Floater Mediclaim in one table
| Insurer | The New India Assurance Company Limited |
|---|---|
| Sum insured | ₹2, 3, 5, 8, 10, 12 or 15 lakh, shared by the whole family on a floater basis |
Claim settlement and complaint figures are IRDAI-published and held centrally by NYVO, not taken from the insurer's marketing.
What Floater Mediclaim covers
These are the terms that decide what you are actually paid when you claim. Room rent, co-pay and restoration do more to shape a settlement than the sum insured does, and they are read from New India Assurance's own policy wording.
| Feature | This plan | What good looks like |
|---|---|---|
| Co-payment | None if you are treated in the zone you paid for. A Zone 2 policyholder treated in Zone 1 – Maharashtra or Gujarat – bears 20%, except for an emergency accident admission | No Co-payment |
| Room Rent Limit | 1% of sum insured a day · ICU 2%. A dearer room triggers a proportionate deduction on the associated medical expenses | No room rent capping |
| What the proportionate deduction spares | Pharmacy and consumables, implants and medical devices, and diagnostics are exempt, as are hospitals that do not bill differently by room category | Deduction limited in scope |
| Disease sub-limit | Cataract capped at 10% of sum insured or ₹50,000 an eye. Mental illness, genetic disorders and puberty or menopause disorders at 25% of sum insured each, macular degeneration at 10% up to ₹75,000 | No sub-limit |
| No Claim Bonus | Sum insured rises 25% at each claim-free renewal, to a ceiling of 50%, and is added on a floater basis. You can swap the accrued bonus for a 2.49% to 4.12% premium discount instead | 50% each year (Minimum upto 100%) |
| Restoration Benefit | Not available on this plan. Once the shared sum insured and bonus are spent, the family has nothing left for the rest of the year | 100% restoration once in a year |
| Critical Care Benefit | 10% of the sum insured on top of an admissible claim for a listed critical illness, paid once in a lifetime per insured person and not if the illness was pre-existing | Included |
| Pre-Hospitalization | 30 days | At least 60 days |
| Post-Hospitalization | 60 days | At least 120 days |
| Consumables | Medical consumables billed as part of an admission are paid. The non-payable items in the policy's List I are not, and the add-on that used to buy them back was withdrawn in the current version | Consumables covered |
| Hospital cash | 0.1% of sum insured for each day of an admission longer than 24 hours, capped at 1% of sum insured for any one illness | Included |
| Day-Care Procedures | Listed day care procedures covered | Covered without a capped list |
| AYUSH Treatment | Covered up to 100% of the sum insured | Included |
| Dental treatment | In-patient dental treatment under anaesthesia is covered where an accident, injury or illness makes an admission necessary | Covered |
| Road ambulance | Up to 1% of the sum insured per insured event | Included |
| Entry age | 18 to 65. Children from 3 months and to 25 while financially dependent. Above 65 you can renew but not join | No maximum entry age |
Floater Mediclaim add-ons you can buy with it
Each of these costs extra and each has its own conditions. Some are genuinely worth it; several exist to patch a gap in the base plan. Ask what each one adds before it goes on your quote.
Floater Mediclaim discounts you can ask for
Published discounts on this plan. Most are applied at quote stage rather than offered, so it is worth naming the ones you qualify for. Every figure is a ceiling, not a promise - what you actually get depends on the case.
| Discount | Worth | When it applies |
|---|---|---|
| Number of members | Up to 5% to 15% | 5% for two members, 10% for three, 15% for four or more on the same floater. |
| Digital purchase | Up to 10% | For a fresh policy bought through New India's own customer portal or mobile app. |
| Long-term policy | Up to 5% or 7% | 5% on a two-year policy term and 7% on three years. Sum insured and sub-limits reset each policy year and do not carry forward. |
From the plan prospectus. Discounts apply to the base premium and are set at quote stage rather than offered, so name the ones you qualify for.
