Policy Highlights
- 1 National Insurance Mediclaim Policy Introduction
- 2 National Insurance Mediclaim Policy Terms conditions and Eligibility
- 3 National Insurance Mediclaim Policy Review and Features
- 4 National Insurance Mediclaim Policy Inclusions
- 5 National Insurance Mediclaim Policy Exclusions
- 6 National Insurance Mediclaim Customer Care
- 7 Assistance:
- 8 National Insurance Mediclaim Policy Buying Procedure
- 9 National Insurance Mediclaim Policy Claim Procedure
- 10 Documents Required during Claim Settlement
- 11 Claim Settlement:
- 12 National Insurance Mediclaim Claim Form
- 13 National Insurance Mediclaim Premium Calculator
- 14 National Insurance Mediclaim Policy Premium Rates
- 15 National Insurance Mediclaim FAQ’s
- 16 National Insurance Mediclaim Forms and Documents
- 17 About National Insurance Parivar Mediclaim Policy
- 18 About National Insurance Mediclaim Plus Policy
- 19 About National Insurance Overseas Mediclaim for Business and Holiday
- 20 About National Insurance Overseas Mediclaim for Employment
National Insurance Mediclaim Policy Introduction
National Insurance Mediclaim Policy is a health insurance policy which is designed by National Insurance Company for you and your family. National Insurance Mediclaim Policy covers medical expenses incurred for treatment of illness or disease or injury during the policy period. It also covers pre-hospitalization and post-hospitalization expenses and more than 140 day care procedures. Cashless facility and Re-imbursement of hospitalization expenses is allowed under National Insurance Mediclaim Policy. This National Insurance Mediclaim Policy is also available for Senior citizens.
National Insurance Mediclaim Policy Terms conditions and Eligibility
| Entry Age for Proposer/Spouse: |
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| Entry Age for Dependent Children: |
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| Policy Period: |
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| Sum Insured: |
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| Renewal till age: |
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| Pre-policy medical checkup: |
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National Insurance Mediclaim Policy Review and Features
- Cumulative Bonus: It is a No Claim Bonus where Sum Insured will be increased by 5% for each claim free policy year.
- Discount: A family discount of 10% for the premium is available. It covers you and your family members (Spouse, Dependent children and Dependent parents).
- Tax Benefit: You can get tax benefit under section 80 D of the Income Tax Act for premiums paid. For more information regarding Income Tax Benefits, visit www.taxqueries.in.
- Free Look Period: If policyholder is not satisfied with the terms and conditions you can return your policy within a period of 15 days from the date of receipt of policy.
- Portability: If you are insured with another non life health insurance company, you can switch to National Mediclaim Policy, on renewal, without losing any accrued benefits.
- Ambulance charges: 1% of sum insured or maximum of Rs 2000/- are paid for ambulance services in a Policy period.
National Insurance Mediclaim Policy Inclusions
Coverages under National Insurance Mediclaim Policy are,
- Inpatient treatment: It covers expenses for hospitalization for more than 24 hours like Room expenses, boarding expenses, nursing expenses, medical practitioner fees, etc.
- More than 140 day care procedures are covered, which require hospitalization for less than 24 hours.
- Medical expenses incurred for Homeopathy and Ayurveda treatment are allowable up to 20% of the sum assured for Any One Illness.
- Pre-hospitalization expenses – up to 30 days prior to the hospitalization.
- Post-hospitalization expenses – 60 days after discharge from the hospital.
- Pre-existing diseases – covered after a waiting period of 4 policy years subject to continuous renewal.
- Accident Coverage is available from the time of inception of the Plan i.e, there is no waiting period for accident coverage.
National Insurance Mediclaim Policy Exclusions
Exclusions under National Insurance Mediclaim Policy are,
- For first 30 days of commencement of the policy, no claim is payable, expect for accidental claims.
- HIV / AIDS, general debility, Convalescence, sterility, Pregnancy and related problems are excluded.
- Obesity, All psychiatric and psychosomatic diseases, genetic disorders etc. are excluded.
- Cosmetic, sex change, plastic surgery, hormone replacement etc. are not covered.
- Dental, Outpatient treatment, abuse of Drugs or alcohol are not covered.
- Spectacles, hearing aid, contact lens, cochlear implants and also home visit charges are excluded.
For complete information about National Insurance Mediclaim Policy non-coverages please refer National Insurance Mediclaim Brochure or National Insurance Mediclaim Policy Wordings.
National Insurance Mediclaim Customer Care
Assistance:
For any Information or doubts regarding National Insurance Mediclaim Policy, Visit www.nationalinsuranceindia.com or call Toll free: 1800 120 1430 or Fax : (033) 2289 6329
You can also contact National Insurance Company through E-Mail: nic.health@nic.co.in
You can also post or write to the following address.
