United India Insurance Company Limited

Corporate Identity Number: U93090TN1938GOI000108

Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

Yuvaan Health Insurance Policy

Prospectus
1. Product – Key Features
Yuvaan Health Insurance Policy is an Indemnity-based health insurance product for you and your family that offers a wide cover at
affordable cost. Our cashless hospitalisation network spans 14000+ hospitals pan India.

COVERAGE AT A GLANCE:

Base Cover
In-Patient Hospitalisation Expenses
All Day Care Treatments
Pre-Hospitalisation – 60 Days & Post Hospitalisation Expenses – 90 Days
Organ Donor Expenses
Road Ambulance Expenses
Modern Treatment Methods & Advancement in Technology
Cumulative Bonus up to 100% of Sum Insured

Optional Covers
Waiver of Co-Payment
2. Cover Type
The Policy provides cover on an Individual basis or Family Floater basis. A separate Sum Insured for each Insured Person is provided
under Individual basis while under Family Floater basis, the Sum Insured is shared by the whole family of the Insured as specified in
the Policy Schedule and Our total liability for the family cannot exceed the Sum Insured and applicable Cumulative Bonus in a Policy
period. The cover type basis shall be as specified in the Policy Schedule.
3. Family
An adult person can take a policy for himself or his/her family consisting of all or either of:
i. Self, Spouse, and dependent children on Individual Sum Insured basis;
ii. Self, Spouse, and dependent children on Floater Sum Insured basis;

4. Eligibility
Eligibility based on age:
i. Adults: 18 years to 45 years.
ii. Dependent Children: 91 days to 17 years, provided either or both parents are covered concurrently. In case, where both the
parents of the child(ren) are already deceased, the minor child(ren) can be covered by the guardian without covering
himself/herself.
Children aged 18 years or above will continue to be covered along with parents till the age of 26 years, provided they are
unmarried/unemployed and dependent.
The upper age limit will not apply to mentally challenged child(ren).
In the event of children becoming independent, employed, getting married, or attaining 26 years of age, a separate policy shall
be taken on the expiry of the current policy for which continuity benefits will be provided.
Beyond 45 years, only renewals are allowed.
Midterm inclusion of family members is allowed at pro-rata premium only in case of:
i. Newly married spouse within 60 (sixty) days of marriage.
ii. New born baby, between the ages of 91 days to 180 days, born to mother, insured under the policy.
iii. An adopted child between the ages of 91 days to 18 years within 60 days of the date of adoption.
5. Policy Term & Payment Options
Policy Term - One Year. Lifelong Renewable ordinarily.
Available Payment Option – Annually.
6. Co-Payment
Geographical Zones
The country is divided into three geographical zones: Zone A, Zone B, Zone C. The Zones are based on the following districts:

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Yuvaan Health Insurance Policy – Prospectus

UIN: UIIHLIP24134V012324
United India Insurance Company Limited
Corporate Identity Number: U93090TN1938GOI000108
Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

Zone Districts

All Districts in NCT of Delhi (incl. Shahdara), Faridabad, Palwal, Gurugram, Rohtak, Jhajjar, Ghaziabad,
A Gautam Buddh Nagar, Bulandshahr, Ahmedabad, Ahmedabad City, Gandhi Nagar, Vadodara, Surat,
Mumbai, Mumbai Suburban, Thane, Raigad (MH), Palghar

Ahmed Nagar, Amritsar, Anand, Bengaluru, Bhopal, Chennai, Coimbatore, Dakshina Kannada, Ernakulam,
Howrah, Hyderabad, Indore, Jaipur, Jalgaon, Jodhpur, Kanpur, Nagar, Kheda, Kolhapur, Kolkata, Kottayam,
B
Krishna, Lucknow, Ludhiana, Nagpur, Nashik, North 24 Parganas, Pune, Rajkot, Ranga Reddy, Solapur,
Thiruvananthapuram, Tiruvallur, Valsad, Visakhapatnam.

C Rest of India

i. If the insured has paid the premium for Zone C, a co-payment of 15% will apply for each and every claim amount for
treatment taken in any city of Zone A.
ii. If the insured has paid the premium for Zone B, a co-payment of 10% will apply for each and every claim amount for
treatment taken in any city of Zone A.
7. Sum Insured
For a new policy, the following Sum Insured options are available:
Rs. 5 lacs, 10 lacs, 15 Lacs, 20 Lacs.
8. Coverage
A. Base Covers
The Policy provides base coverage as described below in this section provided that the expenses are incurred on the written
Medical Advice of a Medical Practitioner and are incurred on Medically Necessary Treatment of the Insured Person.
1. In-patient Hospitalisation Expenses Cover
We will pay the Reasonable and Customary Charges for the following Medical Expenses taken during Hospitalisation provided
that the admission date of the Hospitalisation due to Illness or Injury is within the Policy Period:
i. Room Rent (for Shared Accommodation), Boarding and Nursing expenses incurred as provided by the Hospital. These
expenses will include nursing care, RMO charges, patient’s diet charges, IV Fluids/Blood transfusion/injection
administration charges and similar expenses.
ii. Charges for accommodation in Intensive Care Unit (ICU)/ Intensive Cardiac Care Unit (ICCU).
iii. The fees charged by the Medical Practitioner, Surgeon, Specialists, and anaesthetists treating the Insured Person;
iv. Operation Theatre charges,
v. Anaesthesia, Blood, Oxygen, Surgical Appliances and/ or Medical Appliances, medicines and drugs, Cost of Artificial Limbs,
cost of prosthetic devices implanted during surgical procedure like pacemaker, orthopaedic implants, infra cardiac valve
replacements, vascular stents, relevant laboratory/ diagnostic tests, X-Ray, dialysis, chemotherapy, radiotherapy, and such
other associated expenses related to the treatment.
1.1 Note:
i. PROPORTIONATE PAYMENT CLAUSE: In case of admission to a room other than Shared Accommodation, the
reimbursement/payment of all associated medical expenses incurred at the Hospital shall be effected in the same
proportion as the admissible rate per day bears to the actual rate per day of Room Rent.
Proportionate Deductions shall not be applied in respect of those hospitals where differential billing is not followed or for
those expenses where differential billing is not adopted based on the room category.
ii. No payment shall be made under clause 8.A.1.iii other than as part of the hospitalisation bill. However, the bills raised by
Surgeon, Anaesthetist directly and not forming part of the hospital bill shall be paid provided a pre-numbered bill/receipt
is produced in support thereof, when such payment is made ONLY by cheque/credit card/debit card or digital/online
transfer.
iii. All Day Care treatments as defined in the policy are covered.

2. Pre-Hospitalisation and Post-Hospitalisation Expenses –

We will cover, on a reimbursement basis, the Insured Person’s
i. Pre-hospitalisation Medical Expenses incurred due to an Illness or Injury during the period up to 60 days prior to
hospitalisation; and
ii. Post- hospitalisation Medical Expenses incurred due to an Illness or Injury during the period up to 90 days after the discharge
from the hospital.

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Yuvaan Health Insurance Policy – Prospectus

UIN: UIIHLIP24134V012324
United India Insurance Company Limited
Corporate Identity Number: U93090TN1938GOI000108
Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

Conditions:
a. The Pre-hospitalisation and Post-hospitalisation Medical Expenses are related to the same Illness or Injury.

3. Organ Donor Expenses Cover

We will cover the In-patient Hospitalization Medical Expenses incurred for an organ donor’s treatment during the Policy Period
for the harvesting of the organ donated provided that:
i. The donation conforms to The Transplantation of Human Organs Act 1994 and the organ is for the use of the Insured Person;
ii. We have admitted a claim towards In-patient Hospitalisation under Clause 8.A.1 and it is related to the same condition;
organ donated is for the use of the Insured Person as certified in writing by a Medical Practitioner;
iii. We will not cover:
a. Pre-hospitalization Medical Expenses or Post-hospitalisation Medical Expenses of the organ donor;
b. Screening expenses of the organ donor;
c. Costs directly or indirectly associated with the acquisition of the donor’s organ;
d. Transplant of any organ/tissue where the transplant is experimental or investigational;
e. Expenses related to organ transportation or preservation;
f. Any other medical treatment or complication in respect of the donor, consequent to harvesting.

4. Modern Treatment Methods & Advancement in Technologies:

In case of an admissible claim under Clause 8.A.1, expenses incurred on the following procedures (wherever medically indicated)
shall be covered:
i. Uterine Artery Embolization and HIFU (High Intensity focused ultrasound)
ii. Balloon Sinuplasty
iii. Deep Brain Stimulation
iv. Oral Chemotherapy
v. Immunotherapy - Monoclonal Antibody to be given as an injection
vi. Intra-vitreal injections
vii. Robotic Surgeries
viii. Stereotactic Radio Surgeries
ix. Bronchial Thermoplasty
x. Vaporization of the Prostrate (Green Laser Treatment or Holmium Laser Treatment)
xi. IONM - (Intra Operative Neuro Monitoring)
xii. Stem Cell Therapy; Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered

5. Cumulative Bonus (CB)

The insured person(s) shall be rewarded Cumulative Bonus calculated at 50% of the Sum Insured as bonus for each claim free
year subject to a maximum of 100% of the Sum Insured. If a claim is made in any particular year, the cumulative bonus accrued
shall be reduced at the same rate at which it has accrued.

Note:
i. The CB shall be withdrawn if the policy is not renewed within Grace Period.
ii. In case where the policy is on individual basis, the CB shall be available individually to each insured person. CB shall reduce
only in case of claim from the same Insured Person. In case where the policy is on floater basis, the CB shall be available to
the family on floater basis, provided no claim has been reported from any member of the family. CB shall reduce in case of
claim from any of the Insured Persons.
iii. If the Insured Persons in the expiring policy are covered on an individual basis as specified in the Policy Schedule and there
is an accumulated CB for such Insured Person under the expiring policy, and such expiring policy has been renewed on a
floater policy basis as specified in the Policy Schedule then the CB to be carried forward for credit in such Renewed Policy
shall be the one that is applicable to the lowest among all the Insured Persons.
iv. In case of floater policies where Insured Persons renew their expiring policy by splitting the Sum Insured into two or more
floater policies/individual policies, the CB of expiring policy shall be apportioned to such renewed Policies in the proportion
of the Sum Insured of each renewed Policy.
v. If the Sum Insured has been reduced at the time of renewal, the applicable CB shall be reduced in the same proportion to
the Sum Insured in current Policy.
vi. If the Sum Insured under the Policy has been increased at the time of Renewal the CB shall be calculated on the Sum Insured
of the last completed Policy Year.
vii. If a claim is made in the expiring Policy Year, and is notified to Us after the acceptance of Renewal premium any awarded
CB shall be withdrawn.

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Yuvaan Health Insurance Policy – Prospectus

UIN: UIIHLIP24134V012324
United India Insurance Company Limited
Corporate Identity Number: U93090TN1938GOI000108
Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

6. Road Ambulance Cover

We will cover the costs incurred on transportation of the Insured Person by road Ambulance to a Hospital for treatment in an
Emergency following an Illness or Injury which occurs during the Policy Period. The necessity of use of an Ambulance must be
certified by the treating Medical Practitioner and becomes payable if a claim has been admitted under Clause 8.A.1 and the
expenses are related to the same Illness or Injury.
We will also cover the costs incurred on transportation of the Insured Person by road Ambulance in the following circumstances
under this cover, if:
a. it is medically required to transfer the Insured Person to another Hospital or diagnostic Centre during the course of
Hospitalization for advanced diagnostic treatment in circumstances where such facility is not available in the existing
Hospital;
b. it is medically required to transfer the Insured Person to another Hospital during the course of Hospitalization due to lack
of super specialty treatment in the existing Hospital.
B. Optional Cover:
1. Waiver of Co-payment
If this cover is opted, then the applicable Co-Payment will be waived off, subject to payment of premium for Zone A.

