#Virukipolicy | T&C*
National Health Insurance is one of the oldest insurance companies in India. The National Insurance Company Limited understand the need for insurance and expectations of a consumer. Headquarter of the National Insurance Company Limited is in Kolkata and founded in 1906. It was nationalised in the year 1972. National Insurance Company Limited (NICL) started its operation with 14902 skilled employees and 1998 offices all across India.
National Insurance Company Limited is fully owned by the Government of India and it offers a wide range of general insurance plans that are customised for the varied and unique needs of individuals, families, senior citizens, etc. Every plan of National Health Insurance covers the basic necessities such as the in-patient hospitalisation, day care treatment and considers a plethora of other medical expenses to the insured. Premium payments made towards a National Health Insurance plan by the policyholder attracts tax deduction as per Section 80D of the Income Tax Act, 1961.
|Pre-existing Diseases||Covered after a waiting period of 4 years|
Following are various types of the National Health Insurance that one can opt for, as per requirement.
Medical expenses are skyrocketing and one find it really hard to afford good medical care in India. But, these expenses are unavoidable and one has to bear it all when they knock at the doorstep. Thanks to health insurance, this tough journey of medical emergencies has become much easier. National Mediclaim Policy covers the hospitalization expenses in a reasonably, systematically and necessarily incurred for treatment of illness/disease or injury contracted/sustained by the insured persons during the policy period.
Benefits and Features of the National Individual Personal Accident Policy
National Mediclaim Policy reimburses the expenses that occur under the Room, boarding & nursing up to 1% of the sum insured per day & 2% of sum insured per day for ICU. This reimbursement is subject to an overall limit of 25% of the sum insured.
Expenses incurred on account of anaesthesia, blood, oxygen, operation theatre charges, surgical appliances, diagnostic materials, X-ray, dialysis medicines and drugs, chemotherapy, radiotherapy, cost of pacemaker and etc are also covered under the National Mediclaim Policy for 50 % of the sum insured.
Any cost of organs, hospitalization expenses of an organ donor and artificial limbs and similar expenses are also reimbursed under National Mediclaim Policy which is subject to an overall limit of 50% of the sum insured
National Mediclaim Policy offer AYUSH benefit under which Expenses for Ayurvedic and Homeopathy treatment are admissible up to 20% of the sum insured for any one illness.
National Mediclaim Policy also offers cover for 140+ day care procedures which require hospitalization for less than 24 hrs.
The policyholder is also eligible for 5% Cumulative bonus of sum insured for each claim free policy year provided the National Mediclaim Policy is renewed without break.
Health checks up expenses will be reimbursed once at the end of the tenure of 4 continuous claims free National Mediclaim policy years, which is a matter of up to a maximum of 1% of the average sum insured of the policy tenure.
National Mediclaim Policy also offers
Premium paid for the National Mediclaim policy towards self, spouse, dependent children and dependent parents are exempt from Income Tax under Sec. 80D of the income tax Act.
Eligibility of the National Mediclaim Policy
National Mediclaim Policy is available to persons between minimum age of 18 and a maximum of 65 years. Dependent parents of the insured can also be covered with the family. Dependent children between the ages of 3 months and 18 years can also be covered under the policy provided at least one of the parents is covered under the National Mediclaim Policy at the same time.
|Sum Assured||Rs.50,000 to Rs.5 lakhs|
|Medical Screening||Not required up to age 50 years.|
|Renewability Age||No Limits|
|Free Look||15 days|
Exclusions of the National Mediclaim Policy
If the National Mediclaim Policy is renewed for 48 months continuously, then only the pre-existing diseases will be covered.
Any type of Psychiatric & psychosomatic disorders, disease/ illness /accidental injury that arises out of drug/ alcohol abuse of the policyholder is also excluded from the National Mediclaim Policy.
You can take care of your loved ones only when you are taking care of yourself. National Mediclaim Plus Policy ( Individual Plan )ensure that you take care of your medical expenses in a broader way in a reasonable, customary and systematically manner. National Mediclaim Plus Policy ( Individual Plan ) has three variants –
Plan A- Sum assured is offered in 9 slabs, 2L to 10L in multiple of 1L
Plan B- Sum assured is offered in 3 slabs, 15L/ 20L/ 25L
Plan C- Sum assured is offered in 3 slabs, 30L/ 40L/ 50L
Benefits and features of the National Mediclaim Plus Policy ( Individual Plan )
National Mediclaim Plus Policy ( Individual Plan ) cover the ambulance (including Air Ambulance) Charges and Organ Donor’s expenses up to sub-limits mentioned in the policy.
