Objective

Objective of the policy is to cover senior citizens- a stage of life cycle when insurance is most required.

Suited for

Anyone between 60 and 80 years of age looking for a coverage up to Rs 1.5 lakh can take this policy.

What does it do?

This policy pays for senior citizens' hospitalisation expenses, pre and post hospitalisation expenses, though with sub-limits. It covers ayurvedic, homeopathic and Unani treatment as well. An added advantage is that it covers pre-existing hypertension, diabetes mellitus for an additional 10 per cent premium payment. In the event of four claim-free years, the insured person can get reimbursement for a health check-up.

Pros

Cover can be extended upto 90 years of age.
Family discount of 10 per cent is available if spouse is also covered.
Premium discount of 10 per cent is available for taking a voluntary deductible.
A bonus of 5 per cent is paid for each claim free-year upto a maximum of 30 per cent of initial sum insured.
Provision to cover pre- existing hypertension, diabetes mellitus on payment of additional 10 per cent premium.
Premium paid is eligible for tax benefit under section 80D of the Income Tax Act.

Cons

It allows to take a maximum sum assured upto Rs 1.5 lakh only and has a shorter freelook period of 10 days.
The premium will be loaded by 10 per cent for renewals during 81 to 85 years and by 20 per cent during 86 and 90 years.
It has sub-limits.

Our View

A decent policy for senior citizens, where voluntary deductible option can be availed. The major drawback is that it offers a maximum of 1.5 lakh cover only which may not be sufficient at this age. It is difficult to escape sub-limits at this age.

Eligibility

Entry Age (years)

Minimum

60

Maximum

80

Maximum Policy Renewal Age (years)

90

Coverage Type

Senior Citizens

Policy Term (years)

1

Sum Insured (Rs)

Maximum

1.5 lakh

Minimum

1 lakh

Tax Benefit

Section 80D of the Income Tax Act are applicable

Discount

Family discount of 10% if spouce is also covered
discount of 10% for taking a voluntary deductible of Rs 10000

No Claim Bonus

5% for each claim free year upto maximum of 30% of initial Sum insured. On acceptance of claim during any policy year, entire cumulative bonus earned shall be withdrawn in subsequent policy year.

Pre Policy Medical Check Up

Mandatory

Free look Period

10 days

Premium Loading on Basis of Claim History

Loading of 10% is applicable for renewal between age of 81- 85 years and 20% on renewal between age of 86-90 years

Policy Termination

Insurer may cancel the policy by giving a 30 days written notice to policyholder. Policyholder may also cancel the policy at any time by giving a written notice to insurer. In case policyholder cancelling the policy, a certain percentage of premium would be refunded on prorata basis.

Customer Service

The New India Assurance Co. Ltd Jeevan Bharti Building, Corporate Office: 87, M.G Road, Fort, Mumbai 400001; Regional Office: 124 Connaught Circus, New Delhi-110001

Customer Service

Mail to

nia.310000@newindia.co.in

Call to

1800 209 1415

Network Hospitals

Http://newindia.co.in/listofhospitals.aspx

Scope Of Cover

Cashless Facility

Available at network hospitals

Reimbursement Facility

Available if treatment taken at any non empanelled hospital

Pre-hospitalisation

covers medical expenses upto 30 days immediately prior to hospitalisation subject to maximum of 5% of hospital bill

Post-hospitalisation

covers medical expenses upto 60 days immediately post discharge from hospital subject to maximum of 10% of hospital bill

Inpatient Hospitalisation

Covered

Room rent/ ICU expenses

Room rent and boarding expenses will be covered upto 1% of Sum Insured per day and ICU expenses will be covered upto 2% of Sum Insured per day subject to an overall limit of 25% of Sum Insured

Surgeon, Anaesthetist, Medical Practitioner, Consultant's Specialist fees

covered upto maximum of 25% of Sum Insured

Anaesthesia, blood,oxygen, OT charges, surgical appliances, medicines, drugs, diagnostic material, X Ray and artificial implants

Covered upto maximum of 50% of Sum Insured

Ayurvedic/ Homeopathic/ Unani treatment

Covered upto maximum 25% of Sum Insured

Emergency ambulance

Covered upto maximum of Rs 1000

Expenses for organ donor of transplant

Covered

Pre existing hypertension, diabetes mellitus

will be included in cover since inception of policy only on payment of additional premium of 10% of basic premium for each condition

Domiciliary Treatment

Not Covered

Health Check Up

allowed once after every 4 claim free years maximum upto 1% of sum insured excluding cumulative bonus

Exclusions and Waiting Period

Pre-existing Diseases

Covered after a period of 18 months

No claim period

30 days commencing from inception of policy except for accidental injuries

Waiting Period

Certain diseases such as hernia, diabetes, mellitus, cataract etc. will be covered after a waiting period of 18 months.Age related Osteoarthritis and Osteoporosis and joint replacement due to degenerative condition will be covered after a waiting period of 48 months.

Deductible

Voluntary deductible of Rs 10000 is applicable

General Exclusions

Self inflicted bodily injury Dialysis, Chemotherapy and radiotherapyDental treatment, Cost of spectacles, braces and contact lensesNaturopathy treatmentEngagement in any illegal or criminal activitiesBodily injury arising as a result of terrorismbodily injury or disease caused as a result of HIV/ AIDS or any related conditionEngagement in adventurous acts such as parachuting, bunjee jumping etc