9. What Policy Does Not Cover

A. Waiting Periods
The Company shall not be liable to make any payment under the policy in connection with or in respect of the following expenses
till the expiry of waiting period mentioned below:

1. Pre-Existing Diseases (Code – Excl01)

i. Expenses related to the treatment of a pre-existing disease (PED) and its direct complications shall be excluded until the
expiry of 12 months of continuous coverage after the date of inception of the first policy with us.
ii. In case of enhancement of the Sum Insured, the exclusion shall apply afresh to the extent of the Sum Insured increase.
iii. If the Insured Person is continuously covered without any break as defined under the portability norms of the extant IRDAI
(Health Insurance) Regulations, then the waiting period for the same would be reduced to the extent of prior coverage.
iv. Coverage under the policy after the expiry of 12 months for any pre-existing disease is subject to the same being declared
at the time of application and accepted by us.

2. Specified Disease/Procedure Waiting Period (Code – Excl02)

i. Expenses related to the treatment of the listed Conditions; surgeries/treatments shall be excluded until the expiry of 12
months of continuous coverage after the date of inception of the first policy with us. This exclusion shall not be applicable
for claims arising due to an accident.
ii. In case of enhancement of the sum insured the exclusion shall apply afresh to the extent of the sum insured increase.
iii. The waiting period for listed conditions shall apply even if contracted after the policy or declared and accepted without a
specific exclusion.
iv. If the Insured Person is continuously covered without any break as defined under the applicable norms on portability
stipulated by IRDAI, then the waiting period for the same would be reduced to the extent of prior coverage.
v. List of specific diseases/procedures:
a. Benign ENT disorders/ Acid peptic disease/ Benign skin disorders/cataract.
b. Calculus (stone) Diseases of Gall Bladder including Cholecystectomy
c. All types of Surgery for Hernia /Hydrocele
d. Calculus of the Urinary system (Kidney Stone/Urinary Bladder/Ureteric Stone)
e. Fissure / Fistula / Hemorrhoids/Pilonidal sinus/ varicose veins
f. Gout/ Rheumatism/ Non infective arthritis
g. Spinal diseases unless arising from accident
h. Poly cystic ovarian disease/ Menorrhagia/ Fibromyoma/Hysterectomy
i. Internal congenital anomaly
j. All internal and external benign tumors, cysts, polyps of any kind, including benign breast lumps.
k. Mental illness- Schizophrenia, Bipolar affective disorder, Depression, Obsessive compulsive disorder, Psychosis
3. 30-Day Waiting Period (Code – Excl03)
i. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded
except claims arising due to an accident, provided the same are covered.
ii. This exclusion shall not, however, apply if the Insured Person has Continuous Coverage for more than twelve months.
iii. The within-referred waiting period is made applicable to the enhanced sum insured in the event of granting a higher sum
insured subsequently.

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Yuvaan Health Insurance Policy – Prospectus

UIN: UIIHLIP24134V012324
United India Insurance Company Limited
Corporate Identity Number: U93090TN1938GOI000108
Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

B. Standard Permanent Exclusions

The company shall not be liable to make any payment under this Policy in respect of any expenses incurred by You in connection
with or in respect of:

4. Investigation & Evaluation (Code – Excl04)

i. Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded.
ii. Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment are excluded.

5. Rest Cure, Rehabilitation and Respite Care (Code – Excl05)

Expenses related to any admission primarily for enforced bed rest and not for receiving treatment. This also includes:
i. Custodial care either at home or in a nursing facility for personal care such as help with activities of daily living such as
bathing, dressing, and moving around either by skilled nurses or assistants or non-skilled persons.
ii. Any services for people who are terminally ill to address physical, social, emotional and spiritual needs.

6. Obesity/Weight Control (Code – Excl06)

Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions:
i. Surgery to be conducted is upon the advice of the Doctor
ii. The surgery/Procedure conducted should be supported by clinical protocols
iii. The member has to be 18 years of age or older and
iv. Body Mass Index (BMI):
a. Greater than or equal to 40 or
b. greater than or equal to 35 in conjunction with any of the following severe co-morbidities following failure of less
invasive methods of weight loss:
b.1. Obesity-related cardiomyopathy
b.2. Coronary heart disease
b.3. Severe Sleep Apnea
b.4. Uncontrolled Type2 Diabetes

7. Change-of-Gender treatments (Code – Excl07)

Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite
sex.

8. Cosmetic or Plastic Surgery (Code – Excl08)

Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an Accident,
Burn(s) or Cancer or as part of the medically necessary treatment to remove a direct and immediate health risk to the insured.
For this to be considered a medical necessity, it must be certified by the attending Medical Practitioner.

9. Hazardous or Adventure Sports (Code – Excl09)

Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports, including
but not limited to, para-jumping, rock climbing, mountaineering, rafting, motor racing, horse racing or scuba diving, hand gliding,
sky diving, deep-sea diving.

10. Breach of Law (Code – Excl10)

Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a
breach of law with criminal intent.

11. Excluded Providers (Code – Excl11)

Expenses incurred towards treatment in any hospital or by any Medical Practitioner or any other provider specifically excluded
by the Insurer and disclosed on its website/notified to the policyholders are not admissible. However, in case of life-threatening
situations or following an accident, expenses up to the stage of stabilization are payable but not the complete claim.

12. (Code – Excl12)

Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof.

13. (Code – Excl13)

Treatments received in health hydros, nature cure clinics, spas or similar establishments or private beds registered as a nursing
home attached to such establishments or where admission is arranged wholly or partly for domestic reasons.

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Yuvaan Health Insurance Policy – Prospectus

UIN: UIIHLIP24134V012324
United India Insurance Company Limited
Corporate Identity Number: U93090TN1938GOI000108
Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

14. (Code – Excl14)

Dietary supplements and substances that can be purchased without a prescription, including but not limited to Vitamins,
minerals and organic substances unless prescribed by a medical practitioner as part of a hospitalisation claim or day care
procedure.

