{"uin":"NIAHLIP25046V042425","name":"Janata Mediclaim Policy (Cashless Facility Available)","url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425","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":"Janata Mediclaim Policy is an indemnity health policy for reimbursement or cashless payment of hospitalisation expenses for illness or injury in India. Sum insured options shown are Rs. 50,000 and Rs. 75,000, with a 30-day initial waiting period and a 36-month pre-existing disease waiting period.","analysis":{"state":"machine","analysed_at":"2026-10-19 21:58:31.114602+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":null,"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.","display":"One policy year","note":null,"quote":"POLICY PERIOD means period of one policy year as mentioned in the schedule for which the Policy is issued","sources":[{"clause":"2.48","heading":"POLICY PERIOD","page":7,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-2-48"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"conflicting","value":"For reimbursement claims, preliminary notice with policy number, insured person, illness or injury and doctor or hospital details must be given within 7 days from hospitalisation.","display":"Within 7 days from the date of Hospitalization for reimbursement claims","note":"Prospectus says: 'Within twenty four hours of Hospitalisation the TPA should be intimated.'","quote":"Preliminary notice of claim with particulars relating to Policy Numbers, name of insured person in respect of whom claim is to be made, nature of Illness / Injury and Name and Address of the attending Medical Practitioner / Hospital should be given to the Company / TPA within 7 days from the date of Hospitalization in respect of reimbursement claims.","sources":[{"clause":"5.19","heading":"NOTICE OF CLAIM","page":22,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-5-19"},{"clause":"4.3","heading":"HOW TO GET REIMBURSEMENTS IN CASE OF TREATMENT IN NON-NETWORK HOSPITALS OR DENIAL OF CASHLESS FACILITY?","page":11,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13493#c-4-3"}],"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":["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.","Certificate from attending Medical Practitioner / Surgeon that the patient is fully cured."],"display":"Hospital bills, receipts, discharge certificate/card, cash memos with prescriptions, test reports, surgeon’s certificate and bills, doctor/consultant/specialist/anaesthetist bills and diagnosis certificate, and certificate that the patient is fully cured","note":"Final claim with original bills, claim form and listed documents must be submitted not later than 30 days of discharge.","quote":"1. Bill, Receipt and Discharge certificate / card from the Hospital.\n2. Cash Memos from the Hospitals (s) / Chemists (s), supported by proper prescriptions.\n3. Receipt and Pathological test reports from Pathologist supported by the note from the attending Medical Practitioner / Surgeon recommending such Pathological tests /pathological\n4. Surgeon's certificate stating nature of operation performed and Surgeons’ bill and receipt.\n5. Attending Doctor's/ Consultant's/ Specialist's / Anesthetist’s bill and receipt, and certificate regarding diagnosis.\n6. Certificate from attending Medical Practitioner / Surgeon that the patient is fully cured.","sources":[{"clause":"5.19","heading":"NOTICE OF CLAIM","page":22,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-5-19"}],"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":"Claims other than cashless shall be settled within fifteen days from submission of claim. If payment is delayed, interest is payable from receipt of the last necessary document to payment at 2% above the bank rate.","display":"Within fifteen days from submission of claim for non-cashless claims","note":null,"quote":"Settlement of claims (other than cashless) shall be settled within fifteen days from submission of claim. ... In the case of delay in the payment of a claim, We shall be liable to pay interest from the date of receipt of last necessary document to the date of payment of claim at a rate 2% above the bank rate.","sources":[{"clause":"5.23(i)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-5-23-i"},{"clause":"5.23(c)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-5-23-c"}],"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":["PRE-EXISTING DISEASES (Code- Excl01)","SPECIFIC WAITING PERIOD (Code- Excl02)","FIRST THIRTY DAYS WAITING PERIOD (Code- Excl03)","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)","Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. (Code- Excl12)","STERILITY AND INFERTILITY (Code- Excl17)","MATERNITY EXPENSES (Code - Excl18)","War (whether declared or not) and war like occurrence","Treatment - taken outside India."],"display":"Waiting-period exclusions, investigation/evaluation, rest cure, obesity/weight control, change-of-gender treatment, cosmetic surgery, hazardous sports, breach of law, alcohol/drug abuse, infertility, maternity, war and treatment outside India","note":null,"quote":"PRE-EXISTING DISEASES (Code- Excl01) ... SPECIFIC WAITING PERIOD (Code- Excl02) ... FIRST THIRTY DAYS WAITING PERIOD (Code- Excl03) ... 