National Health Insurance

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About National Health Insurance

National Insurance Company Limited (NICL) is a fully owned General Insurance company by the Government of India. The company was founded in 1906 and is counted as one of the oldest General Insurance Companies in India. At present, the company is headquartered in Kolkata and has offices all over India along with a foreign office in Nepal.

National Health Insurance plans offer a wide range of customizations for various needs of individuals, families, senior citizens, etc. It covers the necessities such as in-patient hospitalisation, daycare treatment, and offers maximum financial comfort to the insured at the time of treatment.

Achievements of National Insurance Company Limited

Given below is a list of its top achievements in the past years. Let's have a look.

awards
  • The company received the Economic Times Best Brands Award.
  • Awarded by Economic Times - BFSI Best Brands 2016 - for all-round Excellence in General Insurance Category.
  • Received 'Samudra Manthan Best Insurer of the Year Award' in 2016.
  • Received SKOCH Financial Inclusion Awards in 2016.
  • Awarded with the 'ICONIC BRAND Award' (Insurance Sector) in 2016.

Features of National Health Insurance

Nowadays, health care costs are rapidly increasing, making it all the more essential to buy a health care policy that can fund your treatment expenses in case of an emergency. But the biggest confusion while buying health insurance is regarding the selection of a good insurance service provider. As per IRDAI's annual report of 2019-20, there are 29 health insurance companies in India. Given such a wide range of insurance companies present in the market, selecting an ideal insurer gets even more difficult.

To make the selection process easier for you, we've discussed below the key features of this company. Let us find out.

Annual premium (2019-20)Rs. 5,277.67 crores
Claim settled within three months (2019-20)45.37
Solvency ratio0.37
No. of cashless hospitals2600+
Head officeKolkata
No. of regional offices1730

Given below is a brief explanation of these features. Let's understand them in detail.

1 Network Hospitals

National Insurance Company has a long list of network hospitals where the policyholder can avail cashless treatment facilities. At present, the company has partnerships with more than 2600 hospitals across the country. Customers can get their treatment done in any of these network hospitals without worrying about the expenses since the company settles all medical expenses on behalf of the policyholder.

Given below is a graph that highlights the number of network hospitals offered by the National Health Insurance in comparison with other top insurance companies based on network hospitals.

Compare National Health Insurance With other Top Insurance Companies Based On Network Hospitals.

Compare National Health Insurance With other Top Insurance Companies Based On Network Hospitals

**Data from IRDAI Annual Reports

2 Annual Premium

If you wish to get an idea about the business reputation of any insurance company, consider your priority to check its market share. The graph given below highlights the increase in the annual premium of National Health Insurance Company over the past four years.From this graph, it can be noted that the company has experienced a rise in its annual premium from 2016-17 to 2018-19.

Annual Premium of National Insurance Company Limited

Annual Premium of National Insurance

**Data from IRDAI Annual Reports

3 Claim Support

Claim support ratio is an important factor that should be essentially considered while buying a health insurance policy as it helps in analyzing the claim settling capability of the company. All of us buy a health insurance plan to ensure that we're able to cover the medical expenses if anything unfortunate happens in the future. It is suggested to opt for an insurance company that has a good claim support ratio. If we talk about the National Insurance Company, then as per IRDAI's data, this company has a claim support ratio of 45.37%.

4 Solvency Ratio

Before investing your funds in a company's insurance plans, it is important to know about the financial soundness of that company. It is advisable to check the solvency ratio of a company before choosing a policy. As per IRDAI, all health insurance companies in India are obliged to maintain a solvency ratio of at least 1.5. At present, the solvency ratio of the National Insurance Company is 0.37.

5 Operating Network

The National Insurance Company has a strong operating network with branches across India. At present, the company has around 1730 offices and more than 13000 skilled employees and over 50000 agents. Apart from this, the National Insurance also operates a foreign office in Nepal. By managing such a wide operation and distribution network, the company aims at making its services accessible to a large number of customers - both in India and Nepal.

Types of National Health Insurance Plans

To cater to the different needs of the customers, the National Insurance company has come out with several health insurance plans. The table given below highlights an overview of all the plans. Let's have a look at it.

