- About Coverfox
National Insurance Company Ltd. was started in the year 1906 in Kolkata (earlier Calcutta) which makes it one of the oldest general insurance companies operating in India. National Insurance Company has collaborated with 11 Indian and 21 foreign companies. It is one of the four subsidiaries of the government-owned General Insurance Company.
National Insurance is India’s 2nd largest non-life insurers in the collection of Gross Direct Written Premium.
Being the oldest general insurance company & oldest health insurance company , it has several pilot introductions of product customizations, both for corporate and rural sectors to its credit. It is also one of India’s first insurance companies to enter into an alliance with corporate giants. It also leads the way of introducing Bancassurance in India by collaborating with some of the largest banks.
It boasts a strong workforce of 13000 employees and 1730 offices, covering a wide network of operation in India and Nepal. National Insurance Company enjoys strong financial strength and issuer credit rating reflecting good performance and stronghold in India’s insurance market.
All About National Insurance Parivar Mediclaim
National Parivar Mediclaim Policy offers health insurance coverage which is designed to provide financial protection against health-related emergencies for the entire family. It is a family floater policy; the entire family gets coverage under a single policy. The applicable sum insured amount can be utilised by any member of the family against various injuries and illnesses. As per the policy terms and conditions, a family is limited to spouse, self and two dependent children. The primary objective of the policy is to mitigate the financial loss of a family during an unexpected hospitalisation due to illness or accidental injury to a family member.
Some of the key features of National Parivar Mediclaim Policy can be listed as follows.
Pre and post hospitalisation: Pre hospitalisation is covered for a period of 15 days and post hospitalisation is covered for a period 30 days.
Ambulance charges: Ambulance charges are limited to INR 1000 per illness and total of INR 2500 in a policy year.
No Claim Bonus: No claim bonus is given if no claims are made in a policy year. On renewal, the policyholder will be entitled to 5% of discount on base premium as No Claims Bonus.
Medical Check- Up: The policy provides a free medical check-up for being enrolled in the policy continuously for 4 years. The medical check-up reimbursement amount is limited to INR 5,000.
Tax Benefits: The premium paid towards the policy plan is eligible for tax benefits as per the provisions mentioned under Section 80D of the Income Tax Act, 1961.
Co-Payment: If the policyholder opts for a pre-existing disease like diabetes and hyper tension, then co-payment of 10% will be applicable to the claims for treatment of those disease.
Pre-existing diseases: Pre-existing diseases can be covered in the scope of the policy after 48 months of continuous policy coverage.
Articles on National Insurance
|Hospital Room Rent||Up to 1% of the sum insured cover per day|
|ICU Charges||Up to 2% of the sum insured cover per day|
|Hospital Cover||Fees given to surgeon, anaesthetist, medical practitioners, and consultants|
|Medical Expenses||Blood, anaesthesia, oxygen, operation theatre charges, surgical appliances, drugs, medicines, chemotherapy, x-rays, cost of pacemaker, cost of artificial limbs, etc.|
|Organ Donor Charges/Expenses||Coverage provided for surgery costs when the insured person is donating an organ to another person|
|Limit For Total Charges/Expenses||Total charge/expenses for one particular illness are limited to 50% of the sum insured coverage|
Flexibility: The policy is available for anyone from the age of 18 years to 60 years and dependent children from the ages of 3 months to 25 years, provided parents are also part of the policy cover.
Sum Insured: The policy offers a choice of the sum insured from INR 2 lakhs to INR 5 lakhs for the different coverage needs to customers.
Coverage: The policy offers comprehensive coverage for hospitalisation due to illnesses and accidental injuries. Pre-existing diseases can also be covered in the policy.
Premium Charges: The premium charges of this family floater plan are based on the age of the eldest member of the family.
Day care procedures covered: The policy covers up to 140+ day care procedures/surgeries up to the limit of the sum insured.
Organ Donor Benefits: The organ donor expenses are covered up to the sum insured by the company.
Plan Option: There are no plan options in the policy. It is one plan family floater policy offered by the company.
Avail AYUSH benefits: The policy provides coverage in respect to allopathy, Ayurveda and homeopathy treatments up to sum insured in the scope of the plan.
