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    Mera Mediclaim Plan

    Good health leads to a good life! We insure both!

    Individual Non-Linked, Non Participating, Pure Risk Premium, combi Insurance Plan | UIN: 117Y102V01

    With Mera Mediclaim Plan, PNB MetLife Insurance (PMLI) and Care Health Insurance Limited (Formerly known as Religare Health Insurance Company Limited) have joined hands so that you can secure your loved ones against rising living expenses and health expenses, allowing them to live their lives to their absolute best. Help them live the life you envision for them, even in your absence. 

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    Mera Mediclaim Plan

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    Mera Mediclaim Plan in a nutshell
    • Life cover with inbuilt Terminal Illness Rider
    • Family Cover under health benefit
    • 7.5% discount on premiums
    • Up to 150% increase in Sum Insured with NCB & NCB – Super
    • Automatic recharge of Sum Insured

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    What you get

    The best of Health Benefits
    Hospitalisation

    Hospitalisation

    The most essential medical expense need, covered with a comprehensive plan.

    Health check up

    Health check up


    Keep your loved ones in the pink of health with regular health check-ups covered under this plan.

    Ambulance

    Ambulance

     In an emergency, you shouldn’t have to worry about expenses. Just your health.

    Organ donation

    Organ donation

    Secure yourself against organ transplant expenses with a cover for organ donation.

    AYUSH

    AYUSH

    Get covered for alternative medical therapies from our network hospitals.

    Under this plan, you will be covered for:

    • Pre-hospitalisation for a maximum of 30 days
    • Post-hospitalisation for a maximum of 60 days
    • Domiciliary Hospitalisation for up to 10% of the sum insured

    Our prime concern is your good health! To ensure this, we provide you preventive care, over and above the amount of Sum Insured. Our annual check-up benefit covers,

    • An annual health check-up at our Network Provider or other Service Providers speci­fically impaneled with us to provide the services in India
    • All Insured Persons covered under the Policy, on a cashless basis.
    • One check up per year per Insured Person.

    Our aim is to ensure that you get the medical attention that you require as soon as possible, especially in an emergency.

    To make sure that your needs are met:

    • We will pay you up to a speci­fied amount per hospitalisation
    • Payment will be done for expenses incurred on an ambulance service
    • We will also pay your necessary transportation fares from one hospital to another hospital
    • Payment is ensured for advanced/better equipped medical support/aid required for rescuing your health condition.

     We care about those who help you as much as we care for you. So, beyond ensuring that your medical needs are met, we will:

    • Pay you up to a specifi­ed amount for medical expenses incurred by you towards your organ donor
    • Payment will be made for medical expenses while undergoing the organ transplant surgery
    • The donation needs to conform to the Transplantation of Human Organs Act 1994 (amended).

    At times, a combination of conventional medical treatment and alternative therapies quicken & aid the process of recovery. Our Alternative Treatments Benefit covers:

    • Medical expenses incurred by you towards your in-patient admission in a Government Hospital or in any institute recognized by Government.
    • Ayurveda, Unani, Siddha, and Homeopathy.
    Partnership with Care Health Insurance Limited
    • PNB MetLife Insurance (PMLI) and Care Health Insurance Limited (Formerly known as Religare Health Insurance Company Limited) have joined hands to help you in protecting you and your family's health and ensuring a secure financial future for your loved ones. Mera Mediclaim Plan is a solution that offers you the benefits of both health and life insurance in a single plan. It’s simple, comprehensive and flexible. The health insurance benefit under the plan is offered by Care Health Insurance Limited (Formerly known as Religare Health Insurance Company Limited) and the life cover is offered by PNB MetLife India Insurance Company Limited. Our dual benefit insurance plan has been crafted through our partnership with one of India’s most trusted health insurance brands, Care Health Insurance Limited (Formerly known as Religare Health Insurance Company Limited). Through this alliance we aim to help families live a fulfilling life without fear of debt, medical expenses, or financial hardships so they can fulfil their dreams and achieve their goals.

    What you don't get

    How can Mera Mediclaim Plan benefit you?

    With its dual benefit of health & life cover, Mera Mediclaim Plan can help you counter life & medical expenses. Find out how!

