United Shramik Seva Policy
The United Shramik Seva Policy is one such group policy that caters to the specific needs employer-employee relationships. The policy secures the employee's and worker's healthcare needs in a cross-section of industrial and commercial establishments. The United Shramik Seva Policy health insurance provides coverage for hospitalization related expenses with a vast range of options to ensure quality healthcare to the insured.
United Shramik Seva Policy Health Insurance: Key Highlight
Type
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Group Policy with a cover on an individual basis
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Tenure
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1 year
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Renewability
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Lifetime
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Pre-existing Illness over
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After 48 months
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Initial Waiting Period
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30 days
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Coverage Offered
The United Shramik Seva Insurance Policy comes with a vast coverage, which can be availed for:
- In-patient Hospitalization: The insured gets quality treatment covering all medical expenses for a hospital stay for more than 24 hours.
- Pre and Post Hospitalization Expenses: The insurer covers expenses for 30 days and 60 days, respectively.
- Daycare Treatment: The policy covers the cost of procedures and surgeries which require hospitalization for only a few hours due to advanced treatment methods.
- Alternative Treatment: The policy pays the cost if the insured chooses Ayush Treatment.
- Modern Treatments: Many modern technology-based therapies, like, Deep Brain Stimulation, Balloon Sinuplasty, Oral Chemotherapy, etc. are covered under the policy with specified limits.
Inclusions of the Plan
Group members buy United Shramik Seva Policy to avail of treatment in the traditional and technology-based modern therapies. Some of the significant inclusions in the policy are:
- Accommodation Limits:
- Room Rent: The cover is up to 1% of the sum insured per day.
- ICU: The insurer pays 2%of the sum insured per day.
- Cataract Surgery: Actual expenses incurred are covered up to 15% of the sum insured or Rs 30, 000 per eye, whichever is lower during the policy period.
- Ambulance Cover: The cover is for emergency evacuation of the insured by road with a cap of Rs 2, 000 per hospitalization.
- Other Expenses:
- Dental treatment is covered if caused by an accident.
- Plastic surgery cover is available if warranted due to disease or injury.
- Optional Cover:
- Out-patient Treatment cover
- The daily hospital cash allowance
- First Diagnosis of Epidemic / Pandemic
- Maternity benefit cover
Exclusions of the Plan
What is not covered is key information to buy UIICL Health Insurance that impacts the claim settlement process. The insured must consult the policy bond for awareness of the conditions for which the insurer is not liable.
- Waiting Period: The acceptance of claims depends on the different parameters applied for the waiting period from the policy inception date.
- The cover for pre-existing diseases starts after the expiry of 48 months of straight coverage.
- The cover for specific listed diseases starts after the expiry of 24/48 months, as mentioned in each condition.
- No claim is accepted during the first 30 days from the policy inception for any illness other than accidental injury.
- Permanent Exclusions: The conditions and situations that invite withdrawal of cover are many and elaborate.
*The insured needs to consult the policy document for the detailed list.
Features & Benefits of the United Shramik Seva Policy
The influencing factors to buy the United Shramik Seva Policy is described below:
- Sum Insured: The policy offers 5 cover options for the members to choose from Rs.1 Lakh to Rs 5 Lakh in multiples of Rs 1 Lakh. The choice of the cover depends on the class of employees. However, within the same salary, grade and class, the sum insured should be uniform.
- Policy Term: The policy term on offer is 1 year with lifelong renewability.
- Tax Benefit: The United Shramik Seva Policy Health Insurance premium is tax-exempt if not paid in cash under Section 80D of the Income Tax Act, 1961, subject to the applicable limits.
Eligibility Criteria
The minimum eligibility condition to buy this policy are:
Minimum Entry Age
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18 years
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Maximum Entry Age
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65 years
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The Number of people covered:
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Minimum 7 members in the group
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Residential Status
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Indian citizens and residents who are working in Indian establishments.
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Cancellation of Policy
The policy can be terminated by the insurer as well as the insured. The insurer terminates the policy after serving a 15-day notice if the insured person is found to misrepresent information or indulge in fraud.
Likewise, the insured can terminate the policy after tendering a 15-day notice, provided there is no pending claim.
FAQs
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Ans: Co-payment is defined as sharing a mutually agreed admissible hospital bill percentage with the insurer. The insurer pays the remaining amount.
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Ans: Yes, it is applied at rates varying from 20% to 50% if the insured chooses to cover for Modern Treatment methods.
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Ans: Yes, premium payment is entitled to tax exemption in all modes other than cash.
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Ans: The insurer manages the claim settlement process by employing a TPA. The insured can adopt cashless treatment or raise reimbursement claims as per prescribed norms.
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Ans: The health insurance policy should be renewed before the policy expiry date, to maintain cover continuity.
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Ans: The insurer manages the claim settlement process by employing a TPA. The insured can adopt cashless treatment or raise reimbursement claims as per prescribed norms.
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Ans: The health insurance policy should be renewed before the policy expiry date to maintain cover continuity.
Written By: PolicyBazaar - Updated: 14 January 2021