Terms & Conditions
These Terms outline how the Health Saathi Plan works, including who can get a Subscription, how to file a claim, coverage, cancellations, and more.
The services described herein are offered through Assurekit and its Partners, and/or their affiliates (in these Terms, “Provider”, “we”, “us” or “our”, as the context may require) to its subscribers who use the Platform either as individual retail users (“Paytm Individual Users”) or as a merchant, business, commercial or other non-retail users (“Paytm Business Users”, and collectively with Paytm Individual Users, the “Paytm Users”, “Subscriber(s)” or “you”).
1.1. Placing an order. You can place an order to subscribe to the Plan exclusively from Paytm’s platform available on the ‘Paytm for Business’ (in case of Paytm Business Users) and the ‘Paytm’ consumer apps (in case of other Paytm Users) on Paytm’s website and on mobile app stores (collectively, “Platform”).
1.2. Subscriptions. Subject always to the requirements set out in these Terms (including but not limited to Section 2), we will accept your order and we will issue a certificate confirming your purchase (“Subscription”), for the period commencing from the date on which you place an order on the Platform, and expiring upon the completion of 12 (twelve) months (“Plan Term”, which shall mean and include the Plan Term for the initial Subscription and each successive and uninterrupted renewal).
1.3. In consideration of availing the Subscription, a flat fee shall be payable on a monthly basis by you to us (“Subscription Fee”).
1.4. The Subscription Fee shall be payable for each calendar month, on the date specified in the certificate of Subscription, commencing from the first day of the Plan Term.
1.5. The Subscription Fee is inclusive of all applicable taxes.
1.6. The Subscription Fee is calculated based on the Subscription to the Plan opted by you.
2. ELIGIBILITY FOR SUBSCRIBING AND FOR CLAIMING BENEFITS
FOR SUBSCRIBING
2.1. You can purchase a Subscription if you are:
(a) a natural person and a resident of India;
(b) competent to contract and purchase the Subscription under applicable law, including but not limited to the Indian Contract Act, 1872; and
(c) in case of Paytm Business Users, a self-employed merchant or business owner who carries out its regular and ordinary business activities or the day-to-day operations from its Business Establishment located in India, which is registered with and receives payments from the Platform (“Work”).
2.2. You cannot purchase the Subscription if you are an affiliate, agent, officer, director, partner, member, representative and/or employee of the Provider, or an employee or relative of an affiliate, agent, officer, director, partner, member, or representative of the Provider.
2.3. Notwithstanding anything contained herein, we reserve the right to seek additional information, reject an order for Subscription, and/or decline or suspend any right to claim benefit, in the event that the Subscriber is ineligible or found to have been ineligible at any time during the Plan Term, in our reasonable determination.
FOR CLAIMING BENEFITS
2.4. Health and Wellness benefits of the Plan will be available to you throughout the Plan Term.
2.5. The benefits of the Plan for coverage against personal Accidents, Floods, and Earthquakes, Civil Disruption and Fire causing physical damage to your Business Establishment (“Fixed Payout”) will be available when you make a claim with us, as set out below (“Claim”).
2.6. You will be eligible to Claim and avail Fixed Payout benefits (“Beneficiary”), if you:
(a) fulfil the criteria set out in Section 2.1 and are not declared or found to be ineligible under this Section 2, in our reasonable determination;
(b) if you are a Paytm Business User, have received any amounts through a transaction on the Platform in the thirty (30) days preceding a Claim;
(c) make a Claim for events occurring after completion or expiry of the Waiting Period (defined below); and
(d) have done all things necessary to avoid, reduce or otherwise mitigate a Claim under this Plan.
