Uttar Pradesh Gramin Bank

[Link]/01/[Link], LH./2025-26/108 ta- 02.06.2025

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Joo Head Office: 2nd and 3rd floor, NBCC Commercial Complex, Vardan Khand, Gomti Nagar Extension, Lucknow -226010
email- ho@[Link]
 Uttar Pradesh Gramin Bank

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Head Office: 2nd and 3rd floor, NBCCCommercial Complex, Vardan Khand, Gomti Nagar Extension, Lucknow - 226010
email- ho@[Link]
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HEALTH INSURANCE
Plan Details:
Plan 1 Plan 2 Plan 3 Plan 4
Partículars
(1Lac to 5 Lac) (6 Lac to 10 Lac) (11 Lac to 15 Lac) (16 Lac to 20 Lac)
Cover Type Individual Individual Individual Individual

Entry Age (Min) & Entry Age 18 years to 70

18 years to 70 years 18 years to 70 18 years to 70
(Max) years
years years
Loan Customers of Loan Customers
Membership Loan Customers of Loan Customers
Bank
Bank.
of Bank
of Bank
Policy Tenure Up to 5 Years Up to 5 Years Up to 5 Years Up to 5 Years
Re- imbursement
Claim payment method Re-imbursement Re-imbursement Re-imbursement

Benefits
Accidental Death Up to SI Up to SI Up to Sl Up to SI
Upto Sum Insured Up to Sum Insured (as Up to Sum Insured
PTO (as per PTO Tabiej JUp to Sum Insuredi
per PTD Table) (as per PTD Table) (as per PTD Table)

Up to Sum Insured
PPD Up to Sum Insured (as Up to Sum Insured Up to Sum Insured
(as per PPD Table)
per PTD Table) (as per PPD Table) (as per PTD Table)
Accidental
Rs.50,000 Rs.50000 Rs.100,000 Rs.100,D00
Hospitalization
>4 Days and <=9
>4Days and <=9 >4 Days and <=9 >4Days and
Days:
Days: Fixed Days: Fixed <=9 Days:
Fixed Benefit=
Benefit= Benefit= Fixed
Benefit=
Hospital Cash Allowance
Rs.2500/ Rs.5000/ Rs.7500/ Rs.10000/
(EMICover -only for
Accidental Hospitalization) >9 Days and
>9Days and <=14 >9 Days and <=14 >9 Days and
<=14 Days: Fixed
Days: Fixed Days: Fixed <=14 Days:
Benefit=
Benefit= Benefit= Fixed
Benefit=
Rs.5,000/ Rs.10,000/ Rs.15,000/ Rs.20,000/
>14 days: Fixed >14days: Fixed
>14 days: Fixed >14 days: Fixed
Benefit=
Benefit= Rs. 15000/ Benefit=
Rs. 7500/ Rs. 22500/ Benefit= Rs. 300010/

fart
Popio,
Group Care 360 - Policy Terms and Conditions Care Health Insurance Limited
 car
HEALTH INSURANCE

Premium Excluding GST:

1. PersonaB Aocidert Cover+ Coeatescence Bereftt:

Premium Chart Excl. of GST @18%

Policy Tenure 1 Lakh 2 Lakh 3 Lakh 4 Lakh 5 Lacs 6 Lacs 7 Lacs 8 Lacs 9 Lacs 10 Lacs

599 799 1099 1299 1599 1699 1800 1899 2099

1 years 399

798 1198 1598 2198 2598 3198 3398 3598 3798 4198
2 years
1197 1797 2397 3297 3898 4797 5096 5397 5697 6296
3years
1597 2397 3195 4396 5196 6396 6796 7196 7596 8396
4 years
1995 2995 3995 5495 6495 7995 8495 8995 9495 10495
5 years

Premium Chart Excl. of GST @18%

11 Lakh 12 Lakh 14 Lakh 15 Lacs 16 Lacs 17 Lacs 18 Lacs 19 Lacs 20 Lacs
Policy Tenure 13 Lakh
2499 2699 2899 3099 3299 3699 3899 4099 4299 4499
1years
4998 S399 S799 6199 6599 7397 7797 8197 &S97 8998
2 years
7497 8097 8697 9297 9897 11097 11697 12297 12897 13497
3 years
4 years 9996 10796 11596 12396 13196 14796 15596 16396 17196 17996

5 years 12495 13494 14495 15495 16495 18495 19495 20495 21495 22496

* Subject to Master Policy Renewal

Notes:

1. This quote is priced on the basis of assumption of that minimum 2,000 COi (Certificate of Insurance)
are issued by the client for the policy year.
2 Every quarter, CHIL will review the experience on the parameter as stated above along
with the Claim experience of the policy.
3 If average no. of certificates issued per quarter is less than 500 or the claim experience is
above an acceptable level, CHIL will have a discretion of cancelling the policy with immediate
effect. This clause is to be a part of the MOU/ Agreement between CHIL and the client.
4 Insurance can only be offered to the existing customers/member once he has become a
customer of the client. Policy will be issued on Named basis only.
5 This quote is valid for 45 days from the date of quote issue or policy start date whichever is earlier.
Insured should be the direct customers/members of the group administrator and
minimum of 7 lives is required
7. In case of any mass media promotion of the product and policy, Prior approval from the
company will be taken.
Allother terms and conditions of Group Care 360 applies for thisquote.

