United India Insurance Company Limited

Corporate Identity Number: U93090TN1938GOI000108

Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

INDIVIDUAL HEALTH INSURANCE POLICY

CUSTOMER INFORMATION SHEET (CIS)
Guide to the CIS
▪ This document provides key information about your Individual Health Insurance Policy. You are
also advised to go through your policy document.
(Description is illustrative and not exhaustive )

Policy
S.
Title Description Clause
No
No

Name of -
1 Insurance Individual Health Insurance Policy
Policy

Policy -
2 {}
Number

Type of
3 Insurance Indemnity Policy
Policy

Sum Insured II.B.16

{}
4 Basis
{}
Sum Insured

Base Covers
1. In-Patient Hospitalisation Expenses
Policy i. Covers hospitalisation expenses for a minimum period of 24 III.A.1
Coverage hours. These include expenses for Room Rent, ICU/ICCU and
5 other associated medical expenses.
(What the
Policy ii. All Day Care Treatments are covered
Covers?) iii. Covers hospitalization expenses for an Organ Donor’s
treatment for the harvesting of Organ which is donated to the
Insured

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Individual Health Insurance Policy – Customer Information Sheet

UIN: UIIHLIP24089V052324
United India Insurance Company Limited
Corporate Identity Number: U93090TN1938GOI000108
Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

2. Pre-Hospitalisation and Post-Hospitalisation Expenses

Covers expenses incurred in the 30 days prior to hospitalisation III.A.2
and in the 60 days post hospitalisation subject to a maximum of
10% of SI for Pre & Post combined. (this sub-limit is only for Gold
& Senior Citizen plans).
3. Domiciliary Treatment
Covers expenses incurred for availing treatment at home which III.A.3
would otherwise require hospitalization

4. Road Ambulance III.A.4

Covers expenses incurred incurred on transportation of the
Insured Person by Road Ambulance to a Hospital for treatment
in an Emergency upto Rs. 2,500 per policy period
5. Modern Treatment Methods & Advancement in Technologies
Covers expenses for advanced medical procedures such as III.A.5
Robotic Surgeries, Oral Chemotherapy, Deep Brain Stimulation
Bronchial Thermoplasty, Stereotactic Radio Surgeries, etc.

6. Cost of Health Check-Up

Insured Person is entitled to a health check-up for a block of III.A.6
every three claim-free years
OPTIONAL COVERS
1. Daily Cash Allowance on Hospitalization
A cash amount will be paid daily to the Insured Person for every
continuous and completed period of 24 hours of Hospitalisation.
Daily cash benefit amount varies based on Sum Insured opted. III.B.1

The following is a partial list. Please refer to Policy Wordings

for the complete list of exclusions
1. Admission primarily for investigation & evaluation (Code – IV.B.4
Excl04)
2. Admission primarily for rest cure, rehabilitation, and respite IV.B.5
care (Code – Excl05)
3. Expenses related to the treatment for correction of eyesight
Exclusions
due to refractive error less than 7.5 dioptres. (Code – Excl15) IV.B.15
(What the
4. Any expenses incurred on Out-patient treatment (OPD
hospital IV.C.3
treatment)
doesn’t
6 cover) 5. Congenital External Diseases or Defects or anomalies IV.C.8

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Individual Health Insurance Policy – Customer Information Sheet

UIN: UIIHLIP24089V052324
 United India Insurance Company Limited
Corporate Identity Number: U93090TN1938GOI000108
Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

6. Cost of hearing aids; including optometric therapy IV.C.9

7. Dental treatment or surgery of any kind unless necessitated IV.C.11
by disease or accident and requiring hospitalisation
8. Intentional self-inflicted Injury or attempted suicide IV.C.12
9. Routine eye-examination expenses, cost of spectacles, IV.C.13
contact lenses
10. Vaccination or inoculation of any kind unless it is post animal
IV.C.18
bite.

