{"uin":"NIAHLGP24181V022324","name":"Good Health Mediclaim Insurance","url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324","insurer":{"slug":"new-india-assurance","name":"The New India Assurance Company Limited","url":"https://indiainsurances.com/insurer/new-india-assurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"Good Health Group Mediclaim Policy is a health indemnity policy for Axis Bank credit card members that reimburses hospitalisation expenses through a TPA up to the sum insured stated in the schedule. It covers treatment only in India, with room rent limited to 1% of the sum insured per day, ICU limited to 2% per day, a 30-day initial waiting period, and 24 or 36 months PED waiting by age.","analysis":{"state":"machine","analysed_at":"2026-10-19 22:01:23.27979+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"not-stated","value":null,"display":null,"note":"The wording refers to plan changes but does not name plan variants.","quote":null,"sources":[],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"One policy year, being a period of twelve months as mentioned in the schedule.","display":"One policy year, twelve months","note":null,"quote":"POLICY PERIOD means period of one policy year as mentioned in the schedule for which the Policy is issued ... POLICY YEAR means a period of twelve months beginning from the date of commencement of the policy period and ending on the last day of such twelve-month period.","sources":[{"clause":"2.57","heading":"POLICY PERIOD","page":8,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-2-57"},{"clause":"2.59","heading":"POLICY YEAR","page":9,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-2-59"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"quote-verified","value":"Intimate the TPA in writing immediately on detection of illness or injury, or forty-eight hours before hospitalisation. For a medical emergency, intimate within twenty-four hours from the time of hospitalisation.","display":"Immediately or 48 hours before hospitalisation; within 24 hours for emergency hospitalisation","note":null,"quote":"Intimate TPA in writing on detection of any Illness/Injury being suffered immediately or forty-eight hours before Hospitalisation. ... Intimate within twenty-four hours from the time of Hospitalisation in case of Hospitalisation due to medical emergency.","sources":[{"clause":"5.20","heading":"NOTICE OF CLAIM","page":28,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-5-20"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"quote-verified","value":["Claim Form duly filled and signed by the claimant","All documents pertaining to the illness starting from the date it was first detected i.e. Doctor's consultation reports/history","Numbered Bill/Receipt and Discharge certificate / card from the Hospital.","Cash Memos from the Hospitals (s) / Chemists (s), supported by proper prescriptions.","Receipt and Pathological test reports from Pathologist supported by the note from the attending Medical Practitioner / Surgeon recommending such Pathological tests / pathological.","Surgeon's certificate stating nature of operation performed and Surgeons’ bill and receipt.","Attending Doctor's/ Consultant's/ Specialist's / Anesthetist’s bill and receipt, and certificate regarding diagnosis.","Details of previous policies if the details are not already with TPA or any other information needed by the TPA for considering the claim."],"display":"Claim form, illness records, hospital bills and discharge papers, pharmacy cash memos, test reports, surgeon and doctor bills/certificates, previous policy details and other information needed by TPA","note":null,"quote":"Claim Form duly filled and signed by the claimant ... All documents pertaining to the illness starting from the date it was first detected i.e. Doctor's consultation reports/history ... Numbered Bill/Receipt and Discharge certificate / card from the Hospital. ... Cash Memos from the Hospitals (s) / Chemists (s), supported by proper prescriptions. ... Receipt and Pathological test reports from Pathologist supported by the note from the attending Medical Practitioner / Surgeon recommending such Pathological tests / pathological. ... Surgeon's certificate stating nature of operation performed and Surgeons’ bill and receipt. ... Attending Doctor's/ Consultant's/ Specialist's / Anesthetist’s bill and receipt, and certificate regarding diagnosis. ... Details of previous policies if the details are not already with TPA or any other information needed by the TPA for considering the claim.","sources":[{"clause":"5.20","heading":"NOTICE OF CLAIM","page":28,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-5-20"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"quote-verified","value":"The company shall settle or reject a claim within 30 days from receipt of the last necessary document. If investigation is warranted, it must complete the investigation within 30 days and settle or reject the claim within 45 days from receipt of the last necessary document, with interest for delay.","display":"30 days from last necessary document; 45 days if investigation is needed","note":"Delay attracts interest at 2% above bank rate.","quote":"The Company shall settle or reject a claim, as the case may be, within 30 days from the date of receipt of last necessary document. ... where the circumstances of a claim warrant an investigation in the opinion of the Company, it shall initiate and complete such investigation at the earliest, in any case not later than 30 days from the date of receipt of last necessary document. ln such cases, the Company shall settle or reject the claim within 45 days from the date of receipt of last necessary document.","sources":[{"clause":"5.10(i)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-5-10-i"},{"clause":"5.10(iii)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-5-10-iii"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"quote-verified","value":["Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications","Specific waiting period for listed conditions, surgeries / treatments","Expenses related to the treatment of any illness within 30 days from the first policy commencement date","Expenses related to any admission primarily for diagnostics and evaluation purposes.","Expenses related to any admission primarily for enforced bed rest and not for receiving treatment.","Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions","Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex.","Expenses for cosmetic or plastic surgery or any treatment to change appearance","Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports","Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent.","Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof.","Medical treatment expenses traceable to childbirth","Any expenses incurred on Domiciliary Hospitalisation.","Treatment taken outside the geographical limits of India"],"display":"PED waiting, specific waiting periods, first 30 days illness waiting, diagnostics-only admission, rest cure, obesity surgery outside conditions, gender change, cosmetic surgery, professional adventure sports, criminal breach of law, substance abuse, maternity, domiciliary hospitalisation and treatment outside India","note":"Maternity may be covered only if the optional Maternity Expenses Benefit is bought.","quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after commencement of the policy for persons above 45 years of age and 24 months of continuous coverage for persons up to 45 years of age. ... Expenses related to the treatment of the following listed conditions, surgeries / treatments shall be excluded until the expiry of Ninety Days / 24 / 36 months of continuous coverage ... Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered. ... Expenses related to any admission primarily for diagnostics and evaluation purposes. ... Expenses related to any admission primarily for enforced bed rest and not for receiving treatment. ... Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions: ... Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex. ... Expenses for cosmetic or plastic surgery or any treatment to change appearance ... Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports ... Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent. ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. ... Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; ... Any expenses incurred on Domiciliary Hospitalisation. ... Treatment taken outside the geographical limits of India","sources":[{"clause":"4.1","heading":"PRE-EXISTING DISEASES (Code- Excl01)","page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-1"},{"clause":"4.2","heading":"SPECIFIC WAITING PERIOD (Code- Excl02)","page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-2"},{"clause":"4.3","heading":"FIRST THIRTY DAYS WAITING PERIOD (Code- Excl03)","page":18,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-3"},{"clause":"4.4.1","heading":"INVESTIGATION & EVALUATION (Code- Excl04)","page":18,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-1"},{"clause":"4.4.2","heading":"REST CURE, REHABILITATION AND RESPITE CARE","page":19,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-2"},{"clause":"4.4.3","heading":"OBESITY/ WEIGHT CONTROL","page":19,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-3"},{"clause":"4.4.4","heading":"CHANGE-OF-GENDER TREATMENTS (Code- Excl07)","page":19,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-4"},{"clause":"4.4.5","heading":"COSMETIC OR PLASTIC SURGERY (Code- Excl08)","page":19,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-5"},{"clause":"4.4.6","heading":"HAZARDOUS OR ADVENTURE SPORTS (Code- Excl09)","page":19,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-6"},{"clause":"4.4.7","heading":"BREACH OF LAW (Code- Excl10)","page":19,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-7"},{"clause":"4.4.9","heading":null,"page":20,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-9"},{"clause":"4.4.15","heading":"MATERNITY EXPENSES (Code - Excl18)","page":20,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-15"},{"clause":"4.4.17","heading":null,"page":20,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-17"},{"clause":"4.4.29","heading":"Treatment taken outside the geographical limits of India","page":22,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-29"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"quote-verified","value":"First contact the company through its website, toll-free number, e-mail, fax, courier, or grievance cell at any branch. If not satisfied, contact the grievance officer, and then the Insurance Ombudsman or IRDAI IGMS.","display":"Company grievance channels first, then grievance officer, then Insurance Ombudsman or IRDAI IGMS","note":null,"quote":"ln case of any grievance the insured person may contact the company through Website: https://www.newindia.co.in/portal/readMore/Grievances Toll free: 1800-209-1415 E-mail, Fax and Courier: As mentioned in the above address ... lnsured person may also approach the grievance cell at any of the company's branches with the details of grievance. ... insured person may contact the grievance officer at https://www.newindia.co.in/portal/readMore/Grievances ... the insured person may also approach the office of lnsurance Ombudsman of the respective area/region for redressal of grievance","sources":[{"clause":"5.14","heading":"REDRESSAL OF GRIEVANCE ln case of any grievance the insured person may contact","page":26,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-5-14"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"not-stated","value":null,"display":null,"note":"The wording says members are covered for the sum insured stated in the Policy Certificate or Schedule, but the selectable amounts are not printed in the clauses.","quote":null,"sources":[],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":null,"quote":"Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.","sources":[{"clause":"4.3","heading":"FIRST THIRTY DAYS WAITING PERIOD (Code- Excl03)","page":18,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-3"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"quote-verified","value":{"unit":"months","amount":24},"display":"24 months up to 45 years; 36 months above 45 years","note":"36 months of continuous coverage for persons above 45 years of age.","quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after commencement of the policy for persons above 45 years of age and 24 months of continuous coverage for persons up to 45 years of age.","sources":[{"clause":"4.1","heading":"PRE-EXISTING DISEASES (Code- Excl01)","page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-1"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"quote-verified","value":{"unit":"days","amount":90},"display":"90 days for some listed conditions; 24 or 36 months for others","note":"The shortest listed waiting period is 90 days. Other listed conditions have 24 months and 36 months waiting periods.","quote":"Expenses related to the treatment of the following listed conditions, surgeries / treatments shall be excluded until the expiry of Ninety Days / 24 / 36 months of continuous coverage, as may be the case after the date of inception of the first policy with the insurer. ... i) 90 Days Waiting Period ... ii) 24 Months waiting period ... iii) 36 months waiting period","sources":[{"clause":"4.2","heading":"SPECIFIC WAITING PERIOD (Code- Excl02)","page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-2"},{"clause":"4.2(f)(i)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-2-f-i"},{"clause":"4.2(f)(ii)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-2-f-ii"},{"clause":"4.2(f)(iii)","heading":null,"page":18,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-2-f-iii"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"quote-verified","value":["Diabetes Mellitus","Hypertension","Cardiac Conditions","All internal and external benign tumours, cysts, polyps of any kind, including benign breast lumps","Benign ear, nose, throat disorders","Benign prostate hypertrophy","Gastric/ Duodenal Ulcer","Gout and Rheumatism","Hernia of all types","Hydrocele","Non Infective Arthritis","Piles, Fissures and Fistula in anus","Pilonidal sinus, Sinusitis and related disorders","Prolapse inter Vertebral Disc and Spinal Diseases unless arising from accident","Skin Disorders","Stone in Gall Bladder and Bile duct, excluding malignancy","Stones in Urinary system","Treatment for Menorrhagia/Fibromyoma, Myoma and Prolapsed uterus","Varicose Veins and Varicose Ulcers","Renal Failure","Puberty and Menopause related Disorders","Total Knee/Hip replacement (due to arthritis, rheumatism and other degenerative disorders)","Cataract","External Congenital Diseases","Treatment of mental illness","Age Related Macular Degeneration (ARMD)","Genetic diseases or disorders"],"display":"Diabetes, hypertension, cardiac conditions, listed benign tumours/cysts/polyps, ENT disorders, prostate hypertrophy, ulcer, gout/rheumatism, hernia, hydrocele, arthritis, piles/fissures/fistula, sinus disorders, spinal diseases, skin disorders, gall/bladder stones, urinary stones, menorrhagia/fibromyoma/myoma/prolapsed uterus, varicose veins/ulcers, renal failure, puberty/menopause disorders, knee/hip replacement, cataract, external congenital diseases, mental illness, ARMD and genetic diseases/disorders","note":null,"quote":"1. Diabetes Mellitus\n2. Hypertension\n3. Cardiac Conditions ... 1. All internal and external benign tumours, cysts, polyps of any kind, including benign breast lumps\n2. Benign ear, nose, throat disorders\n3. Benign prostate hypertrophy\n4. Gastric/ Duodenal Ulcer\n5. Gout and Rheumatism\n6. Hernia of all types\n7. Hydrocele\n8. Non Infective Arthritis\n9. Piles, Fissures and Fistula in anus\n10. Pilonidal sinus, Sinusitis and related disorders\n11. Prolapse inter Vertebral Disc and Spinal Diseases unless arising from accident\n12. Skin Disorders\n13. Stone in Gall Bladder and Bile duct, excluding malignancy\n14. Stones in Urinary system\n15. Treatment for Menorrhagia/Fibromyoma, Myoma and Prolapsed uterus\n16. Varicose Veins and Varicose Ulcers\n17. Renal Failure\n18. Puberty and Menopause related Disorders ... 1. Total Knee/Hip replacement (due to arthritis, rheumatism and other degenerative disorders)\n2. Cataract\n3. External Congenital Diseases\n4. Treatment of mental illness\n5. Age Related Macular Degeneration (ARMD)\n6. Genetic diseases or disorders","sources":[{"clause":"4.2(f)(i)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-2-f-i"},{"clause":"4.2(f)(ii)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-2-f-ii"},{"clause":"4.2(f)(iii)","heading":null,"page":18,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-2-f-iii"}],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"quote-verified","value":{"unit":"months","amount":60},"display":"60 continuous months","note":"For enhanced sum insured, sixty continuous months apply from the date of enhancement on the enhanced limit.","quote":"After completion of sixty continuous months of coverage(including portability and migration in health insurance policy) , no policy and claim shall be contestable by the insurer on grounds of non-disclosure , mis-representation except on grounds of established fraud . This period of sixty continuous months is called as Moratorium period.","sources":[{"clause":"5.8","heading":"MORATORIUM PERIOD","page":24,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-5-8"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"quote-verified","value":"You may port the policy to another insurer by applying at least 45 days before, but not earlier than 60 days from, the renewal date. Credit can be transferred for sum insured, no claim bonus, specific waiting period for pre-existing diseases and moratorium period, if continuously covered without lapses.","display":"Portability allowed to other insurers with waiting-period and other credits","note":null,"quote":"You will have the option to port the policy to other Insurers by applying to such Insurer to port the entire policy along with all the members of the family, if any, at-least 45 days before, but not earlier than 60 days from the policy renewal date as per IRDAI guidelines related to portability. ... the policyholder can transfer the credit gained to the extent of the sum insured, no claim bonus, specific waiting period for pre-existing diseases, moratorium period etc. from the existing insurer to the acquiring insurer in the previous policy.","sources":[{"clause":"5.15","heading":"PORTABILITY AND MIGRATION","page":26,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-5-15"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"quote-verified","value":true,"display":"Yes, ordinarily renewable; above 65 years renewal only","note":"The wording does not use the word “lifelong”; it states renewal above age 65 and says renewal is ordinarily available except for fraud or misrepresentation.","quote":"Persons above the age of 65 years can be considered for renewal only (no change in plan is allowed). ... The policy shall ordinarily be renewable except on grounds of fraud, misrepresentation by the insured person.","sources":[{"clause":"3.18","heading":"AGE LIMIT","page":16,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-18"},{"clause":"5.11","heading":"RENEWAL OF POLICY","page":25,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-5-11"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"quote-verified","value":"Renewal cannot be denied because of claims in preceding policy years, and no loading applies on renewals based on individual claims experience.","display":"No loading on renewals based on individual claims experience","note":null,"quote":"Renewal shall not be denied on the ground that the insured person had made a claim or claims in the preceding policy years. ... No loading shall apply on renewals based on individual claims experience.","sources":[{"clause":"5.11","heading":"RENEWAL OF POLICY","page":25,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-5-11"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"quote-verified","value":["INVESTIGATION & EVALUATION (Code- Excl04)","REST CURE, REHABILITATION AND RESPITE CARE (Code- Excl05)","OBESITY/ WEIGHT CONTROL (Code- Excl06)","CHANGE-OF-GENDER TREATMENTS (Code- Excl07)","COSMETIC OR PLASTIC SURGERY (Code- Excl08)","HAZARDOUS OR ADVENTURE SPORTS (Code- Excl09)","BREACH OF LAW (Code- Excl10)","EXCLUDED PROVIDERS (Code-Excl11)","Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. (Code- Excl12)","health hydros, nature cure clinics, spas or similar establishments","Dietary supplements and substances that can be purchased without prescription","REFRACTIVE ERROR (Code- Excl15)","UNPROVEN TREATMENTS (Code- Excl16)","STERILITY AND INFERTILITY (Code- Excl17)","MATERNITY EXPENSES (Code - Excl18)","Acupressure, acupuncture, magnetic therapies.","Any expenses incurred on Domiciliary Hospitalisation.","Treatment taken outside the geographical limits of India"],"display":"Standard Excl04 to Excl18 plus product exclusions including acupressure/acupuncture/magnetic therapies, domiciliary