{"uin":"NICHLIP24154V042324","name":"National Super Top Up Mediclaim Policy","url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324","insurer":{"slug":"national-insurance","name":"National Insurance Company Limited","url":"https://indiainsurances.com/insurer/national-insurance"},"line":"health","category":"health-topup","category_name":"Top-up and super top-up","irdai_type":"New","kind":"product","status":"active","approved_on":"2019-07-30","withdrawn_on":null,"summary":"National Super Top Up Mediclaim Policy is a high threshold indemnity health insurance product on individual or floater basis that pays admissible hospitalisation claims after cumulative medical expenses exceed the chosen threshold. It offers thresholds from ₹2 Lakhs to ₹20 Lakhs, sum insured options up to ₹80 Lakhs, a 30-day initial waiting period and PED cover starting after 12 months with 100% payable after 36 months.","analysis":{"state":"machine","analysed_at":"2026-10-19 21:48:45.701454+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","Floater"],"display":"Individual and Floater","note":null,"quote":"Plan | Individual | Floater","sources":[{"clause":null,"heading":"No loading shall apply on renewals based on individual claims experience","page":17,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-no-loading-shall-apply-on-renewals-based-on-indi"}],"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 period can be one year, two years or three years, as mentioned in the schedule.","display":"1 year, 2 years or 3 years","note":null,"quote":"Policy Period means period of one year, two years or three years as mentioned in the Schedule for which the Policy is issued.","sources":[{"clause":"2.42","heading":"Policy Period","page":4,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-2-42"}],"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, inform the TPA or Company at least 72 hours before admission. For emergency hospitalisation, inform within 24 hours of admission; if expenses were not initially expected to cross the threshold but later do, notify immediately.","display":"Planned: at least 72 hours before admission; emergency: within 24 hours of admission; if threshold is later crossed: immediately","note":null,"quote":"In the event of planned Hospitalisation | At least seventy two hours prior to the Insured Person’s admission to Network Provider\nIn the event of emergency Hospitalisation | Within twenty four hours of the Insured Person’s admission to Network Provider ... In the event of planned Hospitalisation | At least seventy two hours prior to the Insured Person’s admission to Hospital\nIn the event of emergency Hospitalisation | Within twenty four hours of the Insured Person’s admission to Hospital ... In case of Hospitalisation where initially the Cumulative Medical Expenses are not foreseen to exceed the Threshold but subsequently exceeds the Threshold, notification of claim shall be sent to the TPA mentioned in the Schedule/ Company, immediately.","sources":[{"clause":"6.17.2","heading":"Notification of Claim","page":14,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-6-17-2"}],"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.","Bills, receipt from the Hospital(s)/ chemist(s) supported by prescription from attending Medical Practitioner","Bills, receipt, investigation test reports etc. supported by prescription from attending Medical Practitioner","Attending Medical Practitioner’s certificate regarding diagnosis along with date of diagnosis and bill, receipts etc.","Certificate from the surgeon regarding diagnosis and nature of operation and bills, receipts etc.","Bills, receipt, sticker of the implants.","Bills, payment receipts, medical history of the patient recorded, indoor case papers, discharge certificate/ summary, break-up of final bill from the Hospital etc.","Documents relating to previous Hospitalisation(s) in the Policy Year along with claim settlement advice (if any)","Any other relevant document required by Company/TPA for assessment of the claim."],"display":"Claim form, admission prescription, hospital/chemist bills and receipts, investigation reports, diagnosis certificate, surgeon certificate, implant sticker, case papers/discharge summary/final bill break-up, previous hospitalisation documents and any other relevant document required by Company/TPA","note":null,"quote":"i) Completed claim form ... ii) Medical Practitioner’s prescription advising admission for inpatient treatment. ... iii) Bills, receipt from the Hospital(s)/ chemist(s) supported by prescription from attending Medical Practitioner for period of pre- Hospitalisation, Hospitalisation and post-Hospitalisation (if applicable) ... iv) Bills, receipt, investigation test reports etc. supported by prescription from attending Medical Practitioner for period of pre- Hospitalisation, Hospitalisation and post-Hospitalisation (if applicable) ... v) Attending Medical Practitioner’s certificate regarding diagnosis along with date of diagnosis and bill, receipts etc. ... vi) Certificate from the surgeon regarding diagnosis and nature of operation and bills, receipts etc. ... vii) Bills, receipt, sticker of the implants. ... viii) Bills, payment receipts, medical history of the patient recorded, indoor case papers, discharge certificate/ summary, break-up of final bill from the Hospital etc. ... ix) Documents as listed under Sl. No 6.17.5 (ii) to 6.17.5 (viii) relating to previous Hospitalisation(s) in the Policy Year during the Policy Period along with claim settlement advice (if any), in original or certified copy. ... x) Any other relevant document