Even Infinite terms and conditions

In these Terms and Conditions, unless the context otherwise requires, the following terms shall have the meanings assigned to them below:

In these Terms and Conditions, unless the context otherwise requires:

• the headings are for convenience only and shall not affect the construction or interpretation of any provision;
• words importing the singular include the plural and vice versa, and words importing one gender include every gender;
• the words “include”, “including”, and “in particular” shall be construed as being by way of illustration only and shall not limit the generality of the related general words;
• a reference to a statute or statutory provision is a reference to it as amended, extended, or re-enacted from time to time, and includes all subordinate legislation made under it;
• a reference to a clause is to a clause of these Terms and Conditions;
• references to “writing” or “written” include email and other electronic communications; and
• a reference to a person includes a natural person, a body corporate, and any other legal entity.

Even Infinite is a hospital services programme. Members receive medically necessary OPD Services at no charge, and IPD Services at the Network Rate, at Even Hospital. The Programme is operated by Even Hospital as a network access and population health engagement initiative. The Programme constitutes an arrangement between a Member and Even Hospital for the provision of defined hospital services, and confers no rights, entitlements, or benefits of any kind under any insurance policy or under any legislation governing the business of insurance in India.

Even Infinite is not, and shall not be construed as:

• an insurance product, an insurance policy, or a contract of insurance within the meaning of the Insurance Act, 1938, or any other applicable law;
• a health indemnity plan, a hospital cash benefit plan, a fixed benefit health plan, a defined benefit arrangement, or any analogous product regulated by the IRDAI;
• a supplement to, an amendment of, or a replacement for any insurance policy held by a Member;
• a rebate of premium, or any advantage, gift, or inducement offered, directly or indirectly, to any person to purchase or renew an insurance policy from any insurer or intermediary, including Euston;
• a guarantee of access to any specific clinician, specialist, or clinical facility;
• a guarantee of any specific clinical outcome, recovery period, or treatment result; or
• a health-check programme offered on an elective or preventive-only basis.

No representation made by Even Hospital, or by its employees, agents, or affiliates, whether oral, written, or digital, shall have the effect of characterising the Programme as an insurance product or as conferring any right to indemnity, reimbursement, or benefit payment. Any such representation, if made, shall be of no legal effect whatsoever.

Even Hospital is a separate operational entity from Euston Insurance Advisors Private Limited, which distributes health insurance under the Even brand as an IRDAI-licensed Corporate Agent (IRDAI Registration No. [NUMBER]). The Programme is offered solely by Even Hospital, an entity of Balloon Healthcare. Members are not required to have purchased, or to purchase, insurance through Euston or any Even-affiliated entity in order to be eligible for the Programme. Even Hospital does not act, and shall not be deemed to act, as an insurer, co-insurer, reinsurer, or insurance intermediary in connection with the Programme.

The Programme is provided by Even Hospital gratuitously, and no membership fee, premium, or other consideration is payable by a member for participation in the Programme. The Programme confers upon a Member access to defined hospital services only, and does not confer any right to, or entitlement to claim, any payment of money or money’s worth from Even Hospital, whether upon the occurrence of any contingency or otherwise. A Member’s sole entitlement under the programme is to receive the OPD Services and IPD Services described in clause 4, provided directly by Even Hospital, subject to and in accordance with these Terms and Conditions.

To be eligible for the Programme, a person must:

• hold an active health insurance policy issued by a Partner Insurer at the time of application, whether a retail policy or a group policy under an employer-employee relationship;
• reside in, or regularly access healthcare in, Bengaluru, Karnataka; and
• complete the sign-up process and upload a valid COI or e-card in accordance with clause 3.2.

Eligibility is confirmed by COI or e-card verification only. The Programme is open to any eligible individual regardless of where, or through whom, the relevant insurance policy was purchased.

Activation consists of the following three steps:

• Step 1 — Registration: the applicant provides their name, mobile number, and pincode via the Even app or website.
• Step 2 — COI or E-card Upload: the applicant uploads a clear copy (photograph or PDF) of the COI or e-card for each applicable policy.
• Step 3 — Verification: Even Hospital conducts a manual review within forty-eight (48) hours of upload to confirm that the relevant policy is active with a Partner Insurer. The applicant is notified of the outcome by SMS, WhatsApp, and email.

If a submitted COI or e-card does not qualify (for example, because the insurer is not a Partner Insurer, or the policy has lapsed), Even Hospital will notify the applicant of the specific reason for non-qualification. There is no limit on the number of re-upload attempts.

All individuals listed on a qualifying policy are eligible for the Programme under a single Activation. Where a family member holds a separate qualifying policy, that family member may be added to the Programme by independently uploading their COI or e-card. Each individual Member receives a separate member profile.

Programme access may be subject to capacity limits. Where capacity is reached, eligible applicants will be placed on a waitlist and notified when access becomes available. Even Hospital will endeavour to open new membership batches on a regular basis.