hospitalisation and treatment outside India","note":"Maternity exclusion is deleted only for members who buy the optional Maternity Expenses Benefit.","quote":"INVESTIGATION & EVALUATION (Code- Excl04) ... REST CURE, REHABILITATION AND RESPITE CARE (Code- Excl05) ... OBESITY/ WEIGHT CONTROL (Code- Excl06) ... CHANGE-OF-GENDER TREATMENTS (Code- Excl07) ... COSMETIC OR PLASTIC SURGERY (Code- Excl08) ... HAZARDOUS OR ADVENTURE SPORTS (Code- Excl09) ... BREACH OF LAW (Code- Excl10) ... EXCLUDED PROVIDERS (Code-Excl11) ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. (Code- Excl12) ... Treatments received in health hydros, nature cure clinics, spas or similar establishments ... Dietary supplements and substances that can be purchased without prescription ... REFRACTIVE ERROR (Code- Excl15) ... UNPROVEN TREATMENTS (Code- Excl16) ... STERILITY AND INFERTILITY (Code- Excl17) ... MATERNITY EXPENSES (Code - Excl18) ... Acupressure, acupuncture, magnetic therapies. ... Any expenses incurred on Domiciliary Hospitalisation. ... Treatment taken outside the geographical limits of India","sources":[{"clause":"4.4.1","heading":"INVESTIGATION & EVALUATION (Code- Excl04)","page":18,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-1"},{"clause":"4.4.2","heading":"REST CURE, REHABILITATION AND RESPITE CARE","page":19,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-2"},{"clause":"4.4.3","heading":"OBESITY/ WEIGHT CONTROL","page":19,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-3"},{"clause":"4.4.4","heading":"CHANGE-OF-GENDER TREATMENTS (Code- Excl07)","page":19,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-4"},{"clause":"4.4.5","heading":"COSMETIC OR PLASTIC SURGERY (Code- Excl08)","page":19,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-5"},{"clause":"4.4.6","heading":"HAZARDOUS OR ADVENTURE SPORTS (Code- Excl09)","page":19,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-6"},{"clause":"4.4.7","heading":"BREACH OF LAW (Code- Excl10)","page":19,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-7"},{"clause":"4.4.8","heading":"EXCLUDED PROVIDERS (Code-Excl11)","page":19,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-8"},{"clause":"4.4.9","heading":null,"page":20,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-9"},{"clause":"4.4.10","heading":null,"page":20,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-10"},{"clause":"4.4.11","heading":null,"page":20,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-11"},{"clause":"4.4.12","heading":"REFRACTIVE ERROR (Code- Excl15)","page":20,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-12"},{"clause":"4.4.13","heading":"UNPROVEN TREATMENTS (Code- Excl16)","page":20,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-13"},{"clause":"4.4.14","heading":"STERILITY AND INFERTILITY (Code- Excl17)","page":20,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-14"},{"clause":"4.4.15","heading":"MATERNITY EXPENSES (Code - Excl18)","page":20,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-15"},{"clause":"4.4.16","heading":null,"page":20,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-16"},{"clause":"4.4.17","heading":null,"page":20,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-17"},{"clause":"4.4.29","heading":"Treatment taken outside the geographical limits of India","page":22,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-29"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"quote-verified","value":"You may cancel at any time during the term by giving 7 days’ written notice. If no claim has been made, admitted, lodged, or benefit availed, the insurer refunds proportionate premium for the unexpired policy period.","display":"Proportionate refund for unexpired period if no claim; 7 days’ written notice","note":null,"quote":"The policyholder may cancel his/her policy at any time during the term, by giving 7 days’ notice in writing. ... refund proportionate premium for unexpired policy period, if there is no claim (s) made during the policy period. Notwithstanding anything contained herein or otherwise, no refunds of premium shall be made in respect of Cancellation where, any claim has been admitted or has been lodged or any benefit has been availed by the insured person under the policy.","sources":[{"clause":"5.1","heading":"CANCELLATION","page":22,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-5-1"},{"clause":"5.1(a)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-5-1-a"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"quote-verified","value":"The policy covers medical or surgical treatment and services rendered only in India, and admissible claims are payable only in Indian Rupees.","display":"India only","note":null,"quote":"This Policy covers medical/surgical treatment and/or services rendered only in India.\nAdmissible claims shall be payable only in Indian Rupees.","sources":[{"clause":"5.18","heading":"PLACE OF TREATMENT AND PAYMENT","page":27,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-5-18"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Applicable on new individual health insurance policies, except policies of less than a year, renewals or porting/migrating.","quote":"The insured person shall be allowed free look period of thirty days from date of receipt of the policy document to review the terms and conditions of the policy, and to return the same if not acceptable.","sources":[{"clause":"5.6","heading":"FREE LOOK PERIOD","page":23,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-5-6"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"quote-verified","value":{"unit":"days","amount":15},"display":"15 days for monthly mode; 30 days in all other cases","note":"Renewal clause also states the policy can be renewed within the Grace Period of 30 days to maintain continuity.","quote":"The grace period for payment of the premium for all types of insurance policies shall be: fifteen days where premium payment mode is monthly and thirty days in all other cases.","sources":[{"clause":"2.18","heading":"GRACE PERIOD","page":4,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-2-18"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"quote-verified","value":"Adults can enter from 18 years to 65 years. Children between 3 months and 18 years can be covered if one or both parents are covered simultaneously.","display":"18 years to 65 years; children 3 months to 18 years with parent(s)","note":"Persons aged 61 to 65 require medical reports with a medical practitioner’s certificate.","quote":"This insurance is available to persons between ages of 18 yrs and 65 yrs. ... Children between 3 months and 18 years of age can be covered provided one or both the Parents are covered simultaneously.","sources":[{"clause":"3.18","heading":"AGE LIMIT","page":16,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-18"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"not-stated","value":null,"display":null,"note":"The wording refers to monthly premium mode for grace-period purposes but does not state the available premium payment