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About National Health Insurance

National Insurance is a public sector insurance company which is owned by the Government of India. The company was founded in the city of Kolkata in the year 1906. After 66 years, when the general Insurance Business Nationalisation Act was passed in the year 1972, the company was merged with other foreign and Indian insurance companies and the National Insurance Company was formed. After nationalisation, the company was a subsidiary of the General Insurance Corporation but in the year 2002,it was delinked from GIC and is now operating as an independent general insuranccompany.

National Insurance serves customers in India as well as in Nepal. It has won various awards the latest one being the Economic Times Iconic Brands Award in 2018 in the general insurance category. National Insurance also offers a range of general insurance products to its customers and its health insurance plans are quite popular among individuals.

National Claim Settlement Ratio




Industry Average

Health claim settlement ratio is the percentage of claims settled against the total claims received by the insurance company in a given fiscal year. National has a claim settlement ratio of 86.28%, as compared to the industry average of 94.21%.

National Health Insurance Plans

National health insurance offers 10 health insurance plans. The premium of these plans starts from Rs. 155/yr. The sum insured ranges from Rs. 50,000 - 75 Lakh. Details of the comprehensive coverage provided by the following 10 National health insurance plans are listed below:

National Arogya Sanjeevani Policy

Starting Premium- ₹ 2,018/yr

The Arogya Sanjeevani Policy offered by National Insurance is a standard insurance policy on an individual basis. It is an affordable insurance policy that covers individuals and families for basic health care expenses. It is an annual policy and has a term of 1 year, but can be renewed for a lifetime

The Arogya Sanjeevani Policy covers in-patient hospitalization expenses and also the cost of treatment for any injury sustained or illness contracted during the policy period. It also covers daycare treatment expenses, pre-hospitalization expenses up to 30 days and post-hospitalization expenses up to 60 days. You can also claim ambulance expenses under this policy, up to specified limits.

Features Of National Arogya Sanjeevani Policy: Features Of National Arogya Sanjeevani Policy

  1. The policy offers reimbursement of hospitalization expenses and/or cashless facility for the treatment of any illness or injury sustained
  2. Hospitalization of at least 24 consecutive hours shall be admissible. But there shall be no time limit in case of daycare treatments
  3. The policy is issued for a tenure of 12 calendar months,or one year only
  4. The premium of the policy can be paid in instalments. Prosper can opt for Monthly, Quarterly, Half Yearly or Yearly payment of premium at the time of buying the policy
  5. Prosper can change the frequency of paying the premium only at the time of renewal of the policy
  6. A grace period of 15 days is provided for the payment of the premium.The policy shall be cancelled if the premium is not paid within the grace period and no refund shall be allowed
  7. The policyholder can avail tax rebate for the premium paid as per section 80D of Income Tax Act 1961
  8. A new customer can avail of a discount of 10% if the policy is bought through Customer Portal or if the policy with the yearly premium payment frequency is renewed through Customer Portal
  9. Any pre-existing ailment, condition, disease, the injury shall be specifically mentioned in the Proposal Form.The proposal form should be complete in every respect while buying the policy
  10. A pre-policy checkup is mandatory for individuals aged 55 years and above or first-time policy buyers of the company
  11. If the proposal is accepted by the company then prosper can avail 50% of the expenditure incurred on the pre-policy checkup
  12. The policy can be renewed before the expiry of the policy or within the grace period
  13. Except for children above 18 years or those who are financially independent, the policy can be renewed (without break) for the lifetime of the insured individuals
  14. Hospitalization treatments that are given by Homeopathy, Sidha, Unani, Allopathy are covered under AYUSH treatment under this policy
  15. To avail of the claim the company should be informed within 24 hours of an emergency hospitalization or before the Prosper is discharged from the hospital.In case of planned hospitalization, the company needs to be informed 48 hours before admission to the hospital