required by Company/TPA for assessment of the claim.","sources":[{"clause":"6.17.5(i)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-6-17-5-i"},{"clause":"6.17.5(ii)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-6-17-5-ii"},{"clause":"6.17.5(iii)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-6-17-5-iii"},{"clause":"6.17.5(iv)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-6-17-5-iv"},{"clause":"6.17.5(v)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-6-17-5-v"},{"clause":"6.17.5(vi)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-6-17-5-vi"},{"clause":"6.17.5(vii)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-6-17-5-vii"},{"clause":"6.17.5(viii)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-6-17-5-viii"},{"clause":"6.17.5(ix)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-6-17-5-ix"},{"clause":"6.17.5(x)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-6-17-5-x"}],"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 will settle or reject a claim within 15 days from receipt of the last necessary document. If investigation is needed it must be completed within 30 days and the claim settled or rejected within 45 days from receipt of the last necessary document; delay beyond the stipulated time carries interest at 2% above the bank rate.","display":"15 days from last necessary document; investigation cases: settle/reject within 45 days, with investigation completed within 30 days","note":null,"quote":"i) 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. ... iii) However, 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. ... iv) In case of delay beyond stipulated 45 days, the Company shall be liable to pay interest to the Insured at a rate 2% above the bank rate from the date of receipt of last necessary document to the date of payment of claim.","sources":[{"clause":"6.3(i)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-6-3-i"},{"clause":"6.3(iii)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-6-3-iii"},{"clause":"6.3(iv)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-6-3-iv"}],"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)","Specified 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)","Drug/ Alcohol Abuse (Excl 12)","Out-Patient Department (OPD) or Domiciliary treatment","Treatment taken outside the geographical limits of India"],"display":"Pre-existing diseases, specified disease/procedure waiting periods, first 30 days waiting period, investigation and evaluation, rest cure/rehabilitation/respite care, change-of-gender treatments, cosmetic or plastic surgery, professional hazardous/adventure sports, breach of law, drug/alcohol abuse, OPD or domiciliary treatment and treatment outside India","note":null,"quote":"Pre-Existing Diseases (Excl 01) ... Specified 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) ... Treatment for alcoholism, drug or substance abuse or any addictive condition and consequences thereof (Excl 12). ... Any expenses incurred on OPD or Domiciliary treatment. ... Treatment taken outside the geographical limits of India","sources":[{"clause":"4.1","heading":"Pre-Existing Diseases (Excl 01)","page":9,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-4-1"},{"clause":"4.2","heading":"Specified disease/procedure waiting period (Excl 02)","page":9,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-4-2"},{"clause":"4.3","heading":"First 30 days waiting period (Excl 03)","page":10,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-4-3"},{"clause":"4.4","heading":"Investigation & Evaluation (Excl 04)","page":10,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-4-4"},{"clause":"4.5","heading":"Rest Cure, Rehabilitation and Respite Care (Excl 05)","page":10,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-4-5"},{"clause":"4.7","heading":"Change-of-Gender Treatments (Excl 07)","page":10,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-4-7"},{"clause":"4.8","heading":"Cosmetic or Plastic Surgery (Excl 08)","page":10,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-4-8"},{"clause":"4.9","heading":"Hazardous or Adventure Sports (Excl 09)","page":10,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-4-9"},{"clause":"4.10","heading":"Breach of Law (Excl 10)","page":10,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-4-10"},{"clause":"4.12","heading":"Drug/ Alcohol Abuse (Excl 12)","page":10,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-4-12"},{"clause":"5.9","heading":"Out-Patient Department (OPD) or Domiciliary treatment","page":11,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-5-9"},{"clause":"5.20","heading":"Treatment taken outside the geographical limits of India","page":12,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-5-20"}],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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, and does not apply if the insured person has continuous coverage for more than twelve (12) months.","quote":"a) Expenses related to the treatment of any Illness within thirty (30) days from the date of commencement of the first policy shall be excluded, except the claims arising due to an Accident, provided that the same are covered.","sources":[{"clause":"4.3","heading":"First 30 days waiting period (Excl 03)","page":10,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-4-3"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"quote-verified","value":{"unit":"months","amount":12},"display":"12 months; 100% after 36 months","note":"PED coverage after 12 months applies only if the disease was declared at application and accepted