{"uin":"NIAHLIP25052V032425","name":"Universal Health Insurance Scheme (APL) (Cashless facility available)","url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425","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":"Universal Health Insurance Policy (APL) is an indemnity health policy with floater sum insured of Rs.30000/- per person or family. It has a 30 days initial waiting period, 36 months pre-existing disease waiting period, room rent limit of 0.5% and ICU limit of 1% of sum insured per day, and cashless facility through network hospitals.","analysis":{"state":"machine","analysed_at":"2026-10-19 22:00:00.437303+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":"quote-verified","value":["Individual Person","Family (not exceeding five members)","Family not exceeding 7 members"],"display":"Individual Person; Family not exceeding five members; Family not exceeding 7 members","note":"These are the purchase/family composition options shown in the prospectus.","quote":"a) Individual Person Rs.383/- per annum. ... b) Family (not exceeding five members) consisting of Insured, Spouse and first 3 dependent children Rs.575/- per annum. ... c) Family not exceeding 7 members consisting of Insured, Spouse, first 3 dependent children and dependent parents Rs.767/- per annum.","sources":[{"clause":"4.27(a)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13507#c-4-27-a-5"},{"clause":"4.27(b)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13507#c-4-27-b-5"},{"clause":"4.27(c)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13507#c-4-27-c-3"}],"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/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#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":"quote-verified","value":"Preliminary notice of claim must be given to the Company/TPA within 24 hours of Hospitalisation. The final claim with claim form and listed documents must be submitted not later than 7 days from discharge.","display":"Within 24 hours of hospitalisation; final claim within 7 days from discharge","note":"Waiver of the period may be considered in extreme hardship cases if the Company/TPA is satisfied.","quote":"Preliminary notice of claim with particulars relating to Policy Number, 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 24 hours of Hospitalisation in respect of claims.\nFinal claim along with claim form and documents listed below should be submitted to the Policy issuing Office/TPA not later than 7 days from the date of discharge from the Hospital.","sources":[{"clause":"5.11","heading":"NOTICE OF CLAIM","page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-5-11"}],"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","post-mortem report must be submitted along with other documents of proof of death"],"display":"Hospital bill/receipt/discharge card, cash memos with prescriptions, pathology receipts and reports with doctor note, surgeon certificate and bills, doctors’ bills and diagnosis certificate, certificate that patient is fully cured, and post-mortem report for accident death of earning member","note":null,"quote":"a) Bill, Receipt and Discharge certificate / card from the Hospital.\nb) Cash Memos from the Hospitals(s) / Chemists(s), supported by proper prescriptions.\nc) Receipt and Pathological test reports from Pathologist supported by the note from the attending Medical Practitioner / Surgeon recommending such Pathological tests / pathological.\nd) Surgeon's certificate stating nature of operation performed and Surgeons’ bill and receipt.\ne) Attending Doctor's/ Consultant's/ Specialist's / Anesthetist’s bill and receipt, and certificate regarding diagnosis.\nf) Certificate from attending Medical Practitioner / Surgeon that the patient is fully cured. ... In case of death of earning member of the family due to accident a post-mortem report must be submitted along with other documents of proof of death.","sources":[{"clause":"5.11","heading":"NOTICE OF CLAIM","page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-5-11"},{"clause":"5.14","heading":"In case of death of earning member of the family due to accident a post-mortem report must","page":18,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-5-14"}],"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":"Settlement of claims other than cashless shall be within fifteen days from submission of claim. If payment is delayed, interest is payable from receipt of last necessary document to payment at 2% above the bank rate.","display":"Within fifteen days from submission of claim; delay interest 2% above bank rate","note":"Additional documents or clarification may be called for where necessary.","quote":"i) Settlement of claims (other than cashless) shall be settled within fifteen days from submission of claim. ... iv. 