{"uin":"NICHLIP24005V022324","name":"National Young India Mediclaim Policy","url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324","insurer":{"slug":"national-insurance","name":"National Insurance Company Limited","url":"https://indiainsurances.com/insurer/national-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"National Young India Mediclaim Policy is an indemnity health insurance policy issued on individual or floater basis with Basic SI options of ₹ 3L, 5L and 10L for 1 year or 3 years. It has a 30 days initial waiting period, 36 months PED waiting period, 45 days pre-hospitalisation cover, 60 days post-hospitalisation cover and zone-based co-payment.","analysis":{"state":"machine","analysed_at":"2026-10-19 21:53:53.278258+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":["Individual Basis","Floater Basis"],"display":"Individual Basis; Floater Basis","note":null,"quote":"Policy can be issued on\ni. Individual Basis (i.e., separate Basic Sum Insured and Cumulative Bonus shall apply on each Insured Person) or\nii. Floater Basis (i.e., common Basic Sum Insured and Cumulative Bonus shall apply on all Insured Persons)","sources":[{"clause":null,"heading":"2.1 Type of Policy","page":6,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/13041#c-2-1-type-of-policy"}],"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":"The policy can be issued for 1 year or 3 years.","display":"1 year or 3 years","note":null,"quote":"The Policy can only be issued for a period of 1 year (i.e., 12 calendar months or 1 Policy Year) or 3 years (i.e., 36 calendar months or 3 Policy Years).","sources":[{"clause":null,"heading":"2.3 Policy Period","page":6,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/13041#c-2-3-policy-period"}],"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: at least 72 hours before admission; emergency: within 24 hours of admission","note":null,"quote":"In the event of planned Hospitalisation | At least seventy two (72) hours prior to the Insured Person’s admission to Network Provider\nIn 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\nIn the event of emergency Hospitalisation | Within twenty four (24) hours of the Insured Person’s admission to Hospital","sources":[{"clause":"6.17.1","heading":"Notification of Claim","page":16,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-6-17-1"}],"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; medical prescription; hospital/chemist cash-memos; payment receipts, test reports and plates/CDs; diagnosis certificate; surgeon’s certificate; implant bills/stickers; hospital bills, receipts, medical history, discharge summary and final bill break-up; any other document required by Company/TPA","note":"Separate documents are listed for death and disablement claims under the personal accident cover.","quote":"i) 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":"6.17.4","heading":"Documents","page":16,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-6-17-4"}],"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 15 days from receipt of the last necessary document. If investigation is warranted, it shall complete investigation within 30 days and settle or reject the claim within 45 days from receipt of the last necessary document.","display":"15 days from last necessary document; 45 days if investigation is required","note":"Interest at 2% above bank rate is payable for delay beyond the stipulated period.","quote":"The Company shall settle or reject a claim, as the case may be, within 15 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":"6.3(i)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-6-3-i"},{"clause":"6.3(iii)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-6-3-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":"quote-verified","value":["Pre-Existing Diseases (Excl 01)","Specific disease/procedure waiting period (Excl 02)","First 30 days waiting period (Excl 03)","Investigation& Evaluation (Excl 04)","Rest Cure, Rehabilitation and Respite Care (Excl 05)","Change-of-Gender Treatments (Excl 07)","Cosmetic or Plastic Surgery (Excl 08)","Hazardous or Adventure Sports (Excl 09)","Breach of Law (Excl 10)","Excluded Providers (Excl 11)","Drug/Alcohol Abuse (Excl 12)","Birth control, Sterility and Infertility (Excl 17)","Domiciliary Hospitalization & Out Patient Department (OPD) treatment","War","Treatment taken outside the geographical limits of India"],"display":"Waiting-period exclusions for PED, specific diseases/procedures and first 30 days; plus key exclusions including investigation/evaluation, rest cure, change-of-gender treatment, cosmetic surgery, professional hazardous sports, breach of law, excluded providers, drug/alcohol abuse, infertility, domiciliary/OPD treatment, war and treatment outside India","note":null,"quote":"4.1. Pre-Existing Diseases (Excl 01) ... 4.2. Specific disease/procedure waiting period (Excl 02) ... 4.3. First 30 days waiting period (Excl 03) ... 5.1. Investigation& Evaluation (Excl 04) ... 5.2. Rest Cure, Rehabilitation and Respite Care (Excl 05) ... 5.4. Change-of-Gender Treatments (Excl 07) ... 5.5. Cosmetic or Plastic Surgery (Excl 08) ... 5.6. Hazardous or Adventure Sports (Excl 09) ... 5.7. Breach of Law (Excl 10) ... 5.8. Excluded Providers (Excl 11) ... 5.9. Drug/Alcohol Abuse (Excl 12) ... 5.14. Birth control, Sterility and Infertility (Excl 17) ... 5.23. Domiciliary Hospitalization & Out Patient Department (OPD) treatment ... 5.32. War ... 