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National Health Insurance Benefits And Plans Online

IndianMoney.com Research Team | Updated On Thursday, October 11,2018, 05:37 PM

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National Health Insurance Benefits And Plans Online

 

 

National Insurance Company Limited was incorporated in the year 1906 and is India’s oldest Insurance Company. In the year 1972, it was nationalised along with 21 foreign and 11 Indian insurance companies which were amalgamated with it. It is a Government of India owned company and has its headquarters in Kolkata. It provides General Insurance and specialises in products like Motor Insurance, Health Insurance, Personal Insurance, Rural Insurance, Industrial Risk Insurance, and Commercial Risk Insurance. In this article we will look at the different types of National Health Insurance.

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National Health Insurance - Benefits and Plans Online

National Insurance Mediclaim Policy

This policy covers hospitalization expenses which were incurred for treatment of diseases or illnesses contracted during the policy period. It covers more than 140 different types of day care procedures and surgeries.

Features:

  • The policy is available for anyone between the age of 18 and 65 years.
  • Dependent children aged 3 months and above can also be covered, provided at least one parent is also covered at the same time.
  • Dependent Parents can also be covered along with family.
  • Sum Assured ranges from Rs 50,000 to Rs 5 lakh, increasing in multiples of Rs 25,000.
  • The policy can be renewed lifelong.
  • Pre-existing diseases will only be covered after 4 year waiting period.

Benefits:

  1. Provides reimbursement for hospitalization expenses under the following heads:
  • Room, nursing, and boarding expense – 1% of sum assured per day and 2% of sum assured per day, subject to an overall limit of 25% of sum assured.
  • Fees of doctor, surgeon, anaesthetist, specialist, and consultant, subject to an overall limit of 25% of sum assured.
  • Expenses for oxygen, blood, anaesthesia, medicines, X-Ray, pacemaker, surgical equipment, operation theatre, chemotherapy, and other similar expenses, subject to an overall limit of 50% of sum assured.
  • Ambulance charges up to 1% of sum assured, subject to maximum of Rs 2,000 in a policy period.
  1. Ayurveda and Homeopathy treatment are covered up to 20% of sum assured for any one illness.
  2. Cover for more than 140 day care treatments which require hospitalization for less than 24 hours.
  3. A cumulative bonus of 5% of sum assured is added for every claim free year, provided the policy is renewed without break. At the end of every 4 claim free years, health check-up expenses will be reimbursed, up to 1% of average sum assured.
  4. Cashless facility is available at more than 6,000 hospitals across India.
  5. If the policy is taken for family, comprising the insured and/or spouse, dependent children and parents, a discount of 10% will be allowed on total premium.
  6. Premium is exempt from Income Tax, under Section 80D of the Income Tax Act.

National Insurance Parivar Mediclaim Policy

This policy provides protection to families against financial burden of treatment. It is a floater policy, under which the entire family comprising the insured, spouse, and two dependent children are covered under a single sum assured.

Features:

  • Available to persons aged 18 to 60 years.
  • Dependent children between 3 months and 25 years are covered.
  • Sum assured is between Rs 2 lakh and Rs 5 lakh, increasing in multiples of Rs 50,000.
  • Renewal is allowed up to age 65.
  • Pre-existing diseases are covered after a waiting period of 4 years.
  • For the first 30 days, only accidental claims are covered.

Benefits:

  1. Expenses for oxygen, blood, anaesthesia, medicines, X-Ray, pacemaker, surgical equipment, operation theatre, chemotherapy, and other similar expenses.
  2. Diabetes and Hypertension are covered from inception by paying an extra premium.
  3. Pre and Post Hospitalization expenses for 15 and 30 days respectively.
  4. Cashless facility can be availed at select hospitals.

National Insurance Critical Illness Policy

A basic health insurance is not enough to cover the cost of treatment for critical illnesses. National Insurance Critical Illness Policy is designed to cover expenses relating to a critical illness and the associated recovery process. The policy is available under two plans, Plan A (covering 11 illnesses) and Plan B (covering 37 illnesses including Plan A).

