New India Assured Group Health Insurance

New India Assurance Company was founded by Sir Dorab Tata in 1919 from the incorporated house of TATAs. It was nationalized in 1973 with the merger of Indian companies. The company currently operates in 26 countries and is headquartered in Mumbai, India. It opened an office in London, UK in the year 1921 and has been serving the diverse needs of people for over 100 years, and has a desk at Lloyd’s. New India Assurance acts as a promoter for companies like GIC Housing Finance Limited and the Agriculture Insurance Company of India.

A common third-party administrator known as Health Insurance TPA of India has been promoted by New India Assurance Company along with the Government of India.

New India Assurance is one of the four public sector general insurance companies in India engaged in the non-life insurance business. They offer various insurance products like New India Assurance Mediclaim, New India Assurance Policy, New India Assurance Health Insurance, Motor Insurance, Engineering Insurance, Liability Insurance, Workmen’s Compensation Insurance, etc.

Key Benefits of New India Assurance Group Health Insurance

Some of the benefits of New India Assurance Health Insurance or Mediclaim Insurance Policy are mentioned below:

Impairment of an individual’s intellectual faculties

Impairment of a covered person’s intellectual abilities due to the use of drugs, stimulants, or depressants as prescribed by a medical practitioner, arising during the treatment of a covered illness. Coverage will be available up to the sum assured specified in the New India Assurance Mediclaim policy.

Artificial life maintenance

Artificial life maintenance, including the use of life support machines, in which such treatment shall not, in any event, result in recovery or restoration of a previous state of health unless covered after admission for a covered illness in a vegetative state as certified by the treating physician.

Treatment of mental disease, stress

Costs involved in the treatment of mental disease or stress will be covered including pre-hospitalization and post-hospitalization after a waiting period of 48 months. These diseases include:

• Major depressive disorder – when an individual is violent or aggressive.
  
  
• Acute psychotic state – aggressive/ violent behavior or hallucinations, incoherent speaking, or agitation.
  
  
• Schizophrenia.
  
  
• Bipolar disorder.

Treatment of Neural, Behavioral, and Psychological disorders

Treatment expenses for behavioral, neural, and psychological disorders are covered under the New India Mediclaim health insurance policy. Adult personality disorders and speech and language disorders including stuttering, and dyslexia, are covered as inpatient procedures. Genetic disorders or illnesses are also covered after a specific waiting period cited in the policy document.

Puberty or menopause-related disorders

Treatment of any symptoms, ailments, or complications arising due to psychological conditions associated with puberty, such as menopausal bleeding or flushing is covered only as an inpatient procedure after a certain waiting period specified in the policy copy.

Hospitalization

Hospitalization of the insured member of the New India Assurance Mediclaim policy is covered up to a certain limit specified in the terms and conditions of the policy. Outpatient hospitalization, Inpatient hospitalization, day care hospitalization, etc. are covered under the New India Health Insurance scheme.

Why should New India Assurance be your preference for group health insurance?

With health insurance companies bundled with multiple plans and varied benefits, making the right choice becomes difficult. But there are certain parameters that can determine whether a company is reliable or not. New India Assurance has successfully proved itself to be one and the reasons are mentioned below:

• Excellent Network – The company has 15,249 employees, 1,02,804 licensed agents, and 2214 branches across the country. From the foundation, it has built its network in such a way that you can find this insurer almost anywhere. So, not only is it easy to discover them but you can always have company by your side.
  
  
• Number of Plans – New India Assurance has come up with a wide range of health schemes to cater to the requirements of individuals with multiple benefits. You can not only protect yourself and your family under the company but also find a suitable plan for critical illness or a senior member of your family. Therefore, the company perfectly caters to the various needs of the people.
  
  
• Network Hospitals – Cashless facilities can be availed only if you have undergone medical treatment at any of the company’s network hospitals. Moreover, during a medical emergency, it is not possible to travel long distances to a suitable hospital. For that, the number of network hospitals and their availability is very important. New India Assurance has more than 1500 network hospitals all over India. So, you can not only find a network hospital in your vicinity but you can also avail of the treatment at one of your desired hospitals as you will have multiple choices to select from.
  
  
• Claim Support – We buy health insurance so that it can protect us financially in our time of greatest need. Therefore, a health insurance company should have a good claim settlement ratio and records. According to IRDA’s annual reports, the expenditure claim ratio for New India in the financial year 2019-2020 was 100.83%, which is more than adequate. And, that makes the company a really good choice to buy health insurance from.
  
  
• Background – The company has been faithfully serving its customers for over 100 years. It has gained a good reputation as a giant over the years. Moreover, it is a multinational company. So there is almost no chance of the company going down in near future. So, you can fully trust the company for your health insurance.
  
