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.
National Parivar Mediclaim Policy ensures comprehensive protection of the insured and his family members by offering a variety of useful features mentioned below.
This will consist of all the charges associated with room, pharmaceuticals, operation theatre expenses, diagnostic procedures, ICU, surgeries etc.
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.
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.
This policy provides coverage for listed 140+ daycare procedures which can be cured within 24 hours due to the advancement in medical technology.
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.
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.
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.
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.
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.
A coverage of Rs. 5000 will be supplied towards the vaccination expenses incurred.
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.
The plan provides cover for in-patient care, Pre-Hospitalisation expenses and Post-Hospitalisation expenses resulting due to HIV infection.
To offer comprehensive protection, the policy also covers the expenses of 12 types of modern treatments including immunotherapies, oral chemotherapies, robotic surgery, among others.
The policy also offers additional benefits of a lifelong renewability option that allow customers to enjoy the policy benefits for a long tenure.
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.
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.
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.
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.
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.
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.
|Age at entry||18 years||64 years|
|Sum Insured||Rs. 1 Lakh||Rs. 10 Lakhs|
|Policy Term||1 Year||3 Year|
|Family Members covered||Self, Spouse, Dependent Children, Parents|
|Pre & post-hospitalisation||30 & 60 days|
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.
The policy has 4 zones in total that get a specified percentage of discount on premium paid.
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
There are certain exclusions of this plan under which the company does not provide any coverage. Read below.
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.
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.
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.
The cashless facility is only for policies that are purchased via a Third-Party Administrator (TPA).
Note Submit all the required documents to the TPA within 15 days.
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Yes, the company is liable to pay 50% of the expenses that arise out of pre-policy check-up.
The policyholders, if required had to undergo the following check-ups:
There are certain diseases mentioned in the policy that go through waiting periods.
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.
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.
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.
Yes, the insured person has to pay for the co-payments while buying this optional cover.
|Pre-existing Diabetes||10% of the claim amount admitted by the insurer for diabetes alone.|
|Pre-existing Hypertension||10% of the claim amount admitted by the insurer for Hypertension alone.|
|Pre-existing Diabetes and Hypertension||25% of the claim amount admitted by the insurer for both Diabetes and Hypertension|
The premium paid by the insured is according to the Zone selected. There are 4 Zones in total.
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 risk||Premium charged|
|Up to 1 month||¼ of the yearly amount of premium|
|Up to 3 month||½ of the yearly amount of premium|
|Up to 6 month||¾ of the yearly amount of premium|
|Exceeding 6 months||The whole amount of premium paid in a year|
The major illnesses have been categorized as follows:
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