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Individual Health Insurance Plans

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United India Individual Health Insurance policy

United India Individual Health Insurance Policy is a dedicated health plan that offers maximum coverage against illness and other medical emergencies. The Policy covers an individual on an Individual sum-insured basis. The policy is also available as a family package, with a separate sum insured for each family member, including the proposer, spouse, dependent children, and parents. The policy is available under three plans based on the age of entry into the policy, namely Platinum, Gold, and Senior Citizen.

Continue reading to learn more about the United India Individual Health Insurance Policy in detail!

Eligibility Criteria

Here are the eligibility criteria for the United India Individual Health Insurance Policy.

ParametersDetails
Age

Minimum- 18 Years

Maximum- 65 Years

The age is further classified into three different options.

Platinum: 18 to 35 years

Gold: between 36 and 60 years

Senior Citizens: Between 61 and 65 years

Sum Insured

Platinum: ₹ 2 Lakhs, ₹ 3 Lakhs, ₹ 5 Lakhs, ₹ 8 Lakhs, ₹ 10 Lakhs, ₹ 15 Lakhs, ₹ 20 Lakhs

Gold: ₹ 2 Lakhs, ₹ 3 Lakhs, ₹ 5 Lakhs, ₹ 8 Lakhs, ₹ 10 Lakhs

Senior Citizen: ₹ 2 Lakhs, ₹ 3 Lakhs, ₹ 5 Lakhs

Policy Term1 Year
RenewabilityAnnually

Coverage Details

Here are the coverage details for the United India Individual Health Insurance Policy.

ParametersDetails
CataractUp to 25% of Sum Insured or Rs. 40,000 per eye, whichever is less
Hernia & HysterectomyUp to 25% of Sum Insured or Rs. 1,00,000, whichever is less
Major surgeries include Cardiac Surgeries; Brain Tumour Surgeries; Maker Implantation for Sick Sinus Syndrome; Cancer Surgeries; Hip, Knee, and Joint Replacement Surgery; Organ TransplantUp to 70% of the Sum Insured
Pre-hospitalisation Medical Expenses30 days
Post-hospitalisation Medical Expenses60 days
Road Ambulance CoverRs. 2500 per person per policy period

Benefits of Choosing the United India Individual Health Insurance Policy

The following are the salient features and benefits of considering the United India Individual Health Insurance Policy.

  • In-Patient Hospitalisation Expenses Cover

When an insured person receives medically necessary treatment while hospitalised, the policy will cover the reasonable and customary charges as long as the hospitalisation was caused by an illness or injury and the admission date falls within the policy period.

  • Pre-hospitalization and Post-Hospitalisation Expenses

The plan will reimburse the insured person for any pre-hospitalization medical expenses incurred due to an illness or injury during the 30 days before admission, as well as any post-hospitalization medical expenses incurred due to an illness or injury during the 60 days following hospital discharge.

  • Domiciliary Hospitalisation

The plan will pay for medical care for an illness, disease, or injury that would typically require care and treatment at a hospital but is instead received while confined at home on a reimbursement basis for a period longer than three days.

  • Ayurvedic Treatment

Under the condition that hospitalisation costs are only admissible when the treatment has been received in an AYUSH Hospital, the plan will pay the Reasonable & Customary Charges incurred as an in-patient for an insured person in case of Medically Necessary Treatment taken during hospitalisation.

  • Road Ambulance Cover

When an insured person needs to be transported by road ambulance to a hospital for emergency medical care due to an illness or injury that occurs during the policy period, the plan will pay the costs up to Rs. 2500 per person per policy period.

  • Daily Cash Allowance on Hospitalisation

For each consecutive and completed period of 24 hours in the hospital, the plan will pay the insured person a daily cash allowance, provided the hospitalisation claim is admissible under the terms of the policy.

  • Cancellation

If the policyholder cancels it with 15 days written notice, the company will refund the premium for the remaining portion of the policy period.

  • Free Look Period

The Free Look Period shall only apply to new individual health insurance policies; it shall not apply to renewals or when a policy is ported or moved. From the date of receipt of the policy document, the insured person has fifteen days to review the terms and conditions and return the document if they are not satisfactory.

