{"uin":"NICHLGP23051V052223","name":"National Group Mediclaim Policy","url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223","insurer":{"slug":"national-insurance","name":"National Insurance Company Limited","url":"https://indiainsurances.com/insurer/national-insurance"},"line":"health","category":"group-health","category_name":"Group health","irdai_type":"Group","kind":"product","status":"active","approved_on":"2020-08-26","withdrawn_on":null,"summary":"National Group Mediclaim Policy is a group indemnity health insurance product with individual sum insured options from ₹ 50,000 to ₹ 10 lacs. It covers hospitalisation in India only, has a 30-day initial waiting period, a 48-month pre-existing disease waiting period, and cashless treatment only in Network Providers if TPA service is opted.","analysis":{"state":"machine","analysed_at":"2026-10-19 22:05:51.212545+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"quote-verified","value":["National Group Mediclaim Policy"],"display":"National Group Mediclaim Policy","note":"No separate named plan variants are shown in the documents.","quote":"Name | National Group Mediclaim Policy","sources":[{"clause":null,"heading":"9 TABLE OF BENEFITS","page":15,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-9-table-of-benefits"}],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"One policy period is one year as mentioned in the Schedule.","display":"One year","note":null,"quote":"Policy Period means period of one (01) year as mentioned in the Schedule for which the Policy is issued.","sources":[{"clause":"7.35","heading":"Policy Period","page":13,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-7-35"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"quote-verified","value":"For planned hospitalisation, intimation must be at least seventy two (72) hours before admission. For emergency hospitalisation, intimation must be within twenty four (24) hours of admission.","display":"Planned: 72 hours before admission; emergency: 24 hours after admission","note":"The same 72-hour and 24-hour limits are printed for cashless and reimbursement claims.","quote":"In the event of planned Hospitalisation | At least seventy two (72) hours prior to the Insured Person’s admission to Network Provider ... In the event of emergency Hospitalisation | Within twenty four (24) hours of the Insured Person’s admission to Network Provider ... In the event of planned Hospitalisation | At least seventy two (72) hours prior to the Insured Person’s admission to Hospital ... In the event of emergency Hospitalisation | Within twenty four (24) hours of the Insured Person’s admission to Hospital","sources":[{"clause":"6.5.1","heading":"Notification of Claim","page":7,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-6-5-1"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"quote-verified","value":["Completed claim form","Medical Practitioner’s prescription advising admission for inpatient treatment.","Cash-memo from the hospital (s)/chemist (s) supported by proper prescription from attending medical practitioner for Pre Hospitalisation, Hospitalisation and Post Hospitalisation.","Payment receipt, investigation test reports and associated plates/CDs in original, supported by the prescription from attending medical practitioner for Pre Hospitalisation, Hospitalisation and Post Hospitalisation.","Attending medical practitioner’s certificate regarding Diagnosis along with date of Diagnosis and bill, receipts etc.","Surgeon’s certificate regarding Diagnosis and nature of operation performed along with bills, receipts etc.","Bills, receipt, sticker of the Implants.","Bills, payment receipts, medical history of the patient recorded, discharge certificate/ summary, break up of final bill from the hospital etc.","Any other document required by Company/TPA."],"display":"Completed claim form, prescriptions, bills, receipts, test reports, certificates, discharge summary, implant stickers and any other document required by Company/TPA","note":"Original documents are required; certified copies and the other insurer’s claim settlement advice are accepted when originals have been submitted to another insurer.","quote":"The claim is to be supported with the following original documents and submitted within the prescribed time limit.\ni) Completed claim form\nii) Medical Practitioner’s prescription advising admission for inpatient treatment.\niii) Cash-memo from the hospital (s)/chemist (s) supported by proper prescription from attending medical practitioner for Pre Hospitalisation, Hospitalisation and Post Hospitalisation.\niv) Payment receipt, investigation test reports and associated plates/CDs in original, supported by the prescription from attending medical practitioner for Pre Hospitalisation, Hospitalisation and Post Hospitalisation.\nv) Attending medical practitioner’s certificate regarding Diagnosis along with date of Diagnosis and bill, receipts etc.\nvi) Surgeon’s certificate regarding Diagnosis and nature of operation performed along with bills, receipts etc.\nvii) Bills, receipt, sticker of the Implants.\nviii) Bills, payment receipts, medical history of the patient recorded, discharge certificate/ summary, break up of final bill from the hospital etc.