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HEALTH INSURANCE

All About National Health Insurance Company

Jagrity Sharma Jagrity Sharma 03 May 2019

Health insurance has become more of a necessity than a luxury. And what better than trusting National Health Insurance, one of the experts in this field? Read on to know more about their plans.

National Health Insurance Company

If you’ve bought a health insurance plan for yourself and your family, great! If not, it’s never too late. You can always compare and buy the best health insurance to ensure that you’re financially prepared in case of any medical contingency. And one company that you can absolutely trust when it comes to your health is National Insurance.

Headquartered in Kolkata, National Insurance is a state owned general insurance company that was established in the year 1906, and nationalised in 1972. With its well-earned reputation, the company has been standing tall for many decades and hence, offers some of the best comprehensive national health insurance plans in the country. Let’s take a sneak peek into the health plans offered by National Insurance.

(Note: All information has been sourced from the official website of National Insurance)

National Parivar Mediclaim

The National Parivar Mediclaim Policy is a floater policy which covers the family including self, spouse, dependent children and parents under one sum insured.

The Policy can be renewed life-long.

The basic features include:

  • Hospitalisation expenses are covered.

  • Treatment under Allopathy, Ayurveda and Homeopathy are covered up to full sum insured.

  • Pre (30 days) and Post (60 days) Hospitalisation covered.

  • 140+ Daycare treatments covered.

  • Domiciliary treatment Up to 20% of SI, subject to maximum of INR 50,000

  • Organ Donor’s expenses including pre and post hospitalisation covered.

  • Hospital Cash Benefit as per limits specified in the policy

  • Add on covers such as Critical Illness and Out-patient Treatment

The plan’s other benefits include

  • Pre-existing Diabetes & Hypertension can be covered on payment of additional premium - Up to the full Sum Insured

  • Critical Illness Benefit amount – INR 2,00,000/ 3,00,000/5,00,000/10,00,000 in addition to the Sum Insured

  • Out-patient treatment Limit of cover per family- INR 2,000/ 3,000/4,000/ 5,000/ 10,000 in addition to the Sum Insured

  • Good Health Incentives Health check-up Benefit after every 4 claim free years up to INR 5,000

Discounts offered by National Parivar Mediclaim are as follows-

  • No claim discount -@ 5% discount on base premium for each claim free year

  • Online discount- @5% for new policies, @2.5% for National Health Insurance Renewal Policies

  • Long term discount - @4% for a two years’ term policy & @7.5% for a three years’ term policy

  • Discount in lieu of Maternity/ Infertility cover after 45 years of age- @3% on the base premium for self and spouse

  • Zonal discount - @4.4% for opting for Zone –II / @11.11% for opting for Zone- III / @20% for option for Zone-IV

This health plan also provides Income Tax Benefit under Section 80D of Income Tax Act, 1961

National Parivar Mediclaim Policy Plus

The National Parivar Mediclaim Plus Policy covers the family including self, spouse, children and parents/parents-in-laws under one floater sum insured. This is a unique product which offers coverage as high as Rs. 50 Lakh, with many innovative features. The Policy can be renewed for life-long.

The basic features include-

  • Hospitalisation expenses are covered.

  • Treatment under Allopathy, Ayurveda and Homeopathy are covered upto full sum insured.

  • Pre (30 days) and Post (60 days) Hospitalisation covered.

  • 140+ Daycare treatments covered.

  • Domiciliary treatment:-

    • Plan A – Up to INR 1,00,000
    • Plan B – Up to INR 2,00,000
    • Plan C – Up to INR 2,00,000
  • Organ Donor’s expenses including pre and post hospitalisation covered

  • Maternity and New Born Cover (From birth)

The other features include

  • Optional cover (by paying additional premium)

  • Pre-existing Diabetes & Hypertension –

    • First year – up to 25% of SI
    • Second year – up to 50% of SI
    • Third year – up to 75% of SI
  • Critical Illness Benefit amount – INR 2,00,000/3,00,000/5,00,000/10,00,000/15,00,000/20,00,000/25,00,000 in addition to the Sum Insured

