National Insurance Company Limited

Apart from many other health insurance policies National Insurance Company Limited also has a health insurance policy exclusively for students called “Vidyarthi – medi-claim for students”.

TheSALIENT FEATURES of this policy are:

· It provides health and personal accident cover to students

· It also provides for continuation of the insured student’s education in case of death or permanent total disablement of the guardian due to an accident

· Students from the age of 3 years to 25 years can take this policy

· Expenses of hospitalization for minimum period of 24 hours are admissible

· The above time limit is not applicable to specific treatments such as day care treatment for stitching of wounds, close reduction and application of POP casts, dialysis, chemotherapy, radiotherapy, eye surgery, ENT surgery, laparoscopic surgery, angiographies, endoscopies, lithotripsy and tonsillectomy

· Pre-hospitalization expenses incurred up to 30 days prior to hospitalization are covered

· Post-hospitalization expenses incurred up to 60 days after hospitalization will be reimbursed

· Pre-existing will be covered after 3 continuous claim free years

SCOPE OF COVER UNDER VIDYARTHI:

SCOPE OF COVER FOR PERSONAL ACCIDENT TO STUDENT AND GUARDIAN OF STUDENT:

· If insured person sustains any bodily injury resulting from accident caused by external violent and visible means then the company will pay the sum insured

· If the injury as above within 12 calendar months is the cause of death then the company will give capital sum insured

· If the injury as above within 12 calendar months is the cause of total and irrecoverable loss of sight of both eyes or total and irrecoverable loss of use of two hands or two feet, or of one hand and one foot or of such loss of sight of one eye and such loss of use of one hand or one foot, the capital sum insured is payable

· If the injury as above within 12 calendar months is the cause of total and irrecoverable loss of sight of one eye or total and irrecoverable loss of use of a hand or foot, 50% of capital sum insured is payable

EXCLUSIONS UNDER HOSPITALIZATION:

National India Insurance is not liable to make any payment in respect of any expenses incurred in connection with:

· All diseases/injuries those are pre-existing when the cover incepts for the first time

· Any disease other than diabetes and hypertension that is contracted during the first 30 days from the commencement date of the policy except in case of hospitalization due to an accidental injury

· If the insured is aware of the existence of a congenital internal disease/defect before inception of the policy, it is treated as pre-existing

· Injury or disease caused due to war invasion

· Circumcision unless necessary for treatment of a disease

· Cost of spectacles, contact lenses and hearing aids

· Any dental treatment or surgery which is a corrective, cosmetic or aesthetic procedure, including wear and tear, unless arising from accidental injury and which requires hospitalization for treatment

· Convalescence general debility “run down” condition or rest cure, congenital external disease or defects or anomalies, sterility, venereal disease, intentional self injury and use of intoxicating drugs/alcohol

· All expenses arising out of any condition due to AIDS

· Charges incurred at a hospital/nursing home for diagnostic, X-ray or laboratory examinations not consistent with any ailment, sickness or injury

· Expenses on vitamins and tonics unless forming part of treatment for injury or disease

· Injury or disease caused by nuclear weapons or materials

· Treatment arising from pregnancy, childbirth, miscarriage, abortion or complications of caesarean section

· Any treatment other than allopathic system of medicine

EXCLUSIONS UNDER ACCIDENT:

· Death from intentional self injury, suicide or attempted suicide

· Death whilst under influence of intoxicating liquor or drugs

· Death whilst engaging in aviation or ballooning or traveling in an aircraft other than as a passenger

· Death caused by venereal disease or insanity

· Death arising from committing any breach of law with criminal intent

· Death due to war, invasion, civil war, rebellion, mutiny, seizure, captures, etc

· Death from ionizing radiations or contamination by radioactivity from any nuclear fuel or nuclear waste

· Death or disablement caused by prolonged conditions during childbirth or pregnancy

ADDITIONAL BENEFITSof taking a health insurance policy from National Insurance Company Limited are:

· It is a public sector company so it is perceived to be safer by quite a few people