Eligible Age

91 days - 65 years

PED Waiting Period

4 years


50,000 - 10 Lakh


5% increase in cover;max upto 50%

National Corona Kavach Policy

Starting Premium- ₹ 155/yr

In this time of the pandemic,National insurance has come up with a standard health-based policy. National Corona Kavach Policy is a short-term policy specifically designed for individuals and has the feature of indemnity. This policy eases your financial burden if you get infected with the novel coronavirus. It offers you protection against all the expenses you incur towards the treatment of Covid-19. It caters to your basic health insurance needs

It is a pocket-friendly policy that can be bought on an individual basis or on a floater basis. You can cover yourself, your spouse, your dependent children, your parents and your parents in law. The proposer must be 18 years of age when buying the policy and can include family members up to the age of 65 years. The age of dependent children can be from 1 day to 25 years. The children can be natural children or legally adopted

If the children above 18 years are financially independent, they become ineligible for coverage under this policy. The proposers who are above 65 years can buy the policy for the family, without covering themselves

Features of National Corona Kavach Policy:

  1. This is a covid-specific policy that would cover only covid related hospitalisation that is for 24 hours or more
  2. A short term policy, it can be bought for 3.5 months, 6.5 months and 9.5 months as per your requirement
  3. The sum insured under this policy ranges between INR 50,000 to INR 5 lakh
  4. Under the Corona Kavach Policy offered by National Insurance, the policyholder can opt for cashless treatment or get reimbursement of hospitalization towards the treatment of Covid-19
  5. Pre hospitalization up to 15 days and post-hospitalization up to 30 days are covered
  6. Covid hospitalization cover includes expenses like room, ICU, Consultation fees, surgical appliances, PPE kits, medicines etc.
  7. Ambulance charges up to INR 2000 are covered, per hospitalization
  8. AYUSH treatment, Ayurveda, Yoga, Allopathy, Unani,Naturopathy, Sidha and Homeopathy, is covered up to the sum assured
  9. The doctor prescribed home care treatment for up to 14 days
  10. There is a cashless facility available at network hospitals
  11. You can opt for a Hospital Daily Cash available at 0.5% of the sum insured for a period of 15 days
  12. A discount of 10% is available through Online Customer Portal
  13. Healthcare workers can claim a discount of 5%
  14. Tax rebates can be claimed as per Section 80D of the Income Tax Act
  15. Portability and migration are not allowed in the policy
  16. As it is a short term policy, the Free Look period is not applicable
  17. Corona Kavach is a single premium policy
  18. A Pre-Policy check-up is not asked for
  19. There is a waiting period of 15 days,from the date of commencement of the policy
  20. There is no option of Copayment in this policy

Eligible Age

18 years - 65 years

PED Waiting Period

15 days


50,000 - 5 Lakh



National Critical Illness Policy

Starting Premium- ₹ 211/yr

This is a fixed benefit National medical insurance plan which covers specified critical illnesses.The features of the plan are as follows

  1. There are two coverage options under the plan
  2. Coverage option A covers 11 critical illnesses and coverage option B covers 37 critical illnesses
  3. Pre-existing illnesses can be covered from inception at an additional premium
  4. Pre-entrance medical check-ups are required if you are 45 years and above, if you have chosen a sum insured of INR 25 lakhs and above or if a non-earning spouse is covered for INR 5 lakhs and above

Eligible Age

5 years - 65 years

PED Waiting Period

4 years


1 Lakh - 75 Lakh



National Top-up Plans

National health insurance provides 1 top-up plan. The premium of these top-up plans start from Rs. 1,086/yr. The sum insured ranges from Rs. 3 Lakh - 20 Lakh. National top-up plans provide enhanced coverage and added protection for your well-being. Explore the details of each National top-up insurance policy below:

National Super Topup Mediclaim Plan

Starting Premium- ₹ 1,086/yr

This is a super top-up health insurance plan which allows you to increase your existing health insurance coverage at very limited premiums.The plan has a deductible limit and a sum insured. You have to choose a combination of the deductible and the sum insured.If the aggregate amount of claims in a policy year exceeds the chosen deductible limit, the policy would pay the excess claim.This is the concept of super top-up health insurance plans

