National Health Insurance

One of the oldest insurance companies in India, National Insurance provides health insurance plans that assist you during medical emergencies.

NIC is rated as AAA by CRISIL for its financial strength.

The company completely understands that investing in a health insurance plan is now a basic necessity and hence, every plan covers the in-patient hospitalisation, day care treatment and considers a plethora of other medical expenses. Hence, health insurance plan by National Insurance is unique, keeping in mind the health needs of the end consumer.

What is National Health Insurance?

National Health Insurance belongs to one of the oldest and most renowned insurance companies in India, National Insurance Company Limited (NICL). Headquartered in Kolkata and founded in 1906, it was nationalised in 1972. Fully owned by the Government of India, it specialises in a range of general insurance plans that are customised for the varied and unique needs of individuals, families, senior citizens, etc.

National Insurance Company also has an array of add-on riders like Critical Illness Rider, Accidental Death Benefit, etc. that policyholders can opt for over and above their insurance plan to enhance its effectiveness. Premium payments made towards a National Health Insurance plan attracts tax deduction as per Section 80D of the Income Tax Act, 1961.

What Are The Benefits Of National Health Insurance?

  • Customer Care – National Health Insurance is equipped with a professional team of skilled customer service executives who are adept with assisting and guiding customers with health insurance queries and services through email, online chat and Toll-free number, email and online chat.

  • Online availability - National Health Insurance offers policies that are customised for individuals, families and groups and the same can be bought online. Online Renewal – The insurance company offers the flexibility and convenience of online renewal of insurance policies, ensuring that the processes are fast and hassle-free.

  • Cashless Facility - A robust range of more than 6,000 authorised hospitals across India enables National Health Insurance to offer cashless facilities.

  • Pre-policy check-up – Medical check-ups before purchasing a policy from National Health Insurance is not mandatory with the exception of certain conditions - the policyholder is 40 years or above or is looking for a sum insured of at least Rs.6 lakhs or want to opt for a Critical Illness cover. What’s more, if the proposal for insurance is accepted, National Insurance reimburses 50% of the expenses to policyholders who have purchased a National Health Insurance policy.

  • Tax Benefits - All policies from National Health Insurance are eligible for tax exemptions on premium payments as per Section 80D of the Income Tax Act, 1961.

  • Claim Settlement Ratio - The incurred claim settlement ratio of National Health Insurance for F.Y. 2017 - 18 is 115.55%.

Some other benefits:

  • Hospital cash in cases of hospitalisation for more than 3 days, depending on the type of plan
  • Benefits extend to Homeopathic and Ayurvedic treatments as well
  • Includes a free-look period for a period of 15 days from the date of receipt of the National Health Insurance policy
  • Offers a grace period of 30 days from the date of premium payment or due date of the policy
  • You can switch to another insurance company, but the process has to be completed at least 45 days before the date of expiry of the National Health Insurance policy
  • Add-on riders are applicable for out-patient treatment, pre-existing diabetes, pre-existing hypertension and critical illnesses

National Health Insurance Plans

A health insurance plan provides financial aid at the time of medical emergencies. National Insurance company offers a varied range of health insurance plans to cover an individual and as well as his family. Each plan covers the cost of in-patient hospitalization, pre- and post- hospitalization, day care treatment and other medical expenses.

National Parivar Mediclaim

National Parivar Mediclaim Policy is a perfect family floater health plan offered by National Health Insurance. The plan provides option to cover the family members – you can cover yourself, spouse, dependent children (even your newborn) and parents under a single policy with one sum insured.