· Sum insured under this policy shall be progressively increased by 5% in respect of each claim free year subject to a maximum of 10 claim free years of insurance

· The policyholder also has the option of taking a 5% discount in the premium instead of the cumulative bonus

· In case of claim taken by the person who has earned the cumulative bonus, the increased percentage will be reduced by 10% of sum insured at the next renewal. The basic sum insured will be maintained and will not be reduced

National Insurance Company Limited

Apart from many other health insurance policies National Insurance Company Limited also has a health insurance policy for a family called the “Parivar – medi-claim for family” policy. TheSALIENT FEATURES of this policy are:

· It is a family floater policy that covers the entire family under a single sum insured

· The policy covers reimbursement of hospitalization expenses for illnesses/diseases contracted or injury sustained by the insured

· Total expenses incurred for any one illness is limited to 50% of the sum insured per family

· Expenses of hospitalization for minimum period of 24 hours are admissible

· The above time limit is not applicable to specific treatments such as day care treatment for stitching of wounds, close reduction and application of POP casts, dialysis, chemotherapy, radiotherapy, eye surgery, ENT surgery, laparoscopic surgery, angiographies, endoscopies, lithotripsy and tonsillectomy

· Pre-hospitalization expenses incurred up to 15 days prior to hospitalization are covered

· Post-hospitalization expenses incurred up to 30 days after hospitalization will be reimbursed

· Any pre-existing diseases will be covered only after 4 continuous claim free years

· Sum insured can be taken from Rs.2 lacs to Rs.5 lacs and then may be increased in multiples of Rs.50000

AGE LIMITS:

· Persons between the age of 3 months to 60 years are eligible to take this policy

· Fresh entrants beyond the age of 60 years will not be covered

· The policy can be extended up to the age of 65 years if it is renewed without a break

SCOPE OF COVER UNDER PARIVAR:

PREMIUM CHARTS:

UP TO 35 YEARS:

36-45 YEARS:

46–50 YEARS:

51-55 YEARS:

56-60 YEARS:

EXCLUSIONS:

National India Insurance is not liable to make any payment in respect of any expenses incurred in connection with:

· All diseases/injuries those are pre-existing when the cover incepts for the first time

· Any disease other than diabetes and hypertension that is contracted during the first 30 days from the commencement date of the policy except in case of hospitalization due to an accidental injury

· If the insured is aware of the existence of a congenital internal disease/defect before inception of the policy, it is treated as pre-existing

· Injury or disease caused due to war invasion

· Circumcision unless necessary for treatment of a disease

· Cost of spectacles, contact lenses and hearing aids

· Any dental treatment or surgery which is a corrective, cosmetic or aesthetic procedure, including wear and tear, unless arising from accidental injury and which requires hospitalization for treatment

· Convalescence general debility “run down” condition or rest cure, congenital external disease or defects or anomalies, sterility, venereal disease, intentional self injury and use of intoxicating drugs/alcohol

· All expenses arising out of any condition due to AIDS

· Charges incurred at a hospital/nursing home for diagnostic, X-ray or laboratory examinations not consistent with any ailment, sickness or injury

· Expenses on vitamins and tonics unless forming part of treatment for injury or disease

· Injury or disease caused by nuclear weapons or materials

· Treatment arising from pregnancy, childbirth, miscarriage, abortion or complications of caesarean section

· Any treatment other than allopathic system of medicine

EXCEPTIONS:

· Pre-existing diseases like diabetes and hypertension will be covered from the inception of the policy on payment of additional premium by the insured

· Insured shall bear 10% of any admissible claim if s/he is suffering from either diabetes or hypertension

· S/he shall bear 25% of the admissible claim in case s/he is suffering from both diabetes and hypertension

Another benefit of taking a health insurance policy from National Insurance Company Limited is that t is a public sector company so it is perceived to be safer by quite a few people