With effect from the Activation Date, Members receive the following OPD Services at Even Hospital at no per-visit charge and with no annual cap:

• Unlimited consultations across available specialities, including General Physician, Internal Medicine, Paediatrics, Orthopaedics, General Surgery, Gastroenterology, ENT, Dermatology, Obstetrics & Gynaecology, Cardiology (non-tertiary), Nephrology (non-tertiary), Dietetics, and Physiotherapy. All access to care is subject to clinician availability on a best-efforts basis.
• Prescribed diagnostics, including full pathology, X-ray, ultrasound, CT scan, mammography, ECG, 2D Echo, TMT, EEG, and Pap Smear.
• Protocol-led preventive screenings prescribed by Even doctors based on the Member’s individual age, family history, and risk profile.
• Allied health services, being dietician, physiotherapy, and psychology (mental health) sessions, when prescribed by an Even doctor.
• Teleconsultations, being free 24/7 Teleconsultations with the Even Care doctor team, bookable via the Even app.
• Pharmacy discount, being a twenty per cent (20%) discount on prescribed medicines dispensed at the Even Hospital pharmacy.

There is no per-visit fee and no consultation charge for any of the OPD Services listed above.

For IPD Services at Even Hospital, Members pay the Network Rate, currently fifty per cent (50%) of the List Price. The Network Rate applies to the entirety of the admission bill, including room charges, surgeon and anaesthetist fees, operation theatre charges, consumables, and nursing. No additional charge shall be levied over and above the Network Rate for covered services.

The Network Rate applies to:

• all planned surgical procedures within Even Hospital’s clinical scope;
• emergency admissions at Even Hospital; and
• maternity services, including normal delivery, caesarean section, antenatal care, postnatal care, and newborn screening, with no maternity waiting period.

The Member selects Even Infinite as the payment route at the time of admission. The Network Rate discount is applied at the billing counter at the point of settlement; there is no claim-back or reimbursement process.

Where a Member’s insurance policy covers part or all of an IPD admission at Even Hospital, the insurance coverage shall be processed first. The Network Rate discount shall not be applied where insurance policy coverage has been initiated, but may be applied at Even Hospital’s discretion in such circumstances.

The following services are not included within Programme benefits at this time:

Outpatient Exclusions:

• MRI scans, genetic testing, ophthalmology consultations, and dental procedures; and
• services outsourced to, and not directly provided by, Even Hospital, which are excluded but may be included at such time as Even Hospital provides such services directly.

Inpatient Exclusions:

• complex tertiary surgeries, which shall include but shall not be limited to organ transplants, cardiac surgery (including coronary artery bypass grafting, valve replacement, and open cardiac procedures), and neurosurgery;
• eye surgeries and procedures;
• cosmetic and fertility procedures, and for the avoidance of doubt, fertility procedures remain excluded notwithstanding the positive inclusion of maternity services under clause 4.2;
• in-patient psychiatric hospitalisation; and
• services outsourced to, and not directly provided by, Even Hospital, which are excluded but may be included at such time as Even Hospital provides such services directly.

As Even Hospital’s clinical scope expands, the exclusions may be reduced. Members will be notified of any material change to the scope of excluded services. Where an Even doctor recommends a service not currently available at Even Hospital, Even Hospital’s care coordinators will assist the Member in accessing that service through the Member’s applicable insurance or at a partner facility.

Members may present valid prescriptions issued by any registered medical practitioner, and not only by Even doctors, for diagnostic and pharmacy services under the Programme. Second opinions from Even doctors are included within OPD benefits. For the purposes of this clause, a valid prescription shall contain the following particulars:

• the prescribing doctor’s name, signature, qualification, and registration number;
• the clinic or hospital address of the prescribing doctor;
• the patient’s name, age, and sex; and
• the date of the prescription.

To maintain active Membership, each Member must complete a minimum of one Quarterly Consult per calendar quarter. A Quarterly Consult is a clinical interaction of approximately fifteen (15) minutes, conducted in person at Even Hospital or by Teleconsultation. The subject matter of the Quarterly Consult may include any health matter the Member wishes to discuss, including preventive health review, management of existing conditions, or a physiotherapy assessment. Even Hospital reserves the right to adjust this requirement from time to time at its discretion, subject to prior notice to Members.

Even Hospital will proactively contact each Member who has not initiated a Quarterly Consult within a given quarter. If a Member does not respond to the initial contact, Even Hospital will make reasonable further attempts to reach the Member before the close of that quarter. Even Hospital’s discharge of its initiation obligation does not relieve the Member of the independent obligation to complete the Quarterly Consult.

Failure to complete a Quarterly Consult in any calendar quarter shall result in suspension of the relevant Member’s Programme access for that quarter. Such suspension shall be lifted upon completion of a Quarterly Consult in any subsequent quarter. Membership shall not be renewed at the close of an annual period if the Member has completed fewer than three of the four Quarterly Consults during that period. Even Hospital may, at its discretion, override a suspension in individual cases.

Non-completion of a Quarterly Consult shall not affect a suspended Member’s entitlement to emergency IPD Services at Even Hospital during the period of suspension. All other Programme benefits shall remain suspended until the Quarterly Consult requirement is fulfilled.

