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National Health Insurance

National Insurance Company Overview:

National Insurance Company Limited (NICL) is a government-owned general insurance company in India.  

The company is headquartered at Kolkata.

It was incorporated in 1906 and nationalized in 1972.  

It was declared as a separate company owned by the Government of India in the year 2002.

The company offers health insurance plans under the National Health Insurance scheme India.

Let us see the Various National health Insurance schemes from National Insurance Company Health Insurance.

National Health Insurance Plan List:

Family Health Plans Of National Insurance:

  • National Insurance Parivar Mediclaim
  • Parivar Mediclaim Plus Of National Health Insurance
  • National Health Insurance Mediclaim Policy
  • National Health Insurance Critical Illness Policy
National Health Insurance

Other Plans:

  • National Health Insurance Personal Accident Policy
  • National Health Insurance Varishtha Mediclaim (Senior Citizen Health Insurance policy from National Health Insurance Company)
  • Overseas Policy Of National Health Insurance
  • National Insurance Family Health Plan

National Insurance Parivar Mediclaim Policy

This National Insurance Health Policy is a floater policy that offers cover for the individual, spouse, plus two dependent children.

The sum assured is provided as a single floater which can be avail against treatment in hospitals for accidental injury, illness and diseases.

Key Features Of The Policy:

Age Limit: Individual between the age of 18 and 60 years can avail this policy.

Dependent children: From 3 months to 25 years can be included in this policy.

The dependent male child is covered up to the age of 25 years if unemployed

A dependent female child can be covered up to marriage.

The plan can be renewed up to the age of 65 years.

Maximum sum insured is Rs.5 Lacs.

The policy covers the hospitalization charges, day care procedures, pre and post-hospitalization, includes organ donations also.

One can get 50% of the sum assured for any one illness.

There are good health incentives offered for every claim-free year.

Benefits of National Parivar Mediclaim:

A National health insurance policy provides financial assistance at the time of medical emergencies.

National Health Insurance Company offers a variety of products plans to cover an individual and his family.

1. The plan comprises the cost of inpatient hospitalization, pre- and post- hospitalization, day care treatment cost and other medical expenses as mentioned in the policy document.

2. This plan also offers a maternity cover offering coverage to newborn babies with the 10% of sum insured, maximum of Rs.30,000 in case of normal delivery and maximum of  Rs.50,000 in case of caesarean delivery.

3. One can also opt for an additional cover by paying an extra premium. With every claim-free year, 5% discount on the base premium of the policy is offered.

Premiums paid towards the health plan are exempted from income tax as per the Section 80D of Income Tax Act.

National Health Insurance

National Health Insurance Parivar Mediclaim Plus

This is a major mediclaim plan.

National Mediclaim plus Policy is a coverage plan that helps with medical expenses.

The coverage offers more than the other health plans.

The plan covers the expenses of pre- and post-hospitalization, in-patient hospitalization, and day care treatment.

The medical expenses of Allopathy, Ayurvedic and Homeopathy treatment are payable up to the sum insured.

National Medical Plus covers expenses towards maternity, for newborn and usual vaccination for children, for a medical emergency reunion, air ambulance and provides hospital cash.

All the variants of National Mediclaim Plus provide the option of having a second opinion from World Leading Medical Centers if the insured is diagnosed with a serious illness.

Aditya Birla Health Insurance also provides health insurance.

National Health Insurance

Salient Features of National Health Insurance Parivar Mediclaim Plus:

1. This is Comprehensive family floater plan provided from National Insurance Company is Parivar Mediclaim Policy Plus.

2. There are 3 different variants are available under the plan. The plan can be used to cover the family members same as National Parivar Mediclaim under a single policy with one sum insured.

3. This is a unique product with the help of which one can opt for coverage up to Rs.50 Lakh.

4. National Parivar Mediclaim Plus has 3 variants: Plan A, Plan B, and Plan C, it differs in the in terms coverage’s

5. This policy offers Good Health Incentives in every 2 years irrespective of claims. One can also opt for an additional cover by paying an extra premium.

As per the policy terms, with every claim-free year, there’s a 5% discount on the base premium of the policy.

All the premiums paid towards the health plan gets the tax benefits as per the Section 80D of Income Tax Act.

