Features of United India Health Insurance Scheme

United India Insurance Company was established in the year 1938 as a general insurance company. Later on, when the general insurance business was nationalised in India in the year 1972, the general insurance business of the southern area of LIC, four cooperative insurance societies, twelve Indian insurance companies and the India-based operations of five foreign insurance companies were merged with United India. 

Ever since the nationalisation of the general insurance business, United India has grown considerably. Today, the company is owned by the Government of India and is a leading public sector general insurance company. The company boasts of having a wide presence across India with more than 2274 offices in different cities of India with a workforce of 12500 employees and serving more than 1.74 crore customers under its general insurance policies. With experience that exceeds over 8 decades, United India Insurance Company is surely one of the country’s most trusted insurance companies.

Features of United India health insurance schemes

The health insurance plans offered by United India have the following features –

1.    The plans allow coverage either for a single individual or for his family as well. Family can be covered under family floater plans which allow coverage for self, spouse, dependent children and, in many cases, dependent parents too

2.    You also get the benefit of free health check-ups once after a specific period

3.    If you do not make claims in a policy year, the company rewards you in the form of no claim bonus. This bonus can be an increase in the coverage level or a discount on the renewal premium

4.    There might be optional coverage benefits too under United India health insurance. These benefits can be availed if you choose them and pay an additional premium

5.    All United health insurance plans are renewable lifelong

6.    Premium discounts are also available under United India’s health plans which help in bringing down the premiums

Coverage benefits under United India health insurance schemes

United India Insurance offers a range of health insurance plans with different coverage features and benefits. Some of the commonly found coverage benefits under United India Insurance mediclaim plans are as follows –

Coverage benefit

What it covers

Hospitalisation costs

This benefit covers the costs incurred on room rent, ICU room rent, doctor’s fees, nurse’s fees, treatment costs, medicines, blood, etc. when you are hospitalised in a hospital for 24 hours or more

Pre-hospitalisation 

The pre-hospitalisation benefit covers the costs which are incurred before hospitalisation. These costs can be a doctor’s consultation costs, medicines, diagnostic tests, etc. The costs are covered for a specified duration which ranges from 30 days to 90 days

Post-hospitalisation 

Under this coverage, the costs which are incurred after being discharged from the hospital are covered. These costs are incurred on reviewing and monitoring your health after treatments and include diagnostic tests, doctor’s consultations, medicines, etc. Post hospitalisation costs are also covered for a specific duration which ranges from 60 days to 120 days

Ambulance charges

Ambulance charges are incurred when you are being taken to a hospital for treatments. These charges are also covered under United India health insurance plans up to a specific limit.

Domiciliary treatments

If you have to take treatments at your own home because a hospital bed was not available or because you were in no condition to be shifted to a hospital, such treatments would be covered under most health insurance plans. These treatments are called domiciliary treatments and they are covered up to a specified limit

AYUSH treatments

If you avail of treatments through non-allopathic means like Ayurveda, Homeopathy, etc. you can get coverage under many health insurance plans. This coverage can be granted up to the sum insured or up to a specified limit

Organ donor expenses

If you are undergoing an organ transplant and you need an organ, the costs incurred in harvesting the organ from a donor would be covered under your health insurance plan

Maternity cover

Coverage for maternity is available in select health insurance plans. Under this cover, the cost of childbirth and other pre and post-natal expenses of the insured female are covered up to specified limits.

Newborn baby cover

A newborn baby cover is usually found in health insurance plans which allow maternity cover. Under this cover, the newborn baby is also covered under the policy from birth

Add-ons under United India health insurance plans

Besides the regular coverage features, many plans also offer you the choice to increase the scope of your policy’s coverage through add-ons. Add-ons are optional coverage benefits that can be selected at your discretion. Every add-on comes with an additional premium and you can choose as many add-ons as you like. Some of the add-ons offered by United India include the following –

Hospital daily cash

Under this add-on, you receive a daily allowance if you are hospitalised in a hospital for a period of at least 24 hours. The benefit is paid per day of hospitalisation and is fixed in nature irrespective of the medical costs that you incur.

Ambulance cover

If the plan does not have an inbuilt cover for ambulance costs, the same can opt through this add-on. At a very minimal premium, you can get the ambulance costs covered under the plan.