7 Waiting Initial Waiting Period:

Period 30 days for all illness (not applicable on renewal or for accidents) IV.A.3
Specific Waiting Periods
IV.A.2
1. 24 months for certain specified diseases/procedures/treatments
Table A
2. 48 months for certain specified diseases/procedures/treatments IV.A.2
Table B
IV.A
Pre-Existing Diseases: Covered after forty-eight (48) months of
continuous coverage
(Note: the above waiting periods are applicable only for Gold &
Senior Citizen plans)

8 The policy will pay only u to the limits specified

Financial hereunder for the following diseases/procedures: III.A.1.2
Limits of 1.Cataract (only for Gold & Senior Citizen Plan):
Coverage:
25% of Sum Insured subject to a maximum of Rs. 40,000 per eye
III.A. 1.2
2. Hernia & Hysterectomy (only for Gold & Senior Citizen Plan):
i.Sub-Limits 25% of Sum Insured subject to a maximum of Rs. 1,00,000 per
surgery/hospitalization
3. Major Surgeries (only for Gold & Senior Citizen Plan): III.A. 1.2
up to 70% of the Sum Insured for surgeries including Cardiac
Surgeries; Brain Tumour Surgeries; Pace Maker Implantation for Sick
Sinus Syndrome; Cancer Surgeries; Hip, Knee, Joint Replacement
Surgery; Organ Transplant.

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Individual Health Insurance Policy – Customer Information Sheet

UIN: UIIHLIP24089V052324
United India Insurance Company Limited
Corporate Identity Number: U93090TN1938GOI000108
Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

4. Pre-Post Hospitalization Expenses combined(only for Gold &

Senior Citizen Plan): 10% of S.I
III.A.2
5. Domiciliary Hospitalization:

Sum Insured (in Rs.) Annual Limit (in Rs.)

50,000 10,000 Annexu

75,000 15,000 re-3
100,000 20,000
125,000 23,750
150,000 27,250
175,000 31,250
200,000 35,000
225,000 37,500
250,000 40,000
275,000 42,500
300,000 45,000
325,000 47,500
350,000 – 1,000,000 50,000
1,500,000 75,000
2,000,000 100,000
6. Road Ambulance: Rs. 2,500 per person per policy period III.A.4

7. Health Check: upto 1% of Sum Insured of preceding 3 policy III.A.6

years, subject to a maximum of Rs. 5,000 per policy period.

ii. No co-payment
ii.Co-payment iii.Deductible equivalent to Daily Cash Allowance for the first 48
iii.Deductible hours Hospitalization

iv. In-Patient Hospitalisation expenses

iv.Any Other III.A.1.i
Limit Room Rent 1% of Sum Insured
per day
ICU/ICCU charges 2% of Sum Insured III.A.1.ii
per day
Proportionate Payment Clause:
In case of admission to a room at rates exceeding the aforesaid III.A.
limits, the payment of all associated medical expenses incurred at 1.1.i.1
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Individual Health Insurance Policy – Customer Information Sheet

UIN: UIIHLIP24089V052324
 United India Insurance Company Limited
Corporate Identity Number: U93090TN1938GOI000108
Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

the Hospital shall be effected in the same proportion as the

admissible rate per day bears to the actual rate per day of Room
Rent.
Claims Turn Around Time (TAT) for claims settlement:
9
Procedure
i. TAT for preauthorization of cashless facility 2 hours
ii. TAT for cashless final bill authorization 3 hours
Link for below:
i. Network Hospitals details: https://uiic.co.in/en/tpa - V.B.5.ii
ppn-network-hospitals

ii. Helpline number: https://uiic.co.in/en/tpa -ppn-

network-hospitals
V.B.5.ii
iii. Excluded Providers :
https://uiic.co.in/sites/default/files/Excluded_Provid IV.B11
ers_List.pdf

Policy Downloading claim form:

10 https://uiic.co.in/en/claims/claim -forms
Servicing

Call service number of insurer: Please contact your Policy issuing

office, details of which are mentioned in your Policy Schedule.

Details of company officials: Please contact your Policy issuing

11 office, details of which are mentioned in your Policy Schedule .

