National Health Insurance FAQs

National Insurance settles claims in two different ways. These are-cashless and reimbursement.

National Insurance has over 6,000 network hospitals across India, where the policyholders can seek cashless treatment.

National Insurance requires the following documents for the claim settlement-

• Duly filled claim form
• Relevant cash memos and prescriptions
• Certificate of diagnosis from the attending medical practitioner
• Payment receipt in original along with the attending medical practitioner’s reports
• Any other related documents as asked either by the company or the TPA

Claim Settlement Ratio of National Insurance can be calculated using the formula given below:

Claim Settlement Ratio = (Total no. of claims approved/Total no. of claims received) x 100

To process cashless insurance claim under National Insurance plans, you must follow the steps given below:

• Inform the National Insurance Company about the hospitalisation, before 72 hours in case of planned hospitalisation and within 24 hours in case of emergency hospitalisation.
• Get a cashless claim request form from the insurance company or the insurance provider and submit it to the concerned person at the hospital. The hospital authorities will share the documents with the insurer.
• Your documents will be verified along with the pre-authorisation form.
• On the basis of documents submitted, the insurance company will make a decision on whether to accept or reject the claim request.
• The network hospital will then send the final request and settle the bills at the network hospital.

To make reimbursement claims under health insurance plans offered by the National Insurance Company, you must follow the steps given below:

• Intimate National Insurance Company about the hospitalisation, before 72 hours in case of planned hospitalisation and within 24 hours in case of emergency hospitalisation.
• Avail the required medical treatment and settle the bills out of your own pocket. Collect the documents related to your treatment, when leaving the hospital.
• Submit the duly filled request form along with relevant documents to the insurance company.
• Your documents will be verified by the insurance company and if the claim is made in accordance with the terms and conditions of your health insurance policy, then the company will pay you for the expenses incurred for the treatment.

In case of a claim under National Insurance plan, you are required to inform National Insurance Company 72 hours in advance in case of planned hospitalisation and within 24 hours in case of emergency hospitalisation.

According to the IBAI’s General Insurance Claim Insights Handbook For Policyholders-5th Edition, the Claim Settlement Ratio of National Insurance for the financial year 2019-20 is 83.78%.

As per the IRDAI (Insurance Regulatory and Development Authority of India), the Claim Settlement Ratio of National Insurance for FY 2019-20 is 83.78%.

Anyone who is aged between 20 years and 65 years can seek coverage under the Critical Illness Mediclaim Policy offered by National Insurance.

National Insurance provides cover for up to 37 listed critical illnesses under its Critical Illness Mediclaim Policy.

The sum insured options under the Critical Illness Mediclaim Policy offered by National Insurance starts at Rs. 1 lakh. The company provides a lump sum amount to the insured on the diagnosis of any specified critical illness.

Yes. The policyholders have an option to add two more critical illnesses, viz., permanent paralysis of limbs and total and permanent blindness.

To buy a critical illness policy offered by National Insurance online at InsuranceDekho, you must follow the steps given below:

• Visit insurancedekho.com and click on the Health tab.
• Select your gender. Enter your name and mobile number, on that you will receive an OTP. kindly enter that.
• Answer the question-‘When do you want to buy the policy’ by clicking on one of the options from the drop-down menu. Then click on ‘View Quotes’.
• Select the family members you wish to add to your health insurance policy. Click ‘Continue’.
• Select the age of family members selected.
• Enter your Email ID and City. Click on ‘Submit and View Quotes’. Most suitable quotes for you will be displayed on your screen. Select the one you want to purchase.
• Select the policy term you wish to buy the policy for. Enter the required details and pay online via a secured payment gateway.

Anyone who is aged at least 18 years and is an Indian resident can buy a critical illness plan offered by the National Insurance Company.

Yes. You can avail tax benefits on the premium paid for critical illness plan offered by National Insurance, under Section 80D of the Income Tax Act, 1961.

Critical illness plans offered by National Insurance protect you from the following illnesses:

• Coma of Specified Severity,
• Coronary Artery Bypass Graft Surgery (CABG),
• Kidney Failure Requiring Regular Dialysis,
• Open Heart Replacement,
• Cancer of Specified Severity, etc.

At the time of claim under National Insurance policy, you would require the following documents:

• Identity proof of the claimant
• Doctor’s certificate
• Duly filled Claim form
• Copy of Medical reports/records
• Copy of Investigation reports
• Copy of hospital summary/discharge card/treatment advise/medical reference
• Any other relevant documentation as requested by the Insurer.

You can cover yourself, your spouse, dependent children up to 18 years of age (dependent girl child till marriage, if not employed), parents in law, and parents under the floater health insurance plans by National Insurance Company.

National Insurance Company offers health insurance plans for individuals, families, senior citizens, parents, children, etc. People aged up to 65 years can be covered under these policies.

National Parivar Mediclaim, the ideal family health insurance policy by National Insurance is a good purchase for families willing to get their financial future secured against medical uncertainties. The National Insurance policy is also a must for those who want to insure themselves, their spouse, dependent children, and dependent parents under a single sum insured amount, at an affordable premium rate.

If you want to change your sum insured amount of National Insurance family health insurance policy, you can do so at the time of policy renewal. Please note that National Insurance does not allow any sum insured change during the policy tenure, irrespective of the policy type, amount insured or premium.

There are multiple benefits of buying National Insurance family health insurance policy. Wide sum insured range, lifelong renewal of policy, easy settlement of claims, 5% discount for new policies, 2.5% discount for the policy renewal, 5% no claim discount on the base premium for every claim-free year, second medical second opinion for 80+ major illnesses, availability of add-on covers such as critical illness, opd treatment, and more.

National Parivar Mediclaim Policy, the ideal National family health insurance plan provides cover for inpatient treatment, pre and post-hospitalisation cover, daycare treatment, domiciliary treatment, organ donor expenses, pre-existing diseases (after 48 months), emergency ambulance cover, maternity & newborn baby cover, and more. Please note that the policy also provides cover for optional benefits like hypertension and diabetes Cover, opd cover, and critical illness cover available at the price of a little extra premium.

Yes! A National Insurance family health insurance policyholder is eligible to avail tax benefits as per the Section 80D of the Income Tax Act, 1961.

Yes. National Insurance facilitates the portability feature for the customers.

A free-look period of 15 days is offered to the policyholders under health insurance policies of National Insurance.

Yes. The National Insurance Company offers discounts to the policyholders on some health insurance plans.

According to the annual report of 2017-2018 of IRDAI, National Insurance has sold 18,07,861 policies.

The address of National Insurance Company Ltd. is-

3, Middleton Street, Prafulla Chandra Sen Sarani,
Kolkata, West Bengal, 700071.

The Incurred Claim Ratio (ICR) of National Insurance for FY 2018-19 is 107.64%.

The following reports are required for a pre-policy check-up-

• HbA1c
• Serum creatinine
• Physical examination (signed by a Doctor with minimum MD (Medicine) qualification)
• Any other investigation required by the company
• Urine routine and microscopic examination
• ECG
• Lipid profile
• Eye checkup

The reports should not be older than 30 days prior to the date of proposal.

You can visit the official website of National Insurance Company to purchase a policy, i.e. https://nationalinsurance.nic.co.in. To opt for a smooth and hassle-free process, you can also purchase it at InsuranceDekho.

Thankfully, downloading a National Insurance policy document is an easy and not so time consuming process. To do the same, you are required to follow the steps given below:

• Visit the official website of National Health Insurance
• Go to the customer portal
• Register yourself by entering your name, policy number, contact number and registered email ID.
• After doing the same, your ID and password will be generated.
• Leave a request for a National Health Insurance policy document.
• You will receive your National Health Insurance policy document on your registered email ID that you can download easily.

To ease out the health insurance buying process, the Insurance Regulatory and Development Authority of India (IRDAI) has made it mandatory for the general and health insurance companies offering health insurance plans to sell them online. Not only the policy can be purchased online, but the insured can also make a claim with the help of a soft copy of National Health Insurance. This means, you don’t really need to have a hard copy of your National Health Insurance policy document.

To get a hard copy of your National Health Insurance policy, you must follow the steps listed above to download the policy document and then take its printout. The policy document comes handy in case of health insurance claims. Also, note that there is no limit to downloading your National Insurance policy online. You can do it as many times as you want.

In case of any issue or help required, you can contact the customer care executives at InsuranceDekho on the toll-free number 7551-196-989 and seek help.

After receiving your National Health Insurance policy document, you may want to get some changes done in case you see some errors. Getting the changes done are important so as to avoid any discrepancy at the time of claim settlement. If you find any error in the name of nominee, address, zone, birth, occupation, health condition, name of the insured, etc., then you must contact the customer care executives of National Health Insurance and share your requirements. The executives will guide you through the process and help you make the changes within the stipulated time.