  • Migration Of Policy

According to IRDAI migration guidelines, the insured person will have the option to migrate the policy to additional health insurance products or plans provided by the company by applying for the migration at least 30 days before the policy renewal date.

  • Portability

According to IRDAI portability guidelines, the Insured Person will have the option to port the policy to other Insurers by applying to such Insurer to port the entire policy along with all of the family members, if any, at least 45 days before, but not earlier than 60 days from the policy renewal date.

  • Tax Benefit

Another major feature and benefit of choosing the United India Individual Health Insurance Plan is that the policyholder will get a tax rebate as per the provision of Income Tax Rules under Section 80-D.

Key Exclusions Of United India Individual Health Insurance Plan

Here is the list of the things not covered under the United India Individual Health Insurance Policy.

  • All costs associated with or resulting from a foreign invasion, an act of a foreign enemy, hostilities, warlike operations (whether a war is declared or not, or while serving in the armed forces of any nation), civil war, public defense, rebellion, revolution, insurrection, military or usurped power, or any combination of these.
  • All illnesses and costs resulting from exposure to ionising radiation or contamination by radioactivity from any nuclear fuel (in explosive or dangerous form) or any nuclear waste produced during the burning of nuclear fuel during a nuclear, chemical, or biological attack.
  • Expenses for medical care related to childbirth, except ectopic pregnancy (including complicated deliveries and caesarian sections incurred during hospitalisation).
  • During the policy period, expenses for miscarriage (aside from accidents) and legal medical abortion of pregnancy.
  • Expenses for any treatment that hasn’t been proven effective, as well as services and supplies used in conjunction with treatments. Unproven treatments are those that do not have a substantial body of medical evidence to support their efficacy.
  • Expenses associated with any form of treatment, including surgical intervention, to change a person’s physical characteristics to those of the other sex.
  • Expenses for cosmetic or plastic surgery, as well as any other procedure intended to alter the appearance, unless necessary for reconstruction following an accident, burns, cancer, or as part of a procedure deemed medically necessary to eliminate a direct or immediate threat to the insured’s health. This must be authorised as a medical necessity by the attending medical professional.
  • Costs associated with correcting vision due to refractive error of less than 7.5 dioptres.

How To Buy the United India Individual Health Insurance Policy?

People are beginning to realise how important it is to have a good health insurance plan as health problems rise. In addition, access to high-quality medical facilities and hospitalisation costs may be difficult to afford, given the rising cost of medical expenses. Therefore, purchasing health insurance for you and your family, such as United India Individual health insurance coverage, can give you the extra security you require in these trying times.

Here are the steps you should consider taking to buy the United India Individual Health Insurance plan through Probus Insurance.

  • Find the “Product” section at the top of this page. Hover over it to find “Health Insurance”. Simply click it.
  • Select your gender and enter your “pin code” in the space provided on the right side of the page. From the menu, choose “Continue”.
  • Decide which person you want to insure next. The next step requires you to select your “deductible amount” and enter your age. (Select whether you have experienced ailments by selecting yes or no). After that, click “Get Plan”.
  • A list of plans and the required premium amount will appear. Locate your ” United India Individual Health Insurance plan ” and purchase it right away.

If you are still facing difficulties and still want to purchase the United India Individual Health Insurance plan right away, just get in touch with a Probus Insurance customer service agent. The details for getting in touch are given below.

  • Via Call: +91 7304332968
  • Via WhatsApp: Say “Hi” to 7304332968
  • Mail: care@probusinsurance.com

Claim Process Of United India Individual Health Insurance Policy

The insured person or the insured person’s representative shall notify the TPA (if the claim is processed by TPA) or Company (if the claim is processed by Company) in writing upon the occurrence of any event that may give rise to a claim under this Policy, providing all relevant information relating to the claim, including a plan of treatment, policy number, etc. within the prescribed time limit as set forth below:

  • Before the insured person’s release from the hospital or within 24 hours of the date, emergency hospitalisation was necessary, whichever comes first.
  • If a planned hospitalisation is involved, at least 48 hours before admission.

