National Insurance Mediclaim Policy

About National Insurance Company

National Insurance Company Ltd. is the oldest and one of the leading general insurance companies in India. It was founded in December, 1906, with the objective to create a national identity for India in her fight for Swaraj. It joined hands with 21 international and 11 Indian companies to form National Insurance Company Ltd., after 66 years of its foundation. It is one of the four subsidiaries of the General Insurance Corporation of India, which is owned by the Indian Government.

NIC was the first insurance company in India to introduce products with each of them being customised to meet unique investment objectives of rural India and corporates - Farmers Package Policy to suit the agrarian customer and Techno Marketing Project Cells for corporates. Not just that, it is also the first to enter into collaborative initiatives with automobile manufacturers like Maruti and Hero Moto Corp., amongst many others. What’s more, NIC also launched Bancassurance in the country by joining hands with some of the leading banking institutions in India.

The policy provides the following benefits.

• Reimbursement of hospitalisation expenses which are reasonably and necessarily incurred under the following heads:
  • Room, boarding & nursing expenses up to 1% of the sum insured per day & 2% of sum insured per day for ICU, subject to an overall limit of 25% of the sum insured.
  • Expenses incurred for fees of surgeon, anaesthetist, medical practitioner, consultant and specialist subject to an overall limit of 25% of the sum insured
  • Expenses incurred on account of anaesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines and drugs, diagnostic material, X-ray, dialysis, chemotherapy, radiotherapy, cost of pacemaker, artificial limbs and cost of organs, hospitalisation expenses of organ donor and similar expenses, subject to an overall limit of 50% of the sum insured.
  • Ambulance charges up to 1% of the sum insured, subject to maximum of Rs. 2000/- in a policy period.
• Expenses for Ayurveda and Homeopathy treatment are admissible up to 20% of the sum insured for any one illness.
• Cover for 140+ day care procedures which require hospitalization for less than 24 hrs.
• Good health incentives: Cumulative bonus at 5% of sum insured for each claim free policy year provided the policy is renewed without break. Health check-up expenses will be reimbursed once at the end of a block of 4 continuous claim free policy years, up to a maximum of 1% of the average sum insured of the block.
• Cashless facility available in over 6,000+ hospitals across India.
• Family discount: Discount of 10% will be allowed on the total premium if policy is bought for family comprising the insured and/or spouse, dependent children, dependent parents.
• Premium paid for the policy towards self, spouse, dependent children and dependent parents are exempt from Income Tax under Section 80D of the lncome Tax Act, 1961.

National Insurance Parivar Mediclaim Plus Policy

Salient Features and Benefits:

• Designed for financially protecting families – self, spouse, dependent parents and parents-in-law, dependent children - against accidental deaths, and total permanent and total partial disabilities caused due to an accident
• Offers sum assured of up to Rs. 50 lakhs
• Includes pre and post hospitalisation expenditures up to a certain period
• 5% no-claim discount applicable on the base premium
• Available online
• Lifetime National Insurance renewal option available
• Expenditures incurred on day care procedures spanning over 140 days

National Insurance Mediclaim Policy

Salient Features and Benefits:

• Aims at covering hospitalisation and other medical expenditures incurred for specific illnesses or injuries caused to the insured – chemotherapy, OT charges, oxygen, blood, medicines, X-ray, etc.
• Covers expenses such as hospital room and nursing charges up to 1% of the pre-decided sum assured
• Expenditures incurred on day care procedures spanning over 140 days
• Offers the convenience of cashless facility at more than 6,000 network hospitals across India
• Includes cumulative bonus of 5% on sum insured for every claim-free year

National Insurance Mediclaim Plus Policy

Salient Features and Benefits:

• Covers pre-existing illnesses after a waiting period of 3 years
• Covers Ayurveda, Allopathy and Homeopathy treatments
• Covers a list of specific illnesses and medical conditions
• Covers pre-hospitalisation expenses up to 30 days and 60 days post-hospitalisation expenses
• Offers maternity and new born coverage up to a certain limit
• Offers daily hospital cash benefit
• This mediclaim policy can be purchased or renewed through National Insurance online portal
• Offers optional add-on riders like Critical Illness and Outpatient Treatment

