Parivar – Medi-Claim For Family

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National Insurance Company Limited

Apart from many other health insurance policies National Insurance Company Limited also has a health insurance policy for a family called the “Parivar – medi-claim for family” policy. TheSALIENT FEATURES of this policy are:

· It is a family floater policy that covers the entire family under a single sum insured

· The policy covers reimbursement of hospitalization expenses for illnesses/diseases contracted or injury sustained by the insured

· Total expenses incurred for any one illness is limited to 50% of the sum insured per family

· Expenses of hospitalization for minimum period of 24 hours are admissible

· The above time limit is not applicable to specific treatments such as day care treatment for stitching of wounds, close reduction and application of POP casts, dialysis, chemotherapy, radiotherapy, eye surgery, ENT surgery, laparoscopic surgery, angiographies, endoscopies, lithotripsy and tonsillectomy

· Pre-hospitalization expenses incurred up to 15 days prior to hospitalization are covered

· Post-hospitalization expenses incurred up to 30 days after hospitalization will be reimbursed

· Any pre-existing diseases will be covered only after 4 continuous claim free years

· Sum insured can be taken from Rs.2 lacs to Rs.5 lacs and then may be increased in multiples of Rs.50000

AGE LIMITS:

· Persons between the age of 3 months to 60 years are eligible to take this policy

· Fresh entrants beyond the age of 60 years will not be covered

· The policy can be extended up to the age of 65 years if it is renewed without a break

SCOPE OF COVER UNDER PARIVAR:

 

HOSPITALIZATION BENEFIT

LIMIT

A

1. Room, boarding expenses as provided by hospital/nursing home which also includes nursing care, RMO charges, IV Fluids/blood transfusion/injection charges

2. If admitted in ICU

Up to 1% of sum insured per day

Up to 2% of sum insured per day

B

Surgeon, anesthetist, medical practitioner, consultants, specialist’s fee, nursing expenses

Actual

C

Anesthesia, blood, oxygen, OT charges, surgical appliances, medicines, drugs, diagnostic material and X-ray, dialysis, chemotherapy, radiotherapy, cost of pacemaker, artificial limbs, cost of stent and implants

Actual

PREMIUM CHARTS:

UP TO 35 YEARS:

SUM INSURED

SELF

SPOUSE

1ST CHILD

2ND CHILD

2A+2C

2A+1C
   

25%

20%

20%

    

2 lacs

2469/-

617/-

494/-

494/-

4074/-

3580/-

2.5 lacs

2956/-

739/-

591/-

591/-

4877/-

4286/-

3 lacs

3444/-

861/-

689/-

689/-

5683/-

4994/-

3.5 lacs

3870/-

968/-

774/-

774/-

6386/-

5612/-

4 lacs

4297/-

1074/-

859/-

859/-

7089/-

6230/-

4.5 lacs

4723/-

1181/-

945/-

945/-

7794/-

6849/-

5 lacs

5151/-

1288/-

1030/-

1030/-

8499/-

7469/-

36-45 YEARS:

SUM INSURED

SELF

SPOUSE

1ST CHILD

2ND CHILD

2A+2C

2A+1C
   

30%

20%

20%

    

2 lacs

2683/-

805/-

537/-

537/-

4561/-

4025/-

2.5 lacs

3213/-

964/-

643/-

643/-

5462/-

4820/-

3 lacs

3743/-

1123/-

749/-

749/-

6363/-

5615/-

3.5 lacs

4207/-

1262/-

841/-

841/-

7152/-

6311/-

4 lacs

4670/-

1401/-

934/-

934/-

7939/-

7005/-

4.5 lacs

5135/-

1541/-

1027/-

1027/-

8730/-

7703/-

5 lacs

5598/-

1679/-

1120/-

1120/-

9517/-

8397/-

46–50 YEARS:

SUM INSURED

SELF

SPOUSE

1ST CHILD

2ND CHILD

2A+2C

2A+1C
   

35%

20%

20%

    

