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Terms and Conditions

The following Terms & Conditions shall apply to the United Emergency Care Subscription (“Subscription”), unless specifically waived or amended in writing by United Hospitals:

  1. Scope of Coverage This Subscription provides individual emergency care coverage limited strictly to the following specified emergencies only:
    1. Accident / Trauma
    2. Cardiac Emergencies
    3. Stroke / Neuro Emergencies
    4. Acute Abdomen Pain / Gastrointestinal Emergencies
    No other medical conditions, treatments, or hospitalisations are covered under this Subscription. However, in context of admissions for above four emergencies
  2. Eligibility & Age Criteria
    1. The eligible age for enrolment at the time of joining is 5 years to 65 years.
    2. Once enrolled, the Subscription may be renewed continuously without age restriction, provided there is no break whatsoever in renewal.
    3. Even a single day’s break in renewal shall result in automatic termination of the Subscription and associated benefits.
    4. Upon termination due to break in renewal, continuation or re-enrolment shall be subject to United Hospitals’ prevailing terms and eligibility criteria applicable at the time of fresh subscription.
  3. Activation of Coverage & Pre-Check
    1. Accident / Trauma emergency cover shall be activated 72 hours after enrolment.
    2. Cardiac, Stroke/Neuro, and Acute Abdomen/Gastro emergency cover shall be activated only after completion of a free Pre-Check at United Hospital, conducted for the purpose of identifying pre-existing conditions.
    3. If the Pre-Check establishes that the subscriber is ineligible due to pre-existing conditions, the entire subscription amount of ₹3,588 (inclusive of applicable taxes) shall be refunded.
    4. If, prior to completion of the Pre-Check, the subscriber avails any Accident/Trauma emergency treatment, no refund shall be payable, and the Subscription shall stand terminated upon such free pre-check revealing the ineligibility.
  4. Coverage Limits & Hospital Network
    1. Emergency treatment shall be provided cashless up to a maximum of ₹1 Crore per emergency for the year of subscription at United Hospitals.
    2. In United Hospitals’ network hospitals (other than United Hospitals, emergency treatment shall be limited to a maximum of ₹2,00,000 per year subject to procedure-wise sub-limits.
    3. A subscriber treated initially at a network hospital may, subject to medical stability and consent, be transferred to United Hospital free of cost, in which case the overall emergency treatment limit shall be ₹1 Crore inclusive of expenses already incurred.
    4. Cashless treatment is available only at United Hospitals and its notified network hospitals.
  5. Exclusions – Elective & Non-Emergency Treatments All elective procedures, planned surgeries, and non-emergency treatments are expressly excluded from the scope of this Subscription.
  6. United Wellness Club Membership This Subscription is available exclusively to members of the United Wellness Club. Each enrolled member is entitled to the Subscription upon payment of ₹3,588 (inclusive of GST) for one year.
  7. Mental Illness – Definition & Exclusion “Mental Illness” means a substantial disorder of thinking, mood, perception, orientation, or memory that grossly impairs judgment, behaviour, capacity to recognise reality, or ability to meet ordinary demands of life, including mental conditions associated with abuse of alcohol or drugs. Treatment of mental illness is not covered under this Subscription.
  8. Neurological & Developmental Disorders – Exclusion Treatment relating to mental retardation, arrested or incomplete development of mind, subnormal intelligence, cerebral palsy, cretinism, Down syndrome (Mongolism), intellectual disability, Parkinson’s disease, Alzheimer’s disease, and dementia is excluded.
  9. Specific Exclusions The following are expressly excluded:
    1. Domiciliary (home-based) hospitalisation
    2. Organ transplants under any circumstances
    3. Hospitalisation for contraception
    4. Infertility and related treatments, including male sterility
    5. Experimental or trial treatments
    6. Prosthesis or implant devices not directly related to covered emergencies
    7. Holter monitoring
    8. Cosmetic or aesthetic procedures, including cosmetic septoplasty
    9. Cancer treatment
  10. Terrorism Emergency treatment arising directly from acts of terrorism is covered, subject to all other applicable terms and exclusions.
  11. Healthcare Financing & Insurance Arrangement For the purpose of facilitating cashless emergency treatment, United Hospitals has arranged a group healthcare financing mechanism, including insurance, where applicable. Subscribers are not required to interact with any insurer or submit claims. All benefits under this Subscription remain subject to applicable terms, conditions, limits, and exclusions of the underlying group healthcare arrangement, including the Group Care 360 Policy, to the extent applicable.
  12. Non-Network Hospitals Any treatment, whether emergency or otherwise, taken at non-preferred / non-network hospitals shall not be payable under this Subscription. The updated list of United Hospitals’ network hospitals is available at: https://www.unitedhospitals.com
  13. Governing Law & Jurisdiction These Terms & Conditions shall be governed by and construed in accordance with the laws of India, and all disputes shall be subject to the exclusive jurisdiction of competent courts.