Plan NameTypeWho Should Buy?
National Mediclaim PolicyMediclaim Health InsuranceThe plan provides medical protection to the entire family including self, spouse, dependent children, parents, parents-in-law, brother, and sister.
National Mediclaim Plus PolicyMediclaim Health InsuranceThis plan offers comprehensive coverage to protect the medical needs of the policyholders.
National Parivar Mediclaim PolicyFamily Health InsuranceNational Parivar is a family floater health insurance plan that covers the medical expenses of the entire family.
National Parivar Mediclaim PlusFamily Health InsuranceThis plan is an advanced version of the National Parivar policy and offers comprehensive protection to the family members of the insured.
Overseas Mediclaim Business and HolidayOverseas MediclaimThis policy provides coverage for overseas medical emergencies that might occur while travelling abroad for work or pleasure.
Overseas Mediclaim Employment and Studies PlanOverseas MediclaimThis is a comprehensive, package plan that is designed to cover the medical emergencies that arise while travelling abroad.
National Critical Illness PolicyCritical Illness InsuranceThis plan is designed to provide coverage for the expenses that occur during the treatment of a critical illness.
National Senior Citizen Mediclaim PolicySenior Citizen InsuranceThis health insurance policy provides medical coverage to senior citizens between the age group of 60 to 80 years.
National Super Top Up Mediclaim PolicyMediclaim Health InsuranceThe plan is ideal for customers who wish to buy a policy that provides wide coverage at a reasonable cost.
Arogya Sanjeevani Policy- NationalFamily Health InsuranceThis standard health insurance plan offers wider coverage for the entire family of the insured at affordable premium rates.
Vidyarthi Mediclaim Policy for StudentsMediclaim Health InsuranceThe policy is specifically designed to provide health insurance cover to the students.
Corona Kavach PolicyCOVID-19 Health InsuranceThis policy focuses on protecting the policyholders against the treatment expenses resulting due to COVID-19 infection.

Let's have a detailed discussion of each of these above-listed plans.

  1. National Mediclaim Policy

    National Mediclaim Policy covers the hospitalization expenses for the treatment of illness/disease or injury sustained by the insured person during the policy period. One can cover self, spouse, dependent children, parents, parents-in-law, brother (up to 25 years), sister (if not employed till marriage), and newborn from 3 months of age.

    Features

    • AYUSH treatment is covered (up to 100% of the sum insured).
    • Provides coverage for 140+ day care procedures.
    • The policyholder is also eligible for a 5% cumulative bonus of the sum insured for each claim-free policy year, provided the policy is renewed without break.
    • 12 modern treatments such as immunotherapies, oral chemotherapies, etc. are covered under the plan.

    Eligibility Criteria

    CriteriaMinimumMaximum
    Entry age18 years65 years
    Sum Insured amountRs. 1 LakhRs. 10 Lakhs
  2. National Mediclaim Plus Policy

    National Mediclaim Plus Policy is an individual plan that ensures protection against medical expenses by offering comprehensive cover that goes beyond the traditional health plans.

    Features

    The plan is available within three sum insured payment plans ranging from Rs. 2, 00, 000 to Rs. 50, 00,000. These plans are:

    • Plan A - 9 slabs, 2L to 10L in multiple of 1L
    • Plan B - 3 slabs, 15L/ 20L/ 25L
    • Plan C - 3 slabs, 30L/ 40L/ 50L

    It covers (up to sub-limits mentioned in the policy) the ambulance charges (including air ambulance) and organ donor's expenses.

    It offers coverage (payable as per limits of the plan) against the expenses incurred due to doctor's home visit and nursing care after hospitalization.

    A hospital cash facility (up to a maximum of 5 days) is provided to the insured as per the clauses of the policy.

    Vaccination for children up to 12 years is covered under the plan.

    Eligibility Criteria

    CriteriaMinimumMaximum
    Entry age18 years65 years
    Sum Insured amountRs. 2 LakhsRs. 50 Lakhs
  3. National Parivar Mediclaim Policy

    National Parivar Mediclaim Policy is a family floater health insurance plan that covers the medical expenses of the entire family (at least two family members like self, spouse, parents, and dependent children) in a single sum insured.

    Features

    • It offers coverage only for Allopathic, Ayurvedic, and Homeopathic treatments.
    • The policy covers pre-hospitalisation expenses (up to 30 days) and post-hospitalization expenses (up to 60 days).
    • Enjoy tax exemptions under Section 80D of the Income Tax Act, 1961 for the premiums paid.
    • The plan reimburses the medical expenses incurred under domiciliary hospitalization.

