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Terms & Conditions

Insurance Terms & Conditions

Daily cash plan Insurance

This document is published in compliance of and shall be governed by Indian law, including but not limited to (i) The Indian Contract Act, 1872; (ii) The Information Technology Act, 2000, the rules, regulations, guidelines and clarifications framed thereunder including the Information Technology (Reasonable Security Practices And Procedures And Sensitive Personal Information) Rules, 2011, and the provisions of rule 3 (1) of the Information Technology (Intermediaries Guidelines) Rules, 2011; (iii) The Payment And Settlement Systems Act, 2007 and applicable rules, regulations and guidelines made thereunder; and (iv) Reserve Bank of India Act, 1934 and the applicable rules, regulations and guidelines made thereunder.


This document is an electronic record in the form of an electronic contract formed under Information Technology Act, 2000 and rules made thereunder and the amended provisions pertaining to electronic documents / records in various statutes as amended by the Information Technology Act, 2000. This agreement does not require any physical, electronic or digital signature.

This agreement is a legally binding document between you and Balancehero India Private Limited (both terms defined below). The terms of this document will be effective upon your acceptance of the same (in electronic form or by means of an electronic record or other means) and will govern the relationship between you and Truebalance for the use of Truebalance services.

1. For the purpose of these Terms of Use, wherever the context so requires-

a. “You/Your”, “Customer” or "User" shall mean any natural or legal person who has registered with Truebalance and who has accepted these Terms of Use.

b. "We", "Us", "Our", “Truebalance” shall mean Balancehero India Private Limited.

c. "Insurer" shall mean the respective Insurance company issuing Insurance.

 

2. These terms and conditions ("T&C") and all applicable T&C issued by Insurance Company govern your rights and obligations as a Customer for the Insurance Policy purchased from respective Insurance Company via Truebalance mobile application. You agree and acknowledge that the Insurance purchased through Truebalance application are issued by respective Insurance Company and Truebalance is not the issuer of these Policies.

 

3. Your access to and use of the Truebalance mobile application and the Truebalance services are conditional upon your acceptance of and continuous compliance with these T&C at all times.

 

4. The access to the Truebalance mobile application is only available to persons who are competent to enter into legally binding contracts under the Indian Contract Act, 1872. Any person who shall be considered as incompetent to contract as per the provisions of the Indian Contract Act, 1872, including minors, un-discharged insolvents, etc., are not eligible to use the Truebalance mobile application.

 

5. You agree that the personal information such as name, address, contact number etc. ("Personal Information") you provide to Truebalance upon registration and at the time of purchasing insurance policy and at all other times will be true, accurate, current and complete. You agree to maintain and update the Personal Information and to keep the Personal Information true, accurate and complete.

 

6. Customer hereby agree and acknowledge that his/her Personal Information will be shared with respective Insurance Company while purchasing insurance product from such Insurance Company via Truebalance application.

 

7. Policy purchased via Truebalance application is valid for Indian citizens only.

 

8. Customer should be between the age of 18-65 years at the time of buying the policy. Policy shall be issued in the name of the individual as provided by the User.

9. Policy certificate shall be sent by the respective Insurance Company on his/her email address within 24 hours of the transaction and it can also be downloaded from the order history of TrueBalance.

 

10. The policy is offered for the sum insured as specified in the Policy certificate.

 

11. All the terms and conditions mentioned in the policy certificate shall be applicable.

 

12. Customer can buy a policy only once under the same name. However, he/she can buy the same policy for different people or different policy through TrueBalance.

13. Customer can use multiple payment modes for purchasing insurance policy through TrueBalance.

14. Customer may cancel the policy from the Order History of TrueBalance application. In case of cancellation within 15 days, full amount will be refunded to the source of payment mode. For cancellation after 15 days, please refer to the policy terms and conditions of respective Insurance Company for the amount refunded.

 

15. After cancellation of the policy, the amount will be refunded within 15 days from the date of policy cancellation. For the refund applicable, the conditions apply as per the policy rules mentioned below.

 

16. The insurance policy is a contract between Insurance Company and the Customer. For any issues related to Insurance Policy including claims and cancellations, please reach out to the respective Insurance Company.

 

17. Customer shall receive the policy certificate on his/her mobile number via SMS within 24 hours of the transaction. Policy information shall also be available in the order history of TrueBalance. Policy coverage shall start from T+3 day (T being the day of the transaction).