15. Refractive Error (Code – Excl15)

Expenses related to the treatment for correction of eyesight due to refractive error less than 7.5 diopters.

16. Unproven Treatments (Code – Excl16)

Expenses related to any unproven treatment, services and supplies for or in connection with any treatment. Unproven
treatments are treatments, procedures or supplies that lack significant medical documentation to support their effectiveness.

17. Sterility and Infertility (Code – Excl17)

Expenses related to sterility and infertility. This includes:
i. Any type of contraception, sterilization
ii. Assisted Reproduction services including artificial insemination and advanced reproductive technologies such as IVF, ZIFT,
GIFT, ICSI
iii. Gestational Surrogacy
iv. Reversal of sterilization

18. Maternity (Code- Excl18)

i Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred
during hospitalisation) except ectopic pregnancy;
ii Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy
period.

C. Specific Permanent Exclusions

1. All expenses caused by or arising from or attributable to foreign invasion, an act of foreign enemies, hostilities, warlike
operations (whether war be declared or not or while performing duties in the armed forces of any country), civil war, public
defence, rebellion, revolution, insurrection, military, or usurped power.
2. All Illnesses/expenses caused by ionizing radiation or contamination by radioactivity from any nuclear fuel (explosive or
hazardous form) or any nuclear waste from the combustion of nuclear fuel, nuclear/chemical/biological attack.
3. Any expenses incurred on Domiciliary Hospitalization.
4. Any expenses incurred on Out-patient treatment (OPD treatment). Procedures/treatments usually done in outpatient
department are not payable under the policy even if admitted/converted as an in-patient in the hospital for more than 24 hours.
5. Any item(s) or treatment specified in ‘List of Non-Medical Expenses under this Policy’ as per clauses in Annexure – 1, unless
specifically covered under the Policy.
6. Any treatment related to sleep disorder or sleep apnoea syndrome.
7. Artificial life maintenance including life support machine use, from the date of confirmation by the treating doctor that the
patient is in a vegetative state.
8. Change of treatment from one system of medicine to another system unless recommended by the consultant/hospital under
whom the treatment is taken.
9. Circumcision unless necessary for Treatment of an Illness or Injury not excluded hereunder or due to an Accident.
10. Congenital External Diseases or Defects or anomalies.
11. Cost of hearing aids; including optometric therapy.
12. Cost of routine medical examination and preventive health check-up.
13. Dental treatment or surgery of any kind unless necessitated by disease or accident and requiring hospitalisation.
14. Expenses in respect of the existing diseases, disclosed by the insured and mentioned in the policy schedule (based on insured’s
consent), Insured Person is not entitled to get the coverage for specified ICD Codes.
15. Intentional self-inflicted Injury or attempted suicide.
16. Routine eye-examination expenses, cost of spectacles, contact lenses.
17. Stem cell implantation/Surgery/Therapy, harvesting, storage or any kind of treatment using stem cells except Hematopoietic
stem cells for bone marrow transplant for haematological conditions; growth hormone therapy.

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Yuvaan Health Insurance Policy – Prospectus

UIN: UIIHLIP24134V012324
United India Insurance Company Limited
Corporate Identity Number: U93090TN1938GOI000108
Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

18. Treatments including Rotational Field Quantum Magnetic Resonance (RFQMR), External Counter Pulsation (ECP), Enhanced
External Counter Pulsation (EECP), Hyperbaric Oxygen Therapy, chondrocyte or osteocyte implantation, procedures using
platelet rich plasma, Trans Cutaneous Electric Nerve Stimulation; Use of oral immunomodulatory/ supplemental drugs.
19. Treatments given under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH) systems.
20. Unless used intra-operatively, any expenses incurred on prosthesis, corrective devices; External and or durable Medical/ Non-
medical equipment of any kind used for diagnosis and/or treatment and/or monitoring and/or maintenance and/or support
including instruments used in treatment of sleep apnoea syndrome; Infusion pump, Oxygen concentrator, Ambulatory devices,
sub cutaneous insulin pump and also any medical equipment, which are subsequently used at home. This is indicative. Please
refer to clauses in Annexure-1 for the complete list of non-payable items.
21. Vaccination or inoculation of any kind unless post animal bite.
10. Procedure for Taking a Policy
1. The duly completed and signed Proposal form giving details of all Insured persons along with Pre-Acceptance Health Check-up
reports, if any, should be submitted to the nearest office of the Company.
2. The pre-acceptance health check-up reports, wherever required at Company’s discretion have to be submitted at proposer’s
cost.
Notes
• The date of medical reports should not exceed 30 (thirty) days prior to the date of proposal.
• 50% of the cost of Pre-Acceptance Health check-up shall be reimbursed to the insured in case the proposal is accepted
by the Company

11. Payment Of Premium

1. Applicable premium must be paid before the commencement of risk for this Policy to come into effect.
2. Premium payable – As per the Premium tables attached. The Premium can be paid online for renewals.
3. PAN details must be submitted by the insured. In case PAN is not available, Form 60 or Form 61 must be submitted.
12. Loadings And Discount
i. Family Discount
In case of policies issued on Individual Sum Insured Basis, 5% family discount will be allowed if more than one person of a
family is covered.
ii. Family Floater Discount
If the policy is issued on Family Floater basis, a Family Floater Discount will be allowed based on the family composition.
iii. Direct Channel Discount
A discount is applicable for fresh policies purchased online through the Company’s website or directly from United India's
office, without any agent or an intermediary.
For renewals, the discount shall be offered provided that both the renewing policy and expiring policy are without any agent
or an intermediary.
iv. Underwriting Loading for Pre-existing Conditions
We may apply a risk loading on the premium payable based on your health status if accepted at the time of underwriting.
Loadings will be applied from Inception Date of the first Policy including subsequent renewal(s).
Note: The application of loading does not mean that the illness/ condition, for which loading has been applied, would be
covered from inception. Any waiting period as mentioned in Clause 9.A.1 above shall be applied on illness/condition, as
applicable.
13. Change Of Sum Insured
1. The Insured can apply for change of Sum Insured at the time of renewal, by submitting a fresh proposal form/written request to
the company.
2. Any request for enhancement of Sum Insured must be accompanied by a declaration that the Insured or any other Insured
Person(s) in respect of whom such enhancement is sought is not aware of any symptoms or other indications that may give rise
to a claim under the policy. The Company may require such Insured Person/s to undergo a medical examination to enable the
Company to take a decision on accepting the request for enhancement in the Sum Insured.
3. The acceptance of enhancement of Sum Insured would be at the discretion of the company, subject to underwriting, based on
the health condition of the Insured Persons & claim history of the policy.
4. All waiting periods as defined in the Policy wordings shall apply for the incremental portion of the Sum Insured from the effective
date of enhancement of such Sum Insured considering such Policy Period as the first Policy with the Company.
14. Cancellation
1. The policyholder may request for cancellation of the policy by giving 15 days’ written notice, and in such an event, the Company
shall refund premium for the unexpired Policy Period as per the rates detailed below.
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Yuvaan Health Insurance Policy – Prospectus

