| 3- United India's Super Top UP Medicare Policy - Prospectus |
|
UNITED INDIA INSURANCE COMPANY LIMITED, REGISTERED & HEAD OFFICE: 24, WHITES ROAD, CHENNAI-600014 SUPER TOP UP MEDICARE POLICY - PROSPECTUS |
|
| Sum Insured :Various options are available as given below. |
|
| |
| OPTION |
Sum Insured (Rs.) |
Specified Threshold Level |
| A |
3,00,000 |
2,00,000 |
| B |
5,00,000 |
2,00,000 |
| C |
3,00,000 |
3,00,000 |
| D |
5,00,000 |
3,00,000 |
| E |
7,00,000 |
3,00,000 |
| F |
5,00,000 |
5,00,000 |
| G |
10,00,000 |
5,00,000 |
| H |
15,00,000 |
5,00,000 |
|
|
|
| PAYMENT OF PREMIUM :As per table attached. |
|
| |
| PREMIUM COMPUTATION |
| Top Up Medicare Policy – Individual |
Completed age of the insured person at inception of policy to be reckoned. |
| Top Up Medicare Policy – Family |
Completed age of the oldest member of family is to be considered. |
|
|
|
| TAX REBATE |
|
| Tax rebate available as per provision of Income Tax rules under Section 80-D. |
|
| DETAILS OF COVERAGE |
|
| Hospitalisation Expenses, |
|
(a)Room, Boarding and other expenses as specified in policy. This also includes Nursing Care, RMO Charges, IV Fluids/Blood Transfusion/Injection administration charges and the like but does not include cost of materials.
(b)Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Fees
(C)Anaesthetics, Blood, Oxygen, Operation Theatre Charges, surgical appliances, Medicines & Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Artificial Limbs, cost of prosthetic devices implanted during surgical procedure like Pacemaker, relevant laboratory diagnostic tests, etc & similar expenses.
(d)All Hospitalisation Expenses (excluding cost of organ, if any) incurred for donor in respect of Organ transplant. |
|
| Expenses on Hospitalisation for minimum period of 24 hours are admissible. However, this time limit is not applied for some specific treatments like Dialysis, Chemotherapy, Radiotherapy, Eye surgery, Dental Surgery, Lithotripsy (Kidney Stone removal), D & C, Tonsillectomy or where treatment involves technological advances necessitating hospitalisation for less than 24 hours. |
|
| Note: Procedures/treatments usually done in out patient department are not payable under the policy even if converted as an in-patient in the hospital for more than 24 hours or carried out in Day Care Centres. |
|
| DEFINITION |
|
| HOSPITAL / NURSING HOME should be registered as a Hospital or Nursing Home. Should comply with minimum criteria of having 15 inpatient beds fully equipped, operating theatre, Qualified Doctor and Qualified Nursing staff in employment round the clock. In Class “C” Towns, the minimum number of beds is 10. |
|
| However, Hospital/Nursing Home shall not include an establishment which is a place of rest, a place for the aged, a place for drug-addicts or place for alcoholics, a hotel or a similar place. |
|
| EXCLUSIONS:- |
|
| Pre-existing disease coverage will not be available for an insured person during the first four years since inception of his/her Super Top Up Medicare policy with the Company. |
|
| N.B.:A Pre-existing disease is defined as “any condition, ailment or injury or related condition(s) for which insured person had signs or symptoms, and /or was diagnosed and/or received medical advice/treatment within 48 months prior to Super Top Up Medicare Policy with the Company”. |
|
| In case of persons having any other Health Insurance Policy from any Company with a Sum Insured above Threshold Level at the time of taking this policy, the exclusion period of 48 months for Pre-existing Disease/Condition will be reckoned from the date of inception of the policy for such portion of Sum Insured, including Cumulative Bonus earned if any, above the Threshold Level. If expiring policy sum insured has increased over the years, the 48 months of continuous coverage has to be completed for the incremental sum insured. |
|
|
|
|
