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Everything About National Health Insurance

By Vikas Chandra Das
16 November 2022, 2:31 PM

National Insurance Company Limited (NICL) is an Indian general insurance company entirely controlled by the central government. The Kolkata-based corporation was founded in 1906 and nationalised in 1972. By 2012-13, NIC's gross direct premium income gradually increased to around INR 9,000 crores.

National Insurance Company Limited (NICL) is one of India's oldest general insurance firms, providing customised health insurance policies and comprehensive health coverage. NICL provides a wide range of health insurance products to meet the different needs of its customers, ranging from individual health insurance plans and family floater policies to senior citizen and group health insurance policies.

About National Health Insurance Company

The National Insurance Company (NIC) is India's oldest domestic general insurance company. This corporation, founded 107 years ago, has developed a stronghold in northern and eastern India via various pioneering endeavours.

NIC was in charge of developing adaptable general insurance products that could be tailored to consumers' specific needs. Although it is typical for insurance companies to reach out to customers via bancassurance agreements and tie-ups with auto companies and other important businesses today, NIC was the first to investigate the idea of boosting penetration using strategic partnerships.

National Insurance has offices throughout India and a foreign office in Nepal. In addition, the company has a strong presence throughout the country, with around 1730 offices, over 13,000 experienced workers, and over 50,000 agents.

One of the company's top focuses is social and economic inclusion. It aims to broaden the reach of the general insurance business into places where insurance as a service or form of financial discipline is not widely used. It achieves this through technology, which allows it to traverse geographical barriers and assist needy individuals.

National Insurance Products

With about 300 products, National Insurance Company, Ltd. provides its consumers with diverse insurance services. Its products can be classified into several business lines - 

  • Personal lines of insurance include health insurance, personal accident insurance, homeowners' insurance, shopkeepers' insurance, and so on.
  • Automobile Insurance
  • Rural insurance for livestock and agricultural equipment
  • Industrial and commercial insurance protects industrial units, power plants, and business premises against fire and other risks, natural disasters, and other perils.

National Insurance Company provides health insurance solutions as part of its product portfolio to meet the financial protection needs of individuals and their families. The following policies are available in this category:

  • National Mediclaim Policy - During the policy term, this policy pays for in-patient treatment charges if admitted for at least 24 hours and over 140 day care procedures on a cashless and reimbursement basis. 
  • National Mediclaim Plus Policy - It's a high sum insured policy that pays for in-patient treatment charges and over 140 day care procedures on a cashless or reimbursement basis during the policy period, in addition to several other advantages depending on the plan selected. 
  • National Parivar Mediclaim Policy - During the policy year, this policy covers the entire family under the total sum insured for in-patient treatment expenses, domiciliary hospitalisation, and over 140 day care procedures on a cashless or reimbursement basis.
  • National Senior Citizen Mediclaim Policy - National Senior Citizen Mediclaim Policy is a health insurance policy for the elderly with a larger sum insured of up to INR 10 lakhs. The policy covers expenses for in-patient treatment (allopathy, ayurveda, and homoeopathy) and domiciliary hospitalisation that are fairly and customarily incurred for the treatment of a sickness or injury contracted or suffered during the policy term.
  • National Critical Illness Policy - People are becoming more vulnerable to critical ailments such as cancer, stroke, and others in today's fast-paced world, putting their health and finances at risk. A simple health insurance policy may not be sufficient to cover treatment costs and the costly recovery process associated with certain serious conditions.

National Critical Illness Policy is a one-of-a-kind advantage policy that covers expenses if the insured person is diagnosed with any critical illnesses specified in the policy. A critical illness benefit policy pays a fixed lump sum payment to the insured if a specific illness is diagnosed or undertaking a specified procedure or treatment. Once this lump sum is given, coverage for this condition is no longer available.

  • National Group Mediclaim Policy - National Group Mediclaim Policy is a group indemnity health insurance policy specifically designed to meet the basic health insurance needs of employer-employee and non-employer-employee groups. The plan covers hospitalisation costs for in-patient care or day care treatment that are reasonably and customarily expended by the insured for the treatment of an illness contracted or injury suffered during the Policy Period. 

The policy covers pre- and post-hospitalisation fees, 140+ day care procedures, mental illness treatment, HIV/AIDS therapy, organ donor's medical expenses, ambulance charges, morbid obesity treatment, and correction of refractive error if applicable.

Conclusion

The high rate of medical inflation and specific infrastructural problems that make it difficult to acquire high-quality, reasonably priced healthcare in a growing nation like India highlight the significance of the National health insurance scheme. The Government of India has introduced the programmes mentioned above under the National health insurance scheme to solve this issue and provide adequate healthcare facilities for all inhabitants. In addition, each state government in the nation offers specific health insurance and welfare programs for its residents in addition to the federal government.

Regardless of your choice of any health insurance plan, thoroughly examine all the coverages, features, eligibility requirements, exclusions, inclusions, etc., before you purchase a health insurance policy.

FAQs

1. Is there a free-look period for National health insurance policies?

Yes. Customers have a 15-day free-look period starting on the date they first purchased the policy. Customers should read through each clause within this time and return the policy if they don't agree with any of them. The insured person is then issued a reimbursement.

2. Can someone who already has a disease apply for this programme?

Yes. In this scenario, you will need to provide pertinent documentation proving that the condition is active. However, the insurance will not cover any medical costs incurred because of this illness.

3. Do I still need personal health insurance coverage if my employer offers a health insurance plan?

It is advisable to have a private policy in addition to the one provided by your employer because employer-provided policies are typically group insurance plans that are non-transferable and may present a problem if you decide to change jobs. Thus, having a personal health insurance policy is usually advised.

4. What is the duration of the policy?

Most insurance contracts last for a complete year before needing to be renewed. Some policies, however, also provide a two-year renewal period.

5. Do medical insurance policies cover diagnostic costs?

Yes. Medical insurance plans cover diagnostic procedures, including MRIs, CT scans, etc.

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