5.34. Treatment taken outside the geographical limits of India","sources":[{"clause":null,"heading":"4.1. Pre-Existing Diseases (Excl 01)","page":10,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-4-1-pre-existing-diseases-excl-01"},{"clause":null,"heading":"4.2. Specific disease/procedure waiting period (Excl 02)","page":10,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-4-2-specific-disease-procedure-waiting-period-ex"},{"clause":null,"heading":"4.3. First 30 days waiting period (Excl 03)","page":11,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-4-3-first-30-days-waiting-period-excl-03"},{"clause":null,"heading":"5.1. Investigation& Evaluation (Excl 04)","page":11,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-5-1-investigation-evaluation-excl-04"},{"clause":null,"heading":"5.2. Rest Cure, Rehabilitation and Respite Care (Excl 05)","page":11,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-5-2-rest-cure-rehabilitation-and-respite-care-ex"},{"clause":null,"heading":"5.4. Change-of-Gender Treatments (Excl 07)","page":12,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-5-4-change-of-gender-treatments-excl-07"},{"clause":null,"heading":"5.5. Cosmetic or Plastic Surgery (Excl 08)","page":12,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-5-5-cosmetic-or-plastic-surgery-excl-08"},{"clause":null,"heading":"5.6. Hazardous or Adventure Sports (Excl 09)","page":12,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-5-6-hazardous-or-adventure-sports-excl-09"},{"clause":null,"heading":"5.7. Breach of Law (Excl 10)","page":12,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-5-7-breach-of-law-excl-10"},{"clause":null,"heading":"5.8. Excluded Providers (Excl 11)","page":12,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-5-8-excluded-providers-excl-11"},{"clause":null,"heading":"5.9. Drug/Alcohol Abuse (Excl 12)","page":12,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-5-9-drug-alcohol-abuse-excl-12"},{"clause":null,"heading":"5.14. Birth control, Sterility and Infertility (Excl 17)","page":12,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-5-14-birth-control-sterility-and-infertility-exc"},{"clause":null,"heading":"5.23. Domiciliary Hospitalization & Out Patient Department (OPD) treatment","page":13,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-5-23-domiciliary-hospitalization-out-patient-dep"},{"clause":null,"heading":"5.32. War","page":13,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-5-32-war"},{"clause":null,"heading":"5.34. Treatment taken outside the geographical limits of India","page":13,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-5-34-treatment-taken-outside-the-geographical-li"}],"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":"Submit grievances in writing to the Policy Issuing Office or Grievance cell at Regional Office. If unaddressed, contact the Customer Relationship Management Dept., National Insurance Company Limited.","display":"Policy Issuing Office or Grievance cell at Regional Office first; then Customer Relationship Management Dept.","note":null,"quote":"In case of any grievance related to the Policy, the insured person may submit in writing to the Policy Issuing Office or Grievance cell at Regional Office of the Company for redressal. If the grievance remains unaddressed, the insured person may contact Customer Relationship Management Dept., National Insurance Company Limited","sources":[{"clause":null,"heading":"7 REDRESSAL OF GRIEVANCE","page":18,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-7-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":"The Basic Sum Insured options are ₹ 3L, ₹ 5L and ₹ 10L.","display":"₹ 3L, 5L, 10L","note":null,"quote":"The Policy is available with options of Basic SI of ₹ 3/ 5/ 10 L.","sources":[{"clause":null,"heading":"2.4 Basic Sum Insured (Basic SI)","page":6,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/13041#c-2-4-basic-sum-insured-basic-si"}],"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; does not apply after continuous coverage for more than twelve (12) months.","quote":"Expenses related to the treatment of any illness within thirty (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":null,"heading":"4.3. First 30 days waiting period (Excl 03)","page":11,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-4-3-first-30-days-waiting-period-excl-03"}],"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":36},"display":"36 months","note":"Coverage after 36 months is subject to the PED being declared at application and accepted by the insurer.","quote":"Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of thirty six (36) months of continuous coverage after the date of inception of the first policy with us.","sources":[{"clause":null,"heading":"4.1. Pre-Existing Diseases (Excl 01)","page":10,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-4-1-pre-existing-diseases-excl-01"}],"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; one year, two years and three years for other listed conditions","note":"The same clause’s general line says “four years”, but the printed list has “Three years Waiting Period”. It is not applicable for 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. ... i) 90 Days Waiting Period (Life style conditions) ... ii. One year waiting period ... iii. Two years waiting period ... iv. Three years Waiting Period","sources":[{"clause":null,"heading":"4.2. Specific disease/procedure waiting period (Excl 02)","page":10,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-4-2-specific-disease-procedure-waiting-period-ex"}],"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","Diabetes and related complications","Cardiac conditions","Benign ENT disorders","Tonsillectomy","Adenoidectomy","Mastoidectomy","Tympanoplasty","Cataract","Calculus diseases","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","Surgery of genito-urinary system excluding malignancy","Surgery