2.7. Notwithstanding anything contained herein, you are NOT eligible to be a Beneficiary, if:
(a) you had knowledge at the time of availing this Plan of any circumstances which can result in a Claim, including (a) any pre-existing injuries, Accidents, or any events which may cause physical damage to you or the Business Establishment (as applicable); or (b) any information which can reasonably be construed as knowledge or deemed knowledge of any future injuries, Accidents, or any events which may cause physical damage to you or the Business Establishment;
(b) you inflict intentional self-harm or injury;
(c) you suffer any damage whilst under influence of alcohol or illicit substances;
(d) you commit criminal or fraudulent activities, breach of the contractual terms of this Plan, or any breach of applicable law;
(e) you are involved in any fraud, misrepresentation or concealment, and/or where it is found that you have directly or indirectly continued to receive, earn, and/or accrue income from the Work during the period for which benefits are claimed;
(f) there is an actual or threatened war, invasion, act of foreign enemies, Terrorism, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection, military or usurped power, etc.;
(g) there is damage, contamination, radiation, explosion, combustion, seepage, or any other detrimental or hazardous impact from carriage, transport, or handling of any goods knowingly being carried, transported, or handled;
(h) there is any communicable disease or threat or fear of communicable disease (whether actual or perceived) which leads to: (i) the imposition of quarantine or restriction in movement of people or animals by any national or international body or agency; or (ii) any travel advisory or warning being issued by a national or international body or agency;
(i) there is loss, damage, liability, claim, cost, expense of whatsoever nature directly or indirectly caused by, contributed to by, resulting from, arising out of or as a result of the business activities or assets of the Business Establishment and/or the Subscriber (as applicable) being prone to occurrence of Accidents, Earthquakes, RSMD, Fire or Floods or such similar events, including deterioration of health; or
(j) the Fire is caused by the Business Establishment (or any part thereof) undergoing any heating or drying process, or burning of the Business Establishment by order of any Government Authority.
3.1. The Plan offers well-structured and useful benefits, which may be provided through us and/or business partners engaged by us, including Indian Health Organisation Private Limited (“MediBuddy”) and Universal Sompo General Insurance Company Limited (collectively, “Partners”). Subject to verification of the relevant Claim documents, you will be eligible for the following:
3.2. Health and Wellness:
(a) You can gain access to health and wellness benefits offered by MediBuddy, including unlimited tele consultations with vHealth doctor, one dental wellness package, one free consultation at top hospitals and discounts on OPD, IPD procedures, dental treatments and bloods tests, during the Plan Term, in accordance with the terms set out in https://www.vhealth.io/Terms.
3.3. Fixed Payout:
(a) Accidents
(i) In case you meet with an Accident, we will provide you with the daily sum insured for a specified number of days as per the Plan opted by the Subscriber (as provided under Schedule I).
(ii) These benefits will be provided only if such event is the sole and direct result of a cause which is not otherwise excluded in this Plan and is beyond the control of the Subscriber.
(iii) For the purposes of this Plan, “Accidents” (whether occurring during or in the course of performance of the Work or otherwise) will mean and include occurrence of any and all accidents, injuries, or incapacitations which (without limitation) (1) result in actual, physical, and/or bodily inability to perform the Work (for any reason), including without limitation any partial or whole, temporary or permanent handicap, incapacity, defect, deficiency, constraint, impairment, disability, infirmity, illness, and/or any other physical, physiological, and/or bodily harm; and/or (2) requires hospitalisation and/or can be demonstrated to have been treated at a hospital.
(iv) The number of days for which such payout shall be made shall be the lower of (a) the number of days the business of the Subscriber is impacted or (b) the maximum number of days specified in the Plan opted by the Subscriber as per Schedule I.
(b) Earthquakes, Civil Disruption and Fire (only applicable to Paytm Business Users)
(i) In case of Earthquakes, Civil Disruption and Fire causing physical damage (whether individually or as a combination of any such events) to the primary premises from where Paytm Business Users carry out their Work (“Business Establishment”) and inability of the Paytm Business Users to perform the Work, each for a period of three (3) consecutive days,
(ii) The Paytm Business User will be provided with the sum insured as per the Plan opted (provided under Schedule I).
(iii) These benefits will be provided only if such event is the sole and direct result of a cause which is not otherwise excluded in this Plan and is beyond the control of the Paytm Business User.
(iv) For the purposes of this Plan, Earthquakes shall mean any earthquake in the region of the Business Establishment of the Paytm Business Users; Fire shall mean fire (including due to its own fermentation, or natural heating, or spontaneous combustion) in the Business Establishment; and Civil Disruption shall mean and include civil disruption limited to riots, strikes or malicious damages in the region of the Business Establishment.
