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United India Criticare Policy

To safeguard the insured persons from the specified critical illnesses, United India Insurance Company has come up with the UNI Criticare Insurance Policy that offers protection against 11 critical illnesses and provides for payment of a lump sum in case the insured is diagnosed with one of the critical illnesses during the period of insurance for the first time. An insured can take a policy covering self, spouse, and dependent parents with a separate sum insured for each. The Company shall compensate the Insured person only once in respect of any one or more of the covered diseases under the policy. To know more about this policy, have a look at the following mentions.

Eligibility Criteria

Age at entry

Minimum – 21 years

Maximum – 65 years

Sum insured optionsRs. 1 lakh, Rs. 3 lakhs, Rs. 5 lakhs, and Rs. 10 lakhs.
Survival periodMinimum – 30 days
Waiting period90 days
Grace period30 days
Free look period15 days

What Are The Key Highlights of UNI Criticare?

The following benefits are provided.

Cancer of Specified Severity:

A malignant tumor characterized by the presence of one or more tumors classified histologically as malignant and characterized by the uncontrolled growth and spread of malignant cells and with the invasion of normal tissue and destruction of normal tissues is covered. This diagnosis must be supported by histological evidence of malignancy & confirmed by a pathologist. The term cancer includes leukemia, lymphoma, and sarcoma.

First Heart Attack of Specified Severity:

The first occurrence of an acute myocardial infarction which means the death of a portion of the heart muscle as a result of inadequate blood supply to the relevant area will be covered.

Coronary Artery Surgery Open Chest:

The actual undergoing of open chest surgery for the correction of one or more coronary arteries, which is/are narrowed or blocked, by coronary artery bypass graft is covered.

Heart Valve Replacement:

The expenses of the actual undergoing of open-heart valve surgery to replace or repair one or more heart valves, as a consequence of defects in, abnormalities of, or disease-affected cardiac valve(s) are covered.

Kidney Failure:

End-stage renal disease presents as chronic irreversible failure of both kidneys to function, as a result of which either regular renal dialysis (hemodialysis or peritoneal dialysis) will be covered.

Stroke Resulting in Permanent Symptoms:

Any cerebrovascular incident producing permanent neurological sequelae, including infarction of brain tissue, thrombosis in an intracranial vessel, hemorrhage, and embolization from an extracranial source is covered.

Others:

Apart from the above critical illnesses the following critical diseases are also covered under the UNI Criticare policy – coma of specified severity, major organ or bone marrow transplant, multiple sclerosis, motor neuron diseases with permanent symptoms, permanent paralysis of limbs.

General Exclusions of UNI Criticare

The company shall not be liable to make any payment under this policy in respect of

  • Such Critical Illness caused by or associated with directly or indirectly by any of the following:
    1. Attempted suicide or intentional self-inflicted injury by the insured person.
    2. Addiction to alcohol or drugs.
    3. Disease in the presence of HIV/AIDS infection.
    4. Smoking more than 40 cigarettes/ cigars or equivalent tobacco intake in a day
  • Any pre-existing Critical Illness, symptom/s (and/or the treatment) of which were present in the insured person at any time before the inception of this policy or on the date on which cover here under was granted to such insured person, or which manifests itself within a period of three calendar months from such date, whether or not the insured or the insured person has knowledge that the symptoms or treatment were related to such Critical Illness. In the event of any interruption in cover hereunder, the terms of this exclusion shall apply afresh from re-commencement of cover.
  • Any claim, whether directly or indirectly, occasioned by war, invasion, or act of foreign enemy hostilities (whether war be declared or not or any civil war mutiny rebellion, revolution insurrection, military, or usurped power.
  • Any claim, whether directly or indirectly, caused by ionizing radiation or contamination by radioactivity from any nuclear fuel or any nuclear waste from the combustion of nuclear fuel or from any nuclear weapons materials.

What is the Buying Process of UNI Criticare?

One can buy this policy easily by following the below steps.

  • Go to the official website of Unite India Insurance Company.
  • Click on the products tab available at the top of the homepage.
  • There will be the Buy New Policy/Ger Quote option under the Health Insurance tab. Go for that.
  • On the new page, fill in the gaps with required details such as name, address, contact number, and policy-related information.
  • Put the details carefully. After that, click on the get quote option.
  • On the basis of the given details, the premium amount will be calculated and displayed on the screen.
  • Check the details twice. If satisfied, pay the premium amount online safely to buy this plan.
  • Upon successful payment, download the policy document for better convenience.

Claim Process of UNI Criticare

This company offers both cashless and reimbursement type of claim procedures. Both the procedures are discussed below.

Cashless Procedure:

  • Get admitted to a network hospital of the company.
  • As soon as the incident happens, inform the company/TPA.
  • Submit the duly filled and signed pre-authorization form to TPA.
  • Receive the treatment, and submit all the required documents to the TPA.
  • A surveyor might be appointed to assess the claim and evaluate the documents. If no discrepancy is found, the claim amount will be settled directly with the hospital.

Reimbursement Claim Procedure:

  • Choose any hospital of your choice.
  • Receive the required medical treatments. Collect all the documents.
  • Submit the required documents to the company within 30 days from the date of discharge from the hospital.
  • The company will do the scrutiny of the documents.
  • If everything is right, the claim amount will be settled within the stipulated time period.

Required Claim Documents:

  • Duly filled Claim form
  • Treating Physician’s certificate
  • Original/Attested copy of Discharge summary
  • Original/Attested copies of all lab/radiological/Histopathological/investigation reports
  • Original/Attested copies of Indoor case papers (If needed)
  • Original/Attested copies of all the medical bills
  • Any other document (Disability Certificate, Dialysis records, etc.) deemed necessary at the time of claim investigation for a specific CI condition.

Frequently Asked Questions

Dependent children between the ages of 21 and 26 years pursuing full-time studies can be covered. A bona fide certificate from an educational institution is mandatory as proof. Unmarried and/or unemployed female children can also be covered as dependants.

All persons aged 45 years and above must complete the medical examination report. The Company shall reimburse 50% of the cost of such medical examination expenses if the proposal is accepted.

The insured may at any time cancel this policy and in such event, the Company shall allow a refund of the premium at the Company’s short-period rate table given below, provided no claim has occurred up to the date of cancellation.

Period on riskRate of premium
Up to 1 month¼ of the annual rate
Up to 3 months½ of the annual rate
Up to 6 months¾ of the annual rate
Exceeding 6 monthsFull annual rate

The Company shall be entitled to decline renewal if;

  • Any fraud, misrepresentation, or suppression by the Insured or on his behalf is found either in obtaining insurance or subsequently in relation thereto or,
  • The Company has discontinued the issue of the Policy, in which event the Insured shall, however, have the option for renewal under any similar Policy being issued by the Company; provided, however, benefits payable shall be subject to the terms contained in such other Policy.

 

Premium paid for self, spouse, dependent children, and dependent parents are exempted from income tax under Section 80D of the Income Tax Act as per rules in force.

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