Senior Citizen Insurance Policy


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


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

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


  • 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:
Rs.150/- Rs.250/- Rs.2500/- per policy period
Rs.300/- Rs.500/- Rs.5000/- per policy period

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