\nix) Any other document required by Company/TPA.","sources":[{"clause":"6.5.4","heading":"Documents","page":8,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-6-5-4"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"quote-verified","value":"The Company shall settle or reject a claim within 30 days from receipt of the last necessary document. If investigation is required, the investigation must be completed within 30 days and the claim settled or rejected within 45 days from receipt of the last necessary document.","display":"30 days from last necessary document; 45 days if investigation is required","note":null,"quote":"The Company shall settle or reject a claim, as the case may be, within 30 days from the date of receipt of last necessary document. ... where the circumstances of a claim warrant an investigation in the opinion of the Company, it shall initiate and complete such investigation at the earliest, in any case not later than 30 days from the date of receipt of last necessary document. In such cases, the Company shall settle or reject the claim within 45 days from the date of receipt of last necessary document.","sources":[{"clause":"6.5.6(i)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-6-5-6-i"},{"clause":"6.5.6(iii)","heading":null,"page":8,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-6-5-6-iii"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"quote-verified","value":"The insured person may first contact the company through its website, toll free number, e-mail, phone, post or a branch grievance cell. If not satisfied, the insured person may contact the grievance officer at that location before approaching the Insurance Ombudsman or IRDAI IGMS.","display":"Contact National Insurance first; then branch grievance cell or grievance officer; then Ombudsman/IGMS","note":null,"quote":"In case of any grievance the insured person may contact the company through\nWebsite: https://nationalinsurance.nic.co.in/ | Post: National Insurance Co. Ltd.,\nToll free: 1800 345 0330 | 6A Middleton Street, 7th Floor,\nE-mail: customer.relations@nic.co.in | CRM Dept.,\nPhn : (033) 2283 1742 | Kolkata - 700 071\nInsured person may also approach the grievance cell at any of the company’s branches with the details of grievance. If Insured person is not satisfied with the redressal of grievance through one of the above methods, insured person may contact the grievance officer (Office in-Charge) at that location.","sources":[{"clause":null,"heading":"8 REDRESSAL OF GRIEVANCE","page":14,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-8-redressal-of-grievance"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"quote-verified","value":"Sum insured options are ₹ 50,000 to ₹ 10 L in 15 slabs: ₹ 50,000 to ₹ 5,00,000 in multiples of ₹ 50,000, and ₹ 6,00,000 to ₹ 10,00,000 in multiples of ₹ 1,00,000.","display":"₹ 50,000 to ₹ 10 L in 15 slabs","note":null,"quote":"Sum Insured | ₹ 50,000 – 10 L\nSlab | 15 slabs – ₹ 50,000 to ₹ 5,00,000/- in multiples of ₹ 50,000 ₹ 6,00,000 to ₹ 10,00,000/- in multiples of ₹ 1,00,000","sources":[{"clause":null,"heading":"9 TABLE OF BENEFITS","page":15,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-9-table-of-benefits"}],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Does not apply to accident claims, if covered; does not apply after Continuous Coverage for more than 12 months.","quote":"Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.","sources":[{"clause":"4.3","heading":"First 30 days waiting period (Excl 03)","page":4,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-4-3"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"quote-verified","value":{"unit":"months","amount":48},"display":"48 months","note":"For enhanced sum insured, the exclusion applies afresh to the increased portion; coverage after 48 months is subject to the disease being declared and accepted.","quote":"Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of 48 (forty eight) months of continuous coverage after the date of inception of the first policy with us.","sources":[{"clause":"4.1","heading":"Pre-Existing Diseases (Excl 01)","page":4,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-4-1"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"quote-verified","value":{"unit":"days","amount":90},"display":"90 days","note":"Other specified waiting periods are one year, two year and four years. The exclusion does not apply to claims arising due to an accident.","quote":"Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 90 days/ one year/ two year/ four years (as specified against specific disease/ procedure) of continuous coverage after the date of inception of the first policy with us.","sources":[{"clause":"4.2","heading":"Specified disease/procedure waiting period (Excl 02)","page":4,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-4-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"quote-verified","value":["Hypertension and related complications as mentioned in","Diabetes and related complications as mentioned in","Cardiac conditions","Benign ENT disorders","Mastoidectomy","Tonsillectomy","Tympanoplasty","Adenoidectomy","Cataract and age related eye ailments","Refractive error of the eye more than 7.5 dioptres.","Benign prostatic hypertrophy","Hernia","Hydrocele","Fissure/Fistula in anus","Piles (Haemorrhoids)","Sinusitis and related disorders","Polycystic ovarian disease","Non-infective