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    Frequently Asked Questions

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    What is special about Mera Mediclaim Plan

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    Mera Mediclaim Plan Mera Mediclaim Plan

    What are the Health Benefits offered under Mera Mediclaim Plan?

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    With Mera Mediclaim Plan you get:

    • Comprehensive in-patient hospitalisation and cover for more than 540 day-care treatments
    • Up to 150% increase in Sum Insured in 5 claim-free years with No Claim Bonus & No Claim Bonus – Super (Optional Cover)
    • Automatic Recharge of Sum Insured – reinstate your entire Sum Insured amount when it gets exhausted due to a claim (With Optional Cover ‘Unlimited Automatic Recharge’ you can avail this unlimited times)
    • Annual Health Check-up for all insured members including children
    • Cashless Hospitalisation at more than 7500 network hospitals
    Features Sum Insured
    5, 10 Lacs 15, 25 Lacs
    In-Patient Hospitalization

    Upto Sum Insured

    Upto Sum Insured

    Pre-hospitalization

    30 Days

    30 Days

    Post-hospitalization

    60 Days

    60 Days

    Day Care

    Yes

    Yes

    Room Rent

    Single Private Room

    Single Private Room

    (upgradable to next level)
    ICU Charges

    No Limit

    No Limit

    Ambulance Cover

    Upto Rs.2,000/Hospitalization

    Upto Rs.2,500/Hospitalization

    Domiciliary Hospitalization

    Upto 10% of SI

    Upto 10% of SI

    Health Check-up

    yes

    yes

    Automatic Recharge of Sum Insured

    yes

    yes

    No Claim Bonus

    yes

    yes

    Organ Donor Cover

    Upto Rs.100,000

    Upto Rs.200,000

    Alternative treatments (AYUSH)

    Upto Rs. 20,000

    Upto Rs. 30,000

    *Co-payment during purchase of the first policy, if eldest member insured is

    • Below 61 years, no co-payment is applicable.
    • 61 years or above, 20% of the claim amount under the policy has to be borne by you

    What are the Life Benefits covered in Mera Mediclaim Plan?

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    Insured persons can avail the following benefits under this plan:

    • Protection against Death and Terminal Illness
    • Special rates for women
    • Death or Terminal Illness Benefit shall be payable in the event of Death or Diagnosis of Terminal Illness during the policy term. The policy shall cease upon payment of this benefit.

    What floater combinations are offered by Mera Mediclaim Plan?

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    How can you cover yourself

    Individual basis (maximum up to 6 Persons having equal Sum Insured) or Floater basis

    Floater combinations

    1 Adult + 1 Child OR 1 Adult + 2 Children OR 1 Adult + 3 Children OR 1 Adult + 4 Children OR 2 Adults
    + 1 Child OR 2 Adults + 2 Children OR 2 Adults + 3 Children OR 2 Adults + 4 Children

    Who are covered (Relationship with respect to the Proposer)

    1. Individual: Self, legally married spouse, son, daughter, father, mother, brother, sister, mother-in-law, father-in law, grandmother, grandfather, grandson, granddaughter, uncle, aunt, nephew, niece, employee or any other relationship having an insurable interest.

    2. Family Floater: Self, Legally married spouse, son, daughter, father, mother, employee and his/her dependents (Legally married Spouse, Children & Parents) or any other relationship having an insurable interest.

    Please note:

    • Child would be ported to an individual policy (having a separate Sum Insured) and treated as an adult Insured Person, upon attaining 25 years of age, at the time of renewal.
    • All the age calculations are as per “Age Last Birthday” as on the date of first issue of Policy and / or at the time of Renewal.
    • Option of Mid-term inclusion of a Person in the Policy will be only upon marriage or childbirth; Additional differential premium will be calculated on a pro rata basis.
    • If Insured persons belonging to the same family are covered on an Individual basis, then every Insured person can opt for different Sum Insured and different Optional Covers.

    What are the exclusions under Mera Mediclaim Plan?

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    The following are the exclusions under this plan:

    • Expenses attributable to self-inflicted injury (resulting from suicide, attempted suicide).
    • Expenses arising out of or attributable to alcohol or drug use/misuse/abuse
    • Treatment arising from or traceable to pregnancy and childbirth, miscarriage, abortion and its consequences
    • External Congenital disease
    • Tests and treatment relating to infertility and in vitro fertilization
    • War, riot, strike, nuclear weapons induced Hospitalisation

    What is the waiting period for Mera Mediclaim Plan?

