Frequently Asked Questions

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FAQs
  • What is the eligibility criteria for buying this policy??

    You can insure anyone from 91 days old to 70 years old. The maximum age for a dependent child in the policy is 30 years

  • How much sum can I insure?

    You can insure yourself and your family for the following sum: Rs. 2/3/4/5/6/7/8/9/10/15/20/25/50/75/100 lakhs. Choose the amount which best suits your needs.

  • Who all can I add to one policy?

    "You can add the following family members to the policy: - Yourself - Spouse - Dependent children - Your parents or your parents-in-law The maximum number of adults in a policy cannot be more than 2."

  • How is the premium calculated?

    The premium for this policy depends on certain factors including Age, Members added, Sum Insured, Policy tenure, the health status of the individual and Optional Covers opted.

  • What if a member has pre-existing condition?

    You should declare the pre-exisitng conditions, if any, for all the members included in the policy. We will issue a policy according to our Underwriting Guidelines. There may be some increase in the premium in some cases and 1 to 3 years waiting periods for the pre-exisiting diseases.

  • Can I purchase more than one policy?

    Yes, you can purchase multiple policies with us.

  • My/My family member's illness is not mentioned here, what do I do?

    Don't worry, you can select the 'None of the Above' option from the list of illnesses and proceed with the rest of your application on the app.

  • What are the benefits covered by this policy?

    You can check out the amazing benefits of the Navi Health Insurance policy : If you buy a new policy with us, we offer you these amazing benefits: Inpatient Hospitalisation - Single Room (No Room Rent restriction)
    Day-care treatment
    Pre and Post Hospitalisation Expenses
    Free and Unlimited Online Consultation
    Daily cash for shared room occupancy
    Domicilliary Hospitalisation
    Reinstatement of Sum Insured
    Health Care & Wellness Benefits
    Emergency Road Ambulance
    Reduced Waiting Period for Existing and Specified Illness
    No Claim Bonus for a claim-free Policy year and many more

  • Is COVID19 hospitalisation covered?

    Yes, we pay for COVID-19 hospitalisation after 30 days waiting period from the purchase of the policy.

  • What services are included in daycare treatments?

    Daycare treatments include medical treatments or surgical procedures, which used to take longer than 24 hours, can now be completed within a day with the advancement of technology. Some examples of daycare treatment are Colonoscopy, Dialysis, etc.

  • What is no room rent capping?

    There’s no upper limit on Room rent for single occupancy, which includes associated medical expenses like air-conditioner charges, housekeeping charges, luxury tax, etc. You can choose any room of your preference for the treatment.

  • What is no co-pay?

    We offer you no co-pay coverage, which means we pay 100% of your hospitalisation up to the sum insured.

  • What is the free refill of the cover amount?

    In case of an unfortunate event where you claim the entire sum insured in a policy year, we provide you with a 100% refill of the cover amount, which you can use again for another hospitalisation claim. You will have to wait for 45 days after refill to claim this amount.

  • What is a cumulative bonus?

    If you’ve been safe and healthy and have had No Claims made, you would be eligible for a Cumulative Bonus of 25% or 50% of sum insured at the time of renewal upto maximum of 100% of base sum insured depending upon your plan. This cumulative bonus increases your sum insured without any premium increase.

  • When should I submit Pre and Post Hospitalisation Claims?

    You should submit the Pre – Post hospitalisation claim documents within 15 days of completion of Post-hospitalisation treatment or period, whichever is earlier.

  • How do maternity and newborn baby cover work?

    To ease your journey into parenthood, we encourage you to opt for maternity and newborn baby benefit. We pay additional coverage up to ₹30,000 for up to 2 deliveries/lawful termination of pregnancy after a 3-year waiting period. We also pay up to ₹10,000 for the newborn baby hospitalisation expenses.

  • Can I claim a tax exemption for the premium paid for a health insurance plan?

    Yes! You will be eligible to claim tax benefits, under Section 80D of the Income Tax Act, 1961, up to the amount of premium paid in that financial year.

  • What is a Monthly Premium plan?

    We offer you the flexibility to pay the premium on a monthly basis instead of paying the entire premium at once.

