National Insurance Mediclaim Policy – National insurance India limited is the one of the key player in non-life insurance companies in India. They have introduced an Insurance policy i.e. National Insurance Mediclaim Policy for individuals and the entire family. The mediclaim plan covers medical expenses incurred by a person due to any disease, illness or injury.
Major feature of the policy is that it covers hospitalization expenses reasonably and necessarily incurred for treatment of illness/disease or injury contracted/sustained by the insured persons during the policy period. It also covers 140+ day care procedures/ surgeries.
Key Features of National Insurance Mediclaim Policy
- The policy is available to persons between age of 18 and 65 years.
- Dependent children between the age of 3 months and 18 years can be covered provided at least one
- Policy can be renewed up to the age of 80 years
- Provides coverage for dependent parents also
- Sum insured range is between `50,000 and 5 lakhs, in multiples of `25,000/-
- Cost of treatment in case of an accident where surgery may or may not be involved
- The policy can be renewed lifelong.
Major Benefit of National Insurance Mediclaim Policy?
The major benefit covered under this schemes are generally the reimbursement of hospitalization expenses which are reasonably and necessarily incurred, under the following heads :
- 1% of the sum insured per day for Room, boarding & nursing expenses & 2% of sum insured per day for ICU. subject to an overall limit of 25% of the sum insured.
- Fees of surgeon, anaesthetist, medical practitioner, consultant and specialist subject to an overall limit of 25% of the sum insured
- Anaesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines and drugs, diagnostic material, X-ray, dialysis, chemotherapy, radiotherapy, cost of pacemaker, artificial limbs and cost of organs, hospitalization expenses of organ donor and similar expenses subject to an overall limit of 50% of the sum insured.
- Ambulance charges upto 1% of the sum insured, subject to maximum of `2000/- in a policy period.
- There is a provision for Ayurveda and Homeopathy treatment upto 20% of the sum insured for any one illness.
- Cover for 140+ day care procedures which require hospitalization for less than 24 hrs.
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Additional Benefits of National Insurance Mediclaim Plan
- Cumulative bonus @5% of sum insured for each claim free policy year if policy is renewed without break. Health check up expenses will be reimbursed once at the end of a block of 4 continuous claim free policy years, upto a maximum of 1% of the average sum insured of the block.
- There are network of more than 6000+ hospitals in India where Cashless facility available.
- Discount of 10% will be allowed on the total premium if policy is bought for family comprising the insured and/or spouse, dependent children, dependent parents.
- Premium paid for the policy are exempt from Income Tax under Sec. 80D of the l.T. Act if paid for dependent also.
Eligibility of National Insurance Mediclaim Plan
| Minimum | Maximum | |
| Coverage Amount (in Rs.) | 50,000 | 5,00,000 |
| Policy Term (in years) | 1 | 5 |
| Entry Age (in years) | 18 years | 59 years |
| Renewable till Age (in years) | – | 80 years |
Family floater policy will cover
- An individual with their spouse
- 2 Dependent children from 3 months age till age 25 years for boys and till marriage for girls
- Dependent parents
Exclusions of National Insurance Mediclaim Policy?
- All pre-existing diseases will be covered after 48 months of continuous coverage
- No claims would be paid during the first 30 days of inception of the policy, except accidental claims.
- HIV Aids not included under this policy
- Dental treatment , Venereal disease, intentional self-injury, use of drugs or alcohol, congenital external disease, sterility, are not covered
- Cost of spectacles, contact lenses, hearing aid, cochlear implants
- Purely diagnostic hospitalization is not included under this plan
- No Maternity related expenses
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