.Products Of NIA.

PRODUCTS INDIVIDUAL GROUP JANTA FAMILY SENIOR

REVISED DATE 16/08/2007 16/08/2007 16/08/2007 16/08/2007 16/08/2007

AGE BAND 3 months to 60 years 3 months to 60

years

3 months to 60

years

3 months to 60

years 61 to 80 years

SUM INSURED 1 - 5 lacs

Depend on Group (

tailor made )

50000 and

75000

200000 to

500000 floater

100000 and

150000

ROOM BOARDING + NURSING

1% of SI(without

CB)per day or actual

whichever is less.

1 % of the sum

insured per day or

actual amount

whichever is less.

Rs.450/- per

day 1% of SI per day 1% of SI per day

I.C.U + NURSING

2% of SI/day or

actual whichever is

less.

2% of the sum

insured per day or

actual amount

whichever is less.

Rs.1800/- Per

day 2% of SI per day

2% of SI per day

(overall limit is

25% of SI)

DOCTOR CHARGES As per bill As per bill As per bill As per bill 25% of SI per

illness

LAB + MEDICINE CHARGES As per bill As per bill As per bill As per bill 50% of SI per

illness

AMBULANCE

1% of SI per policy

period or Rs. 2500/-

whichever is less

1% of SI per policy

period or Rs

2500/- whichever

is less

Actual or 1000

whichever is

less

1% of SI per

policy period or

Rs. 2500/-

whichever is less

1000 Per policy

peroid.

PRE- HOSPITALIZATION 30 days 30 days 30 days 30 days 30 days max 5% of

hospital bill

POST HOSPITALIZTION 60 days 60 days 60 days 60 days 60 days max 10%

of hospital bill

DOMICILARY excluded under

4.4.17

excluded under

4.4.17

excluded

under 4.4.17

excluded under

4.4.17

excluded under

4.4.17

ANY ONE ILLNESS 45 days 45 days 45 days 45 days 45 days

AYURVEDIC/HOMEOPATHY/UNANI

25% of SI provided

treatment for the

illness /disease and

accidental injury is

taken in the register

hospital

25% of SI

25% of SI

provided

treatment for

the illness

/disease and

accidental

injury is taken

in the register

hospital

25% of SI

25% of SI provided

treatment for the

illness /disease

and accidental

injury is taken in

the register

hospital

PRE - EXISTING

covered after 4

continues claim free

years provided no

hospitalization for

per- exiting

covered after 4

continues claim

free years

provided no

hospitalization for

per- exiting

covered after 4

continues

claim free

years provided

no

hospitalization

for per- exiting

covered after 4

continues claim

free years

provided no

hospitalization

for per- exiting

covered after 1.5

year or 18 months

and 48 months or

4 continues claim

free yrs

LOCK IN PERIOD 30 days 30 days 30days 30 days 30 days

WAITING PERIOD 2/4 years 2/4 years 2/4 years 2/4 years 1.5/4 year

.Products Of NIA.

C.B 5% up to 6 claim free

years not applicable

5% up to 6

claim free

years

not applicable 5% up to 6 claim

free years

HEALTH CHECK UP

1% of Avg sum for a

block of 4 continues

claim free year

(excluding CB)

Not applicable

1% of Avg sum

for a block of 4

continues

claim free year

(excluding CB)

not applicable

1% of Avg sum for

a block of 4

continues claim

free year

(excluding CB

CLAIM INTIMATION 7 days from DOA 7 days from DOA 7 days from

DOA 7 days from DOA 10 days from DOA

CLIAM DOCUMENT SUBMISSION 30 days from DOD 30 days from DOD 30 days from

DOD

30 days from

DOD 30 days from DOD

MATERNITY not applicable

can be covered by

paying extra

premium

not applicable not applicable not applicable

MISCELLANEOUS

Cataract is payable

actual or maximum

24000/-whichever is

less

As per CBF

Cataract with

imported

foldable lens

10800/-

Insured has to

bear 10% as a co-

payment all the

admissible claims.