Terms & Conditions

Better Ensure LLP – Legal Terms & Conditions

Wellness OPD Benefit Wellness Membership Plan

This document outlines the Terms & Conditions of Better Ensure LLP for its Wellness OPD Benefit Wellness Membership Program.

1. Legal Identity

• Better Ensure LLP is a Limited Liability Partnership registered under the Ministry of Corporate Affairs, Government of India.
• The Wellness OPD Benefit Wellness Plan is a membership-based healthcare facilitation program and is not an insurance product under the jurisdiction of the Insurance Regulatory and Development Authority of India (IRDAI).

2. Nature of the Plan

• This is a healthcare & wellness membership program.
• It provides wellness-based OPD benefits.
• It does not provide hospitalization indemnity.
• It is not Mediclaim or Health Insurance.
• It operates as a service aggregation & healthcare facilitation model.

3. Definitions

• LLP: Better Ensure LLP
• Member: Individual enrolled under the Plan
• Wellness Limit: Pre-defined annual benefit amount
• Network Provider: Empaneled healthcare provider
• Non-Network Provider: Healthcare provider outside empanelment
• Plan Year: 12 months from activation date

4. Eligibility

• Entry age: 18 years and above
• Dependent children: 3 months and above
• Valid KYC mandatory
• No medical underwriting required

5. Plan Activation

• Activation within 24–72 working hours after payment & KYC verification.
• Digital Membership ID issued.
• Benefits valid only post activation confirmation.

6. Wellness Structure (Illustrative)

🩺 Doctor Consultation Wellness

• Reimbursement basis
• Valid prescription required (with registration number)
• Per visit & monthly cap applicable
• Unused amount expires annually

🧪 Lab Wellness

• Cashless at network labs (if available)
• Reimbursement at non-network labs
• Invoice & prescription mandatory
• Transaction cap applicable

💊 Medicine Wellness

• GST bill & valid prescription required
• Only prescribed medicines eligible
• Supplements excluded (unless specified)

🏠 Home Care Wellness

• Physiotherapy/Nursing/Caretaker services
• Subject to post-hospitalization review
• Per-session cap applicable

7. Waiting Period

• OPD benefits – Immediate (unless otherwise stated)
• Home care – 15 to 30 days waiting (if applicable)

8. Claim Process (Reimbursement Mode)

Member must submit:

• Claim Form
• Doctor Prescription
• Original Invoice
• Bank Details

Claim settlement timeline: 7–15 working days after verification.

9. Exclusions

The Plan does NOT cover:

• Hospitalization expenses
• Surgeries
• ICU charges
• Cosmetic procedures
• Maternity (unless specified)
• Dental/Vision (unless included in specific plan)
• Cash withdrawals
• Illegal or self-inflicted injuries

10. Cancellation & Refund

• 7-day free look period (if no claim utilized)
• No refund after claim utilization
• Administrative deductions applicable
• No mid-term refund once activated

11. Fraud & Misuse

Better Ensure LLP reserves the right to:

• Reject fraudulent claims
• Suspend membership
• Initiate legal action

12. Modification Rights

Better Ensure LLP may:

• Modify pricing
• Update wellness limits
• Change network providers
• Amend terms & conditions

Members will be notified of material changes where applicable.

13. Limitation of Liability

• LLP acts only as healthcare service facilitator.
• Liability limited to unused wellness balance.
• LLP not responsible for medical negligence by healthcare providers.

14. Dispute Resolution

• Jurisdiction: Noida, Uttar Pradesh
• Governed by Indian laws
• Arbitration preferred prior to litigation

15. Contact Details

Better Ensure LLP
📍 Corporate Office: Noida, Uttar Pradesh
Support: 9990211659
Email: vivekgupta@betterensure.in