Uni

tedI
ndi
aInsur
anceCompanyLi
mit
ed
Corporat
eIdenti
tyNumber:U93090TN1938GOI
000108
Regist
eredOffi
ce:24Whit
esRoad, Chennai
–600014
I
RDAIREGNO.
545

I
NDI
VIDUALHEALTHI
NSURANCEPOLI
CY
CUSTOMERI
NFORMATI
ON SHEET(CI
S)
Gui
det
otheCI
S
 Thi
sdocumenthasbeenpreparedtogiv
eyouabr i
efandquicki nt
roducti
ontoyourIndiv
idualHeal
thI
nsurancePol
i
cy( I
HP).
 TheCI
Smustber eadconcur
rentlywi
thPol
icyWordingastherear erefer
encest
ovar i
ousclausesi
nthePolicyWor
dings.
 TheCI
Sonlyprovi
desasummar yoft
hekeyfeat
uresofthepolicy.Pleaseref
ert
oy ourPoli
cySchedul
ealongwitht
hePol i
cy
Wordi
ngsforcomplet
einf
ormationonwhatyourpoli
cycovers.

(
Descr
ipt
ioni
sil
lust
rat
iveandnotexhaust
ive)

REFER
TO
TI
TLE DESCRI
PTI
ON POLICY
CLAUSE
NUMBER
Product
I
ndi
vi
dual
Heal
thI
nsur
ancePol
i
cy–Pl
ati
num/
Gol
d/Seni
orCi
ti
zen -
Name
a.Indemni
ty-
basedheal
thi
nsur
ancepr
oductf
ory
ouandy
ourf
ami
l
ythatof
fer
sawi
de
cover
b.Cov
erageonI
ndi
vi
dualSum I
nsur
edbasi
swhi
chmeanseachI
nsur
edPer
sonhast
hei
r
Whati
s ownSI -
I
HP?
c.3pl
ans–Plat
inum/Gold/
SeniorCi
ti
zen.Pl
easenot
ethatt
hepl
any
ouar
eunderi
sbased
ont
heageofentr
yinthepol
icy.
d.Cashl
esshospi
tal
i
sat
ioni
nanet
wor
kspanni
ng8000+hospi
tal
s

BaseCov
er
a.I
n-PatientHospi
tal
isat
ion:Coversexpensesrel
atedt
ohospit
ali
sat
ionforami ni
mum 4.
1
peri
odof24hour s.TheseincludeexpensesforRoom Rent
,SurgeonFees,Oxygen,
Diagnosti
cTestsetc.
4.1(v
)
b.OrganDonor:Cover
shospi
tal
i
sat
ionexpensesf
orOr
ganDonori
nrespectofOr
gan
t
ranspl
antt
ot heI
nsur
ed 4.1.
1(ii
i)
c.DayCarePr
ocedures 4.2(i
)
d.Pr
e-Hospi
tal
i
sat
ion:
Cov
ersexpensesi
ncur
redi
nthe30day
spr
iort
ohospi
tal
i
sat
ion 4.
2(i
i
)
e.Post
-Hospi
tal
i
sat
ion:
Cov
ersexpensesi
ncur
redi
nthe60day
sposthospi
tal
i
sat
ion
4.
3
f.Domi ci
li
aryHospi t
ali
sat
ion:Cov er
sexpensesincur
redforav
aili
ngtreat
mentathome
Whatam I whichwoul dotherwiser
equirehospit
ali
sat
ion
cover
ed 4.
4
f
or? g.AyurvedicTreatment:Coversexpensesincur
redforavai
l
ingt
reatmentunderAy
urv
edi
c
system ofMedicineinaregist
eredAYUSHHospi t
al 4.
5
h.Modern Tr
eatment
s:Cover
s expenses f
oradvanced medi
calpr
ocedur
es such as
Robot
icSurger
y,Bal
loonSi
nupl
asty,Br
onchi
alThermopl
asty
,DeepBrai
nSti
mul at
ion, 4.
6
et
c.
i
.Healt
hCheck-
Up:I
nsur
edi
sent
it
ledt
oaheal
thcheck-
upf
orabl
ockofev
eryt
hreecl
aim
-
fr
eeyear
s
4.
7
Opt
ional
Cov
ers(
onl
yav
ail
abl
euponpay
mentofaddi
ti
onal
premi
um)
a. RoadAmbulance:Cov
ersexpensesf
ort
ranspor
ti
ngt
heI
nsur
edbyRoadAmbul
ancet
o 4.
8
aHospi
tal
fortreat
ment
b. Dai
l
yCashAl
l
owance:Acashamounti
spai
ddai
l
yforev
erycont
inuousandcompl
eted
[
1]
I
ndi
vi
dualHeal
thI
nsur
ancePol
icy–Cust
omerI
nfor
mat
ionSheet
UI
N:UI
IHLI
P21114V032021
Uni
tedI
ndi
aInsur
anceCompanyLi
mit
ed
Corporat
eIdenti
tyNumber:U93090TN1938GOI
000108
Regist
eredOffi
ce:24Whit
esRoad, Chennai
–600014
I
RDAIREGNO.
545