Exclusions under United India health insurance

Though United India’s health insurance schemes provide a good scope of coverage, there are certain medical costs and treatments which are not covered under the plans. These are categorised as policy exclusions. Some of the commonly found exclusions include the following –

1.    Pre-existing diseases are covered only after the expiry of a specified waiting period. This waiting period can range from 2 years to 4 years

2.    Diseases that you suffer within 30 days of buying the policy are not covered

3.    Cosmetic treatments, dental treatments, circumcision, etc. are not covered

4.    Suicides attempted suicides, self-inflicted injuries would not be covered

5.    Mental and psychiatric disorders are not covered

6.    Any type of non-proven and experimental treatments would be excluded from coverage

7.    Venereal diseases, sexual diseases, HIV and AIDS-related infections are excluded from coverage

8.    Maternity treatments and related costs are not covered under all plans. They would be covered only if the plan’s benefits structure specifically states as such

Health insurance plans offered by United India Insurance Company

Now that you know the coverage benefits and exclusions under United India health insurance plans, let’s have a look at the different types of plans that the company offers –

1. United India Insurance Revised Family Medicare Policy

Available on an Individual as well as a Family Floater basis, the United India Revised Family Medicare Policy is an all-inclusive policy that offers a lot of coverage including in-patient hospitalisation, organ donor benefit, modern treatments and daycare treatments. 

Given below are the main features of this plan:

1.    The plan covers in-patient expenses up to the specified limit

1.    Room rent, nursing and boarding are covered depending on the sum insured opted for

2.    ICU and ICCU accommodation charges are covered up to specifies limits

2.    Daycare treatments are covered

3.    Pre-hospitalisation expenses up to 30 days and post hospitalisation up to 60 days is covered 

4.    Ayurvedic, Homeopathic and Unani in-patient treatments are covered

5.    Modern treatment methods cover treatments, with additional sub-limits, such as:

1.    Uterine Artery Embolization & High Intensity Focussed Ultrasound (HIFU)

2.    Balloon therapy

3.    Oral chemotherapy

4.    Intra vitreal injections

5.    Robotic surgeries

6.    Road ambulance cover is provided up to specified limits

7.    Health check-ups up to 1% of the average sum insured of the previous 3 years up to a maximum of INR 5,000 for Individual policies and up to INR 10,0000 per individual policy are covered

8.    Insured members over 60 years of age, under the Family Medicare plan, have to pay a copayment of 10% for every admissible clam

9.    Optional covers are available such as Restoration of Sum Insured, Daily Cash Allowance and Maternity & New Born Baby cover

Eligibility parameters of United India Insurance Revised Family Medicare Policy:

2. United India Revised Individual Health Insurance Policy

As the name suggests the United India Revised Individual Health Insurance Policy offers health coverage on an individual basis. You can take the cover for your family including yourself, your spouse, your dependent children and your parents, however, there would be a separate sum insured for each member. The main features of the plan are as follows:

1.    The plan comes in three plan options – Platinum, Gold and Senior Citizen

2.     It covers in-patient hospitalisation expenses

1.    Room rent, boarding, nursing etc are covered up to 1% of the per day sum insured

2.    ICU and ICCU charges are covered up to 2% of the sum insured

3.     OT charges, expenses on anaesthetics, oxygen, blood etc are covered

3.    Pre and post-hospitalisation are covered for 30 and 60 days respectively

4.    The plan covers doctor prescribed domiciliary hospitalisation exceeding 3 days 

5.    Specific modern treatments are covered

6.    All daycare treatments are covered

7.    Domiciliary hospitalisation expenses are covered on a reimbursement basis

8.    Dental treatments are covered, if required after an injury

9.    If necessitated due to an illness or an injury plastic surgery would be covered

10. After 3 claim-free years, the cost of health check-up is covered up to 3% of the sum insured

11. Optional covers are available: Road Ambulance cover, Daily Cash allowance 

12. For a block of 3 claim-free years, health check-ups up to 1% of the sum insured of the previous 3 years up to a maximum of INR 5,000 are covered per person per policy

Eligibility parameters of United India Revised Individual Health Insurance Policy:

3. United India Insurance Family Medicare 2014 Plan&lt

This is a revamped version of the Family Medicare policy and can be taken to cover yourself as well as your family members. The salient features of the policy are as follows –

