Individual Gold Plan in one table
| Insurer | United India Insurance Company Limited |
|---|---|
| Sum insured | ₹2, 3, 5, 8 or 10 lakh on the Gold plan. The Platinum plan of the same product goes to ₹20 lakh |
Claim settlement and complaint figures are IRDAI-published and held centrally by NYVO, not taken from the insurer's marketing.
What Individual Gold Plan covers
These are the terms that decide what you are actually paid when you claim. Room rent, co-pay and restoration do more to shape a settlement than the sum insured does, and they are read from United India's own policy wording.
| Feature | This plan | What good looks like |
|---|---|---|
| Co-payment | No co-payment | No Co-payment |
| Room Rent Limit | 1% of sum insured a day · ICU 2% of sum insured a day. A dearer room triggers a proportionate deduction on the associated expenses | No room rent capping |
| Disease sub-limit | Applies to Gold only. Cataract capped at 25% of sum insured or ₹40,000 an eye, whichever is lower; hernia and hysterectomy at 25% of sum insured or ₹1 lakh | No sub-limit |
| Pre and post cap | Pre and post-hospitalisation together are capped at 10% of the sum insured on Gold. The Platinum tier of the same product has no such cap | No aggregate cap |
| No Claim Bonus | None. This product does not award a cumulative bonus or a no-claim discount, so the cover does not grow with clean years | 50% each year (Minimum upto 100%) |
| Restoration Benefit | Not available on this plan, and there is no add-on that provides it | 100% restoration once in a year |
| Pre-Hospitalization | 30 days | At least 60 days |
| Post-Hospitalization | 60 days | At least 120 days |
| Consumables | The non-payable items listed in the policy are not covered, and there is no add-on that buys them back | Consumables covered |
| Day-Care Procedures | All day care treatments covered, with no capped list | Covered without a capped list |
| Organ donor | The donor's hospitalisation expenses are covered, excluding the cost of the organ itself | Covered |
| Modern treatments | Twelve listed procedures covered. Oral chemotherapy and monoclonal antibody immunotherapy are treated as post-hospitalisation claims but escape the 10% pre and post cap | Covered |
| Home care treatment | 10% of the sum insured or ₹30,000, whichever is lower, for up to 14 days per incident | Included |
| Road ambulance | Up to ₹2,500 per person per policy period | Included |
| Health check-up | Every three claim-free years – 1% of the average sum insured of the preceding three years, up to ₹5,000 per person. It does not reduce the sum insured | Included |
| Entry age | 36 to 60. Below 36 the insurer places you on the Platinum plan instead; the product closes to new entrants at 65 | No maximum entry age |
Individual Gold Plan add-ons you can buy with it
Each of these costs extra and each has its own conditions. Some are genuinely worth it; several exist to patch a gap in the base plan. Ask what each one adds before it goes on your quote.
Individual Gold Plan discounts you can ask for
Published discounts on this plan. Most are applied at quote stage rather than offered, so it is worth naming the ones you qualify for. Every figure is a ceiling, not a promise - what you actually get depends on the case.
| Discount | Worth | When it applies |
|---|---|---|
| Family discount | Up to 5% | On the total premium where the policy covers you and one or more of your spouse, dependent children or parents. It does not apply to the optional cover premium. |
From the plan prospectus. This product has no no-claim bonus and no premium discount for claim-free years, so these two are the only levers on the price.
Individual Gold Plan waiting periods: when each part of the cover starts
Waiting periods run from the day cover began, not from the day you fall ill, and they run in parallel rather than one after another.
| Initial Waiting Period | 30 days |
|---|---|
| Named specific illnesses (Table A) | 24 months |
| Joint replacement, age-related osteoarthritis, macular degeneration, neurodegenerative disorders (Table B) | 36 months |
| Pre-Existing Disease | 36 months |
The named illnesses that wait 24 months for Table A, 36 months for Table B
These waits are written into the policy for the Gold plan specifically – the wording heads the section "Waiting Periods (Only Applicable for Gold Plan)". Table A, below, waits 24 months. Table B – joint replacement due to a degenerative condition, age-related osteoarthritis and osteoporosis, macular degeneration and all neurodegenerative disorders – waits 36 months. Where a listed condition is also pre-existing, the longer of the two waits applies, and an accident is covered from day one. The list is indicative – the policy wording carries the full set.
Individual Gold Plan exclusions: what the plan will not pay for
Every policy carries exclusions, and they are the clauses people read for the first time at claim stage. These are the ones worth knowing before you buy.
Where Individual Gold Plan falls short
No plan is right for everyone, and a page that only lists strengths is not much use to you. These are the gaps we would raise on a call before recommending it.
Individual Gold Plan questions, answered
Why am I being offered Gold rather than Platinum?
United India assigns the plan by the age at which you first join, not by choice. Adults entering between 18 and 35 go on Platinum, entrants from 36 to 60 go on Gold, and the product closes to fresh entrants at 65. Once you are on a plan you stay on it – crossing 60 does not push you off Gold, provided the policy is renewed without a break. So the tier is decided on the day you buy, and it is not something you can upgrade into later.
What are the sub-limits on the Gold plan?
Two, and the policy applies them to Gold only. Cataract is limited to 25% of the sum insured or ₹40,000 per eye, whichever is lower. Hernia and hysterectomy are limited to 25% of the sum insured or ₹1 lakh, whichever is lower. The current wording no longer carries the separate 70% ceiling on major surgeries – cardiac, cancer, joint replacement and transplant – that an earlier version of this product applied, so those are now paid up to the sum insured.
What waiting periods apply?
Any illness other than an accident waits 30 days. A named list including cataract, hernia, piles, sinusitis and stone disease waits 24 months. A second list – joint replacement for a degenerative condition, age-related osteoarthritis and osteoporosis, macular degeneration and all neurodegenerative disorders – waits 36 months. Declared pre-existing disease waits 36 months, which is the maximum IRDAI permits. Where a listed condition is also pre-existing, you serve the longer of the two.
Does the cover grow if I do not claim?
No. United India's Individual Health Insurance Policy has no cumulative bonus and no no-claim premium discount. What it gives you instead is a health check-up at the end of every three claim-free years, worth 1% of the average sum insured of the preceding three years up to ₹5,000, which does not reduce your cover. If a growing sum insured matters to you, United India's Family Medicare Policy does have a bonus, up to 200% of the sum insured.
Is there a room rent limit?
Yes. Room, boarding and nursing charges are payable up to 1% of the sum insured a day, and ICU up to 2%. On a ₹5 lakh cover that is ₹5,000 a day for a room. Take a room above that and a proportionate deduction is applied to the associated medical expenses – the surgeon's fee, anaesthesia, theatre charges and similar – in the same ratio. The deduction is not applied where the hospital does not bill differently by room category.
Can I add maternity to this plan?
No. Maternity is a permanent exclusion on the Individual Health Insurance Policy and there is no optional cover that brings it in, on either the Gold or the Platinum tier. United India puts maternity in the Family Medicare Policy, as an optional cover on a sum insured above ₹3 lakh with a 24-month wait. If you are planning a family, that is the plan in the range to look at instead.
Read it from the insurer
We summarise. The policy wording is the contract, and it is the only document that settles a dispute. These links go to the insurer's own pages.
Understand the terms before you commit
A plan page tells you what this policy does. These explain why each term matters and what it costs you when it is missing.
Other United India plans we have read
United India files these separately, and the terms differ between them. If you are choosing within the range, compare the waiting periods and the exclusions rather than the sum insured.