Overview
The New India Assurance Premier Mediclaim plan is a comprehensive health insurance policy offering sum insured options from ₹15 lakhs up to ₹1 crore, available in two plans—Plan A (₹15-25 lakhs) and Plan B (₹50 lakhs to ₹1 crore). It covers hospitalization, pre- and post-hospitalization expenses, maternity (up to ₹1L) and infertility treatments(up to ₹2L), outpatient consultations (after two claim-free years), and critical illness benefits. With lifelong renewability, no co-payment, it is designed for individuals and families seeking extensive health protection.
Experts Review
Written by Ishita Jain
Editor
The New India Premier Mediclaim plan stands out for its broad coverage and unique benefits. Its USPs include outpatient consultation reimbursements up to ₹5,000 after two claim-free years, maternity benefits up to ₹1 lakh, and a critical illness lump sum payout of ₹2 lakhs upon diagnosis of conditions like cancer. The policy offers no co-payment, so the insurer bears the full treatment cost up to the sum insured—a significant advantage over competitors.
However, the plan has notable drawbacks: it lacks domiciliary cover, bonus, and restoration benefits. Additionally, there are disease-wise limits on cataracts, modern treatments, and several other conditions. The premium is also comparatively high, typically 20–30% above similar public sector policies. The waiting period for maternity and infertility benefits is 36 months, which is standard but may be restrictive for some.
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.
No coverage if you are forced to hospitalize at home, 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
Maternity
STANDOUT
The insurer will also cover expenses related to maternity— Think hospitalization expenses incurred while giving birth. But they’ll only pay upto ₹50,000 and make you wait 3 years before covering this expense. Also, you’ll only get the benefits if both, you and your spouse are enrolled in a single-family floater plan.
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
Shared room, single room, deluxe room or any room that’s available. The insurer won’t nitpick on your choice of room since the policy has no restrictions on room rent.
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.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Convalescence, General debility and Venereal disease.
Treatments such as Rotational Field Quantum Magnetic Resonance (RFQMR), External
Counter Pulsation (ECP), Enhanced External Counter Pulsation (EECP), Hyperbaric Oxygen
Therapy
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
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.
24-Month Waiting Period:
All internal and external benign tumours, cysts, polyps of any kind (including benign breast lumps)
Benign ear, nose, throat disorders
Benign Prostatic Hypertrophy
Cataract and age-related eye ailments
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.
No coverage if you are forced to hospitalize at home.
Customer Reviews
P
Priya Sharma
Outpatient consultation reimbursement up to ₹5,000 after two claim-free years is a unique benefit.
R
Rajeev M.
Maternity benefits up to ₹1 lakh is quite good.
S
Sunita K.
Critical illness lump sum payout of ₹2 lakhs upon diagnosis is a strong feature.
M
Meera Ahuja
No room rent restrictions was a pleasant surprise—though some disease-wise limits still apply.
V
Vijay N.
Very expensive, premiums are 20-30% higher than comparable PSU plans.
C
Chris D.
Lifelong renewability and wide hospital network are plus points.
Compare Policies
Still confused?
Talk to our expert
advisor for
instant clarity
Frequently Asked Questions
Does Premier Mediclaim Plan 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.
- Specific Illness Waiting Period: There’s a 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.
- Maternity and Newborn Waiting Period: There’s a 3-year waiting period before you can make claims related to pregnancy and childbirth.
Does Premier Mediclaim Plan have room rent restrictions?
Does Premier Mediclaim Plan offer a restoration benefit?
TALK TO OUR ADVISORS
Get real help from advisors who listen, guide and go the extra mile for you.