per
iodof24hour
sofhospi
tal
i
sat
ion

Thefol
lowi
ngi
sapar
ti
all
i
st.Pl
easer
efert
oPol
i
cyWor
dingsf
ort
hecompl
etel
i
stof
excl
usi
ons. 5.
B.1
a.Excl04:Investigati
on&Ev aluation 5.
B.3
b.Excl06:Surgicalt r
eat mentf orObesitythatdoesnotf ul
fi
lallspecifi
edcondi t
ionsi
nthe 5.
B.5
Whatare Poli
cy 5.
B.8
themaj or c.Excl08:PlasticorCosmet icSur ger
yunlessasapar tofmedi cal
lynecessar ytr
eatment 5.B.
13
exclusi
ons d.Excl12:Treatmentf orAl cohol ism,drugorsubst anceabuseoranyaddi ct
ivecondi
ti
on 5.B.
14
i
nthe e.Excl17:Steril
it
y&I nferti
li
t y 5.
C.15
poli
cy? f.Excl18:Expensesi ncur r
edf orMat erni
tyexceptEct opi
cPr egnancy 5.
C.18
g.Expensesduet ofor ei
gni nv asion,warli
keoperations,civ
ilwar,revol
ution,etc. 5.
C.23
h.Congeni t
al External DiseasesorDef ectsorAnomal ies 5.
C.24
i
.Tr eatment sothert hanAl lopathyandAy urv
edicsy stemsofMedi ci
ne
j
.IntentionalSelf -
inf
lictedi njuryorat t
empt edsuicide
a.Pr
e-Exi
sti
ngDi
seases(
Excl
01)
:Cov
eredaf
ter48Mont
hsofcont
inuouscov
erage 5.
A.1
b.Speci
fi
c Di
sease/
Procedur
e(Excl
02)
:Cov
ered af
ter24/
48 Mont
hs ofcont
inuous 5.
A.2
Wai
ti
ng
cover
age
Per
iod 5.
A.3
c.Fi
rstThi
rt
yDay s(Excl
03)
:Al
li
ll
nesses(
exceptAcci
dent
s)shal
lbecov
eredaf
ter30day
s
fr
om thefi
rstpol
i
cycommencementdate

Payment Thepayoutwi
llbeonIndemnit
ybasis,whi
chmeanst hatwewi
l
lpayy
ou,aspert
het
erms
2
Basi
s andcondi
ti
onsofthepol
icy
,forexpensest
haty
ouincur.

a.IfI
nsur
edPersonisadmittedtoaroom atarat
emor ethan1%ofSum I
nsur
ed,
thenal
l Noteto
associ
atedmedi
calexpensesshal
lbepropor
ti
onat
elydeduct
ed. 4.1(2)
b.ThePolicyhasv ari
oussub-l
imit
s,l
inkedtoSI
,forCataract
,Herni
a, Hysterectomy,Major 4.
1.2,4.2,
Loss Surger
ies,Moder n TreatmentMet hods,Pre and PostHospi tali
sation,Domi cil
i
ary 4.3,4.5,
Shari
ng Hospit
alisati
on,Healt
hCheck-Up,andRoadAmbul anceOpt i
onalCov er
.Al lexpensesin 4.
6&4. 7
excessoft hesesub-
li
mitsshal
lbebornebytheInsuredPerson.
c.Adeduct
ibl
eequi
val
entt
oDailyCashAllowancefort
hef
ir
st48hourshospi
tal
i
zat
ionwi
l
l 4.
8(i
i
i)
bel
evi
edoneachadmissi
blecl
aim undertheDai
l
yCashOpti
onalCover
.

a.The poli
cy is ordi
nari
l
y l i
fe-
long renewabl
e, except on grounds of f
raud,
misr
epr
esent
ati
on,ornon-
discl
osureofmateri
alf
act
sbyt heI
nsur
ed.
b.Renewalissubj
ectt
orequestforrenewalandrequisi
tepremium i
nful
lhav
ingbeen
recei
vedbef
oret
heendofthepoli
cyperi
odandreal
isati
onofpremium.