by the Company; 13-24 months pays 50% and 25-36 months pays 75% of admissible claim.","quote":"a) Expenses related to the treatment of a Pre-Existing Disease (PED) and its direct complications shall be excluded until the expiry of twelve (12) months of continuous coverage after the date of inception of the first Policy with the Company. ... Months from inception | Limit of claim\n13-24 months | 50% of the admissible claim\n25-36 months | 75% of the admissible claim\nAfter 36 months | 100% of the admissible claim","sources":[{"clause":"4.1(a)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-4-1-a"},{"clause":"4.1(d)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-4-1-d"}],"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; other tiers are one year and two years","note":"The specific waiting periods are 90 days for lifestyle conditions, one year for listed procedures/conditions, and two years for specified conditions. This exclusion does not apply to claims arising due to an accident.","quote":"Expenses related to the treatment of the listed Conditions, surgeries/ treatments shall be excluded until the expiry of 90 days/ one year/ two years (as specified against specific disease/ procedure) of continuous coverage after the date of inception of the first policy with us.","sources":[{"clause":"4.2","heading":"Specified disease/procedure waiting period (Excl 02)","page":9,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-4-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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, 60 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":14,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#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":"conflicting","value":"The policy wording allows the insured person to port the policy to other insurers by applying at least 15 days before, but not earlier than 60 days from, the renewal date. Continuity benefits are given for specific waiting periods, PED waiting period and moratorium, to the extent of previous sum insured and accrued cumulative bonus.","display":"Yes, apply at least 15 days before but not earlier than 60 days from renewal; continuity credit for specific waiting periods, PED waiting and moratorium","note":"The CIS says: \"at least 45 days before, but not earlier than 60 days from the policy renewal date\".","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-\nexisting diseases and Moratorium period of the Insured Person under the previous health insurance Policy. ... Portability benefit will be offered to the extent of Sum Insured and accrued Cumulative Bonus (as part of the sum insured) of the previous policy.","sources":[{"clause":"6.8","heading":"Portability","page":13,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-6-8"},{"clause":"Row 7(iv)","heading":null,"page":5,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/13122#c-row-7-iv"}],"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, renewable provided the product is not withdrawn","note":"Dependent male child and dependent female child renewal limits are stated in the prospectus.","quote":"A health insurance policy shall be renewable provided the product is not withdrawn, except in case of established fraud or non-disclosure or misrepresentation by the Insured.","sources":[{"clause":"6.9","heading":"Renewal of Policy","page":13,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#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 Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"quote-verified","value":"No loading applies on renewals based on individual claims experience, and renewal shall not be denied because the insured made claims in preceding policy years.","display":"No loading on renewal based on individual claims experience","note":null,"quote":"iii) Renewal shall not be denied on the ground that the insured person had made a claim or claims in the preceding policy years. ... vi) No loading shall apply on renewals based on individual claims experience.","sources":[{"clause":"6.9","heading":"Renewal of Policy","page":13,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#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 notice in writing. The Company refunds proportionate premium for the unexpired policy period if no claim has been made; no premium refund is made if any claim has been admitted or lodged or any benefit has been availed.","display":"Proportionate premium refund for unexpired period if no claim; 7 days written notice","note":null,"quote":"The policyholder may cancel his/her policy at any time during the term, by giving 7 days notice in writing. The Company shall refund proportionate premium for unexpired policy period, if there is no claim(s) made during the policy period.