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":19,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-5-23-i"},{"clause":"5.23(c)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#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":["Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months","Expenses related to the treatment of Cataract, Benign Prostatic Hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Congenital Internal Disease, Fistula in anus, Piles, Sinusitis and related disorders shall be excluded until the expiry of 12 months","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","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 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","Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof","Expenses related to sterility and infertility","Medical treatment expenses traceable to childbirth","War (whether declared or not) and war like occurrence or invasion","Nuclear, chemical or biological attack or weapons","The cost of spectacles, contact lenses and hearing aids","Treatment such as Rotational Field Quantum Magnetic Resonance (RFQMR), External Counter Pulsation (ECP), Enhanced External Counter Pulsation (EECP), Hyperbaric Oxygen Therapy"],"display":"Main exclusions include PED for 36 months, listed illnesses for 12 months, first 30 days illness, investigation/evaluation, rest cure, change of gender, cosmetic surgery, professional adventure sports, alcohol/drug abuse, sterility/infertility, maternity, war, nuclear/chemical/biological attack, spectacles/contact lenses/hearing aids, and RFQMR/ECP/EECP/hyperbaric oxygen therapy","note":null,"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 ... Expenses related to the treatment of Cataract, Benign Prostatic Hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Congenital Internal Disease, Fistula in anus, Piles, Sinusitis and related disorders shall be excluded until the expiry of 12 months ... 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 ... 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 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 ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and\nconsequences thereof. ... Expenses related to sterility and infertility. ... Medical treatment expenses traceable to childbirth ... War (whether declared or not) and war like occurrence or invasion ... Nuclear, chemical or biological attack or weapons ... The cost of spectacles, contact lenses and hearing aids. ... Treatment such as Rotational Field Quantum Magnetic Resonance (RFQMR), External Counter Pulsation (ECP), Enhanced External Counter Pulsation (EECP), Hyperbaric Oxygen Therapy.","sources":[{"clause":"4.1","heading":"PRE-EXISTING DISEASES (Code- Excl01)","page":10,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-1"},{"clause":"4.2","heading":"SPECIFIC WAITING PERIOD (Code- Excl02)","page":10,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-2"},{"clause":"4.3","heading":"FIRST THIRTY DAYS WAITING PERIOD (Code- Excl03)","page":11,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-3"},{"clause":"4.4","heading":"INVESTIGATION & EVALUATION (Code- Excl04)","page":11,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-4"},{"clause":"4.5","heading":"REST CURE, REHABILITATION AND RESPITE CARE (Code- Excl05) Expenses related to any","page":11,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-5"},{"clause":"4.7","heading":"CHANGE-OF-GENDER TREATMENTS (Code- Excl07)","page":11,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-7"},{"clause":"4.8","heading":"COSMETIC OR PLASTIC SURGERY (Code- Excl08)","page":12,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-8"},{"clause":"4.9","heading":"HAZARDOUS OR ADVENTURE SPORTS (Code- Excl09)","page":12,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-9"},{"clause":"4.12","heading":"Treatment for, Alcoholism, drug or substance abuse or any addictive condition and","page":12,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-12"},{"clause":"4.17","heading":"STERILITY AND INFERTILITY (Code- Excl17)","page":12,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-17"},{"clause":"4.18","heading":"MATERNITY EXPENSES (Code - Excl18)","page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-18"},{"clause":"4.19","heading":null,"page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-19"},{"clause":"4.20","heading":null,"page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-20"},{"clause":"4.22","heading":null,"page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-22"},{"clause":"4.27","heading":"Treatment such as Rotational Field Quantum Magnetic Resonance (RFQMR), External Counter","page":14,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-27"}],"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":"For grievances, contact the company through its grievance website, toll free number 1800-209-1415, email/fax/courier as mentioned, or the grievance cell at any branch. If not satisfied, contact the grievance officer before approaching the Insurance Ombudsman.","display":"Company grievance channels or branch grievance cell first; then grievance officer; then Insurance Ombudsman","note":null,"quote":"ln case of any grievance the insured person may contact the company through\nWebsite: | https://www.newindia.co.in/portal/readMore/Grievances\nToll free: | 1800-209-1415 ... lnsured person may also approach the grievance cell at any of the company's branches with the details of grievance.