National Mediclaim Plus Policy ( Individual Plan ) also offer the cover of expense due to doctor’s home visit and nursing care during post hospitalization payable as per limits in each plan.
National Mediclaim Plus Policy ( Individual Plan ) also offer to Add on covers such as Critical Illness and Out-patient Treatment at a minimal extra premium amount.
Hospital cash & Medical Emergency Reunion facility is also offered to the insured as per limits in the National Mediclaim Plus Policy ( Individual Plan).
Room Rent/ICU charges, Medical practitioners, surgeon, anaesthetist, consultants, specialist’s fees and other charges as per limits mentioned in the National Mediclaim Plus Policy ( Individual Plan ).
National Mediclaim Plus Policy ( Individual Plan ) also cover the pre hospitalisation expenses for 30 days and post hospitalisation expenses for 60 days of the policy.
Eligibility of the National Mediclaim Plus Policy ( Individual Plan )
National Mediclaim Plus Policy ( Individual Plan ) can be availed by an individual between the minimum age of 18 and a maximum of 65 years. Dependent parents of the insured can also be covered with the family. Dependent children between the ages of 3 months and 18 years can also be covered under the policy provided at least one of the parents.
|Sum Assured||Rs.2 lakhs to Rs.50 lakhs|
|No claim Bonus||upto 50 percent.|
|Cash allowance||Upto 5 days of Hospitalization|
Exclusions of the National Mediclaim Plus Policy ( Individual Plan )
Any type of Refractive error surgery, Obesity, Psychiatric disorder, intentional self-inflicted injury is excluded from the National Mediclaim Plus Policy ( Individual Plan ).
National Mediclaim Plus Policy ( Individual Plan ) does not cover any dental treatment (unless arising out of the accident and requiring hospitalization) and Out Patient Department treatment (OPD treatment).
What can be best then a health insurance plan that covers the whole family in a single Sum Insured, for In-patient treatment expenses?
Benefits and Features of the Parivar Mediclaim Policy for family (floater Policy)
Parivar Mediclaim Policy for family (floater Policy) offers a cover for only Allopathic treatment.
Parivar Mediclaim Policy for family (floater Policy) has a Provision to cover pre-existing diabetes and hypertension on payment of additional premium of the insured.
Parivar Mediclaim Policy for family (floater Policy) offer a cover for Pre hospitalisation for 15 days and Post Hospitalization up to 30 days for the same disease/illness/injury for which the insured person’s Hospitalization occurred.
Under the Parivar Mediclaim Policy for family (floater Policy) enjoy the Tax Rebate under Section 80D of the Income Tax Act 1961 for the premium paid by the inured.
One has to go through pre policy check up under the following conditions
If the proposers aged 40 (forty) years and above
If the proposer is opting for Sum Insured INR 6,00,000 and above, irrespective of the age of the individual.
If the insurer is opting for Critical Illness optional cover, between the age of 18 (eighteen) years and 65 (sixty five) years
Following is the test/ Reports the tone need to submit under the Parivar Mediclaim Policy for family (floater Policy)
Physical examination report which is to be signed by the Doctor with minimum MD (Medicine) qualification
Blood sugar (fasting/ post prandial), HbA1c (If the policy requires)
Urine routine and microscopic examination
Eye check-up (including retinoscopy)
Any other test required by the company and considered necessary for the insurance policy.
Note: The date of medical reports should not exceed 30 days prior to the date of the proposal. 50% of the expenses incurred for pre policy check-up shall be reimbursed if the proposal is accepted. One needs to check the Terms and conditions properly.
Eligibility of the Parivar Mediclaim Policy for family (floater Policy)
Parivar Mediclaim Policy for family (floater Policy)) can be availed by an individual between minimum age of 18 and a maximum of 65 years. Dependent children between the ages of 3 months and 18 years can also be covered under the policy provided at least one of the parents.
|Sum Assured||Rs.2 lakhs to Rs.5 lakhs|
|No claim Bonus||upto 50 percent.|
|Renewal||Upto 65 years of age|
|Pre & post hospitalization||15 & 30 days respectively|
|Extra Cover||Diabetes and Hypertension cover|
Exclusions of the Parivar Mediclaim Policy for family (floater Policy)
Any type of Non-Allopathic treatment such as Ayurvedic, homoeopathic and etc treatment is excluded from the policy.
