Terms & Conditions

“Clear expectations create confident decisions.”

These Terms & Conditions describe how Winsure Health provides its services, how customers should use them, and what each side can reasonably expect from the other.

We keep everything transparent and straightforward so you always know where you stand.

1. Who We Are

Winsure Health is an independent health insurance advisory service based in Krishnanagar, West Bengal.

We help customers:

  • compare insurers
  • understand policy conditions
  • evaluate risks
  • choose the right coverage
  • and get guidance during claims

We are not a direct insurance company.
We assist customers in making informed decisions.

  • Claim Performance Check
    A comparison of claim behaviour, approval speed, payout quality, and hospital network strength.
  • 30-Parameter Policy Rating
    An evaluation of shortlisted policies to help identify the best fit for your needs.
  • 50-Parameter Final Policy Report
    A detailed explanation of your chosen policy’s coverage, riders, exclusions, rules, and claim guidelines.
  • Guidance During Purchase
    We help you fill forms correctly, disclose medical history accurately, and review documents.
  • Claim Support (when requested)
    We assist you in understanding and navigating the claim process.

3. What Our Service Does NOT Include

✖ We do NOT guarantee claim approval
Claims are approved or rejected by the insurance company based on their investigation, medical records, policy wording, and regulatory rules.

✖ We do NOT make underwriting decisions
The insurance company decides whether:

  • medical tests are required
  • extra premiums (loadings) apply
  • any condition is permanently excluded
  • a policy can be issued or rejected.

✖ We do NOT control hospital billing
Hospitals decide:

  • room rent charges
  • procedure costs
  • non-medical item billing
  • package pricing.

✖ We do NOT modify policy terms
All policy rules are set by the insurer and regulated by IRDAI.

We guide, support, and clarify —
but final decisions rest with insurers and hospitals.

4. Your Responsibilities as a Customer

To ensure correct guidance and smooth claim experience, you agree to:

✔ Provide accurate personal details

(age, address, identity documents, etc.)

✔ Share truthful medical history

(pre-existing illnesses, surgeries, medicines taken, etc.)

✔ Review the final policy documents

including exclusions, waiting periods, and coverage limitations.

✔ Ask for clarification if any point feels unclear

✔ Use our comparison tool honestly

and not for unlawful or fraudulent purposes.
Your accuracy ensures your safety

5. Policy Purchase Terms

If you choose to buy a policy through Winsure Health:

✔We process your application with your chosen insurer

based on the information you provide.

✔You confirm that all details shared are correct.

Incorrect disclosures may affect underwriting or claims.

✔Your premium is paid directly to the insurer

via their official payment gateways.
We do NOT collect premiums in cash on behalf of insurers.

6. Claim Support Terms

We guide you during a claim by:

  • explaining the process
  • helping organize documents
  • communicating with TPA or in-house teams (if needed)
  • clarifying deductibles and coverage.

However:

✔Approval, partial approval, or rejection

is entirely the insurer’s decision.

✔ We cannot influence or override regulatory rules.

✔We cannot force a hospital to provide cashless treatment

if the hospital declines due to internal policies.
We support you —
but decisions follow medical evidence and policy rules.

7. Advice and Recommendations

All advice given by Winsure Health is based on:

  • the information you provide
  • insurer data available at the time
  • our evaluation system
  • our experience with claim trends.

Our recommendations aim to protect you,
but they are not a guarantee of future outcomes.

Health insurance involves:

  • medical risks
  • regulatory rules
  • underwriting decisions
  • hospital billing variations.

We help you navigate these responsibly.

8. Limitations of Liability

Winsure Health is not responsible for:

  • decisions made by insurance companies
  • claim rejections
  • partial claim payments
  • underwriting loadings
  • medical test outcomes
  • delays caused by insurers or hospitals
  • changes in insurance regulations

We are responsible for providing clear, honest, unbiased advice and full transparency — nothing less, nothing more.

9. Use of Our Website and Tools

By using our website or comparison system, you agree:

  • not to misuse the platform
  • not to provide false information
  • not to share comparison data publicly without context
  • not to attempt to manipulate our tools for misleading conclusions

Our tools are designed for personal guidance
not mass redistribution.

10. Confidentiality and Privacy

We protect your information according to our Privacy Policy.
We do not sell, rent, or misuse your data.
Your privacy is central to our relationship

11. Updates to These Terms

We may update these Terms & Conditions to improve clarity or comply with new regulations.

If changes occur, we will notify users transparently.

No hidden updates.
No silent policy changes.

12. Contact for Any Clarification

If you have questions about these terms,
we encourage you to reach out directly.

We believe clear communication creates safe decisions.
We are always here to help.

THE SPIRIT OF THESE TERMS

“We guide with honesty.

You decide with clarity.
Together, we protect what matters most.”