Salient Features of National Parivar Mediclaim:

Sum Insured (SI) / Coverage optionRs.1 lakh to Rs.10 lakh (in multiples of Rs.1 lakh)
RenewabilityLifelong
Policy TenureMinimum – 1 year and Maximum – 3 years
Free Health Check-upsAfter every 4 No Claim years up to Rs.5,000
Capping on any one illness No capping
Pre-existing Diabetes and HypertensionCovered up to the full Sum Insured
Other Benefits
  • Infertility Treatment Cover: Up to Rs.50,000
  • Hospital Cash (per insured person, per day): Rs.300 for maximum 5 days
  • Ambulance Expenses: Rs.1,000 per insured person, per illness subject to maximum of Rs.2,500 in a policy year
  • (Optional) Critical Illness Benefit Amount: Rs.2/3/5/10 lakh in addition to Sum Insured
  • The plan offers a maternity cover that offers coverage to newborn babies with the 10% of sum insured subject to maximum of Rs.30,000 in case of a normal delivery and Rs.50,000 in case of caesarean section.

    You can also opt for an additional cover by paying an extra premium. With every claim-free year, there’s a 5% discount on the base premium of the policy. All the premiums paid towards the health plan are tax exempted as per the Section 80D of Income Tax Act.

    National Parivar Mediclaim Plus

    National Parivar Mediclaim Policy Plus is a comprehensive family floater health plan offered by National Health Insurance Company.

    There are 3 variants under the plan. The plan can be used to cover the family members – you can cover yourself, spouse, dependent children (even newborn), parents/parents-in-laws under a single policy with one sum insured.

    National Parivar Mediclaim Policy Plus is a unique product with the help of which you can opt for a coverage as high as Rs.50 Lakh.

    National Parivar Mediclaim Plus has 3 variants: Plan A, Plan B, and Plan C. Each Plan varies in terms of coverage.

    Salient Features of National Parivar Mediclaim Plus:

    Plan APlan BPlan C
    Sum Insured (SI) / Coverage optionRs.6/7/8/9/10 lakh Rs.15/20/25 lakhRs.30/40/50 lakh
    RenewabilityLifelongLifelongLifelong
    Policy TenureMinimum – 1 year and Maximum – 3 yearsMinimum – 1 year and Maximum – 3 yearsMinimum – 1 year and Maximum – 3 years
    Capping on any one illness No cappingNo cappingNo capping
    Other BenefitsMaternity (New Born Cover): Normal Delivery - Up to Rs.30,000 Caesarean Section – Up to Rs.50,000 Infertility Treatment Cover: Up to Rs.50,000 Hospital Cash (per insured person, per day): Rs.500 for maximum 5 days. Ambulance Expenses: (per insured person, in a policy year) Up to Rs.2,500. No Air Ambulance facility. Maternity (New Born Cover): Normal Delivery - Actual Caesarean Section – Actual Infertility Treatment Cover: Up to Rs.1,00,000 Hospital Cash (per insured person, per day): Rs.1,000 for maximum 5 days. Ambulance Expenses: (per insured person, in a policy year) Up to Rs.4,000. Air Ambulance facility up to 5% of SI. Maternity (New Born Cover): Normal Delivery - Actual Caesarean Section – Actual Infertility Treatment Cover: Up to Rs.1,00,000 Hospital Cash (per insured person, per day): Rs.2,000 for maximum 5 days. Ambulance Expenses: (per insured person, in a policy year) Up to Rs.5,000. Air Ambulance facility up to 5% of SI.

    Offers Good Health Incentives in every 2 years irrespective of claims. You can also opt for an additional cover by paying an extra premium. With every claim-free year, there’s a 5% discount on the base premium of the policy. All the premium paid towards the health plan are tax exempted as per the Section 80D of Income Tax Act.

    National Mediclaim Plus Policy

    National Mediclaim Plus Policy is a comprehensive coverage plan that helps with medical expenses. The coverage offers more than the traditional health plans.

    The plan covers the expenses of pre- and post- hospitalisation, in-patient hospitalization, and day care treatment. The medical expenses of Allopathic, Ayurvedic and Homeopathic treatment are payable up to the sum insured.

    Moreover, National Medical Plus covers expenses of maternity, for new born and vaccination for children, for medical emergency reunion, air ambulance and provides hospital cash. All the variants of National Mediclaim Plus provides the option of having a second opinion from World Leading Medical Centres, if the insured is diagnosed with a serious illness.

    Salient Features of National Mediclaim Plus :

    FeaturesPlan APlan BPlan C
    Sum insured (SI)Rs.2/ 3 /4 / 5/ 6/ 7/ 8/ 9 /10 LakhRs.15/ 20 /25 LakhRs.30/ 40/ 50 Lakh
    Coverage
    Room/ ICU charges (per day)Room - Up to 1% of SI ICU – Up to 2% of SI subject to max. of Rs.15,000 Up to Rs.15,000Up to Rs.20,000
    Limit for cataract surgery (for each eye)Up to 15% of sum insured or Rs.60,000 whichever is lowerUp to Rs.80,000Up to Rs.1,00,000
    MaternityUp to Rs.30,000 for normal delivery and Rs.50,000 for caesarean sectionUp to Rs.60,000 for normal delivery and Rs.75,000 for caesarean sectionUp to Rs.80,000 for normal delivery and Rs.1,00,000 for caesarean section
    Hospital cash per day (max. of 5 days)Rs.500Rs.800Rs.1,000
    Ambulance (in a policy period)Up to Rs.2,500Up to Rs.4,000Up to Rs.5,000
    Air ambulance (in a policy period)Not coveredUp to 5% of SIUp to 5% of SI
    Other benefits
    Medical Second Opinion (MSO) for each new diagnosis of any of the major illnesses, in a policy periodOne MSOOne MSOOne MSO
    Good Health Incentives
    Cumulative bonusIncrease in SI by 5% of SI per year up to 50% of SIIncrease in SI by 5% of SI per year up to 50% of SIIncrease in SI by 5% of SI per year up to 50% of SI
    Health checkup (every 2 years irrespective of claims)Up to Rs.1,000Up to Rs.2,000Up to Rs.3,000
    Copayment
    Copayment of 20% of admissible claim if treatment undergone in non-network providerApplicableApplicableApplicable
    Optional covers
    Critical IllnessRs.2,00,000/ 3,00,000/ 5,00,000/ 10,00,000/ 15,00,000/ 20,00,000/ 25,00,000
    Outpatient TreatmentRs.2,000/ 3,000/ 4,000/ 5,000/ 10,000Rs.2,000/ 3,000/ 4,000/ 5,000/ 10,000Rs.2,000/ 3,000/ 4,000/ 5,000/ 10,000

    A complete health care package and with different variant options to choose from, one must consider National Mediclaim Plus to cover their family.

    Parivar Mediclaim

    National Insurance offers Parivar Mediclaim policy that provides protection to the insured and family against the financial burden of medical expenses. It covers the expenses of treatment in hospitals for illness/ disease/ accidental injury. It is a family floater plan wherein the entire family consisting of self, spouse & two dependent children (from 3 months to 25 years old) are covered under a single policy with a floater sum insured.

    Sum Insured (SI) / Coverage optionRs.2 lakh to Rs.5 lakh (in multiples of Rs.50,000)
    RenewabilityUp to the age of 65 years

    You can avail cashless claim facility through TPA. Total expenses payable for any one illness is restricted to 50% of the sum insured. All the premiums paid towards the policy covering self, spouse, dependent children and dependent parents are exempt from Income Tax under Sec. 80D of the Income Tax Act.

    National Mediclaim Policy

    The National Mediclaim policy covers hospitalization expenses incurred for due to the treatment of illness, disease or any bodily injury during the policy period. It also covers 140+ day care procedures/ surgeries. This is a family plan and dependent children between the ages of 3 months to 18 years can be covered.

    Sum Insured (SI) / Coverage optionRs.50,000 to Rs.5 lakh (in multiples of Rs.25,000)
    RenewabilityLifelong
    Policy TenureMinimum – 1 year and Maximum – 3 years
    Free Health Check-upsAfter every 4 No Claim years up to 1% of average SI of the block
    Other BenefitsCumulative Bonus: @5% of sum insured for each claim free year provided renewal is done without break. Ambulance Expenses: (per insured person, in a policy year) 1% of SI, subjected to the maximum of Rs.2,000.

