National Parivar Mediclaim Policy

This is a floater cover, covering the whole family for a single SI within the range of Rs. 2 lacs to Rs.10 lacs. The Sum Insured floats over the family members i.e. anyone suffering from illness may have the hospitalisation benefit. There are two sections under the policy. This policy has enhanced benefits over and above the National Parivar Mediclaim for family policy. Some of them are non-allopathic treatment, domiciliary hospitalization, Maternity etc.
Family incudes self, spouse, two dependent children and parents. The Sum Insured ranges between Rs. 1/2/3/4//6/7/8/9/10 lacs and Critical Illness Sum Insured should not be more than Hospitalisation SI.
On payment of additional premium Hypertension & Diabetes are covered as in Parivar Mediclaim Policy
Section I covers Hospitalisation and Domiciliary hospitalisation benefits (Ltd. to 20% of SI subject to Maximum) Definition of Domiciliary Hospitalisation is mentioned in the Policy.
Medical Second Opinion: - there are 88 major disease for which insured can take Medical Opinion from the overseas doctors (World Leading Medical Centre - WLMC). If the Insured is diagnosed with any of the major illness one medical second opinion per family can be availed during a policy year for the illness through the TPA named in the policy.
General Exclusions & Deductible: Please refer policy.
Section-II: Critical Illness:
Cover is available for Sum Insured Rs. 2/3/5 & 10 lacs. Sum Insured should not be more than Mediclaim section Sum Insured. Policy can be taken by the Insureds within the age 18 to 65 years subject to satisfactory medical report. For details of cover please refer National Mediclaim plus Policy mentioned earlier.
The premium depends upon the Zone in which the Insured resides. In case the premium is paid for a particular zone and treatment is taken in a higher zone, co-payment is applicable.
Zones
a. Zone-I: Greater Mumbai &Gujarat,
b. Zone-II: Delhi, Chandigarh, Pune, Gurgaon-Maneswar, Alwar-Bhiwadi, FaridabadBallavgarh, Ghaziabad-Loni, Noida-Greater Noida, Bahadurgarh, Sonepat-Kundli Charkhi Dadri, Bhiwani & Narnaul,
c. Zone III: Chennai, Hyderabad, Bangalore & Kolkata
d. Zone IV : Rest of India) for which premium paid
Copayment
a. Premium paid for Zone-I , No copayment.
b. Premium paid for Zone II, No copayment for treatment in zone II, III & IV, copayment 5% for zone I treatment.
c. Premium paid for Zone III, No co-payment for treatment in zone III & IV, however copayment 12.5% for Zone I and 7.5% for zone II
d. Premium paid for Zone IV, no co-payment for treatment in zone IV, however, co-payment 22.5% in zone I, 17.5% in zone II and 10% for zone III.
Pre Acceptance Medical check Up Reports:
Policy can be taken by the Insureds between the ages of 18 to 65 years subject to satisfactory medical reports for persons above 50 years of age. For Critical Illness cover, Medical Reports are a must, irrespective of Age. The Reports are valid for a period of 30 days. Tests required are as follows
• Physical examination (signed by MD)
• Blood Sugar Fasting & PP
• Lipid Profile
• Serum creatinine
• Urine routine and Microscopic Examination
• ECG
• Eye check-up including retinoscopy
• Any other investigation required (proposal assessment)
On acceptance of proposal 50% cost for health check-up is reimbursed.
PREMIUM:
Rate for Zone I with TPA for senior most family member:

SI

18-25

26-35

36-45

46-55

56-59

60-65

66-70

71-75

76-80

81-85

86+

1,00,000

3652

4004

4967

7319

9328

10404

11983

13930

14716

16053

20504

2,00,000

4905

5052

6928

11148

14156

16576

20243

23118

25230

27846

29421

3,00,000

5942

6120

8542

12746

16695

19111

22550

31279

35175

39219

41838

4,00,000

6671

7158

9935

15123

18138

22261

26744

38879

44506

50133

54001

5,00,000

7325

8007

11253

16943

19208

24812

30241

46660

53313

60652

65864

6,00,000

7926

8862

12607

18513

20504

27842

33335

53414

61612

70753

77402

7,00,000

8551

9746

13613

20911

23173

29854

35771

58469

68889

79875

88043

8,00,000

9153

10681

14685

22269

23767

31244

37787

61768

75998

93136

102696

9,00,000

9662

11685

15595

23491

25288

35357

40619

64512

82735

107390

118446

10,00,000

10148

12292

17173

24806

27180

37709

43673

66723

89262

122733

134143

Premium for other family members with TPA

SI

3m -5yrs

6-17

18-25

26-35

36-45

46-55

56-59

60-65

66-70

71-75

76-80

81-85

86+

1,00,000

469

531

594

678

1207

2551

3756

5202

6220

7507

8234

9325

13328

2,00,000

573

644

798

856

1684

3886

5701

8288

10508

12459

14116

16175

19124

3,00,000

656

734

967

1037

2076

4443

6723

9556

11706

16857

19680

22781

27195

4,00,000

701

782

1085

1213

2415

5272

7304

11131

13883

20953

24901

29121

35100

5,00,000

740

824

1192

1357

2735

5906

7735

12406

15698

25146

29829

35231

42812

6,00,000

775

861

1290

1501

3064

6453

8257

13921

17304

28786

34472

41098

50311

7,00,000

811

900

1391

1651

3308

7289

9332

14927

18568

31510

38543

46397

57228

8,00,000

846

937

1489

1810

3569

7763

9571

15622

19615

33288

42521

54100

66752

9,00,000

874

967

1572

1980

3790

8189

10183

17679

21085

34767

46291

62380

76990

10,00,000

900

994

1651

2083

4173

8647

10945

18855

22670

35958

49943

71292

87193

 

NB:
Premium stated with TPA for Zone I and premium for other zones will be discounted by 4.44% for zone II, 11.11% for Zone III & 20% for Zone IV.
1.    Rate for outpatient treatment

Cover Sum (Rs)

2,000

3000

4000

5000

10,000

Premium

1200

1800

2,400

3000

6000

2.    Rate for pre-existing Hypertension/Diabetes

 

Cover- Diabetes or Hypertension

13.5% loading on base premium of each zone

10% co-payment

Diabetes & Hypertension both

30% loading on base premium

25% co-payment

3. Discounts on base premium (not on optional premium)
a. No claim discount 5% for each claim free year
b. On line premium 5% for fresh and in case of renewal 2,5%
c. Above 45 years age opting maternity cover 3%
Long Terms discount- Policy for 2 years 4% & for 3 years 7.5%
Premium for Critical Illness (each Individual)

Sum Insured

18-25

26-35

36-45

46-55

56-59

60-65

66-75

76-85

Above 86

2,00,000

372

647

1198

2217

3209

4643

9501

21109

47155

3,00,000

557

970

1796

3326

4813

6965

14251

31664

70733

5,00,000

929

1617

2994

5543

8022

11608

23752

52773

117889

10,00,000

1858

3234

5988

11086

16043

23217

47505

105546

235777

 

Media