UNITED INDIA INSURANCE COMPANY LIMITED
Another good health insurance product from United India Insurance Company is the SENIOR CITIZEN INSURANCE PLAN.
The DISTINCTIVE FEATURES of this policy are:
- Entry age to the policy is between 61 years to 80 years and taking a Mediclaim Policy for the first time
- Sum insured can range from Rs.50000 to Rs.3 lacs
- Expenses on hospitalization for a minimum period of 24 hours are admissible. However this time limit is not applied to specific treatments such as:
- Appendectomy
- Coronary Angiography
- Coronary Angioplasty
- Dental Surgery
- D&C
- Eye Surgery
- Fracture/dislocation excluding hairline fracture
- Radiotherapy
- Lithotripsy
- Incision and drainage of abscess
- Colonoscopy
- Haemo dialysis
- Hydrocele
- Hysterectomy
- Inguinal/ventral/umbilical/femoral hernia
- Parenteral chemotherapy
- Piles/fistula
- Prostrate
- Sinusitis
- Tonsillectomy
- Liver aspiration
- Sclerotherapy
- Hospitalization expenses are covered as under:
- 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
- ICU expenses up to 2% of sum insured per day or actual amount whichever is less
- Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist’s fee
- Anesthetist, blood, oxygen, OT charges, surgical appliances, medicines and drugs, diagnostic materials and X-rays, dialysis, chemotherapy, radiotherapy, artificial limbs, cost of prosthetic devices implanted during surgical procedures like pace maker, orthopedic implants, infra cardiac valve replacements, vascular stents
- All hospitalization expenses (excluding cost of organ) incurred for donor in respect of organ transplant
- Expenses on major illnesses charged as a total package and needs to be settled with a co-pay on 80:20 basis
- Pre-hospitalization expenses incurred during the period up to 30 days prior to hospitalization
- Post-hospitalization expenses incurred during the period up to 60 days after hospitalization
- Pre-hospitalization and post-hospitalization expenses incurred shall be payable in respect of the actual expenses subject to a maximum of 10% of sum insured
RESTRICTIONS:
Expenses in respect of the following specified illnesses will be restricted as follows:
HOSPITALIZATION BENEFITS | LIMITS PER SURGERY RESTRICTED TO |
Cataract, Hernia, Hysterectomy | Actual expenses incurred or 25% of sum insured whichever is less |
Major Surgeries | Actual expenses incurred or 70% of sum insured whichever is less |
Major Surgeries include:
– Cardiac surgeries
– Cancer surgeries
– Brain tumor surgeries
– Pace maker implantation for sick sinus syndrome
- Hip replacement
- Knee Joint replacement
EXCLUSIONS:
- All congenital diseases
- Any pre-existing disease will be covered after a waiting period of 2 years
- Expenses incurred in the first 2 years of continuous operation of the policy are not payable on treatment of:
- Cataract
- Hysterectomy
- Menorrhagia or Fibromioma
- Joint replacement surgery (other than caused by an accident)
- Prolapsed Inter-vertebral disc (other than caused by an accident)
- Varicose veins/ulcers
- Hernia
- Hydrocele
- Piles
- Sinusitis and related disorders
- Fistula in anus
- Gall stone/renal stone removal
- Gout and Rheumatism
- Calculus disease
- Joint replacement due to degenerative condition
- Age related Osteoarthritis and Osteoporosis
- Expenses incurred for pre and post hospital treatment
- Expenses incurred for treatment of any of the following diseases:
- Asthma
- Bronchitis
- Chronic Nephritis and Nephritic Syndrome
- Diarrhea and all types of Dysenteries including Gastroenteritis
- Diabetes Mellitus
- Epilepsy
- Hypertension
- Influenza, Cough and Cold
- All Psychiatric or Psychosomatic Disorders
- Pyrexia of unknown origin for less than 10 days
- Tonsillitis and Upper Respiratory Tract Infection including Laryngitis and Pharangitis
- Arthritis, Gout and Rheumatism
- 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
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
- A family discount of 5% on the total premium will be allowed if the policy comprises of the insured and/or spouse, dependent children and dependent parents
- There is a 5% no claim discount for every claim free year subject to a maximum of 25%
- 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 3rd 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 |