UIN: UIIHLIP24134V012324
United India Insurance Company Limited
Corporate Identity Number: U93090TN1938GOI000108
Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

Cancellation Grid for single premium payment option

Period on risk Refund (%)
Within 15 days
0% (Free Look Period)
(first time health insurance Policy customers)
> 15 days, up to 1 Month
75%
(first time health insurance Policy customers)
Within 1 month (renewal policy) 75%
> 1 Month, up to 3 Months 50%
> 3 Months, up to 6 Months 25%
> 6 Months NIL
Notwithstanding anything contained herein or otherwise, no refunds of premium shall be made in respect of Cancellation where,
any claim has been admitted or has been lodged or any benefit has been availed by the Insured under the policy.
2. The Company may cancel the policy at any time on grounds of mis-representation, non-disclosure of material facts, fraud by the
Insured Person, by giving 15 days’ written notice. There would be no refund of premium on cancellation on grounds of mis-
representation, non-disclosure of material facts or fraud.
15. Free Look Period
The free look period shall be applicable at the inception of the first policy and the Insured shall be allowed a period of 15 days
from the date of receipt of the policy to review the terms and conditions of the policy and to return the same if not acceptable.
If the Insured has not made any claim during the free look period, the Insured shall be entitled to:
i. A refund of the premium paid less any expenses incurred by the Company on medical examination of the insured persons
and the stamp duty charges or
ii. Where the risk has already commenced and the option of return of the policy is exercised by the insured person, a deduction
towards the proportionate risk premium for period of cover or
iii. Where only a part of the insurance coverage has commenced, such proportionate premium commensurate with the risk
covered during such period.
16. Renewal of Policy
The policy shall ordinarily be renewable except on grounds of fraud or misrepresentation by the Insured Person.
1. The Company shall endeavour to give notice for renewal. However, the Company is not under obligation to give any notice
for renewal.
2. Renewal shall not be denied on the ground that the Insured Person had made a claim or claims in the preceding policy years.
3. Request for renewal along with requisite premium shall be received by the Company before the end of the policy period.
4. At the end of the policy period, the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain
continuity of benefits without break in policy. Coverage is not available during the grace period.
5. No loading shall apply on renewals based on individual claims experience.
17. Migration Of Policy
The Insured Person will have the option to migrate the policy to other health insurance products/plans offered by the company
by applying for migration of the policy at least 30 days before the policy renewal date as per IRDAI guidelines on Migration. If
such person is presently covered and has been continuously covered without any lapses under any health insurance
product/plan offered by the company, the Insured Person will get the accrued continuity benefits in waiting periods as per IRDAI
guidelines on migration.
For Detailed Guidelines on Migration, kindly refer the link: https://irdai.gov.in/document-detail?documentId=393128
18. Portability
The Insured Person will have the option to port the policy to other Insurers by applying to such Insurer to port the entire policy
along with all the members of the family, if any, at least 45 days before, but not earlier than 60 days from the policy renewal date
as per IRDAI guidelines related to portability. If such person is presently covered and has been continuously covered without
any lapses under any health insurance policy with an Indian General/Health Insurer, the proposed Insured Person will get the
accrued continuity benefits in waiting periods as per IRDAI guidelines on portability.
For Detailed Guidelines on Portability, kindly refer the link – https://irdai.gov.in/document-detail?documentId=393128
19. Nomination
The policyholder is required at the inception of the policy to make a nomination for the purpose of payment of claims under the
policy in the event of death of the policyholder. Any change of nomination shall be communicated to the Company in writing and
such change shall be effective only when an endorsement on the policy is made. ln the event of death of the policyholder, the
Company will pay the nominee {as named in the Policy Schedule/Policy Certificate/Endorsement (if any)} and in case there is
no subsisting nominee, to the legal heirs or legal representatives of the policyholder whose discharge shall be treated as full and
final discharge of its liability under the policy.
20. Tax Benefit
Tax rebate is available as per provision of Income Tax Rules under Section 80-D.

8|P a g e

Yuvaan Health Insurance Policy – Prospectus

UIN: UIIHLIP24134V012324
United India Insurance Company Limited
Corporate Identity Number: U93090TN1938GOI000108
Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

