Overview
The National Insurance National Parivar Mediclaim policy is a family floater health insurance plan that covers family members under a single sum insured ranging from ₹1 lakh to ₹10 lakh. It includes optional add-ons such as critical illness cover, outpatient treatment, and pre-existing diabetes/hypertension cover. With lifelong renewability and tax benefits under Section 80D, it aims to provide affordable health protection for families.
Experts' Review
Written by Nikhil Nair
Senior Writer
The National Parivar Mediclaim policy is a decent family floater plan that offers essential health coverage with a focus on affordability and flexibility. It includes coverage for domiciliary hospitalization (up to 20% of sum insured), organ donor expenses, AYUSH, pre-post hospitalization [45-75 days respectively], maternity cover [Up to 10% of SI subject to INR 30,000 in case of normal delivery and INR 50,000 in case of caesarean section ]and a wide range of daycare procedures.
In addition, premiums for this policy are generally 10-15% lower than comparable family floater plans, making it attractive for budget-conscious buyers. The policy also offers optional add-ons like critical illness and outpatient treatment, which enhance its appeal. Basic cover includes AYUSH treatments up to the Sum Insured, has disease-wise sub-limits on modern treatments and cataract, room rent [capped at 1% of SI (ICU at 2%) per day or actuals—whichever is lower], a restoration benefit once per policy year, and a No Claim Bonus of 5% per claim-free year up to a maximum of 50%.
Pros
Insurer has a solid track record with great claim and service metrics.
Offers Infertility treatments, which makes this policy stand out.
Cons
Not very feature-rich.
Good Restoration Benefit, which is a notable gap.
National Insurance
Key Insights
Founded
1906
National Insurance was established 119 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
95% claims settled in 30 Days
National Insurance settles 95% of all claims it receives demonstrating strong credibility.
Network Hospitals
3,200+
National Insurance has a limited network of 3,200 hospitals, which may restrict access to cashless services for policyholders.
Complaints
30 complaints per 10,000 claims registered
National Insurance experiences a moderate number of complaints, indicating room for improvement in addressing customer concerns.
Features
All
Great
Good
Bad
Infertility treatments
STANDOUT
This policy provides coverage for infertility treatments up to ₹50,000 but remember the insurer will make you wait 3 years to be eligible for treatment under this benefit.
Co-payment
The insurer will bear the entire cost of treatment (up to the sum insured). You won’t have to pay a single penny. Meaning this policy has no co-payment.
Room Rent
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.
Disease sub-limit
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.
Pre existing diseases waiting
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.
Customisable
For Hypertension or Diabetes : Pre existing disease waiting period is reduced from 3 Years to Day 1.
Add-ons
Pre-existing Diabetes / Hypertension
Recommended
For Hypertension or Diabetes : Pre existing disease waiting period is reduced from 3 Years to Day 1.
OPD
Get coverage for outpatient consultations i.e. doctor visits along with coverage for prescribed diagnostics and pharmacy up to defined limits.
Critical Illness
Lump sum payment in the event you are diagnosed with 8 listed critical illnesses outlined in the policy document.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Expenses for hormone replacement therapy, unless part of Medically Necessary Treatment, except for Puberty and Menopause related disorders.
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Diagnostic expenses not related or incidental to current diagnosis and treatment are excluded.
Expenses for admission primarily for bed rest and not for treatment are excluded.
Custodial care at home or in a facility for help with daily activities is excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy for 3 years.
Benign ENT disorders
Gout and Rheumatism
Tonsillectomy
Hernia (all types)
Adenoidectomy
Waiting Period
30 days Initial waiting period
3 years Specific illness waiting period
3 years Pre-existing disease waiting periodCustomisable
Ditto's Take
◦ Excellent ◦
Waiting periods on this policy are excellent. This policy also further allows to reduce the PED waiting period to Day 1 for certain diseases.
What's missing in the policy
Good Restoration Benefit.
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Frequently Asked Questions
Does National Parivar Mediclaim policy have waiting periods?
- 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
- Specific Illness Waiting Period: There’s a 90 days to 3 Years-year waiting period for a list of diseases which is a mandate before you can start claiming.
- Pre-Existing Disease Waiting Period: There's a 3-year waiting period for any pre-existing disease you may have while buying the policy.
- Maternity and Newborn Waiting Period: There’s a 3-year waiting period before you can make claims related to pregnancy and childbirth.
Does National Parivar Mediclaim policy have room rent restrictions?
Does National Parivar Mediclaim policy offer a restoration benefit?
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