National Parivar Mediclaim Policy
  • Explore the plan's key features
  • Find out the eligibility criteria
  • Learn its benefits & exclusions

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National Parivar Mediclaim Policy

National Parivar Mediclaim Plan aims to encourage the protection of the whole family on a single sum insured. This is a family floater plan that provides coverage for various illnesses or accidents. The benefits of the policy can be availed of by any of the family members covered in the plan.

The plan comes with a variety of features that provides medical treatment and advice for your family members from medical experts without worrying about the hospital bills.

To help you understand more about the plan, we’ve explained below all the features, additional benefits, eligibility criteria and exclusions of this policy. Read below.

Key Features of National Parivar Mediclaim Policy

National Parivar Mediclaim Policy ensures comprehensive protection of the insured and his family members by offering a variety of useful features mentioned below.

  1. Inpatient Hospitalization

    This will consist of all the charges associated with room, pharmaceuticals, operation theatre expenses, diagnostic procedures, ICU, surgeries etc.

  2. Pre and Post Hospitalization

    The pre-hospitalization expenses will be covered on a reimbursement basis for 30 days before in-patient hospitalization. Whereas the post-hospitalization charges will get coverage for 60 days immediately after the discharge letter has been allocated to the insured.

  3. Domiciliary Hospitalization

    It covers the treatment cost of illness mentioned in the policy that took place at home on the advice of a medical practitioner. The treatment should last for more than three days.

  4. Daycare Procedure

    This policy provides coverage for listed 140+ daycare procedures which can be cured within 24 hours due to the advancement in medical technology.

  5. Ayurveda and Homeopathy

    The plan allows policyholders to claim in-patient, pre and post-hospitalization expenses incurred on Ayurveda and Homeopathy treatment which is up to the sum insured.

  6. Organ Donor Expenses

    This feature provides cover for the expenses of organ transplantation advised by a medical expert to the insured. All the in-patient, pre and post-hospitalization expenses of the donor will get reimbursed.

  7. Hospital Cash

    The insured will get a daily allowance of cash on the hospitalization of more than 3 days. The amount payable on a daily basis is Rs. 300 for a maximum of five days. For example, if the hospitalization is for 10 days, the cash payment will be from the 4th to the 8th day i.e only for five days.

  8. Ambulance

    The insured can avail cover for the ambulance expenses incurred while transporting the insured person to the hospital or from one hospital to another hospital. The amount of this cover equals the sub-limits as mentioned in the policy brochure.

  9. Maternity and Baby Expenses

    All the in-patient expenses of the delivery or termination of pregnancy will get covered a maximum of two times during the life of the policy.

  10. Anti-Rabies Vaccination

    A coverage of Rs. 5000 will be supplied towards the vaccination expenses incurred.

  11. Infertility

    A coverage of Rs. 50,000 maximum will be provided to the spouse of the insured for the in-patient expenses that occurred due to the treatment of infertility.

  12. HIV/AIDS cover

    The plan provides cover for in-patient care, Pre-Hospitalisation expenses and Post-Hospitalisation expenses resulting due to HIV infection.

  13. Modern Treatment

    To offer comprehensive protection, the policy also covers the expenses of 12 types of modern treatments including immunotherapies, oral chemotherapies, robotic surgery, among others.

  14. Lifetime Renewability

    The policy also offers additional benefits of a lifelong renewability option that allow customers to enjoy the policy benefits for a long tenure.

  15. Tax Benefits

    As per section 80D of the Income Tax Act, 1961, the premium paid towards this health insurance policy is liable to get the helpful tax benefits.

Additional Benefits of National Parivar Mediclaim Policy

In addition to the above-listed key features, the National Parivar Mediclaim Policy also comes with a list of added benefits. Customers can increase their coverage by customizing the plan with these benefits. Let’s understand in detail.

  • Health Check-ups - The health check-up expenses are paid by the insurer after four continuous years of the policy and up to Rs. 5,000.
  • No Claims Discount - Insured will gain a discount of 5% on the base premium for not making a claim in a year along with the timely renewal of the policy.
  • Medical Second Opinion - In the case of major illness which can be cancerous/non-cancerous are given the facility of one medical second opinion per year for 88 major ailments listed in the policy.
  • Optional Coverage - This policy provides the benefit of three types of optional coverage to the policyholder. Read below.