\nlf lnsured person is not satisfied with the redressal of grievance through one of the above methods,\ninsured | person | may | contact | the | grievance | officer | at\nhttps://www.newindia.co.in/portal/readMore/Grievances","sources":[{"clause":"5.6","heading":"GRIEVANCE REDRESSAL","page":16,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#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":"The sum insured shown is Rs.30000/- per person or family as mentioned in the Schedule.","display":"Rs.30000/- per person or family","note":null,"quote":"Company’s liability in respect of all claims admitted during the Policy Period shall not exceed the Sum Insured of Rs.30000/- per person or family as mentioned in the Schedule.","sources":[{"clause":"Section I","heading":"Hospitalisation Expenses","page":8,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-section-i"}],"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":"Does not apply if the insured person has continuous coverage for more than twelve months; applies afresh 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.","sources":[{"clause":"4.3","heading":"FIRST THIRTY DAYS WAITING PERIOD (Code- Excl03)","page":11,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#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":"Coverage after 36 months is subject to the PED being declared at application and accepted.","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":10,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#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":"conflicting","value":{"unit":"months","amount":12},"display":"12 months","note":"The policy wording gives 12 months for Excl02 listed conditions and also 24 months and 36 months for specific coverages. CIS says: 'Specific Waiting period- 90 days, 24 and 36 months for listed illnesses (not applicable for renewals and accident)'.","quote":"Expenses related to the treatment of Cataract, Benign Prostatic Hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Congenital Internal Disease, Fistula in anus, Piles, Sinusitis and related disorders shall be excluded until the expiry of 12 months of continuous coverage ... Treatment for any symptoms, Illness, complications arising due to physiological conditions associated with Puberty, Menopause such as menopausal bleeding or flushing is covered only as Inpatient procedure after 24 months of continuous coverage. ... Age Related Macular Degeneration (ARMD) is covered after 36 months of continuous coverage ... Genetic diseases or disorders are covered with 36 months waiting period.","sources":[{"clause":"4.2","heading":"SPECIFIC WAITING PERIOD (Code- Excl02)","page":10,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-2"},{"clause":"3.4(c)","heading":"Puberty and Menopause related Disorders","page":9,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-3-4-c"},{"clause":"3.4(d)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-3-4-d"},{"clause":"3.4(f)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-3-4-f"}],"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":["Cataract","Benign Prostatic Hypertrophy","Hysterectomy for Menorrhagia or Fibromyoma","Hernia","Hydrocele","Congenital Internal Disease","Fistula in anus","Piles","Sinusitis and related disorders","Puberty and Menopause related Disorders","Age Related Macular Degeneration (ARMD)","Behavioural and Neuro developmental Disorders","Genetic diseases or disorders","Treatment of mental illness, stress or psychological disorders and neurodegenerative disorders"],"display":"Cataract, BPH, hysterectomy for menorrhagia or fibromyoma, hernia, hydrocele, congenital internal disease, fistula in anus, piles, sinusitis and related disorders, puberty and menopause related disorders, ARMD, behavioural and neuro developmental disorders, genetic diseases or disorders, and specified mental illness/neurodegenerative disorders","note":null,"quote":"Expenses related to the treatment of Cataract, Benign Prostatic Hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Congenital Internal Disease, Fistula in anus, Piles, Sinusitis and related disorders shall be excluded until the expiry of 12 months ... c) Puberty and Menopause related Disorders: ... d) Age Related Macular Degeneration (ARMD) ... e) Behavioural and Neuro developmental Disorders: ... f) Genetic diseases or disorders ... g) Treatment of mental illness, stress or psychological disorders and neurodegenerative disorders:","sources":[{"clause":"4.2","heading":"SPECIFIC WAITING PERIOD (Code- Excl02)","page":10,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-2"},{"clause":"3.4(c)","heading":"Puberty and Menopause related Disorders","page":9,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-3-4-c"},{"clause":"3.4(d)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-3-4-d"},{"clause":"3.4(e)","heading":"Behavioural and Neuro developmental Disorders","page":9,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-3-4-e"},{"clause":"3.4(f)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-3-4-f"},{"clause":"3.4(g)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-3-4-g"}],"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 for 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\nnon-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":16,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#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 other insurers by applying at least 30 days before, but not earlier than 60 days from, the renewal date; continuity credits can be transferred from an Indian General or Health Insurer.","display":"Porting