21. Claim Procedure

1. Notification of Claim
Upon the happening of any event which may give rise to a claim under this Policy, the Insured Person/Insured Person’s
representative shall notify the TPA (if claim is processed by TPA)/company (if claim is processed by the company) in writing
providing all relevant information relating to claim including plan of treatment, policy number etc. within the prescribed time
limit as under:
i. Within 24 hours from the date of emergency hospitalisation required or before the Insured Person’s discharge from
Hospital, whichever is earlier.
ii. At least 48 hours prior to admission in Hospital in case of a planned Hospitalisation
2. Procedure for Cashless Claims
i. Cashless facility for treatment in network hospitals only shall be available to Insured if opted for claim processing by TPA.
ii. Treatment may be taken in a network provider/PPN hospital and is subject to pre authorization by the TPA. Booklet
containing list of network provider/PPN hospitals shall be provided by the TPA. Updated list of network provider/PPN is
available on website of the company (https://uiic.co.in/en/tpa-ppn-network-hospitals) and the TPA mentioned in the
schedule.
iii. The customer may call the TPA’s toll free phone number provided in the policy copy/on the health ID card for intimation of
claim and related assistance. Please keep the ID number handy for easy reference.
iv. On admission in the network provider/PPN hospital, please produce the ID card issued by the TPA at the Hospital Helpdesk.
Cashless request form available with the network provider/PPN and TPA shall be filled and submitted to the TPA for
authorization.
v. The TPA upon getting cashless request form and related medical information from the Insured Person/ network
provider/PPN shall issue pre-authorization letter to the hospital after verification.
vi. At the time of discharge, the Insured Person shall verify and sign the discharge papers and pay for non-medical and
inadmissible expenses.
vii. The TPA reserves the right to deny pre-authorization in case the Insured Person is unable to provide the relevant medical
details.
viii. Denial of a Pre-authorization request is in no way to be construed as denial of treatment or denial of coverage. The Insured
Person may get the treatment as per treating doctor’s advice and submit the claim documents to the TPA for possible
reimbursement
3. Procedure for reimbursement of Claims
i. In non-network hospitals payment must be made up-front and for reimbursement of claims the Insured Person may submit
the necessary documents to TPA (if claim is processed by TPA)/company (if claim is processed by the company) within the
prescribed time limit.
ii. Claims for Pre- and Post-Hospitalisation will be settled on reimbursement basis on production of relevant claim papers and
cash receipts within the prescribed time limit.
4. Documents
The claim is to be supported with the following original documents and submitted within the prescribed time limit:
a. Duly completed claim form
b. Attending medical practitioner’s / surgeon’s certificate regarding diagnosis/ nature of operation performed along with date
of diagnosis, advise for admission, investigation test reports etc. supported by the prescription from attending medical
practitioner.
c. Medical history of the patient as recorded, bills (including break up of charges) and payment receipts duly supported by the
prescription from attending medical practitioner/ hospital.
d. Discharge certificate/ summary from the hospital.
e. Cash-memos from the Diagnostic Centre(s)/ hospital(s)/ chemist(s) supported by proper prescription.
f. Payment receipts from doctors, surgeons and anaesthetists.
g. Bills, receipts, Stickers of the Implants.
h. Any other document required by company/ TPA
Note: In the event of a claim lodged as per Settlement under multiple policies clause and the original documents having been
submitted to the other Insurer, the company may accept the duly certified documents listed under Clause 21.4 of the policy
wordings and claim settlement advice duly certified by the other Insurer subject to satisfaction of the company.
5. Time Limit for submission of documents
Type of Claim Time Limit for submission of the documents to the
Company/TPA
Reimbursement of hospitalisation, day care and Within 15 (fifteen) days of date of discharge from
pre-hospitalisation expenses hospital.
Within 15 (fifteen) days from completion of post-
Reimbursement of post hospitalisation expenses
hospitalisation treatment.
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Yuvaan Health Insurance Policy – Prospectus

UIN: UIIHLIP24134V012324
United India Insurance Company Limited
Corporate Identity Number: U93090TN1938GOI000108
Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

Notes:
i. The company shall only accept bills/invoices/medical treatment related documents only in the Insured Person’s name for
whom the claim is submitted.
ii. Waiver of clause 21.5 of the policy wordings may be considered in extreme cases of hardship where it is proved to the
satisfaction of the Company that under the circumstances in which the Insured was placed it was not possible for him or
any other person to give such notice or file claim within the prescribed time-limit.
iii. The Insured Person shall also give the TPA / Company such additional information and assistance as the TPA / Company
may require in dealing with the claim including an authorisation to obtain Medical and other records from the hospital, lab,
etc.
iv. All the documents submitted to TPA shall be electronically collected by us for settlement/denial of the claims by the
appropriate authority.
v. Any medical practitioner or Authorised Person authorised by the TPA / Company shall be allowed to examine the Insured
Person in case of any alleged injury or disease leading to Hospitalisation if so required.
6. Services offered by TPA
Servicing of claims i.e. claim admissions and assessments, under this Policy by way of preauthorization of cashless treatment or
processing of claims, as per the terms and conditions of the policy.
The services offered by a TPA shall not include:
i. Claim settlement and claim rejection;
ii. Any services directly to any Insured Person or to any other person unless such service is in accordance with the terms and
conditions of the Agreement entered into with the Company.

22. Possibility Of Revision of Terms of The Policy Including the Premium Rates
The Company, with prior approval of IRDAI, may revise or modify the terms of the policy including the premium rates. The
Insured Person shall be notified three months before the changes are effected.
23. Withdrawal Of Policy
1. In the likelihood of this product being withdrawn in future, the Company will intimate the Policyholders about the same 90 days
prior to expiry of the policy.
2. Insured Person will have the option to migrate to similar health insurance product available with the Company at the time of
renewal with all the accrued continuity benefits such as cumulative bonus, waiver of waiting period as per IRDAI guidelines,
provided the policy has been maintained without a break
24. Redressal Of Grievance
In case of any grievance the Insured Person may contact the company through:
Website: www.uiic.co.in
Toll-free: 1800 425 333 33
E-mail: customercare@uiic.co.in
Courier: Customer Care Department, Head Office, United India Insurance Co. Ltd., 19, IV Lane, Nungambakkam High
Road, Chennai, Tamil Nadu - 600034
Insured Person may also approach the grievance cell at any of the Company's branches with the details of grievance. If Insured Person is
not satisfied with the redressal of grievance through one of the above methods, Insured Person may contact the grievance officer at
customercare@uiic.co.in
For updated details of grievance officer, kindly refer the link https://uiic.co.in/en/customercare/grievance
If Insured Person is not satisfied with the redressal of grievance through above methods, the Insured Person may also approach the office
of Insurance Ombudsman of the respective area/region for redressal of grievance as per Insurance Ombudsman Rules 2017. The contact
details of the Insurance Ombudsman offices have been provided in Clauses of Annexure – 2 of the Policy Wordings.
The grievance may also be lodged at IRDAI Integrated Grievance Management System: https://igms.irda.gov.in/
25. REGULATIONS
This policy is subject to Provisions of Insurance Act, 1938, IRDAI (Health Insurance) Regulations, 2016 and IRDAI (Protection of
Policyholders’ Interest) Regulations, 2017 as amended from time to time.