    All the premiums paid towards the policy covering self, spouse, dependent children and dependent parents are exempt from Income Tax under Sec. 80D of the Income Tax Act.

    Claim Process of National Health Insurance

    Claim Process:

    • The first and foremost step is to inform and lodge a claim by contacting National Insurance on their Toll Free number - 1800 200 7710
    • Keep all your documents and details ready:
      • Always carry and use National Insurance Health Card
      • Provide your Identification details: Name of the insured, contact details, policy number, Passport/voter’s Id/PAN card at the time of claim

    Here’s the step-by-step process to lodge a claim. Understand Do’s and Don’ts’ to ensure your claim gets approved.

    Note:

    For any claim to be processed and approved you need to lodge a claim by intimating the company. It is advisable for speedy claim support contact directly instead of an email.

    Cashless Claim Process

    It gets you covered with the medical expenses of any treatment for sickness, illness or accident provided the treatment is carried out at the listed National Insurance Network Hospital.

    On approval of the claim the medical bills are directly paid by the National Insurance to the hospital.

    Important documents and details to be provided at the time of claim:

    • Policy Number, Policyholder’s/ Insured’s Name
    • Contact Details of the Claimant/ Policyholder
    • Name of the Insured/ Claimant
    • Hospital Details
    • Nature of Ailment/Details of the Accident (Commencement date of the symptoms & related details)

    Reimbursement Claim Process

    The policyholder needs to pay all the medical cost first and later National Insurance will reimburse the same. All the medical expenses bill are required to be submitted to get the reimbursement.

    In case of a reimbursement process, it is not mandatory to get treated in the National Insurance Authorized Hospital. The treatment can be carried out in any registered hospital.

    Important documents and details to be provided to get reimbursement:

    • Claim Form duly signed by the Insured
    • Photocopy of ID Card
    • Photocopy of policy certificate
    • Original discharge card/summary, Original hospital bills
    • For consolidated amounts, a detailed breakup of the amount
    • All investigation reports and bills in original supported by a note from the attending doctor/surgeon recommending such investigations
    • Surgeon’s certificate stating nature of surgery performed, bill and paid receipt
    • Attending doctors/consultants/specialists/anesthetists bill, receipt and certificate

    National Health Insurance Mediclaim Premium Calculator

    The online premium calculator feature, accessible in the insurance company’s official website, enables individuals to get an instant quote for the selected National Health Insurance policy, free of charges. After accessing the premium calculated, you have to choose a National Health Insurance policy from the available options from the dropdown menu, enter the required personal information like date of birth, city, contact number, email ID, etc., mention the sum insured, and select the 'Calculate Premium' option. You can then view the premium amount, including the applicable taxes, on your screen.

    How to Buy and Renew Mediclaim Policy of National Insurance?

    To buy a National Health Insurance plan, you can visit any branch of National Insurance Company for the proposal form, fill up the required details and then submit the form. In certain case, the insurance company analyses if any risk factor is involved as per the report of your existing health condition. This will determine the premium that you will be eligible for. The policy documents will then be handed over to you directly or you will receive it via registered post.

    To renew your National Health Insurance Health policy, you can login to the company’s official website, mention your policy number and email ID, and select the 'Proceed' option. Next, type in the required details of the policy, your contact details, and confirm the accuracy of the details provided by you. You will be able to view the renewal premium, along with the renewal notice, on your screen.

    Cancellation Procedure for National Health Insurance Policy

    In case a policyholder is not agreeable to certain terms and conditions in his/her National Health Insurance during the free-look period of 15 days from the date of receipt of the policy, he/she can return it to the insurance company.