Reimbursement of hospitalisation expenses necessarily incurred, under the following heads:
Room, boarding and nursing expenses as provided by the hospital/nursing home – 1% of sum insured per day for normal room and 2% of sum insured per day for ICU room.
Fees for Surgeon, Anaesthetist, medical practitioner, consultant, specialist’s fees, nursing expenses.
One of the important exclusion is regarding the pre-existing illness. Pre-existing diseases can be covered after 4 years of continuous coverage under this policy. All diseases and injuries related conditions which are pre-existing at the time of the start of the policy, will be covered after only 4 continuous claim free policy years.
Exclusion of certain named diseases up to the 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 hospitalised.
Dental treatment, other than caused by accidental injury and requires hospitalisation.
Treatment required due to pregnancy and childbirth.
All treatment covered other than an allopathic stream of treatment.
War, invasion and nuclear perils.
Pre-existing diseases like diabetes, hypertension, Outpatient treatment and critical illness are optional add-ons covers available in the plan.
Additional Discounts for National Parivar Mediclaim
Long Term Discount: If the policy is issued for a period of 2 years, then a discount of 4% will be allowed on the total premium. If the policy is issued for 3 years, then a discount of 7.5% will be applicable.
Online Discount: If the policy is purchased online, then a discount of 5% on the premium will be applicable. Similarly, if the policy is renewed online, then a discount of 2.5% will be applicable.
Tax Benefits in National Parivar Mediclaim: The premium paid for the National Parivar Mediclaim can be used for tax deduction up to a limit of INR 1,00,000 as per the provisions mentioned in Section 80D of the Income Tax Act,1961. It is to be noted that tax laws are revised from time to time. The applicant should consult the financial advisor to know the current income tax deductions and benefits at the time of buying the Comprehensive National Health Insurance .
Policy shall cover at least two family members, as defined below.
Proposer should be between 18 years and 65 years.
Maximum entry age of any family member is 65 years.
Children between the age of 3 months and 25 years may be covered, provided parents are also covered in the same policy.
Family members include Policyholder, spouse, parents, dependent children (legitimate or legally adopted)
Dependent child up to the age of 18 years
Dependent male child above 18 years and up to 25 years, if he/she is a student and unemployed
Dependent female child, if she is not employed or married
Midterm inclusion of family members at pro-rata premium is allowed only in case of
new-born between the age of 3 months and 6 months
Spouse within 60 days of marriage
On inclusion of a new family member, applicable waiting period shall apply
Dependent children have the option to port to similar health insurance product of the company or any other insurer on completion of the specified exit age as mentioned.
If during the policy period, the number of members covered reduces to a single member, then on expiry of the policy period, the insured person shall be moved to similar health insurance product available with the company or of any other insurer.
|Proof of Age||Identity Proof||Address Proof|
|Birth certificate||Driving license||Ration card|
|10th or 12th mark sheet||PAN Card||Electricity bill|
|Aadhaar card||Aadhaar card||Aadhaar card|
|Voting ID||Voting ID||Voters ID|
|Driving license||Driving license|
|PAN card etc.||Telephone bill|
Proof of Age: The applicant has to provide the age proof of all the persons who will be getting covered with the health insurance policy. Below are the acceptable documents for this:
Identity Proof: The applicant can provide any of the following identity proof:
Address Proof: The applicant will be required to submit your permanent proof of address. You can submit any of the following documents for the same:
Passport Size Photos
The applicant might be required to medical tests to enrol in the plan
In the event of hospital treatment or domiciliary hospital treatment, the insured person or his/her relative or representative is required to inform the TPA. The notification can be done in writing by letter, email, fax providing all necessary information like policy number, treatment details etc. The contact details can be found on the official website of the company.
|Informing Of Claim For Cashless Facility||Time To Inform The TPA|
|In case of planned hospitalisation||TPA should be informed at least 72 hours prior to the insured person’s admission to the network hospital|
|In case of emergency hospitalisation||TPA needs to be informed within 24 of the insured person’s admission to the network hospital|
|Informing of claim for Reimbursement||Company/TPA must be informed:|
|In the case of planned hospitalisation or domiciliary hospitalisation treatment||TPA should be informed at least 72 hours prior to the insured person’s admission to the network hospital|
|In the case of emergency hospitalisation or domiciliary hospitalisation treatment||TPA need to be informed within 24 of the insured person’s admission to the network hospital|
Informing of claim for vaccination: In the case of Anti Rabies Vaccination
Company/TPA must be informed: At least 24 hours prior to getting the vaccination
To get the Cashless facility for treatment in network hospitals, TPA needs to be informed. For this, the insured has to fill a cashless request form and send it for authorisation to TPA.
