Terms and Conditions of Sahara Health Insurance

Whether already purchased or thinking to, here are the terms and conditions of Sahara Health Insurance that you need to keep in mind:

Terms and Conditions

  • The insured person must be between 5 and 65 years old at the time of policy purchase.
  • If the insured person is above 45 years old, a mandatory health check-up is required. The cost of this check-up must be borne by the customer.
  • The insurance policy is valid for one year from the date of purchase.
  • The policy has a waiting period of 30 days, meaning claims can only be made after 30 days from the purchase date (except those that are incurred as a result of bodily injury caused by an accident. This exclusion does not apply for subsequent renewals without a break).
  • Premiums must be paid through eSewa Wallet.
  • The premium amount varies based on the insured person’s age and coverage amount.
  • In any case the policy application is rejected by the insurer, the full amount will be refunded to the user’s eSewa Wallet.
  • Users can make claims through eSewa in two ways:
    • Cashless Hospitalization – Direct hospital treatment if planned in advance without upfront payment (at network hospitals) (No cashless for accidental case).
    • Cash Reimbursement – Submit expenses for reimbursement after treatment.
  • Claims must be submitted within 30 days from date of discharged from the hospital.
  • Users can renew expired policies from their eSewa.
  • If incorrect details (e.g., birthdate) are entered, the insurer may adjust the premium or reject the policy.
  • Users will receive SMS (from Shikhar) and FCM (from eSewa) notifications for:
    • Policy activation and expiration
    • Claim request submission and processing updates
    • Payment reminders for renewals
  • Users are responsible for providing accurate details while purchasing insurance.
  • eSewa and the insurer are not liable for issues arising from incorrect information provided by the user.
  • Transactions and claims will be securely logged for compliance and regulatory purposes.
  • For any queries or claim-related support, users can contact eSewa customer service through eSewa Helpline.

Don’t have an eSewa app on your smartphone? Download it today: bit.ly/eSewa_App

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