(c) Floods
(i) In case of Floods, due to excessive rainfall, the affected Paytm Business User will be provided with the sum insured as per the limits under the Claim Payout Table under Schedule II. A payout shall be made to the Paytm Business User in case the threshold values of the Trigger Events as set out in Schedule II are met.
(ii) For the purposes of this Plan, Floods shall mean storms, tempest, floods or inundation (caused by excessive rainfall) in the region of the Business Establishment of the Paytm Business User; and Trigger Event shall mean the threshold value of the weather index, as defined in the Schedule II, beyond which a claim will first become payable under the Policy as per the Claim Payout Table specified in the Schedule II.
(d) There shall be a deductible of 1 (one) day on any Claims made under Section 3.3 (a) and a deductible of 3 (three) days for each Claim made under Section 3.3 (b) for the Fixed Payout benefits.
3.4. The benefits under this Section 3.3 (a) and (c) are provided in accordance with the terms of the policy cover obtained under the insurance policy from IRDAI licensed insurance company, Universal Sompo General Insurance Company Limited, vide policy no. 3603/73641623/00/000 and bearing UIN no. IRDAN134CP0008V01202122 (please refer to [● – link of the policy] for detailed terms). Further, the benefits under Section 3.3 (b) are provided in accordance with the terms of the insurance cover obtained from IRDAI licensed insurance company, Universal Sompo General Insurance Company Limited, vide policy no. 3603/73635541/00/000 and bearing UIN No. IRDAN134CP0008V01202122 (please refer to [● – link of the policy] for detailed terms). It is hereby clarified that the obligations, responsibilities and liabilities of the Provider will be in accordance with the aforementioned policies.
3.5. Subject to these Terms and availability, we may make additional benefits available to Subscribers who purchase the Subscription after such additional benefits becoming available.
3.6. NO FIXED PAYOUT BENEFITS CAN BE AVAILED BY THE SUBSCRIBER IF THE SUBSCRIBER MAKES A CLAIM WITHIN A PERIOD OF 15 (FIFTEEN) DAYS FROM THE DATE OF THE PURCHASE OF THE SUBSCRIPTION/PLAN (“WAITING PERIOD”).
4.1. In the event of a Claim arising out of any of Accidents, Earthquakes, Civil Disruption, Fire or Floods, the same shall be notified by the Subscriber to the Provider within 14 (fourteen) days from the date of occurrence of such event.
4.2. The following information shall be provided by the Subscriber at the time of making a Claim for benefits:
(a) Certificate Number
(b) Start Date of the event
(c) End date of the event,
(d) Reason for the event,
(e) Evidence that the Claim is outside the Waiting Period, and
(f) Confirmation that the Subscriber’s Subscription of the Plan is in force.
4.3. Once we receive your Claim for benefits, we will assign you a claim number, following which, our authorized representative shall contact you.
4.4. Within a period of 15 (fifteen) days from the date of request by our authorized representative, you shall be required to provide the supporting documents specified in Annexure A.
4.5. Subject to the terms of this Plan and upon verification of the submitted documents and acceptance of the Claim by us, we will provide the applicable benefits to the Subscriber within 14 (fourteen) working days of the acceptance of the Claim by us.
4.6. In case of a Claim for Fixed Payout benefits, we will make the payment towards the applicable benefits after adjusting the monthly Subscription Fee due and payable by you for the remainder of the relevant Plan Term, during which such Claim has been made.
4.7. In addition to verification of the submitted documents, we and our Partners shall reserve the right to investigate the facts and examine the Subscriber.
4.8. In addition to the other benefits, the Subscriber will be entitled to make 1 (one) claim each for the Fixed Payout benefits during each Plan Term.
5.1. You may cancel your Plan at any time by visiting the Platform and following the instructions to cancel the Plan.
5.2. If you cancel your Plan, the benefits will remain active until the end of the current billing period, your subscription to the Plan shall stand terminated, and the Subscription Fee will not be payable by you.
