United India Gold Health Insurance Plan

Entry age

Minimum age -

Maximum age -

Coverage

The following will be covered under this health insurance policy:Hospital expenses:Room, boarding and nursing expenses - not exceeding 1% of the sum insured or the actual expense, whichever is lessICU expenses - not exceeding 2% of the sum insured or the actual expense, whichever is lessSurgeon, anaesthetist, medical practitioner, consultant and specialist's fees.Expenses incurred on anaesthetic, blood, oxygen, OT charges, surgical appliances, medicines, drugs, chemotherapy, dialysis, radiotherapy, etc.Day care treatmentAyurvedic treatmentPre-hospitalisation expenses up to 30 days prior to hospitalisation.Post-hospitalisation expenses up to 60 days after discharge.Cashless facilities at more than 7000 hospitals across India.Ambulance charges up to Rs.2,500 maximum per policy period.Hospital cash benefit Rs.250 or Rs.500 per day subject to maximum of Rs.2,000 or Rs.5,000 per hospitalisation.

Payment mode

Either the amount is reimbursed or the cashless payment option is available in network hospitals. Cities wherein PPN is applicable, cashless will be restricted to PPN.

Renewal

The policy can be renewed throughout the lifetime of the life insured. You get 30 days grace period to renew the policy.

Free look period

You can return the policy in within 15 days from the date of receipt of the policy.

Cancellation

The company can cancel the policy on grounds of fraud, non-disclosure and misrepresentation by sending 15 days written notice.

Claim

The insurer can settle the claim within 15 days from the receipt of the necessary documents.

Tax benefits

Payments made towards this policy in any mode other than cash is eligible for deduction from taxable income under section 80D of the Income Tax Act.

Other benefits

1. Free medical check-up once at the end of the term provided no claims were reported during that term.
2. Cashless facility
3. No claim discount
4. Tax benefit

Waiting period

1. Initial waiting period is 30 days for all illness
2. Pre-existing diseases will be covered after 48 months.
3. Two year waiting period for:

• Cataract
• Benign prostatic hypertrophy
• Hysterectomy
• Hernia
• Hydrocele
• Congenital internal disease
• Fistula
• Piles
• Sinusitis
• Gall bladder stone removal
• Gout and rheumatism
• Calculus disorder

1. Four year waiting period for:

• Joint replacement arising due to degenerative condition
• Age related osteoporosis and osteoarthritis

Exclusions

1. Treatment outside India
2. Injuries arising out of war
3. Circumcision
4. Spectacles
5. Hearing aids
6. Dental treatment
7. HIV, AIDS and STDs
8. Hospitalisation for diagnostic purposes
9. Vitamins and tonic unless they are prescribed for a treatment
10. Pregnancy related disorders
11. Experimental treatment
12. External medical equipment
13. Treating genetic disorder with stem cell therapy
14. ARMD, RFQMR and EECP treatment
15. Non-medical expenses
16. Service charge, admission fee and registration charges
17. Change of system of treatment or medicine