United India Health - Senior Citizen Policy

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United India Health- Senior Citizen Policy

	Objective			This health insurance policy is designed for senior citizens and provides hospitalisation expenses incurred due to an illness or accident.
Suited for			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.
Pros			Premium paid is eligible for tax benefit under section 80D of the Income Tax Act.
Cons			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.
Our View			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.
Eligibility
Entry Age (years)
Minimum		61
Maximum		80
Coverage Type		Individual
Policy Term (years)		1
Sum Insured (Rs)
Maximum		300000
Minimum		100000
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.
Customer Service
Address		United India Insurance Co. Ltd. 24, Whites Road, Chennai - 600014
Mail to		customercare@uiic.co.in
Call to		1800 425 333 33(toll free), 91-044-28520161

 

	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.
Inpatient hospitalisation		covered
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
Other benefits
Domiciliary treatment		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.

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