·         Daycare treatments are covered under the policy

·         If you take Ayurvedic treatments in a Government hospital, such treatments would be covered under the scope of the plan

·         The family members can be covered under a single sum insured on a floater basis

·         Up to 15% premium discount can be availed if you don’t make claims in your policy

·         Free health check-ups are allowed every three policy years

Eligibility parameters of United India Insurance Family Medicare 2014 Plan

4. United India Insurance Individual Health Insurance Policy

This health insurance plan allows coverage on an individual basis. The scope of coverage is good and the plan offers the following salient features –

·         Daycare, as well as domiciliary treatments, are covered under the plan

·         You can avail of the add-on coverage options for hospital daily cash and ambulance charges

·         There are three plan variants of Platinum, Gold and Senior citizens. While the first two variants are for younger individuals, the third variant is specially designed for senior citizens

Eligibility parameters of United India Insurance Individual Health Insurance Policy

5. United India Insurance Super Top-up Plan

This plan provides supplemental health insurance coverage which you can avail to increase an existing coverage. Under the plan, you have to choose a sum insured and a deductible. If during the policy tenure, the aggregate claims incurred exceed the chosen deductible, the plan would pay the excess claim. Other features of the policy are as follows –

·         Hospitalisation expenses are covered up to the chosen sum insured

·         You can buy the policy on an individual basis or a family floater basis

·         A group policy can also be taken 

Eligibility parameters of United India Insurance Super Top-up Plan

6. United India Insurance UNI Criticare Plan

UNI Criticare Plan is a critical illness health insurance plan. This plan covers a list of specific illnesses and if you are diagnosed with any of the covered illnesses, you get the sum insured in lump sum irrespective of the medical costs that you incur. The features of the plan are as follows –

·         A small waiting period of 90 days is applicable after which you can enjoy complete coverage 

·         11 major illnesses are covered under the policy like kidney failure, cancer, heart valve replacement, heart attack, coma, etc.

Eligibility parameters of United India Insurance UNI Criticare Plan

7. United India Arogya Sanjeevni Policy

This is a standard health insurance policy that covers the hospitalisation expenses that you may have to incur in case of hospitalisation of 24 hours or more. This plan is available on a family floater and an individual basis. Arogya Sanjeevani Policy United India covers room rent, nursing, boarding as per the plan conditions. 

Let us look at the main features of the plan:

a.    Room rent, nursing and boarding are covered up to 2% of the sum insured to a maximum of INR 5,000 per day

b.    ICU and ICCU charges are covered up to INR 10,000 per day

c.    In-patient treatment expenses under AYUSH systems of medicine, which are Ayurveda, Yoga, Unani, Siddha and Homeopathy, are also covered

d.    When you buy the policy on an individual or a family floater basis, you can cover your spouse, dependent children, parents, parents in law
Beyond 65 years of age, plans can be continued as renewals
Children between 3 months and 18 years, who are dependent, can be covered if one or both parents are covered
Children over 18 years up to 25 years, who are independent cannot be covered under the policy, a separate policy can be taken for them

e.    The plan covers cataract treatment up to a limit of 25% of the sum insured or INR 40,000

f.     Pre and post-hospitalisation charges are covered for a period of 30 and 60 days respectively

g.    Specific modern treatments are also covered under the plan

h.    For every claim-free year, you receive a 5% increase in the sum insured

i.      The plan comes with a 5% mandatory co-payment

Eligibility parameters of United India Insurance Arogya Sanjeevani Policy

8. United India Insurance Corona Kavach Policy

Launched under the guidelines of IRDA, this is a standard health insurance plan that covers medical expenses on hospitalisation that is due to COVID-19. An adult can purchase this plan on a family floater or an individual basis and apart from self, extend the coverage to his/her spouse, dependent children, parents and parents-in-law. Here are the main features of this plan:

a.    In-hospital cover includes room rent, nursing and boarding

                i.        ICU and ICCU charges

              ii.        Blood, oxygen, PPE Kits, gloves, masks, medicines, surgical appliances

             iii.        Per hospitalisation up to INR 2000 can be covered for road ambulance charges, only for COVID hospitalisation 