arthritis","Pilonidal sinus","Gout and Rheumatism","Calculus diseases","Surgery of gall bladder and bile duct excluding malignancy","Surgery of genito-urinary system excluding malignancy","Surgery for prolapsed intervertebral disc unless arising from accident","Surgery of varicose vein","Hysterectomy","Congenital Internal Anomaly","Joint replacement unless necessitated due to an accident","Osteoarthritis and osteoporosis","Morbid Obesity and its complications","Stem Cell Therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered."],"display":"Lifestyle conditions; ENT procedures; cataract, hernia, hydrocele, piles and listed surgeries; joint replacement, osteoarthritis/osteoporosis, morbid obesity and stem cell therapy","note":null,"quote":"i) 90 Days Waiting Period (Life style conditions)\na) Hypertension and related complications as mentioned in\nb) Diabetes and related complications as mentioned in\nc) Cardiac conditions\nii. One year Waiting Period\na. Benign ENT disorders | d. Mastoidectomy\nb. Tonsillectomy | e. Tympanoplasty\nc. Adenoidectomy\niii. Two years Waiting Period\na. Cataract and age related eye ailments | l. Pilonidal sinus\nb. Refractive error of the eye more than 7.5 dioptres. | m. Gout and Rheumatism\nd. Benign prostatic hypertrophy | n. Calculus diseases\ne. Hernia | o. Surgery of gall bladder and bile duct excluding malignancy\nf. Hydrocele | p. Surgery of genito-urinary system excluding malignancy\ng. Fissure/Fistula in anus | q. Surgery for prolapsed intervertebral disc unless arising\nh. Piles (Haemorrhoids) | from accident\ni. Sinusitis and related disorders | r. Surgery of varicose vein\nj. Polycystic ovarian disease | s. Hysterectomy\nk. Non-infective arthritis | t. Congenital Internal Anomaly ... iv. Four years Waiting Period\na) Joint replacement unless necessitated due to an accident\nb) Osteoarthritis and osteoporosis\nc) Morbid Obesity and its complications\nd) Stem Cell Therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered.","sources":[{"clause":"4.2","heading":"Specified disease/procedure waiting period (Excl 02)","page":4,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-4-2"}],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"quote-verified","value":{"unit":"years","amount":8},"display":"8 continuous years","note":"For enhanced sums insured, eight continuous years applies from the date of enhancement only on the enhanced limits.","quote":"After completion of eight continuous years under this policy no look back would be applied. This period of eight years is called as moratorium period. ... After the expiry of Moratorium Period no claim under this policy shall be contestable except for proven fraud and permanent exclusions specified in the policy contract.","sources":[{"clause":"6.6","heading":"Moratorium Period","page":9,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-6-6"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"not-stated","value":null,"display":null,"note":"The documents mention waiting-period reduction under portability norms and migration to other products of the Company, but do not state an option to port this policy to another insurer.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"quote-verified","value":"No loading applies on renewals based on individual claims experience.","display":"No individual claim-based renewal loading","note":"The policy also has a low claim ratio discount based on the entire group’s incurred claims ratio.","quote":"No loading shall apply on renewals based on individual claims experience. ... Low claim ratio discount at the following scale will be allowed on the total premium at renewal only depending upon the Incurred Claims Ratio for the entire group insured under the Policy","sources":[{"clause":"6.15","heading":"Renewal of Policy","page":10,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-6-15"},{"clause":"6.17","heading":"Low Claim Ratio Discount (Bonus)","page":10,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-6-17"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"quote-verified","value":"The policyholder may cancel by giving 15 days’ written notice. The Company refunds premium for the unexpired policy period after charging 1/4 annual rate for risk up to 1 month, 1/2 annual rate for risk up to 3 months, 3/4 annual rate for risk up to 6 months, and the full annual rate if the risk exceeds 6 months.","display":"15 days’ notice; short-period charges of 1/4, 1/2, 3/4 or full annual rate","note":null,"quote":"The policyholder may cancel this policy by giving 15 days’ written notice and in such an event, the Company shall refund premium for the unexpired policy period as detailed below.