New India Assurance pays for LASIK only above 7.5 dioptres.
Most websites stop at “yes, if your power is high enough.” We went further and pulled New India’s actual policy wording, so you can check your own numbers instead of guessing. There are three gates your claim has to clear: your eye power, your waiting periods, and whether LASIK is admissible on your specific plan. Miss one, and a claim you expected to sail through gets rejected. Here’s exactly what to check, in the order to check it.
Key Takeaways
- Below 7.5 dioptres, it’s excluded. This is the regulator’s standard wording, so other insurers use it too.
- LASIK isn’t on the 226-procedure day-care list, so get pre-authorisation in writing.
- A refractive error you had before buying can count as pre-existing for up to 36 months.
- Your plan’s version matters. Find the UIN on your schedule before you call.
- Rejected? You can appeal to the Insurance Ombudsman within one year, free of charge.
What New India’s Policy Actually Says
We checked the New India Mediclaim Policy. The same refractive-error exclusion appears in the Floater, Premier and Sixty Plus wording. It comes from IRDAI’s standard exclusions, so other insurers use it too; our comparison of insurers that cover LASIK shows how they differ. Older policies can vary, so check your own schedule.
| Policy clause | What it means for LASIK |
|---|---|
| Excl15: no cover for correcting refractive error less than 7.5 dioptres | Below that power, no claim. It doesn’t say if that means sphere, cylinder or total |
| Pays only “reasonable, customary and medically necessary” expenses | The insurer can ask why glasses or contacts aren’t enough for you |
| Day care: under anaesthesia, under 24 hours, and would otherwise need a 24-hour stay | LASIK is normally outpatient, and outpatient treatment is excluded, so it may not fit. It isn’t among the 226 listed procedures |
| First 30 days: no illness claims | Doesn’t apply after 12 months of continuous cover |
| Pre-existing conditions: 36 months | An error diagnosed, or treatment advised, in the 36 months before you bought can count |
| Portability: earlier continuous cover reduces waiting periods | Moving to New India from another insurer? Ask for the credit |
| Moratorium: after 60 continuous months, no challenge for non-disclosure | It bars disclosure disputes, not the exclusions themselves |
Sources: New India Mediclaim Policy; IRDAI exclusion guidelines.
Reading the 7.5-dioptre rule
Your glasses prescription lists SPH (sphere) and CYL (cylinder), both in dioptres. Because the wording doesn’t say which counts, carry both numbers when you ask the insurer.
Does your plan’s version matter?
Yes. New India sells Mediclaim, Floater, Premier and Sixty Plus plans, and each has a UIN (a code on your schedule) that shows which wording applies. Waiting periods have changed between versions: the 2021 Sixty Plus wording we read used 48 months for pre-existing conditions, against 36 months in the 2025 Mediclaim wording.
Where other websites go wrong
- “LASIK is covered as day care.” The list names corneal operations and cataract surgery, not LASIK.
- “There’s a 1–2 year LASIK waiting period.” None is named in this policy. Check the 30-day and pre-existing rules instead.
- “Accident-related errors are always covered.” Excl15 has no such exception. Ask New India in writing.
Find Your Situation
Read across from the row that sounds like you.
| Your Situation | Likely Outcome | Do This First |
|---|---|---|
| Power below 7.5 D | ❌ Excluded | Plan for self-pay. See the LASIK cost in Delhi |
| 7.5 D or more, retail Mediclaim, well past 36 months | ⚠️ Possible, not guaranteed | Ask for written pre-authorisation |
| Switched to New India from another insurer | ⚠️ Earlier cover may shorten waits | Ask New India to credit your past policies |
| 7.5 D or more, policy under 36 months old, glasses before you bought | ⚠️ May be treated as pre-existing | Ask if your error counts as pre-existing |
| Power far above 7.5 D | ⚠️ Insurance isn’t the only question | Check LASIK suits your cornea: can minus 9 get LASIK |
| Policy under 30 days old | ❌ Not payable | Wait, unless you have 12+ months of continuous cover |
| Employer group policy from New India | ✅ Check the schedule | Ask HR if the LASIK special condition is on |
Source: New India Mediclaim and Group Mediclaim policies.
How a Claim Works, Step by Step
These are the timings written into the policy. Read across to see what to do and by when.
| When | What You Do | What the Policy Says |
|---|---|---|
| 48 hours before | Tell the TPA in writing | Notice of claim for planned admission |
| Before surgery | Ask for cashless pre-authorisation | Decision within 1 hour of the request |
| At discharge | Ask the hospital to request final authorisation | Decided within 3 hours |
| Within 15 days of discharge | Send originals: claim form, bills, discharge certificate, surgeon’s certificate, prescriptions | Late claims can still be considered for valid reasons |
| If the TPA asks for more | Reply within 7 days | Three reminders, 7 days apart; then the claim stands repudiated |
| After your last document | Wait for the decision | Settled or rejected within 30 days; delays earn 2% above bank-rate interest |
Sources: New India Mediclaim Policy; IRDAI Master Circular (2024).
Check Before You Book
- Get your refraction report showing the power in each eye. If you’re near the line, see what maximum eye power LASIK can treat.
- Call New India on 1800-209-1415 or your TPA with your UIN ready. Ask how 7.5 D is measured, whether LASIK is admissible on your plan, and whether your error counts as pre-existing.
- Ask your surgeon for a letter explaining why glasses or contacts don’t work for you. It answers the “medically necessary” question before it’s asked.
- Get the answer in writing, and for cashless cover confirm your centre is on the network list first.
Government staff should also read whether LASIK is covered under CGHS.
If Your Claim Is Rejected
- Get the reason in writing. The letter should name the clause.
- Complain to New India’s grievance officer in writing.
- Go to the Insurance Ombudsman if you’re unhappy or hear nothing within a month. File within one year of the insurer’s reply. It’s free, needs no lawyer, and covers claims up to ₹50 lakh.
- Attach your policy and rejection letter. For waiting-period or pre-existing rejections, add your past policies from the last 48 months.
You can’t use the Ombudsman if the same matter is already in court or a consumer forum.
Source: Insurance Ombudsman rules.
If It Isn’t Covered
Coverage doesn’t depend on the laser brand; the exclusion is about your power. If you’re still choosing a technology, see whether WaveLight Plus Innoveyes is covered before comparing prices. If you pay yourself, our LASIK payment plans explain how to spread the cost, and our laser vision correction options show what each procedure involves.
Bottom Line
New India may pay for LASIK if your power is 7.5 dioptres or more and your waiting periods are clear, but nothing in the retail policy promises it. Confirm in writing before you book, and treat any “yes, it’s covered” from a website as a starting point. This is general information, not insurance advice.
Want a second pair of eyes on your policy? Book a consultation with our team.
Frequently Asked Questions
Is LASIK covered under New India Mediclaim?
Not automatically. Below 7.5 dioptres it’s excluded, and above that the insurer decides.
What power do I need for a claim?
At least 7.5 dioptres, as Excl15 is worded. Ask how New India measures it.
Is the 7.5 rule New India’s own?
No. It’s IRDAI’s standard exclusion, in force since 1 October 2020, so other insurers use it too.
Is there a LASIK waiting period?
None specific in this policy. The first 30 days and the 36-month pre-existing rule can apply.
How is cataract different?
It has a 24-month wait and a limit of 20% of the sum insured, up to ₹50,000 (higher with an optional cover on larger sums).
Does the same apply to SMILE Pro?
The exclusion is about your power, but admissibility is the insurer’s call. See insurance for SMILE Pro.
