National Insurance Parivar Mediclaim Policy

Product Overview

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

Unique Features of National Insurance Parivar Mediclaim Policy

• Non-Allopathic Treatment Like Ayurvedic and Homeopathy are covered under this plan - 20% of the Sum Insured for any one illness.
• Any claim arising for Anti Rabies Vaccination (Up to Rs. 5000) will be covered under this plan
• Any Expenses related to Maternity will be covered after 3 years under this plan
• Any treatment related to Infertility (Upto Rs. 50,000) will be covered under this plan.
• Some Organ Specific Treatments are Covered after a waiting period of 1 year like ENT disorder, etc. under this plan.

Features of edit Edit Details

Critical features of National Insurance Parivar Mediclaim Policy

• Room rent:
  Limits imposed towards room and ICU rent expenses

1. Room Rent - Actual or 1% of the Sum Insured, Whichever is lower.
2. ICU - Actual or 2% of the Sum Insured, Whichever is lower.

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

1. 10% copayment clause for treatment in non-network hospital
2. Copayment clause for treatment outside the zone for detail refer the policy document.
3. 10% to 25% copayment on admissible claim amount for Pre existing Diabetes or hypertension claims (Optional cover)
4. Sub limit on Cataract-Up to 10% of SI or INR 50,000 whichever is lower per eye

• 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 any no claim bonus benefits. However, there is a discount on the renewal premium of 5% in case there is no claim in the current year.
• 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 plans has a waiting period of 4 years is case of pre-existing diseases
2. Maternity has a waiting period of 3 years

Eligibility Criteria

• Minimum Age of Entry:- Children - 3 months and 18 years / Adult - 18 years
• Maximum age of Entry:- 65 years
• Sum Insured:- 1 Lakh to 10 Lakhs in multiples of 1,00,000
• 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):
  Covered upto Sum Insured
• 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)

Exclusions

• Vaccination and Inoculation of any kind unless it is post-animal bite
• General debility and Run down conditions
• Circumcision, Cosmetic surgery, Plastic surgery.
• HIV/AIDS
• Psychiatric and psychosomatic disorders
• Injury arising out of drug/alcohol abuse
• War, act of foreign enemy, ionizing radiation and nuclear weapon.
• Naturopathy
• Experimental or unproven treatment
• All external equipments.
• Dental treatments
• Medical Expenses relating to any hospitalisation primarily and specifically for diagnostic, X-ray or laboratory examinations and investigation senses relating to any hospitalisation primarily and specifically for diagnostic, X-ray or laboratory examinations and investigations

Note: Any claims arising out of or attributable to any of the following is not covered

Tax Benefits

When you pay the premium for your health insurance policy, you are liable to get a tax rebate under section 80D of the Income Tax Act, 1961.

Claim Process

In case you would like to know about the Claim Process or would like to register a Claim please click the link below

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