Other salient features of the policy include the following

  1. Sum insured up to INR 20 lakhs can be opted
  2. Both allopathic and AYUSH treatments are covered under the plan
  3. Illnesses such as HIV/AIDS and bariatric surgeries are also covered
  4. Maternity and related costs are covered after a waiting period
  5. Hospital cash benefit and doctor’s home visit or attendant’s charges are both covered under the plan
  6. 5% no claim bonus is allowed for every claim-free year
  7. You can port this plan to another plan without any deductible limit
  8. Attractive premium discounts are allowed under the policy. These discounts are as follows
    • If you buy the policy before the age of 42 years and continue the policy for three years, you can earn a 5% premium discount
    • If another family member is covered under the plan on an individual basis,5% premium discount is allowed
    • Buying the policy online gives you another 10% discount
  9. Pre-entrance medical check-ups are required if you are 50 years and above

Eligible Age

91 days - 65 years

PED Waiting Period

1 year


3 Lakh - 20 Lakh


5% increase in cover;max upto 50%

Top Features From National Health Plans

National Insurance is a preferred health insurance provider among individuals because of the following reasons

  • The company offers a range of health insurance plans which are suitable for the varied insurance needs of individuals
  • The premiums of its policies are low and affordable
  • Policies are also offered for travelling individuals who need health insurance coverage abroad
  • The company has a high claim settlement ratio and settles most of its claims quickly
  • The company provides 24*7 support and assistance to customers for their queries as well as grievances

Coverage offered by National Insurance mediclaim plans :

National Insurance Health Insurance plans provide a range of coverage benefits to policyholders. Some of the benefits which are covered under almost all health insurance plans offered by National Insurance include the following

  • Hospitalisation expenses : If you are hospitalised for a period of 24 hours or more, the costs incurred on such hospitalisation would be covered. These costs include rent of the hospital bed, ICU room rent, fees payable to surgeons, doctors, anaesthetists, nurses, etc., cost of blood or medicines, treatment costs, etc.
  • Pre-hospitalisation expenses : Expenses which are incurred before you are actually hospitalised are called pre-hospitalisation expenses. Health plans cover pre-hospitalisation expenses for a specific period
  • Post hospitalisation expenses : After you are discharged from the hospital you might incur medical costs for monitoring of your condition and for recovery. These expenses are called post hospitalisation expenses and they are covered for a specified period
  • Day care treatments : There are some treatments which do not need you to be hospitalised for 24 hours or more due to the advancements in the field of medicine.These treatments are called day care treatments and health insurance plans cover these treatments up to the sum insured
  • Domiciliary treatments : If you have to take medical treatments at your own home due to non-availability of any hospital bed or if you cannot be moved to the hospital, such treatments are called domiciliary treatments, National health insurance plans cover these domiciliary treatments up to specified limits
  • Organ donor treatments : The costs incurred in harvesting organs from an organ donor so that you can undergo a transplant surgery are covered under health insurance plans under the head organ donor treatments
  • Free health check-ups : Free health check-ups are value-added benefits which are available under National health insurance plans. The plans allow free medical check-ups at specified intervals so that you can monitor and track your health
  • Alternative treatments : Alternative treatments or AYUSH treatments are also covered under some National mediclaim policies. These treatments include treatments taken using non-allopathic means like Ayurveda, Homeopathy, etc.