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) ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. (Code- Excl12) ... STERILITY AND INFERTILITY (Code- Excl17) ... MATERNITY EXPENSES (Code - Excl18) ... War (whether declared or not) and war like occurrence ... Treatment - taken outside India.","sources":[{"clause":"4.1","heading":"PRE-EXISTING DISEASES (Code- Excl01)","page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-1"},{"clause":"4.2","heading":"SPECIFIC WAITING PERIOD (Code- Excl02)","page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-2"},{"clause":"4.3","heading":"FIRST THIRTY DAYS WAITING PERIOD (Code- Excl03)","page":14,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-3"},{"clause":"4.4.1","heading":"INVESTIGATION & EVALUATION (Code- Excl04)","page":14,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-1"},{"clause":"4.4.2","heading":"REST CURE, REHABILITATION AND RESPITE CARE (Code- Excl05) Expenses related to","page":15,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-2"},{"clause":"4.4.3","heading":"OBESITY/ WEIGHT CONTROL (Code- Excl06) Expenses related to the surgical","page":15,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-3"},{"clause":"4.4.4","heading":"CHANGE-OF-GENDER TREATMENTS (Code- Excl07)","page":15,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-4"},{"clause":"4.4.5","heading":"COSMETIC OR PLASTIC SURGERY (Code- Excl08)","page":15,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-5"},{"clause":"4.4.6","heading":"HAZARDOUS OR ADVENTURE SPORTS (Code- Excl09)","page":15,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-6"},{"clause":"4.4.7","heading":"BREACH OF LAW (Code- Excl10)","page":16,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-7"},{"clause":"4.4.9","heading":"Treatment for, Alcoholism, drug or substance abuse or any addictive condition and","page":16,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-9"},{"clause":"4.4.14","heading":"STERILITY AND INFERTILITY (Code- Excl17)","page":16,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-14"},{"clause":"4.4.15","heading":"MATERNITY EXPENSES (Code - Excl18)","page":16,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-15"},{"clause":"4.4.16","heading":"War (whether declared or not) and war like occurrence or invasion, acts of foreign","page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-16"},{"clause":"4.4.26","heading":"Treatment","page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-26"}],"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":"The insured may contact the company through its grievance website, toll-free number, email, fax, courier or branch grievance cell. If not satisfied, the insured may contact the grievance officer and then approach the Insurance Ombudsman or lodge a grievance at IRDAI IGMS.","display":"Company grievance channels first, then grievance officer, then Insurance Ombudsman/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 Senior Citizens may write to seniorcitizencare.ho@newindia.co.in lnsured person may also approach the grievance cell at any of the company's branches with the details of grievance. lf lnsured person is not satisfied with the redressal of grievance through one of the above methods, insured person may contact the grievance officer at https://www.newindia.co.in/portal/readMore/Grievances ... lf lnsured person is not satisfied with the redressal of grievance through above methods, the insured person may also approach the office of lnsurance Ombudsman of the respective area/region for redressal of grievance as per lnsurance Ombudsman Rules 2017. ... Grievance may also be lodged at IRDAI lntegrated Grievance Management System - https://igms.irdai.gov.in","sources":[{"clause":"5.6","heading":"GRIEVANCE REDRESSAL","page":19,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-5-6"}],"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":"quote-verified","value":"Rs. 50,000 and Rs. 75,000.","display":"Rs. 50,000 and Rs. 75,000","note":"From the prospectus premium table.","quote":"SI | 3m-5Y | 6-35 Y | 36-40 Y | 41-45 Y | 46-50 Y | 51-55 Y | 56-60 Y | 61-65 Y | 66-70 Y\n50000 | 867 | 809 | 924 | 1271 | 1617 | 1791 | 2079 | 2368 | 2657\n75000 | 1299 | 1213 | 1386 | 1906 | 2426 | 2715 | 3119 | 3523 | 3985","sources":[{"clause":"4.15","heading":"PAYMENT OF PREMIUM (Excluding GST)","page":14,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13493#c-4-15"}],"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":"Not applicable to accident claims; does not apply after Continuous Coverage for more than twelve months; applies to enhanced sum insured.","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.\nb) This exclusion shall not, however, apply if the Insured Person has Continuous Coverage for more than twelve months.