The minimum and maximum entry age for individuals under health insurance plans offered by National Insurance is 18 years and 65 years. However, children aged between 3 months to 18 years can be added too if at least one parent is also covered under the same policy.

Given below are the benefits of purchasing individual health insurance from National Insurance-

• 30 days pre-hospitalisation cover
• 60 days post-hospitalisation cover
• Over 140 daycare procedures
• AYUSH treatment cover
• In-patient hospitalisation cover
• Good health incentives

National Insurance Company offers health insurance plans for individuals, families, senior citizens, parents, children, etc. People aged up to 65 years can be covered under these policies.

Individuals in need of a reliable health insurance policy, which can take care of medical expenses during an unexpected medical situation should buy a National Insurance individual health insurance policy. For policy buyers seeking individual health insurance, National Insurance has National Mediclaim and National Mediclaim Plus policies as the ultimate option.

No! It will not be possible for you to change your National Insurance individual health insurance sum insured during the policy tenure. It is advised to you wait until your policy renewal time to ensure the successful fulfilment of your requirement.

The individual health insurance plan of National Insurance, i.e., National Mediclaim Plus policy provides cover for inpatient hospitalization, 30 days pre & 60 days post hospitalization, 140-day care procedures, pre-existing diseases, maternity & newborn baby cover, vaccination for children, hospital cash, air ambulance cover, second medical opinion, and allopathic, ayurvedic and Homeopathic treatment, etc. Moreover, an individual can get their critical illness and OPD expenses covered by taking add-on covers Critical illness and Outpatient treatment for the same.

Yes, the National Insurance individual health insurance policy provides tax benefits as per Section 80D of the Income Tax Act, 1961 for the premium paid.

No. Only up to 2 dependent children can be added under the same policy with their parents if either of the parents is covered under the policy.

Yes. National Insurance offers coverage for kids under its various floater health insurance policies.

Health insurance policy buyers willing to insure their children along with them in a reliable health insurance policy should choose kids health insurance by National Insurance. If you have children between the age group 3 months to 18 years, National Insurance kids health insurance, National Parivar Mediclaim policy is the best for you.

If planning to change your sum insured amount for National Insurance kids health insurance policy, make sure you do so at the time of policy renewal as health insurance companies do not allow any changes during the policy tenure.

When you choose National Insurance kids health insurance policy, you gain advantages such as extensive coverage, lifelong renewability of policy, no claim discount, health checkup every 4 years, availability of optional covers like pre-existing diabetes/hypertension, outpatient treatment, critical illness, easy claim settlement, cashless treatment facility available at more than 6000 network hospitals, and others.

National Parivar Mediclaim Policy, the National Parivar Mediclaim policy provides cover for inpatient treatment, pre and post-hospitalisation cover, daycare treatment, organ donor expenses, domiciliary treatment, pre-existing diseases (after waiting period of 48 months), emergency ambulance cover, maternity & newborn baby cover, etc. The plan also covers pre-existing diseases like hypertension and diabetes, outpatient cover and critical illness at an additional premium price.

Yes! Under the National Insurance kids health insurance policy, the policyholder can avail tax benefits in adherence to Section 80D of the Income Tax Act, 1961.

National Insurance bears the in-patient medical expenses incurred as an in-patient for delivery and termination up to the first two deliveries.

• Medical expense for normal or caesarean delivery
• Medical expense for lawful medical termination of pregnancy
• Hospitalisation expenses if necessary, for up to 30 days for pre-natal and up to 60 days for post-natal treatment
• Baby from birth cover

Following are the exclusions under maternity health insurance plans offered by National Insurance-

• Surrogacy
• Pre and post-hospitalisation expenses other than pre and post-natal treatment
• More than one delivery or termination in a policy year

Women and newly married couples should buy National Insurance maternity insurance policy as National Parivar Mediclaim Policy provides cover for maternity cover as well as newborn baby cover at affordable premium rates. It is advisable to buy the National Parivar Mediclaim policy well in advance before planning to start a family as the policy provides maternity benefit after a waiting period of 3 years.

If you feel the need to change (increase or decrease) your sum insured amount for National Insurance maternity health insurance plan, make sure you do so at the time of policy renewal as National Insurance like other health insurance companies does not allow making any change during the policy tenure.

There are many advantages associated with National Parivar Mediclaim, the ideal National Insurance maternity health insurance policy. A few major advantages include easy claim settlement, cashless treatment at 6000+ network hospitals, the sum insured option up to Rs. 10 Lakh, cover for infertility up to Rs. 50,000, medical second opinion for 88 illnesses, good health incentives such as no claim discount & health checkup, availability of optional covers to extend coverage.