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    • Initial Waiting period of 30 days for any illness except injury
    • For Pre-existing diseases, waiting period of four years of continuous coverage is applicable

    What are the eligibility criteria for Mera Mediclaim Plan?

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    To be eligible for this plan, a person must conform to the following conditions and criteria:

    Life Insurance Component

    • The minimum age of enrolment for the life insurance component is 18 years while the maximum age is 65 years.
    • The maximum age at the time of maturity is 28 years and the maximum age for the same is 80 years.
    • The minimum term of the plan is 10 years, while the maximum term is 40 years.
    • The policy only offers regular premium paying term on an annual basis.
    • The maximum sum assured is ₹25 lakhs.

    Health Insurance Component

    • The minimum age of enrolment for health insurance component for an individual is 5 years, while for the floater it is 91 days
    • The health insurance component of the policy is on a continuous renewal basis for the entire life. Making sure the individual lisalways secured.
    • The plan offers lifelong renewability for the entire life of the insurer.
    • The policy only offers regular premium paying term on an annual basis.
    • The minimum and maximum sum assured depends on the individual and can vary between 5 to 10 Lacs and 15 to 25 lacs
    • Product Specifications Life  Health 
      Minimum Maximum Minimum Maximum
      Age at Entry

      18 years

      65 years

      Individual: 5 years
      Floater: 91 days

      No limit on Entry Age

      Max. Age at Maturity (Years)

      28 years

      80 years Lifelong on continuous renewal
      Policy Term (Years) 10 40 1 / 2 / 3
      Premium Paying Term Regular Pay

    What are the key Benefits of Mera Mediclaim Plan?

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    • A cost-effective combination plan with comprehensive health and life insurance cover
    • Stable security for uncertain and vulnerable times
    • A reliable medium to safeguard the family’s financial future in your absence
    • Tax advantageous
    • Better return on investment

    Why should I purchase Mera Mediclaim Plan?

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    Insurance – health and life are two of the most significant protection you can guarantee for yourself and your family. You like to ensure that your loved ones are comfortable protected and financially secured against all eventualities. A comprehensive health insurance policy, which bundles up a life cover, can be a perfect policy for you. The combi plan from PNB MetLife – Mera Mediclaim Plan, aims to provide an all-round health indemnity, wrapped up with a death benefit, thus offering dual blanket cover for you and your family.

    It is important to remember ‘Health is wealth’ and good health is the basic foundation of a good life. With Mera Mediclaim Plan, we insure both!

    What are the product benefits of Mera Mediclaim Plan?

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    Mera Mediclaim Plan is an extremely thoughtful policy designed by PNB MetLife for all those looking to ensure all-round health coverage for themselves and their families, along with enjoying comprehensive life cover. The Mera Mediclaim Plan combines the best of health insurance and life plan to provide you with an all-inclusive policy that caters to dual insurance needs.

    Mera Mediclaim Plan also includes benefits like:

    1. Comprehensive: The Mera Mediclaim Plan by PNB MetLife is a very exhaustive policy that provides for extensive health and life insurance cover. For the health insurance, the plan is not limited to only medical expenses but includes all IPD and Day Care expenses (for more than 540 procedures), pre and post-hospitalisation costs, floater charger, donor, ambulance costs, medical check-ups, etc. Also, there is no sub-limit for ICU. Moreover, in terms of life insurance, the cover includes a death benefit, as well as has an inbuilt terminal illness reimbursement.
    2. Cost-effective: The Mera Mediclaim Plan is a combination plan and hence, is more cost-effective when compared to health and life insurance brought individually. This plan offers a 7.5 per cent discount on both the health and life components.
    3. Affordable: The plan is more affordable since it offers cheaper rates and also annualized combined premiums, which are significantly lower than individual premiums for each of these plans.
    4. Lifelong: This combination plan by PNB MetLife offers a lifelong continuous renewal for the health component.
    5. Terminal Illness Cover: The plan offers an integrated Terminal Illness Cover, along with life cover of up to Rs 25 lakhs.
    6. Tax-benefits: The Mera Mediclaim Plan offers tax benefits for the premiums paid under Section 80C and 80D of The Income Tax Act, 1961. Further, the payout of the sum assured is also exempt from taxes under Section 10(10d).
    7. Family coverage: The health insurance part of the plan provides free annual medical check-ups for the entire family of the insurer. The family includes spouse, children, and parents. Also, the death benefit is received by the family, as directed by the insurer.