Renewal c.Attheendofpolicyperi
od,t
hepoli
cyshallt
erminat
e,andagraceperi
odof30daysis
pr
ov i
dedt
or enewpoli
cytomaint
aincont
inui
tybenef
it
s.Cov
erageisnotav
ail
abl
edur
ing 6.
10
Condit
ions
Graceper
iod.
d.Renewalshallnotbedeniedonthegroundt
hattheI
nsur
edhadmadeacl ai
m orcl
aims
i
nt heprecedingpol
icyyears.Noloadi
ngshal
lappl
yatrenewalbasedonyourcl
aims
exper
ience.

a.Heal
thCheck-
Up:I
nsur
edi
sent
it
ledt
oheal
thcheck-
upf
orabl
ockofev
ery3cl
aim-
fr
ee 4.
6
year
s.
Renewal
b.OnlineDiscount
:Adiscountof10% shal
lbeoff
eredprovidedtheori
ginalpol
i
cywas 6.
25(
ii
)
Benefi
ts
purchasedonli
nethr
oughUIIC’
swebsit
eandal
lsubsequentrenewal
saremadet hr
ough
UII
C’ swebsi
te.
Cancel
l
ati
o a.ThePol
i
cyhol
dermaycancelt
hepol
i
cybygi
vi
ng15day
s’wr
it
tennot
iceandUI
ICshal
l 6.
7

[
2]
I
ndi
vi
dualHeal
thI
nsur
ancePol
icy–Cust
omerI
nfor
mat
ionSheet
UI
N:UI
IHLI
P21114V032021
Uni
tedI
ndi
aInsur
anceCompanyLi
mit
ed
Corporat
eIdenti
tyNumber:U93090TN1938GOI
000108
Regist
eredOffi
ce:24Whit
esRoad, Chennai
–600014
I
RDAIREGNO.
545

ref
undpremium f
ort
heunexpi
redpol
i
cyper
iodaspershor
tper
iodr
atet
abl
egi
veni
n
Poli
cyWordi
ngs.
n b.UII
Cmaycancelt hepoli
cyatanytimeongr oundsofmisrepr
esent
ati
on,f
raud,ornon-
di
sclosur
eofmat eri
alfact
sbyt heInsur
edPer son,bygi
ving15days’wri
ttennoti
ce.
Thereisnor
efundofpremium i
nsuchanev ent
.

a.Noti
fi
cati
on:Pleasenotif
ytheTPA/ UII
Cinwr i
ti
ngwi thi
n24hoursfrom thedateof 6.23(
A)
emergencyhospital
i
zati
onr equi
redorbef
oredi schar
gef r
om Hospi
tal
,whicheveris
ear
li
er;at least 48 hours pri
or t
o admissi
on i n Hospi
tali
n case of planned
Hospit
ali
zat
ion. 6.
23(
B)
b.Cashl
essPr
ocedur
e:

i
.Int
imat
eTPAoft
hecl
aim usi
ngt
oll
-f
reenumbergi
veni
nheal
thI
Dcar
d.

i
i
.Uponadmissi
oninhospi
tal,cashlessrequestf
orm shal
lbecomplet
edandsentt
o
TPAf
oraut
hori
sat
ion.Af
terverif
icati
on,TPAissuespre-
aut
hori
sat
ionl
ett
er.

i
i
i.Att hetimeofdischarge,t
heInsur
edPer sonshallveri
fyandsi gnthedischarge
papersandpayfornon-medical
andinadmissi
bleexpenses.
Howto
Cl
aim? i
v.HospitalNet
workdet ail
scanbeobt ai
ned at
:https:
//ui
i
c.co.
in/
en/
tpa-
ppn-
network- 6.
23(C-
hospit
als E)
c.Rei
mbur
sementPr
ocedur
e:

i
.Submi tt
henecessar
ydocument
stoTPA/
UII
Cwi
thi
nthepr
escr
ibedt
imel
i
mitas
ment
ionedbel
ow:
TypeofReimbursement Pr
escr
ibedTi
meLi
mit
Clai
m
Hospital
i
sati
on and Pr e- Withi
n15( f
if
teen)daysofdateofdi
schargefrom
hospit
ali
sat
ionexpenses hospi
tal
Posthospit
ali
sat
ion Withi
n 15 (fi
ft
een)day sfrom completion ofpost
expenses hospi
tal
isat
iontreat
ment
CostofHealthCheck-
Up Withi
n15( f
if
teen)daysofHealt
hCheck-Up
s

PolicySer
vici
ng
Pleasecontacty
ourPol
i
cyi
ssui
ngof
fi
ce,
det
ail
sofwhi
char
ement
ionedi
nyourPol
i
cy
Schedule.

