United India Insurance has revised policy terms and premiums for its Family Medicare and Individual Health Insurance Policy w.e.f 14th Sep 2023. I recently renewed my family’s medicare policy with them and found that the premiums for me (age 49), my wife (age 47) and my son (age 13) have not increased. These are individual covers for Rs. 25 lakhs each.
My 76-year-old mother has Rs. 6 lakhs cover (United refused to increase it further), and its cost (before discounts and GST) shot up from Rs. 39,230 to Rs. 46,134 (17% hike).
Last year, United significantly changed its family medicare policy by effectively removing room rent sub-limits on covers above Rs. 5 lakhs, removing rent sub-limits from its super top-up policy and hiking the sum insured to Rs. 95 lakhs. These may not be as significant as those but they are in favour of the customer (aside from premium hikes).
Revised terms for the family medicare policy:
- Unrestricted Modern Treatment Methods: All sub-limits are removed on modern treatment methods. There is a list of such treatments in the policy wordings, including stem cell treatment, oral chemo, etc. At the time of writing, the sub-limits are still seen in the policy wordings. I expect they will be updated to reflect this change soon.
- Inclusive Restoration of Sum Insured Cover: The optional cover of Restoration of Sum Insured has been subsumed into the base coverage.
- Scientific Pricing: The company claims, “We have taken great care in crafting a more scientifically-driven pricing structure to ensure that you receive the best value. Our aim is to offer you a claims experience that is second to none”.
Revised terms for the individual health policy:
In addition to points 1 and 3 above,
- Inclusive Road Ambulance Cover: The optional cover of Emergency Road Ambulance has been subsumed into the base coverage.
Terms for the Restoration of Sum Insured Cover in the Family Medicare policy
These are the policy wordings.
“If the Basic Sum Insured is exhausted completely or partially due to claims made and paid/ accepted as payable during the Policy Year, then it is agreed that a Restore Sum Insured equal to 100% of the Basic Sum Insured will be automatically and instantly available for the particular Policy Year, provided that:
- In case of policies on Individual Sum Insured basis the Restore sum insured, will be available to each Insured Person individually and in case of a floater policy, the restore Sum Insured will be available for all insured persons on floater basis.
- A single claim in a Policy Year cannot exceed the Basic Sum Insured.
- Such restored Sum Insured can be utilized only for illness / disease unrelated to the illness / diseases for which claim(s) was / were made.\
- The Restoration of Sum Insured will be applied only once during a Policy Year for family floater policy. For Policy on Individual Sum Insured basis, the restore facility will be available once to each insured person individually in a
policy year. - If the Restore Sum Insured is not utilised in a Policy Year, it shall not be carried forward to any subsequent Policy
Year.
1. Automatic Restoration of Basic Sum Insured is available only for sum insured options from Rs. 3,00,000 and above.
2. For persons with age of entry above 60 years in Family Medicare Policy, every admissible claim under this optional cover
shall be subject to a Co-payment of 10% on the admissible claim amount.
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