Family Medicare Policy

UNITED INDIA INSURANCE COMPANY LIMITED

 

United India Insurance Company is a leading general insurance company in India. It has more than three decades of experience in

non-life insurance business and it was formed by the merger of 22 companies, consequent to nationalization of general insurance.

One of their policies is the FAMILY MEDICARE POLICY.

The EXCLUSIVE FEATURES of this policy are:

· It is a family floater policy

· Family comprises of self, spouse and dependent children

· Sum insured begins from Rs.1 lac in multiples of Rs.50000 and can go up to Rs.5 lacs. From Rs.5 lacs to Rs.10 lacs the sum insured will increase in multiples of Rs.1 lac

· Hospitalization expenses are covered as under:

Ø Room/boarding/nursing expenses and other similar expenses up to 1% of sum insured per day. This also includes nursing care, RMO charges, IV Fluids/Blood Transfusion/Injection administration charges but does not include cost of materials

Ø IC unit up to 2% of sum insured per day

Ø Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist’s fee

Ø Anaesthetist, blood, oxygen, OT charges, surgical appliances, medicines and drugs, diagnostic materials and X-rays, dialysis, chemotheraply, radiotherapy, artificial limbs, cost of prosthetic devices implanted during surgical procedures like pace maker, relevant laboratory diagnostic tests, etc

Ø All hospitalization expenses (excluding cost of organ) incurred for donor in respect of organ transplant

· Pre-hospitalization expenses up to 30 days – actual expenses subject to a maximum of 10% of sum insured will be reimbursed

· Post-hospitalization expenses up to 60 days – actual expenses subject to a maximum of 10% of sum insured will be reimbursed

RESTRICTIONS:

Expenses in respect of the following specified illnesses will be restricted as below:

HOSPITALIZATION BENEFIT	LIMITS RESTRICTED TO
Cataract	10% of sum insured subject to a maximum of Rs.25000
Hernia	15% of sum insured subject to a maximum of Rs.30000
Hysterectomy	20% of sum insured subject to a maximum of Rs.50000
Following specified major surgeries: – Cardiac surgeries – Cancer surgeries – Brain tumor surgeries – Pace maker implantation for sick sinus syndrome – Hip replacement – Knee Joint replacement	70% of sum insured subject to a maximum of Rs.4 lacs

ELIGIBILITY:

· The proposer can be anyone between the age of 18 years and 80 years

· Dependent children between the age of 3 months and 18 years can be a part of this policy provided both their parents are covered with United India

· Children above the age of 18 years will cease to be covered if they are employed/self employed or married

· For unmarried and unemployed girls and disabled children without income who are dependent on the proposer, the age limit of 18 years will not apply

· Males up to the age of 26 years can be covered provided they pursue full time higher studies

EXCLUSIONS:

· Pre-existing disease coverage will be available only after 4 years since inception of the policy

· Any disease contracted by the insured during the first 30 days from the commencement date of the policy. This does not apply if the person has been insured under a health policy issued by the company for the 12 months immediately preceding the commencement of this policy

· During the first 2 years of the operation of the policy, the expenses on treatment of diseases such as Cataract, Benign Prostatic Hyperthrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Congenital internal disease, Fistula in Anus, Piles, Sinusitis and related disorders, Gall Bladder Stone Removal, Gout and Rheumatism, Calculus disease, Joint Replacement due to Degenerative Condition and age-related Osteoarthritis and Osteoporosis are not payable

· Injury/disease caused by invasion, act of foreign enemy, war like operations

· Circumcision unless necessary for treatment of a disease or that caused due to an accident

· Vaccination or inoculation or change of life or cosmetic or aesthetic treatment

· Plastic surgery other than as may be necessitated due to an accident

· Cost of spectacles, contact lenses and hearing aids

· Dental treatment or surgery of any kind unless requiring hospitalization

· Convalescence, general debility, run down condition or rest cure, congenital external disease or defects or anomalies, sterility, venereal disease, intentional self injury and use of intoxication drugs/alcohol

· All expenses arising out of any condition caused by HIV or AIDS

· Charges incurred at hospital/nursing home primarily for diagnosis

· Expenses on vitamins and tonics unless forming part of treatment

· Injury or disease caused by nuclear weapon/materials

· Treatment arising from pregnancy and childbirth

· Naturopathy treatment

· External and durable medical/non medical equipment of any kind for diagnosis/treatment/monitoring/support

· Any kind of service charges, surcharges, admission fees/registration charges levied by the hospital

· All non-medical expenses

ADDITIONAL BENEFITS of taking a policy from United India Insurance Company are:

· It is a public sector undertaking so many people have more faith in its existence

· There is a 3% no claim discount on renewal premium after 3 continuous claim free policies and for every subsequent claim free year subject to a maximum of 15%

· For every block of 3 claim free years, the insured will be eligible for cost of health check-up up to a maximum of 1% of average sum insured of preceding 3 years

· Ambulance charges can be covered on payment of additional premium

· Hospital Daily Cash Benefit allowance will be given from the 3^rd day onwards for the period of hospitalization but on payment of additional premium as per details below:

ADDITIONAL PREMIUM	ALLOWANCE PER DAY	SUBJECT TO MAXIMUM OF
Rs.150/-	Rs.250/-	Rs.2500/- per policy period
Rs.300/-	Rs.500/-	Rs.5000/- per policy period