Yes! Under Section 80D of the Income Tax Act, the National Insurance maternity health insurance policy offers tax deductions for the policy premium paid.

Parents can enjoy the following benefits under health insurance plans offered by National Insurance-

• In-patient hospitalisation cover
• Domiciliary hospitalisation cover
• Cover for more than 140 daycare treatments
• 30 days pre-hospitalisation cover
• 90 days post-hospitalisation cover
• Cover for AYUSH treatments

Following are the exclusions under health insurance plans offered for parents by National Insurance Company-

• Any injury caused by self-harm
• HIV, AIDS or any sexually transmitted disease
• Any disease before the waiting period from the date of inception of the policy
• Cosmetic surgery
• Psychiatric disorder

Varistha Mediclaim Policy is a good option for individuals between the age range of 60 years up to 80 years. The policy provides high protection against medical expenses at the time of an expected emergency situation, therefore it is a great choice for the elderly to secure their health as well as finances.

Individuals having Varistha Mediclaim Policy and looking forward to changing the sum insured amount are advised to make any form of changes during the policy renewal. Also, note that the health insurer does not allow any change of sum insured during the policy tenure.

Varistha Mediclaim Policy, the ideal parents health insurance plan by National Insurance provides cover for inpatient hospitalization, pre & post hospitalization, domiciliary treatment, daycare procedures, emergency ambulance cover, additional cover for critical illness and pre-existing diseases, good health incentives such as cumulative bonus and reimbursement of health checkup expenses, and more.

A National Insurance parents health insurance policyholder can avail tax benefits for the premium paid according to the Section 80D of the Income Tax Act, 1961.

You can cover yourself, your spouse, dependent children up to 18 years of age (dependent girl child till marriage, if not employed), parents in law, and parents under the floater health insurance plans by National Insurance Company.

Yes. Health insurance policies offered by National Insurance do cover in-patient hospitalisation expenses that include the following-

• Nursing, room, boarding charges
• ICU expenses
• Doctor’s fees
• Surgical fees, operation theatre charges, anesthetist, anesthesia, blood, oxygen and their administration
• Dressing, ordinary splints, plaster casts, etc.
• Prescribed drugs and medicines
• Prosthetic and other devices’ cost
• Cost of laboratory and diagnostic tests

You can port your current health insurance policy to a National Insurance health insurance policy at the time of its renewal.

Yes. All the credits that you have earned for your previous policy will be transferred to your new National Insurance policy in case of portability.

Yes. A discount of 10% is allowed on the premium for eligible members if either or both are aged between 18 years to 25 years.

The premiums for National Insurance health insurance policies starts at Rs. 2,469* per annum. *The premium amount is subject to change from time-to-time.

Yes. The company offers a discount of 10% on the premium for eligible family members if the policy is purchased for the family.

You can pay premium for National Insurance policy in any mode other than cash to avail tax benefit.

To calculate the premium for parents under health insurance plans offered by National Insurance, several factors are taken into consideration. These include age, members covered under the policy, the sum insured, add-ons, policy term, etc. To get an estimate of the health insurance premium for a particular insurance policy, you must use the online premium calculator on the website of InsuranceDekho.

Following are the benefits of using National Insurance premium calculator:

• It tells you about the premium you will be required to pay periodically for a particular health insurance plan
• It allows you to compare several health insurance plans
• It lets you alter the coverage benefits and see the premium amount change
• It saves you from complex calculations of health insurance premiums.

There are several factors that affect the premium of National Insurance plans. These are as follows:

• Age
• Policy term
• Medical history
• Coverage details
• Desired sum insured
• Lifestyle (smoking or drinking habits, etc.)
• Body Mass Index (BMI)
• Geographical location
• Type of policy you wish to buy.

Yes. You are required to pay GST at the rate of 18%, for the premiums paid for National Insurance plans. Earlier, the service tax on insurance was levied at 15%. It included Basic Service Tax of 14%, Swachh Bharat Cess of 0.5% and Krishi Kalyan Cess of 0.5%.

To lower premiums for National Insurance plans, you can follow the simple tips given below:

• Buy health insurance policy at an early age to save on health insurance premium
• Choose the deductibles wisely
• Opt for health insurance plans that have a co-payment clause
• Select long term health insurance plans
• Choose top-up health insurance plans for extensive coverage as they come at affordable premiums
• Prefer buying family floater health insurance plans instead of individual health insurance plans.