    Eligibility Criteria

    CriteriaMinimumMaximum
    Entry age18 years65 years
    Sum Insured amountRs. 1 LakhRs. 10 Lakhs
    Policy Term1 year3 year
  4. National Parivar Mediclaim Plus

    National Parivar Mediclaim Plus is a comprehensive health insurance policy that offers coverage to self, dependent children, spouse, and parents/parents-in-law under one sum insured.

    Features

    The plan offers the following 3 variants for making payment of the sum insured amount:

    • Plan A: 5 slabs, 6L to 10L in multiple of 1L
    • Plan B: 3 slabs, 15L/ 20L/ 25L
    • Plan C: 3 slabs, 30L/ 40L/ 50L

    The policy offers AYUSH benefit under which Allopathic, Ayurvedic, and Homoeopathic treatments are covered up to the full sum insured.

    It offers pre-hospitalisation cover for up to 30 days and post-hospitalisation cover for up to 60 days.

    On payment of an additional premium, you can cover pre-existing diabetes and hypertension.

    Eligibility Criteria

    CriteriaMinimumMaximum
    Entry age18 years65 years
    Sum Insured amountRs. 6 LakhsRs. 50 Lakhs
    Policy Term1 year3 years
  5. Overseas Mediclaim Business and Holiday

    Overseas Mediclaim Business and Holiday policy is designed to cover overseas medical emergencies when one is travelling for work or enjoyment. The plan is available for 3 categories of travellers:

    • Business & Holiday
    • Employment and Study
    • Frequent Corporate Traveller

    Features

    • Under the plan, the first US $100 of all claims is to be paid by the traveller.
    • It covers the loss and delay of checked-in luggage.
    • For any traveller who is over 70 years of age and travelling above 60 days of the journey, (s)he has to submit the following medical reports (from an MD Cardiologist) and the proposal form:
      • ECG
      • Fasting Blood Sugar or Urine Strip test
  6. Overseas Mediclaim Employment and Studies Plan

    Overseas Mediclaim Employment and Studies is a package plan that reimburses the expenses for travel emergencies while travelling abroad. It is available for 3 categories of travellers:

    • Business & Holiday
    • Employment and Study
    • Frequent Corporate Traveller

    Features

    • The policy covers the loss and delay of checked-in baggage.
    • Medical accidents and disablement are also covered under the policy.
  7. National Critical Illness Policy

    National Critical Illness Policy looks after the cost of treatment and the expensive recovery process associated with these illnesses. This policy provides cover if the insured person is affected by any of the listed critical illnesses.

    The policy offers 2 types of variants for the critical illness cover.

    • Plan A - Under this 11 Critical Illnesses are covered.
    • Plan B - Under this 37 Critical Illnesses (including Plan A covered illnesses) are covered.

    Features

    • Policyholders can avail of a 10% discount on premiums for eligible family members if the policy is purchased for the family.
    • If you are a National Insurance company's employee, this policy allows a discount of 15% on premiums for covering self and family.

    Eligibility Criteria

    CriteriaMinimumMaximum
    Entry age18 years65 years
    Sum Insured amountRs. 1 LakhRs. 75 Lakhs
  8. National Senior Citizen Mediclaim Policy

    The plan is specially made for senior citizens (60-80 years) and covers the expenses of inpatient treatment (allopathy, Ayurveda, and homeopathy), domiciliary hospitalization, or treatment for a disease/injury during the policy tenure.

    Features

    • The plan offers two variants:
      • Plan A – 10 slabs, Rs. 1,00,000 to Rs. 10,00,000
      • Plan B – 10 slabs, Rs. 1,00,000 to Rs. 10,00,000, with some additional features
    • The plan offers coverage for allopathic, ayurvedic, and homeopathic treatments.
    • The plan also reimburses (up to 20% of the SI) the medical expenses incurred under domiciliary hospitalization.

    Eligibility Criteria

    CriteriaMinimumMaximum
    Entry age18 years65 years
    Sum Insured amountRs. 1 LakhRs. 10 Lakhs
  9. National Super Top Up Mediclaim Policy

    National Super Top Up Mediclaim is a high threshold health insurance policy that covers all the members of a family under a single sum insured. The policy comes with a wide coverage at a reasonable cost.

