National Health Insurance Parivar Mediclaim Policy for Family
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About National Health Insurance Parivar Mediclaim Policy for Family
Parivar Mediclaim Policy for Family by National Insurance is one of a kind policy that provides cover for all family members under a single sum insured. With the hike in costs of medical treatment, a family medical plan providing coverage for not only basic medical expenses but also of pre-existing conditions is definitely a boon in difficult times.
This plan not only covers hospitalisation expenses incurred for treatment of illness/diseases or injury sustained by the insured person during the policy period. But in fact, this plan also has provision to cover pre-existing conditions such as diabetes and hypertension on payment of additional premium. The plan offers cashless facility and/or reimbursement of treatment expenses for treatment of illness, injury or disease. The person between the age of 18 to 65 years can be covered under the policy. The sum insured under this plan ranges from Rs. 2 Lakh to Rs. 5 Lakh.
Key Inclusions and Exclusions of the Plan
- In-patient hospitalisation expenses
- Daycare procedures coverage for over 140+ procedures
- Pre-hospitalisation for 15 days and post-hospitalisation for 30 days
- Expenses for the person donating an organ during organ transplant
- Total expenses incurred for any one illness limited to 50% of SI
What's Not Included
- All pre-existing diseases covered after the first 48 months of the policy
- Treatment expenses related to STD, HIV, AIDS, infertility, sterility, and assisted conception
- Treatment expenses related to non-allopathic treatment
- Any costs incurred under cosmetic/plastic surgery
- Dental treatment and outpatient department treatment
For all members under single sum insured
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Plan covers pre-existing diseases also
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Add-ons to Enhance Benefits
Under this plan, diabetes and hypertension, if pre-existing, will be covered since the inception of the policy on payment of additional premium by the insured person.
Expert Review for National Parivar Mediclaim Policy for Family
Are you looking out for a health insurance policy for your family? If so, the Parivar Mediclaim Policy for Family can be the right option. Designed by National Insurance Company, the policy features to protect you and your family from unforeseen medical conditions. It prevents you from falling prey to the financial burden because of hospitalisation due to an illness/disease/accidental injury. With the policy in hand, you can secure yourself, your spouse, and two dependent children under a single floater sum insured.
Further, the Parivar Mediclaim Policy for Family comes with the sum insured options starting from Rs. 2 Lakh to Rs. 5 Lakh. It covers people between the age of 18 years to 65 years. And the policy is issued for a period of one year. On payment of additional premium, the policyholder can get cover for pre-existing diseases such as diabetes and Hypertension from the inception of the policy.
There are a whole lot of customer-friendly features under the Parivar Mediclaim Policy for Family that makes the policy more attractive. Right from the day the policy is issued, you can get cover for inpatient treatment, pre-hospitalisation (15 days) and post hospitalisation (30 days), daycare procedures, and organ transplant. Not only this, the insurance company under this policy provides cashless treatment in network hospitals and the reimbursement facility if the treatment is taken in a non-network hospital. Here are some other key attractions:
- Add-on cover for pre-existing diabetes and hypertension
- Cover for 140+ daycare procedures
- Cover for room charges subject to 1% of sum insured per day
- Cover for ICU up to 2% of the sum insured per day
- Cover for alternative treatment - Allopathy
- Cashless facility available through dedicated TPA service
- The dependent female child is covered until she gets married irrespective of age
- No pre-policy medical checkup for persons aged 40 or below
What’s more about the Parivar Mediclaim Policy for Family is that there is no waiting period to cover accidental claims provided that the insured member of the family sustains an injury due to an accident after the policy purchase date. With the policy, you can get cover for the expenses incurred for surgeon, medical practitioner, anaesthetist, consultant, specialist, etc. Besides, there are other benefits that you can happen to enjoy by choosing this health policy of National Insurance Company. Some of them are:
- The policy can be renewed annually throughout the lifetime
- The policyholder has 15 days of grace period to continue or cancel the policy
- He/she can also port the policy to similar health product of the same insurer or other insurance company
- A period of 30 days is given to renew the policy if it gets expired
- Tax benefits under section 80D of the Income Tax Act
After discussing all the benefits and features, we can conclude that the Parivar Mediclaim for Family is worth buying. The only thing is that there is co-payment of 10% to 25% in the case of diabetes and/or hypertension and 1-2% on room rent and ICU. Overall, the policy is good to buy.
When you decide to buy any health insurance policy, it is good to choose an online platform like InsuranceDekho where you can get adequate customer service support right from choosing the policy to finding free quotes and filing claims. Overall, purchasing the policy from InsuranceDekho can lead to a hassle-free policy purchase experience.
Claim Process at National Health Insurance
- Network Hospital
- Non-Network Hospital
Claim IntimationEmergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 72 hours prior to admission.
Claim ProcessingFill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
Claim SettlementOnce your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.
Claim AssistanceFor any assistance call Insurancedekho at 1800-120-5698 or call toll free number of National Health Insurance at 1800-345-0330.
Claim IntimationEmergency hospitalisation needs intimation within 72 hours and for planned hospitalisation intimate within 72 hours prior to admission.
Claim ProcessingSubmit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
Claim SettlementOnce your request for reimbursement of expenses is approved, the claim will be settled.
Claim AssistanceFor any assistance call insurancedekho at 1800-120-5698 or call toll free number of National Health Insurance 1800-345-0330.
Parivar Mediclaim Policy for Family FAQs
What is the eligibility criteria for coverage under the policy?
The persons between the age of 18 years and 65 years can be covered under the policy.
Are children covered under the Parivar Mediclaim Policy for Family?
Yes, up to two dependent children can be covered under this policy.
a)Dependent child up to 18 years of age
b)Dependent unemployed male child above 18 years up to 25 years
c) Dependent female child if not employed, till marriage
Is there any co-payment clause under this policy?
There is a co-payment clause applicable for pre-existing hypertension and/or diabetes.
a)Co-payment of 10% shall apply to all admissible claims arising out of diabetes and/or hypertension, in case diabetes or hypertension is pre-existing
b)Co-payment of 25% shall apply to all admissible claims arising out of diabetes and/or hypertension, in case diabetes and hypertension is pre-existing
Accidental claims are covered after how much waiting period?
There is no waiting period for accidental claims provided the insured has suffered in an accident after the inception of the policy.
Is OPD covered under this policy?
No, the plan does not provide coverage for outpatient department (OPD) treatment.
Is critical illness covered under the National Parivar Mediclaim Plus Policy?
The critical illness is covered as an optional cover, but pre-policy medical checkup is required in such a case.
What is the provision for pre-policy medical checkup under this policy?
Pre-policy medical checkup is required under the following conditions:
1) If the proposer is aged 40 years and above
2) If the proposer opted for SI of Rs. 6 Lakh or above, irrespective of the age
3) If the proposer has opted for critical illness optional cover, between the age of 18 years and 65 years
Is there any tax rebate available under this plan?
The premium paid under the plan is exempted from tax under Section 80D.
Does Parivar Mediclaim Policy for Family cover allopathy?
Yes, allopathy is covered under Parivar Mediclaim Policy for Family.
I have hypertension, can I be covered under Parivar Mediclaim Policy for Family?
Yes, pre-existing hypertension is covered after a waiting period of 48 months. Also, there is a co-payment clause attached to it. However, upon payment of additional premium pre-existing hypertension can be covered since the inception of policy as an optional benefit.