Health Insurance April 30, 2021

United India CSC Individual Health Insurance Policy provides you financial coverage during the policy period in case you are hospitalized for the treatment of an Illness or Injury at a hospital or daycare centre, following your doctor’s medical advice. The insurance company shall compensate for the following medical expenses under this policy –

  1. In-Patient Hospitalization Expenses
  2. Organ Donor Medical Expenses  
  3. Daycare Treatments 
  4. Major Surgeries 
  5. Pre & Post-hospitalization 
  6. Domiciliary Hospitalization
  7. Ayurvedic Treatment  
  8. Modern Treatment 
  9. Cost of Health Check-Up

Continue reading this page further and know more about the coverage of the United India CSC Individual Health Insurance Policy.

Health Insurance

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United India CSC Individual Health Insurance Policy Cover Options

The following are the available coverage options for you –

Platinum Plan – You can opt for this plan if your age is between 18-35 years. Under this plan, you can also cover your family members such as your spouse, children above 91 days of age and both the parents. Sum insured options under this plan are as follows- INR 2 Lakh, INR 3 Lakh, INR 4 Lakh, INR 5 Lakh, INR 8 Lakh, INR 10 Lakh, INR 15 Lakh and INR 20 Lakh.

Gold Plan – If your age is 36-60 years, you can opt for this plan offering sum insured options of – INR 2 Lakh, INR 3 Lakh, INR 4 Lakh, INR 5 Lakh, INR 8 Lakh and INR 10 Lakh.

Senior Citizen Plan – Senior citizens aged between 61-65 years can buy this plan where the sum insured options are – INR 2 Lakh, INR 3 Lakh, INR 4 Lakh and INR 5 Lakh

List of United India CSC Individual Health Insurance Policy Coverages

You’ll get coverage for the following medical expenses under United India CSC Individual Health Insurance Policy.

In-Patient Hospitalization Expenses Cover

The following is the list of medical expenses covered under this policy –

  1. Room, Boarding and Nursing expenses up to 1% of the sum insured per day or actual, whichever is less
  2. Nursing care, RMO charges, IV Fluids, Blood transfusion, injection administration charges and similar expenses
  3.  Intensive Care Unit (ICU) or Intensive Cardiac Care Unit (ICCU) up to 2% of sum insured per day or actual, whichever is less
  4. Fees charged by the Medical Practitioner, Surgeon, Specialists, Consultants and Anaesthetists
  5. Operation theatre charge
  6. Expenses incurred for Anaesthetics, Blood, Oxygen, Surgical Appliances and Medical Appliances
  7. Cost of Artificial Limbs and prosthetic devices implanted during surgical procedures like pacemaker, orthopedic implants, infra cardiac valve replacements, vascular stents, relevant laboratory or diagnostic tests, X-Ray

Note – Hospitalization expenses are admissible for claims, provided the insured person is admitted for a minimum of 24 consecutive hours.

Organ Donor Medical Expenses Cover

The medical expenses for organ donors, excluding the cost of organs, will be covered by the insurer, provided the donation conforms to The Transplantation of Human Organs Act 1994.

Day Care Treatments Cover

Expenses for medical or surgical procedures undertaken under general or local anesthesia in a hospital or daycare centre for less than 24 hours due to technological advancements are covered under daycare treatments.

Cover for Major Surgeries

Medical expenses in respect of the following specified illnesses and surgeries shall be restricted as per the limit shown below:

  1. Cataract up to 25% of sum insured or INR 40,000 per eye, whichever is less
  2. Hernia & Hysterectomy up to 25% of sum insured or INR 1 Lakh, whichever is less
  3. Cardiac Surgeries, Brain Tumour Surgeries, Pacemaker Implantation for Sick Sinus Syndrome, Cancer Surgeries, Hip, Knee, Joint Replacement Surgery, Organ Transplant, up to 70% of the sum insured

Note – If the insured chooses the Platinum Cover, the cover for major surgeries will be up to the actual expenses.

Pré-hospitalization and Post-hospitalization Expenses Cover

The insurer reimburses the medical expenses of the insured for pre-hospitalization for up to 30 days and post-hospitalization expenses incurred up to 60 days.

Domiciliary Hospitalization Cover

If a medical treatment that would require care and treatment at a hospital but is taken at home due to the following circumstances –

  1. The condition of the patient is not good to be moved to a hospital
  2. Non-availability of room in a hospital

The insurer will then cover such medical expenses up to the sum insured.

Ayurvedic Treatment Cover

The insurer will pay the reasonable and customary charges for in-patient treatment taken in an AYUSH Hospital.

Modern Treatment

United India CSC Individual Health Insurance Policy covers the following modern treatments –

  1. Uterine Artery Embolization & High Intensity Focussed Ultrasound (HIFU) up to 20% of sum insured, subject to a maximum of INR 2 Lakh per policy period for Uterine Artery Embolization & HIFU claims
  2. Balloon Sinuplasty up to 10% of sum insured, subject to a maximum of INR 1 Lakh per policy period for Balloon Sinuplasty claims
  3. Deep Brain Stimulation up to 70% of the sum insured per policy period
  4. Oral Chemotherapy up to 20% of the sum insured, subject to a maximum of INR 2 Lakh per policy period
  5. Immunotherapy-Monoclonal Antibody, if given as an injection, up to 20% of the sum insured, subject to a maximum of INR 2 Lakh per policy period
  6. Intra vitreal Injections up to 10% of the sum insured, subject to a maximum of INR 1 Lakh per policy period
  7. Robotic Surgeries and Robotic-Assisted Surgeries up to 75% of the sum insured per policy period for the treatment of Central Nervous System irrespective of etiology, malignancies covered up to 50% of the sum insured.
  8. Stereotactic Radio Surgeries up to 50% of the sum insured per policy period
  9. Bronchial Thermoplasty up to 30% of the sum insured, subject to a maximum of INR 3 Lakh per policy period
  10. Vaporization of the Prostate (Green laser treatment for holmium laser treatment) up to 30% of the sum insured, subject to a maximum of INR 2 Lakh per policy period.
  11. Intra Operative Neuro Monitoring (IONM) up to 15% of the sum insured, subject to a maximum of INR 1 Lakh per policy period.
  12. Stem Cell Therapy, such as Hematopoietic Stem Cells for bone marrow transplant for hematological conditions.

Cost of Health Check-Up

The insurer will cover health check-up expenses up to 1% of the average sum insured, subject to a maximum of INR 5,000 per person per policy period. You’ll get this health-check-up benefit after a block of every three claim-free years. You will get the cover only if you do a health check-up at hospitals/diagnostic centres authorized by the insurer.

Note – Payment under this benefit will not reduce from your sum insured.

Free Look Period

A free look period of 15 days shall be applicable on United India CSC Individual Health Insurance Policy. During the free look period, you can read the terms and conditions of the policy and return it to the insurer if not acceptable. If you haven’t made any claim during the free look period, you’ll be entitled to:

  1. A refund of the paid premium after the deduction of medical examination expenses and the stamp duty charges
  2. If the risk has already commenced and you have returned the policy, a deduction towards the proportionate risk premium for the period of cover will be reduced from the refund amount
  3. If only a part of the insurance coverage has commenced, such proportionate premium will be refunded to you

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