5.3. The Subscription Fee shall be non-refundable.
6.1. The Subscriber represents and warrants that (a) they have completed the age of 18 (eighteen) years, competent to contract, and are a resident of India; and (b) the personal information provided by the Subscriber for the purposes of the Subscription and/or any benefits is and shall be true and accurate for the duration of the Plan Term.
6.2. The Subscriber agrees to defend, indemnify and hold the Provider and its officers, directors, employees, customers, affiliates and agents harmless from and against any and all claims, losses, suits, proceedings, action, liabilities, damages, expenses and costs (including attorney’s fees) incurred by the Provider or its officers or employees arising out of or in relation to (a) any wrongful act or omission of the Subscriber in relation to the usage of this Plan; (b) wilful misconduct, gross negligence or fraud by the Subscriber; (c) failure of the Subscriber to comply with applicable law; (d) breach of these Terms; and I any third-party claims arising out of the Subscriber’s use of this Plan.
6.3. The Provider merely facilitates the provision of the Plan through the Platform. The Provider shall not, in any manner, be liable for any cancellation, withdrawal or termination of the Plan. The Fixed Payout benefits are provided through the Platform. The Fixed Payout benefits under Section 3.3(a) and (c) are provided in accordance with the terms of the policy cover obtained from IRDAI licensed insurance company, Universal Sompo General Insurance Company Limited, vide policy no. 3603/73641623/00/000 and bearing UIN no. IRDAN134CP0008V01202122. Further, the benefits under Section 3.3 (b) are provided in accordance with the terms of the insurance cover obtained from IRDAI licensed insurance company, Universal Sompo General Insurance Company Limited, vide policy no. 3603/73635541/00/000 and bearing UIN No. IRDAN134CP0008V01202122. You acknowledge and accept that the obligations, responsibilities and liabilities of the Provider will be in accordance with and limited by the policies referred under Section 3.4.
6.4. By subscribing to the Plan, you provide your acceptance of the consents and waivers set out in Annexure B.
6.5. Notwithstanding anything contained herein, in no event shall the Provider be liable for any loss, claim, or direct damages or any special, exemplary, punitive, incidental, or consequential damages of any kind.
6.6. Provider’s maximum liability will be limited to the benefit limits for each Claim provided under this Plan.
6.7. Benefits shall automatically terminate in the case of Subscriber’s demise or exhaustion of the maximum coverage.
6.8. Provider shall not be liable to make any payments or provide any benefits to the legal heirs of the Subscriber in the event of death of the Subscriber.
7.1. These Terms. These terms & conditions (referred to as the “Terms”) govern the provision of Health Saathi Plan (“Plan”) and the services described herein through Assurekit by its Partners, and/or their affiliates (in these Terms, “Provider”, “we”, “us” or “our”, as the context may require) to its subscribers who use the Platform either as individual retail users (“Paytm Individual Users”) or as a merchant, business, commercial or other non-retail users (“Paytm Business Users”, and collectively with Paytm Individual Users, the “Paytm Users”, “Subscriber(s)” or “you”). Please read the Terms carefully and reach out to us for any questions at +91 88263-90016.
7.2. Force Majeure. The Provider shall not be liable for any loss, delay or non-performance of its obligations under these Terms arising from any cause beyond its control including, without limitation, any of the following: act of God, governmental act, war, fire, flood, pandemics, lockdown, explosion or civil commotion and shall not be liable to pay any amount as compensation, or otherwise, for any such loss, delay or non-performance.
7.3. External Sites. This Plan may contain links to third-party websites (“External Sites”). These links are provided solely as a convenience to the Subscriber and not as an endorsement by us of the content on such External Sites. We are not responsible for the content of any linked External Sites and do not make any representations regarding the content or accuracy of materials on such External Sites. The Subscriber should contact the site administrator or webmaster for those External Sites in the event of any concerns regarding such links or any content located on such External Sites.