--------------------------o--------------------------
Insurance is the subject matter of Solicitation.

10 | P a g e

Yuvaan Health Insurance Policy – Prospectus

UIN: UIIHLIP24134V012324
United India Insurance Company Limited
Corporate Identity Number: U93090TN1938GOI000108
Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

Table of Benefits
The following table of Benefits is intended as a brief indicative list for quick and easy reference. For details of what
your coverage is, please refer to your Policy Schedule along with the Policy Wordings.

Features

Dependent Children – 91 Days to 17 years

Age of Entry
Adults – 18 years to 45 years

Policy Type Individual Basis/ Family Floater Basis

SI Options (new) Rs. 5 lacs, 10 lacs, 15 Lacs, 20 Lacs

Policy Period 1 Year

Base Cover

Room Eligibility Shared Accommodation

ICU/ICCU Actuals

Day Care Treatments All Day Care Treatments as per the definition in the policy wordings are covered

Pre-Hospitalisation 60 Days

Post-Hospitalisation 90 Days

Road Ambulance Covered

Modern Treatment MATs Covered

Cumulative bonus will be calculated at 50% of sum insured for each claim free Policy Year subject to a
Cumulative Bonus
maximum of 100% of the sum insured

Organ donor’s medical Hospitalisation Expenses (excluding cost of organ) incurred for/by a Donor within the Sum Insured of
expenses the Insured Person

Optional Cover

A Co-payment will be applied in the following cases:

i If the insured has paid the premium for Zone C, a co-payment of 15% will apply for each and every
claim amount for treatment taken in any city of Zone A.
Waiver of Co-Payment ii If the insured has paid the premium for Zone B, a co-payment of 10% will apply for each and every
claim amount for treatment taken in any city of Zone A.

If the optional cover is opted, the applicable co-payment at the time of claims will be waived off

Sub-Limits None

11 | P a g e

Yuvaan Health Insurance Policy – Prospectus

UIN: UIIHLIP24134V012324
United India Insurance Company Limited
Corporate Identity Number: U93090TN1938GOI000108
Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

Premium Rate Tables

IMPORTANT INFORMATION

▪ All premium rates shown in this document are Annual Premium Rates in INR (₹) and are exclusive of Goods & Service Tax
(GST) & Cess (if any). GST as applicable will be charged extra.
▪ Premium rates are applicable per individual insured person and will be based on their completed age.
▪ Premium rates in Section I are for standard healthy individuals. The final premium payable may change post underwriting of
proposal based on medical tests (where applicable) and information provided in the proposal form.
▪ Entry Age:
• Adults: 18 to 45 years
• Children: 91 days to 17 years
▪ Premium rates vary depending on the Proposer’s place of residence. In this regard, the country is divided into three
geographical zones: Zone A, Zone B, Zone C. The Zones are based on the following districts in India:
Zone Districts

All Districts in NCT of Delhi (incl. Shahdara), Faridabad, Palwal, Gurugram, Rohtak, Jhajjar, Ghaziabad, Gatuam Buddh
A Nagar, Bulandshahr, Ahmedabad, Ahmedabad City, Gandhi Nagar, Vadodara, Surat, Mumbai, Mumbai Suburban, Thane,
Raigarh, Palghar

Ahmed Nagar, Amritsar, Anand, Bengaluru, Bhopal, Chennai, Coimbatore, Dakshina Kannada, Ernakulam, Howrah,
Hyderabad, Indore, Jaipur, Jalgaon, Jodhpur, Kanpur Nagar, Kheda, Kolhapur, Kolkata, Kottayam, Krishna, Lucknow,
B
Ludhiana, Nagpur, Nashik, North 24 Parganas, Pune, Rajkot, Ranga Reddy, Solapur, Thiruvananthapuram, Tiruvallur,
Valsad, Visakhapatnam.

C Rest of India

A Co-payment will be applied in the following cases:

i. If the insured has paid the premium for Zone C, a co-payment of 15% will apply for each and every claim amount for treatment taken
in any city of Zone A.

ii. If the insured has paid the premium for Zone B, a co-payment of 10% will apply for each and every claim amount for treatment taken
in any city of Zone A.

12 | P a g e

Yuvaan Health Insurance Policy – Prospectus

UIN: UIIHLIP24134V012324
 United India Insurance Company Limited
Corporate Identity Number: U93090TN1938GOI000108
Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

I. BASE COVER PREMIUM RATES (EXCL. GST)

Zone A
91
SI/Age
days- 18-25 26-30 31-35 36-40 41-45 46-50 51-55 56-60 61-65 66-70 71-75 76-100
Band
17
500,000 2,943 4,966 5,517 6,621 8,046 11,694 14,076 17,275 24,805 34,230 41,818 47,214 54,465
1,000,000 3,511 5,924 6,583 7,899 9,600 13,953 16,796 20,499 29,435 42,887 52,395 59,155 68,240
1,500,000 3,806 6,420 7,135 8,563 10,405 15,126 18,207 22,099 31,732 46,323 56,593 63,895 73,705
2,000,000 4,018 6,780 7,533 9,040 10,987 15,972 19,224 23,334 33,506 48,959 59,814 67,532 77,902

