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Top Up Medicare Policy Details

This document provides a customer information sheet for a Top Up Medicare policy from United India Insurance Company. It covers inpatient hospitalization expenses exceeding the chosen threshold limit, including room costs and medical fees. Pre-and post-hospitalization expenses are also covered. Major exclusions include pre-existing conditions, cosmetic procedures, HIV/AIDS, and pregnancy. There is a 48 month waiting period for pre-existing diseases. The policy can be renewed annually for life. A 15-day free look period allows customers to review the terms. Cashless payments are available at network hospitals up to specified limits, while reimbursement is offered for other covered expenses. The policy may be cancelled if fraudulent claims are made.

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93 views2 pages

Top Up Medicare Policy Details

This document provides a customer information sheet for a Top Up Medicare policy from United India Insurance Company. It covers inpatient hospitalization expenses exceeding the chosen threshold limit, including room costs and medical fees. Pre-and post-hospitalization expenses are also covered. Major exclusions include pre-existing conditions, cosmetic procedures, HIV/AIDS, and pregnancy. There is a 48 month waiting period for pre-existing diseases. The policy can be renewed annually for life. A 15-day free look period allows customers to review the terms. Cashless payments are available at network hospitals up to specified limits, while reimbursement is offered for other covered expenses. The policy may be cancelled if fraudulent claims are made.

Uploaded by

Akanksha221291
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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UNITED INDIA INSURANCE COMPANY LIMITED

HEAD OFFICE
CUSTOMER INFORMATION SHEET
Description is illustrative and not exhaustive
S.No.

TITLE

Product
Name
What am I
covered for

DESCRIPTION
Top Up Medicare Policy
a.

b.

What are
the major
exclusions
in the
policy

a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
m.

4
5

Waiting
period
Payment
basis

REFER TO POLICY
CLAUSE NO.

In Patient Hospitalisation Expenses for each and


every hospitalization more than 24 hours exceeding the
chosen Threshold Limit
i.
Room, Boarding and Nursing Expenses including
RMO charges, IV fluids/Blood Transfusion/
Injection administration charges.
ii. Surgeon fees, Anesthetist, Medical Practitioners,
Consultants, Specialists fees, etc.
iii. Anaesthesia, Blood, Oxygen, Operation Theatre
Charges, Surgical appliances, Medicines & drugs,
Dialysis, Chemotherapy, Radiotherapy, cost of
Artificial limbs, cost of prosthetic devices
implanted during surgical procedure viz.
Pacemaker, Orthopaedic implants, infra cardiac
valve replacements, vascular stents, relevant
diagnostic tests.
iv. Ambulance charges by road not exceeding
Rs.2,500/Pre and Post Hospitalisation Related medical
expenses incurred 30 days prior to hospitalization and
within 60 days from the date of discharge.
Domiciliary treatment, treatment outside India
War and warlike operations
Circumcision, vaccination and plastic surgery unless
forming part of treatment and requires hospitalization.
Spectacles, contact lens and hearing aids
Dental treatment unless arising due to an accident
HIV, AIDS and sexually transmitted diseases
Any hospitalization primarily for
investigation/diagnostic purposes.
Vitamins, tonics unless necessitated for treatment
Pregnancy and related disorders
Naturopathy and Experimental treatment
External Medical equipments
Any kind of service charges, admission
fees/registration charges
Non-medical expenses

(Note : the above is a partial listing of the policy exclusions.


Please refer to the policy clauses for the full listing)
a.
Waiting period of 48 months for Pre-existing diseases

Reimbursement of covered expenses up to


specified limits
Cashless payment of covered expenses upto
specified limits in Network Hospitals.
In cities where PPN Network is applicable,
cashless will be restricted to PPN Hospitals and
claim payments as per agreed tariff.

2.1 A
2.1 B
2.1 C

2.1 F
2.1 E

4.2
4.3
4.4
4.5
4.7
4.8
4.9
4.11
4.12
4.13
4.14
4.15

4.1

6
7

8
9

10

Cost ii.
sharing
Renewal
condition

Renewal
benefits
Cancellation

Special
condition
and special
benefit

Not applicable
The policy can be renewed annually throughout the lifetime of
the insured.
In the event of break in the policy a grace period of 30 days is
allowed.

5.10
5.10.3
5.11

Enhancement of sum Insured at renewal will be considered at


the discretion of the Company.
Nil
This policy would be cancelled and no claim or refund would
be due to you if :
a.
you have not correctly disclosed details about
your current and past health status or
b.
have otherwise encouraged or participated in any
fraudulent claim under the policy.
At least 15 days from the issuance of first policy would be
given as free-look period to the insured to review the terms
and conditions

5.12

LEGAL DISCLAIMER
The information must be read in conjunction with the product brochure and policy document.
In case of any conflict between the Customer Information sheet and policy document the terms
and conditions mentioned in the policy document shall prevail.
For details, please refer to policy clauses for full details.

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