of gall bladder and bile duct excluding malignancy","Congenital Internal Anomaly (not applicable for new born baby)","Surgery for prolapsed intervertebral disc unless arising from accident","Surgery of varicose vein","Hysterectomy","Refractive error of the eye more than 7.5 dioptres","Joint replacement unless necessitated due to an accident","Osteoarthritis and osteoporosis","Obesity and its complications","Stem Cell Therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered."],"display":"Hypertension, diabetes, cardiac conditions; listed ENT procedures; cataract, hernia, piles, sinusitis and other listed two-year conditions; joint replacement, osteoarthritis/osteoporosis, obesity complications and specified stem cell therapy","note":null,"quote":"a) Hypertension and related complications\nb) Diabetes and related complications\nc) Cardiac conditions\nii. One year waiting period\na. Benign ENT disorders | b. Tonsillectomy\nc. Adenoidectomy | d. Mastoidectomy\ne. Tympanoplasty\niii. Two years waiting period\na. Cataract | b. Calculus diseases\nc. Benign prostatic hypertrophy | d. Hernia\ne. Hydrocele | f. Fissure/Fistula in anus\ng. Piles (Haemorrhoids) | h. Sinusitis and related disorders\ni. Polycystic ovarian disease | j. Non-infective arthritis\nk. Pilonidal sinus | l. Gout and Rheumatism\nm. Surgery of genito-urinary system excluding | n. Surgery of gall bladder and bile duct excluding\nmalignancy | malignancy\no. Congenital Internal Anomaly (not applicable for | p. Surgery for prolapsed intervertebral disc unless arising\nnew born baby) | from accident\nq. Surgery of varicose vein | r. Hysterectomy\ns. Refractive error of the eye more than 7.5 dioptres ... a) Joint replacement unless necessitated due to an accident\nb) Osteoarthritis and osteoporosis\nc) Obesity and its complications\nd) Stem Cell Therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered.","sources":[{"clause":null,"heading":"4.2. Specific disease/procedure waiting period (Excl 02)","page":10,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-4-2-specific-disease-procedure-waiting-period-ex"}],"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":"months","amount":60},"display":"60 continuous months","note":"For enhanced Basic Sum Insured, sixty continuous months applies from the date of enhancement on the enhanced limits.","quote":"After completion of sixty continuous months of coverage (including Portability and Migration), no claim shall be contestable by the Company on grounds of non-disclosure, misrepresentation, except on grounds of established fraud. This period of sixty continuous months is called as Moratorium Period.","sources":[{"clause":"6.11","heading":"Moratorium Period","page":15,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-6-11"}],"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":"quote-verified","value":"The insured person may port the policy to other insurers by applying at least 15 days before, but not earlier than 60 days from, the renewal date. Accrued continuity benefits for specific waiting periods, PED waiting period and moratorium transfer to the extent of previous Sum Insured.","display":"Can port to other insurers with waiting-period, PED and moratorium continuity credit","note":"Portability benefit does not apply to additional increased Sum Insured.","quote":"The Insured Person will have the option to port the Policy to other insurers by applying to such Insurer to port the entire policy along with all the members of the family, if any, at least 15 days before, but not earlier than 60 days from the policy renewal date ... The proposed Insured Person will get all the accrued continuity benefits for specific waiting periods, waiting period for pre-existing diseases and Moratorium period","sources":[{"clause":"6.8","heading":"Portability","page":15,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-6-8"}],"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":"quote-verified","value":true,"display":"Yes, throughout the lifetime of the Insured Persons","note":"Covered children or siblings can renew till the insured person’s marriage.","quote":"The Policy can be renewed without break throughout the lifetime of the Insured Persons except for the covered Children or siblings, who can renew till the Insured Person’s marriage.","sources":[{"clause":null,"heading":"2.9 Renewal Terms","page":7,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/13041#c-2-9-renewal-terms"}],"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 shall apply on renewals based on individual claims experience.","display":"No loading on renewals based on individual claims experience","note":null,"quote":"No loading shall apply on renewals based on individual claims experience.","sources":[{"clause":"6.9","heading":"Renewal of Policy","page":15,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-6-9"}],"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 at any time during the term by giving 7 days’ written notice. For a term up to one year, proportionate premium for the unexpired period is refunded if no claim is made; for terms over one year, unexpired future policy years and proportionate current policy year premium are refunded, but no refund is made if any claim has been admitted, lodged or any benefit availed.","display":"Proportionate refund for unexpired period if no claim; no refund if any claim admitted, lodged or benefit availed","note":null,"quote":"The policyholder may cancel his/her policy at any time during the term, by giving 7 days’ notice in writing. ... refund proportionate premium for unexpired policy period, if the term of policy upto one year and there is no claim (s) made during the policy period. ... no