b.    The positive diagnosis report should be from a government authorized diagnostic centre

c.    Doctor-prescribed home care treatment would be covered 

d.    After the age of 65 years, the insured can renew his policy

e.    For the children who are between 3 months and 18 years and are dependent, they can be covered provided one or both parents are covered

                i.        Children between 18 and 25 and financially dependent on their parents would be covered 

              ii.        A child over 18 years, who is financially independently will not be covered under this policy, and a new policy would be required

f.     AYUSH treatment for Covid-19 will also be covered 

g.    There is a waiting period of only 15 days

h.    Pre and post-hospitalisation charges, related to Covid-19, are covered for a period of 15 and 30 days respectively

i.      The plan covers home care treatment expenses, provided it is advised by a medical practitioner. The treatment would be eligible if it otherwise required hospitalisation. The treatment would cover:

                i.        Diagnostic tests

              ii.        Prescribed medicines

             iii.        Consultation charges

             iv.        Cost of an oxygen cylinder, oximeter and nebulizer 

Eligibility parameters of United India Insurance Corona Kavach Policy

9. United India Insurance Revised Super Top-up Policy

The aggregate expenses of hospitalisation exceeding the deductible/threshold level and up to the sum insured, in respect to all covered treatments during the term of the policy are covered under the United India Super Top-Up plan. You can buy this plan on an individual basis where the sum insured is separate for each member or you can buy it on a family floater basis where the whole family is covered under one sum insured.

Here are the main features of this plan:

a.    The plan covers in-patient hospital expenses

                i.        Boarding, nursing and room rent

              ii.        The fee of medical practitioners, consultants, surgeons, specialists etc are covered

             iii.        OT charges, medicines, X-ray charges, diagnostic materials, chemotherapy, radiotherapy is covered

b.    Expenses on Organ transplant, under the norms of Transplantation of Human Organs Acts 1994

c.    Individual Policy can cover self, spouse, dependent children and parents

d.    Family Floater can cover self, spouse and dependent children

4. 1. Children who are between 3 months and 18 years will be covered when either one or both their parents are covered

              II.        Children over 18 will not be covered if they are employed or married

             III.        The age limit of 18 years does not apply to unemployed and unmarried girls, disabled children 

            IV.         Male children till the age of 26 years, can be covered if they are pursuing full-time higher studies

             V.        A child over 18 years, who is financially independently will not be covered under this policy, and a new policy would be required

e.    Ayurveda treatment in an AYUSH hospital is covered

f.     Specific modern treatments are covered

Eligibility parameters of United India Insurance Revised Super Top-up Policy

10. United India Group Health Insurance

United India Insurance Group Mediclaim Policy is a group health insurance plan that can be bought by a policyholder when he has a group of up to seven employees to avail these benefits. The sum insured and the premium are determined on the basis of the coverage sought by the insured. 

The main features of this policy are as follows:

a.    Medical expenses for the in-hospitalisation treatment of the insured are covered as per the specified limit or the category, this includes:

                i.        Room rent, boarding and nursing, RMO charges, Fluids/ Blood transfusion 

              ii.        ICU and ICCU charges 

             iii.        OT charges

             iv.        Blood, oxygen, medical and surgical appliances, cost of prosthetic devices and artificial limbs

              v.        Diagnostic procedures, radiology, pathology tests, x-rays, physiotherapy, MRIs and CT scans

b.    Daycare treatments are covered, however, OPD treatments are not covered under this benefit 

c.    Organ donor expenses are covered

d.    Road ambulance expenses are covered up to the specified limit when transferring an insured 

e.    Domiciliary hospitalisation is covered when it continues for at least 3 days

f.     Pre and post-hospitalisation medical expenses, related to the same illness or injury, are covered up to a specific number of days

g.    Various optional covers are offered under this plan such as Maternity Expenses cover, Pre and Postnatal Care Cover, Newborn Baby Cover, Disease Category Sub-Limit etc. 

h.    The plan offers optional covers that can be added to the base cover:

                I.        Disease category sub-limit

              II.        Maternity expenses cover

             III.        Pre and post-natal cover

            IV.        Newborn baby cover

             V.        Mother care cover

            VI.        Out-patient treatment cover

           VII.        Sub-limit on treatment/ medical conditions/ illness surgery

         VIII.        Voluntary co-payment for in-patient hospitalisation

            IX.        Annual aggregate Deductible

             X.        Pre-claim Deductible

            XI.        Hospitalisation daily cash benefit

           XII.        Critical illness benefits cover

Eligibility parameters of United India Insurance Group Health Insurance

          o     To be eligible for this policy the insured individual must be an employee of the policyholder where there is an employer/ employee relationship OR

          o     The insured is an enrolled member of a non-employer/ employee group

          o     Self, legal spouse or life partner can be covered

11. United Shramik Seva Policy

The United Shramik Seva Policy is a group health plan that takes care of the health needs of workers and employees in offices and workplaces. Employer or employee Groups that have a minimum strength of 7 insured people would be eligible to opt for this policy. Shramik Seva Policy is available on an Individual Sum Insured basis. 

The main features of this policy are:

a.    The policy can be purchased by an employee/ employer 

b.    In-hospital medical expenses are covered up to the sum insured, including:

                i.        Room rent, nursing and boarding would be covered up to 1% of the sum insured

              ii.        ICU and ICCU expenses are covered up to 2% of the sum insured

c.    Daycare procedures are covered

d.    Dental treatment and plastic surgery is covered when necessitated after a surgery/ an illness

e.    There are 5 sum insured options that are available that can opt for the different classes/ grades of employees. But keep in mind that with a similar salary scale, the sum insured has to be equal

f.     Cataract treatment is covered up to INR 30,000 or 15% of the sum insured

g.    AYUSH treatments are covered for treatments under Ayurveda, Yoga, Siddha, Unani and Homeopathy

h.    Specified modern treatments and technological advancements are covered 

i.      Optional covers are covered, such as:

                i.        Out-patient Treatment cover (which lies between the basic sum insured)

              ii.        Daily Hospitals cash allowance

             iii.        Benefit cover for the first diagnosis of a pandemic/ epidemic

             iv.        Waiver of co-payment for pre-existing epidemic/ pandemic related comorbidities

              v.        Maternity benefit cover

j.      Pre-hospitalisation is covered for 30 days and post-hospitalisation is covered up to 60 days

k.    Multiple optional covers are available 

Eligibility parameters of United India Insurance 

How to make a claim under United India health insurance policies?

Claims under United India Insurance mediclaim policies can be made using the claim procedure specified by the insurance company. To make a claim, you should take the following steps –

1.    Whenever a claim occurs, you should inform the insurance company or its TPA (Third Party Administrator) immediately of the claim. If you are undergoing a planned hospitalisation, you should give the intimation 3-4 days before being hospitalised. On the other hand, if the hospitalisation is an emergency case, inform the insurer or the TPA within 24 hours of your hospitalisation

2.    If you want to avail of a cashless settlement of your claim, submit a pre-authorisation claim form to the TPA upon hospitalisation 

3.    If, on the other hand, you are taking treatment in a non-networked hospital and are opting for reimbursement claims, collect the claim form from the insurance company or its TPA. The claim form should, then, be filled and submitted along with other relevant documents to the TPA. The documents should be submitted within 15 days of your discharge from the hospital

There is another way to get a settlement of your health insurance claims and it is through Turtlemint. If you have bought your health insurance policy through Turtlemint you can inform the company and the company will take the necessary steps to get your claims settled. Turtlemint has a dedicated claims department that helps customers in the settlement of their claims. You can contact this department by calling 1800 266 0101 or by sending an email to claims@turtlemint.com. Once the department is informed, the team of experts would coordinate with United India and help you get your claims settled quickly.

Documents required for claims:

Health insurance claims require you to submit a list of documents that are used by the insurance company to verify and process the claims. These documents are as follows –

1.    Claim form

2.    Hospital discharge certificate 

3.    Medical bills associated with the treatments and medicines that you have purchased

4.    Hospital bills showing the expenses incurred on hospitalisation

5.    Doctor’s reports containing the details of the illness and the treatments done

6.    Bills from the pharmacy

7.    Any other documents which are required by the insurance company

United India Insurance paid all 20 Personal Accident Insurance claims to the next of kin of the gallant soldiers who were martyred in Ladakh’s Galwan Valley on 15th June 2020. The Insurance claim amounts