    Features

    • Treatment expenses of morbid obesity are covered after the listed waiting period.
    • The plan offers coverage (up to the sum insured) for pre & post hospitalisation expenses (up to 30 and 60 days), organ donor's medical expenses, and inpatient treatment.
    • 12 modern treatments are also covered under the policy.

    Eligibility Criteria

    CriteriaMinimumMaximum
    Entry age18 years65 years
    Sum Insured amountRs. 3 LakhsRs. 20 Lakhs
  10. Aarogya Sanjeevani Policy

    Arogya Sanjeevani is a standard individual health insurance product that covers hospitalisation expenses for any illness/injury sustained during the policy period.

    Features:

    • For cataract treatment of one eye, the plan will offer decent coverage (Rs. 40,000 or 25% of SI, whichever is lower).
    • A policyholder will get coverage for AYUSH treatment.
    • The plan offers pre and post hospitalization coverage (up to 30 days and 60 days respectively).

    Eligibility Criteria

    CriteriaMinimumMaximum
    Entry age18 years65 years
    Sum Insured amountRs. 1 LakhRs. 5 Lakhs
  11. Vidyarthi Mediclaim Policy for Students

    Vidyarthi Mediclaim policy is designed to provide health and personal accident cover to the students. If the guardian dies or becomes permanently disabled, the plan provides for the continuation of the insured student's education.

    Features

    The plan offers three sections:

    • Section I covers hospitalization expenses of students with a sum insured that ranges from Rs. 50,000 to Rs. 2,00,000.
    • Section II covers the personal accident of parents, where the sum insured will be two times the SI under Section I.
    • Section III covers personal accident of insured students with a sum insured of Rs. 50, 000.

    The plan offers an increase in the sum insured by 5% for each claim-free year.

    Eligibility Criteria

    CriteriaMinimumMaximum
    Entry age3 years25 years
    Sum Insured amountRs. 50 ThousandRs. 2 Lakhs
  12. Corona Kavach Policy

    Corona Kavach Policy has been introduced to offer coverage against the treatment cost of COVID-19.

    Features

    • No pre-policy health check-up is required.
    • The policy covers pre and post hospitalization expenses (up to 15 days and 30 days respectively).
    • Ambulance charges are also covered by the plan.

    Eligibility Criteria

    CriteriaMinimumMaximum
    Entry age8 years65 years
    Sum Insured amountRs. 50 ThousandRs. 5 Lakhs

Exclusions of National Health Insurance Plans

Here is a list of exclusions under which no coverage is provided to the insured person.

Let's have a look.

  • Any type of psychiatric and psychosomatic disorder, disease/illness/accidental injury that arises out of drug/alcohol abuse by the policyholder.
  • If the policyholder is travelling against medical advice or for medical treatment including routine check-up, (s)he is not provided with any cover.
  • Claims arising out of participation in military, naval, or air force operations.
  • Any injury or illness that is directly or indirectly caused by war, invasion, any terrorist act, or riot.
  • Any type of spinal cord injury treatment.
  • Any expense incurred with the treatment of any sexually transmitted disease, HIV, or AIDS.

How to Purchase National Health Insurance Plans?

To buy a health insurance policy from the National Insurance company, there are two options available. First, you can easily purchase health insurance from the company's official website. However, please note that the company sells only a few health insurance products online. Second, you can also buy the policy from third-party agents or brokers.

In the section below, we've given a detailed step-by-step process for buying health insurance from the National Insurance company's website. Read along to find out.

  • Visit the official website of the company.
  • Click on 'Products' and select the 'Health' tab.
  • Click on the 'Get Quote/Buy Policy' menu.
  • Select your desired plan and click on it.
  • Fill in all the required information and details.
  • Make an online payment of the premium amount.

Once done, you will get a soft copy of the policy on your registered email ID. You can also visit the nearest National Insurance company's branch to buy health plans.

What Is the Claim Procedure of National Health Insurance Plans?

National insurance company settle claims using two easy methods:

  • Cashless Claim process
  • Reimbursement Claim process

In the cashless claim process, the company settles all the hospitalization expenses of the policyholder, thereby reducing the burden off his shoulders. But in the reimbursement process, the policyholder has to make payment of the hospital expenses on his own and can later reimburse those expenses from the insurance company by submitting the hospital bills and other required documents.

Given below is a detailed explanation of both these claim processes. Let's find out.

Cashless Claim

The cashless facility is only for policies that are purchased via a Third-Party Administrator (TPA).

