All About National Critical Illness Policy

National Critical Illness Policy is a unique benefit policy that covers expenses in case the policyholder is affected with any of the listed critical illnesses. The policy pays out a fixed lump sum amount to the insured if he or she is diagnosed with a specified illness or undergoes a specified procedure or treatment. Once this lump sum is paid out, the insurance coverage for the disease ceases and the policy lapses.

About National Insurance Company

Founded in Kolkata, National Insurance Company Limited is India’s oldest non-life insurance company. The insurer has offices across the country and a foreign office in Nepal. It has set up about 1,730 offices and constitutes a workforce of over 13,000 employees and more than 50,000 agents. National Insurance offers a range of services to its clients, with about 300 insurance products. These products can be classified into Personal Line of Insurance, Motor Vehicle Insurance, Rural Insurance and Industrial & Commercial Insurance. (Note - All the information in this article has been sourced from the official website of National Insurance.)

Features of National Critical Illness Policy

National critical illness policy is available under two plans:

Plan A – Covers 11 critical illnesses

Plan B – Covers 37 critical illnesses (including Plan A)

  • Every member of the family member has to opt for the same plan
  • Sum insured range – Rs.1,00,000 to 75,00,000
  • Entry Age – 18 to 65 years
  • Cover can be taken for self, spouse, dependent children and parents
  • Provision to cover pre-existing conditions (on payment of additional premium)
  • Life-long renewability
  • Portability allowed from/to similar products
  • Pre policy check-up is required for i) proposers who are 45 years and above or ii) opting for sum insured of Rs. 25 lakhs and above, irrespective of the age of the individual and iii) non-earning spouse, opting for sum insured higher than Rs. 5 lakhs

List of Tests/Reports:

  • Physical examination
  • Blood sugar (fasting/ post prandial), HbA1c in some policies
  • ECG
  • Eye check-up (including retinoscopy)
  • Lipid profile
  • Serum creatinine
  • Urine routine and microscopic examination
  • Any other test required by the insurer and considered necessary

Benefits of National Critical Illness Policy

The Benefits of National Critical Illness Policy are as follows:

  • The policy covers up to 37 critical illnesses
  • Sum insured ranges from Rs. 1 lakh to Rs. 75 lakhs.
  • An individual can take this policy for family members as well
  • It is renewable life-long
  • Sum insured is paid in full on the first diagnosis of a covered critical ailment.
  • Tax benefits can be claimed under Section 80D of the Income Tax Act, 1961

What is Covered in National Critical Illness Policy?

Critical Illness Covered Under The Policy Are Follows:

  1. Cancer of Specified Severity
  2. Myocardial Infarction (First Heart Attack of Specified Severity)
  3. Open Chest Coronary Artery Bypass Graft Surgery (CABG)
  4. Open Heart Replacement or Repair of Heart Valves
  5. Coma of Specified Severity
  6. Kidney Failure requiring Regular Dialysis
  7. Stroke Resulting in Permanent Symptoms
  8. Major Organ/Bone Marrow Transplant
  9. Permanent Paralysis of Limbs
  10. Motor Neurone Disease with Permanent Symptoms
  11. Multiple Sclerosis with Persisting Symptoms
  12. End Stage Liver Failure
  13. Third Degree Burns
  14. Goodpasture’s Syndrome
  15. Apallic Syndrome
  16. Aplastic Anaemia
  17. Systemic Lupus Erythematosus with Lupus Nephritis
  18. Bacterial Meningitis
  19. Multiple System Atrophy
  20. Progressive Scleroderma
  21. Aorta Graft Surgery
  22. Pneumonectomy
  23. Primary (Idiopathic) Pulmonary Hypertension
  24. Primary Parkinson’s Disease
  25. Alzheimer’s Disease
  26. Benign Brain Tumour
  27. Cardiomyopathy
  28. End Stage Lung Failure
  29. Brain Surgery
  30. Progressive Supranuclear Palsy
  31. Creutzfeldt-Jakob Disease (CJD)
  32. Major Head Trauma
  33. Encephalitis
  34. Blindness
  35. Deafness
  36. Loss of Speech
  37. Loss of Limbs

What is Not Covered in National Critical Illness Policy?

  • Pre-existing critical illness

Any critical illness resulting out of the following:

  • Congenital, genetic disorders, sterility, infertility and assisted conception
  • Pregnancy
  • Non-prescribed drug & drug addiction
  • Self-inflicted injury
  • AIDS, HIV
  • Cosmetic treatment, plastic surgery, sex change, hormone replacement therapy

Discounts for National Critical Illness Policy

  • Early Entry Discount - If an individual has availed National Critical Illness Policy before the age 42 (completed years) and renewed the cover for a continuous period of 3 years, a discount of 5% on individual premium shall be allowed. This will begin from the fourth policy period and continue in subsequent renewals during the policy’s life-time.
  • Family Discount - A 10% discount is allowed in the premium for eligible family members if the policy is taken for family.
  • Staff Discount - A 15% discount shall be allowed on the total premium for policies availed by the employees of National Insurance Company to cover themselves and their family members.
  • Online, Direct and POS Machine Discount - A 10% discount is allowed on the total premium for policies purchased i) online, ii) by walk in customers (direct sales) and iii) from Point of Sale (POS) Machines.

