This policy has been designed to cater to the needs of Senior Citizens. It covers Hospitalization and Domiciliary Hospitalization Expenses under Section I as well as expenses for treatment of Critical Illnesses, if opted for, under Section II. Diseases covered under Critical Illnesses are as under:
Coronary Artery Surgery
Renal Failure i.e. Failure for both kidneys
Major Organ Transplants like kidney, Lung, Pancreas or Bone marrow
Paralysis and blindness at extra premium
Critical Illness cover is an optional cover under the policy. Persons who will not opt for critical illness cover are entitled to Hospitalization and Domiciliary hospitalization expenses cover for those diseases/ailments categorized above as critical illness but up to the limit of Sum Insured under Section I i.e. under Hospitalization and Domiciliary Hospitalization Expenses and the claim for those diseases will be paid on reimbursement basis or as cashless hospitalization. Person opting for Critical Illness cover may opt for claim either under Section I or Section II (if not hospitalized) or under both sections for those diseases categorized above as Critical Illnesses but claim under Section I will be paid either on reimbursement basis or as cashless hospitalization if it is otherwise admissible. If in any policy year a critical illness is diagnosed and claim paid thereafter, in subsequent renewals the person may avail cover both under Section I & II but with the exclusion, both under Section I & II, of that particular critical illness which has been diagnosed and claim paid in the preceding policy year.
Sum Insured: Sum Insured is fixed per person. Under Hospitalization & Domiciliary Hospitalization Cover Sum Insured is Rs.1,00,000/- and under Critical Illness cover Sum Insured is Rs.2,00,000/-.
Age Group: For fresh entry in to the scheme-60 years to 80 years. However, for renewal, age limit will be extended up to 90 years, in which case the premium of 76-80 age band will be loaded by 10% up to 85 years and 20% up to 90 years of age.
Pre-Acceptance Medical Check up: No Medical Check up is required if the insured is covered under any Health Insurance Policy of National Insurance Company or any other Insurance companies uninterruptedly for preceding three years. Other persons who are uninsured or have a break in the policy period have to undergo medical check up at their own individual cost for Blood/Urine Sugar, Blood Pressure, Echo Cardiogram and Eye check-up including Retinoscopy.