\nNotwithstanding anything contained herein or otherwise, 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":13,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-6-6-ii"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"quote-verified","value":"All medical treatment for this insurance must be taken in India only.","display":"India only","note":null,"quote":"All medical treatment for the purpose of this insurance will have to be taken in India only.","sources":[{"clause":"6.19","heading":"Territorial Limit","page":16,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#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":"Applicable on new individual health insurance policies, not on renewals or at the time of porting/migrating.","quote":"The Insured Person shall be allowed Free Look Period of thirty (30) 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":14,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#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":"Continuity benefits for waiting periods and PED coverage are preserved if premium is paid within the grace period, but coverage is not available during the unpaid period.","quote":"The Grace Period for payment of the premium shall be thirty days. In case of Renewal, Coverage shall not be available during the period for which no premium is received.","sources":[{"clause":"2.22","heading":"Grace Period","page":3,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-2-22"}],"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 must be between 18 years and 65 years. Children above 3 months may be covered for the first time, subject to the stated dependent-child limits, and the maximum entry age of any family member is 65 years.","display":"Proposer: 18 to 65 years; children: above 3 months; maximum entry age of any family member: 65 years","note":"For dependent children, the prospectus states male child up to twenty five (25) years or till employed, whichever is earlier, and female child till employed or married.","quote":"iii) Entry age of Proposer should be between eighteen years and sixty five years.\niv) Maximum entry age of any family member is sixty five years.\nv) Children above the entry age of three months may be covered for the first time subject to maximum entry age as mentioned below, provided parent(s) is/are covered at the same time.","sources":[{"clause":"2.1","heading":"Eligibility","page":4,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/13026#c-2-1"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"Coverage is not available during the grace period.","display":"Not available 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":"2.22","heading":"Grace Period","page":3,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-2-22"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"The amount (per claim or per year) that must be crossed before this policy pays. Your base policy or you pay this part.","status":"quote-verified","value":"The threshold is the amount of cumulative medical expenses, chosen by the insured and shown in the schedule, up to which no amount can be claimed. Available threshold options are ₹2 Lakhs, ₹3 Lakhs, ₹5 Lakhs, ₹8 Lakhs, ₹10 Lakhs and ₹20 Lakhs.","display":"Threshold of ₹2, ₹3, ₹5, ₹8, ₹10 or ₹20 Lakhs; no amount can be claimed up to the Threshold","note":"The threshold is chosen along with the corresponding sum insured slab.","quote":"Threshold means the amount of Cumulative Medical Expenses (as per Definition 2.15 of the Policy), as chosen by the Insured and mentioned in the Schedule, up to which no amount can be claimed under this Policy. ... Threshold – Sum Insured (in ₹) | Threshold | Sum Insured\n2 Lakhs | 3,5,7 Lakhs\n3 Lakhs | 3,5,7,10 Lakhs\n5 Lakhs | 5,7,10,15 Lakhs\n8 Lakhs | 8,10,15,20 Lakhs\n10 Lakhs | 10,15,20,30 Lakhs\n20 Lakhs | 20,30,50,80 Lakhs","sources":[{"clause":"2.57","heading":"Threshold","page":5,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-2-57"},{"clause":null,"heading":"No loading shall apply on renewals based on individual claims experience","page":17,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-no-loading-shall-apply-on-renewals-based-on-indi"}],"law":[]},{"key":"deductible_basis","label":"Per claim or aggregate","section":"Limits and co-pay","meaning":"Top-up: deductible applies to each claim. Super top-up: to the total of all claims in the year.","status":"quote-verified","value":"aggregate","display":"Aggregate of medical expenses during the Policy Year","note":null,"quote":"Cumulative Medical Expenses means the aggregate of Medical Expenses incurred during the Policy Year of the Policy Period of this Policy towards one or more out of the Coverage mentioned in Section 3.1 of the Policy ... Claim shall be admissible for the Hospitalisation during which the Cumulative Medical Expenses in respect of Hospitalisation(s) of any Insured Person (individual plan) or one or more Insured Persons (floater plan) in a Policy Year of the Policy Period exceeds the Threshold and for all subsequent Hospitalisation(s) during the Policy Year.","sources":[{"clause":"2.15","heading":"Cumulative Medical Expenses","page":2,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-2-15"},{"clause":"1(b)","heading":null,"page":1,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-1-b"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"Daily room limit, if any.","status":"quote-verified","value":"Room rent is covered under in-patient treatment and the Table of Benefits states in-patient treatment is up to the sum insured with no sub-limits.","display":"Up to Sum Insured, no sub-limits","note":null,"quote":"i) Room Rent and Intensive Care Unit Charges (including diet charges, nursing care by qualified nurse, RMO charges, administration charges for IV fluids/ blood transfusion/ injection) ... In patient Treatment | Up to Sum Insured, No sub limits","sources":[{"clause":"3.1.1","heading":"In-patient Treatment","page":5,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-3-1-1"},{"clause":null,"heading":"No loading shall apply on renewals based on individual claims experience","page":17,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-no-loading-shall-apply-on-renewals-based-on-indi"}],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"Share of each admissible claim you pay.","status":"quote-verified","value":"The Customer Information Sheet states co-payment is none.","display":"None","note":"The