modes.","quote":null,"sources":[],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"quote-verified","value":["OPTIONAL COVER I: HOSPITAL CASH BENEFIT","OPTIONAL COVER II: MATERNITY EXPENSES BENEFIT","OPTION COVER III : MODERN TREATMENT COVERAGE UPTO 100% OF SUM INSURED","OPTIONAL COVER IV: NON-MEDICAL ITEMS (CONSUMABLES)"],"display":"Hospital Cash Benefit, Maternity Expenses Benefit, Modern Treatment Coverage up to 100% of Sum Insured, Non-Medical Items (Consumables)","note":null,"quote":"OPTIONAL COVER I: HOSPITAL CASH BENEFIT ... On payment of additional Premium as mentioned in Schedule ... OPTIONAL COVER II: MATERNITY EXPENSES BENEFIT ... On the payment of additional Premium as mentioned in Schedule ... OPTION COVER III : MODERN TREATMENT COVERAGE UPTO 100% OF SUM INSURED ... On payment of additional premium as mentioned in Schedule ... OPTIONAL COVER IV: NON-MEDICAL ITEMS (CONSUMABLES) ... On payment of additional Premium as mentioned in Schedule","sources":[{"clause":"3.10","heading":"OPTIONAL COVER I: HOSPITAL CASH BENEFIT","page":12,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-10"},{"clause":"3.11","heading":"OPTIONAL COVER II: MATERNITY EXPENSES BENEFIT","page":12,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-11"},{"clause":"3.12","heading":"OPTION COVER III : MODERN TREATMENT COVERAGE UPTO 100% OF SUM INSURED","page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-12"},{"clause":"3.13","heading":"OPTIONAL COVER IV: NON-MEDICAL ITEMS (CONSUMABLES)","page":14,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-13"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"Coverage is not available for the period for which no premium is received, including during the grace period.","display":"Coverage is not available during the grace period","note":null,"quote":"Coverage is not available for the period for which no premium is received. ... Coverage is not available during the Grace Period.","sources":[{"clause":"2.18","heading":"GRACE PERIOD","page":4,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-2-18"},{"clause":"5.11","heading":"RENEWAL OF POLICY","page":25,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-5-11"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for the hospital room, or the room category allowed. If you take a costlier room, other bills can be cut in proportion.","status":"quote-verified","value":"Room rent, boarding, DMO/RMO/CMO/RMP charges and nursing expenses are covered up to 1% of the sum insured, including cumulative bonus, per day. Proportionate deduction is waived, but if a higher room than the eligible category is chosen, the insured must pay the room rent difference.","display":"1% of Sum Insured per day; pay room-rent difference for higher room","note":null,"quote":"Room Rent, boarding DMO/RMO/CMO/RMP Charges, Nursing expenses (including Injection / Drugs and Intravenous fluid administration expenses) as provided by the Hospital not exceeding 1 % of the Sum Insured (including Cumulative Bonus) per day ... Proportionate Deduction clause is waived in Good Health Policy. However, if the insured persons opts for a higher Room than their eligible category, they will still have to pay the difference in Room Rent.","sources":[{"clause":"3.1","heading":null,"page":10,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-1"},{"clause":"3.2","heading":"PROPORTIONATE DEDUCTION","page":10,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-2"}],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"not-applicable","value":null,"display":null,"note":"The policy states a room rent amount limit of 1% of sum insured per day, not a room-category limit.","quote":null,"sources":[],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"quote-verified","value":"ICU or ICCU charges, intensivist charges, monitor and pulse oxymeter expenses are covered up to 2% of the sum insured, including cumulative bonus, per day.","display":"2% of Sum Insured per day","note":null,"quote":"Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU), Intensivist charges, Monitor and Pulse Oxymeter expenses not exceeding 2 % of the Sum Insured (including Cumulative Bonus) per day","sources":[{"clause":"3.1","heading":null,"page":10,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-1"}],"law":[]},{"key":"proportionate_deduction","label":"Proportionate deduction","section":"Limits and co-pay","meaning":"If you choose a room above your limit, whether the insurer reduces associated charges (doctor fees, tests, procedures) by the same proportion.","status":"quote-verified","value":"Proportionate deduction is waived under Good Health Policy. If the insured chooses a higher room than the eligible category, the insured still pays the difference in room rent.","display":"Waived; only the room-rent difference is payable for a higher room","note":null,"quote":"Proportionate Deduction clause is waived in Good Health Policy. However, if the insured persons opts for a higher Room than their eligible category, they will still have to pay the difference in Room Rent.","sources":[{"clause":"3.2","heading":"PROPORTIONATE DEDUCTION","page":10,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-2"}],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"not-stated","value":null,"display":null,"note":"No co-payment percentage for the base policy is stated in the clauses.","quote":null,"sources":[],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"An amount of each claim or each year that you bear before the policy pays.","status":"not-stated","value":null,"display":null,"note":"No general deductible for the base policy is stated. The optional Modern Treatment Cover has a 10% deductible on the admissible claim amount above the base-policy sublimit.","quote":null,"sources":[],"law":[]},{"key":"disease_sublimits","label":"Disease or procedure sub-limits","section":"Limits and co-pay","meaning":"Caps on what is paid for named treatments (cataract, knee replacement...), even if the sum insured is higher.","status":"quote-verified","value":["Cataract: 20% of Sum Insured subject to a maximum of Rs.40,000 for each eye","Artificial life maintenance: up to 10% of the Sum Insured and for a maximum of 15 days per policy period","Puberty and Menopause related Disorders: sub-limit of up to 25% of Sum Insured per policy period","Age Related Macular Degeneration (ARMD): sub-limit of 10% of Sum Insured, maximum upto Rs. 75,000 per policy period","Genetic diseases or disorders: sub-limit of 25% of Sum Insured per policy period","Treatment of Mental Illness: sub-limit up to 25% of Sum Insured per policy period","Uterine Artery Embolization and HIFU: Upto 20% of Sum Insured subject to a Maximum upto Rs. 2 Lakh","Balloon Sinuplasty: Upto 20% of Sum Insured subject to a Maximum upto Rs. 2 Lakh","Deep Brain stimulation: Upto 50% of Sum Insured subject to a maximum upto Rs. 5 Lakh","Oral chemotherapy: Upto 10% of Sum Insured subject to Maximum upto Rs.1 Lakh.","Robotic surgeries: Upto 50% of Sum Insured subject to Maximum of Rs. 5 Lakh.","Stem cell therapy: Upto 50% of Sum Insured subject to