Address:
Head Office
3 Middleton Street
Kolkata
West Bengal
Pin code: 700071
National Insurance Mediclaim Policy Buying Procedure
- Submit National Insurance Mediclaim prospectus and the National Insurance Mediclaim proposal form to the office or to the agent.
- Proposal form is to be filled with accurate information.
- Additional documents like address proof, medical reports, photographs are to submitted along with proposal form (if required by the company)
- You can also buy National Insurance Mediclaim online at http://niconline.in/.
- Download National Insurance Mediclaim Proposal form and Prospectus here.
National Insurance Mediclaim Proposal Form
National Insurance Mediclaim Prospectus
National Insurance Mediclaim Policy Claim Procedure
| Claim procedure to avail Cashless facility | Information to TPA |
| Planned hospitalisation | At least 72 hours before the insured person’s admission to network hospital/PPN |
| Emergency hospitalisation | Within 24 hours of the insured person’s admission to network hospital/PPN |
| Claim procedure for Reimbursement | Information to Company/TPA |
| Planned hospitalisation | At least 72 hours before the insured person’s admission to hospital |
| Emergency hospitalisation | Within 72 hours of the insured person’s admission to hospital |
Documents Required during Claim Settlement
- Claim form with complete information.
- Original bills, medical history of the patient, payment receipts, discharge certificate from the hospital etc.
- Original cash-memo from the hospital or chemist supported by the prescription.
- Original payment receipt and investigation test reports supported by proper prescription from attending medical practitioner.
- Attending medical practitioner’s certificate regarding bill receipts and diagnosis etc.
- Surgeon’s certificate stating nature of operation performed and diagnosis along with bills etc.
- Any other documents required by National Insurance company/TPA (Third Party Administrator).
Claim Settlement:
- If your offer of settlement is accepted by the company, the payment shall be made within 7 days from the date of acceptance of your offer.
- If, there is a delay in the payment, the National Insurance Company shall pay interest at a rate which is 2 percent above the bank rate.
- If your claim is rejected by the company for any cases, company shall communicate to you in writing & within a period of 30 days from the final document receipt.
National Insurance Mediclaim Claim Form
National Insurance Mediclaim policy Claim Form is to submitted to the company or TPA during claim settlement. It is to be filled completely and accurately.
National Insurance Mediclaim Claim Form
National Insurance Mediclaim Premium Calculator
You can calculate the premium using National Insurance Mediclaim Premium calculator. Personal details, Number of members, Policy period, Age and Sum assured and other details are required to calculate the premium.
National Insurance Mediclaim Policy Premium Rates
National Insurance Mediclaim Policy Premium Chart is shown below,
National Insurance Mediclaim FAQ’s
At what situation National Insurance Mediclaim Policy will get cancelled?
- Company may cancel your policy on grounds of misrepresentation, fraud etc. by sending you 30 days notice.
- You (The Insured person) may cancel the policy at any time during the policy term. In such case the company shall refund of premium.
What are the Services offered by a TPA?
TPA (Third Party Administrator) handles, claim admission and recommend the National Insurance company for the payment of the claim settlement.
What are the reports required for Pre-policy Checkup?
- Physical examination
- Lipid profile
- Blood sugar
- ECG
- Eye checkup
- Urine routine & microscopic examination
- Serum creatinine
National Insurance Mediclaim Forms and Documents
National Insurance Mediclaim Brochure
National Insurance Mediclaim Customer Information Sheet
My renewal date falls on 10.10.2015. My policy No. 10100048148500005340. Kindly inform me the amount of renewal would be for this year., so that I can go with the cheque amount to deposit the same. I may also be informed the office address where the premium need to be deposited.
Thanks, in anticipation of your kind sympathetic consideration.
S. S. Nandi
Mobile No. 9088010100
may i help u i am agent nic
Dear sir,
Please send me to renewal message of policy.
sir,
how to pay the national insurance mediclaim premium online .please send the details.
I applied for medical claim on 04/09/15.my policy no is 604200/48/14/8500000841.till the date i hv not receive the money.my TPA is med seva health care.please make my mediclaim as soon as possible.
My National Medical claim policy no:551800501510000008 .premium due by 08.04.2016. I intend to remit premium on or before 31.03..2016 so as to claim exemption under Sec.80D of IT.Contact. Please send me renewal notice to my following
changed address. I also request you to note my revised following addressing consequent to my retirement .KINDLY SEND
YOUR RENEWAL NOTICE SHOWING THE AMOUNT PAYABLE.