refunds of premium shall be made in respect of Cancellation where, any claim has been admitted or has been lodged or any benefit has been availed under the Policy.","sources":[{"clause":"6.6(ii)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-6-6-ii"},{"clause":"6.6(a)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-6-6-a"},{"clause":"6.6(b)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-6-6-b"}],"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":"6.19","heading":"Territorial Limit","page":18,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-6-19"}],"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":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days from date of receipt of the policy document","note":"Applies to new individual health insurance policies, not renewals or porting/migration, and to policies with a term of one year or more.","quote":"The insured person shall be allowed free look period of thirty days from date of receipt of the policy document to review the terms and conditions of the policy.","sources":[{"clause":"6.13","heading":"Free Look Period","page":15,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-6-13"}],"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":null,"quote":"The Grace Period for payment of the premium shall be thirty days.","sources":[{"clause":"2.20","heading":"Grace Period","page":3,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-2-20"}],"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":"The proposer’s entry age must be between 18 years and 43 years, and the maximum entry age of any family member is 43 years. Children over 3 months may be covered for the first time if parent(s) are covered at the same time.","display":"Minimum 3 months for children; proposer 18 to 43 years; maximum family member entry age 43 years","note":null,"quote":"Entry age of Proposer should be between eighteen (18) years and forty three (43) years.\nii. Maximum entry age of any family member is forty three (43) years.\niii. Minimum 2 Insured Persons shall be covered on Floater Basis.\niv. Children over the age of three (03) months may be covered for the first time, provided parent(s) is/are covered at the same time.","sources":[{"clause":null,"heading":"2.2 Eligibility","page":6,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/13041#c-2-2-eligibility"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"quote-verified","value":["Full premium shall be paid in full before the commencement of the Policy."],"display":"Full premium before commencement","note":"The documents do not state half-yearly, quarterly or monthly instalment modes.","quote":"Full premium shall be paid in full before the commencement of the Policy.","sources":[{"clause":null,"heading":"2.8 Payment of Premium","page":7,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/13041#c-2-8-payment-of-premium"}],"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":["Waiting period waiver of pre-existing Diabetes and/or Hypertension – Optional 1","Double SI for 11 Critical Illnesses – Optional 2","Non-Medical Expenses (Available for Sum Insured ₹ 5L & Above)"],"display":"Waiting period waiver of pre-existing Diabetes and/or Hypertension; Double SI for 11 Critical Illnesses; Non-Medical Expenses add-on for SI ₹ 5L and above","note":null,"quote":"At the option of the Insured and on payment of additional premium the following covers shall be available to the Insured Persons during the Policy Period, provided the same is mentioned in the Policy Schedule.\n3.3.1 Waiting period waiver of pre-existing Diabetes and/or Hypertension – Optional 1 ... 3.3.2. Double SI for 11 Critical Illnesses – Optional 2 ... Add-on (cover available on payment of additional premium)\nNon-Medical Expenses (Available for Sum Insured ₹ 5L & Above)","sources":[{"clause":null,"heading":"3.3 OPTIONAL COVER","page":9,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-3-3-optional-cover"},{"clause":null,"heading":"3.3.2. Double SI for 11 Critical Illnesses – Optional 2","page":9,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-3-3-2-double-si-for-11-critical-illnesses-option"},{"clause":null,"heading":"TABLE OF BENEFITS","page":19,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-table-of-benefits"}],"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 for which no premium is received.","display":"No coverage during the grace period","note":null,"quote":"In case of Renewal, Coverage shall not be available during the period for which no premium is received.","sources":[{"clause":"2.20","heading":"Grace Period","page":3,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-2-20"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for the hospital room, or the room category allowed. If you take a costlier room, other bills can be cut in proportion.","status":"quote-verified","value":"Room Rent is payable up to INR 5,000 per day for Basic SI 3L and 5L, and up to INR 10,000 per day for Basic SI 10L. The sub-limit does not apply for hospitalisation in a Preferred Provider Network as a package.","display":"Up to INR 5,000 per day for Basic SI 3L/5L; up to INR 10,000 per day for Basic SI 10L","note":null,"quote":"Room Rent – Upto INR 5,000 per day for Basic SI 3L, 5L and upto INR 10,000 per day for Basic SI 10L ... Sub limit will not apply in case of Hospitalisation in a Preferred Provider Network (PPN) as a package","sources":[{"clause":null,"heading":"TABLE OF BENEFITS","page":19,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-table-of-benefits"}],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"not-applicable","value":null,"display":null,"note":"The product states room-rent rupee sub-limits, not an allowed