Network hospitals
3000+
Incurred claim ratio
102.35%
Sum insured
Up to 50 Lakh
No. of Plans
13
Solvency Ratio
0.3
Pan India Presence
1730
Network hospitals
3000+
Incurred claim ratio
102.35%
Sum insured
Up to 50 Lakh
No. of Plans
13
Solvency Ratio
0.3
Pan India Presence
1730
Buying individual health insurance may seem hectic for some of us, as the monthly premiums might be a pain for our pockets. Here comes the contribution of a group mediclaim policy that offers you all-inclusive health support benefits. The National Insurance Group Mediclaim Policy is an indemnity insurance product that significantly provides coverage for a group of policyholders. The plan caters to the basic health care needs of an employer-employee and a non-employer-employee. Anyone is entitled to get issued with this policy on an individual basis under a group. Given that the separate sum insured of the plan applies to each of the individuals who are insured under the group policy, the above condition applies to a family group or an employee-employer group.
This plan has a wide sum insured ranging from INR 50,000 to INR 10 Lakhs in 15 slabs (in the multiples of x value in ascending order). The value of the sum insured is attended in two ways:
Apart from this, if you are worried about getting coverage for daycare treatment or hospitalisation, worry not. National Insurance Group policy covers 140+ daycare procedures, along with in-patient hospitalisation (for allopathic, homoeopathic, and Ayurvedic treatment), pre-hospitalisation (30 days prior hospitalisation), post-hospitalisation (60 days from the date of hospital discharge), and an illness constrained during the policy tenure.
Similarly, the plan has extended coverage facilitating 12 kinds of modern treatment, the inclusion of advanced treatment like HIV/AIDS, mental illness, morbid obesity, refractive error correction, organ donor's expenses, ambulance service benefits, etc. Additionally, this plan has a clause of sub-limits which is subject to be applied over the mentioned expenses from the policy schedule. For example, room rent charges, medical practitioner/doctor's visit fees, procedures such as hemodialysis, radiotherapy, and chemotherapy (subject to over-sub-limit expenses), pre & post-hospitalisation, etc are advised under or over the sub-limit (as per the schedule).
This page consists of the benefits and specifications of the National Insurance Company Group Policy. Read further to know more.
These are a few factors that decide the eligibility criteria for the National Insurance Group Mediclaim Policy:
Child Entry Age
3 Months - 18 Months (dependant)
Adult Entry Age
18 Years - No Maximum Limit
Plan Type
Group indemnity policy (on an individual basis)
Policy Tenure
1 Year
Initial Waiting Period
30 Days
Sum Insured
INR 50,000 - 10 Lakhs
*The Initial Waiting Period is the period between the issuance of the policy and the time it starts actively. During this period, a policyholder has to wait to avail of the benefits offered under a health insurance plan.
To know more about the plan, read the prospectus provided below:
Read below to know in detail about the benefits of a group mediclaim policy by the National Insurance Company:
The National Insurance Group Mediclaim Policy has different features based on the criteria mentioned in the company's policy schedule. See below the plan specifications:
In-patient & Out-patient coverage
Room Rent
Available
ICU Charges
Available
Pre-Hospitalization
Available
Post-Hospitalization
Available
Domiciliary Hospitalization
Not Covered
Daycare Treatment
Covered
OPD Charges
Not Covered
Coverage Terms
COVID-19 Treatment
Covered
Cataract
Covered
No Claim Bonus
Not Applicable
Automatic Restoration
Not Covered
Daily Hospital Cash
Not Covered
Organ Donor
Covered
Maternity Cover
Covered
New Born Baby Cover
Covered
Alternative Treatments
AYUSH Treatment
Covered
IVF Treatment
Not Applicable
Modern Treatment
Covered
Emergency Coverage
Ambulance
Covered
Air Ambulance
Not Covered
Compassionate Travel
Not Available
Global Coverage
Not Available
Wellness Programmes
E-Consultation
Not Covered
Health Check-Up
Not Covered
Second Medical Opinion
Not Covered
Vaccination
Not Covered
Limitations
Co-payment
Applicable
Sub-limits
Applicable
The room rent limit is the maximum amount of bed charge that you can claim if you are hospitalized.
Common room categories covered under room rent are:
Coverage status under the National Insurance Group Mediclaim Policy?
Room rent per day shall be payable up to 1% of the Sum Insured subject to a maximum of INR 10,000 per day. The maximum amount admissible under room charges for any one illness shall be 25% of the SI.
It is a special department in the hospitals where patients with serious medical conditions are treated.
Coverage status under the National Insurance Group Mediclaim Policy?
ICU Charges per day shall be payable up to 2% of Sum Insured subject to a maximum of INR 20,000 per day (sub-limits are applicable)
Medical expenses incurred before the hospitalization of the policyholder.
Coverage status under the National Insurance Group Mediclaim Policy?
Covered for up to 30 days before hospitalisation.
Medical expenses incurred after the discharge of the policyholder from the hospital.
Coverage status under the National Insurance Group Mediclaim Policy?
Covered for up to 60 days after hospitalisation.
Home hospitalization arrangement for the insured person due to unavailability of medical amenities in hospitals. The treatment should last equal to or more than 72 hrs to get financial coverage.
Coverage status under the National Insurance Group Mediclaim Policy?
Not Available
Treatments that can be treated in less than 24 hours of hospitalization like blood dialysis, cataract, etc.
Coverage status under the National Insurance Group Mediclaim Policy?
140+ listed daycare treatments covered up to SI.
Covers the cost of doctor consultation and prescribed medical tests that may not require hospitalization.
Coverage status under the National Insurance Group Mediclaim Policy?
Not covered.
COVID-19 treatment includes the cost of treatment for COVID-19 with a confirmative diagnosis from Govt. an approved center.
Coverage status under the National Insurance Group Mediclaim Policy?
Covid-19 Covered.
A common eye condition in which your vision gets blurred.
Coverage status under the National Insurance Group Mediclaim Policy?
Covered. Subject to 25% of the Sum Insured or INR 40,000 per eye, whichever is lower in a policy period for each insured person with a waiting period of 2 years.
For every claim-free year, insurance companies reward policyholders with an increase in the Sum Insured amount as a no-claim bonus on policy renewal. However, in the case of a claim, this bonus amount either lapses or is reduced by a certain percentage that varies from plan to plan.
Coverage status under the National Insurance Group Mediclaim Policy?
Not Applicable.
Automatic restoration is a benefit in which an insurance company restores the sum insured amount completely or up to a certain percentage after it gets fully exhausted in treatments. This restoration amount may vary from plan to plan.
Coverage status under the National Insurance Group Mediclaim Policy?
Not applicable.
It is a cash amount that you receive each day during the time of hospitalization.
Coverage status under the National Insurance Group Mediclaim Policy?
Not available
It is a cover that includes the cost of the procedure for removing the damaged or malfunctioning organs from the body.
Coverage status under the National Insurance Group Mediclaim Policy?
The expenses of the organ donor are covered.
It refers to the cover that includes expenses for normal and c-section procedures deliveries.
Coverage status under the National Insurance Group Mediclaim Policy?
Covered only under the optional covers. Ranges up to INR 50,000 for up to the first two deliveries or terminations of pregnancy of the insured.
It takes care of the medical expenses that arise due to the hospitalization of the newborn baby in case of unforeseen circumstances. Some of the common treatments that are covered under the newborn cover are listed below and these common treatments can vary from plan to plan:
Coverage status under the National Insurance Group Mediclaim Policy?
Pre-natal and post-natal hospitalisation expenses per delivery are covered under maternity cover (applicable under optional covers only)
Refers to the cost of medicines and procedures used under AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) treatment.
Coverage status under the National Insurance Group Mediclaim Policy?
Only Ayurveda and Homeopathy treatment and hospitalisation under these two are applicable.
