National Health Insurance

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6 min read

Updated on Jul 13, 2022

Overview of National Health Insurance

About the Company

National Health Insurance is a renowned insurance company in India offering health coverage of an extensive range. The insurance company has a range of plans designed to cover most of the insurance requirements of individuals and families. These plans can be easily bought online by following simple steps.

National Health Insurance presents a vast choice of network hospitals with over 6000+ hospitals in the list that specifically cater to the needs of cashless treatment to policyholders. The insurance plans of the insurer are much sought after due to their exclusive features and benefits.

National Insurance Company is a central government backed company which is commonly known as NIC. It was established in 1906 and in 1972 the company was nationalized. With its head office in Kolkata, it is termed as one of the oldest General Insurance Companies in the country.

The company caters to comprehensive health policies with customized plans to cater to the needs of common people at large.  They offer both individual as well as family floater plans along with overseas health insurance.

National Insurance Company provides top insurance solutions with over 1340 offices across India as well as in countries like Nepal. The company has tie-ups with over 6000+ network hospitals PAN India to allow policyholders to avail cashless treatment without having to compromise on quality of healthcare facilities as well as on the savings of the policyholders.

Key Highlights of National Health Insurance Company

Key Features Specifications
Network Hospitals Available 6000+
Waiting Period (Pre-existing Ailments) 4 years
Claims Settlement Ratio 83.78%
Policies Issued 17, 24,290
Covid-19 cover Available
Renewability Lifelong

* Year Data 2019-20

Awards and Achievements of National Health Insurance Company

  • They are the first insurance company in India to introduce the concept of ‘Office on Wheels’.
  • The company pioneered the idea of Bancassurance and Auto tie ups in the country
  • They are the leading insurer in the field of Social Schemes.
  • National Health Insurance presents 24×7 live support of customer care via chat.
  • The Company is the recipient of the Economic Times Iconic Brands 2018 award for General Insurance Category.
  • They are the winner of SKOCH order of merit 2017 for General Insurance Company of the year
  • They also won the Asset Asian awards 2017 for cash management solutions.

Benefits of Availing National Health Insurance Plans

The various benefits that can be availed by procuring National Health policies include:

  • Tax benefits
  • Cashless benefits
  • Add-on covers
  • Overseas coverage

Health Insurance Plans Offered by National Health Insurance Company

The various National Insurance mediclaim policies offered by National Insurance company include:

  • National Mediclaim Plus Policy
  • National Mediclaim Individual Policy
  • National Senior Citizen Mediclaim Policy
  • National Super Top-up Mediclaim Policy
  • Vidyarthi Mediclaim Policy for Students
  • Parivar Mediclaim Policy for Family
  • National Parivar Mediclaim Policy
  • National Parivar Mediclaim Plus Policy
  • National Critical Illness Policy
  • Varishtha Mediclaim Policy for Senior Citizens
  • National Overseas Mediclaim Policy
  • National Overseas Mediclaim Employment & Studies

Here is a detailed glance at some of the top National Health Insurance plans:

1. National Mediclaim Plus Policy

This is an individual health plan available with wide insurance coverage.

Eligibility

  • Min. entry age – 18 years
  • Max. entry age – 65 years
  • Sum insured – between Rs 2 lakhs to Rs 50 lakhs
  • Plans –  Three options, namely Plan A, B and C with varying sum insured
  • Coverage offered to – insured, spouse, dependent kids, parents and siblings

Features and Benefits:

  • In-patient hospitalization costs.
  • Annual increase of Sun Insured up to 5% for each claim-free year.
  • Coverage includes air ambulance, maternity, hospital cash, kid’s vaccinations and so on.

2. National Super Top-up Mediclaim Policy

Eligibility

  • Entry Age – 18 to 65 years
  • Sum Insured –  Rs. 3 lakhs to 10 lakhs
  • Coverage Type – Individual and family Floater

Features and benefits

  • Available with and without base policy
  • Cashless hospitalization is available
  • Lifetime renewability
  • No sub-limits on room rent costs
  • Pre-medical screening needed for people above 50-years old
  • Organ donor costs covered
  • In-patient hospital costs covered
  • ICU, surgeon fees etc. are covered
  • Coverage encompasses insured, spouse, parents, in-laws, and new-born
  • Waiting period of 1-year for pre-existing diseases

 

How to buy National Health Insurance Policy

Below are the steps to follow:

  • Submit full name, gender and age.
  • Enter your phone number and click on the view plan option.
  • Click the ‘continue’ tab and select your city and enter the pin code.
  • Select the plan from the selection offered.
  • Compare different plans and calculate National health insurance premium online.
  • Once you opt for the right plan, you can buy the policy by paying the premium or can contact the customer support team to get more details.
  • Once the premium is paid, the insurer will email the policy details to you.

The process of Renew of National Health Insurance Plans

Health insurance provides the insured individual and his/her family the required coverage to stay protected from health emergencies. The process of National Insurance mediclaim policy renewal is easy and quick via the online renewal process. All you need is to provide a few details such as policy number of the active policy, and some personal information like name of insured, age and gender of insured as well as recent contact details.