 

18. Daily cash plan details - Health insurance to protect your income loss in case of hospitalisation :

a. If you are hospitalised for any reason for more than 24 hours, you will get ₹1000 for each day you are in the hospital.

b. If you are hospitalised in ICU for more than 24 hours, you will get ₹2000 for each day you are in the ICU.

c. Hospitalisation due to any illnesses that you already have (pre-existing conditions) is covered after 48 months.

d. Sickness-related hospitalisation within 30 days of buying this policy is not covered. There is no waiting period for accident-related hospitalisation.

e. You can be hospitalised multiple times in a year but they cannot exceed 30 days.

 

 

What’s not covered:

a. Hospitalisation due to any illnesses that you already have (pre-existing conditions) is covered after 48 months.

b.Individuals below 18 years and above 65 years are not eligible for this Toffee.

c. Participation in a dangerous activity or adventure sport is not covered

An Insured Person’s participation or involvement in naval, military or air force operation, racing, diving, aviation, scuba diving, parachuting, hang-gliding, rock or mountain climbing in a professional or semi-professional nature, is not covered.
Illnesses: Arthritis if non infective; calculus diseases of gall bladder

d. Treatment at a healthcare facility which is NOT a Hospital is not covered.

e. Non-allopathic treatment is not covered.

f. Any expense due to pregnancy (directly or indirectly) is not covered.

g. Hospitalisation for less than 24 hours is not covered.

h. Hospitalisation due to alcohol or drug abuse is not covered.

i. 2 year waiting period for the listed Illnesses and treatments

The illnesses and treatments listed below will be covered subject to a waiting period of 2 years as long as in the third Policy Year the Insured Person has been insured continuously and without any break:

  1. Illnesses: Arthritis if non infective; calculus diseases of gall bladder and urogenital system; cataract; fissure/fistula in anus; hemorrhoids; sinus; gastric and duodenal ulcers; gout and rheumatism; internal tumors; cysts; nodules; polyps including breast lumps (each of any kind unless malignant); osteoarthritis and osteoporosis if age related; polycystic ovarian diseases; sinusitis and related disorders and skin tumors unless malignant.

  2. Treatments: Surgeries for benign ear; adenoidectomy, mastoidectomy, tonsillectomy and tympanoplasty; dilatation and curettage (D&C); hysterectomy for menorrhagia or fibromyoma or prolapse of uterus unless necessitated by malignancy; joint replacement; myomectomy for fibroids; surgery of gallbladder and bile duct unless necessitated by malignancy; surgery of genito urinary system unless necessitated by malignancy; surgery of benign prostatic hypertrophy; surgery of hernia; surgery of hydrocele; surgery for prolapsed inter vertebral disk; surgery of varicose veins and varicose ulcers; Nasal septum deviation; surgery on tonsils and sinuses.

 

DETAILED EXCLUSIONS:

Exclusions:

1. Waiting Periods: We are not liable for any treatment which begins during waiting periods except if any Insured Person suffers an Accident.

a. 30 days Waiting Period: A waiting period of 30 days (or longer if specified in any benefit) will apply to all claims.

b. 2 year waiting period for the listed Illnesses and treatments

c. Pre-existing conditions will be covered after 48 months continuous coverage have elapsed since inception of the first Group Easy cash Insurance policy with us.

d. We will not make any payment for any claim in respect of any Insured Person directly or indirectly for, caused by, arising from or in any way attributable to any of the following unless expressly stated to the contrary in this Policy:

  1. War or any act of war, invasion, act of foreign enemy, war like operations (whether war be declared or not or caused during service in the armed forces of any country), civil war, public defence, rebellion, revolution, insurrection, military or usurped acts, nuclear weapons/ materials, chemical and biological weapons, radiation of any kind.

  2. Any Insured Person committing or attempting to commit a criminal or illegal act, or intentional self injury or attempted suicide while sane or insane.

  3. Any Insured Person’s participation or involvement in naval, military or air force operation, racing, diving, aviation, scuba diving, parachuting, hang gliding, rock or mountain climbing.

  4. Pregnancy (including voluntary termination), miscarriage (except as a result of an Accident or Illness).

  5. Maternity or birth (including caesarean section) except in the case of ectopic pregnancy in relation to Inpatient Treatment only.

  6. Nasal septum deviation; circumcisions, laser treatment for correction of eye due to refractive error, aesthetic or change-of-life treatments of any description such as sex transformation operations, treatments to do

  7. Artificial limbs, crutches or any other external appliance and/or device used for diagnosis or treatment.


19. For cancellation of the insurance policy, user will have to cancel it from the Order History of TrueBalance app. Request will be sent to the Insurance company for cancellation of the policy.

20. After cancellation, the amount shall be refunded within 15 days. The following terms and conditions apply in case of cancellation:

a. Within 15 days, 100% amount shall be refunded.

b. After 15 days, the refund amount shall be as follows: