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Health Insurance - New India Assurance

As the name suggests this Insurance policy takes care of your health. It ensures coverage during hospitalization or operation due to accidents or sickness. Please note It is important to have ones own Health Insurance cover apart from the one provided by the company because hospitalization is expensive and the medical insurance provided by the company may not be enough to cover all medical costs in case of an emergency.

In the first 2 years of the policy; treatment for hernia, hysterectomy, fistula, sinusitis, cataract and cancer treatment are not covered.

Pre-existing health conditions like sicknesses or accidents are not covered under the policy immediately. Expenditure for the same can be sought only after completion of four years of policy. This coverage is available all over India and is according to the zone adopted and the kind of insurance plan taken.

The cover includes the room rent for the hospital per day at 1% of the policy amount in the case of a normal room and 2 % in the case of ICU. Other charges - Doctor’s fees, medicines, use of the OT and other tests - are applicable as per the hospital’s schedule which is based on the room charges. This policy does not cover administrative charges. Under this claim reimbursement can be sought for 30 days of pre-hospitalization and 60 days of post- hospitalization.

In case of hospitalization intimation must be provided to the insurance company within 24 hours after which the claim must be submitted for reimbursement within 30 days from the date the person has been discharged. You can also avail of cashless facility within a few registered hospitals. To use this procedure you would be required to submit an identification document and a copy of the policy. Once the hospital administration staff receives the documents they will forward the required information to the company or third party administrators. For New India Assurance policies contact their Third Party Administrators (TPA’s) at:

Medi Assist India Pvt. Ltd.

301, 3rd Floor, Mantri Terrace,

Thube Park, Shivajinagar

Pune 411005

Phone numbers: 020-25530068, 020-25530078

Max Bupa

In case of claim settlement from Max Bupa you can call their toll free number: 180030103333.

When you call them you will be required to provide them with the name of the policy holder, policy number etc. If the company is featured on the network list then you will need to show your Max Bupa card at the hospital. Once that is done, the hospital will directly be in touch with Max Bupa in order to get your claim sanctioned. If the hospital you are getting admitted to is not on the network list then the Max Bupa team will guide you as per the requirements. In this case, one would need to pay the bill first and then submit the claim and all the necessary documents to Max Bupa. In case of hospitalization it is important to give the Max Bupa team prior intimation.

Star Health

For claim settlements you would need to get in touch with them at their toll free number: 18004252255.

Once you call them you will be asked for the name of the policy holder as well as the policy number. If the hospital you have selected is on the network list you will be need to show your Star Health card. When that is done the hospital will call up the team at Star Health and get your claim sanctioned. In case the hospital is not on the list your will be guided by the team at Star Health. If the hospital is not on the network list you will need to pay the bill first and then submit the claim and all the necessary documents to Star Health. If hospitalization is required prior intimation needs to be provided to the team at Star Health.

For Planned Hospitalization: Incase the hospitalization is planned the team at the respective Insurance companies have to be intimated in advance. The time set for the same is:

  • New India Assurance: 1 week
  • Max Bupa: 72 hours
  • Star Health: 72 hours

For Unplanned Hospitalization: In the scenario that the hospitalization is unplanned; intimation has to be provided to the insurance company within the given time frames.

  • New India Assurance: 7 days
  • Max Bupa: 48 hours
  • Star Health: 24 hours

Personal Accident Insurance

You never know how a day will go because life in unpredictable. In these circumstances all you can do is get a personal accident insurance done. This policy will help as it provides compensation against loss due to an accident - death, permanent injury and temporary injury. This policy can be in the name of an individual or a group provided by an employer.