room category.","quote":null,"sources":[],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"quote-verified","value":"ICU Charges are payable up to INR 10,000 per day for Basic SI 3L and 5L, and up to INR 20,000 per day for Basic SI 10L.","display":"Up to INR 10,000 per day for Basic SI 3L/5L; up to INR 20,000 per day for Basic SI 10L","note":null,"quote":"ICU Charges – Upto INR 10,000 per day for Basic SI 3L, 5L and upto INR 20,000 per day for Basic SI 10L","sources":[{"clause":null,"heading":"TABLE OF BENEFITS","page":19,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-table-of-benefits"}],"law":[]},{"key":"proportionate_deduction","label":"Proportionate deduction","section":"Limits and co-pay","meaning":"If you choose a room above your limit, whether the insurer reduces associated charges (doctor fees, tests, procedures) by the same proportion.","status":"quote-verified","value":"If admitted to a room with rates exceeding the room-rent limits, associated medical expenses are paid in the same proportion as the admissible room rent bears to the actual room rent. Proportionate deduction does not apply if admitted to ICU and associated medical expenses exclude pharmacy/consumables, implants/medical devices and diagnostics.","display":"Applies if room rent exceeds limit; not for ICU","note":null,"quote":"In case of admission to a room at rates exceeding the aforesaid limits, the reimbursement/payment of Associated Medical Expenses incurred at the Hospital, shall be effected in the same proportion as the admissible rate per day bears to the actual rate per day of Room Rent charges. Proportionate deduction shall not apply if admitted to ICU. ... Associated Medical Expenses shall include all related expenses except the following expenses,\na) Cost of pharmacy and consumables;\nb) Cost of implants and medical devices\nc) Cost of diagnostics","sources":[{"clause":"3.1.1.3","heading":"Treatment related to participation as a non-professional in hazardous or adventure sports","page":6,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-3-1-1-3"},{"clause":null,"heading":"Associated Medical Expenses","page":6,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-associated-medical-expenses"}],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"quote-verified","value":"Zone-based co-payment applies if treatment is taken in a zone other than the zone for which premium was paid. Zone II premium with Zone I treatment has 12.5% co-pay; Zone III premium with Zone I treatment has 35% co-pay; Zone III premium with Zone II treatment has 20% co-pay.","display":"Zone-based: 12.5%, 35% or 20% depending on premium zone and treatment zone","note":"Zone I premium allows treatment in Zones I, II and III without co-payment. Zone II premium allows treatment in Zones II and III without co-payment. Zone III premium allows treatment in Zone III without co-payment.","quote":"Where treatment has been taken in a zone, other than the one for which premium has been paid, the claim shall be subject to copayment. ... Availing treatment in Zone I will be subject to a copayment of 12.5% ... Availing treatment in Zone I will be subject to a copayment of 35% ... Availing treatment in Zone II will be subject to a copayment of 20%","sources":[{"clause":"6.17.7","heading":"Classification of Zone and Copayment","page":17,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-6-17-7"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"An amount of each claim or each year that you bear before the policy pays.","status":"quote-verified","value":"No deductible is stated in the CIS financial limits.","display":"None","note":"CIS lists Deductible as None.","quote":"iii. Deductible iv. Any other limit | a. Room Rent – Upto INR 5,000 per day for Basic SI 3Lacs, 5Lacs and upto INR 10,000 per day for Basic SI 10Lacs ... Copayment of 20% if insured paying premium as per Zone III but availing treatment in Zone II None None","sources":[{"clause":"Row 7","heading":"Waiting Period","page":2,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/13134#c-row-7"}],"law":[]},{"key":"disease_sublimits","label":"Disease or procedure sub-limits","section":"Limits and co-pay","meaning":"Caps on what is paid for named treatments (cataract, knee replacement...), even if the sum insured is higher.","status":"quote-verified","value":["Cataract – Up to 10% of Sum Insured, subject to maximum ₹ 50,000 per eye per year.","Coverage for Modern Treatment (12 nos) – Up to 25% of SI for each treatment","Expenses due to hazardous or adventure sports (non-professionals) – Up to 25% of SI","Maternity Cover (1 delivery/ termination, Waiting Period 2 years) – up to INR 30,000 (Basic SI 3L), INR 40,000 (Basic SI 5L), INR 50,000 (Basic SI 10L)"],"display":"Cataract 10% of SI up to ₹ 50,000 per eye per year; modern treatments 25% of SI each; non-professional hazardous/adventure sports 25% of SI; maternity limits by SI","note":null,"quote":"Cataract – Up to 10% of Sum Insured, subject to maximum ₹ 50,000 per eye per year. Coverage for Modern Treatment (12 nos) – Up to 25% of SI for each treatment Expenses due to hazardous or adventure sports (non-professionals) – Up to 25% of SI ... Maternity Cover (1 delivery/ termination, Waiting Period 2 years) – up to INR 30,000 (Basic SI 3L), INR 40,000 (Basic SI 5L), INR 50,000 (Basic SI 10L)","sources":[{"clause":null,"heading":"TABLE OF BENEFITS","page":19,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-table-of-benefits"}],"law":[]},{"key":"pre_hospitalisation","label":"Pre-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days before admission that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":45},"display":"45 days immediately before