1 Pre-Existing Diabetes/Hypertension

Though pre-existing ailments are covered after a waiting period but with this add-on cover insured can get coverage on the inception of the policy. The insured is liable to pay some percentage of the claim as a co-payment.

If opting either for one Pre-Existing Diabetes or Pre-Existing Hypertension cover, then you will pay 10% of co-payment. If opting for both Pre-Existing Diabetes and Hypertension cover, then you have to pay 25% of the co-payment.

2 Outpatient Treatment

The expenses such as consultation fee, pharmaceuticals, medical tests, and out-patient dental treatment can get reimbursed with this add-on. The additional coverage amount offered by the company is Rs. 2,000; Rs. 3,000; Rs. 4,000; Rs. 5,000; Rs. 10,000 along with the sum insured.

3 Critical Illness

With the payment of additional premium, the insured can easily get covered in the event of critical illness detection. The additional amounts that the insured can utilize towards the treatment of an illness are Rs. 2/ 3/ 4/ 5/ 10 lakhs along with the sum insured.

Eligibility Criteria of National Parivar Mediclaim Policy

National Insurance Company has fixed a certain set of conditions that customers are required to fulfill in order to buy this plan. The table given below enlists the eligibility conditions of this plan.

CriteriaMinimumMaximum
Age at entry18 years64 years
Sum InsuredRs. 1 LakhRs. 10 Lakhs
Policy Term1 Year3 Year
Family Members coveredSelf, Spouse, Dependent Children, Parents
Pre & post-hospitalisation30 & 60 days

Discounts Available on National Parivar Mediclaim Policy

Long Term Discount

Buying the policy of more than one year will permit a discount of 4% on two years and 7.5% on a three-year policy period.

Online Purchase Discount

Online purchase or renewal of a policy will offer a discount of 5% and 2.5%, respectively.

Discount for Infertility for Insured Above 40 Years

If the insured and his spouse suffers any infertility, they will avail a discount of 3% on the premium paid annually. The couple must be more than 40 years.

Zonal Discount

The policy has 4 zones in total that get a specified percentage of discount on premium paid.

  • Zone I - No discount available
  • Zone II - A discount of 4.4%,
  • Zone III - A discount of 11.11%
  • Zone IV - A discount of 20%

Sample Premium Illustration of National Parivar Mediclaim Policy

Before buying any health insurance plan, it is important to get an idea about the premium amount you’ll be paying. This helps customers in making an informed decision. We’ve provided here a sample premium illustration chart of the National Parivar Mediclaim Policy for better understanding.

This chart here shows premium rates for different amounts of the sum insured. Note that the data in this chart is calculated for a 25-year old person taking cover for one person in his policy, and for a term period of 1 year.

Sample Premium Illustration of National Parivar Mediclaim Policy

Premium chart of National Parivar Mediclaim Policy

Exclusions of National Parivar Mediclaim Policy

There are certain exclusions of this plan under which the company does not provide any coverage. Read below.

  • Sexually transmitted HIV/AIDS
  • Genetic Disorders, Dental treatment, miscarriage, abortion, surrogacy
  • Vaccinations except for anti-rabies
  • Cosmetic or aesthetic treatment, hormone replacement therapy
  • Massages, spa, naturopathy
  • Obesity, self-inflicted injuries, suicides, psychiatric disorder
  • Hearing aid, contact lens, spectacles

How to Purchase National Parivar Mediclaim Policy?

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.

In the section below, we've given a 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 make an online payment for 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 Parivar Mediclaim Policy?

National insurance company settles claims using two easy methods:

Cashless Claim processReimbursement Claim process

In the cashless claim process, the company settles all the hospitalization expenses of the policyholder. 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 and approve the claim amount.

What is the Renewal process for the National Parivar Mediclaim Policy?

  • Visit the official website of the company.
  • Click on "Quick Renewal" and a new tab will open.
  • Enter your current policy number.
  • Answer the given CAPTCHA and click on the "Renew Policy" option.
  • Make an online payment for the premium and your policy will be renewed.

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FAQ's

1. Will, the company pay for the pre-policy expenses?

Yes, the company is liable to pay 50% of the expenses that arise out of pre-policy check-up.