Any loss or damage that occurs due to the influence of any Drug, alcohol or any in toxic item which is not prescribed from any legal doctor is excluded.
When you are in India, at least you can hope that by any chance someone, some friend or relative will come as a helping hand in the hour of need during a medical emergency. But, when you are travelling overseas, there is no one to look upon in any type of emergency. We all plan beforehand about our travel plans and business trips, remember to keep our important stuff, but, during sudden medical emergencies, everything is just useless. Along with the disease/ illness, this dilemma of where to go, which hospital to look for, currency and etc., gives a big headache to the person.
Overseas Mediclaim Business and Holiday Policy is designed just for the same medical emergency overseas, while one is travelling or out for work. Overseas Mediclaim Business and Holiday cover the illness, repatriation, medical evacuation and that starts from 50000 USD to 500000 USD faced by policyholder abroad.
National Overseas Mediclaim Business and Holiday Policy is available for three categories of travellers-
Business & Holiday
Employment and Study
Corporate Frequent Traveller
Features and benefits of the Overseas Mediclaim Business and Holiday Policy
Overseas Mediclaim Business and Holiday Policy cover the various travel emergencies faced by the policyholder while he/ she is abroad.
The premium of the Overseas Mediclaim Business and Holiday Policy can be paid in Indian Rupees (except in the case of Employment)
Overseas Mediclaim Business and Holiday Policy provide Claim assistance even from an international service provider.
Overseas Mediclaim Business and Holiday cover Loss and delay of checked baggage, loss of passport can also be covered under this plan.
Personal accident and disablement are also covered under the National health insurance plan.
Claims under the Overseas Mediclaim Business and Holiday Policy are payable in foreign currency to Doctors / Hospitals abroad, directly by the service provider in most cases. In case, cashless service is not available insured can claim reimbursement
The Overseas Mediclaim Business and Holiday policy can be purchased by any Citizens of India, Nepal or Bhutan who is going abroad for business or holiday purposes or any Foreign nationals working in India for Indian employers of multinational organizations getting salary in Indian rupees
Under the Overseas Mediclaim Business and Holiday Policy First US$ 100 of all claims is to be borne by the traveller.
Note – If any traveller who is over 70 years of age and travelling above 60 days of the journey then he/ she have to submit the following Medical reports (from an MD Cardiologist) along with the proposal form:
Fasting Blood Sugar or Urine Strip test
In case of travellers unable to submit the above Medical reports cover stands restricted to USD 10,000.
|Extra Cover||Personal accident and disablement|
Exclusions of Overseas Mediclaim Business and Holiday Policy
National Parivar Mediclaim Policy is an effective health insurance policy that offers coverage to the self, dependent children, spouse and parents as well under one sum insured.
Features and Benefits of the National Parivar Mediclaim Policy
National Parivar Mediclaim covers the Hospitalisation expenses of the insured.
National Parivar Mediclaim also offers the AYUSH Treatment under which Allopathic, Ayurvedic, Homeopathy is covered.
National Parivar Mediclaim offers the Pre hospitalisation cover for 30 days and Post hospitalisation cover for 60 days.
140 + Day care treatments (In which the insured do not require hospitalisation for more than 24 hours) is also covered under the National Parivar Mediclaim policy.
Domiciliary treatments ( which are done at home, as suggested by the doctor or due to unavailability of bed in hospital but should be done at the hospital ) are also covered and offer an amount of up to 20%. The Domiciliary treatment benefit is subject to a maximum of INR 50,000
Any expense that occurs due to the treatment that requires an organ transplant from someone then the organ donor expenses are also covered.
Insured also enjoy the no claim benefit, under this a 5% discount on base premium for each claim free year.
National Parivar Mediclaim Policy offers the benefit of tax exemption to the policyholder under section 80 D of the Income Tax Act
National Parivar Mediclaim Policy also covers any expense incurred transferring patient to the hospital in an emergency situation. Insured benefit Up to INR 1,000/- per illness & INR 2,500/- Zone wise rating with discounts on lower rated zones
The policyholder can also avail the benefit of Hospital cash which is one day Rs 300 maximum of 5 days per insured person
National Parivar Mediclaim Policy also offers coverage under Maternity NewBorn up to 10% of Sum Insured subject to Rs 30000 in case of normal delivery and Rs 50000 in case a caesarean.
|Sum insured option||INR 1 Lac to 10 Lac in multiples of 1,00,000|
|Who can be covered||Family including Self, Spouse, dependent children & Parents|
|Policy period||Min – 1 year, Max – 3 year|
Exclusions of the National Parivar Mediclaim Policy
Any type of spinal cord injury treatment is not covered under the National Parivar Mediclaim Policy.