allowed; apply at least 30 days before and not earlier than 60 days from renewal date","note":"The clause also states that continuity credit can be transferred for sum insured, no claim bonus, specific waiting period for pre-existing diseases, moratorium period etc.","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.","sources":[{"clause":"5.7","heading":"PORTABILITY AND MIGRATION","page":16,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#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; policy wording says renewal is ordinarily available except on grounds of fraud or misrepresentation.","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":null,"heading":"HOSPITALS OR DENIAL OF CASHLESS FACILITY?","page":19,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13507#c-hospitals-or-denial-of-cashless-facility"}],"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. However, a premium adjustment clause says if the claim ratio exceeds 80% of premium paid, the renewal rate will be adjusted to keep the claim ratio within 80%.","display":"No individual claim-based loading; renewal rate may be adjusted if claim ratio exceeds 80%","note":null,"quote":"No loading shall apply on renewals based on individual claims experience. ... If the Claim ratio exceeds 80% of the premium paid the\nrenewal rate will be adjusted so as to ensure that the claims ratio remains within 80% of the premium paid.","sources":[{"clause":"5.4","heading":"RENEWAL CLAUSE","page":15,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-5-4"},{"clause":"5.19","heading":"PREMIUM ADJUSTMENT CLAUSE: If the Claim ratio exceeds 80% of the premium paid the","page":18,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-5-19"}],"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)","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","Nuclear, chemical or biological attack or weapons","Circumcision unless required to treat Injury or Illness","The cost of spectacles, contact lenses and hearing aids","Any Dental treatment or surgery which is a corrective, cosmetic or aesthetic procedure","Convalescence general debility","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 specific exclusions such as war, nuclear/chemical/biological attack, circumcision unless medically required, spectacles/contact lenses/hearing aids, cosmetic dental treatment, convalescence/general debility, and RFQMR/ECP/EECP/hyperbaric oxygen therapy","note":"Excl13 is stated in the wording without the code in the same excerpt; Excl14 appears with its code in the clause heading/body split in the prospectus.","quote":"4.4 INVESTIGATION & EVALUATION (Code- Excl04) ... 4.5 REST CURE, REHABILITATION AND RESPITE CARE (Code- Excl05) ... 4.6 OBESITY/ WEIGHT CONTROL (Code- Excl06) ... 4.7 CHANGE-OF-GENDER TREATMENTS (Code- Excl07) ... 4.8 COSMETIC OR PLASTIC SURGERY (Code- Excl08) ... 4.9 HAZARDOUS OR ADVENTURE SPORTS (Code- Excl09) ... 4.10 BREACH OF LAW (Code- Excl10) ... 4.11 EXCLUDED PROVIDERS (Code-Excl11) ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and\nconsequences 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 ... 4.15 REFRACTIVE ERROR (Code- Excl15) ... 4.16 UNPROVEN TREATMENTS (Code- Excl16) ... 4.17 STERILITY AND INFERTILITY (Code- Excl17) ... 4.18 MATERNITY EXPENSES (Code - Excl18) ... War (whether declared or not) and war like occurrence ... Nuclear, chemical or biological attack or weapons ... Circumcision unless required to treat Injury or Illness. ... The cost of spectacles, contact lenses and hearing aids. ... Any Dental treatment or surgery which is a corrective, cosmetic or aesthetic procedure ... Convalescence general debility. ... 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","heading":"INVESTIGATION & EVALUATION (Code- Excl04)","page":11,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-4"},{"clause":"4.5","heading":"REST CURE, REHABILITATION AND RESPITE CARE (Code- Excl05) Expenses related to any","page":11,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-5"},{"clause":"4.6","heading":"OBESITY/ WEIGHT CONTROL (Code- Excl06) Expenses related to the surgical treatment of","page":11,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-6"},{"clause":"4.7","heading":"CHANGE-OF-GENDER TREATMENTS (Code- Excl07)","page":11,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-7"},{"clause":"4.8","heading":"COSMETIC OR PLASTIC SURGERY (Code- Excl08)","page":12,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-8"},{"clause":"4.9","heading":"HAZARDOUS OR ADVENTURE SPORTS (Code- Excl09)","page":12,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-9"},{"clause":"4.10","heading":"BREACH OF LAW (Code- Excl10)","page":12,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-10"},{"clause":"4.11","heading":"EXCLUDED PROVIDERS (Code-Excl11)","page":12,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-11"},{"clause":"4.12","heading":"Treatment for, Alcoholism, drug or substance abuse or any addictive condition and","page":12,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-12"},{"clause":"4.13","heading":null,"page":12,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-13"},{"clause":"4.14","heading":null,"page":12,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-14"},{"clause":"4.15","heading":"REFRACTIVE ERROR (Code- Excl15)","page":12,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-15"},{"clause":"4.16","heading":"UNPROVEN TREATMENTS (Code- Excl16)","page":12,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-16"},{"clause":"4.17","heading":"STERILITY AND INFERTILITY (Code- Excl17)","page":12,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-17"},{"clause":"4.18","heading":"MATERNITY EXPENSES (Code - Excl18)","page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-18"},{"clause":"4.19","heading":null,"page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-19"},{"clause":"4.20","heading":null,"page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-20"},{"clause":"4.21","heading":null,"page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-21"},{"clause":"4.22","heading":null,"page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-22"},{"clause":"4.23","heading":"Any Dental treatment or surgery which","page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-23"},{"clause":"4.24","heading":null,"page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-24"},{"clause":"4.27","heading":"Treatment such as Rotational Field Quantum Magnetic Resonance (RFQMR), External Counter","page":14,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-27"}],"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’ notice in writing. For terms up to one year, proportionate premium for the unexpired period is refunded if no claim has been made; no refund is made if any claim has been admitted, lodged or benefit availed.","display":"7 days’ notice; proportionate unexpired premium refund if no claim","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 the term of policy up to one year and there is no claim (s) made during the policy period. ... 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":"5.2","heading":"CANCELLATION CLAUSE","page":14,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-5-2"},{"clause":"5.2(a)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-5-2-a"},{"clause":"5.2(b)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-5-2-b"}],"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":"All medical treatments and surgeries must be taken in India and admissible claims are payable in Indian currency.","display":"India only","note":null,"quote":"All medical treatments and /or Surgeries under this policy shall have to be taken in India and admissible claims thereof shall be payable in Indian currency.","sources":[{"clause":"5.17","heading":null,"page":18,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-5-17"}],"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":"Applies on new individual health insurance policies, not policies of less than a year, renewals, or porting/migration.","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.\nA period of 30 days (from the date of receipt of the policy document) is available to the policyholder to review the terms and conditions of the policy.","sources":[{"clause":"5.5","heading":"FREE LOOK PERIOD","page":15,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-5-5"}],"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":30},"display":"30 days","note":"The general grace period definition also says fifteen days where premium payment mode is monthly and thirty days in all other cases.","quote":"At the end of the policy period, the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy. Coverage is not available during the Grace Period.","sources":[{"clause":"5.4","heading":"RENEWAL CLAUSE","page":15,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-5-4"}],"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":"Fresh entry is for persons/families between 3 months and 65 years. Renewal beyond 65 years is allowed if there is no break in insurance.","display":"3 months to 65 years","note":"From the prospectus.","quote":"This Policy covers Persons / Families between the age of 3 months and 65 years. Insured may renew his Policy beyond the age of 65 years provided there is no break in Insurance.","sources":[{"clause":null,"heading":"i.13FRAUD, MISREPRESENTATION, CONCEALMENT","page":16,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13507#c-i-13fraud-misrepresentation-concealment"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"quote-verified","value":["per annum"],"display":"per annum","note":"From the prospectus. The wording also contains a general grace-period definition mentioning monthly mode, but the product premium table shows annual premium.","quote":"a) Individual Person Rs.383/- per annum. ... b) Family (not exceeding five members) consisting of Insured, Spouse and first 3 dependent children Rs.575/- per annum. ... c) Family not exceeding 7 members consisting of Insured, Spouse, first 3 dependent children and dependent parents Rs.767/- per annum.","sources":[{"clause":"4.27(a)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13507#c-4-27-a-5"},{"clause":"4.27(b)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13507#c-4-27-b-5"},{"clause":"4.27(c)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13507#c-4-27-c-3"}],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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 during the Grace Period.","display":"Not covered during the grace period","note":null,"quote":"Coverage is