National Parivar Mediclaim Plus Policy

Product Overview

National Parivar Mediclaim Plus Health Insurance Plan is an inpatient hospitalization policy, along with host of other benefits like - Day Care Treatments, Pre & Post Hospitalization expenses, Ayurvedic & Homeopathic Treatments, etc.

Unique Features of National Parivar Mediclaim Plus Policy

• Pre-Existing Disease are covered after 3 years under this plan
• Maternity are covered after 2 years/Infertility covered under this plan
• Air Ambulance and Medical Emergency Reunion Covered under Plan B & C.
• Reinstatement of sum insured due to road traffic accident
• Ayurveda and Homeopathy are covered/Medical Second Opinion
• Some Organ Specific are Covered after 1 year like ENT disorder etc.

Features of edit Edit Details

Critical features of National Parivar Mediclaim Plus Policy

• Room rent:
  Limits imposed towards room and ICU rent expenses
  This Product has 3 variants Plan-A, Plan-B, Plan-C

1. Plan A Room rent limit 1% and ICU 2% of the sum insured per day or actual whichever is lower
2. Plan B Room and ICU rent limit is Actual
3. Plan C Room and ICU rent limit is Actual

• Co-Pay:
  Specific % of admissible claim amount to be borne by Insured

1. Plan A has 10% copayment treatment in non-network hospital
2. There is Zone wise copayment clause for detail refer the policy document
3. Cataract Treatment: Plan A - For each eye – Up to 15% of SI or INR 60,000 whichever is lower. Plan B & C - Actual treatment cost upto Sum Insured.

• No Claim Bonus:
  Health Insurance policies may offer Cumulative Bonus wherein for every claim free year, the Sum Insured is increased by a certain percentage at the time of renewal
  This plan does not offer no claim bonus benefits However, in the event of no claim 5 % discount will be available in renewal premium
• Pre-Existing Diseases:
  Means any condition, ailment or injury or related condition(s) for which you had signs or symptoms, and / or were diagnosed, and / or received medical advice/ treatment, within 48 months prior to the first policy issued by the insurer

1. This plan has a waiting period of 3 years is case of pre-existing diseases
2. Maternity has a waiting period of 2 years

Eligibility Criteria

• Minimum Age of Entry:- Children - 3 months and 18 years / Adult - 18 years
• Maximum age of Entry:- 65 years
• Sum Insured:-
  Plan A - Rs 6/7/8/9/10 Lakhs
  Plan B - Rs 15/20/25 Lakhs
• Policy Tenure:- 1, 2 & 3 years
• Premium Calculated on Basis of:- Age, Zone (i.e. sum Insured Choosen)

Add-ons

• Pre-existing Diabetes/Hypertension (as Floater):
  Pre-existing Diabetes & Hypertension –

1. First year – up to 25% of SI
2. Second year – up to 50% of SI
3. Third year – up to 75% of SI

• Out-patient Treatment (as Floater in a policy year):
  The Company shall pay up to the limit, as stated in the schedule with respect of

1. Out-patient consultations by a medical practitioner
2. Diagnostic tests prescribed by a medical practitioner
3. Medicines/drugs prescribed by a medical practitioner
4. Out-patient dental treatment

• Critical Illness (per insured person in a policy year):

1. Critical illness means stroke resulting in permanent symptoms, cancer of specified severity, kidney failure requiring regular dialysis, major organ/ bone marrow transplant, multiple sclerosis with persisting symptoms and open chest CABG (Coronary Artery Bypass Graft), permanent paralysis of limbs and blindness.
2. Waiting Period of 90 days from the inception date of the policy.
3. Survival Period - The Insured needs to survive for a period of 30 days from the date of the diagnosis of the Critical Illness.

 Additional Discounts

• Discount in premium - 4.4% for opting Zone II, 11.11% for opting Zone III, 20% for opting for Zone IV.
• Discount in Lieu of No Maternity/ Infertility cover for individuals above forty five years - 3% on individual premium for self and spouse.
• Discount for multi year polices - 4% discount for opting 2yr policy tenure and for 3yrs tenure 7% (Including premium for optional covers)