Any expense incurred with the treatment of any sexually transmitted disease, HIV, AIDS is also excluded from the National Parivar Mediclaim Policy.
National Parivar Mediclaim plus Policy is a comprehensive health insurance policy that offers coverage to self, children,spouse, and parents/parents-in-law under one sum insured. The National Parivar Mediclaim Plus policy can be a renewed lifetime.
National Parivar Mediclaim plus policy offer the benefit of the AYUSH Treatment under which Allopathic, Ayurvedic, and Homeopathy are covered up to the full sum insured.
National Parivar Mediclaim plus Policy offers the Pre hospitalisation cover for 30 days and Post hospitalisation cover for 60 days.
National Parivar Mediclaim plus is a unique policy that offers coverage as high as Rs. 50 Lakh, with many innovative features
140 + Day care treatments (In which the insured do not require hospitalisation for more than 24 hours) is also covered under the National Parivar Mediclaim Plus policy.
The policyholder can avail an online discount of 5% while enrolling for new policies and 2.5% if you are renewing your health insurance policy.
National Parivar Mediclaim Plus policy offers three variants namely
Benefits and Features of National Parivar Mediclaim Plus variants are as following
|PLAN A||PLAN B||PLAN C|
|Sum Insured/ Coverage option||Rs.6/7/8/9/10 lakh||Rs.15/20/25 lakh||Rs.30/40/50 lakh|
|Hospital cash benefit (per insured person, per day )||INR 500, max. of 5 day||INR 1,000, max. of 5 day||INR 2,000, max. of 5 days|
|Domiciliary treatment||Up to INR 1,00,000||Up to INR 2,00,000||Up to INR 2,00,000|
|Maternity, Newborn baby cover||Up to INR 30,000 for normal delivery and INR 50,000 for caesarean section||Actual||Actual|
|Infertility treatment Cover||Up to INR 50,000||Up to INR 1,00,000||Up to INR 1,00,000|
|Ambulance expenses (per insured person, in a policy year)||Up to INR 2,500||Up to INR 4,000||Up to INR 5,000|
|Air Ambulance expenses||Not covered||Up to 5% of Sum Insured||Up to 5% of Sum Insured|
|Policy Tenure||Minimum – 1 year and Maximum – 3 years||Minimum – 1 year and Maximum – 3 years||Minimum – 1 year and Maximum – 3 years|
Exclusions of National Parivar Mediclaim plus policy
Expenses incurred towards the treatment of Illness or Injury arising out of alcohol or any in the toxic drug is excluded from the National Parivar Mediclaim plus insurance policy.
Any injury or Illness that is directly or indirectly caused by attributable to war, invasion, any terrorist act or riot is not covered under the National Parivar Mediclaim plus plan.
Every illness has a different treatment process and it has a different set of, medication rules to follow. There are many diseases which are not covered under the basic health insurance policies of various providers and require different health insurance plan to get assistance and expense cover. Critical illness requires different Critical Illness policy cover that secures the individual when he/ she suffers from any critical illness.
National Critical Illness Policy cover the cost of treatment as well as the expensive recovery process associated with these critical illnesses. National Critical Illness Policy is one of its kind critical illness insurance policies that cover expenses in the event the insured person is affected with any of the listed critical illnesses.
National Critical Illness Policy offers two types of Plans 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 illness) are covered.
National Critical Illness policy includes the following illness/ surgeries, depending on the plan opted.
Cancer of Specified Severity
Myocardial Infarction (First Heart Attack of Specified Severity)
Open Chest Coronary Artery Bypass Graft Surgery (CABG)
Open Heart Replacement or Repair of Heart Valves
Coma of Specified Severity
Kidney Failure requiring Regular Dialysis
Stroke Resulting in Permanent Symptoms
Major Organ/Bone Marrow Transplant
Permanent Paralysis of Limbs
Motor Neurone Disease with Permanent Symptoms
Multiple Sclerosis with Persisting Symptoms
End Stage Liver Failure
Third Degree Burns
Good pasture’s Syndrome
Systemic Lupus Erythematosus with Lupus Nephritis
Multiple System Atrophy
Benefits and features of the National Critical Illness Policy
The National Critical Illness Policy pay the full sum insured as mentioned in the schedule, provided the insured person survives for the survival period applicable to that Critical Illness.