National Health Insurance Policy Details

Plan: Parivar Mediclaim

  • Minimum Entry Age: 18 Yrs
  • Maximum Entry Age: 65 Yrs
  • Maximum Policy Renewal Age: Whole Lifetime with mutual consent
  • Sum Insured: Minimum 6 Lakhs to Maximum 50 Lakhs
  • Policy Term: 1 to 3 Yrs
  • Pre-Policy Medical Check Up is mandatory for all individuals who have completed 40 yrs of age.
  • Termination of the policy: The Company may cancel the policy (on the grounds of fraud, moral turpitude, misrepresentation or non-cooperation) by sending 30 days prior notice to the policyholder.

Plan: National Mediclaim Policy

As the cost of medical expenses is increasing at a very high rate, it is becoming very difficult for the middle class to tackle such expenses.  

National Mediclaim plus Policy offers comprehensive coverage with package higher than traditional health covers.

National Health Insurance Mediclaim Policy takes care of hospitalization, pre & post and day care treatment.

This is a unique health care package and with different variant options to choose from, one must consider National Mediclaim to cover his entire family.

National Health Insurance Mediclaim Policy Key Features:

It covers 140-day care procedures.

Pre-hospitalization expenses covered up to 30 days before hospitalization.

Post-hospitalization expenses up to 60 days after hospitalization will get covered

Ambulance charges ( Maximum up to Rs. 2,000)  will be covered

Room charges will be covered.

General physicians, surgeon, anaesthetist fees will be covered.

For Pre-existing conditions waiting period will be 4 yrs.

For the first 30 days after buying policy only accidental injuries will be covered

National Health Insurance India Mediclaim Policy Benefits:

  • Covers Ayurvedic/Homeopathic treatments up to 20% of the sum insured
  • For Every claim free year, the sum insured increased by 5%
  • Online Policy is available
  • Cashless treatments can be availed at over 6000 hospitals throughout India through cashless health insurance.
National Health Insurance

Exclusions For  National Insurance Health Plan Mediclaim Policy:

  • Domiciliary treatment
  • Injuries caused by wars and dangerous sports
  • Visits by nurses or doctors to the house
  • Treatment outside India
  • Treatment for HIV/AIDS and other STDs
  • Vaccinations and inoculations are not covered
  • Dental treatment
  • Experimental and unproven treatments

B ) Additional Plans from National Insurance Health Plan

National Health Insurance Plans For Overseas Mediclaim Employment And Studies:

This particular mediclaim plan is specially designed to cover travel emergencies for people who are travelling out of the country.

Following are the there are three categories of people covered under this policy:
  • Business and holiday
  • Employment and study
  • Corporate frequent traveller

Overseas Mediclaim From National Insurance Health Insurance

This National Health Insurance policy has the  following features:

  •  Covers loss of checked in baggage
  •  Premiums can be paid in rupees
  •  Claim settlement is done in USD ( For Medical Reason)
National Health Insurance

Plan Features and Benefits under National Health Insurance:

The below table shows the details of insurance cover and sums assured (in US Dollars).

National Health Insurance Overseas Plans Sum Assured Table:

Visit PlanWorldwide Excluding  USA/CanadaWorldwide including USA/Canada
Section A Medical Evacuation, Medical Treatment50000250000100000500000
Section B Personal Accident10000250002500025000
Section C Loss of checked baggage1000100010001000
Section D Delay of checked baggage100100100100
Section E Loss of Passport150250250250
Section F Third party Injury & Property Damage200000200000200000200000

National Health Insurance Critical Illness Policy:

National Health Insurance Critical Illness Policy Features:

  • Entry Age is 20 Yrs to 65 Yrs
  • Policy Period is 1 Year
  • The policy can be renewed up to the age of 65
  • Covers the individual as well as family
  • Sum Assured up to 25 Lacs

National Health Insurance Critical Illness Policy Benefits:

 National Health Insurance Critical Illness Policy covers medical expenses incurred for the critical illness by the insured.

This policy provides protection against 6 major critical illnesses.

If the proposer is diagnosed with any critical illness, a lump sum amount is paid to the proposer; Major 6 critical illnesses are covered.  

United India Health Insurance also provides one of the best health insurance plans.

To make the claim, the concerned will need to survive for 30 days after the diagnosis has been made.

This National Insurance Health plan covers the following 6 major critical illnesses:           

  • Cancer
  • Renal failure
  • Stroke    
  • Multiple Sclerosis
  • Kidney, Lung, Pancreas or Bone Marrow Transplant
  • Coronary Artery Surgery

Entire sum assured is paid in a lump sum on the diagnosis of the critical illness by an authorized medical practitioner only.

National Health Insurance

National Health Insurance Policy Exclusions :

1. No claim accepted within 90 days from buying the policy.

2. For claims reimbursement, the insured person must survive the critical illness for at least 30 days after the diagnosis of the illness.