Maximum of Rs. 2.5 Lakh."],"display":"Cataract, artificial life maintenance, puberty/menopause disorders, ARMD, genetic diseases, mental illness and listed modern treatments have sub-limits","note":"The modern treatment list also contains limits for immunotherapy, intravitreal injections, stereotactic radio surgeries, bronchial thermoplasty, vaporisation of the prostrate and IONM.","quote":"Cataract, for each eye, shall not exceed 20% of the Sum Insured (including Cumulative Bonus) subject to a maximum of Rs.40,000. ... Artificial life maintenance, including life support machine use ... up to 10% of the Sum Insured and for a maximum of 15 days per policy period ... Puberty and Menopause related Disorders ... sub-limit of up to 25% of Sum Insured per policy period. ... Age Related Macular Degeneration (ARMD) ... sub-limit of 10% of Sum Insured, maximum upto Rs. 75,000 per policy period. ... Genetic diseases or disorders are covered with a sub-limit of 25% of Sum Insured per policy period ... Treatment of Mental Illness ... sub-limit up to 25% of Sum Insured per policy period. ... Uterine Artery Embolization and HIFU (High intensity focused ultrasound) | Upto 20% of Sum Insured subject to a Maximum upto Rs. 2 Lakh ... Balloon Sinuplasty. | Upto 20% of Sum Insured subject to a Maximum upto Rs. 2 Lakh ... Deep Brain stimulation. | Upto 50% of Sum Insured subject to a maximum upto Rs. 5 Lakh ... Oral chemotherapy. | Upto 10% of Sum Insured subject to Maximum upto Rs.1 Lakh. ... Robotic surgeries. | Upto 50% of Sum Insured subject to Maximum of Rs. 5 Lakh. ... Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered. | Upto 50% of Sum Insured subject to Maximum of Rs. 2.5 Lakh.","sources":[{"clause":"3.3","heading":"LIMIT ON PAYMENT FOR CATARACT","page":11,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-3"},{"clause":"3.15(a)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-15-a"},{"clause":"3.15(b)","heading":"Puberty and Menopause related Disorders","page":14,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-15-b"},{"clause":"3.15(c)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-15-c"},{"clause":"3.15(d)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-15-d"},{"clause":"3.15(e)","heading":"Treatment of Mental Illness","page":15,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-15-e"},{"clause":"3.16","heading":"COVERAGE FOR MODERN TREATMENTS or PROCEDURES: The following procedures will be covered","page":15,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-16"}],"law":[]},{"key":"pre_hospitalisation","label":"Pre-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days before admission that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"The expenses must be for the same condition and the inpatient hospitalisation claim must be admissible.","quote":"PRE-HOSPITALISATION MEDICAL EXPENSES means Medical Expenses incurred during the period of 30 days preceding the Hospitalisation of the Insured Person","sources":[{"clause":"2.38","heading":"PRE-HOSPITALISATION MEDICAL EXPENSES","page":7,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-2-38"}],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days after discharge that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":60},"display":"60 days","note":"The expenses must be for the same condition and the inpatient hospitalisation claim must be admissible.","quote":"POST-HOSPITALISATION MEDICAL EXPENSES means Medical Expenses incurred during the period of 60 days immediately after the Insured Person is discharged from the Hospital","sources":[{"clause":"2.39","heading":"POST-HOSPITALISATION MEDICAL EXPENSES","page":7,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-2-39"}],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital (chemotherapy, dialysis, cataract) and whether all or only listed ones are covered.","status":"quote-verified","value":"Day care treatment is treatment or surgery in a hospital or day care centre in less than 24 hours because of technological advancement, which otherwise would have required hospitalisation of more than 24 hours. The policy treats admission below 24 hours as covered only for procedures/treatments mentioned in Annexure I.","display":"Listed Annexure I day-care procedures covered when less than 24 hours","note":"Treatment normally taken on an out-patient basis is not included in the day-care definition.","quote":"DAY CARE TREATMENT refers to medical treatment or Surgery which is:\n- Undertaken under General or Local Anesthesia in a Hospital/ Day Care Centre in less than 24 hours because of technological advancement, and\n- Which would have otherwise required a Hospitalization of more than 24 hours. ... HOSPITALISATION means admission as an Inpatient in a Hospital for a minimum period of 24 consecutive hours except for the procedures/ treatments mentioned in Annexure I, where such admission could be for a period of less than 24 consecutive hours.","sources":[{"clause":null,"heading":"2.12DAY CARE TREATMENT","page":3,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-2-12day-care-treatment"},{"clause":"2.20","heading":"HOSPITALISATION","page":4,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-2-20"}],"law":[]},{"key":"domiciliary","label":"Treatment at home","section":"Cover","meaning":"Whether treatment at home is covered when hospital admission is not possible or a doctor advises it.","status":"quote-verified","value":"Domiciliary hospitalisation is not covered.","display":"Not covered","note":null,"quote":"Any expenses incurred on Domiciliary Hospitalisation.","sources":[{"clause":"4.4.17","heading":null,"page":20,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-17"}],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"quote-verified","value":"Expenses for Ayurveda, Yoga, Unani, Siddha and Homeopathy systems of medicines are covered up to 100% of the sum insured during the policy period.","display":"AYUSH covered up to 100% of Sum Insured","note":null,"quote":"Expenses incurred for Ayurveda, Yoga, Unani, Siddha and Homeopathy system of medicines are covered up to 100% of the Sum Insured during the policy period.","sources":[{"clause":"3.4","heading":"COVERAGE FOR AYUSH TREATMENT","page":11,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-4"}],"law":[{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 1","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 2","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 1","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II A.I(1)","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"modern_treatments","label":"Modern treatments","section":"Cover","meaning":"Robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and the like, and any cap on them.","status":"quote-verified","value":"The policy covers specified modern treatments or procedures as inpatient or day-care treatment in a hospital, up to the listed sub-limits per policy period. An optional cover can raise listed modern treatment coverage to 100% of the sum insured.","display":"Listed modern treatments covered with