Cover
Plan type
Individual and family floater
Individual and family floater
Sum insured options
5 lakh, 7 lakh, 10 lakh, 15 lakh, 20 lakh, 25 lakh, 50 lakh, 75 lakh, 1 crore, 2 crore
—
Highest sum insured
200 lakh
—
Entry age
From 18 years (adult); 91 days (dependent child, floater/multi-individual); 5 years (individual policy) (no maximum stated)
From 91 days (no maximum stated)
Room rent
No capping - actuals up to base sum insured
Option: 1%, 1.5% or 2% of Sum Insured per day, or No Limit
Co-payment
Nil
Optional co-payment 0% to 50%
Waiting periods
Initial waiting period
30 days
—
Pre-existing disease waiting
36 months
—
Specific illness waiting
24 months
—
Benefits
Day-care treatment
Yes
Yes
Restore benefit
Super Reload: 2X Sum Insured from Day 1 and unlimited refills up to 100% of base Sum Insured from 2nd claim in a policy year
Optional Sum Insured Refill Benefit: refills 100% of the Sum Insured specified and utilized under Section 1.A/1.B
No-claim bonus
Not in base NXT; optional Super Credit: 100% of SI per year up to 500% of Base SI (max Rs 3 crore), irrespective of claims
Cumulative Bonus (increase in SI) or No Claim Discount, as opted; upper limit as per Policy Schedule
Maternity
Not covered
Optional cover (Section 6), limited to two childbirth events; waiting period options No Waiting Period, 6 Months, 9 Months, 1 Year, 2 Years, 3 Years, 4 Years; SI 10,000 to 5,00,000
OPD
—
Optional Out-Patient (OPD) Benefit, Sum Insured 2,500 to 50,000
Insurer
Health incurred claim ratio (insurer)
71.5%
83.78%
Claims figures for
FY 2024-25: health incurred claim ratio including personal accident, IRDAI Annual Report (Statement 10)
FY 2024-25: health incurred claim ratio including personal accident, IRDAI Annual Report (Statement 10)
Network hospitals (insurer)
—
9000+
IRDAI UIN
ADIHLIP27048V022627
GODHLIP27048V052627