3. Dependent diseases will not be covered.

Personal Accident Policy From National Health Insurance

Benefits and Features:

  • The Personal accident insurance policy from National Health Insurance covers, the following benefits:
  • Cover against Accidental Death or Permanent Total Disablement (PTD) if an accident happens.
  • Optional Cover is offered for Accidental Hospitalization Expenses and Accidental Hospital Daily Allowance
  • National Health Insurance Company Covers different types of accidents like road, rail accidents, accidents due to natural calamities and arising out of terrorism/ terrorist acts
  • Health check-up  is not required
  • Applicable worldwide and is a 24 hours cover.
  • Different Risk covers are available ranging from a restricted cover of Death only, to a comprehensive cover for the death of proposer, permanent disablements and temporary total disablements.
  • Family Package cover is available to Individuals under Personal Accident Policy whereby the proposer, his spouse and dependent children can be covered under a single policy with a 10% discount in premium.
  • Group personal accident policies can be availed for specified groups with a discount in premium depending upon the size of the group.
  • The selected Individual PA policies can be purchased online using credit, debit cards as well as net banking.

National Health Insurance Varishtha Mediclaim Policy

This policy is designed for Senior Citizens which cover Critical Illness, Injury and Accident cover.

It is also called Senior Citizen Health Insurance from National Insurance Company’s Health Insurance Plans.

Features Under Senior Citizen Health Insurance National Insurance:

  • Entry Age: Minimum 60 to Maximum 80 Yrs
  • Policy Period: 1 Year
  • The policy can be renewed up to 90 years of age.
  • Sum Insured is Minimum 1 Lac to 2 Lacs

Benefits Under Senior Citizen Health Insurance National Insurance:

  • Cumulative Bonus and cost of health Check-ups are provided on claim-free years.
  • 1% of the sum insured is paid towards hospitalization costs.
  • Fees of the surgeon, anaesthetist, medical practitioner, consultants, specialists etc. will be covered up to 25% of the sum insured.
  • Cost of medicine, Drugs, Blood, Oxygen, Diagnostic charges, will get covered.
  • Ambulance expenses up to Rs.1,000 is covered per policy year.
  • Treatment of cataract, benign prostatic hyperplasia and organ transplant are covered as per terms
  • Number of Critical Illness like cancer, stroke, multiple sclerosis etc. will get paid.
  • Pre-hospitalization expenditures incurred 30 days before being hospitalized, are covered.
  • Post hospitalization expenditures up to 60 days are covered.
  • Pre-existing Conditions like diabetes and hypertension will be covered from the inception on paying an additional premium.
National Health Insurance

National Insurance Health Policy Online Renewal

For National Health Insurance policy online renewal, one should go to the portal of National Insurance Health Section and enter the policy number along with personal details.

For National Insurance Health Policy renewal.

You can pay the required premium online and you will also receive a notification from National Health Insurance Customer Care.

National Health Insurance renewal is also possible in offline mode.

The Policyholder can visit the nearest branch to know about national insurance health plans renewal process.

National Health Insurance Claim Process

The Claim Process for National Insurance Company is as given below:

  • In case of any medical emergency or in the event of any loss, intimation to be given to the Policy issuing office immediately.
  • The FIR to the nearest Police Station to be registered, if the loss has occurred due to any cause like Fire, Burglary, Theft, Damage to the third party, Accident etc., i.e. due to any reason other than Act of God Peril e.g. Flood, Earthquake, inundation etc.
  • Next step is to collect relevant National insurance health claim form.
  • Filling up of National insurance health claim form correctly is required after reading it thoroughly.

Submit claim form to the Policy issuing office either directly or by an authorized Agent along with  mandatory documents required /asked for, such as Police Reports, Medical Prescriptions, details of Pathological tests, Cash Memos from the Chemists Shop for the medicine purchased Admission and Discharge Certificates, Receipts from Surgeon, Doctors etc. as the case may be.

The Company may then appoint Surveyor/ Loss Assessor or may refer the case to panel Doctors, if necessary.

In the last step, the claim is finally settled by the Policy issuing office and payment is made to the Policyholder as a full and final settlement of the claim.

In some cases provisional payment is also made to the Policyholder pending the final processing of the claim, depending on the merits of the case.

For more details regarding the claim, procedure policyholder may contact the nearest Company office.

National Health Insurance

National Health Insurance Review

Here is a financial review of National Health Insurance.

National Health Insurance achieved  A.M. Best financial company rating of B++ (Good) and issuer credit rating of “bbb+”.

