New India Janata Mediclaim Policy

New India Janata Mediclaim policy is perfect for those who want to provide insurance coverage for all the members of their family during the tenure of the policy. This health insurance policy covers self, spouse and a maximum of two dependent children. Minimum sum assured is Rs.50,000 and the maximum is Rs.75,000. Children between the ages of 3 months and 18 years will be covered if the parents are covered. You can also avail tax benefits under Section 80D of the Income Tax Act.

Features & Benefits of New India Janata Mediclaim policy:

Entry age Minimum age – 18 years Maximum age – 60 years Children between the ages of 3 months and 18 years will be covered provided the parents are covered.
Policy term 1 year
Sum insured Minimum: Rs.50,000 Maximum: Rs.75,000
Premium Premium for the sum insured is based on the age of the proposer. It is as follows:

Age Rs.50,000 sum insured Rs.75,000 sum insured
3 months – 5 years Rs.750 Rs.1,125
6 years – 35 years Rs.700 Rs.1,050
36 years – 40 years Rs.800 Rs.1,200
41 years – 45 years Rs.1,100 Rs.1,650
46 years – 50 years Rs.1,400 Rs.2,100
51 years – 55 years Rs1,550 Rs.2,350
56 years – 60 years Rs.1,800 Rs.2,700
61 years – 65 years Rs.2,050 Rs.3,050
66 years – 70 years Rs.2,300 Rs.3,450
Age limit for renewal There is no age limit for renewal, the policy has to be renewed within 30 days from the date of expiry.
Treatments covered Costs for the following will be covered under this policy:

  • Cost of treatment taken in general ward or day-care centre
  • ICU charges
  • Surgeon, anaesthetist, medical practitioner and consultant specialists fees
  • Charges of procedure like pacemaker, x-ray, bloody, oxygen, etc.
  • Pre-hospitalisation medical expenses up to 30 days.
  • Post-hospitalisation expenses up to 60 days
  • Ayurvedic or homeopathic or unani treatment expenses, 25% of the sum insured.
  • Ambulance service
  • Hospitalisation expenses
  • Payment for diseases are as follows:
    Illness Maximum payment allowed
    Cataract Rs.10,800
    Hysterectomy Rs.22,500
    Appendectomy Rs.16,200
    Cholecystectomy Rs.18,000
    TURP Rs.16,200
    Hernia inguinal Rs.19,800
    Hernia ventral or incisional Rs.9,000
    Septoplasty Rs.8,100
    Haemorrhoidectomy Rs.9,000
    Fissurectomy Rs.10,800
    Fistulectomy Rs.12,000
    Angiography Actual sum or the sum insured, whichever is less.
    Angioplasty Actual sum or the sum insured, whichever is less.
    CABG Actual sum or the sum insured, whichever is less.
    Total knee replacement Actual sum or the sum insured, whichever is less.
    Total hip replacement Actual sum or the sum insured, whichever is less.
    Tonsillectomy Rs.7,20
    Tympanoplasty Rs.13,500
    Kidney stone Rs.13,50
    Arthroscopy Rs.10,800
    PID Discectomy Rs.31,500
    Mastectomy Rs.36,000
    Exploratory laparotomy Rs.13,500 to Rs.27,000
  • Per day charges will be given for intermediate surgery, major surgery and supra major surgery.
Cancellation The policy can be cancelled on the grounds of misrepresentation, fraud, non-disclosure, etc. The premium will be refunded and the rate of premium to be charged is as follows:

Risk period Rate of premium to be charged
Up to 1 month 1/4th of the annual rate
Up to 3 months Half of the annual rate
Up to 6 months 3/4th of the annual rate
Exceeding 6 months Full annual rate
Free look period You can return the policy in within 15 days from the date of receipt of the policy.
Claim The insurer can settle the claim within 30 days from the receipt of the necessary documents.
Tax benefits Payments made towards this policy in any mode other than cash is eligible for deduction from taxable income under section 80D of the Income Tax Act.
Other benefits You can avail the following benefits under this policy:

  • Good health discount
  • Loyalty discount
  • Cumulative bonus
  • Cost of health check-up
  • Discount in premium for family cover
Exclusions The following conditions or diseases will be excluded under this policy:

  • Pre-existing diseases
  • Illness contracted during the first 30 days from commencement date of the policy
  • Medical expenses arising out of:
  1. War
  2. Circumcision
  3. Cosmetic or aesthetic treatment
  4. Vaccination and inoculation
  5. Cost of braces, prosthetic devices, implants, spectacles, etc.
  6. Dental treatment not arising out of an accident
  7. Obesity treatment
  8. Bodily injury or sickness due to deliberate exposure to danger, while participating in criminal act or participating in any kind of hazardous sport
  9. STDs
  10. Diagnosis, x-ray or lab examination that doesn’t lead to you being hospitalised.
  11. Vitamins and tonics not forming a part for injury that is certified
  12. Maternity expense
  13. Naturopathy treatment
  14. Genetic disorder and stem cell implantation
  15. Instrument used in treating sleep apnea syndrome and continuous peritoneal ambulatory dialysis
  16. Domiciliary hospitalization
  17. Experimental treatment
  18. Treatment taken outside India
  19. Services charges other than those levied by hospital
  20. Treatment for age related macular degeneration, rotational field quantum magnetic resonance, external counter pulsation, enhanced external counter pulsation and hyperbaric oxygen therapy.
  • There is waiting period for the following diseases or conditions:
  1. 2 year waiting:
  1. Skin disorder
  2. Internal and external benign tumors
  3. Throat, ear, nose disorders
  4. Benign prostate hypertrophy
  5. Cataract and other age related ailments
  6. Diabetes
  7. Gastric ulcer
  8. Gout and rheumatism
  9. All types of hernia
  10. Hydrocele
  11. Hypertension
  12. Non infective arthritis
  13. Hysterectomy
  14. Piles, fistula and fissure
  15. Sinusitis
  16. Prolapsed inter vertebral disc that is not arising out of an accident
  17. Gall bladder stone
  18. Bile duct stone
  19. Stones in urinary systems
  20. Congenital internal disorders that are unknown
  21. Varicose veins and ulcers
  1. 4 year waiting:
  1. Age related osteoporosis and osteoarthritis
  2. Joint replacement due to degenerative condition

Disclaimer: Please read the terms, conditions and exclusions mentioned in the policy document before taking the policy.

 

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