  • Out-patient treatment Limit of cover per family- INR 2,000/ 3,000/4,000/ 5,000/ 10,000/ 15,000/ 20,000/ 25,000 in addition to the Sum Insured

Good Health Incentives of the plan are

  • Plan A – Every 2 yrs., up to INR 5,000 irrespective of claims
  • Plan B – Every 2 yrs., up to INR 7,500 irrespective of claims
  • Plan C – Every 2 yrs., up to INR 10,000 irrespective of claims

Discounts offered by National Parivar Mediclaim are as follows

  • Online discount- @5% for new policies, @2.5% for renewal policies

  • Long term discount - @4% for a two years’ term policy & @7.5% for a three years’ term policy

  • Discount in lieu of Maternity/ Infertility cover after 45 years of age- @3% on the base premium for self and spouse

  • Zonal discount-

    • @4.4% for opting for Zone –II
    • @11.11% for opting for Zone- III
    • @20% for option for Zone-IV

The Plan also provides Income Tax Benefit under Section 80D of Income Tax Act, 1961 (except the Critical Illness cover)

National Critical Illness Policy

National Critical Illness Policy is a one of its kind critical illness insurance policy that covers expenses in the event the insured person is affected with any of the listed critical illnesses.

The Policy is available under two Plans (please see Table of Benefits for details)

  • Plan A – Covering 11 Critical Illnesses
  • Plan B – Covering 37 Critical Illnesses (including Plan A)

Following are some of the critical illnesses covered under this plan

Plan A (11 CIs)

  • Cancer of Specified Severity

  • Myocardial Infarction (First Heart Attack of Specified Severity)

  • Open Chest Coronary Artery Bypass Graft Surgery (CABG)

  • Open Heart Replacement or Repair of Heart Valves

  • Coma of Specified Severity

  • Kidney Failure requiring Regular Dialysis

  • Stroke Resulting in Permanent Symptoms

  • Major Organ/Bone Marrow Transplant

  • Permanent Paralysis of Limbs

  • Motor Neurone Disease with Permanent Symptoms

  • Multiple Sclerosis with Persisting Symptoms

Plan B (37 CIs including Plan A)

  • Cancer of Specified Severity

  • Myocardial Infarction (First Heart Attack of Specified Severity)

  • Open Chest Coronary Artery Bypass Graft Surgery (CABG)

  • Open Heart Replacement or Repair of Heart Valves

  • Coma of Specified Severity

  • Kidney Failure requiring Regular Dialysis

  • Stroke Resulting in Permanent Symptoms

  • Major Organ/Bone Marrow Transplant

  • Permanent Paralysis of Limbs

  • Motor Neurone Disease with Permanent Symptoms

  • Multiple Sclerosis with Persisting Symptoms

  • End Stage Liver Failure

  • Third Degree Burns

  • Goodpasture’s Syndrome

  • Apallic Syndrome

  • Aplastic Anaemia

and many more

The Discounts offered by the company for this plan are as follows

Early Entry Discount (EED)

If an insured person has entered the policy before the age 42 (completed years) and renewed the policy for a continuous period of 3 years, an EED of 5% on individual premium will be allowed starting from the fourth policy period and continue in subsequent renewals during the life time of the Policy.

Family Discount

Discount of 10% (ten percent) is allowed in the premium for eligible family members if policy is bought for family, comprising the insured and any one or more of the family members as mentioned below

i. Spouse ii. Dependent children iii. Dependent parents Staff Discount

Discount of 15% shall be allowed on the total premium for policies bought by the employees of National Insurance Company to cover themselves and their family members.

Online, Direct and POS Machine Discount

Discount of 10% shall be allowed on the total premium for policies bought online, by walk in customers (direct sales) and from Point of Sale (POS) Machines, where no intermediary is involved.