    What are the additional benefits offered by Mera Mediclaim Plan?

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    Apart from these benefits, there are a host of advantages offered by the Mera Mediclaim Plan.

    These include:

    1. Cashless treatment: The policy secures the insurer by allowing cashless treatment facilities across India in over 7500 network hospitals. This allows for quick and hassle-free treatment
    2. NCB and Super NCB: Up to 150% increase in Sum Insured with NCB & NCB – Super (Optional Cover
    3. Automatic recharge cover: In such critical times, insurance is more a necessity than a luxury. Hence, the Mera Mediclaim Plan ensures you never run out of insurance and thus, provides an automatic recharge cover facility. In this feature, the insurer can avail the recharge benefit for unlimited times in a year
    4. Alternative treatment: This combination plan also covers alternative medical treatment costs up to ₹30,000 such as Ayurveda, Unani, Siddha and Homeopathy.

    How does Mera Mediclaim Plan Work?

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    The procedure of a Mera Mediclaim Plan is remarkably simple and hassle-free to understand. The two-in-one plan that offers Health Cover and Death Benefits has been widely popular among people aspiring for a flexible, cost-effective, and affordable cover with extensive dual benefits.

    To demonstrate how the Mera Mediclaim Plan works, here are some illustrations of the plan:

    Case 1: Mr Pandit is a 35-year old man who is looking for illness and a death cover. Hence, he buys the Mera Mediclaim Plan to get health insurance and life cover for a term of 30 years. Under the policy, the basic sum assured as a life insurance component by Mr Pandit is ₹25 lakhs, while the health component is ₹10 lakhs.

    He opts for a regular premium paying term, and the annualized combined premium of the plan is calculated at ₹14,157. The Mera Mediclaim Plan offers a 7.5% discount on both the life and health plan. In this case, the discount calculates to be ₹1,148.

    • Annualized Premium: ₹14,157 including:
    • Life Component: ₹ <figure missing in the live website>
    • Health Component: ₹7,705
    • Discount: ₹1,148

    However, at the age of 40, Mr Pandit is admitted in the hospital and thus, makes a health insurance claim. He is eligible to get benefits up to ₹25 lakhs (owing to ₹10 lakh of sum assured + 10% sum assured as No claim bonus + 50% sum assured as No claim bonus Super). This amount is reimbursed to Mr Pandit, and the policy continues with the medical policy available for all insured. At the age of 50 years, Mr Pandit dies, and the family gets the death benefit of ₹25 lakhs and the policy terminates.

    Case 2: In another example, Mrs Sridevi, 40 years, buys the Mera Mediclaim Plan to get a health policy along with a life cover. In the regular pay programme, she opts for a 25-year long policy term with ₹25 lakhs as life insurance and another ₹5 lakhs as a health plan.


    Her annualized combined premium for the policy is ₹13,262. The Mera Mediclaim Plan offers a 7.5% discount on both the life and health plan. In this case, the discount calculates to be ₹1,075.

    • Annualized Premium: ₹13,262 including:
    • Life Component: ₹7,625
    • Health Component: ₹6,712
    • Discount: ₹1,075

    At the age of 45 years, Mrs Sridevi made a medical insurance policy claim and was reimbursed ₹12.5 lakhs (owing to ₹5 lakh of sum assured + 10% sum assured as No claim bonus + 50% sum assured as No claim bonus Super). Post this, the policy continues to provide a health insurance plan for all those insured. At the age of 55 years, Mrs Sridevi dies, and the family gets the death benefit of ₹25 lakhs and the policy terminates.

    Case 3: Mr Ayush, who is a healthy 55-year-old man, aims to get a health insurance plan combined with life insurance policy. He secures a sum of ₹25 lakhs in life insurance and ₹15 lakhs in health policy under the Mera Mediclaim Plan. The policy term is 20 years.