\nc) The within referred waiting period is made applicable to the enhanced sum insured in the event of granting higher sum insured subsequently.","sources":[{"clause":"4.3","heading":"FIRST THIRTY DAYS WAITING PERIOD (Code- Excl03)","page":14,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#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":36},"display":"36 months","note":"For enhanced sum insured, the exclusion applies afresh to the increased amount; portability credit can reduce the waiting period.","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 the date of inception of the first policy with us.","sources":[{"clause":"4.1","heading":"PRE-EXISTING DISEASES (Code- Excl01)","page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#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; 24 Months and 36 Months","note":"The shortest listed waiting period is 90 Days; other listed conditions have 24 Months or 36 Months waiting periods. Not applicable for claims arising due to an accident.","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":13,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-2"},{"clause":"4.2(e)(i)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-2-e-i"},{"clause":"4.2(e)(ii)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-2-e-ii"}],"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","Any Skin disorders","All internal & external benign tumors, cysts, polyps of any kind, including benign breast lumps","Benign Ear, Nose, Throat disorders","Benign Prostate Hypertrophy","Cataract & age-related eye ailments","Gastric/ Duodenal Ulcer","Gout & Rheumatism","Hernia of all types","Hydrocele","Hysterectomy for Menorrhagia/Fibromyoma, Myomectomy and Prolapse of uterus","Non-Infective Arthritis","Piles, Fissure and Fistula in Anus","Pilonidal Sinus, Sinusitis and related disorders","Prolapse Inter Vertebral Disc unless arising from Accident","Stone in Gall Bladder & Bile duct","Stones in Urinary Systems","Unknown Congenital Internal Anomaly","Varicose Veins and Varicose Ulcers","Puberty and Menopause related Disorders","Behavioural and Neuro-Developmental Disorders","Disorders of adult personality","Disorders of speech and language including stammering, dyslexia","Joint Replacement due to Degenerative Condition","Age-related Osteoarthritis & Osteoporosis","Treatment of mental illness, stress or psychological disorders and neurodegenerative disorders.","Age Related Macular Degeneration (ARMD)","Genetic diseases or disorders","External Congenital Diseases"],"display":"Diabetes, hypertension, cardiac conditions, listed 24-month conditions and listed 36-month conditions","note":null,"quote":"i) 90 Days Waiting Period\n1. Diabetes Mellitus\n2. Hypertension\n3. Cardiac Conditions ... ii) 24 Months waiting period\n1. Any Skin disorders\n2. All internal & external benign tumors, cysts, polyps of any kind, including benign breast lumps\n3. Benign Ear, Nose, Throat disorders\n4. Benign Prostate Hypertrophy\n5. Cataract & age-related eye ailments\n6. Gastric/ Duodenal Ulcer\n7. Gout & Rheumatism\n8. Hernia of all types\n9. Hydrocele\n10. Hysterectomy for Menorrhagia/Fibromyoma, Myomectomy and Prolapse of uterus\n11. Non-Infective Arthritis\n12. Piles, Fissure and Fistula in Anus\n13. Pilonidal Sinus, Sinusitis and related disorders\n14. Prolapse Inter Vertebral Disc unless arising from Accident\n15. Stone in Gall Bladder & Bile duct\n16. Stones in Urinary Systems\n17. Unknown Congenital Internal Anomaly\n18. Varicose Veins and Varicose Ulcers\n19. Puberty and Menopause related Disorders\n20. Behavioural and Neuro-Developmental Disorders:\na) Disorders of adult personality\nb) Disorders of speech and language including stammering, dyslexia\n(iii) 36 Months waiting period\n1. Joint Replacement due to Degenerative Condition\n2. Age-related Osteoarthritis & Osteoporosis\n3. Treatment of mental illness, stress or psychological disorders and neurodegenerative disorders.\n4. Age Related Macular Degeneration (ARMD)\n5. Genetic diseases or disorders\n6. External Congenital Diseases","sources":[{"clause":"4.2(e)(i)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-2-e-i"},{"clause":"4.2(e)(ii)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-2-e-ii"}],"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":"sixty continuous months","note":"For enhanced sum insured, sixty continuous months applies 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: After completion of sixty continuous months of coverage (including","page":20,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#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":"The policy can be ported to other insurers by applying at least 30 days before, but not earlier than 60 days from, the policy renewal date. Continuous coverage credit for sum insured, no claim bonus, specific waiting period for pre-existing diseases and moratorium period can be transferred.","display":"Porting allowed with application at-least 30 days before, but not earlier than 60 days from, renewal date","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 30 days before, but not earlier than 60 days from the policy renewal date as per IRDAI guidelines related to portability. If policyholder is presently covered and has been continuously covered without any lapses under any Health Insurance policy with an Indian General or Health Insurer, then 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":"5.7","heading":"PORTABILITY AND MIGRATION: MIGRATION","page":20,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-5-7"}],"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, no age limit for renewal","note":"From the prospectus.","quote":"No. Your Policy can be renewed, as long as You pay the Renewal Premium before the date of expiry of the Policy. There is an age limit for taking a fresh Policy, but there is no age limit for renewal.","sources":[{"clause":"4.7","heading":"IS