  • How are Monthly Premiums calculated?

    Your monthly Monthly Premium is calculated by dividing the total premium by the number of months without any additional cost.

  • When does my cover start if I opt for an Monthly Premium plan?

    You will have to wait for a period of 30 days, from the first Monthly Premium payment, before your policy starts covering you. In the case of a pre-existing disease or specific disease, the waiting period starts from the first Monthly Premium payment. There is no waiting period in case of an accident.

  • Will I be eligible for a claim before paying all Monthly Premiums?

    You can raise a claim even if some of your Monthly Premiums are pending. We will deduct the amount of balance Monthly Premiums while settling the claim.

  • What if I forget to pay my monthly Monthly Premium before the due date?

    We will send you timely reminders before the due date of the monthly Monthly Premium so that you don't miss out. Even then if you are unable to pay the Monthly Premium before the due date, we give you a grace period of 15 days to pay your Monthly Premium. You will not be covered during the grace period. If you don't pay the Monthly Premium even in the grace period, your policy will lapse.

  • What is a grace period?

    If you are unable to pay the Monthly Premium before the due date, we give you a period of 15 days to pay your Monthly Premium, this period is called the grace period. You will not be covered during the grace period. If you don't pay the Monthly Premium even in the grace period, your policy will lapse.

  • Will I be eligible for a claim in the grace period?

    No, you can not raise a claim during the grace period unless you pay the due Monthly Premium.

  • How can I initiate a claim?

    To initiate a claim you can go to the policy card in our app, click on "Make Claim" and select the call option from there. We'll help you with the next steps.

  • In which hospitals can I get a Cashless claim?

    You can make a Cashless claim in any of our 10,000+ network hospitals. To find out your nearest network hospital, click here.

  • Which are the documents needed for reimbursement of the claim?

    We’ll need signed copies of the following documents: - Claim form - Original Medical records (like Hospital Main Bill along with break up Bill and original receipts, Discharge/Death Summary, Doctors Reference Slips for Investigations/Pharmacy, Original Pharmacy Bills, etc) - KYC documents (Photo ID proof, Pan Card, Aadhar Card) - A cancelled cheque for NEFT payment

  • What is the maximum number of claims allowed in a year?

    There is no limit on the number of claims you can raise in a year as long as you have the balance sum insured.

  • Would there be any process to be followed at discharge?

    At the time of discharge, the Network Hospital may forward a final request for authorization for any residual amount to us along with the discharge summary and the billing format. Upon receipt of the final authorisation letter, you may be discharged by the Network Hospital. Please ensure that you have signed the pre-authorization form at the time of admission and the final hospital bill at the time of discharge.

  • What if I’m admitted to a non-network hospital? How will I get the claim?

    If you are admitted to a non-network hospital, you can raise a request for a reimbursement claim. Submit the required documents to us and we'll reimburse your hospitalisation expenses.

  • Who should I contact in a hospital for claims?

    When in a network hospital, you can reach out to the Insurance/TPA desk for any claim related help.

  • Where can I see my balance Monthly Premiums for a policy?

    You can check your balance Monthly Premiums in the Monthly Premium schedule in the app after purchasing the policy.

  • What is health insurance?

    "A health insurance policy covers medical expenses incurred due to accidents, illness or injury. You can buy our insurance policy by paying small monthly premium for 1, 2 or 3 years tenure. During this period, if you meet with an accident or are diagnosed with a severe ailment, we pay the expenses incurred for treatment purposes.
    If you buy a new policy with us, we offer you these amazing benefits: Inpatient Hospitalisation - Single Room (No Room Rent restriction)
    Day-care treatment
    Pre and Post Hospitalisation Expenses
    Free and Unlimited Online Consultation
    Daily cash for shared room occupancy
    Domicilliary Hospitalisation
    Reinstatement of Sum Insured
    Health Care & Wellness Benefits
    Emergency Road Ambulance
    Reduced Waiting Period for Existing and Specified Illness
    No Claim Bonus for a claim free Policy year and many more."

  • What is a claim?

    When you are hospitalised and want to us pay, you can raise a request for payment by calling us via app or you can simply to go the Insurance/TPA desk in a hospital. This request for payment is called a claim.