not available during the Grace Period.","sources":[{"clause":"5.4","heading":"RENEWAL CLAUSE","page":15,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-5-4"}],"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 and boarding expenses are covered up to 0.5% of Sum Insured per day.","display":"Up to 0.5% of Sum Insured per day","note":"Total expenses for any one illness are limited to Rs.15,000/- and all claims cannot exceed Rs.30000/- per person or family.","quote":"A | (i) Room, Boarding expenses as provided by the Hospital / Nursing Home (ii) If admitted in IC Unit | (i) Upto to 0.5% of Sum Insured per day (ii) Upto 1% of Sum Insured per day","sources":[{"clause":"Section I","heading":"Hospitalisation Expenses","page":8,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-section-i"}],"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 percentage limit, not a room category.","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 expenses are covered up to 1% of Sum Insured per day.","display":"Up to 1% of Sum Insured per day","note":"Total expenses for any one illness are limited to Rs.15,000/- and all claims cannot exceed Rs.30000/- per person or family.","quote":"A | (i) Room, Boarding expenses as provided by the Hospital / Nursing Home (ii) If admitted in IC Unit | (i) Upto to 0.5% of Sum Insured per day (ii) Upto 1% of Sum Insured per day","sources":[{"clause":"Section I","heading":"Hospitalisation Expenses","page":8,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-section-i"}],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"quote-verified","value":"Co-payment is not applicable.","display":"Not Applicable","note":null,"quote":"ii. Co-Payment/ Deductible/ Any Other limit as applicable | Not Applicable","sources":[{"clause":"Section II","heading":"Coverage for Earning Head of the family | 3.1","page":1,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13475#c-section-ii"}],"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":"quote-verified","value":"Deductible is not applicable.","display":"Not Applicable","note":null,"quote":"ii. Co-Payment/ Deductible/ Any Other limit as applicable | Not Applicable","sources":[{"clause":"Section II","heading":"Coverage for Earning Head of the family | 3.1","page":1,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13475#c-section-ii"}],"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":"not-stated","value":null,"display":null,"note":"The wording gives overall and head-wise limits, but no lower disease/procedure caps for named treatments were stated.","quote":null,"sources":[],"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":0},"display":"NA","note":"CIS states pre-hospitalisation is NA. The wording defines pre-hospitalisation medical expenses but does not state a general number of days.","quote":"Pre-hospitalisation-NA","sources":[{"clause":null,"heading":"CUSTOMER INFORMATION SHEET/KNOW YOUR POLICY","page":1,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13475#c-customer-information-sheet-know-your-policy"}],"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":0},"display":"NA","note":"CIS states post-hospitalisation is NA. The wording defines post-hospitalisation medical expenses but does not state a general number of days.","quote":"Post-Hospitalisation-NA","sources":[{"clause":null,"heading":"CUSTOMER INFORMATION SHEET/KNOW YOUR POLICY","page":1,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13475#c-customer-information-sheet-know-your-policy"}],"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 covered for specified procedures requiring less than 24 hours, including Dialysis, Chemotherapy, Radiotherapy, Eye Surgery, Lithotripsy, D & C, Tonsillectomy, and any other surgeries/procedures agreed by TPA/Company due to medical advancement.","display":"Specified procedures and other TPA/Company-agreed procedures needing less than 24 hours","note":"Procedures/treatments usually done in outpatient department are not payable even if converted to inpatient for more than 24 consecutive hours.","quote":"HOSPITALISATION means admission in a Hospital for a minimum period of 24 in patient Care consecutive hours except for specified procedures / treatments, where such admission could be for a period of less than 24consecutive hours.\nDialysis | Chemotherapy\nRadiotherapy | Eye Surgery\nLithotripsy (kidney stone removal) | D & C\nTonsillectomy\nOR any other Surgeries / Procedures agreed by TPA / COMPANY which require less than 24 hours Hospitalisation due to subsequent advancement in Medical Technology.","sources":[{"clause":"2.16","heading":"HOSPITALISATION","page":3,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-2-16"}],"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 Hospitalization expenses are excluded.","display":"Not covered","note":"The CIS lists this under exclusions.","quote":"Any expenses incurred on Domiciliary Hospitalization","sources":[{"clause":"Section II","heading":"Coverage for Earning Head of the family | 3.1","page":1,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13475#c-section-ii"}],"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 incurred for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems are covered up to 100% of the Sum Insured during each policy year as specified in the policy