THERE AN AGE LIMIT UPTO WHICH THE POLICY WOULD BE RENEWED?","page":12,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13493#c-4-7"}],"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":"No loading shall apply on renewals based on individual claims experience.","display":"No loading on renewals based on individual claims experience","note":null,"quote":"No loading shall apply on renewals based on individual claims experience.","sources":[{"clause":"5.3","heading":"RENEWAL OF POLICY","page":18,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-5-3"}],"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)","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)","War (whether declared or not) and war like occurrence or invasion","Nuclear, chemical or biological attack or weapons","Circumcision unless required to treat Injury or Illness.","Vaccination & Inoculation.","Cost of braces, equipment or external prosthetic devices, non-durable implants, eyeglasses, Cost of spectacles and contact lenses, hearing aids including cochlear implants, durable medical equipment.","All types of Dental treatments except arising out of an Accident.","Convalescence, general debility.","Bodily injury or sickness due to wilful or deliberate exposure to danger","Instrument used in treatment of Sleep Apnea Syndrome (C.P.A.P.) and continuous Peritoneal Ambulatory dialysis (C.P.A.D.) and Oxygen Concentrator for Bronchial Asthmatic condition.","Stem cell implantation / surgery for other than those treatments mentioned in clause 3.13.12.","Treatment - taken outside India.","Change of treatment from one system of medicine to another unless recommended by the Medical practitioner / Hospital under whom the treatment is taken.","Service charges or any other charges levied by hospital, except registration/admission charges.","Treatment such as Rotational Field Quantum Magnetic Resonance (RFQMR), External Counter Pulsation (ECP), Enhanced External Counter Pulsation (EECP), Hyperbaric Oxygen Therapy."],"display":"Permanent exclusions include Excl04 to Excl18 and product-specific exclusions such as war, nuclear/chemical/biological attack, vaccination, dental treatment except accident, treatment outside India and listed non-medical charges/treatments","note":null,"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 or private beds registered as a nursing home attached to such establishments or where admission is arranged wholly or partly for domestic reasons. ... 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) ... War (whether declared or not) and war like occurrence or invasion ... Nuclear, chemical or biological attack or weapons ... Circumcision unless required to treat Injury or Illness. ... Vaccination & Inoculation. ... Cost of braces, equipment or external prosthetic devices, non-durable implants, eyeglasses, Cost of spectacles and contact lenses, hearing aids including cochlear implants, durable medical equipment. ... All types of Dental treatments except arising out of an Accident. ... Convalescence, general debility. ... Bodily injury or sickness due to wilful or deliberate exposure to danger ... Instrument used in treatment of Sleep Apnea Syndrome (C.P.A.P.) and continuous Peritoneal Ambulatory dialysis (C.P.A.D.) and Oxygen Concentrator for Bronchial Asthmatic condition. ... Stem cell implantation / surgery for other than those treatments mentioned in clause 3.13.12. ... Treatment - taken outside India. ... Change of treatment from one system of medicine to another unless recommended by the Medical practitioner / Hospital under whom the treatment is taken. ... Service charges or any other charges levied by hospital, except registration/admission charges. ... Treatment such as Rotational Field Quantum Magnetic Resonance (RFQMR), External Counter Pulsation (ECP), Enhanced External Counter Pulsation (EECP), Hyperbaric Oxygen Therapy.","sources":[{"clause":"4.4.1","heading":"INVESTIGATION & EVALUATION (Code- Excl04)","page":14,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-1"},{"clause":"4.4.2","heading":"REST CURE, REHABILITATION AND RESPITE CARE (Code- Excl05) Expenses related to","page":15,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-2"},{"clause":"4.4.3","heading":"OBESITY/ WEIGHT CONTROL (Code- Excl06) Expenses related to the surgical","page":15,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-3"},{"clause":"4.4.4","heading":"CHANGE-OF-GENDER TREATMENTS (Code- Excl07)","page":15,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-4"},{"clause":"4.4.5","heading":"COSMETIC OR PLASTIC SURGERY (Code- Excl08)","page":15,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-5"},{"clause":"4.4.6","heading":"HAZARDOUS OR ADVENTURE SPORTS (Code- Excl09)","page":15,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-6"},{"clause":"4.4.7","heading":"BREACH OF LAW (Code- Excl10)","page":16,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-7"},{"clause":"4.4.8","heading":"EXCLUDED PROVIDERS (Code-Excl11)","page":16,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-8"},{"clause":"4.4.9","heading":"Treatment for, Alcoholism, drug or substance abuse or any addictive condition and","page":16,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-9"},{"clause":"4.4.10","heading":"Treatments received in health