\nPeriod of risk | Rate of premium to be charged\nUp to 1month | 1/4 of the annual rate\nUp to 3 months | 1/2 of the annual rate\nUp to 6 months | 3/4 of the annual rate\nExceeding 6 months | Full annual rate","sources":[{"clause":"6.11(ii)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-6-11-ii"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"quote-verified","value":"All medical treatment for the policy must be taken in India only.","display":"India only","note":null,"quote":"All medical treatment for the purpose of this Policy will have to be taken in India only.","sources":[{"clause":"6.8","heading":"Territorial Limit","page":9,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-6-8"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Coverage is not available during the grace period.","quote":"At the end of the policy period, the Policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy. Coverage is not available during the grace period.","sources":[{"clause":"6.15","heading":"Renewal of Policy","page":10,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-6-15"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"quote-verified","value":"Policy can be availed by persons 18 years of age and above. Children between 3 months and 18 years may be covered if the parent or parents are covered at the same time.","display":"Adults: 18 years and above; children: 3 months to 18 years with covered parent(s)","note":"From the prospectus. The documents do not state a maximum adult entry age.","quote":"Policy can be availed by persons 18 years of age and above.\n3. Children between the age of 3 months and 18 years may be covered, provided parent(s) is/are covered at the same time.","sources":[{"clause":"2.6","heading":"Eligibility","page":4,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13097#c-2-6"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"quote-verified","value":["Maternity Benefit","Enhanced limit of Modern Treatment"],"display":"Maternity Benefit; Enhanced limit of Modern Treatment","note":"Optional covers once opted cannot be cancelled mid-term.","quote":"The covers listed below are Optional Covers and shall be available to Insured Persons in accordance with the terms set out in the Policy, if the listed cover is opted and the premium paid. ... The Company shall pay Maternity Expenses up to ₹ 50,000/- for up to first two deliveries or terminations of pregnancy of the Insured Person ... Maximum amount admissible for any one Modern Treatment under Section 2.5 shall be enhanced to 50% of Sum Insured.","sources":[{"clause":"3.2","heading":"OPTIONAL COVERS","page":3,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-3-2"},{"clause":"3.2.1","heading":"Maternity Benefit","page":3,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-3-2-1"},{"clause":"3.2.2","heading":"Enhanced limit of Modern Treatment","page":4,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-3-2-2"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"Coverage is not available during the grace period.","display":"No coverage during the grace period","note":null,"quote":"Coverage is not available during the grace period.","sources":[{"clause":"6.15","heading":"Renewal of Policy","page":10,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-6-15"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"Daily room limit, if any.","status":"quote-verified","value":"Room Rent per day is payable up to 1% of Sum Insured, subject to a maximum of ₹ 10,000 per day. ICU charges per day are payable up to 2% of Sum Insured, subject to a maximum of ₹ 20,000 per day, and total Room Charges for any one illness are capped at 25% of Sum Insured.","display":"Room rent: 1% of SI up to ₹ 10,000/day; ICU: 2% of SI up to ₹ 20,000/day","note":"These sub-limits do not apply in case of treatment undergone as a package for a listed procedure in a Preferred Provider Network (PPN).","quote":"Room Rent per day shall be payable up to 1% of Sum Insured subject to max of ₹ 10,000 per day ii. ICU Charges per day shall be payable up to 2% of Sum Insured subject to max of ₹ 20,000 per day | Maximum amount admissible under Room Charges for Any One Illness shall be 25% of Sum Insured","sources":[{"clause":null,"heading":"Coverage – Sub Limits","page":1,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-coverage-sub-limits"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Childbirth cover and any waiting period.","status":"quote-verified","value":"Maternity is excluded under the base cover but may be covered if Optional Cover 3.2.1 is opted. The optional cover pays up to ₹ 50,000 for up to the first two deliveries or terminations, with a 9-month waiting period unless waived for delivery, miscarriage or abortion induced by accident or other medical emergency.","display":"Optional: up to ₹ 50,000; 9-month waiting period","note":"Maternity Benefit is an optional cover available only if opted and premium is paid.","quote":"Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; ... Exclusion 5.15 may be deleted by opting for Optional Cover 3.2.1 ... The Company shall pay Maternity Expenses up to ₹ 50,000/- for up to first two deliveries or terminations of pregnancy of the Insured Person ... Delivery or termination within a Waiting Period of 9 months. However, the Waiting Period may be waived only in the case of delivery, miscarriage or abortion induced by accident or other medical emergency.","sources":[{"clause":"5.15","heading":"Maternity (Excl 18)","page":6,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-5-15"},{"clause":"3.2.1","heading":"Maternity Benefit","page":3,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-3-2-1"},{"clause":"3.2.1.2","heading":"Exclusions","page":3,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-3-2-1-2"}],"law":[]},{"key":"ped_cover_group","label":"Pre-existing diseases","section":"Waiting periods","meaning":"Whether pre-existing diseases are covered from day one for the group.","status":"quote-verified","value":"Pre-existing