Varistha Mediclaim Policy by National Insurance is a health insurance policy designed to meet the requirements of senior citizens in the country. Senior citizens are among the most vulnerable groups when it comes to ailments and injuries. This policy focuses on providing financial security to that vulnerable group against various health risks. This is an individual policy, and it cannot be taken as a group cover or family floater cover.
As a health insurance policy specifically designed for senior citizens, this cover comes with a set of specific eligibility criteria that must be met.
Some of the key features of National Insurance Varistha Mediclaim Policy can be listed as follows.
Varistha Mediclaim Policy by National Insurance comes with a range of benefits tailor-made for senior citizens. The policy is designed in such a way that senior citizens get the maximum out of the limited sum insured amount. Some of the major benefits offered by this medical insurance policy can be provided in the following table.
|Room rent||1% of the sum insured per day subject to a maximum of 25% of the sum insured per illness or injury|
|Intensive care unit charges||2% of the sum insured per day subject to a maximum of 25% of the sum insured per illness or injury|
|Hospitalisation expenses||Doctor’s fees, consultant fees, surgeon fees, medical practitioner fees, anaesthetist fees, etc.|
|Other medical expenses||Blood, anaesthesia, oxygen, surgical appliances, medicines, drugs, x-ray, chemotherapy, radiotherapy, cost of pacemaker, artificial limbs, etc.|
|Cataract treatment||Sub-limit up to Rs.10,000|
|Benign prostatic hypertrophy||Sub-limit up to Rs.20,000|
|Domiciliary hospitalisation||Up to 20% of the sum insured amount|
|Ambulance charges||Up to Rs.1,000 per policy period|
|Critical illness coverage||Lump sum up to the limit of sum insured is paid for conditions such as cancer, stroke, multiple sclerosis, etc.|
There are certain cases for which the insurer is not liable to provide any compensation. Some of the key exclusions from this policy can be listed as follows.
Both cashless treatment and reimbursement is available with National Insurance Varistha Mediclaim Policy. In case of an event that may give rise to a claim, the insurer must be notified without any delay. Cashless treatment is possible only after receiving an approval letter from the third-party administrator (TPA). For planned hospitalisation, the TPA must be informed at least 72 hours prior to admission in the hospital. In case of emergency hospitalisation, the TPA must be informed within 24 hours after admission in the hospital.
For cashless treatment, the TPA will check the validity of the claim and issue the authorization letter. The insured person must submit this authorization letter along with the insurance details and identity card.
For reimbursement claims, the insured must provide the following list of documents while filing for the claim.
Once the treatment is over, the insured must submit all the above mentioned documents within 15 days after discharge from the hospital. After receiving all the documents, the TPA and the insurance company will verify the validity of the claim. The insurance company may also send an agent to check with the policyholder regarding the claim. After verifying the validity of the claim, the reimbursement amount will be disbursed to the insured.
If you want to get in touch with the customer care executives of the company, you can call the toll-free numbers 1800-200-7710 and 1800-120-1430.
A pre-policy check-up can be requested by the insurance company to ascertain the physical condition of the proposer of the policy. However, pre-policy check-ups are not demanded always. Pre-policy check-ups are required when:
The reports for the following tests need to be submitted as part of the pre-policy check-up:
The date of the medical reports should be within 30 days from the date of proposal of the policy.
The following documents can be submitted as proof of identity:
The following documents can be submitted as proof of residence:
The insurance company will reimburse 50% of the expenses incurred on the pre-policy check-up.
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