schedule.","display":"Covered up to 100% of Sum Insured","note":null,"quote":"Expenses incurred for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy system of medicines is covered up to 100% of the Sum Insured during each policy year as specified in the policy schedule.","sources":[{"clause":"3.2","heading":"COVERAGE FOR AYUSH TREATMENT","page":8,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-3-2"}],"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 listed modern treatments or procedures are covered where medically indicated as inpatient or day care treatment in a hospital, up to Sum Insured for each listed procedure during the policy period.","display":"Covered up to Sum Insured","note":"Includes the 12 listed procedures in clause 3.4.1 to 3.4.12.","quote":"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.\nS No | Treatment or Procedure | Limit(Per Policy Period)\n3.4.1 | Uterine Artery Embolization and HIFU (High intensity focused ultrasound) | Upto Sum Insured ... 3.4.4 | Oral chemotherapy. | Upto Sum Insured\n3.4.5 | Immunotherapy- Monoclonal Antibody to be given as injection. | Upto Sum Insured ... 3.4.7 | Robotic surgeries. | Upto Sum Insured ... 3.4.12 | Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered. | Upto Sum Insured","sources":[{"clause":null,"heading":"Exclusions","page":9,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-exclusions"}],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Ambulance is listed among items for which coverage is not available.","display":"Not covered","note":null,"quote":"List I – Items for which coverage is not available in the policy ... 67 | AMBULANCE","sources":[{"clause":"Annexure I","heading":null,"page":20,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-annexure-i"}],"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":null,"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":"not-stated","value":null,"display":null,"note":"Portability/migration clauses mention transfer of no claim bonus generally, but the product wording does not state a bonus for this policy.","quote":null,"sources":[],"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":"Listed non-medical items such as gloves are not covered; other listed items are to be subsumed into room charges, procedure charges, or cost of treatment.","display":"Gloves and List I non-medical items not covered; some items subsumed into charges","note":null,"quote":"List I – Items for which coverage is not available in the policy ... 56 | GLOVES ... List II – Items that are to be subsumed into Room Charges ... List III – Items that are to be subsumed into Procedure Charges ... List IV – Items that are to be subsumed into costs of treatment","sources":[{"clause":"Annexure I","heading":null,"page":20,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-annexure-i"},{"clause":null,"heading":"List II – Items that are to be subsumed into Room Charges","page":21,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-list-ii-items-that-are-to-be-subsumed-into-room"},{"clause":null,"heading":"List III – Items that are to be subsumed into Procedure Charges","page":22,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-list-iii-items-that-are-to-be-subsumed-into-proc"}],"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, including childbirth expenses except ectopic pregnancy, and miscarriage or lawful medical termination unless due to accident.","display":"Not covered, except ectopic pregnancy; miscarriage only if due to accident","note":null,"quote":"a) Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy;\nb) Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period.","sources":[{"clause":"4.18","heading":"MATERNITY EXPENSES (Code - Excl18)","page":13,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-4-18"}],"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":null,"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":"Specified inpatient treatment of mental illness, stress or psychological disorders and neurodegenerative disorders is covered after a 36 months waiting period, when the patient shows specified severe traits and requires hospitalisation on a psychiatrist’s advice.","display":"Covered after 36 months for specified inpatient cases","note":"The listed conditions are Major Depressive Disorder when aggressive or violent, acute psychotic conditions, schizophrenia especially psychotic episodes, and bipolar disorder manic phase; injury due to suicidality is not covered.","quote":"Treatment of mental illness, stress or psychological disorders and neurodegenerative disorders: Our shall indemnify the Hospital or the Insured the Medical Expenses (including Pre and Post Hospitalisation Expenses) related to following and they are covered after a waiting period of 36 months.