    His annualized combined premium for the policy is ₹47,088. The Mera Mediclaim Plan offers a 7.5% discount on both the life and health plan. In this case, the discount calculates to be ₹3,818.

    • Annualized Premium: ₹47,088 including:
    • Life Component: ₹26,850
    • Health Component: ₹24,056
    • Discount: ₹3,818

    At the age of 60 years, Mr Ayush is admitted to the hospital and thus, files for reimbursement. He is granted ₹37.5 lakh (owing to ₹15 lakh of sum assured + 10% sum assured as No claim bonus + 50% sum assured as No claim bonus Super). Post this, the policy continues to provide health coverage for all those insured. At the age of 75 years, Mr Ayush dies, and the policy terminates.

    How to buy Mera Mediclaim Plan?

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    The plan can be bought via the below steps:

    1. Visit the official PNB MetLife website
    2. Choose the Mera Mediclaim Plan and fill in the required details on Speak to an Advisor form
    3. A representative/agent from the company will help you buy the perfect policy for your requirements

    Tell me more about PNB MetLife.
    PNB MetLife is a joint venture between MetLife International Holdings LLC, Punjab National Bank Limited, Jammu & Kashmir Bank Limited, M. Pallonji and Company Private Limited, and other private investors. MetLife International Holdings LLC and Punjab National Bank Limited are the major shareholders in the company, which started operation in 2001 in India. PNB MetLife is an amalgamation of MetLife Inc’s financial know-how and Punjab National Bank’s distribution strength. MetLife Inc has served over 90 million customers in the last 140+ years, while Punjab National Bank has catered to over 80 million customers in the last 120 years.

    What is Health Insurance?

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    Health insurance is a policy that covers a host of medical and surgical expenses of an insured individual, provided certain conditions are met.

    What is Mera Mediclaim Plan?

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    Mera Mediclaim Plan is a cost-effective, tax-advantageous, combi policy by PNB MetLife which provides an extensive health insurance coverage along with a comprehensive life insurance policy, inclusive of an inbuilt terminal illness. The plan provides several additional benefits, along with a promising value of the sum insured by the insurer.

    Will the Mera Mediclaim Plan cover my family?

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    Yes, the Mera Mediclaim Plan covers the family. In terms of the health component, the annual medical check-ups of the family members are conducted for free on a cashless basis in the authorized network hospitals. Also, upon policy termination, the death benefit is directly paid to the nominee or family. The plan also offers floater coverage to provide insurance to family members.

    How should I determine my Health Insurance coverage

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    There is no fixed rule to determine health insurance coverage. However, the amount should ideally be dependent on factors such as general health of the insurer, residential city, history of family illnesses, nature of the job, current income, future liabilities, tax advantageous, etc.

    Why should I buy Mera Mediclaim Plan?

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    Some of the advantages of buying Mera Mediclaim Plan include:

    • More competitive rates with lower premiums
    • Ease of comparison of features and policy terms
    • Convenience of purchase and better service
    • Simple process and easy documentation

    What is the difference between Mera Mediclaim Plan and a traditional Health Insurance Plan?

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    Unlike a traditional health insurance plan that only provides medical coverage, the Mera Mediclaim Plan offers health insurance, along with a comprehensive life insurance cover. The combi policy also offers other attractive features such as automatic recharge, No Claim Bonus, No Claim Super Bonus, and double sum insured for accidental Hospitalisation.

    Moreover, the plan provides free medical check-ups, cashless treatment across 7500+ network hospitals, and covers IPD + Day Care charges, pre and post-Hospitalisation costs, floater, donor, ambulance expenses, and others. Further, it provides coverage for alternative treatment methods such as homoeopathy, Ayurveda, etc.

    Can my claim be rejected? What are the grounds for claim rejection?

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    Yes, a claim can be rejected if the following conditions are true:

    • The ailment, injury or the nature of the problem is not covered under the policy
    • The claim is not filed in the proper time with adequate documentation
    • The information presented is false, misleading, inaccurate, or missing such as a pre-existing health condition
    • Claims made for self-infliction
    • Claims made for value over the sum insured

    How can I avail Cashless Hospitalisation Benefits?

