Product Brochure
Product Brochure
Product Brochure
New India Assurance Company Ltd. Good Health packs a variety of medical covers
and comes in a wide range of plans to choose from.
Good Health takes care of your Hospitalization expenses due to illness or accident.
(Hospitalization refers to medical treatment for a period of not less than 24 hours
for such illness/ disease which requires care and treatment at a Hospital).
Cashless Facility in 8000 plus network hospitals across India is offered under
Good Health. The cashless facility is subject to conditions (refer to Claim
procedure detailed separately in brochure). Hospitalization at non network
hospitals is also covered on reimbursement basis.
Pre and Post Hospitalization charges are covered for 30 and 60 days respectively.
SUM INSURED
Good Health Mediclaim cover is available for a sum insured of up to Rs.10 lakhs.
Good Health Personal Accident cover is available for a sum insured of up to Rs.25 lakhs.
Good Health is available for persons aged between 18 years and 65 years. Children between 3
months and 18 years can be covered provided one or both parents are covered
simultaneously. For applicants between the age of 61 and 65 years, the following medical
reports are needed with Doctors certificate of Health
ECG
Blood sugar - fasting & PP
Urine sugar
These reports should be dated not prior to 30 days from the date of application
Persons up to 60 years of age are permitted to shift to any plan of their choice at the time of
renewal. On the other hand, persons between 61 and 65 years of age are allowed to increase
sum insured by one slab only. No Change in plan is allowed for persons above the age of 65
years.
The unique Good Health Cover package comes to you in attractive plans & options with
competitive rates & benefits. The table below shows the premium chart based on a sum
insured of Rs. 4 lakhs for a one year policy.
Premium rates indicated below are inclusive of GST applicable as on now (GST subject to
change if revised by GOI)
Good Health Upto 25 26-35 36-45 46-55 56-60
Plan/ Premium years years years years years
The above rates are inclusive of Goods & Services Tax @ 18%. Goods & Services tax is
subject to change as amended by Government of India and Ministry of Finance from time to
time.
TAX BENEFITS
Good Health Premium paid in following cases is eligible for Tax Deduction Under Section 80D.
Premium paid for self, spouse and children up to a maximum of Rs. 25,000* per year. In case
of premium paid towards dependent Parents, you can avail an additional benefit of Rs.
25,000* and if they are senior citizens the benefit is extended to up to a maximum of Rs.
30,000*.
*The above exemption is as per the Income tax act 1961 and is subject to change as per
amendments made there to from time to time.
CLAIM PROCEDURE
I) MEDICLAIM
Claims will be administered by M/s. MDIndia Health Care Services TPA Pvt. Ltd..
This policy provides for cashless access to network hospitals I.e. those hospitals
empanelled by the TPA. If cashless facility is availed, the TPA will directly settle the
hospital bills, subject to fulfillment of specified formalities by the insured and policy
terms and conditions.
If cashless access facility is not availed, the hospital bills will have to be first settled by
the insured and thereafter reimbursement to be claimed from the TPA. The same
procedure is applicable for Non-Network hospitals. Such claims will be processed by the
TPA as per policy terms and conditions. Preliminary notice of claim with particulars
relating to policy number, name of insured person in respect of whom claim is made,
nature of illness/.injury and name and address of attending medical
Practitioner/hospital/nursing home should be given by the card member to TPA within 7
days from the date of hospitalization, in receipt of which clam form will be sent by the
TPA.
Final claim along with originals of all receipts bills and cash memos, claim form and other
documents as listed in the claim form, and the policy copies of current and earlier years,
should be submitted to the TPA within 30 days from date of completion of treatment in
the Hospital.
The claim for reimbursement of pre and post hospitalization expenses should be sent
to the TPA which will also be processed by them as per policy terms and conditions.
Insured person will need to inform the Insurance Company, fill up the claim form
and support claims with appropriate documents as per procedure laid by
Insurance Company.
Good Health policy comes to you with certain additional benefits as listed below:
In case of Cash Less approval for Hospitalization claim, Hospital Cash claim
will be paid separately to insured directly.
Additional lump sum payments are made in respect of accident treatment, ICU treatment
and Prolonged Hospitalization under our Table 5 plans @ Rs 2000 per day for 15 days in
case of Accident Treatment / ICU and Lump sum amount of Rs 15,000 in case of prolonged
Hospitalization when confinement to hospital exceeds 21 consecutive days. These benefits
are payable only once during the policy period.
c. Day Care Procedures : Good Health covers 1 6 0 Day Care Procedures. Please refer to
our Terms & Conditions for the list of Day Care Procedures covered under Good Health.
d. Cumulative Bonus : Good Health provides rewards for claim free record by way of
Cumulative Bonus. Sum insured under the policy shall be progressively increased by 5% in
respect of each claim free year of insurance subject to maximum accumulation of 10 claim
free years. In case of claim under the policy the cumulative bonus shall stand reduced by
5% for the person who has made the claim.