\nThe below covers are subject to the patient simultaneously exhibiting the following traits and requiring Hospitalisation as per the treating Psychiatrist’s advice","sources":[{"clause":"3.4(g)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-3-4-g"}],"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":"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 medicines without admission, and the limit.","status":"quote-verified","value":"Out-patient treatment is not included; procedures or treatments usually done in outpatient department are not payable even if converted as inpatient for more than 24 consecutive hours.","display":"OPD not covered","note":null,"quote":"Treatmentnormally taken on an out-patient basis is not included in the scope of this definition. ... Note: Procedures / treatments usually done in outpatient department are not payable under the Policy even if converted as an Inpatient in the Hospital for more than 24 consecutive hours.","sources":[{"clause":null,"heading":"2.10DAY CARE TREATMENT","page":2,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-2-10day-care-treatment"},{"clause":null,"heading":"Note","page":3,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-note"}],"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":null,"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 in network hospitals, with payments made directly to the network provider to the extent pre-authorisation is approved.","display":"Available in Networked Hospitals, subject to pre-authorisation","note":null,"quote":"CASHLESS FACILITY means a facility extended by the insurer to the Insured 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 the Company to the extent pre-authorization approved. ... Cashless facility is available only in Networked Hospitals. Prior approval is required from the TPA before the patient is admitted into the Network Hospital.","sources":[{"clause":"2.5","heading":"CASHLESS FACILITY","page":2,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-2-5"},{"clause":null,"heading":"HOSPITALS OR DENIAL OF CASHLESS FACILITY?","page":19,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13507#c-hospitals-or-denial-of-cashless-facility"}],"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 TPA; notices and final claims go to the Company/TPA, and cashless settlement is done directly by the TPA on the insurer’s behalf.","display":"TPA","note":null,"quote":"Preliminary notice of claim with particulars relating to Policy Number, 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 24 hours of Hospitalisation in respect of claims.\nFinal claim along with claim form and documents listed below should be submitted to the Policy issuing Office/TPA ... Cashless hospitalization is service provided by the TPA on Our behalf whereby you are not required to settle the hospitalization expenses at the time of discharge from hospital. The settlement is done directly by the TPA on Our behalf.","sources":[{"clause":"5.11","heading":"NOTICE OF CLAIM","page":17,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484#c-5-11"},{"clause":null,"heading":"HOSPITALS OR DENIAL OF CASHLESS FACILITY?","page":19,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13507#c-hospitals-or-denial-of-cashless-facility"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"quote-verified","value":true,"display":"Yes, Floater Sum insured","note":null,"quote":"4 | Sum Insured Basis | Floater Sum insured Sum Insured to be printed","sources":[{"clause":null,"heading":"CUSTOMER INFORMATION SHEET/KNOW YOUR POLICY","page":1,"url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13475#c-customer-information-sheet-know-your-policy"}],"law":[]}],"documents":[{"kind":"wording","label":"Policy Clause Universal Health Insurance APL","pages":24,"fetched_at":"2026-10-17 19:52:32+00","source_url":"https://www.newindia.co.in/assets/docs/know-more/health/universal-health-insurance/Policy%20Clause%20Universal%20Health%20Insurance%20Policy.pdf","url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13484"},{"kind":"prospectus","label":"Prospectus Universal Health Insurance APL","pages":21,"fetched_at":"2026-10-17 19:53:19+00","source_url":"https://www.newindia.co.in/assets/docs/know-more/health/universal-health-insurance/Prospectus%20Universal%20Health%20Insurance%20Policy%20%28APL%29%20.pdf","url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13507"},{"kind":"cis","label":"Customer Information Sheet","pages":3,"fetched_at":"2026-10-17 19:52:16+00","source_url":"https://www.newindia.co.in/assets/docs/know-more/health/universal-health-insurance/Customer%20Information%20Sheet%20UNIVERSAL%20HEALTH%20INSURANCE%20POLICY%28APL%29.pdf","url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/13475"},{"kind":"premium","label":"Premium Chart Universal Health Insurance (WEF 01 Nov 2024)","pages":null,"fetched_at":"2026-10-17 19:51:22+00","source_url":"https://www.newindia.co.in/assets/docs/know-more/health/universal-health-insurance/Premium%20chart%20Universal%20Health%20Insurance%20%20WEF%2001%20NOV%202024.pdf","url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/30477"},{"kind":"proposal","label":"Proposal Form Universal Health Insurance APL","pages":null,"fetched_at":"2026-10-17 19:52:19+00","source_url":"https://www.newindia.co.in/assets/docs/know-more/health/universal-health-insurance/Universal%20Health%20Insurance%20Proposal%20Form%20WEF%2001%20Oct%202024.pdf","url":"https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425/document/30486"}],"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":"Universal Health Insurance Scheme (APL) (Cashless facility available) (UIN NIAHLIP25052V032425), IndiaInsurances, https://indiainsurances.com/policy/new-india-assurance/universal-health-insurance-scheme-apl-cashless-facility-available-niahlip25052v032425"}