  • What is a cashless claim?

    A cashless claim is when you are hospitalised at one of our 10,000+ network hospitals, you don't need to pay cash for medical treatment and hospitalisation expenses. We will directly pay the hospital.

  • What is a reimbursement claim?

    A reimbursement claim is when you pay the hospital for medical treatment & hospitalisation expenses and we pay you back the bills after discharge.

  • What are network hospitals?

    "Hospitals with which we or our TPA has tie-up to protect you from the long process of collecting and submitting documents for reimbursement are called network hospitals. If you are hospitalised at one of the network hospitals, you can raise a cashless claim.
    You can find your nearest network hospital here."

  • What is a pre-existing disease?

    Pre-existing disease is a medical condition that already exists when one is purchasing a health insurance policy. Medical conditions such as high blood pressure, diabetes, thyroid, asthma, depression, etc., are considered pre existing ailments.

  • What is the Annual Sum Insured?

    Annual Sum Insured is the maximum amount that we’ll pay in case you are hospitalised. You can choose a sum insured from Rs. 2 lakhs up to Rs. 1 Crore

  • What is the Waiting Period in a health insurance plan?

    ​​The waiting period is the time span during which you cannot claim some or all benefits of the health insurance. You must wait for a specified amount of time before you make a claim. You can refer to your policy document to know your exact waiting periods.

  • What do you mean by Premium?

    "Premium is the small cost we charge you so that we can provide you with the best benefits and coverage in case of hospitalisation. You can either pay this amount in one go or you can opt for easy Monthly Premiums. You can check your premium now by giving us a few details"

  • What does Critical Illness insurance mean?

    Under this coverage, we cover you and your family against critical diseases such as stroke, heart attack, kidney failure, amongst others. You can add this cover separately as an Add-on while buying a policy.

  • What does permanent exclusion mean?

    There are some diseases which we will not cover in the health insurance policy. These diseases are specified in your policy schedule.

  • Where can I find more information about the policy?

    You can find more about this policy in the Policy Prospectus and the Policy Wordings documents. You can also reach out to us at 18001230004 to clear your doubts.

  • Can I make changes to the policy after purchasing?

    Yes, please write to us at insurance.help@navi.com about the changes you want to make to your policy. We'll get back to you shortly. We can make changes to the policy according to the Underwriting Guidelines of the Company.

  • I entered the wrong DOB. Can I update it?

    Don't worry if you made a mistake while entering your DOB. You can write to us at insurance.help@navi.com for correction. We'll get back to you shortly.

  • Can I add family members to this policy?

    Yes, you can add a family member after purchasing the policy. To add a family member, you can write to us at insurance.help@navi.com. We'll get back to you shortly.

  • Can I remove family members from this policy?

    Yes, you can remove a family member after purchasing the policy. To remove a family member, you can write to us at insurance.help@navi.com. We'll get back to you shortly.

  • Can I renew this policy for a lifetime?

    Yes, you can renew this policy for the lifetime of the members covered in the policy. For a dependent child, the policy can be renewed up to the age of 30 years.

  • Will my premium increase on renewal?

    The premium calculation at the time of renewal depends upon several factors. At the time of renewal, you may increase the sum insured, add a family member or opt for new add-on covers, these changes can lead to an increase in your renewal premium.

  • Can I cancel this policy after purchase?

    We'll be sorry to see you go. But, yes, you can choose to discontinue your policy anytime. Your refund will be calculated on a pro-rata basis.

  • What is the waiting period for pre-existing diseases?

    The waiting period for pre-existing diseases is 1 to 3 years. To check the exact waiting period for existing illnesses, please refer to your policy schedule.

  • What is the waiting period for COVID-19 hospitalisation?

    The waiting period for COVID-19 hospitalisation is 30 days.

  • Is OPD covered?

    No, your offline doctor consultation is not covered under this policy.

  • Is dental treatment covered?

    We will not cover any kind of dental surgery or treatment unless a dental treatment is required due to an accident, which led to hospitalisation.


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Navi General Insurance Limited
IRDAI Registration No: 155 | CIN: U66000KA2016PLC148551