| 7- Family Floater Coverage - Parivar Mediclaim (National Insurance Prospectus) |
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| Source: Website of National Insurance Company Limited |
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| Insured shall bear 10% of any admissible claim if he is suffering from either Diabetes or Hypertension and 25% of the admissible claim amount in case he is suffering from both diabetes and hypertension. This provision is applicable only for claims arising out of Diabetes and/or Hypertension. |
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4.2 |
Any disease other then those stated in Clause 4.3, contracted by the Insured Person during the first 30 days from the commencement date of the policy. This condition 4.2 shall not however, apply in case of hospitalization due to accidental injury or if the Insured Person having been covered under this scheme or a similar Health Insurance Scheme with any of the Indian Insurance Companies for a continuous period of preceding 12 months without any break. |
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4.3 |
During the first 2 years of the operation of the policy the expenses incurred on treatment of diseases such as Cataract, Benign Prostatic Hypertrophy, Hysterectomy, Hernia, Hydrocele, Congenital Internal Disease, Fistula in anus, Chronic fissure in anus, Piles, Pilonidal Sinus, Sinusitis, Stone disease of any site, Benign Lumps/growths in any part of the body, CSOM(Chronic Suppurative Otitis Media), joints replacements of any kind unless arising out of accident, surgical treatment of Tonsils, Adenoids and deviated nasal septums and related disorders are not payable. If these diseases (other than Congenital Internal Disease/Defects) are pre-existing at the time of proposal, they will be covered only after four continuous claim free years as mentioned in column 4.1 above. |
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If the Insured is aware of the existence of Congenital Internal Disease/Defect before inception of the policy, the same will be treated as pre-existing. |
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4.4 |
Injury or disease directly or indirectly caused by or arising from or attributable to War Invasion Act of Foreign Enemy Warlike operations (whether war be declared or not). |
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| 4.4.1 |
Injury or disease directly or indirectly caused by or contributed to by nuclear weapons/materials. |
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4.5- |
Circumcision unless necessary for treatment of a disease not excluded hereunder or as may be necessitated due to an accident, vaccination or inoculation or change of life or cosmetic or aesthetic treatment of any description, plastic surgery other than as may be necessitated due to an accident or as part of any illness. |
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4.6- |
The cost of spectacles, contact lenses and hearing aids. |
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4.9- |
All expenses arising out of any condition directly or indirectly caused to or associated with Human T-Cell Lymphotrophic Virus Type III (HTLB-III) or Lymphadinopathy associated Virus (LAV) or the Mutants Derivative or variations Deficiency Syndrome or any Syndrome or condition of a similar kind commonly referred to as AIDS. |
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4.10- |
Charges incurred at Hospital or Nursing Home primarily for diagnostic, X-Ray or laboratory examinations or other diagnostic studies not consistent with nor incidental to the diagnosis and treatment of positive existence or presence of any ailment, sickness or injury for which confinement is required at a Hospital/Nursing Home. |
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4.11- |
Expenses on vitamins and tonics unless forming part of treatment for injury or disease as certified by the attending physician. |
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4.12- |
Treatment arising from or traceable to pregnancy, childbirth, miscarriage, abortion or complications of any of these including caesarean section. |
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4.13- |
Any treatment other than Allopathic System of Medicine. |
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| 5. |
AGE LIMIT |
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Persons between the age of 3 months to 60 years are eligible to enter the scheme. Fresh entrant beyond 60 years will not be covered. However, the policy may be |
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extended up to the age of 65 years if it is renewed without break. In that case the premium applicable for 56-60 age band will be loaded as shown in the Premium Chart. |
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