incidences apart from specified surgeries, Permanent exclusion & Pre-existing diseases (if any)
• Covered after 2 Year:
  Any Skin disorder, All internal & external benign tumors, cysts, polyps of any kind, including benign breast lumps, Benign Ear, Nose, Throat disorders, Benign Prostate Hypertrophy, Cataract & age related eye ailments, Diabetes Mellitus, Gastric/ Duodenal Ulcer, Gout & Rheumatism, Hernia of all types, Hydrocele, Hypertension, Hysterectomy for Menorrhagia / Fibromyoma, Myomectomy and Prolapse of uterus, Non Infective Arthritis, Piles, Fissure and Fistula in Anus, Pilonidal Sinus, Sinusitis and related disorders, Prolapse Inter Vertebral Disc unless arising from accident, Stone in Gall Bladder & Bile duct, Stones in Urinary Systems, Unknown Congenital internal disease/defects, Varicose Veins and Varicose Ulcers.
• Covered after 4 Years:
  Age related Osteoarthritis & Osteoporosis, Joint Replacements due to Degenerative Condition.

Exclusions

• Debility and General Run down Conditions
• Sexually transmitted diseases and HIV (AIDS)
• Circumcision, Cosmetic surgery, Plastic surgery unless required to treat injury or illness
• Vaccination and Inoculation
• Pregnancy, ailments related thereto and child birth
• War, Act of foreign enemy, ionising radiation and nuclear weapon.
• Treatment outside India
• Naturopathy
• Domiciliary Treatment
• Experimental or unproven treatment
• All external equipments such as contact lenses, cochlear implants etc
• Medical Expenses relating to any hospitalisation primarily and specifically for diagnostic, X-ray or laboratory examinations and investigations

 

Note: Any claims arising out of or attributable to any of the following is not covered,Please refer policy T & C for detailed list of exclusions.

Tax Benefits

When you pay the premium for your health insurance policy, you are liable to get a tax rebate under section 80D of the Income Tax Act, 1961.

Claim Process

In case you would like to know about the Claim Process or would like to register a Claim please click the link below

Know More