United India Health- Senior Citizen Policy
This health insurance policy is designed for senior citizens and provides hospitalisation expenses incurred due to an illness or accident.
Any person between 61 and 80 years of age, looking for insurance up to Rs 3 lakh can enter this policy.
What does it do?
It covers expenses of hospitalisation, treatment taken at home on advice of doctors, day care treatment which does not need overnight hospitalisation. There exists a co-payment clause which requires the insured person to bear 20 per cent of the admissible claim amount.
Premium paid is eligible for tax benefit under section 80D of the Income Tax Act.
There are sub-limits on room rent, boarding and ICU charges. Co-payment clause in case of major illnesses is another drawback. It offers a maximum cover up to Rs 3 lakh only.
It offers basic coverage to senior citizens with co-payment clause and sub-limits. When buying insurance for elderly, you cannot escape such clauses as most senior citizen policies come attached with these. You should prefer a policy with least exclusions and low waiting period to cover an illness.
|Entry Age (years)|
|Sum Insured (Rs)|
|Policy Term (years)||1|
|Discount||Family discount of 5% will be allowed comprising the insured any one or more of family members|
|Pre Policy Medical Check Up||Required at the discretion of insurer. Insurer will reimburse 50% of the cost upon acceptance of the proposal.|
|Policy Termination||Insurance company may cancel the policy by giving a 15 days notice period. Insurance company in such a case will repay the pro-rata premium to the insurer if claim has not been made. Insurer may also cancel the policy at any time.|
|Address||United India Insurance Co. Ltd.|
24, Whites Road,
Chennai - 600014
|Mail to||[email protected]|
|Call to||1800 425 333 33(toll free), 91-044-28520161|
Additions to the Plan
|Scope of Cover|
|Cashless facility||available if treatment availed in a network hospital|
|Reimbursement facility||available if treatment availed in a non-network hospital|
|Pre and post hospitalisation||covers medical expenses incurred during 30 days prior to admission to hospital and 60 days after discharge upto maximum of 10% of the sum insured or the actual expenses whichever is less.|
|Room, boarding and nursing expenses||covered upto lower of 1% of sum insured per day or actual expenses|
|I.C.U charges||covered upto lower of 2% of sum insured per day or actual amount|
|Surgeon, anaesthetist, medical practitioner, consultants, specialist fees, blood, oxygen, chemotherapy, Radiotherapy, Artificial limbs, Cost of prosthetic devices implanted during surgical procedure like pacemaker etc., X-Ray||covered|
|organ donor's hospitalisation expenses||medical expenses for treatment of organ donor in case of major organ transplant is covered|
|Day care procedures||covers those treatments which do not require an overnight stay in the hospital due to technological advancement as stated in the policy document|
|Cost of health check-up||reimburses an amount upto maximum of 1% of average basic sum insured once after every 3 continuous claim free years|
|Cataract, Hernia, Hysterectomy||Actual expenses incurred or 25% of the sum insured whichever is less|
|Major surgeries including cardiac surgeries, brain Tumour surgeries, pace maker implantation for sick sinus syndrome, cancer surgeries, hip, knee, joint replacement surgery, Organ Transplant||Actual expenses incurred or 70% of the sum insured.|
|Exclusions and Waiting Period|
|Pre-existing illnesses||will be covered after 4 continuous renewals with the company|
|No claim period||initial 30 days since inception of the policy|
|Waiting period||certain illnesses such as Hernia, Piles, Cataract, Hypertension, Diabetes etc, will be covered after a waiting period of 2 years.Joint Replacement due to degenerative condition and Age related osteoarthritis, and Osteoporosis will be covered after a period of 4 years.|
|Sum Insured (in Rs)||Domiciliary Hospitalisation limit (R)||Age (in years)|
|Premium rates are exclusive of service tax. Renewals beyond 80 years slab will be done at same premium as 80 years slab.|