  
• Solvency Ratio – The solvency ratio is an important parameter as it indicates the ability of the company to meet its long-term financial obligations. If it is higher, it means that the company has the capacity to pay the claim amount at once; So your claims will be settled more easily. According to IRDA’s annual report, the solvency ratio for New India Assurance as on March 2020 was 2.11, which is much higher than other health insurance companies. This indicates that you are protected under this company.
  
  
• Customer Support – The company has a toll-free number and keeps its customer service open 24×7. You can also contact him through the mail. So, whenever you need it, this company will always be with you.
  
  
• Maternity Benefit: New India Assurance health insurance policy comes with maternity benefits as well as baby cover. A maximum of 10% of the average sum assured by the insured person in the previous three years will be given as maternity benefit. A newborn baby is also covered under the New India Assurance Group Mediclaim health insurance policy for 90 days after which the baby should be added to the main policy on payment of an additional premium. Maturity benefits can be availed by adding a member or a member’s spouse to a New India Mediclaim Health Insurance policy immediately after an event such as marriage or joining an organization.
  
  
• Competitive Premiums: New India Assurance is known for its affordable premiums. New India Assurance’s health insurance premiums are very competitive in the market. All services like endorsement, addition, deletion, claim settlement, etc. are provided by New India Assurance only at the level of private insurance companies. The Indian insurance market is a highly premium-sensitive market and even a slight difference in premium will influence the purchasing decisions of consumers.
  
  
• Free Health Checkup: Another advantage of the New India Assurance Company is that it offers free medical checkups to all the members of the group health insurance policy. A free medical checkup can be availed at any network hospital or diagnostic center on a cashless basis with prior approval from the insurance company. The insured member needs to show the health card at the hospital or diagnostic center to avail of the free health checkup. Free health check-up is available once every 3 claim-free years. It is basically offered as an incentive for zero claims during the previous 3 years. Eligibility for health check-ups is different for different policyholders depending on their sum assured and plans. Insured customers can avail of health checks once every 3 claim-free years.

Inclusions of New India Assurance group health insurance

Your group health policy is tailored to your preferences. Here’s what your New India Group Health Insurance covers.

Room charges and domiciliary treatments

New India Group Health Insurance covers hospital room charges including nursing and boarding expenditures. It also offers domiciliary charges in case of hospitalization at home.

ICU and additional expenses

ICU expenditures are covered in the New India group health insurance scheme. Additional expenses like surgical expenditures, anesthesia, blood, etc are also covered.

Expenditures for Pre and Post-hospitalisation

New India Group Health Insurance offers cover for your pre-hospitalization and post-hospitalization expenditures which can be claimed 30 to 60 days prior to hospitalization.

Ayush Treatment

Treatment through the AYUSH system is covered by New India Group Health Insurance.

Exclusions of New India Assurance group health insurance

Cosmetic treatments

Cosmetic treatments like liposuction, plastic surgery, and botox are usually not covered by your group health insurance scheme.

Gender reassignment surgeries

Expenditures incurred due to gender-reassignment treatment or surgery are excluded from your group insurance policy.

Self-harm injuries

Injuries due to self-harm, such as suicide, and hospitalization expenditures for the same are not covered under this policy.

Treatments for substance abuse

Treatment expenditures caused by substance abuse like alcohol or drugs are exempted from coverage in your New India Group Health Insurance.

Injuries caused by participation in dangerous sports

In case of participating in any dangerous sport and in case of injuries, the New India Group Health Insurance Policy does not cover the same.

Health supplements

The supplements expenses such as protein powder and other health tonics that are taken by individuals cannot be claimed in your group medical policy. However, these may be covered if a doctor advises them as part of treatment during your hospitalization. This is covered according to the terms of your policy.

The process to buy a health plan from New India Health Insurance

You can purchase health policies under New India Assurance both offline and online (only for 3 policies).

Offline buying procedure:

If you want to buy it offline, visit the nearest branch of the company and their experts will guide you through the buying process completely. Or, you can also take the help of licensed agents of the company. They are knowledgeable enough to provide you with a seamless purchasing process. Otherwise, you can call their helpline or toll-free number to get assistance from the company.

Online buying procedure:

• Go to the company’s official website and then go to the ‘Products’ section and select ‘Health’.
  
  
• The company mentions several health plans available. If you click on the policies, you will find the ‘Buy Online’ option and click on it.
  
  
• You need to put the required details like Sum Assured, Address, Proposer Name, Contact Details, etc.
  
  
• You can save the information and continue or you can compute the premium.
  
  
• Pay the premium amount online after submitting all the details and details.
  
  
• When the payment is successful, you will be informed and the policy document will be mailed to your registered email id.

Renewal Process of New India Health Insurance Policy

Under this company, you can renew your health insurance schemes in both ways – online and offline.

For the offline method, visit any nearest branch of the office and pay the renewal amount via cash and cheque, and you are done.

