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Home Insurance Health Insurance

What is National Health Insurance? How to claim and Surrender a Policy?

by InvestPolicy
February 27, 2021
in Health Insurance, Insurance
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There are many insurance companies in the market, who have brought their special products to the people. Along with this, there are many government insurance companies, which are providing better services and facilities to the people. So through this post we are going to give you information about National Health Insurance.

What is National Health Insurance?

National Health Insurance is the oldest insurance provider in India. It was established in 1906. It is completely owned by the central government. Its objective is to cater to the insurance needs of the general public and to introduce flexible and general insurance products in the Indian market. It is known to offer health plans that you can renew for a lifetime. You can avail the policy throughout your lifetime. However, after the age of 60, you have to make a co-payment. The National Insurance Company offers a variety of plans and insurance solutions. These schemes are made keeping in mind all types of groups and their purpose is to meet the insurance needs of the people. These schemes offer comprehensive benefits like add-on cover, cashless claim, lifetime renewal etc. The following are the insurance products offered by the National Insurance Company –

  • National Insurance Mediclaim Policy
  • National Insurance Mediclaim Plus Policy
  • National Insurance Family Mediclaim Policy
  • Senior Mediclaim Policy for Senior Citizen
  • National Insurance Critical Illness Policy
  • National Insurance Personal Accident Policy
  • National Insurance Janta Personal Accident Policy etc.

These policies have a lock-in period of 15 days. During this time the customer has to read and understand the terms of the policy. If the customer is not satisfied with its conditions, he can return the policy. If customers return the policy, they are refunded.

National Health Insurance Scheme Claim Procedure

Policyholders can make claims in two ways under the National Health Insurance Scheme –

Cashless claim process

You can make cashless claims in case of company network hospitalization. However, you have to inform the insurer at least 72 hours before hospitalization. If you are undergoing treatment at a company networked hospital, you must notify the insurer within 24 hours to make a cashless claim. This is done so that the insured can obtain a request authorized by the TPA to avail the cashless facility. TPA is authorized to accept or reject cashless claims.

Reimbursement claim process

Reimbursement claims work like normal health insurance claims. In this, the insured has to pay the medical bills out of his own pocket and later claim for reimbursement with the insurer. The insured can submit all the details and documents to the insurer up to 15 days after discharge from the hospital. The insured also has to fill a claim form to begin the claim process. The claim is then verified and approved by third parties.

How to buy and renew National Insurance Mediclaim Policy?

To purchase and renew the Mediclaim Policy, you have to contact the nearest NICL branch and visit them. Here you have to take the renewal form from the authorized insurance agent and fill all the required details in the form and sign it and submit it to the agent. In some cases a surveyor is appointed by the insurer to understand and know the health status of the policy buyer. The estimated premium of your policy is calculated only after taking details from the surveyor. Policy documents are sent to your address by the company.

Procedure to close National Health Insurance Policy

It is possible to cancel the National Health Insurance Policy only during the free lock-in period. If you do not understand the terms of the policy or you have any objection, you can return it during this period. In this case, you can return your policy to the insurer and claim the premium for the refund. Your premium will be refunded after deducting some money from your premium. You can also surrender the policy during the term of the policy. For this, you have to submit a duly filled and signed the surrender form. In the meantime be sure to attach the policy document and submit it to the nearest branch office to cancel your membership.

How does the National Health Insurance Policy cover the entire family?

You can avail of individual as well as family floater health plans under the National Insurance Scheme. A personal health insurance scheme provides coverage to a person within the age of 18 to 70 years. On the other hand, the Family Floater Health Scheme also covers children, dependent parents, you and your spouse. It also provides cashless mediclaim facility in network hospitals of NICL across the country. Maternity expenses are covered after a waiting period of one year and pre-existing diseases are covered after a waiting period of 2 years.

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