IMPORTANT DEFINITIONS
Pre-Existing condition:
means any condition, ailment, Injury or Illness
a. That is/are diagnosed by a physician within 48 months prior to the effective date of the
Policy issued by Us and its reinstatement or
b. For which medical advice or treatment was recommended by, or received from, a
physician within 48 months prior to the effective date of the Policy or its reinstatement.
Pre-Existing conditions at the time of applying for insurance shall be covered after 48
months of continuous Insurance under this policy.
Any illness/disease which occurs during the first 30 days of Policy (not applicable on
renewal)
Any pre-existing illness i.e. any sickness or symptoms of the same illness,
existing prior to effecting insurance and complications thereof
Any dental treatment or surgery unless arising out of an accident and requiring
hospitalization
All health check-ups and any routine eye examination and cost of glasses /
lenses, hearing aids, crutches, walker and similar expenses
Any expenses traceable to pregnancy/child birth/abortion
Any expenses on vitamins and tonics unless necessitated by surgery/disease
Any expenses incurred for diagnosis etc., not consistent with treatment for
injury/illness/disease
Circumcision, vaccination, inoculation, cosmetic or aesthetic, plastic
surgery unless necessitated by an accident
Convalescence, nervous breakdown, rest cure, venereal disease, insanity,
intentional self injury and any disease resulting from use of drugs or liquor
Naturopathy treatment
Voluntary medical termination of pregnancy
RFQMR, ECP and Hyperberic Oxygen Theraphy..
Any Claims arising out of intentional self-injury or attempted suicide will NOT be
covered
Any accident caused by liquor, drugs, while engaged in aviation or travelling as non
passenger in any aircraft will NOT be covered.
Any accidents caused due to veneral disease, insanity and actions committing
breach of law with criminal intent will NOT be covered
Any accidents caused by war, nuclear weapons, radiations, claims traceable to
pregnancy/child birth/abortion will NOT be covered
Any pre-existing disablements will NOT be covered,.
Please refer to policy wordings for complete list of exclusions.
CANCELLATION
In case you cancel your coverage before the end of policy period and have not made any
claim, New India will refund part of the premium paid as per chart detailed below.
Cancellation Premium
Request Refundable
Within 45 Days 100%
Within 3 Months 50%
Within 6 Months 25%
Beyond 6 Nil
Months
Even in the event of Citibank not renewing the master policy or the individual ceasing to be
a customer of Citibank, the existing health certificate can be renewed under The New
India Assurance Co's Retail Mediclaim Policy.
This brochure is only a brief summary of Good Health Policy. This is not an insurance contract
or an offer of insurance. The coverage will be subject to the Terms & Conditions of the Good
Health Master Policy.
Good Health Insurance is brought to you by The New India Assurance Co. Ltd.
New India is a leading global insurance group, with offices and branches throughout India
and various countries abroad. The company services the Indian subcontinent with a
network of 2 2 1 4 offices, comprising 31 Regional Offices, 6 Large Corporate Offices, 473
Divisional Offices, 5 8 7 Branches and 1086 Micro Offices. With approximately 15249
employees, New India has the largest number of specialist and technically qualified
personnel at all levels of management, who are empowered to underwrite and settle
claims of high magnitude.
New India has been rated bbb+ (Stable) by A.M.Best Co., making it the only Indian insurance
company to have been rated by an international rating agency. Rating is based on following
factors :
Corporate Head Office Address : The New India Assurance Co. Ltd.
87, M.G. Road, Fort,
Mumbai 400 001. Phone :
022 22708100/8400
Toll free number : 1800-209-1415
IRDA REGN NO.190
CIN: U99999MH1919GOI000526
Good Health Policy Servicing Divisional Office: The New India Assurance Co. Ltd.
2nd Floor, Allied’s Mount Casa
Blanca Building 260, Anna Salai,
Chennai 600 006.
Phone 044 23456824/826/827
Fax : 044 23456825
Web:www.newindia.co.in/portal/Citib
ank.html#/home
E-mail:nia.712500@newindia.co.in
Section 41 of the insurance act 1938 – Prohibition of rebates