These international ratings reflect the Company’s strong risk-adjusted capitalization, consistent performance and strong presence in India’s insurance market.

National Health Insurance Customer Care Number:

Head Office Address:

National Insurance Company Ltd.

3, Middleton Street, P.B. No. 9229, Kolkata 700 071.

Toll Free Number: 1800 1200 7710

Phone number: 033-22831705

Fax: 033-22831712

National Health Insurance

National Health Insurance FAQs

What are the formalities for getting Reimbursement for National Health Insurance?

To get reimbursement the policyholder needs to pay all the medical cost first and later National Insurance will reimburse the same.

The entire original medical expenses bill is required to be submitted to get the reimbursement.

In case of a reimbursement process; it is not required to get treated in the National Insurance Authorized Hospital.

The policyholder or his family members can avail the treatment in any registered hospital.

Following are the mandatory documents list to be provided to get reimbursement:

  • Claim Form should be duly signed by the Insured
  • Photocopy of ID card of the policyholder.
  • Photocopy of policy certificate issued by National Insurance Company.
  • Original discharge card/summary, Original hospital bills should be submitted.
  • For consolidated amounts, a detailed breakup of the amount should need to be provided.
  • All investigation reports and bills in original  should be supported by a note from the concerned doctor/surgeon  having recommendations for such investigations
  • If the surgery is being done, Surgeon’s certificate stating the nature of surgery performed, bill and paid receipt
  • Bill, receipt and original documents provided by a concerned doctor, anaesthetic or surgeon.

Can I get the cashless claims from National Health Insurance?

Yes. This facility is available from the company.

As per cashless claim process, one gets covered with the medical expenses of any treatment for sickness, illness or accident provided that the treatment is carried out at the National Health Insurance Network Hospitals are listed under National Insurance Network.

One can download the National Health Insurance Hospital list from using google.

After approval of the claim, the medical bills are directly paid by the National Insurance Company to the concerned hospital.

Can I renew my National Health Insurance policy Online?

Yes. The policy can get renewed by visiting nearest NICL’s Branch or one can get renew the existing policy online.

But it should be done before the expiry of the existing policy period.

Can anyone buy National Health insurance Online?

Yes. National Insurance Company offers its customers the facility of buying the policy online.

The Premiums can also be paid in online mode.

Just go to below link and fill your details like personal details, medical details etc., you will come to know about all the available policies.

Just make your decision which policy to purchase according to your needs.

Pay the premium and you will receive the policy within a few hours after successful payment.

One may able to renew his policy online.

One can make the online payment through Credit Card, Debit Card or Net banking.

What are the mandatory documents required for Claim?

Mandatory documents and details to be provided at the time of claim:

  • Policy Number
  • Policyholder’s/ Insured’s Name
  • Valid Contact Details of the Claimant/ Policyholder
  • Name of the  Claimant
  • Hospital  Name and Address
  • Nature of Ailment or details regarding  the Accident
  • Commencement date of the symptoms & related details should be provided in case of illness

Which family members can be covered under National Insurance Health Policy?

National Health Insurance Policy will be provided for self and the following family members:

  • Spouse
  • Dependent legitimate kids or legally adopted children
  • Dependent child up to maximum 18 (eighteen) years of age
  • The male child which is dependent above 18 years and up to 25 years, if a bonafide student and not employed
  • Dependent female child if not employed, until marriage
  • Parents

What is Pre-policy Check Up in National Health Insurance?

To apply for National Health Insurance Policy, Pre policy check-up is required in cases where the proposer is 40 (forty) years and above or opting for SI  INR 6,00,000 and above (irrespective of age)

It is also required for opting for Critical Illness optional cover, between the age of 18 (eighteen) years and 65 (sixty-five) years.

What is National Health Insurance Premium Calculator?

The customer only needs to provide the National Health Insurance Scheme cover required for the number of persons and the current age of policyholder online.

After providing this information one needs to fill the personal details and you will receive the National Health Insurance Company’s premium quotes.

National Health Insurance

What is National Insurance Health Card?

The policyholder can download the National Insurance Health Card online by visiting the Company Website and providing basic details such as Policy Number and date of birth etc..

The National Insurance Health Card is useful for getting cashless health insurance benefits from national Health insurance.

What is the premium rate for National Insurance Health Insurance?

Below is the premium rates for National Insurance Mediclaim Policy:

National Insurance Health Policy Premium ChartAnnual Premium (Rs.)
Age (in years)Sum Insured (in Rs)
50000750001 lakh2 lakh3 lakh4 lakh5 lakh
Taxes will be extra
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