Exclusions Across National Health Plans

Exclusions under National health insurance plans: Though National Insurance health insurance plans have a comprehensive scope of coverage, there are some instances and treatments which are not covered under any health plan. These are called exclusions and common exclusions found under every National insurance health policy includes the following

  • Suicide, self-inflicted injuries or attempted suicides are excluded
  • Pre-existing illnesses are not covered during a specific waiting period
  • Illnesses within the first 30 to 60 days of buying the policy are not covered
  • Illnesses or injuries suffered due to alcohol usage, drug usage and under the influence of any other intoxicants are not covered
  • Cosmetic treatments are not covered
  • Dental treatments and expenses incurred on outpatient basis are not covered under all health plans
  • Maternity related expenses are not covered unless the plan specifically covers them
  • Illnesses or injuries due to nuclear perils, war, rebellion and other related perils are not covered
  • Treatments for infertility, obesity, mental disorders and congenital abnormalities are not covered under most National medical insurance plans

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National Claim Process

National supports both cashless claims and reimbursement claims. This section covers the information on how to check National health insurance claim status, fill National health insurance claim form, and the claim settlement process.

Cashless claim process:

  1. Find out the empanelled hospitals in your area. Empanelled hospitals would be the one which would allow you cashless claim settlement
  2. If your hospitalisation is planned, inform the TPA (Third Party Administrator) of the company at least 72 hours prior to hospitalisation. You should mention the reason for hospitalisation and the hospital which you have selected
  3. In case your hospitalisation is an emergency, inform the TPA within 24 hours of such hospitalisation
  4. When you are admitted, a pre-authorisation form would be sent by the hospital to the TPA. The form would contain all the medical details and the expected cost of treatment. The insurance company would assess the form and approve the claim
  5. The costs would then be directly settled by National Insurance
  6. You would have to submit the medical documents and bills to the insurance company within 15 days after the post-hospitalisation coverage is over
  7. After the documents are submitted, the claim would be settled by the National health insurance company
  8. Collect the Discharge Summary from the hospital after you are discharged and submit the summary along with all the relevant medical reports and bills to the TPA
  9. The documents should be submitted within 15 days of discharge from the hospital for the claim to be processed easily

Reimbursement claims :

  1. If you are admitted to a non-empanelled hospital, your claim would be settled on a reimbursement basis. You should inform the TPA of the company within 72 hours of planned or emergency hospitalisation
  2. Collect the Discharge Summary from the hospital after you are discharged and submit the summary along with all the relevant medical reports and bills to the TPA
  3. The documents should be submitted within 15 days of discharge from the hospital for the claim to be processed easily
  4. After the submission of the documents, they would be verified by the company
  5. After successful verification, National Health Insurance company would reimburse you for the medical costs incurred by you and settle the claim

National Health Insurance Renewal Process

To maintain the coverage and benefits of your health insurance policy from National Insurance Company Limited, policyholders must undergo a renewal process at the end of the policy term.Any necessary modifications can be made during this renewal process.In the event of a delay in renewal, the insurer allows a grace period of 30 days

National Insurance health plans typically have a 1-year policy term,and each plan offers a lifetime renewal option. After the policy period concludes, you have the option to renew it either online or offline

For National Health Insurance Policy Renewal through offline channels, you can connect with the insurer at 1800-345-0330.Alternatively, you can visit the nearest branch of National Insurance for renewal

If you face any problem during the renewal process then you can contact NICL at their toll free number above or you may write to them at customer.support@nic.co.in


Yes, National Insurance offers a range of family floater health insurance plans which can be taken to cover your entire family including you, your spouse, dependent children and dependent parents

The group health insurance policy would give you limited coverage which might not be sufficient for the coverage needs of your family. The sum insured would also be limited and given the rising medical costs, you need a higher coverage level. Moreover, the group insurance coverage would be valid until you are employed with your employer. When you leave your job, the coverage would stop. It is, therefore, better to buy an independent health insurance plan covering all the family members and having an optimal level of sum insured

Yes, National health insurance plans allow coverage even if you have pre-existing illnesses. Pre-Existing diabetes would, however, be covered after a waiting period. Alternatively, if you want coverage from the start of the policy, you can pay an additional premium and get coverage for your diabetes

The coverage level depends on various factors which include the expected cost of treatments, the number of members covered, the city where you live (metro cities have higher hospitalisation costs than non-metro ones), etc. You should always choose a high level of sum insured so that the rising medical costs can be easily covered under your health insurance plan.

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