Zone B
91
SI/Age Band days- 18-25 26-30 31-35 36-40 41-45 46-50 51-55 56-60 61-65 66-70 71-75 76-100
17
500,000 2,513 4,242 4,713 5,655 6,872 9,988 12,023 14,756 21,187 29,239 35,720 40,329 46,523
1,000,000 2,999 5,061 5,623 6,747 8,200 11,918 14,346 17,510 25,142 36,634 44,754 50,529 58,289
1,500,000 3,251 5,485 6,094 7,314 8,887 12,919 15,552 18,877 27,105 39,568 48,340 54,577 62,958
2,000,000 3,432 5,792 6,435 7,722 9,384 13,642 16,420 19,931 28,619 41,821 51,091 57,684 66,542

Zone C
91
SI/Age Band days- 18-25 26-30 31-35 36-40 41-45 46-50 51-55 56-60 61-65 66-70 71-75 76-100
17
500,000 2,330 3,931 4,368 5,241 6,369 9,258 11,144 13,677 19,637 27,099 33,106 37,378 43,118
1,000,000 2,779 4,690 5,212 6,253 7,600 11,047 13,297 16,229 23,303 33,953 41,479 46,831 54,023
1,500,000 3,013 5,083 5,648 6,779 8,237 11,976 14,414 17,496 25,121 36,672 44,802 50,583 58,350
2,000,000 3,181 5,367 5,964 7,157 8,698 12,645 15,220 18,474 26,525 38,760 47,352 53,463 61,672

Note for all premium tables: Premium for ages 45 years and above are applicable only for Renewals.

II. OPTIONAL COVER

If this cover is opted, then the applicable Co-Payment will be waived off.

In case the insured resides in Zone C and opts for waiver of Co-payment, then he will have to pay premium for
i.
Zone A
In case the insured resides in Zone B and opts for waiver of Co-payment, then he will have to pay premium for
ii.
Zone A

III. DISCOUNTS
▪ Family Discount: In case a single policy covers more than one member of the family, a discount of 5% is offered on the premium of
each and every member of the family. This discount is only applicable for policies taken on Individual Sum Insured basis.
▪ Direct Channel Discount: A discount is applicable for fresh policies purchased online through the Company’s website or directly
from United India's office, without any agent or an intermediary. For renewals, the discount shall be offered provided that both the
renewing policy and expiring policy are without any agent or an intermediary.
▪ Floater Discount: For policies taken on floater basis, a floater discount is offered on the premium of each and every member of the
family as follows:
Family Composition Floater Discount
1 Adult + any no. of Children 15%
2 Adults 25%

13 | P a g e

Yuvaan Health Insurance Policy – Prospectus

UIN: UIIHLIP24134V012324
United India Insurance Company Limited
Corporate Identity Number: U93090TN1938GOI000108
Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

Family Composition Floater Discount

2 Adults + any no. of Children 25%
IV. LOADINGS
We may apply a risk loading on the premium payable based upon information declared in the proposal form and the health status of the
persons proposed for insurance. Loadings will be applied from Inception Date of the first Policy including subsequent renewal(s).

Note:
▪ The application of loading does not mean that the illness/ condition, for which loading has been applied, would be covered from
inception. Any waiting period as mentioned in Policy Terms and Conditions shall be applied on illness/condition, as applicable.

14 | P a g e

Yuvaan Health Insurance Policy – Prospectus

UIN: UIIHLIP24134V012324
 United India Insurance Company Limited
Corporate Identity Number: U93090TN1938GOI000108
Registered Office: 24 Whites Road, Chennai – 600014
IRDAI REG NO.545

B e n e f i t / P r e m i u m I l l u st r a t i o n
Please note:
1. Premium rates specified in the illustrations below are standard premium rates exclusive of any loadings and GST.
2. Rates shown below are for Zone A.
ILLUSTRATIONS

Illustration 1: Self, Spouse and 2 Dependent Children

Coverage opted on
Individual basis Coverage opted on Individual basis
Coverage opted on family floater basis with overall
covering each covering multiple members of the family
Sum Insured (Only one Sum Insured is available for
member of the family under a single policy (Sum Insured is
the entire family)
separately (at a single available for each member of the family)
point in time)
Age of
Insured
Member

Premium per Premium

Sum Premium Sum Floater Sum
Premium Premium Discount, member for after
Insured after Insured Discount Insured
(Rs.) (Rs.) if any floater basis discount
(Rs.) discount (Rs.) if any (Rs.)
(Rs.) (Rs.)

36 9,600 10 lakh 9,600 5% 9,120 10 lakh 9,600 25% 7,200

31 7,899 10 lakh 7,899 5% 7,504 10 lakh 7,899 25% 5,924
10 lakh
10 3,511 10 lakh 3,511 5% 3,335 10 lakh 3,511 25% 2,633
20 5,924 10 lakh 5,924 5% 5,628 10 lakh 5,924 25% 4,443

Total Premium for all members of

Total Premium for all members of the family is Rs.
the family is Rs. 26,934/-, when Total Premium when policy is opted on floater basis
25,587/-, when they are covered under a single
each member is covered is Rs. 20,200/-
policy.
separately.

Illustration 2: Self and Spouse

Coverage opted on
Coverage opted on Individual basis
Individual basis
covering multiple members of the
covering each Coverage opted on family floater basis with overall Sum Insured (Only
family under a single policy (Sum
member of the family one Sum Insured is available for the entire family)
Insured is available for each
separately (at a single
member of the family)
Age of point in time)
Insured
Member
Premium or
Premium
Sum Premium Sum consolidated Floater Sum
Premium Premium Discount, after
Insured after Insured premium for all Discount if Insured
(Rs.) (Rs.) if any discount
(Rs.) discount (Rs.) members of any (Rs.)
(Rs.)
family (Rs.)

42 15,972 20 lakh 15,972 5% 15,173 20 lakh 15,972 25% 11979

20 lakh
38 10,987 20 lakh 10,987 5% 10,438 20 lakh 10,987 25% 8240
Total Premium for all members of
Total Premium for all members of
the family is Rs. 26,959/-, when
the family is Rs. 25,611/-, when they Total Premium when policy is opted on floater basis is Rs. 20,219/-
each member is covered
are covered under a single policy
separately.

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Yuvaan Health Insurance Policy – Prospectus

UIN: UIIHLIP24134V012324