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    The cashless Hospitalisation benefit can be obtained by filing and submitting a pre-authorization form at the hospital desk or downloaded from Third Party Administrator’s official website.

    What are the Benefits of a No Claim Bonus?

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    Up to 150% increase in sum insured in 5 claim-free years with No Claims Bonus & No Claim Bonus – Super (Optional Cover).

    Is there an Automatic Recharge Facility with the Mediclaim plan?

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    The Mera Mediclaim Plan is not an ordinary plan which expires once a claim is made. PNB MetLife understands the critical need for a person to be insured and backed financially for all times.

    In this option, if an insurer runs out of or completely exhausts his health insurance policy component due to claims made, then PNB MetLife reinstates the entire sum insured in the policy for the leftover period of the cover. The reinstated amount can be used by the insurer for a different claim or by any other individual (in case of a floater policy) for any claim. The automatic recharge feature allows the insurer to avail the recharge benefit for as many times as needed in a year.

    Disclaimer:

    Mera Mediclaim Plan is a Individual Non-Linked, Non Participating, Pure Risk Premium, combi Insurance Plan (UIN: 117Y102V01). It is advised to familiarize yourselves with the policy benefits and policy service structure of the ‘Combi Product’ before deciding to purchase the policy. Please read the Sales brochure carefully before concluding any sale. This product is jointly offered by PNB MetLife India Insurance Company” and “Care Health Insurance Limited” (Formerly known as Religare Health Insurance Company Limited). PNB MetLife is lead insurer for this product. The risks of this ‘Combi Product’ are distinct and are assumed / accepted by respective insurance companies as per their underwriting guidelines. The liability to settle the claim vests with respective insurers, i.e., for health insurance benefits “Care Health Insurance Limited” (Formerly known as Religare Health Insurance Company Limited) and for life insurance benefits “PNB MetLife India Insurance Company”. The policyholders of the ‘Combi Product’ are eligible to continue with either part of the policy, discontinuing the other during the policy term. The Risk of this “Combi Product” are distinct and are assumed/accepted by respective Insurance companies. Goods and service Tax (GST) shall be levied as per the prevailing tax laws which are subject to change from time. "Tax benefits are as per the Income Tax Act, 1961, & are subject to amendments made thereto from time to time. Please consult your tax consultant for more details". Cash payment is not eligible for tax benefit under Sec 80D of Income Tax Act, 1961. For complete details on terms, coverage, exclusions, please refer to Policy Terms & Conditions.

    This product is jointly offered by “Care Health Insurance Limited” (Formerly Religare Health Insurance Co. Ltd.) and “PNB MetLife India Insurance Co. Ltd.

    Reg Office - Care Health Insurance Limited (Formerly known as Religare Health Insurance Company Limited), 5th Floor, 19, Chawla House, Nehru Place, New Delhi-110019 | IRDAI Regd. No.: 148 | CIN - U66000DL2007PLC161503

    1For 2 consecutive claim-free years by using No Claim Bonus & No Claim Bonus Super (optional cover). Incremental increase every year is applicable on base Sum Insured. If a claim is made in any particular year, accrued No Claim Bonus & Claim Bonus Super will be reduced at the same rate at which it is accrued. No Claim Bonus Super is an optional cover available on payment of additional premium.

    AD-F/2021-22/090

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    Disclaimer

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    As your trusted life insurance partner, PNB MetLife is with you amidst the current COVID-19 outbreak. Our policies also cover COVID-19 Claims. In case of a Death Claim, kindly submit the signed Claim Intimation Letter mentioning the policy number, brief of the insured event and other claim documents on the email mentioned herewith. Please write-in to us at claimshelpdesk@pnbmetlife.com or indiaservice@pnbmetlife.co.in. You can also call us on 1800-425-6969 for death claims intimations and for any queries on Monday - Saturday between 10:00 am - 7:00 pm.

    PNB MetLife Insurance, amongst the trusted Life Insurance companies in India, aims to provide a wide range of Life Insurance products that suits the needs of an individual at every stage of his life. Life Insurance Plans range from Term Life Insurance PlansTerm PlanProtection PlansLong Term Savings Plans , Retirement Plans & Child Education Plan.

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