sub-limits; optional cover up to 100% of Sum Insured","note":"The optional modern treatment cover has conditions and a 10% deductible on the claim amount exceeding the base-policy sublimit.","quote":"COVERAGE FOR MODERN TREATMENTS or PROCEDURES: The following procedures will be covered (wherever medically indicated) either as in patient or as part of day care treatment in a hospital up to the limit specified against each procedure during the policy period. ... On payment of additional premium as mentioned in Schedule ... The following Modern Treatment or Procedures will be covered (wherever medically indicated) either as in patient or as part of day care treatment in a hospital up to 100% of Sum insured","sources":[{"clause":"3.16","heading":"COVERAGE FOR MODERN TREATMENTS or PROCEDURES: The following procedures will be covered","page":15,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-16"},{"clause":"3.12","heading":"OPTION COVER III : MODERN TREATMENT COVERAGE UPTO 100% OF SUM INSURED","page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-12"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 2","url":"https://indiainsurances.com/law/irdai-health-mc-2024"}]},{"key":"organ_donor","label":"Organ donor expenses","section":"Cover","meaning":"Whether the donor's hospital costs for an organ transplant are paid.","status":"quote-verified","value":"If treatment involves an organ transplant to the insured person, the policy also pays the donor’s hospitalisation expenses, excluding the cost of the organ, within the insured recipient’s sum insured plus cumulative bonus.","display":"Donor hospitalisation expenses covered, excluding cost of organ, within recipient’s SI plus CB","note":null,"quote":"If treatment involves Organ Transplant to Insured Person, then we will also pay Hospitalisation Expenses (excluding cost of organ) incurred on the donor, provided our liability towards expenses incurred on the donor and the insured recipient shall not exceed the aggregate of the Sum Insured and Cumulative Bonus, if any, of the Insured Person receiving the organ.","sources":[{"clause":"3.8","heading":"MEDICAL EXPENSES FOR ORGAN TRANSPLANT","page":11,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-8"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Emergency ambulance charges are covered up to 1% of the sum insured, subject to a maximum of Rs.5,000, for shifting an insured person to hospital for admission in an emergency ward or ICU, or from one hospital to another for better medical facilities.","display":"Emergency ambulance up to 1% of SI, maximum Rs.5,000","note":null,"quote":"We will pay You the charges for Emergency Ambulance services up to 1% of the Sum Insured subject to a maximum of Rs.5,000/-, Reasonably and Medically Necessarily incurred for shifting any Insured Person to Hospital for admission in Emergency Ward or ICU, or from one Hospital to another Hospital for better medical facilities.","sources":[{"clause":"3.6","heading":"PAYMENT OF AMBULANCE CHARGES","page":11,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-6"}],"law":[]},{"key":"restoration","label":"Restoration of sum insured","section":"Cover","meaning":"Whether the sum insured is refilled after it is used up in a year, how much, how often, and whether it works for the same illness.","status":"not-stated","value":null,"display":null,"note":"No restoration or refill of sum insured after claims is stated in the clauses.","quote":null,"sources":[],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"quote-verified","value":"The sum insured increases by 5% as cumulative bonus for each claim-free year, up to a maximum of 50%. If a claim is made after earning the bonus, the increased percentage is reduced by 5% at the next renewal, but the basic sum insured is maintained.","display":"5% per claim-free year, max 50%; reduced by 5% after a claim","note":"Cumulative Bonus is available only if the policy is renewed within the grace period.","quote":"Sum Insured under the Policy shall be progressively increased by 5%, by way of cumulative bonus, ... in respect of each claim free year of insurance, subject to a maximum accumulation of 50%. ... In case of any under this policy in respect of the insured person who has earned the cumulative bonus, the increased percentage will be reduced by 5% at the next renewal. However basic sum insured will be maintained and will not be reduced.","sources":[{"clause":"3.14","heading":"CUMULATIVE BONUS","page":14,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-14"}],"law":[]},{"key":"consumables","label":"Consumables and non-medical items","section":"Cover","meaning":"Gloves, PPE, syringes and other items hospitals bill that standard policies exclude; whether this policy pays them.","status":"quote-verified","value":"The base cover includes cost of pharmacy and consumables, but List I items are not covered under the base policy. Optional Non-Medical Items (Consumables) cover makes List I items payable up to Rs. 15,000 in a policy period for sum insured of 7 L and above.","display":"Base covers pharmacy and consumables; List I non-medical items only by optional cover up to Rs. 15,000","note":"The optional Non-Medical Items cover is separate and must be bought for additional premium.","quote":"Cost of Pharmacy and Consumables, Cost of Implants and Medical Devices and Cost of Diagnostics. ... List I – Items for which coverage is not available in the policy ... On payment of additional Premium as mentioned in Schedule, it is declared and agreed that items listed in Annexure II (List 1) shall become payable up to Rs. 15,000/- in a policy period. This Optional Cover is available for Sum Insured of 7 L & above.","sources":[{"clause":"3.1","heading":null,"page":10,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-1"},{"clause":"Annexure II","heading":null,"page":35,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-annexure-ii"},{"clause":"3.13","heading":"OPTIONAL COVER IV: NON-MEDICAL ITEMS (CONSUMABLES)","page":14,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-13"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"quote-verified","value":"Maternity expenses are excluded under the base policy, except ectopic pregnancy and miscarriage due to accident. Optional Maternity Expenses Benefit is available for sum insured of Rs.5 lacs and above, with a 36-month waiting period and liability up to 10% of the average sum insured in the preceding three years.","display":"Base excluded; optional cover after 36 months, limit 10% of average SI, for SI Rs.5 lacs and above","note":"Optional maternity claim is considered only for the first two children; pre-natal and post-natal expenses are not covered unless admitted in hospital and treatment is taken there.","quote":"MATERNITY EXPENSES (Code - Excl18)\na) Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; ... Our liability for claim admitted for Maternity shall not exceed 10% of the average Sum Insured of the Insured Person in the preceding three years.