Renewal
(Sponsored article from New India Assurance)
Renewal of Mediclaim policy should not be rejected on grounds other than bad moral hazard. In case of adverse claims experience the premium can be suitably loaded up to 200% of basic premium for the relevant age band and if required also deductible/excess up to 25% of the sum insured may be imposed. This loading/excess should be applied only after completion of minimum of two-policy period.
Imposition of loading and excess will be applicable provided the average claim experience during two policy years exceed 10% of Sum insured for any Individual person covered under the policy. This claim experience will be taken for two previous policy ie expiring policy and one immediate earlier to that. The loading and co payment under the policy will be as under:
| % of Sum Insured claimed for any individual person covered under the policy | Loading | Co-payment (Excess) |
| 0-10 | Nil | Nil |
| More than 10 up to 20 | 25% | Nil |
| More than 20 upto 30 | 50% | Nil |
| More than 30 upto 50 | 100% | Nil |
| More than 50 upto 75 | 100% | 15% |
| More than 75 upto 90 | 100% | 20% |
| More than 90 | 200 | 25% |
Introduction of sub limits: The medi claim policy (2007) contains the following sub limits
| 1 | Room, boarding and nursing expenses as provided by the Hospital/nursing home not exceeding 1% of the sum insured (without cumulative bonus)per day or actuals, whichever is less |
| 2 | Intensive Care Unit (ICU)/ Intensive Cardiac Care Unit (ICCU) expenses not exceeding 2% of the sum insured per day or actuals, whichever is less. |
| 3 | Expenses incurred for Ayurvedic/ Homeopathic/ Unani treatment are admissible upto 25% of the sum insured provided the treatment is taken in a Government Hospital. |
| 4 | Ambulance Services-!% of the sum insured or actuals, whichever is less, subject to a maximum of Rs2,500/- shall be reimbursed in case patient has to be shifted from residence to hospital for admission in Emergency ward or ICU or from one hospital/nursing home to another hospital/nursing home by fully equipped ambulance for better medical facilities. |
(Sponsored article from New India Assurance)