Group Care 360°- Policy Terms and Conditions Care Health Insurance Limited
 car
HEALTH INSURANCE
Plan Details:

Particulars Descriptlon
Coverage Details
Cover Type Individual/ Floater
Relationship Type Self/Spouse/3 Dependent Children
Entry Age - Min Adult: 18 years Child:91 Days
Entry Age -Max Adut: 65 years Child: 24 years
Exit Age Adult: Lifelong* Child:25 years
Pre-policy Medical Check-up No, Good Health declaration bases
Membership Registered Customers of BARODA U.P BANK
Policy Tenure 1Year
HE:-Cashless (within network) /Re-imbursement
Claims pay-out
HS:- Cashless(within network)
Claims Servicing In - house
Covered Benefits
Hospitalization Expenses -
Sum Insured (SI) in Rs. 2Lacs /3 Lacs / 4 Lacs /5 Lacs/7 Lacs/10 Lacs/15 Lacs/20 Lacs/25 Lacs
In - patient care Up to SI
Day Care Treatment Up to SI
Pre-hospitalization Medical expenses 60 days
Post-hospitalization Medical expenses 180 days
Domestic Road Ambulance Up to Rs. 10,000 per hospitalization
Donor Expenses Up to SI
Modern Treatments Up to SI
Alternative Treatments (|PD basis) Up to SI
Annuat Heatthh Check-up Once for att fnsured every poticy year
Domiciliary Hospitalization Up to Sl; if it continues for a period exXceeding 3 consecutive days
Recharge of coverage Amount Up to SI

Wait Period
30 Days Yes (except for Injuries/Accident)
Named Ailment (as defined in Graup Care 360
Product) 24 Months
Pre-existing diseases 36 Months

Sub-limits

On Room rent Up to 2% of SI for up to 4 Lac SI, Single Private Room for 5 Lac and above
SI
ICUcharges Up to 4% of S for up to 4 Lac St, otiits for 5 tac and above St

Care Health Insurance Limited

Group Care 360\ PolEy Terms and Conditions
 car
HEALTH INSUAANCIE

Health Services
Doctors on CalI Covered only GP

Health Portal- Doctor on chat, Healthy tips reminder, etc. Discount

Discount Connect Connect - Discounts on services such as consultations, diagnostics,
maternity etc at our network.

Premium Excluding GST for HE + HS:

Zone 1:
Individual (1A)
Age
Band/ SI 2,00,000 3,00,000 4,00,000 5,00,000 7,00,000 10,00,000 15,00,000 20,00,000 25,00,D00

18-35 5,560 5,792 6,033 6,284 6,381 7,099 8,507 9,354 10,097
36-40 6,988 7,279 7,583 7,899 8,032 8,949 10,739 11,776 12,685
41-45 7,951 8,282 8,627 8,986 9,136 10,188 12,238 13,381 14,363
46-50 9,893 10,306 10,735 11,182 11,380 12,702 15,272 16,715 17,961
51-55 12,509 13,030 13,573 14,139 14,402 16,092 19,365 21,217 22,824
56-60 16,947 17,653 18,388 19,154 19,531 21,843 26,312 28,859 30,699
61-65 24,045 25,047 26,091 27,178 27,740 31,055 37,444 41,112 43,622
Above 65
Yr* 31,486 32,798 34,164 35,588 36,340 40,664 48,989 53,796 58,017

1A1C

Age
Band/ SI 2,00,000 3,00,000 4,00,000 5,00,000 7,00,000 10,00,000 15,00,000 20,00,000 25,00,,000
18-35 6,055 6,307 6,570 6,844 6,948 7,728 9,997 11,147 11,996
36-40 7,322 7,627 7,945 8,276 8,413 9,370 12,109 13,439 14,455
41-45 8.232 8,575 8,932 9,304 9,455 10,539 13,617 15,063 16,1167
46-50 11,083 11,545 12,026 12,527 12,737 14,206 17,667 19,629 21,116
51-55 13,427 13,986 14,569 15,176 15,444 17,239 21,396 23,749 25,567
56-60 17,689 18,426 19,194 19,994 20,366 22,756 28,424 31,503 33,613
61-65 24,558 25,581 26,647 27,757 28,306 31,661 39,049 43,206 45,966
Above 65
Yr* 33,330 34,719 36,166 37,673 38,441 42,987 52,771 58,279 62,857