In Vitro Fertilization (IVF) is a method of assisted reproductive technology. The common expenses incurred under IVF and infertility treatments are for:
Coverage status under the National Insurance Group Mediclaim Policy?
Not covered
Medical treatments that demand modern technology such as robotic surgeries, stem cell therapy, etc.
Coverage status under the National Insurance Group Mediclaim Policy?
12 kinds of modern treatment are covered. The maximum amount admissible for any one modern treatment shall be 25% of the Sum Insured and this limit may be increased to 50% of the Sum Insured, by opting for optional cover.
An ambulance is used to move the patient from home to hospital, transfer to another hospital, and take them for different tests outside the hospitals.
Coverage status under the National Insurance Group Mediclaim Policy?
Covered up to 1% of the Sum Insured subject to a maximum of INR 1,000 in a policy year for each insured person, for transportation to the hospital or from the hospital to another hospital or from the hospital to the diagnostic centre and return during the same hospitalisation.
Air ambulances are specially prepared planes that transfer the patient from one place to another in case of a health emergency.
Coverage status under the National Insurance Group Mediclaim Policy?
Not covered.
Refers to the traveling expenses of a family member of the insured person in case the policyholders get admitted to a hospital outside his/her residential city.
Coverage status under the National Insurance Group Mediclaim Policy?
Not Applicable
Any kind of medical/health emergency when you are outside of India.
Coverage status under the National Insurance Group Mediclaim Policy?
Not covered.
If a policy offers E-consultation it allows policyholders to connect with a doctor for medical consultation through video chat, audio call, or chatbot.
Coverage status under the National Insurance Group Mediclaim Policy?
Not covered.
A facility where the policyholder can avail free health check-ups after fulfilling the company's policies.
Coverage status under the National Insurance Group Mediclaim Policy?
Not covered.
If the policyholder wants, they may opt for a second medical opinion wherein the policyholder can consult another doctor within the company's network of medical practitioners.
Coverage status under the National Insurance Group Mediclaim Policy?
Not covered.
Coverage against the expenses incurred on vaccinations is provided by the insurance companies.
Coverage status under the National Insurance Group Mediclaim Policy?
Not covered.
In the co-payment clause, policyholders have to pay a portion of the hospitalization expense on their own and the insurer will pay the rest of the amount.
Status under National Mediclaim Policy?
Applicable.
Sub limit is a condition in which the insurer will have to pay the medical expense up to a certain percentage and the remaining amount will have to be paid by the policyholder.
Status under National Mediclaim Policy?
Available.
Here is a list of standard exclusions under the National Group Mediclaim Policy:
Investigation and evaluation
Rest cure, rehabilitation and respite care
Obesity/ weight control treatment
Change-of-gender treatments, cosmetic or plastic surgery, and unproven treatments
Birth control, sterility and infertility
Hazardous or adventure sports
Breach of law, drug/alcohol abuse, self-inflicted injury, suicidal act, and non-prescription drug
Hormone replacement therapy, general debility, congenital external anomaly, and dental treatment
Domiciliary hospitalisation & out-patient department (OPD) treatment
Massages, steam baths, alternative treatment (Other than Ayurveda and Homeopathy)
Treatment taken outside the geographical limits of India
Permanently excluded diseases, etc.
To avail of claim settlement services, the insured individual must follow the process below:
Individuals can call the toll-free number 1800 345 0330 or email nic.health@nic.co.in to know about their policy's claim settlement procedure.
National Health offers a wide range of health insurance plans to fulfill the medical needs of individuals, families, and senior citizens.
Standard
If you are looking for a policy that covers you for In-patient treatment expenses and 140+ Day Care Procedures then this plan is the right choice.
Unique Features
Comprehensive
This plan suits you best if you are a newly married individual or have dependents like kids or elderly parents as this health plan covers all of them along with you.
Unique Features
Family Floater
An affordable health plan, that offers 140+ day care procedures and covers pre-existing conditions like diabetes and hypertension.