Under Plan A and Plan B policyholder can avail the benefit of the sum insured from INR 1 lac to 75 lakh.
Policyholders can avail Discount of 10% (ten percent) is allowed in the premium for eligible family members if the policy is bought for family.
If the insured person has entered the policy before the age 42 (completed age) and renewed the policy for a continuous period of 3 years, an Early Entry Discount ( EED ) of 5% on individual premium will be allowed starting from the fourth policy period and continue in subsequent renewals during the lifetime of the Policy.
If the employees of National Insurance Company want to cover themselves and their family members under the insurance policy, then they can avail the benefit of 15%.
Eligibility of National Critical Illness policy
The proposer should be a minimum of age eighteen (18) years and maximum eligibility age is sixty-five (65) years. Children between the age of five (5) years and eighteen (18) years may be covered, provided parent(s) is/are covered concurrently. Critical Illness Health Policy can be availed for self and the following family members, Spouse, any Dependent legitimate or legally adopted children, up to twenty-five (25) years of age.
|Sum Insured||1 lac to 75 lacs|
|Dependent children cover||Upto 25 years|
|Early Entry Discounts||Available|
Exclusions of the National Critical Illness Policy
Any Total permanent and irreversible loss of all vision in both eyes as a result of illness or accident is excluded from the National Critical illness cover.
Total and irrecoverable loss of the ability to speak as a result of injury or disease to the vocal cords. The inability to speak must be established for a continuous period of 12 months is excluded from the insurance plan.
National Overseas Mediclaim Employment and studies plan is available for three categories of travellers
Business & Holiday
Employment and Study
Corporate Frequent Traveller
|Section – 1 A, illness||1,50,000||1,50,000||5,00,000|
|Section – 1B
|Section – 1 C
|Section – 1 D
Medical Emergency reunion
|Section – II
|USD 750 for each month of study completed||USD 750 for each month of study completed||USD 750 for each month of study completed|
Features and Benefits of National Overseas Mediclaim Employment and studies plan
Overseas Mediclaim Employment and studies Policy covers the various travel emergencies faced by the policyholder while he/ she is abroad.
A premium of the Overseas Mediclaim Employment and studies Policy can be paid in Indian Rupees (except in the case of Employment)
Overseas Mediclaim Employment and studies Policy provide Claim assistance even from an international service provider.
Overseas Mediclaim Employment and studies cover Loss and delay of checked baggage, loss of passport can also be covered under this plan.
Personal accident and disablement are also covered under the National health Mediclaim Employment and studies insurance plan.
Claims under the Overseas Mediclaim Employment and studies policy are payable in foreign currency to Doctors / Hospitals abroad, directly by the service provider in most cases. In case, cashless service is not available insured can claim reimbursement
Eligibility of National Overseas Mediclaim Employment and studies Plan
Citizens of India, Nepal or Bhutan who are going abroad for a holiday or some business purpose or any Foreign Nationals working in India for Indian employers of multinational organizations getting salary in Indian Rupees.
|Extra Cover||Personal accident and disablement|
Exclusions of the National Overseas Mediclaim Employment and studies
If the policyholder is travelling against Medical advice or for Medical treatment including routine check-up, then he is not provided with any cover.
Claims arising out of participation in Military, Naval or Air force operations are also not covered.
Senior citizens are the most important part of our society. Their experience helps society to grow in every aspect. And along with that, they become weak and more prone to health problems. Their treatment cost also gets high. That is why health insurance becomes very important. National Varistha Mediclaim Policy for Senior Citizen is specially designed for senior citizens between the age group of 60 years to 80 years. This policy renewal is available up to the age of 90 years.
Features and benefits of National Varistha Mediclaim Policy for Senior Citizen
National Varistha Mediclaim Policy for Senior Citizen Provides coverage for room costs and ICU charges up to 1% of selected Sum Insured.
The National Varistha Mediclaim Policy for Senior Citizen covers the expenses that occur due to medicines, drugs, blood, diagnostic charges, oxygen etc. up to 50% of the Sum Insured to the insured.