2. What kind of check-ups are done in pre-policy check-ups?

The policyholders, if required had to undergo the following check-ups:

  • Physical examination
  • Blood sugar and lipid profile
  • Urine and microscopic examination
  • ECG
  • Eye check-up
  • Serum creatinine
  • There may be a possibility of additional examination as demanded by the company.

3. What are the waiting periods in the policy?

There are certain diseases mentioned in the policy that go through waiting periods.

  • 4 years of waiting- Pre-existing diseases like diabetes, hypertension, joint replacement (not by accident) are covered after 48 months from the starting date of the policy.
  • 2 years of waiting- Ailments such as cataract, hysterectomy, non-infective arthritis, piles, hernia, Sinusitis, calculus, diabetes, hypertension, surgeries of the gallbladder and genito-urinary, etc. are covered after passing of 24 months.
  • 30 days waiting- If the insured suffered any illness or injuries in the first thirty days of the policy, then he will not get any reimbursement for the expenses incurred.

4. What is the time limit to inform the TPA of a cashless claim?

In the case of planned hospitalization, the insured is given a time limit of 72 hours to inform before the patient is hospitalised into the network hospital.

In the case of emergency hospitalization, the insured have to notify the insurer within 24 hours immediately after the hospitalisation of the patient into the network hospital.

5. What is the notification period for reimbursement of claim?

For planned and domiciliary hospitalization, the insurance provider has to be notified at least 72 hours before the admission process of the patient takes place.

For emergency and domiciliary hospitalization, a time limit of 24 hours is given to update the insurer after the admission to the network provider.

For Anti-Rabies Vaccination, the insurer must be notified at least 24 hours before the vaccination takes place.

6. What is co-payment?

When the insured is bound to pay some percentage of the claim as determined during the purchase of the policy, it is called co-payment.

7. Are there any co-payments in the optional cover of Pre-existing Diabetes/Hypertension?

Yes, the insured person has to pay for the co-payments while buying this optional cover.

CoverCopayment
Pre-existing Diabetes10% of the claim amount admitted by the insurer for diabetes alone.
Pre-existing Hypertension10% of the claim amount admitted by the insurer for Hypertension alone.
Pre-existing Diabetes and Hypertension25% of the claim amount admitted by the insurer for both Diabetes and Hypertension

8. What are the different zones in the policy?

The premium paid by the insured is according to the Zone selected. There are 4 Zones in total.

  • Zone I: Includes Metropolitan area of Mumbai and the whole of Gujarat
  • Zone II: Delhi NCR, Chandigarh, Pune
  • Zone III: Chennai, Hyderabad, Kolkata
  • Zone IV: Remaining parts of India

9. What copayment is involved in availing treatment outside of the selected Zone?

  • If Zone I is selected, the treatment is taken in zone II, Zone III, Zone IV is free of any copayment.
  • If zone II is selected, then the treatment carried out in zone II, Zone III, Zone IV is free of copayment. While the treatment in Zone I will subject to a copayment of 5% of the claim.
  • If zone III is selected, then the treatment carried out in Zone III, Zone IV is free of copayment.
  • Whereas treatment availed in zone II and Zone I will subject to a copayment of 7.5% and 12.5%, respectively.
  • If zone IV is selected, then the treatment carried out in Zone IV is free of copayment. On the other side, if the treatment is availed in Zone III/ Zone II/ Zone I, then copayment percentages will be 10%/ 17.5%/ 22.5%, respectively.

10. How much premium is charged in case we cancel the policy?

If you cancel your policy, the insurance company will charge a cancellation cost on the premium submitted for a year. The rate will be determined on the period of risk.

Period of riskPremium charged
Up to 1 month¼ of the yearly amount of premium
Up to 3 month½ of the yearly amount of premium
Up to 6 month¾ of the yearly amount of premium
Exceeding 6 monthsThe whole amount of premium paid in a year

11. What are some major illnesses for which the second opinion can be availed?

The major illnesses have been categorized as follows:

  • Non-Cancerous - AIDS/HIV, coronary artery, Elephantiasis, liver and lung diseases, kidney and liver failure, paralysis, heart disease, stroke, cirrhosis, brain tumor, etc.
  • Cancerous - Cancer-related to breast, eye, thyroid, bladder, cervical, lung, kidney, skin, uterine, stomach, pancreas, ovary, etc.

Find Out What the 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 20July, 2021

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