  • One has to check whether the selected hospital falls under the list of network hospitals as the cashless claim facility is available at the network hospital only.
  • In planned hospitalisation, the insured has to inform TPA/company in advance (72 hours prior) about the case.
  • In emergency hospitalisation of the insured, (s)he must inform the TPA/company within 24 hours of the hospitalization.
  • On getting admitted, a pre-authorisation request will be shared with the TPA by the hospital along with the duly signed documents.
  • The TPA will settle all the bills with the hospital.

Note Submit all the required documents to the TPA within 15 days.

Reimbursement Claims

  • One has to submit a written intimation (through the mail/fax) about the hospitalisation to the Third-Party Administrator (TPA)/company within 72 hours of emergency/planned hospitalisation.
  • Don't forget to collect the discharge summary, investigation report, and required documents from the hospital.
  • All original documents should be submitted to TPA/company within 15 days from the date of discharge.
  • The company will verify all the documents. On approval, the claim amount will be released.

Documents Required For Filing National Health Insurance Claim

Given below is a list of documents that the customers are required to submit while filing a claim for their national health insurance plan:

  • Duly completed claim form
  • Photo Identity proof of the patient
  • Medical practitioner's prescription advising admission
  • Original bills with the itemized break-up
  • Payment receipts
  • Discharge summary including a complete medical history of the patient along with other details
  • Investigation/Diagnostic test reports etc. supported by the prescription from the attending medical practitioner
  • OT notes or surgeon's certificate giving details of the operation performed (for surgical cases).
  • Sticker/Invoice of the Implants, wherever applicable.
  • MLR (Medico-Legal Report) copy if carried out an FIR (First information report) if registered, where ever applicable
  • NEFT Details (to enable direct credit of claim amount in a bank account) and cancelled cheque
  • KYC (Identity proof with Address) of the proposer, where claim liability is above Rs. 1 Lakh as per AML Guidelines
  • Legal heir/succession certificate, wherever applicable

Any other relevant document required by the Company/TPA for assessment of the claim.

How To Contact National Insurance Company?

Corporate Office Address: National Insurance Company Ltd., 3, Middleton Street, Prafulla Chandra Sen Sarani, Kolkata, West Bengal, 700071.

Head Office Telephone: 22831705

Fax: 22831740

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FAQs

1. How can I renew my National Health Insurance Plan?

Renewing your National Health policy online is a convenient process. Follow the below steps for the same:

  • Visit the official website of the National Insurance Company and click on the 'Quick Renewal' tab given at the top of the page.
  • Enter your 'Policy Number' and 'Captcha' to continue.
  • Fill in the required details and make the payment.
  • You will receive the renewal confirmation on your registered email ID.

2. How can I check the policy status for my National Health plan?

Log in to the company's website with valid credentials and enter the policy number.

3. I have an existing health insurance policy from the National Insurance company. Will it cover Coronavirus-related ailments?

Yes. If you are hospitalized for a minimum period of 24 hours for treatment of COVID-19, medical expenses will be covered in all standard health insurance policies issued by the National Insurance Company.

4. Does National Parivar Mediclaim policy cover infertility cases?

Yes, the National Parivar Mediclaim policy covers infertility cases after 45 years of age at a discount of 3% on the individual premium (for both self and spouse).

Find Out What Customers Are Saying

(Showing latest 5 reviews only)

- 4.5/5 (29 Total Rating)

September 1, 2021

Urmil Thakur

Kochi

I bought my health plan from National a while back. Recently had to make a claim for hospitalization. I was a little worried but the response time was at best amazing! Thanks guys

August 18, 2021

Akshay Malhotra

Gurgaon

I have bought health insurance from National Health Insurance and I am very impressed by their services and attention towards customers.

May 10, 2021

Pooja Singh

Delhi

I will recommend everyone to buy health insurance plan from this company because I am very happy with the plan I purchased from the company. I am using my insurance from two years and till now I ve not faced any issue with it.

October 26, 2020

Bipinchandra Somabhai Patel

Vadodara

I want to portability of United India insurance company individual health mediclaim policy taken since December 2005 and falling due for renewal on 06-12-2020

May 6, 2018

Shilpa

Thane

I hold a National Parivar Mediclaim insurance plan with National Insurance from last 3 years, i am happy with the coverage value of this policy.

Last updated on July, 2021

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