Grievance/Comp In case of any grievance, you may contact UIIC through:

laint a. Website: www.uiic.co.in
b. Toll Free Number: 1800 425 333 33
c. E-Mail: [email protected]
V.A.14
d. You may also approach the grievance cell at any of our
branches with details of the grievance

Alternatively, you may lodge a complaint at the IRDAI

Integrated Grievance Management System
(https://igms.irda.gov.in/ ) OR approach the Office of the
Insurance Ombudsman in your respective Area/Region.
Details of Insurance Ombudsman offices have been
provided as Annexure – 3 in the Policy Wordings.

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Individual Health Insurance Policy – Customer Information Sheet

UIN: UIIHLIP24089V052324
 United India Insurance Company Limited
Corporate Identity Number: U93090TN1938GOI000108
Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

Free Look cancellation : You are allowed a period of 15 days V.A.7

Things to
12 remember from date of receipt of the policy document to review its terms and
conditions and to return the policy if not acceptable to you. This is not
applicable on renewals.

If the Insured has not made any claim during the free look period, the
Insured shall be entitled to:
If the Insured has not made any claim during the free look period, the
V.A.7.i
Insured shall be entitled to:
i. A refund of the premium paid less any expenses incurred by
the Company on medical examination of the insured persons V.A.7ii
and the stamp duty charges or
ii. Where the risk has already commenced and the option of
return of the policy is exercised by the insured person, a
deduction towards the proportionate risk premium for period of V.A7iii
cover or
iii. Where only a part of the insurance coverage has commenced,
such proportionate premium commensurate with the risk V.A.15
covered during such period
Policy renewal: Except on grounds of fraud, moral hazard
or misrepresentation or non -cooperation, renewal of your
policy shall not be denied, provided the policy is not
withdrawn. V.A.8

Migration: Insured Person has the option to migrate the policy to

other health insurance products/plans offered by UIIC by applying at
least 30 days before the policy renewal date. V.A.12

Portability: Insured Person has the option to port the entire policy
to an individual health insurance product offered by another Insurer
by applying at least 45 days before policy renewal date. Portability
is subject to underwriting. V.B.3
Change in Sum Insured: Sum Insured can be changed
(increased/decreased) only at the time of renewal or at any times
subject to underwriting by the Company. For increase in S.I, the
waiting period if any shall start afresh only for the enhanced portion
of the sum insured. V.A.9
Moratorium Period: After completion of eight continuous years
under the policy no look back to be applied. This period of eight
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Individual Health Insurance Policy – Customer Information Sheet

UIN: UIIHLIP24089V052324
 United India Insurance Company Limited
Corporate Identity Number: U93090TN1938GOI000108
Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

years is called as moratorium period. The moratorium would be

applicable for the sum insured of the first policy and subsequently
completion of eight continuous years would be applicable from date
Your of enhancement of sum insured only on the enhancement limits.
Obligations After the expiry of Moratorium Period no health insurance policy shall
be contestable except for proven fraud and permanent exclusions
13 specified in the policy contract

Please disclose all pre -existing disease/s or condition/s.

Policyholder is required to disclose all material information such as, V.A.5
but not limited to, pre-existing diseases/conditions, medical history,
etc. as sought in the Proposal form and other connected
documents. Non-disclosure, misrepresentation or misdescription of
such information may result in claim not being paid and shall make
the policy void and all premium paid thereon shall be forfeited to
UIIC.
Nomination: Policyholder is required at the inception of the policy
to make a nomination for the purpose of payment of claims under
the policy in the event of death of the Policyholder.

Declaration by the Policy Holder:

I have read the above and confirm having noted the details.
Place:

Date: Signature of Policy Holder

Legal Disclaimer Note: The information must be read in conjunction with the policy document. In
case of any conflict between the CIS and the policy document, the terms and conditions mentioned
in the policy shall prevail.

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Individual Health Insurance Policy – Customer Information Sheet

UIN: UIIHLIP24089V052324