United India Individual Health Insurance Policy - Senior Citizens Plan

Policy Benefits

• In-patient hospitalization expenses such as room rent, boarding expenses, nursing care, blood transfusion, Anaesthetist, Specialists fees, etc. are covered up to the limits specified in the policy.
• ICU hospitalization expenses are also covered under this policy.
• Pre hospitalization treatment expenses are covered for 30 days prior to hospitalization.
• Post hospitalization treatment expenses are covered for 60 days after hospitalization.
• Organ donor expenses are covered, excluding the cost of the organ.
• Listed day care procedures/surgeries that require less than 24 hours of hospitalization are covered under this policy.
• Domiciliary hospitalization treatment expenses are covered for a period beyond three days of hospitalization.
• Hospital daily allowance is payable as an add-on cover.

Value Added Benefits

• Ambulance charges are covered and it is available as an add-on cover.
• AYUSH treatment is covered under this plan.
• If claim occurs within two policy periods, such claims are payable considering the available sum insured for the both policy periods, including the deductibles.
• Cost of health check-up is reimbursed at the completion of 3 claim-free policy years.
• Avail tax exemption for premiums paid under section 80D of IT Act, 1961.
• Enhancement of Sum Insured is available at the renewal and it will be considered at the discretion of the company.
• Portability benefit is available under this policy.

Sub Limits

• Room rent/boarding/nursing expenses are covered up to 1% of the Sum Insured (SI) per day or actual expenses, whichever is less.
• ICU expenses are covered up to 2% of SI per day or actual expenses, whichever is less.
• Pre & post hospitalization expenses are payable for actual expenses incurred or 10% of SI, whichever is less.
• Co-pay of 20% applies, in case of expenses incurred on major illnesses as mentioned in the policy.
• Sub limits are applicable on treatment/surgery of Cataract, Hernia & Hyterectomy up to 25% of SI or actual expenses whichever is less.
• Treatment expenses towards major surgeries, including cardiac surgeries, cancer surgeries, hip, knee & joint replacement surgery are payable up to 70% of SI or actual expenses whichever is less.
• Ambulance charges are payable up to Rs 2500 during a policy period. It is available on payment of additional premium of Rs 100.
• Daily cash benefit is paid up to Rs 250/500 per day, up to a maximum of Rs 2500/5000. It is available on payment of additional premium of Rs 150/300.
• Cost of health check-up is payable up to 1% of the average SI for the previous three policy periods.

Waiting Period Clause

• Initial Waiting Period: There is a waiting period of 30 days for any claims to be admissible under this policy.
• Specific Waiting Period: Some illnesses such as Cataract, Hydrocele, Fibromyoma, Congenital internal disease, hernia, etc. are covered after 24 months of continuous policy coverage.
• Pre existing Disease Waiting Period: Any pre-existing disease/illness/injury that was diagnosed /acquired within 48 months before issuance of the first policy.