oroup Care 360-

Po andConditions Care Health Insurance Limited
 car
HEALTH INSURANCE

1A2C
Age
Band/ SI2,00,000 3,00,000 4,00,000 5,00,000 7,00,000 10,00,000 15,00,000 20,00,000 25,00,000
18-35 8,051 8,387 8,736 9,100 9,237 10,274 13.358 14,998 16,116
36-40 8,649 9,010 9,385 9,776 9,935 11,064 14,363 16,053 17,250
41-45 9,232 9,616 10,017 10,434 10,600 11,812 15,326 17,076 18,324
46-50 13,955 14,537 15,142 15,773 16,029 17,868 22,506 25,218 27,1144
51-55 16,471 17,158 17,872 18,617 18,934 21,121 26,524 29,676 31,962
56-60 20,974 21,848 22,758 23,706 24,132 26,944 33,958 37,900 40,517
61-65 27,955 29,120 30,333 31,597 32,201 35,994 44,772 49,823 53,107
Above 65
Yr* 35,902 37,397 38,956 40,579 41,383 46,255 57,179 63,435 68,424

1A3C
Age
Band/ SI |2,00,000 3,00,000 4,00,000 5,00,000 7,00,000 10,00,000 15,00,000 20,00,000 25,001,000
18-35 9,259 9,645 10,047 10,465 10,623 11,815 15,362 17,248 18,534
36-40 9,946 10,361 10,793 11,242 11,426 12,723 16,518 18,461 19,838
41-45 10,617 11,059 11,520 12,000 12,190 13,583 17,625 19,637 21,073
46-50 15,630 16,281 16,959 17,666 17,953 20,013 25,206 28,245 30,401
51-55 18,448 19,216 20,017 20,851 21,206 23,656 29,707 33,237 35,797
56-60 23,491 24,470 25,489 26,551 27,027 30,178 38,033 42,448 45,379
61-65 31,310 32,614 33,973 35,389 36,065 40,313 50,145 55,801 S9,480
Above 65
Yr* 40,210 41,885 43,630 45,448 46,349 51,805 64,040 71,047 76,635
2A

Age
Band/ SI 2,00,000 3,00,000 4,00,000 5,00,000 7,00,000 10,00,000 15,00,000 20,00,000 25,010,000
18-35 7,345 7,651 7,969 8,302 8,429 9,377 12,036 13,913 15,018
36-40 9,360 9,750 10,156 10,579 10,754 11,978 15,392 17,754 19,:133
41-45 10,608 11,050 11,511 11,990 12,187 13,588 17,479 20,104 21,598
46-50 13,105 13,651 14,220 14,812 15,071 16,819 20,751 23,871 25,646
51-55 17,540 18,271 19,032 19,825 20,191 22,555 27,532 31,706 34,:100
56-60 24,345 25,359 26,416 27,517 28,052 31,367 38,675 44,585 47,1532
61-65 35,458 36,935 38,474 40,077 40,898 45,777 56,076 64,713 68,,698
Above 65
Yr* 48,980 51,021 53,147 55,362 56,525 63,252 77,203 89,119 95,806

Group Care 360 PdlicýTd dions Care Health Insurance Limited

 car
HEALTH INSURANCIE

2A1C

Age 5,00,000 7,00,000 10,00,000 15,00,000 20,00,000 25,00),000

Band/ SI 2,00,0003,00,000 4,00,000
18-35 9,341 10,136 10,558 10,719 11,923 15,397 17,764 19,139
9,730
36-40 11,133 11,597 12,081 12,584 12,790 14,244 18,385 21,188 22,811
41-45 12,322 12,836 13,370 13,928 14,153 15,776 20,369 23,424 25,158

46-50 15,977 16,643 17,336 18,058 18,363 20,482 25,590 29,460 31,6 74
51-55 20,584 21,442 22,336 23,266 23,681 26,438 32,661 37,633 40,494

S6-60 27,630 28,781 29,980 31,229 31,817 35,556 44,208 50,981 54,436
61-65 38,855 40,474 42,161 43,917 44,793 50,110 61,809 71,330 75,8440
Above 65
51,723 53,878 56,123 58,462 59,665 66,740 81,890 94,538 1,01,6i61
Yr*

2A2C
Age 2,00,000 3,00,000 4,00,000 5,00,000 7,00,000 10,00,000 15,00,000 20,00,000 25,001,000
Band/ SI
18-35 11,337 11,810 12,302 12,814 13,008 14,469 18,759 21,616 23,259

36-40 12,907 13,445 14,005 14,589 14,826 16,509 21,379 24,621 26,488
41-45 14,036 14,621 15,230 15,865 16,118 17,963 23,259 26,743 28,719
46-50 18,849 19,634 20,452 21,304 21,655 24,144 30,428 35,049 37,702
51-55 23,629 24,613 25,639 26,707 27,170 30,320 37,790 43,559 46,889
56-60 29,369 30,592 31,867 33,195 33,803 37,758 47,254 54,508 58,273