For the online procedure, go to the ‘Quick Help’ section on the company’s official website. Under this tab is the ‘Quick Renew’ option, click on it. Then you have to enter your customer ID and renewal amount and proceed. If required, then enter other required details and pay the renewal amount through a debit card, credit card, or net banking. On successful payment, the policy will be renewed and you will be notified about it.

You can also renew your health scheme through the New India app.

Factors Determining New India Assurance Group Health Insurance Premium

The premium of New India Group Health Insurance is directly proportionate to the risks involved. It is important to use the New India Group Health Insurance Premium Calculator to estimate the cost of your policy. There are also several factors that influence your premium.

Average age

The premium is calculated based on the average age of the insured. The younger the age, the lower the premium. This is because the younger generation has fewer health risks.

Type of plan opted

Different types of group health insurance policies are selected including Employee only (E), Employee+Spouse+Children (ESC), and Employee+Spouse+Children+Parents (ESCP) plans. The number of people covered under the ESCP scheme is more than those covered under the E scheme. Hence, when the scope of coverage is more the premium will be higher.

Nature of the job

The nature of the job a person does is also a factor in determining the annual premium. Jobs involving more risk will have higher premiums than jobs with less risk. For instance, employees working in factories will have higher group health insurance premiums than employees working in the IT industry.

Sum insured

Sum Assured is the maximum amount that the insurance company will pay you in case of any hospitalization in a particular year. If the hospital charges exceed the sum assured, it will be paid by the policyholder himself. So the higher the sum assured, the higher the premium paid for the group health insurance policy.

Add-ons opted

Maternity insurance riders and dental insurance riders and selected add-ons to existing group health insurance policies will increase your group health insurance premium. The premium increases depending on the type of add-on selected.

Claims history

In case of renewal of a group health insurance policy, the claim history is considered to calculate the premium for that particular financial year. If the number of claims raised in the previous financial year is high, the premium towards the policy will increase during policy renewal.

For example, a company named XYZ wants to renew its New India Group Health Insurance policy for 2022. The premium paid by him for 2021 was ₹25,000. If the number of claims raised during 2021 is more than in 2020, the premium for 2022 will be more than ₹25,000.

Calculating the premium for New India Health Insurance Policy

New India Assurance calculates the premium for a health policy based on various factors. You can also easily know the premium amount by following the steps mentioned below.

First, go to their official website and select Health under the ‘Product’ tab and select the desired plan. There you can find the ‘Get Quote’ option, click on it. Now you are asked the information like policy period, date of birth of the proposer, gender, sum assured, contact details, etc. If you want to add a member, you can do that too. You need to declare whether you smoke or not. After entering all the mandatory details, click on the ‘Calculate Premium’ option and you will know the same.

Claim Settlement Procedure of New India Health Insurance

Under this company, you can obtain two options to file your claim – a compensation claim and a cashless claim for some policies. Here are the steps for both procedures.

Cashless claim settlement procedure

To avail of the easy cashless claim process, follow the steps mentioned below:

• For a cashless claim, you have to visit the company’s network hospital.
  
  
• In case of hospitalization, you need to inform the insurer within the specified time.
  
  
• Show your health card and identity card at the hospital.
  
  
• The hospital will verify the documents provided by you and after successful verification, the hospital will send the pre-authorized form to the hospital or TPA.
  
  
• New India Assured will confirm and evaluate the information.
  
  
• The claim can be accepted or rejected. On approval of the claim, the company will settle the claim amount directly with the hospital.

Reimbursement Claim Settlement Procedure

To get a seamless reimbursement claim, follow the simple steps mentioned below:

• Notify your insurer as soon as possible in case of hospitalization. For reimbursement claims, you don’t need to be admitted to any network hospital.
  
  
• Avail treatment, pay bills, and save all documents safely.
  
  
• Provide all the documents requested by the company like hospital and pharmacy bills, discharge certificates, and reports of attending doctors and surgeons.
  
  
• You have to provide the duly filled and signed claim form along with all the required documents. You can download the claim form from the official web portal of the company or collect it from the closest branch.
  
  
• Remember, incorrect information can cause your claim to be denied.
  
  
• The company will verify your documents. A surveyor may be appointed on behalf of the company.
  
  
• If your claim is found to be valid, it will be approved and the claim amount will be credited back to your account.

How to contact New India Health Insurance?

Address: New India Assurance Building.
87, M G Road, Fort, Mumbai Maharashtra, 400001
Toll-free number: 1800-209-1415
Email ID: [email protected]

To contact them, you can also choose their ‘Call Me’ option from their official web portal. Then enter your username, email id, mobile number, preferred time to call, and comments, and then submit. You will obtain a call from a company professional to clarify your questions.

FAQs The New India Assured Group Health Insurance