V.SETHA RAMA MURTHY
FLAT NO:5436, JANAPRIYA METROPOLIS APARTMENTS,
MOTINAGAR, HYDERABAD:500018
My wife and I have mediclaim policy for Rs.1,50,000 each. Bonus earned so far is Rs.55,000 on each. Policy No. is 500300501410000751 valid till midnight of 22/03/2016.
Being senior citizens, (aged 84 & 60) residents in Bangalore,(on retirement from Kodaikanal, Tamil Nadu), we informed the insurance company that we were going out of the country for six months and desired extension of the policy period.. We were advised to submit on return to India proof of our stay out of India by passport endorsements.. Accordingly, on our return as proof of our stay out of India and stay in the United States of America, in Chicago Mi, for six months from 1.6.2015 to 29.11.2016 we sent on 13.2.2016 by speed post copies of passport pages showing emigration and immigration endorsements and our return travel airticket to the National Insurance Co Chennai 60002 which issued the policy. We have followed the request by email dated 29.2.2016. We are awaiting response from the insurance company.
In the meanwhile, our question is whether we can have policy amounts increased to 4 lakhs each, and if so at what additional premium and whether we can have our policy transferred to Koramangala branch of National Insurance Co. Ltd., Bangalore, Karnataka, which is at a convenient distance for us.
We are unable to renew my policy online due to your site fault. Please advise us so we won’t loose discount on online payment.
I need the premium payment certificate for the financial year 2015-16 . premium paid last year.
Policy name: BOI National Swasthya BIMA Policy.
Policy No:603901501510000426
Validity: 15-04-2015 to 14-04-2016
customer ID: 9510253892
covered Mr.T S Sundaresan and Mrs.Usha Sundaresan
I have a medi-policy since 10 years. there was delay in payment of premia in 2015. i paid it after 45 days (excl 30 days race).
The co did not indicate to me that the delay would affect my policy.I also did not receive any reminder to pay the premia.There was no new policy form. Now the co is not settling the claim and is not giving any reasons also.
I am eager to know from learned friends on the site , my claim to have a continuous policy is vitiated because of the delay. Does the previous 10 yers not give me any benefit for a 1 month gap. I shall be glad to hear from knowledgeable viewers.
ramu, mumbai 19/4/16
i want portiblity my mediclaim policy national insurance co. to united insurance co.
please guid me how possible no any problem to company only problem to AGENT
My mobile No +91 90999 40915
I wish tin renew my mediclaim policy of Nationqal Insurance company which fallsn due on 23-7-2016. But I cannot access the site online as it is unexpectedly closed till date. pl. suggest the way.
Please inform my renewal amount for policy number 246012501510000104 from National Insurance.
Can I make online payment. If yes send me the site link.. Thanks.
I added my mother name in this year in the policy of my father (It was continue running since last 5 years after renewal)
Now my mother has having problem & doctor saying surgery is required.
Please suggest…
Our claim was rejected,our policy number is 100900/48/15/8500004291.It was due to a misrepresentation by the doctor. It would be grateful if our matter is look after by your team mates.
Thank you.
Mobile number-9830185199,9830934781
I want to renew my Medi-claim policy bearing No. 100800/48/15/8500001686. The same is to be renewed before 14 / 10 /2016. Please advise as how to pay the premium online and how much amount is to be paid?
Physical examination for pre policy check up done by MD doctor is there any performa for physical examination if yes then please provide one.
i had a policy as a individual for since 2010, and i had also added my parents in the policy on 2012 on wards, how my mother wants, to do the eye operation, kindly reply me with eligbility pls.
how about the heart deases pls clarify
My Mediclaim policy No.270201/48/15/8565000044 will expire on 19 JAN 2017. I would like to renew through online payment. Following Information required :- 1) what will be the premium Amount. 2) which website i should visit to make the on line payment. 3) I do reside at Pune, Maharashtra. 4) when i have contacted pune office they have told that your website for receiving payment is not working ALL OVER INDIA.
Request for guiding me how shall i make the payment online.
I want to renew my policy by online. My policy No. 154400/48/15/8500005929. Pl. inform my premium value. Pl. give the massage in M No.9007024740.
Thanking you.
I have to renew my medi claim policy holder from last 16 years and I used to pay by cheque till last year but now I want to pay on line for renewal of my policy no 170801/48/15/8500001928 which will expire on 18/02/2017.
Pls. let me know the premium amt and the process to deposit online for this premium
When does the coverage period starts from the date of payment of premium and also the premium amount on a policy of Rs.1 lac for 38 years female
Dr SHROFFS CHARITY EYE HOSPITAL DARYA GANJ DELHI-110002 Paitiant name,-Mrs LAJWANTI & RAJINDER KUMAR CHOUDHARY POLICY NO-354302/48/16/8500004322 & 354302/48/16/8500004321
How can I renew the mediclaim policy online?