\nThis optional cover is applicable for persons having sum insured of Rs.5 lacs and above. ... A waiting period of thirty-six months is applicable, from the date of opting this cover, for payment of any claim relating to normal delivery or cesarean section or abdominal operation for extra uterine pregnancy.","sources":[{"clause":"4.4.15","heading":"MATERNITY EXPENSES (Code - Excl18)","page":20,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-15"},{"clause":"3.11","heading":"OPTIONAL COVER II: MATERNITY EXPENSES BENEFIT","page":12,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-11"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"not-stated","value":null,"display":null,"note":"No newborn baby cover from birth is stated in the clauses.","quote":null,"sources":[],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"quote-verified","value":"Inpatient treatment of listed mental illnesses is covered after 36 months of continuous coverage, with a sub-limit up to 25% of sum insured per policy period, if treatment is at a mental health establishment or a hospital with a specific mental illness department under a qualified mental health professional.","display":"Covered after 36 months, sub-limit up to 25% of SI","note":"Psychological counseling, cognitive/family/group/behavior/palliative therapy or other psychotherapy is not covered.","quote":"The Company shall indemnify the Medical Expenses incurred towards treatment of Mental Illness subject to the condition that Treatment shall be undertaken at a Hospital categorized as Mental Health Establishment or at a Hospital with a specific department for Mental Illness, under a Medical Practitioner qualified as Mental Health Professional.\nThe following Mental Illnesses are covered after completion of 36 months of Continuous Coverage with a sub-limit up to 25% of Sum Insured per policy period.","sources":[{"clause":"3.15(e)","heading":"Treatment of Mental Illness","page":15,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-15-e"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"quote-verified","value":"Medical check-up cost is reimbursed at the end of every block of three claim-free years, restricted to Rs. 5,000 or 1% of the average sum insured in the preceding three years, whichever is less. It is available only once in three years.","display":"Once every 3 claim-free years, up to Rs. 5,000 or 1% of average SI, whichever is less","note":"The waiting period of 3 years applies afresh for new and existing policyholders.","quote":"The Insured Person shall be entitled for reimbursement of the cost of Medical check-up at the end of a block of every three Claim Free Years. Such payment shall be restricted to Rs. 5,000 or 1% of the average Sum Insured of the Insured Person in the preceding three years, whichever is less. This benefit is available only once in three years.","sources":[{"clause":"3.5","heading":"HEALTH CHECK-UP","page":11,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-3-5"}],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"quote-verified","value":"Procedures or treatments usually done in the outpatient department are not payable, even if converted to an inpatient admission for more than 24 hours. Treatment normally taken on an out-patient basis is not included in day care treatment.","display":"OPD procedures/treatments not payable","note":null,"quote":"Procedures/treatments usually done in outpatient department are not payable under the Policy even if converted as an in-patient in the Hospital for more than 24 hours. ... Treatment normally taken on an out-patient basis is not included in the scope of this definition.","sources":[{"clause":"4.4.32","heading":null,"page":22,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-4-4-32"},{"clause":null,"heading":"2.12DAY CARE TREATMENT","page":3,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-2-12day-care-treatment"}],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"not-stated","value":null,"display":null,"note":"No city or zone-based premium, co-pay or treatment-location pricing rule is stated in the clauses.","quote":null,"sources":[],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"quote-verified","value":"Cashless facility is available where treatment payments are made directly to a network provider to the extent of pre-authorisation approved. Payment is made directly to a network hospital if cashless facility is applied for before treatment and accepted by the TPA.","display":"Cashless at network hospitals if pre-authorised and accepted by TPA","note":"Cashless is only a mode of claim payment and cannot be demanded in every claim.","quote":"CASHLESS FACILITY means a facility extended by Us to You where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the Network provider by Us to the extent of pre-authorization approved. ... Payment shall be made directly to Network Hospital if Cashless facility is applied for before treatment and accepted by TPA.","sources":[{"clause":"2.6","heading":"CASHLESS FACILITY","page":2,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-2-6"},{"clause":"5.18","heading":"PLACE OF TREATMENT AND PAYMENT","page":27,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-5-18"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"quote-verified","value":"Claims are handled through the Third Party Administrator, and communications and papers regarding a claim must be sent to the TPA at the address shown in the schedule.","display":"Third Party Administrator (TPA)","note":null,"quote":"we will reimburse such expense incurred by You, through the Third Party Administrator, in the manner stated herein. ... You must send all communications and papers regarding a claim to the TPA at the address shown in the Schedule.","sources":[{"clause":"1","heading":"PREAMBLE","page":1,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-1"},{"clause":"5.19","heading":"COMMUNICATION","page":27,"url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578#c-5-19"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"not-stated","value":null,"display":null,"note":"The clauses mention family cover in portability definitions but do not state that one sum insured can be shared by the whole family.","quote":null,"sources":[],"law":[]}],"documents":[{"kind":"wording","label":"Policy clause","pages":40,"fetched_at":"2026-10-17 19:56:15+00","source_url":"https://www.newindia.co.in/assets/docs/know-more/health/good-health-mediclaim-insurance/GH_NIAPOLICYCLAUSEDOCGH.PDF","url":"https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324/document/13578"}],"versions":[],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"New India Assurance official website","url":"https://www.newindia.co.in/","note":"Buy directly from the insurer."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"insurer","name":"Grievance redressal","url":"https://www.newindia.co.in/grievance","note":null},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"Good Health Mediclaim Insurance (UIN NIAHLGP24181V022324), IndiaInsurances, https://indiainsurances.com/policy/new-india-assurance/good-health-mediclaim-insurance-niahlgp24181v022324"}