Features:

  • Minimum age is 18 and maximum is 65 years.
  • Children between age 5 and 18 can be covered if one parent is already covered.
  • Policy can be taken for self and /or spouse, children up to 25 years, and parents.
  • Sum assured is between Rs 1 lakh to 10 lakhs, increasing in multiples of 1 lakh, and between 15 lakhs to 75 lakhs, increasing in multiples of 5 lakhs.
  • The policy is issued for a period of one year and must be renewed annually.

Benefits:

  1. If the policy is taken for family, comprising the insured and/or spouse, dependent children and parents, a discount of 10% will be allowed on total premium.
  2. A discount of 15% on total premium is available to employees of National Insurance Company for self and family insurance.
  3. Dependent Children have the option to port to a similar health insurance policy of the company or any other insurer on completion of the exit age.
  4. In case the applicant takes the policy before the age of 42, and renews the policy without fail for 3 continuous years, an Early Entry Discount (EED) of 5% on premium will be allowed from the fourth policy period and continue in subsequent renewals.

SEE ALSO: Aadhaar Card Verification For Personal Loan

National Insurance Individual Personal Accident Policy

Personal Accident Policy provides coverage for Permanent Total Disablement (PTD) as a result of accident to self. It also provides a death benefit to the beneficiary in case of death by accident.

Features:

  • Any resident of India who is an adult can take the policy for self and / or family aged between 5 and 70 years.
  • Optional coverage for hospitalization and daily hospital expenses due to accident.
  • Different covers are available based on the type of policy and subject to premium.
  • Policies are of the following types:
    • Accidental Death – covers for death as a result of bodily injury and where death occurs within 12 months from the date of accident.
    • Permanent Total Disablement – provides coverage for bodily injury, resulting in Permanent Total Disablement caused as a result of accident.
    • Permanent Partial Disablement – it provides compensation for accidents resulting in Permanent Partial Disablement within 12 months from the date of accident.
    • Temporary Total Disablement - provides compensation for accidents resulting in Temporary Total Disablement. The compensation will be payable for the period of disablement.

Benefits:

  1. Policies taken under family package offer 10% discount on premium.
  2. The policy operates worldwide and for 24 hours a day.
  3. Covers road and rail accidents, as well as accidents due to natural calamities and terrorism.
  4. Family packages and group packages are available, where all the members are covered under a single policy.

National Insurance Janata Personal Accident Policy

Features:

  • Provides coverage for people in the age group of 10 to 70 years for Permanent Partial Disablement and Permanent Total Disablement.
  • The sum assured is between Rs 25,000 and Rs 1,00,000 per person.
  • The policy is available for a long term period of 5 years.
  • Group policies are eligible for the applicable rate of discount.

How to Take a National Health Insurance Policy?

In general, the following steps need to be followed to take a National Health Insurance Policy:

  • Contact the near office of National Insurance Company, either personally or through an agent.
  • Collect the proposal form which is pre-printed.
  • Fill and submit the form at the office.
  • Some policies may require a pre-acceptance survey. In that case, a surveyor shall be appointed by the company to estimate risk and other details.
  • Premium estimates will be given to the applicant through the company’s Computerised Office.
  • Policy will be issued either directly or through registered post.

How to File a Health Insurance Claim with National Insurance?

The following steps can be followed to make a claim:

  • Lodge an FIR with the police immediately after the occurrence of the incident, except for loss due to Act of God Peril.
  • Intimate the policy issuing office on the incident and fill the relevant claim form.
  • Submit the claim form along with all other relevant documents like police report, medical certificates and prescriptions, receipts for expenses and so on.
  • The policy issuing office may appoint a surveying officer or a panel of doctors, if necessary.
  • The claim is settled by the company and payment is made to the policy holder.
  • In some cases, if the processing of claim is pending, provisional payment is also made, depending on the merit of the case.

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