61-65 41,197 42,913 44,701 46,564 47,470 53,081 65,835 75.997 80,9(07
Above
52,987 55,195 57,494 59,890 61,099 68,322 84,217 97,234 1,04,.585
65 Yr*
2A3C

Age 3,00,000 4,00,000 5,00,000 7,00,000 10,00,000 15,00,000 20,00,000 25,0o),000

2,00,000
Band/ SI
1835 13,038 13,581 14,147 14,736 14,959 16,639 21,572 24,858 26,748
36-40 14,843 15,462 16,106 16,777 17,050 18,986 24,585 28,315 30,4161
41-45 16,142 16,814 17,515 18,244 18,536 20,657 26,748 30,755 33,0126
46-50 21,111 21,990 22,906 23,861 24,253 27,042 34,080 39,255 42,2:26
51-55 26,464 27,567 28,716 29,912 30,431 33,959 42,325 48,786 52,5:16
56-60 32,893 34,263 35,691 37,178 37,860 42,288 52,925 61,049 65,2(66
61-65 46,140 48,063 50,065 52,151 53,167 59,451 73,735 85,117 90,616
Above
59,345 61,818 64,394 67,077 68,431 76,521 94,323 1,08,902 1,17,,136
65 Yr*

Group Care 360 /Plcy Fesmsa Conditions Care Health Insurance Limited
 car
HEALTH INSURANCE

Zone 2:
Individual (1A)
Age 5,00,000 7,00,000 10,00,000 15,00,000 20,00,000 25,00,000
Band/ SI 2,00,000 3,00,000 4,00,000
18-35 5,032 5,241 5,460 5,687 5,888 6,550 7,849 8,631 9,316

36-40 6,324 6,588 6,862 7,148 7,411 8,257 9,909 10,866 11,705

41-45 7,636 7,954 8,285 8,630 8,957 9,989 11,998 13,118 14,082
46-50 9,502 9,897 10,310 10,739 11,157 12,453 14,972 16,387 17,6(09
51-55 12,014 12,514 13,036 13,579 14,120 15,776 18,985 20,801 22,376

56-60 16,275 16,953 17,660 18,396 19,148 21,415 25,796 28,293 30,097

61-65 23,093 24,055 25,057 26,101 27,196 30,446 36,710 40,306 42,767
Above
30,239 31,498 32,811 34,178 35,627 39,866 48,028 52,741 56,880
65 Yr*

1A1C

Age 5,00,000 7,00,000 10,00,000 15,00,000 20,00,000 25,001,000

2,00,000 3,00,000 4,00,000
Band/ Sl
18-35 5,480 5,708 3,946 6,194 6,411 7,131 9,224 10,286 11,069
36-40 6,626 6,902 7,190 7,490 7,763 8,646 11,173 12,401 13,3:38
41-45 7,906 8,235 8,578 8,936 9,269 10,332 13,350 14,768 15,850
46-50 10,644 11,088 11,550 12,031 12,487 13,927 17,320 19,245 20,7(02
51-55 12,895 13,432 13,992 14,575 15,141 16,901 20,976 23,284 25,066
56-60 16,989 17,696 18,434 19,202 19,967 22,309 27,867 30,886 32,953
61-65 23,585 24,567 25,591 26,657 27,751 31,040 38,283 42,359 45,064
Above
65 Yr*
32,010 33,344 34,733 36,180 37,687 42,144 51,737 57,136 61,625

Group Care 360 - Policy Terms and Conditions Care Health Insurance Limited
 car
HEALTH INSUJRANCE

1A2C

Age 2,00,000 3,00,000 4,00,000 5,00,000 7,00,000 10,00,000 15,00,000 20,00,000 25,00,000
Band/ SI
8,523 9,480 12,326 13,839 14,871
18-35 7,286 7,590 7,906 8,236
10,209 13,253 14,812 15,917
36-40 7,827 8,153 8,493 8,847 9,168
41-45 8,866 9,235 9,620 10,021 10,392 11,580 15,025 16,741 17,965
46-50 13,402 13,961 14,543 15,148 15,715 17,518 22,064 24,724 26,611
51-55 15,819 16,478 17,164 17,880 18,562 20,707 26,004 29,094 31,335
56-60 20,143 20,982 21,857 22,767 23,658 26,416 33,292 37,156 39,722

61-65 26,848 27,966 29,132 30,345 31,569 35,288 43,895 48,846 52,066
Above
34,479 35,916 37,412 38,971 40,572 45,348 56,058 62,191 67,082
65 Yr*

1A3C
Age
Band/ 2,00,000 3,00,000 4,00,000 5,00,000 7,00,000 10,00,000 15,00,000 20,00,000 25,00,1000

