National Parivar Mediclaim for Family

This is a floater cover, covering the whole family for a single SI within the range of Rs. 2 lacs to Rs. 5 lacs. The Sum Insured floats over the family members ie anyone suffering from illness may have the hospitalisation benefit. Maximum expenses payable for any one illness is 50% of sum insured.
Cover: Covers In patients’ hospitalisation expenses:
a. under the heads Room, Boarding including nursing care, RMO charges, administration charges for IV fluids/blood transfusions/injections . Room charges 1% of SI per day & ICU charges 2% of SI per day.
b. Medical practitioners’ surgeon, anaesthetist, consultants, specialists’ fees
c. Anaesthesia, blood, oxygen, OT charges, surgical appliance, medicine, drugs, implants, diagnostic tests, organs donors expenses, ambulance charges. Upto 10% of
Sum Insured.
d. Covers Day care procedure for 140+ named diseases
e. Pre & Post Hospitalisation expenses related to medical diagnosis or procedure that resulted in hospitalisation and expenses incurred 15 days prior and 30 days post hospitalisation period.
f. Hospitalisation expenses of person donating organ during course of organ transplant
g. Any one illness total expenses is 50% of family floater Sum Insured.
General Exclusions & Co-Payment:
a. Pre-existing diseases 48 months.
b. Internal congenital disease/defects known will be treated as pre-existence disease.
c. First 30 days waiting period
d. Specific waiting period of 2 years for 17 named diseases.
e. Some permanent exclusions, like HIV, AIDs, diseases resulting from drug/alcohol abuses, cosmetic surgery, massage/spa etc.
f. Co-payment of 10% claim arising from diabetes or hypertension, in case one of these is pre-existing and covered with loading.
g. Co-payment of 25% of claim arising from diabetes or hypertension, in case both are pre-existing and covered with a loading
Eligibility:
Policy can be availed by person between the age 18 to 60 years.
Children between the age 3 months to 18 years can be covered, provided parents are also covered under the policy.
Policy can be availed for self, spouse and two dependent children up to 18 years. Male child can be covered up to 25 years if a bonafide student and not employed. Female dependent child can be covered up to marriage
Premium:

Age up to 35 years

Age 36 to 45 years

 

Sum insured (Rs)

self

spouse

Ist child

2nd child

Self

spouse

1st child

2nd child

2,00,000

2469

617

494

494

2683

805

537

537

2,50,000

2956

739

591

591

3213

964

643

643

3,00,000

3444

861

689

689

3743

1123

749

749

3,50,000

3870

968

774

774

4207

1262

841

841

4,00,000

4297

1074

859

859

4670

1401

934

934

4,50,000

4723

1181

945

945

5135

1541

1027

1027

5,00,000

5151

1288

1030

1030

5598

1679

1120

1120

Sum Insured

Age 46-50

Age 51-55

           

2,00,000

4290

1502

858

858

4485

1794

897

897

2,50,000

5200

1820

1040

1040

5436

2174

1087

1087

3,00,000

6108

2138

1222

1222

6386

2554

1277

1277

3,50,000

6942

2430

1388

1388

7258

2903

1452

1452

4,00,000

7776

2722

1555

1555

8129

3252

1626

1626

4,50,000

8610

3013

1722

1722

9001

3600

1800

1800

5,00,000

9444

3305

1889

1889

9873

3949

1975

1975

Age 56-60

Age 61-65

             

Sum insured

self

spouse

Ist child

2nd child

Self

spouse

1st child

2nd child

2,00,000

5127

2051

1025

1025

6409

2564

1281

1281

2,50,000

6236

2495

1247

1247

7795

3119

1559

1559

3,00,000

7346

2938

1469

1469

9183

3673

1836

1836

3,50,000

8375

3350

1675

1675

10469

4188

2094

2094

4,00,000

9406

3762

1881

1881

11758

4703

2351

2351

4,50,000

10436

4175

2087

2087

13045

5219

2609

2609

5,00,000

11466

4586

2293

2293

14333

5733

2866

2866

 Beyond 65 years 25% loading on premium be made. Add On Cover from inception for pre-existing DM and HT. In case any member of family suffers from hypertension or diabetes 10% extra on total premium may be charged to include this cover. If both hypertension and diabetes are pre-existing, 20% loading is to be charged.

No cumulative Bonus.

 

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