hospitalisation","note":"Expenses must be for the same condition and the in-patient hospitalisation claim must be admissible.","quote":"The Company shall indemnify the Medical Expenses incurred up to forty five (45) days immediately before the Insured Person is hospitalised","sources":[{"clause":"3.1.2","heading":"Pre Hospitalisation","page":6,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-3-1-2"}],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days after discharge that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":60},"display":"60 days immediately after discharge","note":"Expenses must be for the same condition and the in-patient hospitalisation claim must be admissible.","quote":"The Company shall indemnify the Medical Expenses incurred up to sixty (60) days immediately after the Insured Person is discharged from Hospital","sources":[{"clause":"3.1.3","heading":"Post Hospitalisation","page":6,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-3-1-3"}],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital (chemotherapy, dialysis, cataract) and whether all or only listed ones are covered.","status":"quote-verified","value":"Day care treatments requiring hospitalisation as an in-patient for less than 24 hours are covered in a hospital or day care centre, but not in the outpatient department.","display":"Covered for day care treatments requiring less than 24 hours in hospital/day care centre","note":null,"quote":"The Company shall indemnify the Medical Expenses (including Pre and Post Hospitalisation Expenses) for Day Care Treatments requiring Hospitalization as an In-Patient for less than 24 hours undergone by the Insured Person in a Hospital/ Day Care Centre, but not in the Outpatient department of a Hospital.","sources":[{"clause":"3.1.4","heading":"Day Care Procedure","page":6,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-3-1-4"}],"law":[]},{"key":"domiciliary","label":"Treatment at home","section":"Cover","meaning":"Whether treatment at home is covered when hospital admission is not possible or a doctor advises it.","status":"quote-verified","value":"Domiciliary Hospitalization is excluded generally. The modern treatment clause mentions Domiciliary Hospitalisation for listed modern treatments, creating a product-specific exception in that clause.","display":"Generally excluded; mentioned for listed modern treatments","note":"This is an internal qualification in the same policy wording, not a conflict between documents.","quote":"Any expenses incurred on Domiciliary Hospitalization and OPD treatment ... The Company shall indemnify the Medical Expenses for In-Patient Care, Domiciliary Hospitalisation or Day Care Procedure along with pre hospitalisation expenses and post hospitalization expenses incurred for following Modern Treatments","sources":[{"clause":null,"heading":"5.23. Domiciliary Hospitalization & Out Patient Department (OPD) treatment","page":13,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-5-23-domiciliary-hospitalization-out-patient-dep"},{"clause":null,"heading":"3.1.10 Modern Treatment","page":7,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-3-1-10-modern-treatment"}],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"quote-verified","value":"Inpatient AYUSH treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy is covered up to the Sum Insured in any AYUSH Hospital.","display":"AYUSH inpatient treatment covered up to Sum Insured","note":null,"quote":"The Company shall indemnify Medical Expenses incurred for Inpatient Care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Period up to the limit of Sum Insured as specified in the Policy Schedule in any AYUSH Hospital.","sources":[{"clause":"3.1.5","heading":"AYUSH Treatment","page":6,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-3-1-5"}],"law":[{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 1","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 2","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 1","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II A.I(1)","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"modern_treatments","label":"Modern treatments","section":"Cover","meaning":"Robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and the like, and any cap on them.","status":"quote-verified","value":"Listed modern treatments are covered for in-patient care, domiciliary hospitalisation or day care procedure with pre- and post-hospitalisation expenses, subject to 25% of Sum Insured for the related modern procedure/component/medicine of each treatment.","display":"Covered up to 25% of Sum Insured for each listed modern treatment","note":"The table lists UAE & HIFU, Balloon Sinuplasty, Deep Brain Stimulation, Oral Chemotherapy, Immunotherapy, Intravitreal injections, Robotic Surgery, Stereotactic Radio surgeries, Bronchial Thermoplasty, Vaporization of the prostrate, IONM and Stem cell therapy.","quote":"The Company shall indemnify the Medical Expenses for In-Patient Care, Domiciliary Hospitalisation or Day Care Procedure along with pre hospitalisation expenses and post hospitalization expenses incurred for following Modern Treatments (wherever medically indicated), subject to the limit of 25% of the Sum Insured for the related modern procedure/ component/ medicine of each Modern Treatment during the Policy Period.","sources":[{"clause":null,"heading":"3.1.10 Modern Treatment","page":7,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-3-1-10-modern-treatment"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 2","url":"https://indiainsurances.com/law/irdai-health-mc-2024"}]},{"key":"organ_donor","label":"Organ donor expenses","section":"Cover","meaning":"Whether the donor's hospital costs for an organ transplant are paid.