Unique Features
Family Floater
If you are looking for a healthcare policy providing a high sum assured and covers your family members under one cover this is the right policy for you.
Unique Features
Standard
Standard indemnity health insurance product, having Sum Insured up to 10 Lakhs available in both individuals and floater type.
Unique Features
Super Top-up
This policy covers your family members and offers high coverage at affordable prices.
Unique Features
Comprehensive
A versatile health insurance policy available on an individual and family floater basis offering various optional covers.
Unique Features
Global Coverage
This plan is essential for those who like to travel, a package policy that covers travel emergencies while traveling abroad.
Unique Features
Global Coverage
A plan beneficial for students who are traveling abroad for education, it is designed to cover medical evacuation, illness, and more.
Unique Features
Critical Illness
A unique benefit policy that covers expenses in the event of the insured person being affected with any of the listed critical illnesses.
Unique Features
Senior citizen
Secure your parents' future by providing medical coverage to senior citizens.
Unique Features
Student Specific
Mediclaim for Students is a unique policy designed to provide health and personal accident cover to students.
Unique Features
COVID-19
This policy focuses on protecting the policyholders against the treatment expenses resulting due to COVID-19 infection.
Unique Features
Disability Plan
An indemnity health insurance designed for people falling under the category of disabled, affected with HIV/AIDS, and mental illnesses.
Unique Features
Group Health Plan
It is a group indemnity health insurance plan designed to address the basic health insurance needs of employees.
Unique Features
Accident Policy
This policy is designed to cater to high-risk professionals categorized as the normal, medium, and heavy occupational risk of the person.
Unique Features
National Insurance Group Mediclaim policy is a wholesome indemnity insurance that provides overall coverage to the policyholder. The coverage benefits include pre and post-hospitalisation, in-patient care (for Allopathy, Ayurveda, and Homoeopathy) modern treatment, daycare procedures, mental illness coverage, and much more.
There's no better way of safeguarding yourself as the entitled insured of a group and your family with a group plan than the National Insurance mediclaim policy. So, why the wait? Waste no time to buy a health policy now!
Want to know more? Contact our customer care executives at 18003450330 or visit the official website of PolicyX.com.
In-patient care (Allopathic, Ayurveda and Homoeopathy), day care treatment, pre-hospitalisation (30 days) and post-hospitalisation (60 days) expenses, 140+ day care procedures, mental illness treatment, HIV/ AIDS treatment, organ donor's medical expenses, ambulance charges & Morbid Obesity Treatment,
Yes, more than 140 daycare procedures are covered under the National Insurance group mediclaim policy.
The maximum sum insured of this plan goes up to INR 10 Lakhs of which SI ranging from INR 50,000 - 5 Lakhs comes in a multiple of INR 50,000. Whereas, SI of INR 6-10 Lakhs is available in the multiples of INR 1 Lakh.
Yes, 12 kinds of modern treatment within the sub-limit are available under the plan.
The National Insurance group mediclaim policy is curated to provide basic health care support for a group of people either as an employer-employee or a non-employer-employee.
See More Health Insurance Articles
See More Health Insurance Articles
4.4
Rated by 2629 customers
Select Your Rating
Let us know about your experience or any feedback that might help us serve you better in future.
Simran has an experience of 3 years in insurance content writing. She transitioned from hospitality to the insurance industry after her emerging interest in how vast insurance is. With her ability to write complex insurance concepts in a simple, relatable manner she keeps her audience hooked and solves their doubts smoothly.
You May Also Know About
Our experts will provide you with guidance and address all your concerns within 30 minutes.
Note: Choose your desired date and time slot and our expert will get in touch with you shortly.
In case you have not found your desired slot, you can visit at website and use the Request Call Back option.
You are just one step away from getting insurance.
Policyx offers a completely spam-free experience. We will never contact you unless you request us to do so.
Your call has been scheduled with Policyx for health insurance.
Talk to an advisor
February 5, 2023
Asia/Kolkata
Do you have any thoughts you’d like to share?