Rules, Rights & Rites -114
I usually post all important items related to official rulings, union news, and other general matters on my YouTube channels: Yourskayveeyes (English) and Anbudan Kayveeyes (Tamil).
However, due to the recent spate of orders and the high volume of information being received, I have not been able to convert every item into a video. Therefore, I am introducing these new slots to post current matters and updates that have not yet been published on YouTube. This ensures you stay informed on every detail, even if a video hasn't been made yet …………….Kayveeyes
Paripoorna Mediclaim Ayush Bima
• The Paripoorna Mediclaim Ayush Bima is a specialized health insurance product launched by The New India Assurance Company Limited (NIACL) on January 14, 2026. It is designed specifically for Central Government Health Scheme (CGHS) beneficiaries to complement their existing benefits.
• The policy is exclusively available to serving and retired CGHS members. A CGHS card is mandatory for retirees.
• Up to six members can be covered under a single policy, including the primary member, spouse, children, parents, and parents-in-law.
• Beneficiaries can choose a sum insured of either ₹10 Lakh or ₹20 Lakh.
• Policyholders must choose between two cost-sharing models:
o 70:30 model: The insurance company pays 70% of the admissible claim, and the policyholder pays 30%.
o 50:50 model: Both the insurance company and the policyholder share the claim amount equally at 50% each.
• Due to the co-sharing models, the policy is offered at a discount compared to regular NIACL policies—28% discount for the 70:30 model and 42% discount for the 50:50 model. No GST is charged on the premium to ensure affordability.
• Covers indemnity-based hospitalization within India.
• Provides 100% coverage of the sum insured for treatments under Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy.
• Includes medical expenses for 30 days before admission and 60 days after discharge.
• Room rent and boarding are capped at 1% of the sum insured per day, while ICU/ICCU charges are capped at 2% per day.
• Covered up to 0.5% of the sum insured per event for emergency or inter-hospital shifts.
• Specific sub-limits apply per eye: up to ₹1,00,000 for a ₹10 Lakh sum insured and up to ₹1,50,000 for a ₹20 Lakh sum insured.
• Procedures like robotic surgeries, oral chemotherapy, and immunotherapy are covered up to 25% of the sum insured.
• A 10% increase in the sum insured is granted for every claim-free year, up to a maximum of 100%.
• There is a 24-month waiting period for any pre-existing diseases declared at the time of application.
• 30 days: Initial waiting period from policy inception (not applicable to accidents).
• 24 months: Waiting period for specific conditions like cataracts (requires one renewal), congenital internal diseases, and mental illness treatments.
• New Born/Newly Wed: Coverage begins from the date of enrollment, provided they are also enrolled under CGHS. However, a 24-month waiting period applies for Congenital External Anomalies in newborns.
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