diseases are not covered from day one. Expenses for a PED and its direct complications are excluded until 48 months of continuous coverage; after that, coverage is subject to the PED being declared and accepted.","display":"No day-one PED cover; 48-month waiting period","note":null,"quote":"Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of 48 (forty eight) months of continuous coverage after the date of inception of the first policy with us. ... Coverage under the policy after the expiry of 48 (forty eight) months for any pre-existing disease is subject to the same being declared at the time of application and accepted by us.","sources":[{"clause":"4.1","heading":"Pre-Existing Diseases (Excl 01)","page":4,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-4-1"}],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"quote-verified","value":"Cashless treatment is available in Network Providers if TPA service is opted, subject to pre-authorization by the TPA. Under the cashless facility, payments for treatment costs are directly made to the Network Provider by the Company to the extent pre-authorization is approved.","display":"Available in Network Providers if TPA service is opted, subject to TPA pre-authorisation","note":"If cashless is denied, the insured may take treatment and submit documents for reimbursement.","quote":"Cashless Facility for treatment in Network Providers can be availed, if TPA service is opted. ... Treatment may be taken in a Network Provider and is subject to pre authorization by the TPA. ... Cashless Facility means a facility extended by the Company to the Insured where the payments, of the costs of treatment undergone by the Insured in accordance with the Policy terms and conditions, are directly made to the Network Provider by the Company to the extent pre-authorization approved.","sources":[{"clause":"6.5.2","heading":"Procedure for Cashless Claims","page":8,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-6-5-2"},{"clause":"7.7","heading":"Cashless Facility","page":11,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-7-7"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"quote-verified","value":"Claims may be processed by the TPA if claim is processed by TPA, or by the Company if claim is processed by the Company. TPA services include pre-authorization of cashless treatment and processing of claims other than cashless claims, but do not include claim settlement or rejection.","display":"TPA or Company; TPA processes/pre-authorises but does not settle or reject claims","note":null,"quote":"the Insured Person/Insured Person’s representative shall notify the TPA (if claim is processed by TPA)/Company (if claim is processed by the Company) ... Servicing of claims, i.e., claim admissions and assessments, under this Policy by way of pre-authorization of cashless treatment or processing of claims other than cashless claims or both ... The services offered by a TPA shall not include\ni) Claim settlement and claim rejection;","sources":[{"clause":"6.5.1","heading":"Notification of Claim","page":7,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-6-5-1"},{"clause":"6.5.7","heading":"Services Offered by TPA","page":9,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000#c-6-5-7"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"quote-verified","value":false,"display":"No; individual basis only","note":"The prospectus also says separate SI shall apply to each individual Primary Group Member or Primary Group Member along with family.","quote":"Policy can be issued on Individual Basis (i.e., separate Sum Insured shall apply on each Insured Person) only.","sources":[{"clause":"2.2","heading":"Type of Policy","page":3,"url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13097#c-2-2"}],"law":[]}],"documents":[{"kind":"wording","label":"National Group Mediclaim Policy (NGMP)","pages":19,"fetched_at":"2026-10-17 19:56:39+00","source_url":"https://nationalinsurance.nic.co.in/sites/default/files/2026-04/National%20Group%20Mediclaim%20Policy%20%28NGMP%29.pdf","url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13000"},{"kind":"prospectus","label":"NGMP - Prospectus","pages":18,"fetched_at":"2026-10-17 19:59:26+00","source_url":"https://nationalinsurance.nic.co.in/sites/default/files/2026-04/NGMP%20-%20Prospectus_1.pdf","url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/13097"},{"kind":"premium","label":"NGMP - Rate Chart","pages":null,"fetched_at":"2026-10-17 19:52:22+00","source_url":"https://nationalinsurance.nic.co.in/sites/default/files/2026-04/NGMP%20-%20Rate%20Chart.pdf","url":"https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223/document/30368"}],"versions":[{"uin":"NICHLGP21171V042021","version":null,"approved_on":null},{"uin":"NICHLGP23051V052223","version":null,"approved_on":null}],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"National Insurance official website","url":"https://nationalinsurance.nic.co.in","note":"Website as listed by IRDAI. Not checked: the site could not be reached from our crawler on 2026-10-19 (connection or TLS error)."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"National Group Mediclaim Policy (UIN NICHLGP23051V052223), IndiaInsurances, https://indiainsurances.com/policy/national-insurance/national-group-mediclaim-policy-nichlgp23051v052223"}