hydros, nature cure clinics, spas or similar","page":16,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-10"},{"clause":"4.4.11","heading":null,"page":16,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-11"},{"clause":"4.4.12","heading":"REFRACTIVE ERROR (Code- Excl15)","page":16,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-12"},{"clause":"4.4.13","heading":"UNPROVEN TREATMENTS (Code- Excl16)","page":16,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-13"},{"clause":"4.4.14","heading":"STERILITY AND INFERTILITY (Code- Excl17)","page":16,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-14"},{"clause":"4.4.15","heading":"MATERNITY EXPENSES (Code - Excl18)","page":16,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-15"},{"clause":"4.4.16","heading":"War (whether declared or not) and war like occurrence or invasion, acts of foreign","page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-16"},{"clause":"4.4.17","heading":"Nuclear, chemical or biological attack or weapons, contributed to, caused by, resulting","page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-17"},{"clause":"4.4.18","heading":null,"page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-18"},{"clause":"4.4.19","heading":null,"page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-19"},{"clause":"4.4.20","heading":null,"page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-20"},{"clause":"4.4.21","heading":null,"page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-21"},{"clause":"4.4.22","heading":null,"page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-22"},{"clause":"4.4.23","heading":"Bodily injury or sickness due to wilful or deliberate exposure to danger (except in an","page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-23"},{"clause":"4.4.24","heading":"Instrument used in treatment of Sleep Apnea Syndrome (C.P.A.P.) and continuous","page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-24"},{"clause":"4.4.25","heading":"Stem cell implantation / surgery for other than those treatments mentioned in clause","page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-25"},{"clause":"4.4.26","heading":"Treatment","page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-26"},{"clause":"4.4.27","heading":"Change of treatment from one system of medicine to another unless recommended","page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-27"},{"clause":"4.4.28","heading":"Service charges or any other charges levied by hospital, except registration/admission","page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#c-4-4-28"},{"clause":"4.4.29","heading":"Treatment such as Rotational Field Quantum Magnetic Resonance (RFQMR), External","page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466#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":"The policyholder may cancel during the term by giving 7 days’ written notice. 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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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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 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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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and 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available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]}],"documents":[{"kind":"wording","label":"Policy Clause Janata Mediclaim Policy","pages":32,"fetched_at":"2026-10-17 19:51:52+00","source_url":"https://www.newindia.co.in/assets/docs/know-more/health/janata-mediclaim-policy/Policy%20Clause%20Janata%20Mediclaim%20Policy.pdf","url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13466"},{"kind":"prospectus","label":"Prospectus Janata Mediclaim Policy","pages":15,"fetched_at":"2026-10-17 19:52:50+00","source_url":"https://www.newindia.co.in/assets/docs/know-more/health/janata-mediclaim-policy/Prospectus%20Janata%20Mediclaim%20Policy.pdf","url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13493"},{"kind":"cis","label":"Customer Information Sheet","pages":3,"fetched_at":"2026-10-17 19:51:51+00","source_url":"https://www.newindia.co.in/assets/docs/know-more/health/janata-mediclaim-policy/Customer%20Information%20Sheet%20JANATA%20MEDICLAIM%20POLICY.pdf","url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/13465"},{"kind":"premium","label":"Premium Chart Janata Mediclaim Policy (WEF 01 Nov 2024)","pages":null,"fetched_at":"2026-10-17 19:50:55+00","source_url":"https://www.newindia.co.in/assets/docs/know-more/health/janata-mediclaim-policy/Premium%20Chart%20Janata%20Mediclaim.pdf","url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/30474"},{"kind":"proposal","label":"Proposal Form","pages":null,"fetched_at":"2026-10-17 19:52:02+00","source_url":"https://www.newindia.co.in/assets/docs/know-more/health/janata-mediclaim-policy/revised%20Janata%20Mediclaim%20Proposal%20Form%20.pdf","url":"https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425/document/30484"}],"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":"Janata Mediclaim Policy (Cashless Facility Available) (UIN NIAHLIP25046V042425), IndiaInsurances, https://indiainsurances.com/policy/new-india-assurance/janata-mediclaim-policy-cashless-facility-available-niahlip25046v042425"}