Sum insured options available for senior citizens under Varistha Mediclaim Policy are of Rs. 1 Lakh and Rs. 2 Lakh.

Yes. National Insurance offers two add-on benefits under the senior citizen health insurance plan. These are-critical illness cover and pre-existing disease cover.

National Insurance Company offers health insurance plans for individuals, families, senior citizens, parents, children, etc. People aged up to 65 years can be covered under these policies.

Senior citizens looking forward to securing their health and finances in the time of an unexpected medical emergency should buy Varistha Mediclaim Policy, the affordable National Insurance senior citizen health insurance policy. If you are between the age range of 60 years up to 80 years, this plan is for you.

If you are a senior citizen having Varistha Mediclaim Policy and willing to change your policy’s sum insured amount, it would be best to do so at the time of policy renewal. Please note that any change of sum insured amount will not be permitted by National Insurance during the policy tenure.

Varistha Mediclaim Policy, National Insurance’s senior citizen health insurance policy has a wide range of advantages to offer. Quick claim settlement, 5% cumulative bonus at the time of renewal, cover for critical illness, optional 5% discount on renewal premium, lifelong renewability, reimbursement of health checkup at a block of 3 continuous cover, 15 days free look period, tax benefits, cashless treatment at more than 6000 network hospitals are some of the prime benefits of Varistha Mediclaim Policy.

National Insurance Varistha Mediclaim Policy provides cover for in-patient hospitalisation expenses, domiciliary hospitalisation, pre and post-hospitalisation cover, cover for room charges, ICU charges, and other expenses, along with cover for ambulance expenses. It must be noted that the policy also comes with the option to extend coverage in the form of add-on covers for critical illness and pre-existing diseases like hypertension and diabetes.

Yes! Under Section 80D of the Income Tax Act, 1961, the National Insurance’s senior citizen health insurance provides tax benefits for the policy premium paid.

Yes. The premiums paid for National Insurance policies are eligible for tax benefit.

Health insurance policies offered by National Insurance are eligible for tax benefits under Section 80D of the Income Tax Act, 1961.

Riders are additional benefits that you can purchase voluntarily by paying an extra premium. For instance, maternity cover, critical illness cover, etc. On the other hand, super top-up plans offer additional health insurance coverage to your existing health insurance policy. These plans offer the most inclusive protection at affordable premiums.

Super top-up policies offer the following benefits:

• It increases your sum insured at a very affordable premium.
• There is no capping, no co-payment, less waiting period
• Cover for pre-existing diseases.

You should get a super top-up policy mainly because it offers you extensive coverage at affordable premiums thereby offering you utmost protection in case of health emergencies.

Those who are not satisfied with the coverage under their existing health insurance policy can purchase a super top-up policy offered by National Insurance.

Yes. Daycare procedures are covered under health insurance plans offered by National Insurance for women.

Yes. Women can enjoy the following good health incentives under health insurance plans offered by National Insurance-

• No Claim Discount
• Health check-up

National Parivar Mediclaim Plus Policy is the perfect woman health insurance by National Insurance. Women as well as looking forward to starting a family soon can buy this plan to get their maternity as well as newborn baby expenses covered at a reasonable premium cost.

The best time to make any sum insured changes of your National Insurance woman health insurance policy would be policy renewal as health insurance companies do not allow any sum insured change during the policy period.

One of the biggest advantages of the National Insurance women health insurance policy, National Parivar Mediclaim Plus Policy is that it provides massive cover at an affordable premium cost. Some of the key advantages are cashless treatment at 6000+ network hospitals, maternity cover, newborn baby cover, vaccination for newborn baby, infertility, vaccination for children, no claim discount, health checkup, availability of optional covers, etc.

National Parivar Mediclaim Plus Policy, the ideal National Insurance woman health insurance plan provides cover for maternity cover, newborn baby cover, vaccination for newborn baby, infertility, vaccination for children along with inpatient treatment, pre & post hospitalization, pre-existing diseases, domiciliary hospitalization, daycare procedures, road ambulance, air ambulance, medical second opinion, reinstatement of sum insured, good health incentives like no claim discount, health checkup, and optional covers like pre-existing diabetes/hypertension, outpatient treatment, and critical illness.

Yes, under National Insurance woman health insurance policy the policyholder can claim tax deductions according to the Section 80D of the Income Tax Act, 1961.