    The premium already paid will be refunded after certain deductions such as stamp duty and other applicable charges. If a policyholder wants to cancel a policy after the free-look period, he/she can submit the relevant surrender form and the necessary policy documents at any National Insurance Company branch office to initiate the cancellation procedure for your National Health Insurance policy.

    What is Covered in National Health Insurance Policy?

    • Charges incurred for treatment like doctor consultation fees, surgeon's fees, charges for anaesthetist and specialist doctors up to a maximum of 25% of sum insured

    • Hospital room rent of 1% of the pre-determined sum insured, provided it is not more than Rs. 5,000 per day

    • Reimbursement for Intensive Care Unit room rent of up to 2% of sum insured, till a maximum of Rs. 10,000 per day

    • Expenditures towards medicines, operation, nursing, operation theatre expenses, blood, oxygen, etc. is payable by the insurance company

    • Specialised medical treatments like radio therapy, chemotherapy, organ transplant, etc. are payable up to a certain percentage of sum insured

    What is Not Covered in National Health Insurance Policy?

    • Hospitalisation charges incurred solely due to diagnostic purposes

    • Pre-existing diseases are excluded, even after the policyholder has renewed the National Health Insurance policy several times

    • Medical and/or hospitalisation due to intentional self-injury, overuse of drugs or alcohol, congenital external disease, venereal diseases, sterility, etc.

    • Diseases like HIV AIDS is excluded from this policy

    • Treatments such as dental treatment, etc.

    • Expenditures for maternity-related needs and childbirth treatments

    Review of National Health Insurance

    National Insurance, is the oldest insurance company in India. One of the insurance company owned by Indian Government that was founded before Independence. And is planning to go public. Health Insurance policies by National Insurance provides a comprehensive coverage to protect yourself and your family in case of any medical emergencies. You can widen the scope of health insurance policy and also for cover critical illness by paying additional premium. National Insurance is a sure shot consideration for all family health insurance needs.

    Contact Details of National Health Insurance

    National Insurance Company Ltd.

    3, Middleton Street, P.B. No. 9229, KOLKATA 700 071.

    Contact number: 1800 200 7710

    Phone number: 033-22831705

    Fax: 033-22831712

    Frequently Asked Questions

    How can you check the status of your Mediclaim policy from National Health Insurance?

    All you need to do to check the status of your Mediclaim policy is to visit the official website of National Health Insurance, login with valid credentials and then type the policy number. The status of your policy will be displayed on the screen.

    What is the renewal process for National Health Insurance plan?

    You can renew your National Health Insurance plan through these simple steps:

    • Go to the official website of National Health Insurance

    • Mention your policy number and email ID and then select the ‘Proceed’ option

    • Enter the required information regarding your policy and contact details

    • Confirm that the details entered by you are accurate

    • The premium amount to be paid to renew the National Health Insurance plan and the renewal notice will be displayed on the screen

    How National Health Insurance policy covers whole family?

    The National Health Insurance policy covers the whole family till a maximum of the sum assured opted by the policyholder, as per the policy document.

    Do National Health Insurance policies cover Homeopathy and Naturopathy?

    Yes, Homeopathy and Naturopathy are covered under the National Health Insurance policy, provided the treatments are undertaken at a government hospital, or any health centre recognised by the government. Such treatments undertaken at health centres that are accredited by the National Accreditation Board of Health or Council of India can also avail the benefits offered by National Health Insurance policies.

    How does National Health Insurance function?

    Any individual between the ages of 18 and 70 years are eligible to applying for an individual National Health Insurance policy. Apart from individual policies, there are Family Floater plans that are especially designed to cover the policyholder and his/her family, which includes children, spouse and dependent parents. Pre-policy medical tests are not mandatory for National Insurance Mediclaim policies. However, a waiting period is applicable for policyholders with a history of pre-existing diseases.

    An extensive range of network hospitals across India enable them to offer the benefit of cashless treatments to their policyholders. The co-payment benefit is extended only to policyholders of at least 60 years of age and above. Further, maternity expenditures are covered post the waiting period and up to the first two children.

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