2 lacs

4290/-

1502/-

858/-

858/-

7508/-

6650/-

2.5 lacs

5200/-

1820/-

1040/-

1040/-

9099/-

8060/-

3 lacs

6108/-

2138/-

1222/-

1222/-

10690/-

9468/-

3.5 lacs

6942/-

2430/-

1388/-

1388/-

12149/-

10760/-

4 lacs

7776/-

2722/-

1555/-

1555/-

13608/-

12053/-

4.5 lacs

8610/-

3013/-

1722/-

1722/-

15067/-

13345/-

5 lacs

9444/-

3305/-

1889/-

1889/-

16526/-

14637/-

51-55 YEARS:

SUM INSURED

SELF

SPOUSE

1ST CHILD

2ND CHILD

2A+2C

2A+1C
   

40%

20%

20%

    

2 lacs

4485/-

1794/-

897/-

897/-

8073/-

7176/-

2.5 lacs

5436/-

2174/-

1087/-

1087/-

9785/-

8698/-

3 lacs

6386/-

2554/-

1277/-

1277/-

11495/-

10218/-

3.5 lacs

7258/-

2903/-

1452/-

1452/-

13064/-

11612/-

4 lacs

8129/-

3252/-

1626/-

1626/-

14633/-

13007/-

4.5 lacs

9001/-

3600/-

1800/-

1800/-

16202/-

14402/-

5 lacs

9873/-

3949/-

1975/-

1975/-

17771/-

15796/-

56-60 YEARS:

SUM INSURED

SELF

SPOUSE

1ST CHILD

2ND CHILD

2A+2C

2A+1C
   

40%

20%

20%

    

2 lacs

5127/-

2051/-

1025/-

1025/-

9228/-

8203/-

2.5 lacs

6236/-

2495/-

1247/-

1247/-

11226/-

9978/-

3 lacs

7346/-

2938/-

1469/-

1469/-

13223/-

11754/-

3.5 lacs

8375/-

3350/-

1675/-

1675/-

15076/-

13401/-

4 lacs

9406/-

3762/-

1881/-

1881/-

16931/-

15049/-

4.5 lacs

10436/-

4175/-

2087/-

2087/-

18785/-

16698/-

5 lacs

11466/-

4586/-

2293/-

2293/-

20638/-

18345/-

EXCLUSIONS:

National India Insurance is not liable to make any payment in respect of any expenses incurred in connection with:

· All diseases/injuries those are pre-existing when the cover incepts for the first time

· Any disease other than diabetes and hypertension that is contracted during the first 30 days from the commencement date of the policy except in case of hospitalization due to an accidental injury

· If the insured is aware of the existence of a congenital internal disease/defect before inception of the policy, it is treated as pre-existing

· Injury or disease caused due to war invasion

· Circumcision unless necessary for treatment of a disease

· Cost of spectacles, contact lenses and hearing aids

· Any dental treatment or surgery which is a corrective, cosmetic or aesthetic procedure, including wear and tear, unless arising from accidental injury and which requires hospitalization for treatment

· Convalescence general debility “run down” condition or rest cure, congenital external disease or defects or anomalies, sterility, venereal disease, intentional self injury and use of intoxicating drugs/alcohol

· All expenses arising out of any condition due to AIDS

· Charges incurred at a hospital/nursing home for diagnostic, X-ray or laboratory examinations not consistent with any ailment, sickness or injury

· Expenses on vitamins and tonics unless forming part of treatment for injury or disease

· Injury or disease caused by nuclear weapons or materials

· Treatment arising from pregnancy, childbirth, miscarriage, abortion or complications of caesarean section

· Any treatment other than allopathic system of medicine

EXCEPTIONS:

· Pre-existing diseases like diabetes and hypertension will be covered from the inception of the policy on payment of additional premium by the insured

· Insured shall bear 10% of any admissible claim if s/he is suffering from either diabetes or hypertension

· S/he shall bear 25% of the admissible claim in case s/he is suffering from both diabetes and hypertension

Another benefit of taking a health insurance policy from National Insurance Company Limited is that t is a public sector company so it is perceived to be safer by quite a few people

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