Useful Information

National

TPA Information

Mediclaim 2020

Synopsis:

National Mediclaim Policy is an indemnity health insurance policy. The Policy covers expenses incurred due to Hospitalisation for In-Patient Care (allopathy, ayurveda and homeopathy) or Day Care Treatment

Highlight:

  • The Policy is available with options of Basic SI of INR 1/ 2/ 3/ 4/ 5/ 6/ 7/ 8/ 9/ 10 L.
  • Discount for Optional Co-payment
  • Hospitalisation coverage for HIV/ AIDS and Mental Illness
  • 10% discount in premium (for new and Renewal, ONLY where no intermediary is involved)

Benefit:

Title
Description
Room Rent Limit
Room Rent per day shall be payable up to 1% of Sum Insured subject to max of INR 10,000 per day
ICU Daily Rent Limit
ICU Charges per day shall be payable up to 2% of Sum Insured subject to max of INR 20,000 per day
Pre-Hospitalization Expenses
45 days
Post Hospitalization Expenses
60 days
Minimum Hospitalization Period
24 hours
Day Care Procedure Coverage
140+ Day Care Procedures covered
Automatic Restoration of Sum Insured
Available to Basic Sum Insured of INR 6L and above
Pre-Existing Disease / Illness coverage
After 48 months of continuous coverage
Waiting Period for New Policy
30 days
Co-Payment
The Insured may opt for Optional Co-payment, with discount in premium.
Medical Screening
Pre policy checkup is required for persons aged fifty (50) years and above,
Ambulance Expenses
Up to 1% of Sum Insured subject to maximum INR 2,000/- in a Policy Period for each Insured Person
Non-Allopathic Treatments
Covered up to SI, including CB
Free Health Checkup
Expenses payable shall be up to 1% of the average Basic Sum Insured of the block, subject to a maximum of INR 5,000 per Insured Person. at the end of a block of four (04) continuous Policy Periods provided no claims are reported
Donor Expenses
Medical Expenses for organ donor?s treatment during the course of organ transplant to any Insured Person.