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.

Features of National Insurance Mediclaim Policy

  • Cashless treatment – Offers the convenience of cashless treatment to policyholders on treatments at authorised hospitals and medical institutes.
  • Reimbursement – For treatments at non-network hospitals, policyholders have to submit the receipts and bills as proof of expenses incurred while claiming reimbursements.
  • Pre and Post-hospitalisation - Aims at covering hospitalisation and other medical expenditures incurred for specific illnesses or injuries caused to the insured – chemotherapy, OT charges, blood transfusion, oxygen, drugs and medicines, diagnostic tests, etc.
  • Ambulance charges - Includes ambulance charges up to a certain limit, at the rate of 1% of the sum insured, up to a maximum of Rs. 2,000.
  • No Claim Bonus – Offers a cumulative bonus of 5% on the sum insured for every claim-free year till up to a maximum of 50%.
  • Medical Check-up - Covers expenses for hospital room and nursing charges up to 1% of the pre-decided sum insured per day. Expenses incurred on 140+ day care procedures. Pre-policy medical check-up is mandatory for applicants over the age of 50 years, and 50% of the medical check-up expenses are borne by the insured. Health check-ups are offered once, at the end of four continuous claim-free years.
  • Tax Benefits – The premium amount paid for this health insurance plan is eligible for tax deductions. These tax deductions can be availed only when the premiums are paid through Debit Card, Credit Card and Net Banking, cheque or draft. Payments made through cash are not eligible for tax benefits.
  • Pre-existing disease – Illnesses that are hereditary or exist before the National Insurance Mediclaim Policy was purchased is covered under the policy, after 48 months of continuous coverage with the insurance company.
  • Renewability – Offers the convenience of lifelong renewability option.

Benefits of National Insurance Mediclaim Policy

  • Offers a maximum sum insured of Rs. 5 lakhs
  • Entry age for adults extends from 18 years to 65 years of age, while it ranges between 3 months to a maximum of 18 years for dependent children
  • Covers more than 140+ day care treatments
  • Covers expenditures incurred by an organ donor for hospitalisation
  • Apart from covering hospitalisation expenses, ambulance charges, day care fees, it also covers AYUSH treatments
  • 10% discount is offered on family plans
  • Offers the benefit of lifelong renewability
  • While specific illnesses and surgeries are covered after the first policy year, some other medical conditions like hypertension, diabetes, hernia, cataract, etc. are covered after the first two policy years

Additional Discounts for National Insurance Mediclaim Policy

  • Family policies are eligible for 10% discount.

National Insurance Mediclaim Policy: Coverages

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 Mediclaim Policy: What is Not Covered?

  • No claims would be paid during the first 30 days of inception of the policy, except accidental claims.
  • All pre-existing diseases will be covered after 48 months of continuous coverage with the company.
  • Waiting periods of 1/2 years for certain specific diseases/ illness/ treatment.
  • HIV/ AIDS/ STD etc.
  • Pregnancy & related complications, obesity, cosmetic treatment, hormone replacement, genetic disorders.
  • Psychiatric and psychosomatic disorders, disease/illness/accidental injury arising out of drug/ alcohol abuse.
  • Dental treatment, cost of spectacles, contact lenses, hearing aid, cochlear implants.
  • Hospitalisation primarily for diagnostic purposes.

Source: Official website of National Insurance

Eligibility Criteria for Applying for National Insurance Mediclaim Policy

ParametersMinimumMaximum
Age of entry18 years (adults), 3 months (children)65 years (adults), up to 18 years (dependent children)
Sum AssuredRs. 50,000Rs. 5 lakh
Policy Term1 yearNA
No Claim Bonus5% for each claim-free year till it reaches 50%5% for each claim-free year till it reaches 50%

Tax Benefit against National Insurance Mediclaim Policy

Premiums paid towards this health insurance plan are eligible for claiming tax deductions from total taxable income.

List of Leading Health Insurance Plans from National Insurance

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.

Documents Required & Renewal Process National Insurance Mediclaim Policy

Documents Required to Buy National Insurance Mediclaim Policy

  • Proposal form, duly filled up with accurate details
  • Proof of Identity (PoI), self-attested at the time of submission
  • Proof of Address (PoA), self-attested at the time of submission
  • Proof of Income, self-attested at the time of submission
  • Passport size photographs

Accepted Proof of Address and Identity are:

  • Aadhaar card
  • Passport
  • PAN card
  • Driving License
  • Ration card
  • Certificate of Birth issued by the Registry of Births and Deaths (RBD), or from a Municipality, as per the provisions of the RBD Act
  • Matriculation or School-leaving or Transfer Certificate
  • EPIC (Electoral Photo Identity Card) issued by the Election Commission of India

National Insurance Mediclaim Policy Renewal Process

Online renewal for National Insurance Mediclaim Policy can be completed through the following simple steps:

  • Visit the official website of National Insurance Company and select the ‘National Mediclaim Policy’ option
  • Mention your National Insurance Policy number in the given space, along with all other relevant details
  • Choose your preferred payment method from the available options – Debit Card, Credit Card and Net Banking
  • A confirmation will be generated and sent to your registered contact number and/or email ID, notifying you about the successful renewal of your National Insurance health plan

National Insurance Mediclaim Policy: Claim Settlement Process

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.

Conclusion & Reviews

Conclusion

National Insurance Mediclaim Policy is one of the most popular health insurance policies from National Insurance. It boasts of a robust range of health insurance policies that are customised to suit varied needs of their customers. To top that, a high claim settlement ratio that is one of the highest among insurance companies in India speaks volumes about the industry knowledge and competence of their professionals, and the company as a whole. Being one of the oldest and a pioneer in the Indian insurance market has also contributed to their goodwill.

Reviews for National Insurance Mediclaim Policy

“National Insurance Mediclaim Policy offers a wider coverage in comparison to other mediclaim policies. For instance, it covers children as young as 3 months, it extends its coverage to Ayurveda and Homeopathy treatments as opposed to covering only Allopathic treatment, among several other unique features. The comprehensive coverage makes it a smart choice.” – Smiti Jaswani

“The huge list of network hospitals in Kolkata makes the Mediclaim Policy from National Insurance a natural choice for me. This will enable me to avail cashless benefits, if and when need be.” – Surita Mahato

“I have been the holder of National Insurance Mediclaim Policy for the last 7 years. With a high sum insured available at an affordable premium, I have gradually included my entire family – elderly parents and spouse, and have been thoroughly satisfied with their services. I must say that I don’t find a reason why should shift to any other mediclaim. Keep up the good work!” – Anil Ranade

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