| 7- Family Floater Coverage - Parivar Mediclaim (National Insurance Prospectus) |
|
| Source: Website of National Insurance Company Limited |
|
| |
NOTICE TO CLAIM |
|
| |
Preliminary notice of claim with particulars relating to policy numbers, Name of Insured Person in respect of whom claim is made, nature of illness/injury and Name and Address of the attending Medical Practitioner/Hospital/Nursing Home should be given by the insured person to the TPA immediately but not later than 7 days from the date of hospitalization in case of reimbursement claim. In order to avail cashless benefit immediate notice but not later than 24 hours from the time of hospitalization must be given in case of emergency or 72 hours advance in case of planned hospitalization. |
|
|
In case of notice received beyond 24 hours from the time of Hospitalization etc., the matter may be referred to the insurer for considering waiver of the condition, wherever felt appropriate. |
|
|
Final Claim along with receipted Bills/Cash Memos, Claim Form and list of documents as listed in the Claim Form etc., … should be submitted to the TPA within 30days from the date of completion of treatment. |
|
|
NOTE: Waiver of the Condition may be considered in extreme cases of hardship where it is proved to the satisfaction of the Company that under the circumstances in which the insurer was placed it was not possible for him or any other person to give such notice or file claim within the prescribed time limit. |
|
| 6. |
PAYMENT OF CLAIM |
|
| |
All claims under this policy shall be payable in Indian Currency only. All medical treatments for the purpose of this insurance will have to be taken in India only. |
|
| 7. |
SUM INSURED |
|
| |
Rs.2,00,000/- to Rs.5,00,000/- in multiples of Rs.50,000/- |
|
| 8. |
Premium Chart : Annexure-A |
|
| 9. |
Claims Minimization Clause : |
|
| |
The Insured will at all times cooperate with the TPA/Company to contain claims ratio by ensuring that the treatment charges and other expenses are reasonable and necessary and will be subject to further sub-limits as may be required. |
|
| 10. |
Cancellation Clause : |
|
| |
The policy may be renewed by mutual consent. The Company shall not however be bound to give notice that it is due for renewal and the Company may at any time cancel this policy by sending the insured 30 days notice by registered letter at the insured’s last known address and in such event the Company shall refund to the insured a pro-rata premium for un-expired period of insurance. The Company shall, however, remain liable for any claim arose prior to the date of cancellation. The insured may at any time cancel this policy and in such event the Company shall allow refund of premium at Company’s Short Period Rate(Table given hereunder) provided NO CLAIM has occurred upto the date of cancellation. |
|
| Period on risk |
Rate of premium to be charged |
| Upto 1 month |
¼ th of the annual rate |
| Upto 3 months |
½ of the annual rate |
| Upto 6 months |
¾ th of the annual rate |
| Exceeding 6 months |
Full annual rate |
|
|
