| 5- United India's Super Top UP Medicare Policy - Prospectus |
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UNITED INDIA INSURANCE COMPANY LIMITED REGISTERED & HEAD OFFICE: 24, WHITES ROAD, CHENNAI-600014 |
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The TPA of the regular Health Insurance Policy/Reimbursement Provider will first process the claims and the TPA for this policy will make the balance payments either to the Hospital in the case of cashless settlement or to insured in case of reimbursement. The insured has to submit the details of settlement made by the TPA of regular Health Insurance Policy in the case of cashless settlement. In the case of reimbursement, the above details along with photo-copies of bills attested by Primary TPA/Reimbursement Provider are to be submitted to TPA of Super Top Up Medicare Policy.
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In addition to the claim for the hospitalisation reported to Super Top Up TPA, details of earlier hospitalisation claim settlements have also to be provided.
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The details of claims lodged and settlement details under regular Health Policy since inception of this policy should be furnished to the TPA of Super Top Up Policy even when the claim is not under the Super Top Up Medicare Policy. This will enable faster response by the TPA in case of future hospitalisation requiring requiring the services of Super Top Up Medicare policy.
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| All claims under this policy shall be payable in Indian currency. |
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| CANCELLATION |
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| The Company may at any time cancel the Policy on grounds of misrepresentation, fraud, non-disclosure of material fact or non-cooperation by the insured by sending seven days notice in writing by Registered A/D to the insured at his last known address in which case the Company shall return to the insured a proportion of the last premium corresponding to the unexpired period of insurance if no claim has been paid under the policy. |
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The insured may at any time cancel this policy and in such event the Company shall allow refund of premium at Company’s short period rate table given below provided no claim has occurred upto the date of cancellation. |
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| PERIOD ON RISK |
RATE OF PREMIUM TO BE CHARGED. |
| Upto one month |
1/4 th of the annual rate |
| Upto three months |
1/2 of the annual rate |
| Upto six months |
3/4th of the annual rate |
| Exceeding six months |
Full annual rate. |
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| RENEWAL |
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The Policy may be renewed by mutual consent and in such event the renewal premium shall be paid to the Company on or before the date of expiry of the Policy or of the subsequent renewal thereof and in any case not later than 15 days from the date of expiry of the current policy. |
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If, during the grace period of 15 days, any insured person incurs any hospitalisation expenses, he shall not be entitled for any claim. |
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The Company shall not be bound to give notice that such renewal premium is due, provided however that if the insured shall apply for renewal and remit the requisite premium before the expiry of this policy, renewal shall not normally be refused, unless the Company has reasonable justification to do so. |
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| A policy that is sought to be renewed after the grace period of 15 days will be underwritten as a Fresh Policy. |
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Break-in insurance for persons above 60 years and request for much higher value Sum Insured at renewals may be considered after a satisfactory pre-acceptance health checkup. |
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In case of existing Health policyholders taking Super Top Up Medicare Policy in addition to their existing Health Policy, No Claim Discount/Cumulative Bonus, if any, under existing policy will not be carried forward. |
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The Company reserves the right to accept or reject the proposal at its discretion.
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| This Prospectus shall form part of the proposal form. Please sign in token of having noted the contents of Prospectus. |
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