Due to the sudden increase in healthcare costs, complex health coverage and high premiums, IRDAI launched a standardised health insurance policy which is uniform across the industry. The policy is called the Arogya Sanjeevani Policy and is provided by all general insurance companies. The policy's purpose is to make the health insurance purchasing process simple and affordable.
United India Arogya Sanjeevani Policy is a basic indemnity health insurance plan that provides wider coverage against hospitalisation expenses and daycare procedures expenses, including pre and post-hospitalizations and AYUSH treatment expenses. The policy provides comprehensive coverage at affordable premiums and is a stepping stone for first-time buyers.
The covers mentioned in the policy are built-in benefits available to all insured individuals under the policy.
Expenses that are covered for hospitalisation include room rent, boarding and nursing charges, ICU/ICCU and OT charges, doctor’s fee, surgeon or any other medical practitioner's fee, blood, oxygen, medical equipment or any other related expenses.
Here are some important things you should know about the United India Arogya Sanjeevani Policy.
There are several reasons why you should opt for a United India Arogya Sanjeevani policy:
The claim procedure for health insurance policies by United India is simple and fast.
All Network Hospitals provide a cashless facility. The patient must show his health card and photo Id at the time of hospitalisation and get a pre-authorisation form. A duly filled and signed pre-authorisation form is sent to the insurance company, which accepts or rejects the claim after verification. Once the claim is accepted, an authorisation letter is issued. The hospital sends the final bill, and the discharge paper to the insurance company, and the claim is settled.
In case of planned hospitalization, the insurance company should be notified at least 48 hrs in advance with details of the hospital and treatment. In case of emergency hospitalization, the company should be notified within 24 hrs of the hospitalization.
A reimbursement request should be raised by the insured to the company/TPA within the time limit. The insured should submit all the necessary documents within 30 days of discharge for verification, and the claim is settled according to the policy’s conditions as specified in the policy bond. There are several documents required to raise a reimbursement request, such as claim form, patient’s photo id, medical prescription advising hospitalization, payment receipts and original medical bills, discharge summary, test reports, NEFT details and cancelled cheque, KYC details of the proposer, and any other relevant document required by the insurer.
Ans: The company does not cover any expenses due to hospitalisation for evaluation purposes, rehabilitation purposes, obesity treatment, gender treatments, cosmetic surgery, injury caused by participation in adventure sports or breach of law, etc.
Ans: It offers a sum insured ranging from Rs. 50,000 to Rs. 10 Lakhs.
Ans: This sum insured can be changed at the time of the renewal or according to the underwriting by the company. A fresh waiting period for an increase in the sum insured will be applicable only for the increased part.
Ans: Yes. The policy covers pre-existing diseases declared at the time of application after a waiting period of 48 months of continuous coverage.