Eligibility Criteria To Apply National Critical Illness Policy

  • Proposer has to be between 18 years and 65 years.
  • Maximum entry age of any family member is 65 years.
  • Children between the 5 years and 18 years of age are eligible, provided parent(s) is/are covered concurrently.
  • Policy can be taken for self and family members - spouse, dependent legitimate or legally adopted children, up to 25 years of age and parents.
  • Midterm inclusion of family members at pro-rata premium is permitted only for spouse, within 60 days of marriage.
  • Dependent children can port to similar health insurance policy of the company or any other insurer following completion of the specified exit age as mentioned.

Tax Benefits in National Critical Illness Policy

Premiums paid toward a critical illness insurance policy is tax deductible under Section 80D of the Income Tax Act, 1961. One can claim a tax deduction of Rs. 25,000 for insurance availed for self, spouse and dependent children. An additional deduction of Rs 25,000 can be claimed if the policy is taken for parents, who are less than 60 years of age. If the parents are over 60 years, this deduction can go up to Rs. 50,000. If the taxpayer and his or her parents are all above 60 years, the maximum deduction available under Section 80D of the Income Tax Act is Rs. 1,00,000.

List of National Insurance Health Insurance Plans

  • Overseas Mediclaim Business and Holiday - This is a package policy which covers travel emergencies when one is travelling abroad. It is available for three categories of travellers - Business & Holiday, Employment & Study and Corporate Frequent Traveller.
  • National Parivar Mediclaim - This 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.
  • National Parivar Mediclaim Plus - This covers the family, including self, spouse, children and parents/parents-in-law under one sum insured. The policy offers coverage as high as Rs. 50 lakhs, with a number of innovative features. National Parivar Mediclaim Pluspolicy can be renewed life-long.
  • Overseas Mediclaim Employment and Studies - This is a package policy which covers travel emergencies when one is travelling abroad. The plan is available for three categories of travellers- 1) Business & Holiday, 2) Employment and Study and 3) Corporate Frequent Traveller
  • National Critical Illness Policy - This covers expenses in the event the insured person is affected with any of the listed critical illnesses. The policy is available under two Plans A (covers 11 critical illnesses) and B (covering 37 critical illnesses).
  • National Mediclaim Plus Policy - This is a comprehensive policy that covers expenses of hospitalisation- pre & post, and day care treatment. Expenses of Ayurvedic, Allopathic and Homeopathic treatment are payable up to the sum insured. Maternity expenses as well as expenses for medical emergency reunion, air ambulance and hospital cash are also covered.
  • Parivar Mediclaim - This provides protection for families against the financial burden of treatment in hospitals for illness, disease or accidental injury. It is a floater policy, where the whole family, comprising of self, spouse and two dependent children are covered under a single sum insured.
  • National Mediclaim Policy - This covers the hospitalization expenses reasonably and necessarily incurred for treating illness, disease or injury contracted/sustained by the policyholder persons during the policy term. It also covers 140 plus day care procedures and surgeries.

Documents Required to Buy National Critical Illness Policy

An individual will have to submit certain documents to avail National Critical Illness Policy. The documents include:

  • Identity Proof - PAN card, Aadhaar card, Passport, etc.
  • Address Proof - Aadhaar card, Passport, Driving license, etc.

    Easy Procedure to Renew National Critical Illness Policy

    National Critical Illness Policy comes with life-long renewability feature. Individuals can renew their cover on the website of the insurance company or by visiting one of the company’s branches. Under the online mode, an individual will need to enter his or her policy number on the insurance company's portal and then proceed to make the payment.

    What is Claim Procedure for National Critical Illness Policy?

    The insured will have to inform the policy-issuing office in writing about the occurrence of a critical illness within 15 days of diagnosis or undergoing the procedure. The notification must contain full particulars, such as policy number, policy term, name of the insured person suffering critical illness, date of diagnosis or undergoing procedure and the name of the critical illness suffered. The underwriting office will provide a claim form, which needs to be filled, signed and submitted to the underwriting office along with the required documents.

    Documents Required to Claim National Critical Illness Policy

    To support the insurance claim, an insured will be required to support the following documents:
  • Medical practitioner’s certificate that confirms the diagnosis of the critical illness
  • Original discharge summary, if any
  • Pathological/radiological/other diagnostic test reports that confirm the diagnosis of the critical illness.
  • Any other documents required by the company in support of the claim.

Conclusion & Reviews

Conclusion

With the cost of medical treatment, particularly those related to major illnesses or health conditions, going up, a plain-vanilla health policy may not be enough. Additionally, when one has to take time off work, the entire family can get affected on account of loss of income. To lift this financial burden, it is advisable to avail a critical illness insurance plan. National Critical Illness Policy is a unique benefit plan that is popular among the masses. It pays out a fixed lump sum amount to the insured if he or she is diagnosed with a specified illness or undergoes a specified procedure or treatment.

Reviews of National Critical Illness Policy

“This plan is value for money. I have taken this for myself and my wife. Also, it covers almost all the major illnesses.”- Dhruv Sehgal, Ahmedabad

“I bought National Critical Illness Policy few months back. I am very satisfied with the service the company has provided. I got this policy very quickly and I did not face any trouble.”- Madhuri Pawar, Pune

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