7.4. Assignment. This Plan will inure to the benefit of the legal successors and assigns of the Provider. Provider reserves the right to assign, transfer, and subcontract its rights and/or obligations under this Plan without any notification. With respect to the Subscriber, these Terms are personal in nature and the Subscriber cannot assign, transfer, or subcontract any of his/her rights and/or obligations under these Terms.
7.5. Entire Agreement. These Terms along with the Annexure and Schedules constitute the entire agreement between the Provider and the Subscriber with respect to and in relation to the use of this Plan (including any modification or amendment thereto), and supersedes all prior agreements and understandings, if any.
7.6. Governing Law and Jurisdiction. These Terms shall be governed by, construed and enforced in accordance with the laws of India, without giving effect to any conflict of law provisions. Subject to Section 7.7 below, any dispute arising under this Plan shall be resolved exclusively by an appropriate court of law in New Delhi.
7.7. Dispute Resolution. All disputes arising in connection with these Terms shall be finally settled by arbitration pursuant to the rules of the Arbitration and Conciliation Act, 1996, by one arbitrator appointed in accordance with the said Rules. The language of the arbitration proceedings shall be English. The seat and venue of the arbitration proceedings shall be New Delhi. The decision of the arbitrator shall be final and binding on the parties.
7.8. Notices. Any specific notices and declarations for the attention of the Subscriber shall be in writing, and shall be delivered to the Subscriber’s address and/or email address as provided by the Subscriber. Provider or its Partners may issue general notices or declarations through the relevant Platform/s or through any other electronic communications. Any and all notices and declarations for the attention of the Provider shall be in writing and shall be sent to the addresses specified hereunder:
Assurekit Technology and Services Private Limited
S7-12, PINNACLE BUSINESS PARK, 7th floor,
Shanti Nagar, Andheri East, Mumbai,
Maharashtra – 400 093, India
7.9. Set-off & Waiver. Provider’s failure to act on or enforce any provision of the Agreement shall not be construed as a waiver of that provision or any other provision in this Agreement. No waiver shall be effective against us unless made in writing, and no such waiver shall be construed as a waiver in any other or subsequent instance. You agree that the Provider and/or its Partners may set-off or deduct from any monies payable to you under this Plan, any amounts which are payable by you to the Provider and/or its Partners, provided that the Provider and/or its Partners (as applicable) will endeavour to notify you prior to any such set-off or deduction.
7.10. Amendments and Modifications. Provider reserves the right to extend, cancel, discontinue, prematurely withdraw, change, alter or modify this Plan and/or the Terms. Upon such amendment this Plan and/or the Terms, will become applicable immediately and intimated to the Subscriber in due course. If the Subscriber does not accept the amendment of this Plan and/or the Terms, he/she shall have the right to terminate this Plan with appropriate notice. The alteration of this Plan and/or the Terms shall be deemed accepted where the Subscriber continues to use the service for one (1) month after the amendment has taken effect.
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Coverage and Limits
For Paytm Individual Users:
Benefits Coverage | Coverage Up to |
Accidents | INR 10,000 (at the rate of INR 3,333.33 per day) |
Benefit Limit:
· For Accidents, the pay-out benefit will be payable for each day of incapacity, up to a period of 3 days.
For Paytm Business Users:
Benefits Coverage | Coverage Up to |
Accidents | INR 10,000 (at the rate of INR 3,333.33 per day) |
Earthquakes | INR 3,000 |
Civil Disruption | INR 3,000 |
Fire | INR 3,000 |
Benefit Limit:
· For Accidents, the number of days for which such pay-out will be made shall be the lower of (a) the number of days the business of the Subscriber is impacted; or (b) the maximum number of days specified above.
· For Earthquakes, Civil Disruption and Fire, the number of days for which such payout shall be made shall be the coverage specified above.
Other terms (for all Paytm Users / Subscribers):
Deductible:
· For Accidents, there shall be a deductible of 1 (one) day on any Claims made for Accidents.
· For Earthquakes, Civil Disruption and Fire, there shall be a deductible of 3 (three) days on any Claims made for Earthquakes, Civil Disruption or Fire.