policy separately has threshold and loss-sharing for PED and some specified conditions; this field is for a general co-payment.","quote":"ii. Co-payment (It is a specified amount/perc entage of the admissible claim amount to be paid by policyholder/i nsured). iii. Deductible iv. Any other limit | Lakh, ₹ 2,000 per day for 10 days per individual None None None","sources":[{"clause":"Row 7","heading":"Waiting period","page":2,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/13122#c-row-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 is available if TPA service is opted. Treatment may be taken in a Network Provider/PPN or any other provider, subject to pre-authorisation by the TPA; the first claim must be supported by evidence that cumulative medical expenses exceed the threshold.","display":"Yes, if TPA service is opted; subject to TPA pre-authorisation at Network Provider/PPN or any other provider","note":null,"quote":"For the first claim under the Policy (i.e. the claim in which Cumulative Medical Expenses exceeds the Threshold) cashless facility shall be available provided that all evidences and documents are produced prior to cashless authorisation, to substantiate that the Cumulative Medical Expenses (CME) exceeds the Threshold. ... Cashless facility for treatment 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.","sources":[{"clause":"6.17.3","heading":"Procedure for Cashless Claims","page":15,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-6-17-3"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"quote-verified","value":"Claims may be processed by the TPA if TPA service is opted, or by the Company if claim is processed by the Company. TPA may handle claims admission and recommend settlement, but claim settlement and rejection are not TPA services.","display":"TPA if TPA service is opted; otherwise the Company","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 under health insurance policies by way of pre-authorisation of cashless treatment or settlement of claims other than cashless claims or both ... i) Claim settlement and claim rejection. However, TPA may handle claims admission and recommend to the Company for settlement of the claim.","sources":[{"clause":"6.17.2","heading":"Notification of Claim","page":14,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#c-6-17-2"},{"clause":"6.17.6","heading":"Services Offered by TPA","page":16,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938#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 a single sum insured for family members","note":null,"quote":"National Super Top Up Mediclaim Policy is a high threshold indemnity health insurance product, covering the members of a family under a single sum insured on floater basis or each member on individual sum insured basis.","sources":[{"clause":"1.1","heading":"Product","page":1,"url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/13026#c-1-1"}],"law":[]}],"documents":[{"kind":"wording","label":"NSTUMP Policy Wordings","pages":21,"fetched_at":"2026-10-17 19:54:54+00","source_url":"https://nationalinsurance.nic.co.in/sites/default/files/2026-04/NSTUMP%20Wordings.pdf","url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/12938"},{"kind":"wording","label":"National Super Top Up Mediclaim Policy (IRDAI copy)","pages":23,"fetched_at":"2026-10-20 02:30:57+00","source_url":"https://irdai.gov.in/documents/37343/931203/NICHLIP19042V021920_2019-2020.pdf/4f7bfa7d-f03e-2eff-9eca-809813e47c5f?version=1.1&t=1668575568214&download=true","url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/28614"},{"kind":"prospectus","label":"NSTUMP Prospectus","pages":22,"fetched_at":"2026-10-17 19:57:37+00","source_url":"https://nationalinsurance.nic.co.in/sites/default/files/2026-04/NSTUMP%20Prospectus.pdf","url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/13026"},{"kind":"cis","label":"NSTUMP Customer Information Sheet","pages":8,"fetched_at":"2026-10-17 20:00:26+00","source_url":"https://nationalinsurance.nic.co.in/sites/default/files/2026-04/NSTUMP%20CIS.pdf","url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/13122"},{"kind":"premium","label":"NSTUMP - Rate Chart","pages":null,"fetched_at":"2026-10-17 19:50:47+00","source_url":"https://nationalinsurance.nic.co.in/sites/default/files/2026-04/NSTUMP%20Rate%20Chart.pdf","url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/30358"},{"kind":"proposal","label":"NSTUMP - Proposal Form","pages":null,"fetched_at":"2026-10-17 19:59:41+00","source_url":"https://nationalinsurance.nic.co.in/sites/default/files/2026-04/NSTUMP%20Proposal.pdf","url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/30376"},{"kind":"claim-form","label":"NSTUMP - Claim Form","pages":null,"fetched_at":"2026-10-17 20:00:51+00","source_url":"https://nationalinsurance.nic.co.in/sites/default/files/2026-04/NSTUMP%20-%20Claim%20Form.pdf","url":"https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324/document/30391"}],"versions":[{"uin":"NICHLIP19042V021920","version":null,"approved_on":null},{"uin":"NICHLIP24154V042324","version":null,"approved_on":null}],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"National Insurance official website","url":"https://nationalinsurance.nic.co.in","note":"Website as listed by IRDAI. Not checked: the site could not be reached from our crawler on 2026-10-19 (connection or TLS error)."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"National Super Top Up Mediclaim Policy (UIN NICHLIP24154V042324), IndiaInsurances, https://indiainsurances.com/policy/national-insurance/national-super-top-up-mediclaim-policy-nichlip24154v042324"}