After taking authorisation from TPA for the treatment at the network hospital (list of network hospital can be seen in the booklet provided or from the official website of the company).
TPA, after checking and verifying the request form, will issue a pre-authorisation letter to the hospital.
The insured person, after the treatment, will need to verify and sign the discharge papers and pay for non-medical expenses.
The TPA reserves the right to reject the pre-authorisation request in case the policyholder is not able to provide the relevant medical details.
In case of rejection of cashless treatment, the policyholder may still get the required treatment as per treating doctor’s advice and submit the claim papers to the TPA for processing.
For reimbursement of claims, the policyholder is required to submit the necessary documents to TPA within the given time limit. Procedure for Reimbursement of Claim under Domiciliary Hospitalisation
For reimbursement of claims under domiciliary hospitalisation, the policyholder is required to submit the necessary documents to TPA within the given time limit.
Once the TPA/insurance Company has received the required final document and investigation report if required in the case, the claim needs to be settled within a time frame of 30 days by the Insurance Company.
If the claim is rejected by the insurance company or any reason it will communicate the same to the policyholder in writing within 30 days of receipt of the claim.
Upon acceptance of an offer of settlement by the policyholder, the payment of the claim amount will be made within 7 days from the date of acceptance of the offer by the Health Insurance Company.
If there is a delay in payment, the company is liable to the claimant an interest at the rate of 2% above the prevailing bank rate.
To successfully submit and get the claim approved, the claimant needs to submit the following documents in original within the given time limit.
Completed filled claim form
Original Bills, receipts for payment, medical history of the patient recorded, discharge certificate or summary from the hospital etc.
Cash-memo from the hospital /medical store/chemist verified by proper prescription
Attending medical consultant’s certificate regarding diagnosis along with date and day mentioned clearly with necessary bills and receipts etc.
Certificate from the surgeon confirming the diagnosis and nature of operation and bills/receipts etc.
Any other document required by Company/TPA as depending from case to case basis
National Parivar Mediclaim is an affordable Health Insurance Plan for the entire family. It offers the flexibility of sum insured as per the needs of different customers. The plan offers a lot of features and benefits to the insured and his whole family. The plan offers rewards for not making claims on renewal of the policy. It also offers an additional discount on online purchase and renewal. The terms and conditions of the plan are very simple to understand and the claim procedure is also very easy to understand and follow. The company gives quick authorisation for cashless treatments and the claims are also reimbursed to the policyholder in a timely manner.
National Insurance Company is one of the oldest Indian insurance companies and it has put all its expertise to ensure the National Health Insurance offers peace of mind against any health emergencies in the family. It is one of the most simple and comprehensive health insurance plans in the market today.
I was looking for an affordable but comprehensive health insurance plan. I searched online and the National Parivar Mediclaim was best suited for my needs. I also got a discount of 5% on premium for purchasing the plan online. I am satisfied with the purchase of this health insurance plan. (Rahul Bhatt – Kanpur)
I purchased this plan for my family and had to make a claim for my father’s illness. The claim procedure was easy and customer service was also efficient in helping me during the claim process. Happy with the purchase! (Neha More – Mumbai)
This is my first insurance policy with National Insurance Company. I purchased National Parivar Mediclaim and found the enrolment process hassle free. The premium amount is also pocket- friendly. I will recommend this health insurance plan to my friends and family. (Thirumalai Konar – Chennai)
This is my 4th year in this health insurance policy. I have been rewarded with no claim bonus on multiple occasions and my premium on renewal has been all the more affordable. The website provides with comprehensive and accurate information which has enhanced my knowledge on health insurance and its benefits. (Kunal Gupta – Uttar Pradesh)