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Ambulance charges are covered for transportation to hospital, between hospitals, or from hospital to diagnostic center and return during the same hospitalisation, up to 1% of SI subject to a maximum of ₹ 2,000 per year.","display":"Up to 1% of SI, max ₹ 2,000 per year","note":"The ambulance claim requires an admitted claim under in-patient treatment.","quote":"Ambulance Charges – Up to 1% of SI, subject to max of ₹ 2,000 per year","sources":[{"clause":null,"heading":"TABLE OF BENEFITS","page":19,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-table-of-benefits"}],"law":[]},{"key":"restoration","label":"Restoration of sum insured","section":"Cover","meaning":"Whether the sum insured is refilled after it is used up in a year, how much, how often, and whether it works for the same illness.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"quote-verified","value":"For each claim-free policy year, Cumulative Bonus increases by 5% of Basic Sum Insured. If a claim is made, the accrued CB is reduced at the same rate; maximum CB is 50% of the Basic Sum Insured of the renewed policy.","display":"5% of Basic SI for each claim-free year; reduced by 5% after a claim; maximum 50% of Basic SI","note":null,"quote":"For each claim free Policy Year (i.e., no claims are reported), Cumulative Bonus allowed shall be an amount equal to 5% of the Basic Sum Insured (excluding CB) of the expiring Policy Year. If a claim is made in any particular Policy Year, the CB accrued shall be reduced at the same rate at which it has accrued. ... Maximum CB shall not exceed 50% of the Basic Sum Insured of the renewed Policy.","sources":[{"clause":null,"heading":"3.4 GOOD HEALTH INCENTIVES","page":10,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-3-4-good-health-incentives"}],"law":[]},{"key":"consumables","label":"Consumables and non-medical items","section":"Cover","meaning":"Gloves, PPE, syringes and other items hospitals bill that standard policies exclude; whether this policy pays them.","status":"quote-verified","value":"Base policy coverage is not available for listed non-medical items such as gloves. A Non-Medical Expenses add-on is available on payment of additional premium for Sum Insured ₹ 5L and above, up to 10% of Basic Sum Insured.","display":"Excluded in base policy; optional add-on up to 10% of Basic SI for SI ₹ 5L and above","note":"The add-on changes this only if bought for additional premium.","quote":"List I – List of which coverage is not available in the policy ... 56 | GLOVES ... Add-on (cover available on payment of additional premium)\nNon-Medical Expenses (Available for Sum Insured ₹ 5L & Above) | Up to 10% of Basic Sum Insured (excluding Cumulative Bonus, if any) of base Policy and shall be part of the base Policy Basic Sum Insured","sources":[{"clause":"Appendix I","heading":null,"page":20,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-appendix-i"},{"clause":null,"heading":"TABLE OF BENEFITS","page":19,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-table-of-benefits"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"quote-verified","value":"Maternity expenses for a female insured person are covered, including pre-natal and post-natal hospitalisation expenses per delivery and necessary vaccination for the newborn baby, after continuous coverage of at least 24 months. The table limits the cover to INR 30,000 for Basic SI 3L, INR 40,000 for Basic SI 5L and INR 50,000 for Basic SI 10L, for 1 delivery/termination.","display":"Covered after 24 months; up to INR 30,000/40,000/50,000 by Basic SI 3L/5L/10L","note":"Only one admissible claim for delivery or lawful medical termination is payable under the policy or its renewals.","quote":"The female Insured Person should have been continuously covered for at least 24 months before availing this benefit. ... Maternity Cover (1 delivery/ termination, Waiting Period 2 years) – up to INR 30,000 (Basic SI 3L), INR 40,000 (Basic SI 5L), INR 50,000 (Basic SI 10L)","sources":[{"clause":"3.1.7","heading":"Maternity","page":6,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-3-1-7"},{"clause":null,"heading":"TABLE OF BENEFITS","page":19,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-table-of-benefits"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"The newborn baby is automatically covered from birth under the sum insured available to the mother during the corresponding policy period, up to 3 months of age. After 3 months, the newborn is covered only if specifically included mid-term and requisite premium is paid.","display":"Covered from birth up to 3 months under mother’s available SI; then only if included and premium paid","note":null,"quote":"The New Born Baby shall be automatically covered from birth under the Sum Insured available to the mother during the corresponding Policy Period, for up to 3 months of age. On attaining 3 months of age, the New Born Baby shall be covered only if specifically included in the Policy mid-term and requisite premium paid to the Company.","sources":[{"clause":"3.1.7","heading":"Maternity","page":6,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-3-1-7"}],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"quote-verified","value":"In-patient care, pre-hospitalisation and post-hospitalisation expenses for mental illnesses are covered if treatment is at a hospital with a specific department for mental illness and under a qualified psychiatrist or specified qualified practitioner.","display":"In-patient mental illness treatment covered with pre- and post-hospitalisation expenses","note":"Depression and schizophrenia are covered