New India Flexi Floater Mediclaim Policy (Cashless Facility Available)
Health Insurance Policy
Health Insurance Policy
Salient features of the Policy
1.0 COVERAGE: The Policy covers reimbursement of Hospitalisation Expenses for Illness/ Injury sustained.
2.0 In event of any claim being admissible, following Reasonable and Customary expenses are reimbursable under the policy:
2.1 Room, Boarding Expenses as provided by the hospital including Nursing charges, not exceeding 1% of Sum Insured per day.
2.2 Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses, not exceeding 2% of the sum insured per day.
2.3 Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialists Fees.
2.4 Anesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances, Medicines &Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs & Cost of Organs and similar expenses.
2.5 Pre-hospitalization medical charges up to 30 days period.
2.6 Post-hospitalization medical charges up to 60 days period.
NOTE: SUB-LIMIT CLAUSE
(N.B: Company’s Liability in respect of all claims admitted during the period of insurance shall not exceed the Sum Insured per person mentioned in the schedule.)
2.7 LIMIT ON PAYMENT FOR CATARACT: Company’s liability for payment of any claim relating to Cataract shall be limited to Actual or maximum of INR 24,000 (inclusive of all charges, excluding service tax), for each eye, whichever is less.
2.8 AYUSH: Expenses incurred for Ayurvedic/Homeopathic/Unani Treatment are admissible up to 25% of the sum insured provided the treatment for Illness and accidental injuries, is taken in a Government hospital or in any institute recognized by Government and /or accredited by Quality Council Of India / National Accreditation Board on Health, excluding centers for spas, massage and health rejuvenation procedures.
2.9 Ambulances services – 1.0 % of the sum insured or actual, whichever is less, subject to maximum of INR 2,500/- in case patient has to be shifted from residence to hospital for admission in Emergency Ward or ICU or from one Hospital to another Hospital by fully equipped ambulance for better medical facilities.
2.10 Hospitalization expenses (excluding cost of organ) incurred on the donor during the course of organ transplant to the insured person. The Company’s liability towards expenses incurred on the donor and the insured recipient shall not exceed the sum insured of the insured person receiving the organ.
2.11 SPECIAL CONDITIONS: The Policy is subject to deviations from the standard wordings as mentioned in the schedule of the policy.