Following are certain aspects to be kept in mind while renewing this policy

Renewal of Policy

i. Policy can be renewed annually throughout the lifetime of the insured person. ii. The Policy may be renewed by mutual consent before the expiry of the Policy. iii. The Health Insurance Companies is not bound to send renewal notice. iv. Renewal of Policy can be denied on grounds of fraud, moral hazard or misrepresentation or non-cooperation. v. In the event of break in the Policy a grace period of thirty days is allowed. Coverage is not available during the grace period

National Mediclaim Plus Policy

National Mediclaim Plus Policy offers protection against high health care costs and makes health care and related services easy and accessible. The Policy provides for expenses related to hospitalisation and pre & post and day care treatment. Expenses of Allopathic, Ayurvedic and Homeopathic treatment are payable up to the sum insured. The Policy covers expenses of maternity, for new born and vaccination for children. Expenses for medical emergency reunion, air ambulance and hospital cash are also payable. In the event of being diagnosed with a serious illness, a medical second opinion from World Leading Medical Centres will be arranged. In addition, optional covers for Critical illness and Outpatient treatment can also be availed.

The Salient features and Eligibility of the plan is as follows

The Policy offers three plans with varying covers

  • Plan A of Rs. 2 lakh to Rs. 10 lakh in multiples of Rs. 1 lakh
  • Plan B of Rs. 15 lakh, Rs. 20 lakh and Rs. 25 lakh
  • Plan C of Rs. 30 lakh, Rs. 40 lakh and Rs. 50 lakhs

Eligibility

  • Self, spouse, dependent children and parents.

  • Entry age of proposer - 18 years to 65 years.

  • Children - 3 months to 18 years.

  • Entry age of members - 18 years to 65 years.

  • The policy can be renewed lifelong.

It is also vital to note the exclusions of the plan, which are as follows

  • Treatment of HIV, AIDS, STD, etc.

  • Convalescence, general debility, run-down condition, sterility, etc.

  • Treatment of obesity

  • Treatment of genetic disorders

  • Cosmetic treatment, plastic surgery, change of sex, hormone replacement

  • Naturopathy and experimental treatment

  • Drug/ alcohol abuse

  • Spectacles, contact lens, hearing aid, cochlear implants.

Parivar Mediclaim

Parivar Mediclaim policy provides protection to families against the financial burden of treatment in hospitals for illness/ disease/ accidental injury. It is a floater policy wherein the entire family consisting of self, spouse & two dependent children are covered under a single floater sum insured.

The key benefits of the plan are

The policy is available to persons between age of 18 and 60 years. Dependent children between the age of 3 months and 25 years can be covered. Sum insured range is between Rs. 2 Lakh and 5 lakh, in multiples of Rs. 50,000/-. Renewal is allowed up to the age of 65 years.

Certain exclusions of the plan are listed below

  • The most important exclusion relates to pre-existing illness. Pre-existing diseases can be covered after four (4) years of continuous coverage under a health policy. All diseases/ injuries and related conditions which are pre-existing at the time of inception of the policy, will be covered after four (4) continuous claim free policy years.

  • No claim other than accidental injuries, is payable within the first 30 days of the policy

  • The other exclusions for illustrative purposes are :-

  • Exclusion of certain named diseases up to first 2 years of the policy.

  • Congenital diseases, sterility, venereal disease, intentional self-injury, use of drugs, alcohol, rest cure etc.

  • AIDS and other HIV related treatment

  • Expenses incurred primarily for diagnostic, laboratory examinations not related to or consistent with the diagnosis for which insured is hospitalized. So also for vitamins and tonics unless forming a part of the main treatment.

  • Dental treatment other than necessitated by accidental injury and requires hospitalization.

  • Treatment arising from or traceable to pregnancy, childbirth (including caesarean).

  • All treatment other than allopathic stream of medicine.

  • War, invasion and nuclear perils.

In Conclusion

As a company, National Insurance offers health plans that cater to varied needs of each individual. Whether it is for yourself, your spouse, parents or children, National Insurance has health insurance for each member of the family. So the next time you look out for your family’s health, be wise and check out the plans by National Insurance. Stay Healthy, Stay Happy!

Recommended Link: Difference between National Insurance Parivar Mediclaim and Mediclaim Policy

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Jagrity Sharma
Written by Jagrity Sharma
A bibliophile who hates alliterations, but loves cream, comics and content immensely! On another note, a content marketer who leverages the power of words to explain...almost anything!
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