National Parivar Mediclaim Policy is a health insurance cover designed to provide protection for an entire family. As a family floater policy, this cover protects the entire family under a single policy. The available sum insured amount can be used by any member of the family against various ailments or injuries. As per the policy description, a family is limited to self, spouse, and two dependent children. This policy primarily aims to minimise the financial burden of a family during an unexpected illness or accidental injury.
Policyholders must fit within the following eligibility criteria in order to successfully avail the Parivar Mediclaim Policy offered by National Insurance.
Some of the key features of National Parivar Mediclaim Policy can be listed as follows.
The benefits offered by National Parivar Mediclaim policy can be given in the following table.
|Room rent charges||Up to 1% of the sum insured per day|
|Intensive care unit charges||Up to 2% of the sum insured per day|
|Hospitalisation charges||Fees provided to surgeon, anaesthetist, medical practitioners, and consultants|
|Medical expenses covered||Blood, anaesthesia, oxygen, operation theatre charges, surgical appliances, drugs, medicines, chemotherapy, x-rays, cost of pacemaker, cost of artificial limbs, etc.|
|Organ donor expenses||Coverage provided for surgery costs when the insured person is donating an organ to another person|
|Limit for total expenses||Total expenses for one particular illness are limited to 50% of the sum insured|
National Parivar Mediclaim policy comes with a range of exclusions for which the insurer is not liable for any payment. Some of the key exclusions can be listed as follows.
Cashless treatment facility for National Parivar Mediclaim policy is available only in the company’s network hospitals. It is possible to avail cashless treatment only after prior approval from the third-party administrator (TPA). For planned hospitalisation, the TPA must be informed at least 72 hours before hospitalisation. For emergency hospitalisation, the TPA must be informed within 24 hours of hospitalisation.
For reimbursement claims, the insured must submit a list of documents to the insurance company. These documents include:
Once these documents are submitted, the insurer will check the validity of the claim. All these documents must be submitted to the TPA or insurance company within 15 days after discharge from hospital. Any claims regarding post hospitalisation treatment must also be completed within 15 days after the end of the treatment. The insurer may also assign an agent to enquire with the insured person regarding a claim. The company will inform about the acceptance or rejection of the claim within a maximum of 30 days after submitting all documents. In case of rejection, the reason shall be provided in writing to the insured. Once the claim is accepted, the reimbursement amount will be paid to the claimant within 7 days.
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