18-35 8,379 8,728 9,092 9,471 9,802 10,902 14,175 15,915 17,10)2
36-40 9,001 9,376 9,767 10,174 10,543 11,740 15,241 17,034 18,30)5
41-45 10,196 10,621 11,063 11,524 11,951 13,317 17,279 19,252 20,660
46-50 15,011 15,636 16,288 16,966 17,601 19,620 24,712 27,691 29,805
51-55 17,717 18,455 19,224 20,025 20,790 23,192 29,125 32,585 35,0995
56-60 22,560 23,500 24,479 25,499 26,497 29,586 37,287 41,615 44,4889
61-65 30,069 31,322 32,627 33,987 35,358 39,523 49,162 54,707 58,314
Above
38,617 40,226 41,902 43,648 45,440 50,790 62,785 69,654 75,132
65 Yr*

far

Group Care 360 - Policy Terms and Conditions Care Health Insurance Limited
 care
HEALTH INSURANCIE

2A

Age
Band/ S 2,00,000 3,00,000 4,00,000 5,00,000 7,00,000 10,00,000 15,00,000 20,00,000 25,00,000
18-35 6,647 6,924 7,212 7,513 7,778 8,653 11,106 12,838 13,858
36-40 8,470 8,823 9,191 9,574 9,923 11,053 14,202 16,382 17,654
41-45 10,188 10,612 11,055 11,515 11,949 13,322 17,136 19,710 21,174
46-50 12,586 13,110 13,657 14,226 14,775 16,489 20,344 23,403 25,143
51-55 16,845 17,547 18,278 19,040 19,795 22,113 26,992 31,084 33,431
56-60 23,381 24,355 25,370 26,427 27,502 30,752 37,917 43,710 46,600
61-65 34,053 35,472 36,950 38,489 40,096 44,879 54,976 63,444 67,351
Above 65
Yr* 47,040 49,000 51,042 53,168 55,417 62,012 75,689 87,371 93,928

2A1C
Age
Band/ SI 2,00,000 3,00,000 4,00,000 5,00,000 7,00,000 10,00,000 15,00,000 20,00,000 25,00),000
18-35 8,453 8,806 9,172 9,555 9,890 11,002 14,207 16,392 17,660
36-40 10,075 10,495 10,933 11,388 11,802 13,143 16,964 19,550 21,048
41-45 11,834 12,327 12,841 13,376 13,875 15,466 19,970 22,965 24,665
46-50 15,344 15,983 16,649 17,343 18,003 20,080 25,088 28,883 31,053
51-55 19,769 20,593 21,451 22,344 23,216 25,919 32,021 36,895 39,700
56-60 26,535 27,641 28,792 29,992 31,193 34,859 43,341 49,981 53,369
61-65 37,316 38,871 40,490 42,177 43,915 49,127 60,588 69,931 74,353
Above 65
Yr* 49,674 51,744 53,900 56,146 58,495 65,432 80,284 92,685 99,668

Group Care 360 - Policy Terms and Conditions Care Health Insurance Limited
 car
HEALTH INSUAANCIE

2A2C

Age 10,00,000 15,00,000 20,00,000 25,00,000

2,00,000 3,00,000 4,00,000 5,00,000 7,00,000
Band/ SI
18-35 10,260 10,687 11,133 11,597 12,003 13,351 17,309 19,945 21,462
36-40 11,681 12,167 12,674 13,203 13,681 15,233 19,726 22,719 24,441

41-45 13,480 14,042 14,627 15,236 15,802 17,610 22,803 26,219 28,155
46-50 18,102 18,856 19,642 20,460 21,230 23,671 29,832 34,362 36,963
51-55 22,693 23,638 24,623 25,649 26,638 29,726 37,049 42,705 45,970
56-60 28,205 29,380 30,605 31,880 33,140 37,017 46,328 53,440 57,131
61-65 39,564 41,213 42,930 44,719 46,539 52,040 64,544 74,507 79,321

Above 65
50,888 53,008 55,217 57,517 59,901 66,982 82,566 95,327 1,02,535
Yr*
2A3C

Age 5,00,000 7,00,000 10,00,000 15,00,000 20,00,00025,00,000

2,00,000 3,00,000 4,00,000
Band/ SI
18-35 11,799 12,291 12,803 13,336 13,803 15,353 19,905 22,937 24,681
36-40 13,433 13,993 14,576 15,183 15,733 17,518 22,685 26,126 28,107

41-45 15,502 16,148 16,821 17,522 18,172 20,252 26,224 30,152 32,379
46-50 20,274 21,119 21,999 22,916 23,778 26,512 33,411 38,485 41,398

51-55 25,416 26,475 27,578 28,727 29,834 33,293 41,495 47,830 51,486
56-60 31,590 32,906 34,277 35,705 37,117 41,459 51,887 59,852 63,9186

61-65 44,312 46,159 48,082 50,085 52,124 58,285 72,289 83,448 88,839

Above
56,994 59,369 61,843 64,419 67,089 75,020 92,474 1,06,767 1,14,839
65 Yr*

* Subject to Master Policy Renewal

(0 Medical Tests covered in the Annual Health Check-up, applicable for Insured Persons who are of Age below
18 year on the Policy Period Start Date.