National Varistha Mediclaim Policy for Senior Citizen cover the Costs of surgeons fees, anaesthetists, doctors, consultants or specialists are covered up to 25 % of the Sum Insured.
The National Varistha Mediclaim Policy for Senior Citizen policy provides critical illness covers up to 2 lakhs.
Hospitalization charge up to 1% of Sum Insured is payable to the policyholder
Under this national health insurance policy, the policyholder can get Rs. 1000 on Ambulance cost.
National Varistha Mediclaim Policy for Senior Citizen cover Pre 30 day’s hospital and post hospitalization expenses up to 60 days respectively.
National Varistha Mediclaim Policy for Senior Citizen is eligible for Tax rebate under Indian Income Tax law.
|Entry Age||60 years – 80 years|
|Renewability||Upto 90 years of age.|
|Sum Insured||Rs.1,00,000 for hospitalisation and Rs.2,00,000 for Critical illness cover|
|Policy Period||1 year|
Exclusions of the National Varistha Mediclaim Policy for Senior Citizen policy
Any loss or damage that is caused due to any sexually transmitted diseases such as HIV, AIDS and etc is excluded from National Varistha Mediclaim Policy for Senior Citizen.
Any attempt to harm own self like suicide in a conscious or unconscious state is also not covered under National Varistha Mediclaim Policy for Senior Citizen policy.
Bad time always comes unannounced and with silent steps. Accident cases are just a brilliant example of the disheartening and irreversible impact of a bad time in life
Features and Benefits of the National Individual Personal Accident Policy
National Individual Personal Accident Policy offer Discount of 10% on the total premium if the policy is bought for a family comprising the insured and/or spouse, dependent children, dependent parents.
National Individual Personal Accident Policy offer cover in case of accidental death and permanent or total disability of the policyholder caused by the accident.
There is no necessity of any medical check up in order to avail the benefits of the National Individual Personal Accident Policy.
One can easily purchase and renew the National Individual Personal Accident Policy online.
Eligibility of the National Individual Personal Accident Policy
The National Individual Personal Accident Policy is available for the individual between the minimum age group of 5 years to the maximum age group of 70 years.
|Entry Age||5 years – 70 years|
|Sum Assured||Upto 1000000|
|Bonus||No Claim Bonus upto 50 percent|
|Renewability||Upto 70 years of Age|
|Policy Period||1 Year|
Exclusions of the National Individual Personal Accident Policy
Any accident under the influence of any alcohol, drugs etc is not covered under National Individual Personal Accident Policy.
Any accident during which the insured was not having legal age to drive the vehicle is also not covered under the National Individual Personal Accident Policy.
One should always be clear about what cover do he/ she needs for example maternity, newborn, pre-existing illnesses, heart, cancer, diabetes, etc.
One should read, talk and Research different plan options as much as possible.
It is heartbreaking when your sum assured get exhausted in the middle of your treatment hence always decide on an optimum sum assured taking into consideration inflation.
Always look for the eligibility factor and look at your family and if other members can be added to reduce the overall premium.
Once you have decided on a policy, ensure you read the brochure, terms and conditions and any other relevant documents provided by the National Health Insurance.
Remember and be aware of all points like the exclusions, co-payment options, network hospitals, cashless claim settlement options, and other terms and conditions of the National Health Insurance policy.
Look out for add-ons/ riders as that could help you enhance your cover by paying just a minimal amount of extra premium.
If you want to keep on the coverage of your National Health Insurance as strong and closely packed as it was when you bought the insurance policy, you have to renew it before the due date. National insurance renewal online process is easy and simple. One just needs to follow some simple steps to complete his/ her National Mediclaim insurance renewal.
First, you have to log into the online portal of the National Health Insurance and select the health plan that you want to renew online and enter the policy number and date of birth to continue
Then you have to enter the required details and make your payment through online transaction. You can choose from the payment mode out of Internet Banking or Debit/Credit Card as per your convenience.
Once you finish this, you will receive an online receipt and your National Health Insurance renewal online is complete. You can even download or print the receipt.
It is very transparent and easy to apply for claim under the National Health Insurance. It can be done in two ways –
The cashless facility of the National Health insurance is there only for policies service by a Third Party Administrator (TPA)
One has to check that the selected hospital is falling under the list of network hospitals (Preferred provider network/other network Hospitals), as the cashless claim facility is available in the network hospital only.
