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Who can take this policy?
This insurance is available to persons between the age of 18 years to 60 years.
Children between the age of 3 months to 18 years can be covered provided
parents are covered simultaneously. The persons beyond 60 years can continue
their insurance provided they are insured under Mediclaim policy with our
Company without any break.
What does this policy cover?
The policy covers hospitalisation expenses for the treatment of illness/injury
provided hospitalisation is more than 24 hours. Pre-hospitalisation expenses
for 30 days and post hospitalisation expenses for 60 days are also payable.
Day-care treatment - The Medical expense towards specific technologically
advanced day-care treatments / surgeries where 24 hour hospitalisation is not
Ambulance Charges for shifting the insured from residence to hospital are
covered up to the limits specified in the policy.
Ayurvedic / Homeopathic and Unani system of medicine are covered to the extent
of 25% of Sum Insured provided the treatment is taken in the Government
Pre-existing diseases are covered only after 4 continuous and claim free
renewals with our Company.
Pre-existing conditions like Hypertension, Diabetes, and their complications are
covered after two years of continuous insurance on payment of additional
Diseases contracted within 30 days of insurance
Dental treatment except arising out of accident.
Debility and General Run Down Conditions.
Sexually transmitted diseases and HIV (AIDS)
Circumcision, Cosmetic surgery, Plastic surgery unless required to treat injury
Vaccination and Inoculation
Pregnancy and child birth
War, Act of foreign enemy, ionising radiation and nuclear weapon.
Treatment outside India
Experimental or unproven treatment
All external equipments such as contact lenses, cochlear implants etc.
Premium is based on age of the proposer and geographical area of treatment.
Special features of the policy
- Discount in premium for family cover
- Loyalty Discount
- Good Health Discount
- Cumulative Bonus
- Cost of Health Check up
- Income Tax Benefit under Section 80D of IT Act.
How to avail claim?
Claims are administered through Third Party Administrators (TPA) whose contact particulars appear on the policy document. Insured can opt for cashless or reimbursement facility for their claims. The proposer has the option to avail TPA services, which is cashless or direct service by Policy issuing Office, which is on reimbursement basis.
Click here for List of TPAs
Information Furnished in Compliance to CIC Order in Case No. CIC/AT/A/2009/000268 Dated 11.06.2009 (New / Revised) (100 KB)
Note: Policy details given are indicative, not exhaustive. Please contact your nearest "NIA office" for further details.
List of Hospitals(PPN) for Cashless facility through TPA.