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| Medilcaim Policies for Students |
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| 1- VIDYARTHI-Mediclaim for Students (Domestic)- National Insurance Company Limited |
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| Salient Feature |
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VIDYARTHI-Mediclaim for Students is a unique policy designed to provide Health and Personal accident cover to the students. It also provides for continuation of insured students education in case of death or permanent total disablement of the guardian due to accident.
Parents/Legal Guardian of individual student in any Registered Educational Institution affiliated to any State Board, Council, University and AICTE or any other Govt. Statutory Authority, within the territory of India may take this policy. The Educational Institutions may also take a Group Policy covering named students enrolled with them.
Age: 3 years to 25 years. |
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| Section I - Hospitalization for illness, diseases or accident |
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A. Scope Of Cover
1) Room, Boarding expenses as provided by the Hospital/Nursing Home.
2) Nursing expenses.
3) Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Fees.
4)Anaesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical appliances(any disposable consumables subject to upper limit of 10% of Sum Insured), Medicines & Drugs, Diagnostic Materials and X-Ray, Dialysis, Chemotherapy, Radiotherapy, Cost of pacemaker, Artificial Limbs and cost of Stents and implants
Note: Hospitalization expenses of person donating an organ during the course of organ transplant will also be payable subject to the sub limits under “4” above applicable to the insured person within the overall sum insured of the insured person. |
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| B. Other benefits |
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1. The guardian of the insured will be eligible for deduction under Section 80 D of the Income Tax Act 1961 as amended from time to time, for the premium paid under this section of the policy subject to limits specified in the Income Tax Act.
2.The Policy will be serviced by Third Party Administrators (TPA) for hospitalization expenses.
3. Cumulative Bonus
Sum insured under this policy shall be progressively increased by 5 % in respect of each claim free year of insurance subject to maximum accumulation of 10 claim free years of insurance.
In case of claim under the policy in respect of insured person who has earned the cumulative bonus, the increased percentage will be reduced by 10% of sum insured at the next renewal. However, basic sum insured will be maintained and will not be reduced.
N.B.:
a) for existing Mediclaim policy holders (as on date of implementation) of the company the accrued amount of benefit of cumulative bonus will be added to the sum insured, subject to maximum 10 claim free years.
b) Cumulative Bonus will be lost if policy is not renewed on the date of expiry.
However, insured has the option either to avail cumulative bonus or claim 5% discount in renewal premium in respect of each claim free year of insurance subject to maximum of 10 claim free years of insurance. This discount will not be applicable to the S.I. increased ,if any, by the insured at renewal. |
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| C. Definitions |
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1. Hospital/Nursing Home means any institution in India established for indoor care and treatment of sickness and injuries and which either
(a) has been registered either as a Hospital or Nursing Home with the local authorities and is under the supervision of the registered and qualified medical practitioner OR
(b) should comply with minimum criteria as under:
i. It should have at least 15 inpatient beds. In Class "C" towns condition of number of beds may be reduced to 10
ii. Fully equipped Operation Theatre of its own wherever surgical operations are carried out.
iii. Fully qualified nursing staff under its employment round the clock
iv. Fully qualified Doctor(s) should be in charge round the clock
The term‚ `Hospital/Nursing Home’‚ shall not include an establishment which is a place of rest, a place for the aged, a place for drug addicts or place of alcoholics, a hotel or a similar place.
2. Surgical Operation means manual and/or operative procedures for correction of deformities and defects, repair of injuries, diagnosis and cure of diseases, relief of suffering and prolongation of life
3.Expenses of Hospitalization for minimum period of 24 hours are admissible. However, this time limit is not applied to specific treatments i.e. day care treatment for stitching of wound/s, close reduction/s and application of POP casts, Dialysis, Chemotherapy, Radiotherapy, Arthroscopy, Eye surgery, ENT surgery, Laparoscopic surgery, Angiographies, Endoscopies, Lithotripsy (Kidney stone removal), D & C, Tonsillectomy taken in the Hospital/Nursing Home and the Insured is discharged on the same day. The treatment will be considered to be taken under Hospitalization benefit. This condition will also not apply in case of stay in Hospital of less then 24 hours provided –
a) The treatment is such that it necessitates hospitalization and the procedure involves specialized infrastructural facilities available in Hospitals.
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b) Due to technological advances hospitalization is required for less then 24 hours only.
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