Floater Mediclaim waiting periods: when each part of the cover starts
Waiting periods run from the day cover began, not from the day you fall ill, and they run in parallel rather than one after another.
| Initial Waiting Period | 30 days |
|---|---|
| Diabetes, hypertension and cardiac conditions | 90 days |
| Named specific illnesses | 24 months |
| Joint replacement, mental illness, genetic disorders, congenital external disease | 36 months |
| Pre-Existing Disease | 36 months |
The named illnesses that wait 90 days to 36 months, depending on the condition
Three tiers run alongside the 30-day and pre-existing waits. Diabetes, hypertension and cardiac conditions wait 90 days. The list below waits 24 months. Joint replacement for a degenerative condition, age-related osteoarthritis and osteoporosis, mental illness, macular degeneration, genetic disorders and congenital external disease wait 36 months, and several of those also carry a 25% sub-limit. An accident is covered from day one. The list is indicative – the policy clauses carry the full set.
Floater Mediclaim exclusions: what the plan will not pay for
Every policy carries exclusions, and they are the clauses people read for the first time at claim stage. These are the ones worth knowing before you buy.
Where Floater Mediclaim falls short
No plan is right for everyone, and a page that only lists strengths is not much use to you. These are the gaps we would raise on a call before recommending it.
Floater Mediclaim questions, answered
Does this plan restore the sum insured after a claim?
No. There is no reinstatement clause in the New India Floater Mediclaim Policy. Once the shared sum insured and any accrued cumulative bonus are exhausted, nothing more is payable for anyone on the policy until renewal. Its individual sibling, the New India Mediclaim Policy, does reinstate once a year on a sum insured of ₹5 lakh or more, so if restoration matters to you, that is the plan in this range that has it.
What is the Critical Care Benefit?
If an insured person is diagnosed with one of the critical illnesses defined in the policy and that results in an admissible claim, New India pays a further 10% of the sum insured alongside the claim. It is paid on top of the sum insured and does not reduce it. Two conditions bite: it is payable only once in the lifetime of each insured person, and never where the illness was a pre-existing condition for that person.
When does the 20% co-payment apply?
New India rates this policy across two zones: Zone 1 is Maharashtra and Gujarat, Zone 2 is the rest of India. Buy at Zone 1 rates and you can be treated anywhere in India with no co-payment. Buy at Zone 2 rates and get treated in Zone 1 and you bear 20% of the claim. An emergency admission following an accident is exempt. The zone is fixed at proposal and can be changed only at renewal.
How many people can go on one policy?
Between two and six. It cannot be issued to a single person. The eligible members are the proposer, spouse, dependent children, parents, and a financially dependent brother, sister or ward, with parents aged 60 or under covered only if they are dependent. Children are covered from 3 months and can stay to 25 while financially dependent.
How much is cataract surgery covered for?
Per eye, the lower of 10% of your sum insured and ₹50,000, after a 24-month wait. On a ₹2 lakh floater that works out at ₹20,000 an eye; from ₹5 lakh upward the ₹50,000 figure is the one that binds, however large the sum insured. On ₹8 lakh and above you can buy the Revision in Limit of Cataract cover, which adds ₹80,000 to ₹1.5 lakh depending on the sum insured, but it only pays 36 months after you take it. The individual New India Mediclaim Policy allows 20% of the sum insured on the same ₹50,000 ceiling, so the floater is the tighter of the two at lower sums insured.
What happens to my cover after five years?
A five-year moratorium applies. Once the policy has run five continuous years, New India cannot contest a claim on the grounds of non-disclosure or a pre-existing condition, except where fraud is established or the treatment is permanently excluded. If you raise the sum insured later, the moratorium restarts on the increased portion only.
Read it from the insurer
We summarise. The policy wording is the contract, and it is the only document that settles a dispute. These links go to the insurer's own pages.
Understand the terms before you commit
A plan page tells you what this policy does. These explain why each term matters and what it costs you when it is missing.
Other New India Assurance plans we have read
New India Assurance files these separately, and the terms differ between them. If you are choosing within the range, compare the waiting periods and the exclusions rather than the sum insured.