National Insurance Company Limited

Apart from offering health insurance policies for individuals, families and students, National Insurance Company Limited also has a health insurance policy for the senior citizens called the “Varistha – medi-claim for senior citizens” policy. TheSALIENT FEATURES of this policy are:

· This policy caters to the needs of senior citizens by covering their hospitalization and domiciliary hospitalization expenses as well as expenses for treatment of Critical illnesses

· The diseases covered under critical illness are coronary artery surgery, cancer, renal failure of failure of both kidneys, stroke, multiple sclerosis, major organ transplants like kidney, lung, pancreas or bone marrow, paralysis and blindness at extra premium

· Fixed sum insured for each policyholder

· Under hospitalization and domiciliary hospitalization cover the sum insured is Rs.1 lac

· Under critical illness cover the sum insured is Rs.2 lacs

· If the applicant did not have an insurance policy in her/his name then s/he will have to undergo medical check up at her/his own cost for blood/urine sugar, blood pressure, echo-cardiography and eye check up including retinoscopy

· Company’s overall liability in respect of claims arising due to cataract is Rs.10000 and that of benign prostatic hyperplasia is Rs.20000

· Company’s liability in respect of claims admitted during the period of insurance shall not exceed sum insured

· Liability of the company under domiciliary hospitalization clause is limited to 20% of sum insured

· Ambulance charges up to a maximum limit of Rs.1000 in a policy year will be reimbursed

· Expenses of hospitalization for minimum period of 24 hours are admissible

· The above time limit is not applicable to specific treatments such as day care treatment for stitching of wounds, close reduction and application of POP casts, dialysis, chemotherapy, radiotherapy, eye surgery, ENT surgery, laparoscopic surgery, angiographies, endoscopies, lithotripsy and tonsillectomy

· Domiciliary hospitalization benefit means medical treatment for a period exceeding 3 days for such illnesses/diseases/injury which in the normal course would require care and treatment at a hospital/nursing home but taken whilst at home

· When treatment such as Dialysis, Chemotherapy, Radiotherapy is taken in the hospital/nursing home and the insured is discharged the same day, the treatment will be considered to be taken under hospitalization benefit section

· Pre-hospitalization during period up to 30 days prior to the disease will be considered as part of claim

· Post-hospitalization during period up to 60 days prior to the disease will be considered as part of claim

· Two pre-existing diseases namely diabetes and hypertension will be covered from the inception of the policy on payment of additional premium

· Insured shall bear 10% of any admissible claim that is a part of Compulsory Excess

· Insured has to bear additional 10% of all admissible claims if the claim arises out of any pre-existing disease for which the insured opted cover and paid additional premium

· No claim will be paid if a critical illness incepts during the first 90 days of the inception of the policy

· The insured needs to survive for 30 successive days after the diagnosis of the critical illness in order to make the claim

AGE LIMITS:

· The age group for fresh entry in to the scheme is between 60 years and 80 years

· The renewal age limit will be extended up to 90 years in which case the premium of 76-80 age band will be loaded by 10% up to 85 years and 20% up to 90 years of age

SCOPE OF COVER UNDER VARISTHA:

PREMIUM CHART:

ADDITIONAL POINTS TO THE PREMIUM CHART:

· For fresh entrants to National Insurance the above premium will be loaded by 10%

· If a person suffers from any of the terminal diseases referred under critical illness cover then s/he will never be covered for that in this policy even on payment of additional premium

· Cover for Paralysis and Blindness may be given under Critical Illness by loading the Critical Illness premium by 15% in each case or 25% in case of both covers together

EXCLUSIONS:

The company shall not pay any benefit to the insured that suffers an event-giving rise to a Critical Illness that is caused by any of the following:

· Indigestion of drugs other than those prescribed by a medical practitioner

· Indigestion of medicines, prescribed or not, for treatment of drug addiction and any related to it

· Any attempt to commit suicide or any self inflicted injury

· Where the insured at any time suffered from the condition known as AIDS or HIV

· The company will not be liable for a Critical Illness or its symptoms of which were present in the insured at any time before inception of the policy or that manifests within a period of 90 days from such date