Procedure for Cashless Claims:

  • If the insured chooses to have their claims processed by TPA, they will have access to a cashless facility for care at only network hospitals.
  • A network provider/PPN hospital may be used for treatment with the TPA’s prior approval.
  • Call the toll-free number listed on your health ID card to notify the TPA of your claim and receive any necessary assistance. Provide the ID number for quick access.
  • Present the ID card issued by the TPA at the hospital helpdesk upon admission to the network provider/PPN hospital.
  • Fill out the cashless request form provided by the network provider/PPN and TPA, then send it to them for approval.
  • The TPA will issue a pre-authorization letter to the hospital after verification once it has received the cashless request form and pertinent medical information from the insured person, network provider, or PPN.
  • The insured person is responsible for paying non-medical and inadmissible costs at the time of discharge as well as verifying and signing the discharge documents.
  • If the insured person is unable to provide the necessary medical information, the TPA reserves the right to refuse pre-authorization.
  • In no way should the denial of a pre-authorization request be interpreted as a refusal of treatment or coverage. The insured person may follow the doctor’s recommendations for treatment and submit the claim materials to the TPA for potential reimbursement.

Procedure for Reimbursement of Claims:

  • Payment is required upfront in non-network hospitals, and the insured person may submit the required paperwork to the TPA (if the claim is processed by the TPA) or the Company (if the claim is processed by the Company) within the allotted time frame for reimbursement of claims.
  • If the proper claim documentation and cash receipts are produced within the allotted time frame, claims for Pre and Post-Hospitalization will be resolved on a reimbursement basis.
  • Health check-up cost claims will be resolved on a reimbursement basis upon production of test results and payment receipts within the allotted time frame.

Required Documents

The following original documents must be submitted along with the claim within the allotted time frame.

  • Duly completed claim form
  • Certificate from the attending physician or surgeon detailing the diagnosis or type of procedure carried out, as well as the date of diagnosis, a recommendation for admission, investigation test results, etc., and backed by the physician’s prescription.
  • Records of the patient’s medical history, bills (including a breakdown of costs), and payment receipts properly supported by a prescription from the treating physician or hospital.
  • Discharge certificate/ summary from the hospital.
  • Cash memo from the Diagnostic Centre(s)/ hospital(s)/ chemist(s) supported by proper prescription.
  • Payment receipts from doctors, surgeons, and anaesthetists.
  • Bills, receipt, Sticker of the Implants.
  • Any other document required by the Company/ TPA

Steps To Renew the United India Individual Health Insurance Policy?

Without prompt renewal, there is a chance that the coverage will lapse. Health emergencies can occur at any time because we are unable to predict the future. Therefore, it is wise to have ongoing health insurance coverage by renewing it. If you are looking to renew the United India Individual Health Insurance Policy, then listed below are the steps to follow.

  • Go to the official website of United India Insurance Company.
  • Then, in the blue banner, go to the products section, and under health insurance, click on “Know More”.
  • Then, you will need to select the Individual Health Insurance Policy under “I am Looking for” and then click on Go.
  • Then, on the left side, you will “Renew” option in the yellow-colored button. Click on it.
  • The moment you click on it, you will then see a new page, asking you to enter your policy number and then enter a captcha code. Once you have entered all the details, click on the “Proceed” Button.
  • Enter it and then complete the renewal process. The policy’s information will then show up on your screen.
  • You must then pay the insurance renewal premium after that. At that point, you can renew your insurance using a credit or debit card.
  • After you make the payment, a text message containing details about your insurance will be sent to your registered phone number and email address.

Frequently Asked Questions

Yes, but only in the following situations is the inclusion of family members allowed midterm:

  • Newly married spouse within 60 (sixty) days of marriage.
  • Newborn baby (between 91 days to 180 days) born to mother insured under the policy.

You can make the online payment through Internet banking / Debit card / Credit card / UPI.

Under United India Health Insurance, there are typically no restrictions on making claims (up to the coverage amount). You are free to submit the same at any time.

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