after a 2 years waiting period; psychotherapy not requiring hospitalisation is not covered.","quote":"The Company shall indemnify the Medical Expenses for In-patient Care, Pre-Hospitalisation expenses and Post-Hospitalisation expenses, related to Mental Illnesses, provided the treatment shall be undertaken at a Hospital with a specific department for Mental Illness, under a Medical Practitioner qualified as Psychiatrist","sources":[{"clause":null,"heading":"3.1.9 Mental Illness Cover","page":7,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-3-1-9-mental-illness-cover"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"quote-verified","value":"OPD treatment is excluded.","display":"OPD treatment excluded","note":null,"quote":"Any expenses incurred on Domiciliary Hospitalization and OPD treatment","sources":[{"clause":null,"heading":"5.23. Domiciliary Hospitalization & Out Patient Department (OPD) treatment","page":13,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-5-23-domiciliary-hospitalization-out-patient-dep"}],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"quote-verified","value":"Premium is zone-based and co-payment depends on the premium zone and the treatment zone. Zones are Zone I: Gujarat, Zone II: Delhi, Delhi NCR, Maharashtra, Chennai, Hyderabad and Indore, and Zone III: Rest of India.","display":"Yes. Zone-based premium and co-pay by treatment zone","note":"The policy wording says “four zones” but then lists Zone I, Zone II and Zone III.","quote":"Depending upon the zone for which premium has been paid and the zone where treatment has been taken, Copayment shall apply.\n* The country has been divided into four zones. Zone I – Entire state of Gujarat Zone II – Delhi, Delhi NCR, Maharashtra, Chennai, Hyderabad, Indore Zone III – Rest of India","sources":[{"clause":"6.17.7","heading":"Classification of Zone and Copayment","page":17,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-6-17-7"}],"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 facility can be availed if TPA service is opted. Treatment may be taken in a network provider/PPN or any other provider and is subject to pre-authorisation by the TPA.","display":"Available if TPA service is opted, subject to TPA pre-authorisation","note":"If claims are serviced by the Company rather than TPA, the prospectus says Cashless Facility shall not be available.","quote":"Cashless Facility can be availed, if TPA service is opted.\nii) Treatment may be taken in a network provider / PPN or any other provider and is subject to pre-authorisation by the TPA.","sources":[{"clause":"6.17.2","heading":"Procedure for Cashless Claims","page":16,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-6-17-2"}],"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 TPA if TPA service is opted, or by the Company if claim is processed by the Company. TPA services include claim admissions and assessments, pre-authorisation of cashless treatment and processing of non-cashless claims, but not claim settlement or rejection.","display":"TPA if opted, otherwise Company; TPA 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":"6.17.1","heading":"Notification of Claim","page":16,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-6-17-1"},{"clause":"6.17.6","heading":"Services Offered by TPA","page":17,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949#c-6-17-6"}],"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":true,"display":"Yes, Floater Basis with common Basic Sum Insured and Cumulative Bonus","note":"Minimum 2 insured persons must be covered on floater basis.","quote":"Floater Basis (i.e., common Basic Sum Insured and Cumulative Bonus shall apply on all Insured Persons)","sources":[{"clause":null,"heading":"2.1 Type of Policy","page":6,"url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/13041#c-2-1-type-of-policy"}],"law":[]}],"documents":[{"kind":"wording","label":"NYIMP Wordings","pages":21,"fetched_at":"2026-10-17 19:55:16+00","source_url":"https://nationalinsurance.nic.co.in/sites/default/files/2026-06/NYIMP%20Wordings.pdf","url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/12949"},{"kind":"prospectus","label":"NYIMP Prospectus","pages":24,"fetched_at":"2026-10-17 19:57:56+00","source_url":"https://nationalinsurance.nic.co.in/sites/default/files/2026-06/NYIMP%20Prospectus.pdf","url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/13041"},{"kind":"cis","label":"NYIMP CIS","pages":7,"fetched_at":"2026-10-17 20:00:42+00","source_url":"https://nationalinsurance.nic.co.in/sites/default/files/2026-04/NYIMP%20CIS.pdf","url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/13134"},{"kind":"premium","label":"NYIMP Rate Chart","pages":null,"fetched_at":"2026-10-17 19:51:16+00","source_url":"https://nationalinsurance.nic.co.in/sites/default/files/2026-04/NYIMP%20Rate%20Chart.pdf","url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/30361"},{"kind":"proposal","label":"NYIMP Proposal","pages":null,"fetched_at":"2026-10-17 19:59:56+00","source_url":"https://nationalinsurance.nic.co.in/sites/default/files/2026-04/NYIMP-Proposal.pdf","url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/30379"},{"kind":"claim-form","label":"NYIMP Claim Form","pages":null,"fetched_at":"2026-10-17 20:01:06+00","source_url":"https://nationalinsurance.nic.co.in/sites/default/files/2026-04/NYIMP%20Claim%20Form.pdf","url":"https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324/document/30396"}],"versions":[],"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 Young India Mediclaim Policy (UIN NICHLIP24005V022324), IndiaInsurances, https://indiainsurances.com/policy/national-insurance/national-young-india-mediclaim-policy-nichlip24005v022324"}