Gri
evance/Compl
aints
I
ncaseofanygr i
evance,youmaycont
actUI
ICt
hrough:
a.Websi t
e:www.uii
c.co.
in
Pol
icy
Servi
cing/ b.Tol l
FreeNumber:180042533333
6.
15
Gri
evance/
Complai s c.E-
nt Mail
:cust
omer
care@uii
c.co.
in
Youmayal soappr
oacht hegr i
evancecel
latanyofourbr
ancheswi
thdet
ail
soft
he
gri
evance.

Alt
ernati
v el
y,youmayl odgeacompl ai
ntatt heIRDAIInt
egr
atedGr i
evanceManagement
System (htt
ps://
igms.i
rda.gov.i
n/)ORapproachtheOffi
ceoftheInsur
anceOmbudsmani n
yourrespectiv
eAr ea/
Regi on.Detai
l
sofInsur
anceOmbudsmanof f i
ceshavebeenprov
ided
asAnnexur e–3i nthePol icyWordi
ngs.

a.FreeLookPer
iod:Youareal
l
owedaperiodof15day
sf r
om dat
eofrecei
ptofthepoli
cy 6.
14
I
nsured’
s
documenttor
eviewit
stermsandcondi
ti
onsandt
oretur
nthepoli
cyi
fnotaccept
ableto
Ri
ghts
you. 6.
10

[
3]
I
ndi
vi
dualHeal
thI
nsur
ancePol
icy–Cust
omerI
nfor
mat
ionSheet
UI
N:UI
IHLI
P21114V032021
Uni
tedI
ndi
aInsur
anceCompanyLi
mit
ed
Corporat
eIdenti
tyNumber:U93090TN1938GOI
000108
Regist
eredOffi
ce:24Whit
esRoad, Chennai
–600014
I
RDAIREGNO.
545

b.Impli
ed Renewabi
li
ty:The pol
i
cyi
s or
dinar
il
yli
fel
ong r
enewabl
e excepton cer
tai
n
speci
ficgr
ounds. 6.
18
c.ChangeofSum Insur
ed:TheI nsur
edPersoncanapplyforanenhancementofSum
I
nsuredattheti
meofr enewal
.Theacceptanceofsuchenhancementwoul
dbeatthe 6.
8
di
scret
ionofUI
IC.
d.Migrati
on:Insur
edPersonhastheopt
iontomigrat
ethepol
i
cytootherheal
thi
nsurance 6.
9
products/
plansoff
eredbyUIICbyapplyi
ngatleast30daysbef
orethepoli
cyrenewal
date.
e.Portabil
ity
:InsuredPersonhastheopti
ontoportt
heent
ir
epol
icyt
oanindi
vidualheal
th 6.
17
i
nsur ancepr oductof
feredbyanotherI
nsur
erbyappl
yi
ngatl
east45daysbeforepoli
cy
renewal date.Port
abi
li
tyissubj
ecttounder
wri
ti
ng.
f
.TurnAr oundTime(TAT):Forr
eimbursementcl
aims,thecompanyshal
lset
tl
eorr
ejecta
cl
aim wit
hin30day
sf r
om dateofrecei
ptofl
astnecessar
ydocument.
a. DisclosureofI nf ormat i
on:Pol i
cyhol deri
srequiredt odiscloseal lmateri
alinf
ormat i
on 6.
1
suchas,butnotl i
mi t
edt o,pre-existi
ngdiseases/ condit
ions,medi calhistor
y,etc.as
soughti nt hePr oposal form andot herconnecteddocument s.
Non- disclosure,mi srepresentati
onormi sdescri
ptionofsuchi nformati
onmayr esul
tin
I
nsured’
s
Obl
igati
ons cl
a i
m notb ei
ngp ai
da n dsha l
lma ket hepoli
c yvoida nda l
lp r
emi um paidther
e onshall
bef orfeit
edt oUI I
C.
b. Nomi nati
on:Pol icyholderi sr equired att he incepti
on oft he policy to make a 6.
16
nomi nationf ort hepur poseofpay mentofcl aimsundert hepol i
cyintheev entofdeath
ofthePol icy
hol der .

LegalDiscl
aimerNote:
Theinf
ormat
ionmustber
eadinconjunct
ionwitht
heproductbrochur
eandpol
i
cydocument.
Incaseofanyconfli
ctbet
weentheCISandt
hepol
icydocument,thet
ermsandconditi
onsmenti
onedi
nthepol
icy
shal
lprevai
l.

[
4]
I
ndi
vi
dualHeal
thI
nsur
ancePol
icy–Cust
omerI
nfor
mat
ionSheet
UI
N:UI
IHLI
P21114V032021