Below are the steps to follow for National Insurance mediclaim renewal online:

  • First go to the official portal of the National Insurance company.
  • Check the dropdown menu on the home page and click on the ‘Renewal’ option.
  • You will be redirected to a page where you need to submit your policy details like policy number etc.
  • Once you provide the information, select the online mode of payment from the options given.
  • Once the National Insurance mediclaim renewal online payment of premium is done successfully, you would receive a confirmation notification on mobile and email ID to verify the renewal of the policy.
  • You can download the receipt of the policy to keep as proof for future reference.

How to File a National Health Insurance Claim?

National health insurance offers the facility of cashless as well as reimbursement claims.

Cashless Claim: To avail cashless claims, the insurer has to get the treatment done in a network hospital of the insurer. Here, the TPA register the claim at the hospital. Below are the steps to follow to file a cashless National insurance mediclaim:

  • If the hospitalization is planned, the insurer should be informed prior to 72 hours of hospital admission.
  • If it is an emergency hospitalization, the TPA should be informed within 24 hours of hospital admission.
  • Once admitted, the first requirement is to fill the pre-authorization form and get it signed by a medical practitioner who is overseeing the treatment.
  • Submit this signed form and other medical documents to TPA for availing cashless treatment.
  • Once the insurer receives the request, they convey their decision of approving or declining the claim to the hospital within 72 hours.
  • If the claim is approved, the insurer pays the bills directly to the hospital.

 

Reimbursement Claim: In this claim process, the insured needs to make the payment of hospital bills on his/her own after undergoing treatment. Later, he/she can register a reimbursement claim. However, the policyholder should inform the insurer via calling them or emailing the company to inform them about the process of hospitalization.

  • If the hospitalization is planned, the insurer should be informed prior to 72 hours of hospital admission, while in case of emergency it should be done within 24 hours of hospitalization.
  • The insurer has to pay the bills at the hospital during discharge and keep the bills, reports etc. safely.
  • All original documents are needed to be submitted together with a duly filled claim form and handed to the insurer or the TPA within 15 days of discharge.
  • If the insured avails the post-hospitalization costs separately, they need to submit documents after 15 days of post-hospitalization.

Claim Settlement Ratio of National health insurance

The ratio of claims that are settled by an insurer during a policy year as against the complete claims that the insurer receives during the year is called Claim Settlement Ratio.

The claim settlement ratio of National Health insurance for the financial year 2019-20 was 83.78%.

FAQs on National Health Insurance

Why National Health Insurance?

National Health Insurance is a renowned insurance company in India with a range of plans designed to cover most of the insurance requirements of individuals and families. The company presents a vast network of 6000+ hospitals to specifically cater to the needs of cashless treatment of the policyholders. National Insurance Company is a central government-backed company established in 1906 and in 1972 the company was nationalized. With its head office in Kolkata, it is termed as one of the oldest General Insurance Companies in the country.

What are the benefits of buying National health insurance plans?

Benefits include:

# Tax benefits
# Cashless benefits
# Add-on covers
# Overseas coverage

Can I port out my current plan to any of the National health insurance plans?

Yes, most National health plans allow portability features within the company from one plan to another as well as from one policy provider to another. You need to approach the company to avail this feature.

What is the process to make a claim through the National Insurance Company?

Cashless Claim: To avail cashless claims, the insurer has to get the treatment done in a network hospital of the insurer. Here, the TPA register's the claim at the hospital. Below are the steps to follow to file a cashless National insurance mediclaim:

# If the hospitalization is planned, the insurer should be informed prior to 72 hours of hospital admission.
# If it is emergency hospitalization, the TPA should be informed within 24 hours of hospital admission.
# Once admitted, the first requirement is to fill the pre-authorization form and get it signed by medical practitioner who is overseeing the treatment.
# Submit this signed form and other medical documents to TPA for availing cashless treatment.
# Once the insurer receives the request they convey their decision of approving or declining the claim to the hospital within 72 hours.
# If the claim is approved, the insurer pays the bills directly to the hospital

What kind of insurance policies are offered by the National Insurance Company?

National Insurance Company offer insurances for diverse categories:

# Motor Insurance
# Health Insurance
# Personal Accident Insurance
# Householders' Insurance
# Shopkeepers' Insurance
# Rural Insurance
# Industrial & Commercial Insurance etc.

How to make the National Insurance online payment to renew the policy?

Below are the steps:

# Go to the website of National health Insurance.
# Click on ‘Renew’ on the home page.
# Submit policy details. Now, click on the tab ‘Renew’.
# Choose the quote that suits you aptly.
# Make the payment online.

What are the health insurance claim settlement options offered by National insurance?

Policyholders of National health insurance can make health insurance claims via any of the two options of cashless treatment or reimbursement claim option.

What are the documents required for the claim settlement process at National insurance?

The documents required include:
Duly filled Claim form
Original bills received from the hospital
Payment receipts
Medical history of the patient recorded
Discharge summary from the hospital
Other diagnosis and bill receipts etc.

Mar 31, 2022
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PayBima Team
PayBima is an Indian insurance aggregator on a mission to make insurance simple for people. PayBima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 17 years of experience. PayBima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.

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