· No claim will be payable if the insured smokes 40 or more cigarettes/cigars or equivalent tobacco intake in a day

· No claim will be payable if a critical illness is caused by ionizing radiations or contamination by radioactivity from any nuclear fuel or nuclear waste or any war/invasion

ADDITIONAL BENEFITSof taking this health insurance policy for senior citizens from National Insurance Company Limited are:

· It is a public sector company so it is perceived to be safer by quite a few people

· No medical check up is required if the insured was covered under any health insurance policy of National Insurance Company or any other insurance company uninterruptedly for preceding three years

· Sum insured shall be progressively increased by 5% in respect of each claim free year subject to a maximum of 10 claim free years of insurance

· The policyholder also has an option to take a 5% discount each year instead of increasing the sum insured each year

· The insured shall be entitled for reimbursement of the cost of medical check up once at the end of block of every 3 underwriting years provided there are no claims during that block. But the cost of reimbursement will not exceed amount equal to 2% of the amount of average sum insured excluding the cumulative bonus

National Insurance Company Limited

National Insurance Company Limited was incorporated in 1906 and is one of the leading public sector insurance companies of India. Their Personal Accident Policy is another popular policy. The SALIENT FEATURES of this policy are:

· This policy compensates the individual or policyholder against death, loss of limbs, loss of eyesight, permanent total disablement, permanent partial disablement and temporary total disablement, solely and directly resulting from accidental injuries

· In case of death 100% of sum insured is paid to the nominee

· In case of loss of two limbs, two eyes or one limb and one eye there is 100% payment of sum insured

· Loss of one limb or one eye gets the insured 50% of the sum insured

· Permanent total disablement from injuries other than the ones mentioned above will also get 100% of sum insured

· Temporary total disablement will get 1% of sum insured per week up subject to a maximum of 104 weeks. Weekly benefits should not exceed Rs.5000

· Reimbursement of medical expenses directly arising out of an accident can be covered at an additional premium of 20% of the basic premium

· Medical expenses reimbursable shall be 10% of sum insured or 40% of the admissible claim whichever is lower

· Expenses incurred for carriage of dead body of the insured (in case of death due to accident only) to place of residence will be given at the rate of 2% of sum insured subject to a maximum of Rs.1000

· Education fund of 10% of sum insured per dependent child subject to a maximum of Rs.5000 per child up to a maximum of 2 dependent children will be given

· Cumulative bonus of 5% of sum insured will be given for every claim free year subject to a maximum of 50% of sum insured

· This policy is geographically accepted worldwide

RISK CLASSIFICATION:

Everyone is classified based on the risk that each job or profession entails. The classification is on Normal Risk, Medium Risk and Heavy Risk. The details of risk classification are:

NORMAL RISK:

Bureaucrats, Doctors, Lawyers, Accountants, Architects, Bankers, Consulting Engineers, Teachers, Persons engaged in administrative functions, Persons primarily in occupations of similar hazard

MEDIUM RISK:

Builders, Contractors, Engineers engaged in superintending functions only, Veterinary Doctors, Paid Drivers and Persons engaged in occupations of similar hazard and not engaged in manual labor, all persons engaged in manual labor, cash carrying employees, garage and motor mechanics, machine operators, drivers of heavy vehicles, professional athletes and sports persons, wood working mechanists and persons engaged in occupations of similar hazard

HEAVY RISK:

Persons working in underground mines, Explosive, Magazines, Workers involved in electrical installation with high tension supply, Jockeys, Circus Personnel, Persons engaged in activities like racing on wheels or horse back, big game hunting, Mountaineering, Winter sports, Skiing Ice Skating, Ballooning, River Rafting, Polo playing and persons engaged in occupations/activities of similar hazard

Another benefit of taking a health insurance policy from National Insurance Company Limited is that t is a public sector company so it is perceived to be safer by quite a few people

National Insurance Company Limited

National Insurance Company Limited was incorporated in 1906 and is one of the leading public sector insurance companies of India. They also have a medi-claim policy in place.