Documents needed for making a claim:

Intimation regarding the accident needs to made to the insurance company within 7 days of the accident

  • Claim form duly filled by the claimant

  • Doctor’s certificate
  • Medical Reports
  • Medical Bills
  • Leave certificate by the employer (incase of employed)

Compensation offered in each case:

Temporary Disablement compensation:

If there is loss of income, the compensation payable is -

1 % of the policy amount, the maximum amount coming up to Rs. 3000 a week, whichever is less. This amount is payable up to 100 weeks. Apart from this, 40% of Loss of Income compensation or amount of medical bills submitted (whichever amounts to less) is payable as medical expenses.

Permanent Total Disablement Compensation:

In this case the compensation is –

1 % of the policy amount, the maximum amount coming up to Rs. 3000 a week, whichever is less. This amount is payable up to 100 weeks. Apart from this, 40% of Loss of Income compensation or amount of medical bills submitted (whichever amounts to less) is payable as medical expenses.

In the case of lump sum compensation one would need to submit the permanent disablement certificate from a civil surgeon. The compensation paid is based on the percentage of disablement.

Death Claim Procedure:

In this scenario, along with the claim form one would need to submit a police FIR, panchnama, hospital reports (admission and post-mortem reports)

Once the papers are checked and all of them are in order; a lump sum and cumulative bonus is payable to the nominee of the deceased.

Vehicle Insurance

Insurance for vehicles is of 2 types -

Comprehensive Insurance:

Not only is your vehicle covered under this policy but, any damages to the third party property - human being and affected assets are also covered. The calculation of this premium is made according to the age of the vehicle. A no claim bonus is applicable if the policy is renewed within the stipulated time. This claim can also be made if the other insurance provider renews the policy with us. In order to buy this insurance you will require a copy of the earlier insurance (in the case of an old car), registration book (smartcard) and a copy of the owner’s driving license. Another additional document required is a renewal notice or no claim bonus confirmation from the existing insurer. If the policy has lapsed, you would be needed to submit a vehicle inspection form duly filled by the surveyor of New India Assurance Company Limited along with the other documents.

Third Party Insurance:

This policy covers any damage to the third party property – human being and affected asset due to an accident. In order to buy this insurance you will need a copy of the earlier insurance (in the case of an old car), registration book (smartcard) along with a copy of the owner’s driving license. Like comprehensive insurance in the case of lapse policies you would be required to submit a vehicle inspection form duly filled by the surveyor of the New India Assurance Company Limited along with the other documents.

Fire Insurance

Natural calamities and accidents can strike at any hour. Such situations cause loss and immense grief because it results in the destruction of property and assets. Thankfully today there is no cause for sleepless night as there is a policy that covers your assets. As the name suggests, this policy gives coverage for fire but, is not restricted to only that. Under this policy claims can be made for natural calamities (flood, storm, lightening, earthquake etc) along with road, railway and air accidents too. To make a claim the place is first surveyed by a representative from the insurance company before any repair work has begun.

This insurance policy is applicable for business assets, industrial premises and residential premises (including contents of the house.) The premium rate for this insurance varies for commercial and residential premises and depends on its usage.

Marine Insurance

This insurance is applicable for the transportation of material from one place to another - within the county or outside. The premium for this insurance has to be paid before the transit period begins. The rates vary depending on the final destination and the more of transport that is used.

Overseas Medi-Claim Policy

As is evident from the name, this policy provides coverage to a person travelling out of the country for a short period of time. In many countries travel insurance is also a prerequisite for visa purposes. Medical, accident, loss of luggage, loss of passport, delayed baggage as well as public liability are covered under this policy. Buying this insurance in India itself before embarking on your journey is a good idea because the premium cost might be higher there. All claims made under this policy will be settled in the respective country. Today with the World Wide Web at our disposal policies can also be issued online.

Documents/Information Required:

  • Copy of valid passport
  • Mother’s maiden name
  • Phone Number/Mobile Number/Postal Address/ E-mail Address
  • Doctor’s Name/Number
  • Information regarding any pre-existing treatment

All this information needs to be sent via e-mail to the concerned person. The policy will be issued through e-mail after the validation and payment procedures are complete.

 
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