List of Medical Tests covered as a part of Annual Health Check-up

Physical Examination (Height, Weight and Body Mass Index (BMI), Eye Examination,
Dental Examination and Scoring, Growth Charting, Doctor Consultation, Urine Examination
(Routine and Microscopic)

(i) Medical Tests covered in the Annual Health Check-up, applicable for Insured Persons who are of Age 18
ears er above on the Policy Period Start Date, are as follows :

Care Health Insurance Limited

36gPoicy Terms and Conditions
 care
HEALTH INSURANCIE

Set No. List of Medical Tests covered as a part of AnnualHealth Check- up Sum Insured

1 COMPLETE BLOOD COUNT(CBC), URINE ROUTINE, ESR,

ABO GROUP & RH TYPE, BLOOD SUGAR FASTING, CHOLESTE ROL,
CHOLESTEROL DIRECT LDL, CHOLESTEROL
HDL, TRIGLYCERIDES, TOTAL CHOLESTEROL/HDL RATI0, 5Lakhs-10Lakhs
CREATININE, BLOOD UREA NITROGEN, BUN/ CREATININE RATIO, URIC ACID
COMPLETE BLOOD COUNT(CBC), URINE ROUTINE, ESR,
ABO GROUP & RH TYPE, BLOOD SUGAR FASTING, CHOLESTEROL,
CHOLESTEROL DIRECT LDL, CHOLESTEROL
HDL,TRIGLYCERIDES, TOTAL CHOLESTEROL/HDL RATIO, Above 10Lakhs
CREATININE, BLO0D UREA NITROGEN, BUN/ CREATININE
RATIO, URIC ACID, TREADMILL TEST

Special Conditions:

1 Insurance can only be offered to the existing customers/member once he has become a customer of the cliemt.
Policy will be issued on Named basis only.
2 Insured should be the direct customers/members of the group administrator and minimum of 7 lives is require.
3. Allother terms and conditions of Group Care 360 applies for this master policy

far

Group Care 360 - Policy Terms and Conditions Care Health Insurance Limited
 car
HEALTH INSURANCE
Plan Details:
Option 1:
Particulars Descrlption
Coverage Details
Cover Type Individual
Relationship Type Self
Entry Age - Min Adult: 18 years
Entry Age - Max Adult: 65 years
Exit Age Adult: Lifelong*
NO, Good health declaration basis, above 55 years Tele UW
Pre-policy Medical Check-up require for Cl

Membership Registered Loan Customers of Baroda U.P. Bank

Policy Tenure 1/2/3/4/5 Year
Claims payout Re-imbursement Only
Claims Servicing In - house

Covered Benefits
Critical Ilness Benefit
Sum Insured 1 Lac to 3 Cr (n line with financial liability)
Critical Illness Benefit 100% of SI
Number of Critical llness 32 CI
Wait Periods
Initial Wait Period 90 Days
Survival Period U
Days
Named Ailment (as defined in Group Care 360 Product) Not Covered

Pre-existing diseases Not Covered

Premium Excluding GST:

1 Critical Illness Benefit:
Per Lac premium for 32 Critical Illness

Age Band/Policy Term 1Year 2 Year 3 Year 4 Year 5 Year

18-25 74 131 193 253 310

26-30 94 186 279 333 415

31-35 126 243 386 540 673

36-40 243 473 739 937 1174

41-45 357 741 1095 1480 1878

46-50 705 1351 2019 2732 3457

51-55 1048 2079 3087 4071 5027

56-60 1372 2847 4397 5996 7625

60-65 2503 4918 7238 9460 11579
Above 65 Years* 3779 7426 10930 14285 17484

Care Health Insurance Limited

Gro %Car3O- \ljcy Terms and Conditions
 care
HEALTH INSURANGE

* Subject to Master Policy Renewal

32 CI

CIConditions
CANCER OF SPECIFIED SEVERITY

MYOCARDIAL INFARCTION

OPEN CHEST CABG

OPEN HEART REPLACEMENT OR REPAIR OF HEART
VALVES
COMA OF SPECIFIED SEVERITY

KIDNEY FAILURE REQUIRING REGULAR DIALYSIS

STROKE RESULTING IN PERMANENT SYMPTOMS

MAJOR ORGAN BONE MARROW TRANSPLANT

PERMANENT PARALYSIS OF LIMBS

MOTOR NEURONE DISEASE WITH PERMANENT

SYMPTOMS
MULTIPLE SCLEROSIS WITH PERSISTING SYMPTOMS

BENIGN BRAIN TUMOR

BLINDNESS

END STAGE LUNG FAILURE

END STAGE LIVER FAILURE

THIRD DEGREE BURNS
PARKINSON'S DISEASE

ALZHEIMER'S DISEASE
BACTERIAL MENINGITIS

APLASTIC ANAEMIA
PULMONARY THROMBOEMBOLISM

PRIMARY(IDIOPATHIC) PULMONARY HYPERTENSION

fNFECTVE ENDOCARDITIS

SURGERY OF AORTA
CARDIOMYOPATHY

SURGERY FOR CARDIAC ARRHYTHMIA

ANGIOPLASTY

BALLOON VALVOTOMYNALVULOPLASTY
CAROTLD ARTERY SURGERY
PERICARDECTOMY

IMPLANTATION OFPACEMAKER OF HEART

IMPLANTABLE CARDIOVERTER DEFIBRILLATOR

Special Conditions:

1. Insurance can only be offered to the existing customers/member once he has become a customer of the client. IPolicy
witt be íssued on Named basís onty.
2. Insured should be the direct customers/members of the group administrator and minimum of 7 lives is require.
3. Allother terms and conditions of Group Care 360& Group Care 360 plus applies for this master policy.

360-pAolicy Terms and Conditions Care Health Insurance Limited

 care
HEALTH INSURANCIE

Plan Details:
Option 2:

Particulars Description
Coverage Details
Cover Type Individual
DC:- Self
Relationship Type HS:- Self/Spouse/2 Dependent Children/2 Dependent Parent
Entry Age - Min Adult: 18 years, Child: 91 Days
Entry Age -Max Adult: 65 years, Child:24 years,Dependent Parent:79 years
Exit Age Adult: Lifelong* ,Child: 25 years
Pre-policy Medical Check-up NO, Good health declaration basis
Membership Registered Loan Customers of Baroda U.P. Bank
Policy Tenure 1/2/3/4/5 Year
Claims payout HS:-Cashless (within network) DC:- Re-imbursement Only
Claims Servicing In - house

Covered Benefits
Daily Cash Allowance
INR 500 per day hospitalization with maximum limit upto 30 days in a
year with 2 days deductible on Per claim, Payout Double In case off
ICUHospitalization with maximum limit upto 20 days in a Year witth 2
Covered Amount days deductible on Per claim. Customer can collectively dairm for 30
Days in a year for both comprehensive and ICU hospitalization
however lCU hospitalization should not exceed 20 Days in a year.
Wait Period
30 Days Yes(Except injuries/accidents)
Named Ailment (as defined in Group Care 360 24 Months
Product)
Pre-existing diseases 24 Months
Maternity Not Covered
Health Service
Doctors on Call Cover only GP.

1. Daily Cash Allowance + Health Services:

Premium Exchuding GST/Berefit 500 DC 1A_Dot onCai (Farnity of

Amount 6)
1 Year 254.24

2Year 508.47

3 Year 762.71
4Year 1016.95
5 Year 1271.19

* Subject to Master Policy Renewal

Groubare &66 PolicyTerms and Conditions Care Health Insurance Limited

 car
HEALTH INSURANCE

Plan Details:
Option 3:
Particulars Description
Coverage Details
Individual
Cover Type
DC:- Self/Spouse(Borrower/Co Borrower)
Relationship Type HS:- Self/Spouse/2 Dependent Children/2 Dependent Parent
Entry Age - Min Adult: 18 years, Child: 91 Days
Entry Age - Max Adult: 65 years, Child:24 years, Dependent Parent:79years
Exit Age Adult: Lifelong* , Child: 25 years
Pre-policy Medical Check-up NO, Good health declaration basis
Membership Registered Loan Customers of Baroda U.P. Bank
Policy Tenure 1/2/3/4/5 Year
Claims payout HS:-Cashless (within network) DC:- Re-imbursement Only
Claims Servicing In - house

Covered Benefits
Daily Cash Allowance
INR 500 per day hospitalization with maximum limit upto 30 days in a
year with 2 days deductible on Per claim, Payout Double In case of ICUI
Hospitalization with maximum limit upto 20 days ina Year with 2 days
Covered Amount deductible on Per claim. Customer can collectively claim for 30 Days im a
year for both comprehensive and lICU hospitalization however ICU
hospitalization should not exceed 20 Days in a year.
Wait Period
30 Days Yes(Except injuries/accidents)
Named Ailment (as defined in Group Care 360 24 Months
Product)
Pre-existing diseases 24 Months
Maternity Not Covered
Health Service
Doctors on Call Cover only GP.

1. Daily Cash Allowance + Health Services:

Premium Excluding GST/Benefit 500 DC 2A_Doc on Call (Family of

Amount 6)
1Year 466.10
2 Year 932.20

3 Year 1398.31

4Year 1864.41

5 Year 2330.51

Grouptare 360alcy Terms and Conditions Care Health Insurance Limited

PochTO,
 car
HEALTH INSURANCE

Special Conditions:

he has becomne a customer of

1. Insurance can only be offered to the existing customers/member once
the [Link] willbe issued on Named basis only.
administrator and minimum of 7 lives. is
2. Insured should be the direct customers/members of the group
required.
this master policy.
3. All other terms and conditions of Group Care 360 & Group Care 360 plus applies for
2
4. Doctor on Call will be applicable for all 6 Family Members (self, spouse, 2 dependent parents,
dependent children).