National Varistha Mediclaim Policy for Senior Citizens

Salient Features and Benefits:

• Covers medical expenses of senior citizens – drugs and medicines, blood, diagnostic charges, oxygen etc., extending to a maximum of 50% of the sum insured
• Specialises in offering financial security to senior citizens against certain injuries, illnesses and medical conditions
• Offers hospitalisation expenses up to a maximum of 1% of the sum insured
• Covers pre-hospitalisation expenditures of up to 30 days and post-hospitalisation of up to 60 days
• Includes policy renewal option to insured person up to the age of 90 years
• Offers tax benefits as per Section 80D of the Income Tax Act, 1961

National Insurance Individual Personal Accident Policy

Individual Personal Accident Policy from National Insurance Company Limited (NICL) is designed to provide some advantage to an individual against such unfortunate events like death, Permanent Total Disablement (PTD) resulting from an accident. Salient Features and Benefits:

• Designed to offer coverage to individuals
• Covers accidental death, permanent total disability, permanent partial disability, temporary total disability arising due to an accident
• Flexibility of online purchase and renewal of the policy through the official portal of National Insurance
• Includes 24 hours coverage across the globe
• Medical check-up is not mandatory while applying for this policy

National Insurance Janata Personal Accident Policy

Salient Features and Benefits:

• Any individual between the ages of 5 years and 70 years is eligible for purchasing this policy
• Suitable for individuals as well as family members
• Offers financial security to the insured, or the nominee in case of the death of the insured – 100% sum assured on the death and permanent total disablement, and 50% sum assured for permanent partial disablement
• Offers the convenience of online purchase via the official website of the insurance company
• Operational 24*7 across the globe

National Insurance Critical Illness Policy

Salient Features and Benefits:

• Entry age for adults varies between 18 years and 65 years, while for children, the entry age varies between 5 years and extends to up to 18 years.
• Designed for self and family members like spouse, dependent children of up to 25 years of age and dependent parents. Also, includes mid-term inclusion of spouse at pro-rata premium is allowed, within sixty days of marriage. Other members can be included at the time of renewal of the policy. Dependent children can port to another health insurance from the same or any other insurance company on reaching the pre-decided exit age.
• Two plans available for critical illnesses – 11 critical illnesses and 37 critical illnesses, which applicants can select from as per their preference.
• The sum insured options available per insured is Rs. 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70 and 75 lakhs. However, for individuals of 60 years and above, the maximum sum insured offered is Rs. 25 lakhs.
• Sum insured cannot exceed more than 5 times of the policyholder’s annual income.
• Policy period extends to one year.
• Apart from concessions on online purchase of the plan, discounts like Early Entry Discount (EED), Family Discount and Staff Discount are applicable on this health plan.

For Cashless Facility – available only for policies serviced by a Third Party Administrator (TPA)

• Check if the hospital falls under the networked hospitals (Preferred provider network/other network Hospitals), as cashless is available only for empanelled network hospitals of the Company/TPA.
• For planned hospitalisation, intimation is to be sent to the TPA/Company in advance (72 hours prior) with details of Name and address of the hospital and condition requiring hospitalization.
• In case of an emergency hospitalisation, intimation is to be sent to the TPA/Company within 24 hours of admission.
• On admission, a Pre-Authorisation Request for cashless will be sent to the TPA by the hospital – duly signed by the insured and Hospital Authorities giving the details of admission, illness, proposed line of treatment and the estimated expenses. Pre and post hospitalisation expenses can be claimed separately after treatment.
• All documents in original are to be submitted within 15 days to TPA, after completion of Post Hospitalisation treatment.

For Reimbursement Claims:

• Written intimation/mail/fax about hospitalisation is to be sent to TPA /Company within 72 hours of hospitalisation, in the case of emergency hospitalisation, and 72 hours prior, in case of planned admission.
• Before leaving the hospital, Discharge Summary, investigation report and other relevant documents (Claim form – Part A& Part B) may be obtained from the hospital authorities. All the documents in original are to be submitted to TPA / Office within 15 days from date of discharge.
• Pre and post hospitalisation expenses can be claimed separately after treatment.
• All documents in original to be submitted within 15 days after completion of Post Hospitalisation treatment.