National Insurance
National Parivar Mediclaim Plus policy
The National Parivar Mediclaim Plus is a decent policy for couples planning a child as it offers Rs. 50k.However, the policy comes with some notable caveats -- It has a cover amount capped at ₹10 lakhs, which might not be sufficient for extensive medical needs. Apart from this, the room rent limit is restricted to 1% of the cover amount, which can lead to out of pocket expenses. The No Claim Bonus is not that impressive either. The insurer increases the sum insured by just 5% annually, capped at 50%, which is relatively modest. Coming to this insurer, they have a relatively high incurred claim ratio, indicating that they are paying out more in claims than they have been collecting in premiums.
What's good here?
Reinstatement of Sum Insured due to Road Traffic Accident
Once you exhaust your entire cover, you will have 100% of the cover restored, if you are hospitalized one more time in a bid to treat injury due to road traffic accident.
Once you exhaust your entire cover, you will have 100% of the cover restored, if you are hospitalized one more time in a bid to treat injury due to road traffic accident.
You may pay a portion of the bill
On most occasions the insurer will pay your medical bills in full up to the sum insured — no questions asked. However, if you were forced to be treated in a hospital that’s not a part of their network, then they’ll make you co-pay 10% of the final bill.
Day Care treatments covered
If you’re hospitalized for less than 24 hours in lieu of a minor procedure, then the insurer will cover these costs too. Think dialysis, chemotherapy or minor surgeries.
Maternity benefits offered
The insurer will also cover expenses related to maternity— Think hospitalization expenses incurred while giving birth. But they’ll only pay upto ₹50,000 and make you wait 2 years before covering this expense. Also, you’ll only get the benefits if both, you and your spouse are enrolled in a single-family floater plan.
Pre & Post hospitalization expenses covered
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 30 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.
Covers Alternative Medicine
Think of getting Ayurvedic, Homeopathic or other alternative treatments to cure an illness? Your insurer will cover you fully, up to the sum insured.
What's bad here?
Restrictions on the rooms you can pick and much more
Your insurer won’t let you stay in a room whose rent exceeds 1% of the sum insured. If it’s an ICU they’ll bump it to 2% of the sum insured. And in the event you breach these limits, then you’ll have to pay a lot more - Read more here
Your insurer won’t let you stay in a room whose rent exceeds 1% of the sum insured. If it’s an ICU they’ll bump it to 2% of the sum insured. And in the event you breach these limits, then you’ll have to pay a lot more - Read more here
Has disease wise sub-limits
Your insurance cover won’t be fully available in case you are treated for Cataracts, Modern treatments and a few other diseases. Meaning the insurance company has a cap on the total amount they’ll pay out if you are treated for these specific illnesses.
Your insurance cover won’t be fully available in case you are treated for Cataracts, Modern treatments and a few other diseases. Meaning the insurance company has a cap on the total amount they’ll pay out if you are treated for these specific illnesses.
What's okay here?
Reasonable waiting period for pre-existing diseases
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after you wait for 3 years.
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after you wait for 3 years.
Free Health Checkups every 2 years
If you’re planning on getting a full body checkup every 2 years just to make sure you’re in fine working condition, the insurer will cover the costs.
Some coverage if you are forced to hospitalize at home
The insurer will pay up to ₹1,00,000 if you are forced to hospitalize at home due to a medical condition or the hospital running out of beds. In insurance lingo, they call this a policy with domiciliary cover.
What's lacking here?
No Restoration Benefit
Some policies will tell you - Even after you claim part of the cover on one occasion, you will have the full cover restored, if you are hospitalized another time during the same year. So if you have a family cover and multiple members of the family are hospitalized in the same year, this feature will come in handy. Unfortunately, this policy offers no such benefit.
No Bonus for being healthy and not claiming insurance
Some policies offer you extra cover if you go an entire year without claiming your insurance. This policy, however, offers no such benefit.
Add-ons
OPD
With this add on, you can get coverage for outpatient consultations i.e. doctor visits along with coverage for prescribed diagnostics and pharmacy up to the specified limits.
Critical Illness
With this add-on you get a lumpsum payment in the event you are diagnosed with critical illnesses outlined in the policy document.
Frequently Asked Questions
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