The SALIENT FEATURES of which are:

· It covers reimbursement of room boarding expenses; nursing expenses; fees of surgeon, anesthetist, medical practitioner, consultant and specialist; expenses on account of anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines/drugs, diagnostic material, x-ray, dialysis, chemotherapy, radiotherapy, cost of pacemaker, artificial limbs and cost of organs and similar expenses

· No inclusion of family member during the running of the policy is permissible except for a new born child between the age of 3 months to 6 months and a newly married spouse within 60 days of the marriage

· Otherwise inclusion will be allowed only at the time of renewal

· Minimum sum insured is Rs.50000, which can be increased in multiples of Rs.25000 up to Rs.5 lacs

· There is a mandatory health check up at the age of 50 years and above if seeking insurance for the first time or if there is a break in the insurance. The medical test that needs to be done should include physical examination, blood, urine sugar, blood pressure, echo cardiograph and eye check up including retinoscopy

· Pre-existing diseases will be covered after 4 continuous claim free years

ELIGIBILITY:

· Dependent children are covered

· Children above 18 years of age cannot be covered if they are employed

· Male children, if not employed but if students, can be covered up to the age of 25 years

· Female children, if not employed, can be covered until such time that they are married

· Dependent parents are covered under the same policy

· Insurance is available for any person between the age of 18 to 59 years

· Policy can be renewed up to the age of 80 years

· Children above the age of 3 months can be covered provided the parents are covered with National

EXCLUSIONS:

· Congenital disease

· Sterility

· Venereal disease

· Intentional self injury

· Use of drugs or alcohol

· Rest cure

· AIDS

· Charges primarily for diagnostic, laboratory examinations that are not related to any treatment in the hospital

· Vitamins and tonics unless prescribed for treatment

· Dental treatment not requiring hospitalization

· Naturopathy treatment

· Treatment arising from or traceable to pregnancy, childbirth, including caesarean

ADDITIONAL BENEFITS of taking a health insurance policy from National Insurance Company Limited are:

· It is a public sector company so it is perceived to be safer by quite a few people

· If the insured has taken continuous health insurance policy from National for at least 5 years prior to attaining the age of 80 years, the policy can be renewed up to the age of 90 years as a special case with approval. The premium chargeable will be 10% of the premium for 75-80 years age slabs for proposers above 85 years of age and 20% of the premium for 75-80 years age slabs for proposers above 90

· The premium includes cashless facility through TPA. If the policyholder does not opt for the cashless facility, the company gives a 6% discount on the premium amount

National Insurance Company Limited

National Insurance Company Limited was incorporated in 1906 and is one of the leading public sector insurance companies of India. They also have a Critical Illness Policy theSALIENT FEATURES of which are:

· It is an exclusive benefit policy for individuals in the age group of 20 years to 65 years

· It covers critical ailments of Coronary Artery Surgery, Cancer, Renal Failure, Stroke, Multiple Sclerosis, Major organ transplants like kidney, lung, pancreas or bone marrow

· There are 4 levels of sum insured, level 1 Rs.5 lacs; level 2 Rs.10 lacs; level 3 Rs.20 lacs; and level 4 Rs.25 lacs

· Compensation for Coronary Artery surgery shall be limited to 20% of the limit of indemnity

· If the critical illness manifests within the first 90 days from the inception of the policy, the claim will not be given

· The insured person should survive for 30 successive days after the diagnosis of the critical illness in order to make the claim

BASIC PROVISIONS:

· In the event of a claim, the critical illness has to be diagnosed by a registered medical practitioner, supported by radiological, histological and laboratory evidence accepted to the company

· The person insured will be compensated only once by the company in respect of any particular illness

· The cover under this policy shall cease upon payment of the compensation on the happening of a critical illness and no further payment will be made for any consequent disease or any dependent disease

Another benefit of taking a health insurance policy from National Insurance Company Limited is that t is a public sector company so it is perceived to be safer by quite a few people