In case of planned hospitalisation, insured has to inform TPA/Company in advance (72 hours prior) about the case with basic details.
In case of emergency hospitalisation of the insured, he/she must inform the TPA/Company within 24 hours of hospitalization.
On getting admitted, a Pre-Authorisation Request associated with the cashless service will be shared with the TPA by the hospital along with the duly signed papers.
The claim settlement team have the authority to question and result in the cashless claim. One can go for the Reimbursement claim if the request is rejected for the cashless claim.
Pre hospitalisation and post hospitalisation expenses can be claimed separately after treatment.
All original documents should be submitted within 15 days to TPA, after Post Hospitalisation treatment.
For Reimbursement Claims
One has to submit a written intimation that can be done through the mail, fax about the hospitalisation of the insured to Third Party Administrator (TPA) /Company within 72 hours of hospitalisation in the case of emergency hospitalisation. And in case of planned, the intimation should be done 72 hours prior.
Don’t forget to collect Discharge Summary, investigation report and required documents from the hospital.
All original documents should be submitted to TPA / Office within 15 days from the date of discharge.
You can claim for Pre hospitalisation and post hospitalisation separately as well.
Submit original copies of all required documents within 15 days after completion of Post Hospitalisation treatment.
Every shining thing is not gold. Although there are many health insurance companies all over India, you cannot compromise with the safety of your health and your loved one. The National Health Insurance is one of the insurance companies owned by Indian Government that was founded before Independence. National Health Insurance plans are designed in a flexible manner and keeping in mind the India customer and their need it offers a wide range of health products with free quotes to fulfil all the requirements.
It not only offers economic support but National health insurance also make the insured and loved ones stress free from the various factors like doctors’ consultation, compromise due to expensive treatments and no guidance during an emergency. National Health Insurance even gives a chance to widen the scope of health insurance policy and also for cover critical illness by paying additional premium without burning a hole in the pocket of an individual.
1. What are the original documents required to settle the claim of National Health Insurance ?
Following original documents are required to settle the claim of National Health Insurance -
Duly signed claim form Discharge documents
Doctor's certificates and prescriptions
Hospital bills and receipts
Pharmacy bills and receipts
Laboratory and other investigation reports/plates/films and bills
2. Who have to go for the pre policy, check up?
Pre policy check up is required in cases where the proposer is
40 (forty) years and above or
He/ She opting for Sum Insured INR 6,00,000 and above (irrespective of age)
He/ She opting for Critical Illness optional cover, between the age of 18 (eighteen) years and 65 (sixty five) years.
3. How to pay the National Health Insurance premium? What are the modes of payment available?
The National Insurance Company offers 2 modes of premium payment namely:
Cash payment at the branch
For the online payment mode, the policyholder can pay via;
4. From where can I buy the National Health Insurance Policy
The National Health Insurance Policy can be bought from the channels mentioned below.
Online from http://niconline.in/, for policies where Pre Policy Check up is not required.
From the National Health Insurance offices
From the National Health Insurance agents
From self service kiosks (POS Machines)
From Office on Wheels (office on the mobile van)
5. What are the documents required for purchasing National Insurance Medical Insurance?
Following documents are Required for Purchasing National Insurance Medical Insurance -
Valid government-issued ID proof such as Aadhaar, Voter ID, Driving Licence, Passport, etc.
Valid address proof such as electricity bill, water bill, ration card, Driving Licence, Passport, Aadhaar, etc.
Medical reports if needed.
6. Is there any tax benefit on the National Health Insurance schemes?
Yes. Tax exemption is available under section 80D of the Income Tax Act for the National Health Insurance schemes.
7. How can I check my policy status for National Health Insurance?
In order to check the status of your National Health Insurance policy, log in to the company website with valid credentials and enter the policy number.
8. What is called the claim settlement ratio?
Claim settlement ratio of National Health Insurance policy is the number of insurance policy claims settled by the insurer against the total number of claim request received by the company.
9. Can a doctor refuse to release my medical records?
HIPAA (Health Insurance Portability and Accountability Act of 1996) gives the patients total right to get a copy of their medical records, therefore a doctor can’t refuse to release the medical records of a patient.
10. What is the benefit of the National Health Insurance network hospitals?
The benefit of the National Health Insurance network hospitals is the cashless treatment of the policyholder. If the hospital is not network hospital, then policyholder can only opt for the reimbursement claim, not the cashless claim.
Last updated on 08-07-2019