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What is National Health Insurance? Research Team | Posted On Friday, November 29,2019, 06:04 PM

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What is National Health Insurance?



What is National Health Insurance?

National health insurance is the oldest health care provider in India. It is fully owned by the central government and was established in the year 1906. It is responsible for introducing flexible general insurance products in the Indian market aimed to meet the insurance requirements of masses. It is known to offer health plans that can be renewed throughout one’s lifetime. You can avail the benefits of the policy throughout its tenure; however, the co-pay clause starts only after the insured attain 60 years of age.

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The National insurance company offers a large number of insurance solutions. These plans aim to cater to all groups of people and fulfil their insurance needs. These plans come with extensive benefits like add-on cover, cashless claims, lifetime renewality etc. The insurance products offered by National insurance company are:

  • National Insurance Mediclaim Policy:
  • National Insurance Mediclaim Plus Policy
  • National Insurance Parivar Mediclaim Policy
  • Varistha Mediclaim Policy for Senior Citizens
  • National Insurance Critical Illness Policy
  • National Insurance Individual Personal Accident Policy
  • National Insurance Janata Personal Accident Policy

 The policies come with a lock-in of 15 days within which the subscriber must go through the policy terms. They can return the policy if they are not satisfied with its terms. A refund is granted to the subscribers if they opt-out of the policy.

See Also: Lesser Known Key Benefits of Health Insurance Schemes You Should Know

Claim Process of National Health Insurance:

Policyholders can file two types of claims under the national health insurance scheme. They are:

-Cashless Claim Process: in case of planned hospitalization, you can consider making cashless claims. However, you need to convey this to the insurer at least 72 hours prior to your admission. If you are getting treated in an empanelled hospital then you need to intimate the insured within 24 hours to make cashless claims. The reason is the insured would have to get an authorization request approved by the TPA to avail the cashless facility. The TPA is authorised to accept or deny the right to cashless claim.

-Reimbursement Claim Process: the reimbursement claim works like normal health insurance claims. Here the insured is required to pay the medical bills out-of-pocket and later initiate claims with the insurer. The insured person has to submit all details and documents to the insurer with 15 days of discharge. The insured will also have to fill and sign the claim form to initiate the process. Thereafter the claim will be verified and approved by the third party administrator.

See Also: Health Insurance for Family

How to Buy and Renew Mediclaim Policy of National Insurance?

In order to buy and renew the mediclaim policy, you need to contact or visit the nearest NICL branch. Here you can collect the renewal form from an authorised insurance agent. Fill the form with all necessary details, sign it and submit it to the agent.

In some cases, a surveyor is appointed by the insurer to understand the health condition of the policy buyer. The estimated premium of your policy will be calculated after collecting the details from the surveyor. The documents of the policy issued will be delivered to your home through your mailing address.

Cancellation Procedure for National Health Insurance Policy:

Cancellation of the National Health Insurance Policy is possible only during the free lock-in period. If you do not understand the policy terms or have any objections then you may opt-out of it during this period. You will have to return your policy to the insurer and claim for the premium refund which will be given with certain deductions.

You may also surrender your policy during the policy tenure. You have to submit a duly filled and signed surrender form. Make sure to attach the policy documents and submit it to the nearest branch office to cancel your subscription.

See Also: Family Health Insurance Plan

How National Health Insurance policy covers the whole family?

You can avail an individual as well as family floater health plans under the national insurance scheme. The individual health insurance is meant to provide coverage for an individual falling within the age group of 18 to 70 years. On the other hand, family floater health plans cover children, dependent parents, self and spouse.

It also provides benefits like cashless mediclaim facility at NICL empanelled hospitals across the country. Maternity expenses are covered after 1-year waiting period and pre-existing diseases are covered after a 2-year waiting period. You do not have to go through a medical test to be a subscriber under National Insurance Mediclaim policies.

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