Group Care 360 - Policy Terms and Conditions Care Health Insurance Limited
 car
HEALTH INSURANCE
* Subject to Master Policy Renewal

SpecialConditions:
S. Insurance can only be offered to the existing customers/member once he has become a customer of
the client. Policy will be issued on Named basis only.
6. Insured should be the direct customers/members of the group administrator and minimum of 7 lives is
require.
7. Allother terms and conditions of Group Care 360 &Group Care 360 plus applies for this master policy.
8. Doctor on Call will be applicable for all 6 Family Members (self, spouse, 2 dependent parents, 2
dependent children).

Group Care 360 - Policy Terms and Conditions Care Health Insurance Limited
 care
HEALTH INSURANCIE

Plan Details:- Option 4

Particulars Description
Coverage Details
Individual
Cover Type
DC:- Self/Spouse (Borrower/Co Borrower)
Relationship Type HS:- Self/Spouse/2 Dependent Children/2 Dependent Parent
Entry Age - Min Adult: 18 years, Child: 91 Days
Entry Age - Max Adult: 65 years, Child:24 years, Dependent Parent:79 years
Exit Age Adult: Lifelong*, Child: 25 years
Pre-policy Medical Check-up NO, Good health declaration basis
Registered Loan Customers of Baroda U.P. Bank
Membership
Policy Tenure 1/2/3/4/5 Year
HS:-Cashless (within network) DC:- Re-inmbursement Only
Claims payout
Claims Servicing In - house

Covered Benefits
Daily Cash Allowance
INR 1000 per day hospitalization with maximum limit upto 30 days in a
year with 2 days deductible on Per claim, Payout Double In case of ICU
Hospitalization with maximum limit upto 20 days in a Year with 2 days
Covered Amount deductible on Per claim. Customner can collectivelyclaim for 30 Days in
ayear for both comprehensive and ICU hospitalization however ICU
hospitalization should not exceed 20 Days in a year.
Wait Period

30 Days Yes(Except injuries/accidents)

Named Ailment (as defined in Group Care 360
24 Months
Product)
Pre-existing diseases 24 Months
Not Covered
Maternity
Health Service
Doctors on Call Cover only GP+15 Specialities

1. Daily Cash Allowance + Health Services:

Premium Excluding GST/Benefit 1000 DC 2A Doc on Call (Family of

Amount 6)
1 Year 635.59

2 Year 1271.19

3 Year 1906.78

4Year 2542.37
5Year 3177.97

Group Care 34b-PaidTatgandConditions Care Health Insurance Limited

 care
HEALTH INSURANCIE

* Subject to Master Policy Renewal

SpecialConditions:
has become a customer of
1. Insurance can only be offered to the existing customers/member once he
the client. Policy willbe issued on Named basis only.
and minimum of 7 Iives is
2. Insured should be the direct customers/members of the group administrator
require.
3. Allother terms and conditions of Group Care 360 & Group Care 360 plus applies for this master policy.
2
4. Doctor on Call will be applicable for all 6 Family Members (self, spouse, 2 dependent parents,
dependent children).

Group Care 360 - Policy Terms and Conditions Care Health Insurance Limited
 car
HEALTH INSURANCE
Plan Details
Particays Description
Coverage Details
Cover Type Individual
Relationship Type Self
Entry Age - Min Adult: 18years
Entry Age - Max Adult: 65 years
Exit Age Adult: Lifelong*
Pre-policy MedicalCheck-up No

Membership Registered Customers of Baroda U.P. Bank

Policy Tenure 1 Year
Claims payout Re-imbursement
Claims Servicing In - house
Covered Benefits
Personal Accident Cover
Sum Insured 2 lacs
Accidental Death 100% of SI
Children's Education INR 15,000 [Link] thild:(Maximum two children)
Fracture Up to 20k
Repatriation of Mortal Remains Up to 1Ok
Accidental Hospitalization Up to 5Ok
INR 1000 per day hospitalization with maximum limit upto 50 days ina
Daily Cash year with 2 days deductible on Per claim

1. Personal Accident Cover:

Sum Insured 200000
Premium Excluding GST 517

* Subject to Master Policy Renewal

Specialconditions:
1. Insurance can only be offered to the existing customers/member once he has become
a customer of the client. Policy will be issued on Named basis only.
2 Imsured shoutd be the direct customers/members of the group administrator and
minimum of 7lives is required
3. Allother terms andconditions of Group Care 360 applies for this master policy.

Group Care 360° - Policy Terms and Conditions Care Health Insurance Limited