| 8- Family Floater Coverage - United india Insurance Company Limited |
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| Family Medicare Policy from United India Insurance Company |
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| NO CLAIM DISCOUNT/CLAIMS LOADING |
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At renewal, the Company will review the claims experience and apply a No Claim Discount/Loading based on the claims incurred as given below. |
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No Claim Discount – 3% on renewal premium after three continuous claim free Policies for every subsequent claim free year subject to a maximum of 15%. |
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If any claim is reported or if the policy is not renewed within the grace period, the Policy will not be eligible for any No Claim discount. |
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| Loading – If three or more claims are lodged during the two immediately preceding two policy periods – |
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Upto 25% of Sum Insured
26 to 50% of Sum Insured
51 to 75% of Sum Insured
Above 75%
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25% loading on applicable premium
50% loading on applicable premium
75% loading on applicable premium
100% loading on applicable premium |
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The sum insured referred to above will be the total of sum insureds of immediately preceding two years.
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The applicable premium refers to policy premium only without any premium for add on covers.
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This loading will be removed after three continuous claim free years. The No Claim Discount will apply only after completion of four claim free years in such cases. |
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| TAX REBATE |
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| Tax rebate available as per provision of Income Tax rules under Section 80-D. |
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| HEALTH CHECK-UP BENEFIT |
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For every block of three claim free years, the insured person(s) will be eligible for Cost of Health check-up up to a maximum of 1% of average SI of preceding three years. |
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| The following optional covers are available on payment of additional premium as given below |
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| 1. |
Ambulance Charges |
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The Policy will cover Ambulance charges in connection with admitted claim incurred to shift the insured person from Residence/accident site to Hospitals in emergency cases and from one Hospital/Nursing Home to another Hospital/Nursing Home/Diagnostic centre for better care/diagnosis, upto a maximum of Rs.2500/- per policy period – Additional Premium Rs.100/-. |
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| 2. |
Hospital Daily Cash Benefit |
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The Policy will pay to the insured person a Daily Cash Allowance as given below from the third day onwards for the period of hospitalisation in connection with admitted claims subject to a maximum stated below on payment of additional premium as under – |
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| Additional Premium |
Allowance per day |
Subject to maximum of |
| Rs.150/- |
Rs.250/- |
Rs.2,500/- per policy period |
| Rs.300/- |
Rs.500/- |
Rs.5,000/- per policy period |
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| CLAIM PROCEDURE |
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| All claims will be processed and settled by specified Third Party Administrator (TPA) licensed by IRDA. |
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The payment will be made either to Hospital/Nursing Home in case of Cashless treatment and to the Proposer/insured person in other cases. |
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| Intimation of Hospitalisation |
to be made immediately to the TPA. |
| To avail Cashless facility |
Pre-authorisation request to be sent or faxed to TPA
immediately on admission. |
| In Reimbursement cases |
Insured to intimate TPA about hospitalisation of insured
persons immediately on admission or not later than 24 hours.
Claim bills to be submitted to TPA within seven days of discharge. |
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| All claims under this policy shall be payable in Indian currency. |
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