Main Highlight of the plan
- This policy is available only for families with girl child in their family.
- This policy offers coverage under two Sections. Section 1 covers basic hospitalization expenses while the Section 2 covers offers personal additional coverage.
Scope of cover
|
Plan |
Entry Age |
Maximum Number of Members |
Sum Insured Range |
Discount on premium |
|
Family Floater |
Children 3 months to
25 years Adults 18 years to 65
years |
Adults – 2 Children – 2 (at least
daughters) |
INR 2,00,000 to INR 8,00,000 |
All the members are covered under
single premium. |
Note: The upper age limit for the dependent children is not applicable for mentally challenged or financially dependent unmarried daughters.
Pre-policy medical check-up
is required after age 50 years and also for individuals with medical history at
the time of buying the policy.
50% of expenses on
pre-policy medical check-up will be reimbursed after acceptance and policy
issue.
Coverage: Benefits & Features
Most Important
ROOM RENT/ ROOM CATEGORY
This plan does have limits for coverage of room expenses.
- For normal hospitalization, room-rent up to 1% of sum insured is covered.
- For ICU hospitalization, room-rent up to 2% of sum insured is covered.
CO-PAYMENT
This plan has zonal co-payment up to 20% of claimable expenses.
NO-CLAIM BENEFITS
This plan does not offer no-claim benefits.
SUB-LIMITS
This plan covers cataract treatment up to 10% of sum insured for a maximum of INR 50,000 for each eye.
- External congenital diseases would be covered up to 10% of the sum insured up to a maximum of average sum insured for the 4 preceding policy years.
Good to have
PRE/POST HOSPITALIZATION
30 days of pre-hospitalization and 60 days of post hospitalization are provided in this plan.
RESTORE BENEFITS
This plan does not offer restore benefit.
HEALTH CHECK-UP
This plan does not offer health check-up benefit.
Value Adds
AMBULANCE CHARGES
This plan provides coverage for ambulance expense up to 1% of sum insurance per hospitalization.
EYE COVER
This plan does not cover expenses for eye treatments.
DOMICILIARY HOSPITALIZATION
This plan does not offer coverage for domiciliary expenses.
OUTPATIENT BENEFITS
This plan does not cover out-patient treatment expenses.
CRITICAL ILLNESS COVERAGE
This plan provides additional coverage for listed critical illnesses up to 10% of sum insured once in lifetime.
PERSONAL ACCIDENT COVERAGE
The Section 2 of this plan exclusively covers personal accident which includes death, permanent total disability, loss of limb, etc.
ALTERNATIVE PRACTICE
This plan covers non-allopathic treatments (Ayurvedic, Unani and Homeopathic treatments) up to 25% of sum insured.
- Note: The above mentioned non-allopathic treatments should be with government hospital, hospital or institute recognized by government or accredited by Quality Council of India/ National Accreditation board on health.
DENTAL COVER
This plan does not cover expenses on dental treatments.
DAILY CASH
This plan offers daily cash allowance up to 0.1% of sum insured up to a maximum of 1% of sum insured. This allowance is however paid after completion of 24 hours of hospitalization.
ORGAN DONOR COVER
This plan offers coverage for medical expenses up to sum insured, on harvesting organ for the insured or for the donor and for transplantation.
CONVALESCENCE BENEFIT
This plan does not have any convalescence benefit.
MATERNITY COVER
This plan does not cover maternity expenses.
Exclusions
A cooling off period of 30 days is applicable on buying health insurance policy for the first year. No claims (other than claims related to an accident) can be made in this cooling off period. There is no cooling off period applicable on renewal of this policy.
Waiting period of 2 years is applicable for specified ailments while that of 4 years for treatments like joint replacement, osteoarthritis, etc. Refer to the policy wordings for the list of these specified ailments.
Waiting period of 4 years is applicable for pre-existing.
Waiting period of 2 years is applicable for internal congenital diseases un-diagnosed till the time of buying an insurance.
Waiting period of 4 years for external congenital diseases.
- Note: The congenital disease is applicable only for new born covered under this policy.
PERMANENT EXCLUSIONS
Cosmetic surgery, Lasik eye treatments, drugs or alcohol abuse, genetic disorders, self-inflicted injuries, war related injuries, etc. are some of the permanent exclusions. For the detailed list of please refer the New India Assurance policy document.