Please note that the above benefits are provided by IRDAI licensed insurance company, Universal Sompo General Insurance Company Limited (IRDAI Registration Number - 134), bearing UIN no. IRDAN134CP0008V01202122:
· For Accidents, IRDAI licensed insurance company, vide policy no. {{Master policy number}} (please refer to {{Policy URL}} for detailed terms); and
· For Earthquakes, Civil Disruption and Fire, vide policy no. {{Master policy number}}(please refer to {{Policy URL}} for detailed terms).
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Claim Payout Table
Benefits Coverage | Coverage Upto |
Flood, due to excess rainfall | INR 3,000 per Insured Person per policy |
Benefit trigger:
In case of Floods, due to excess rainfall, the benefits shall pe paid out if:
1. The cumulative rainfall for a maximum of five (5) consecutive days greater than the Strike Index (as defined under the insurance policy) (“Affected Period”), AND
2. Fall in the number of transactions of the Subscriber’s / Paytm Business User’s business by at least seventy five percent (75.00%) during the course of Affected Period when compared to the immediately preceding active business days of the same period.
Please note that the above benefits are provided by IRDAI licensed insurance company, Universal Sompo General Insurance Company Limited, (IRDAI Registration Number - 134) vide policy no. {{Master policy number}} and bearing UIN no. IRDAN134CP0008V01202122 (please refer to {{Policy URL}} for detailed terms).
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Supporting Documents
The Subscriber shall be required to provide the following supporting documents for the purposes of verification of claim for benefits:
In case of a Claim for Accident, the Subscriber shall provide the following documents:
(a) Hospital bill & discharge summary;
(b) Medical certificate showing incapacitation or inability to drive or work along with number of days for which such incapacity/ inability subsists; and
(c) Location, area and postal code of the place where such Accident/ injury was suffered.
In case of a Claim for Floods, the Subscriber / Paytm Business User shall provide the following documents:
(a) Proof of reduction in the transaction on the Platform over affected days;
(b) Data of the rainfall index in the area where the Business Establishment of the Subscriber is located along with the postal code;
(c) Photographs of damage to the Business Establishment (with date and timestamp); and
(d) Copy of the news article covering the occurrence of Floods.
In case of a Claim for Earthquake, Civil Disruption or Fire, the Subscriber / Paytm Business User shall provide the following documents
(a) Proof of shutdown of the Business Establishment for a minimum period of three (3) days;
(b) Photographs of damage to the Business Establishment (with date and timestamp);
(c) If the Claim is for Civil Disruption or Fire, a copy of the first information report, except for where there is a strike and no damage has been done to the Business Establishment;
(d) If the Claim is for Earthquake, relevant metrological data; and
(e) Copy of the news article covering the occurrence of Earthquake, Civil Disruption or Fire (as the case may be).
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Consents and Waivers required from You
(a) By placing an order for a Subscription, you acknowledge that you have carefully read and understood these Terms.
(b) You acknowledge that these Terms constitute a binding agreement between you and the Provider (and its assignees and/or affiliates, as applicable), effective from the date of purchasing a Subscription.
(c) You hereby provide your consent to the Provider (and its assignees and/or affiliates, as applicable), to use your information, collected directly or through any third-parties, for carrying out background verification for verifying the criteria for purchasing a Subscription.
(d) You hereby provide your consent to the collection, storage, processing, and/or transfer of the information, whether by us, our Partners, or other third-parties providing services necessary for the provision of the Subscription, the Plan, and the benefits provided thereunder. The information referred above may include name, email, phone number, employment history and other details, phone calls between the Provider and the Subscriber, know-your-customer and related requirements including Government issued identity cards, academic qualifications, and such other information as may be required for the purpose of the Plan and providing the benefits thereunder.
(e) You agree and understand that the Provider makes no warranty or guarantee relating to income or employment. However, we are committed to ensure that you receive the best possible support and guidance from us and our Partners.
(f) We may engage certain third-party service providers to provide the services and benefits offered under the Plan. You understand and accept that we are not liable for any defaults or defects in the services or benefits provided by such third-parties, to the extent that such services or benefits are not within our control.
(g) It is understood that the Plan is intended to provide short-term security and other benefits, and is not intended to be a source of income.
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