Highlights of Arogya Sanjeevani, The New India Assurance Co. Ltd.

• 1. Sum Insured

  The sum insured is from INR 50,000 to INR 10 Lakhs, in multiples of INR 50,000.

• 2. Basis of Policy

  The policy can be taken either on an Individual or Floater Sum Insured basis.

• 3. Pre-Acceptance Medical Check-Up

  Pre-Acceptance Medical Check-Up is required for persons above 50 years and for Sum Insured of 5.5 Lakhs and above. However, the condition of 50 years shall be relaxed to 60 years subject to the following conditions:

  • A minimum of 3 persons should be covered in the policy.
  • At least one of the members’ age should be less than 35 years.

   

• 4. Room Rent and ICU/ICCU Charges

  Room rent is up to 2% of the sum insured, subject to a maximum of INR 5,000. ICU/ICCU will be up to 5% of the sum insured, subject to a maximum of INR 10,000.

• 5. Coverage for Family

  Dependent spouse, children, parents, and parents-in-law can be covered under the policy.

• 6. Cataract Surgery Coverage

  Cataract surgeries will be paid up to 25% of the sum insured, subject to a maximum of INR 40,000.

• 7. AYUSH Treatments Coverage

  Expenses incurred for Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy systems of medicines are covered 100% of the Sum Insured.

• 8. Coverage for Special Treatments

  Treatments towards HIV, Mental Illness, and Genetic disorders are also payable under the policy.

• 9. Cumulative Bonus

  Cumulative bonus is available at 5% per claim-free year, up to a maximum of 50%.

• 10. Advance Treatments Coverage

  The following advanced treatments are covered up to 50% of the sum insured:

  • Uterine Artery Embolization and HIFU (High Intensity Focused Ultrasound)
  • Balloon Sinuplasty
  • Deep Brain Stimulation
  • Oral Chemotherapy
  • Immunotherapy – Monoclonal Antibody to be given as an injection
  • Intra Vitreal Injections
  • Robotic Surgeries
  • Stereotactic Radiosurgeries
  • Bronchial Thermoplasty
  • Vaporization of the Prostate (Green Laser Treatment or Holmium Laser Treatment)
  • ONM – Intra Operative Neuro Monitoring
  • Stem Cell Therapy: Hematopoietic Stem Cells for Bone Marrow Transplant for Hematological Conditions

   

• 11. Dental Treatment Coverage

  Dental treatment due to disease or injury is also covered under the policy.

• 12. Pre-Hospitalization Expenses

  Pre-hospitalization expenses are covered up to 30 days prior to hospitalization.

• 13. Post-Hospitalization Expenses

  Post-hospitalization expenses are covered up to 60 days from the date of discharge from the hospital.

• 14. Loading for Pre-existing Lifestyle Diseases

  A loading of 5% is applied for pre-existing lifestyle diseases like hypertension, diabetes, and BMI >32.

• 15. Co-Pay

  There is a 5% co-pay on each and every claim.

• 16. Waiting Period

  There is a waiting period of 30 days under the policy.

• 17. Specific Illness Waiting Period

  In addition, there is a 24 & 36 months waiting period for specific illnesses.

• 18. Pre-existing Diseases Waiting Period

  A 36-month waiting period is applicable for all pre-existing diseases (PEDs).

• 19. Moratorium Period

  A moratorium period of 5 years is applicable, after which no claim can be turned down for non-disclosure and/or misrepresentation.

• 20. Multiple Policies

  No multiple policies from The New India Assurance Co. Ltd. are allowed.

• 21. Installment Premium Facility

  An installment premium facility is available for policyholders.