Overview
The New India Assurance Top-up Mediclaim plan offers additional health coverage beyond a base policy with sum insured options ranging from ₹5 lakhs to ₹22 lakhs. It provides coverage after a chosen deductible (₹5 or ₹8 lakhs) is exhausted. The plan covers up to six family members (entry ages 18-65, dependent children from 91 days), offers cashless treatment at over 3,700 network hospitals, and includes benefits like hospital cash and get-well benefits. It is designed for individuals seeking enhanced financial protection against high medical costs.
Experts Review
Written by Nikhil Nair
Senior Writer
The New India Assurance Top-up Mediclaim plan is a decent option for those looking to augment their existing health coverage, with sum insured options up to ₹22 lakhs. Its key feature is that it does not require a base policy, allowing standalone purchase, and it covers daycare treatments and alternative medicine, which some top-up plans exclude. The plan offers no co-payment, meaning the insurer pays the full claim amount once the deductible is crossed.
However, the maximum cover of ₹22 lakhs is modest compared to some competitors offering higher limits, potentially leaving gaps for costly treatments. Room rent caps are linked to the deductible chosen (e.g., ₹5,000 for ₹5 lakh deductible & ₹8,000 for ₹8 lakhs). And that’s the downside, because you’ll have to cross the deductible threshold for every claim instead of once every year like in the case of super top-up.
Pros
Insurer has a solid track record with great claim and service metrics.
Cons
Not very feature-rich.
No Restoration Benefit, which is a notable gap.
No Bonus for being healthy and not claiming insurance, which could be a drawback for some.
Your insurer doesn’t provide free health check-ups, which is a key feature.
New India Assurance
Key Insights
Founded
1919
New India Assurance was established 106 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
99% claims settled in 30 Days
New India Assurance settles 99% of all claims it receives demonstrating strong credibility.
Network Hospitals
3,700+
New India Assurance has a limited network of 3,700 hospitals, which may restrict access to cashless services for policyholders.
Complaints
5 complaints per 10,000 claims registered
New India Assurance maintains a low volume of complaints, reflecting strong customer satisfaction and effective service.
Features
All
Great
Good
Bad
Co-payment
The insurer will bear the entire cost of treatment (up to the sum insured). You won’t have to pay a single penny. Meaning this policy has no co-payment.
Room Rent
Your insurer won’t let you stay in a room whose rent exceeds ₹5,000 if your deductible is ₹5 lakh. For an ICU, they’ll allow up to ₹10,000. But if your deductible is ₹8 lakh, then you get a cap of ₹8,000 for a regular room and ₹16,000 for an ICU. And if you breach these limits, be prepared to pay a lot more.
Disease sub-limit
Your insurance cover won’t be fully available in case you are treated for cataracts, modern treatments and a few other diseases. Meaning the insurance company has a cap on the total amount they’ll pay out if you are treated for these specific illnesses.
Pre existing diseases waiting
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after you wait for 3 years.
Pre/Post hospitalization
While the policy covers the main hospitalization costs, do keep in mind that any diagnostic tests, medications, or follow-up consultations you may need before getting admitted or after discharge won’t be covered by the insurer. You’ll need to account for these out-of-pocket if the treatment requires extensive preparation or recovery care outside the hospital stay.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Convalescence and General debility
Expenses incurred for Rotational Field Quantum Magnetic Resonance (RFQMR)
External Counter Pulsation (ECP)
Enhanced External Counter Pulsation (EECP)
Hyperbaric Oxygen Therapy
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy for 3 years.
All internal and external benign tumours, cysts, polyps of any kind (including benign breast lumps)
Benign ear, nose, and throat disorders
Benign prostatic hypertrophy
Cataract and age-related eye ailments
Gastric / Duodenal Ulcer
Waiting Period
30 days Initial waiting period
3 years Specific illness waiting period
3 years Pre-existing disease waiting period
Ditto's Take
◦ Standard ◦
After a close look at the waiting periods, it’s safe to say they are fairly standard.
What's missing in the policy
No Restoration Benefit.
No Bonus for being healthy and not claiming insurance.
Your insurer doesn’t provide free health check-ups.
No coverage if you are forced to hospitalize at home.
Maternity benefits not offered.
Doctor consultations are not covered.
Customer Reviews
K
Kavita Singh
No co-payment means the insurer pays the full claim amount after deductible.
A
Anand Krishnan
Covers daycare treatments and alternative medicine, which is good for a top-up.
S
Shruti Sharma
Can be purchased standalone without a base policy from the same insurer.
S
Suresh G.
Premiums can be 10-15% higher than similar private insurer top-ups.
M
Mohanlal P.
Room rent caps are linked to the deductible (e.g., ₹5,000 for ₹5L deductible), which is restrictive.
B
Ben Carter
Cashless treatment at over 3,700 network hospitals.
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Frequently Asked Questions
Does New India Top-up Mediclaim have waiting periods?
- 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
- There’s a 2 to 3-year waiting period for a list of diseases which is a mandate before you can start claiming.
- Pre-Existing Disease Waiting Period: There's a 3-year waiting period for any pre-existing disease you may have while buying the policy.
Does New India Top-up Mediclaim have room rent restrictions?
Does New India Top-up Mediclaim offer a restoration benefit?
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