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.