My dear honorable members of NOIP
Sir,
I have received MediClaim policy for the current year 25-26 and observed the following changes over last year.
1. Pre - and post hospitalization expenses, in case of Renal Failure and/or Organ Transplantation and/or Cancer related ailment/treatment, the condition of 30/60 days was waived in policy year 23-24. Last year (24-25), it was waived only for post hospitalization expenses 60 days (pre hospitalization up to 30 was not waived). But this year, they have waived both pre - and post 30/60 days. (Please see A CONDITIONS item⁷ no 7) So it's a great relief.
2. LIC has accepted our suggestion no. 5 to ED PERSONNEL on 22.1.2025, and deleted the entire section of A CONDITIONS item no7, "However the following expenses are NOT payable" from master policy condition. Now, it will be decided as per the Annexture II only (as suggested by us).
3. The increase in limits of delivery expenses (norm delivery 1lac and Caesarian delivery 1.5lac. There's a change in condition that medical expenses due to any complication developed during the gestation period shall be paid separately as per the terms and conditions of the policy (E MATERNITY Benefits).
4. There is some favorable change in DENTAL TREATMENT. PLEASE SEE F. EXCLUSIONS v. All types of dental treatments except arising out of an accident. However, in case of hospitalization for treatment of any infection in mouth where extraction of tooth/teeth is/are unavoidable and necessary as per surgical guidelines during treatment for infection; medical expenses shall be payable, provided routine Dental procedures like Rootcanal treatment, orthodontics, Brous/Aligners, Dental implants etc which are carried out on OPD BASIS shall not be covered under policy even if any of the above routine procedure is done during hospitalization.
5. New section under G DEFINITIONS 19 h is added - person engaged under Board approve policy on Fixed Term Engagements on contractual basis and their eligible Family Members.
6. DEPEND MEANS : Financial depends on employee/retired employee and their income, not more than Rs13950/-.
7. Inserted clause h under H CONDITIONS: Claimant has to submit any photo identity proof issued by Central/State government while claiming medical expenses.
8. ANNEXTURE II LIST OF NON MEDICAL items are increased from 198 to 205.
9. Physiotherapy limit increased from 40,000 to 50000.
10. Added Color doppler report charges Rs.3500, in CONDITION C
I request you all to go through the policy conditions, and in case of any doubt, please don't hesitate to contact me.
Thanks and regards,
V.K.DUTTA,
Chairman, All India MediClaim Assistance Committee.
NOIP (BMS)
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