A Member may cancel their Membership at any time, without notice and without any cancellation fee. Cancellation may be effected through the Even app or by written notice addressed to support@even.in.

If a Member’s qualifying insurance policy lapses, expires without renewal, or is cancelled by the issuing insurer, Membership shall be automatically suspended with effect from the date of such lapse, expiry, or cancellation. The Member may reinstate Membership by uploading a valid COI for a new or renewed qualifying policy, whether retail or group, without the need to make a fresh application. No reinstatement fee is payable.

Even Hospital reserves the right to amend these Terms and Conditions, the scope of Programme benefits, or the list of Partner Insurers at any time. Members will be given not less than thirty (30) days’ prior written notice of any material adverse change to Programme benefits. Continued use of Programme benefits following the expiry of the notice period shall constitute acceptance of the amended terms.

Even Hospital reserves the right to terminate the Programme in its entirety upon giving not less than ninety (90) days’ written notice to Members.

Member health records generated through Even Hospital are stored within Even Hospital’s clinical information systems. Members may access their records through the Even app. Even doctors treating a Member may access records held within Even Hospital’s systems in the course of providing clinical care.

Even Hospital processes the personal data of Members in accordance with the DPDP Act and other applicable data protection laws. Member health data constitutes sensitive personal data, and by activating the Programme, each Member consents to the collection, storage, and processing of such personal data by Even Hospital for the purposes of operating the Programme, delivering clinical care, and discharging Even Hospital’s legal and regulatory obligations. Personal data shall be processed only for these purposes, shall be retained only for so long as is necessary for such purposes or as required by applicable law, and shall be secured by reasonable technical and organisational safeguards.

Even Hospital may use anonymised, aggregated, and non-identifiable data for research, population health analysis, and service-improvement purposes. No data that identifies a Member individually shall be shared with any third party without the Member’s explicit consent, except as required by applicable law or by a treating clinician in a medical emergency.

Subject to and in accordance with the DPDP Act, a Member may request access to, or correction or erasure of, their personal data, and may withdraw consent to its processing, by contacting Even Hospital at support@even.in. The withdrawal of consent necessary for the operation of the Programme may result in the suspension or cancellation of Membership. Even Hospital’s full privacy policy is available at even.in/privacy-policy.

Even Infinite is not a guarantee of any specific health outcome, diagnostic result, treatment efficacy, or recovery period. Even Hospital’s obligation under the Programme is solely to make Programme benefits available to eligible Members in accordance with these Terms and Conditions. Clinical outcomes are dependent on individual health circumstances, the independent professional judgment of treating clinicians, and factors entirely outside Even Hospital’s control. Even Hospital assumes no responsibility for clinical outcomes in connection with the Programme.

To the fullest extent permitted by applicable law:

• No liability for consequential loss: Even Hospital shall not be liable to any Member for any indirect, special, incidental, consequential, or punitive loss or damage of any nature, including loss of income, loss of earnings, loss of opportunity, mental distress, or any analogous loss, however caused and whether arising in contract, tort, or otherwise.
• Aggregate cap on Programme-related liability: Even Hospital’s aggregate liability to any single Member in respect of all claims arising out of or in connection with the Programme shall not exceed a sum of Rs 5,000/- (Five Thousand Rupees Only).
• No liability for third-party services: Even Hospital shall not be liable for any act, omission, error, or negligence of any third-party provider, partner facility, or external clinician to whom a Member is referred by Even Hospital under clause 4.3, whether in connection with the Programme or otherwise.
• No liability for insurance decisions: Even Hospital shall bear no liability whatsoever arising from any decision made by a Partner Insurer or any other insurer in connection with a Member’s insurance policy, including decisions relating to claim settlement, policy renewal, loading, exclusion, or cancellation.
• No liability for system or platform downtime: Even Hospital shall not be liable for any loss or inconvenience arising from temporary unavailability of the Even app, the Even website, or the Teleconsultation platform, provided that Even Hospital takes reasonable steps to restore availability within a reasonable period.
• Force majeure: Even Hospital shall not be liable for any failure or delay in making Programme benefits available where such failure or delay arises from circumstances beyond Even Hospital’s reasonable control, including epidemic, pandemic, natural disaster, governmental order, or civil unrest.

By activating the Programme, each Member expressly acknowledges that:

• Even Infinite is a hospital services access arrangement and not an insurance product of any description;
• Even Hospital does not assume, and the Programme does not constitute, any obligation to indemnify the Member against medical expenses, loss of income, or any other financial risk;
• the Member is solely responsible for maintaining adequate health insurance coverage independently of the Programme; and
• the limitations of liability set out in this clause 9 are reasonable in the context of a programme made available to Members at no membership fee.

These Terms and Conditions constitute the entire agreement between Even Hospital and each Member in respect of the Programme, and supersede all prior representations, understandings, and arrangements, whether oral or written, relating to its subject matter.

If any provision of these Terms and Conditions is or becomes invalid, illegal, or unenforceable under any applicable law, that provision shall be deemed modified to the minimum extent necessary to make it valid and enforceable, or, if such modification is not possible, shall be deemed severed. The validity and enforceability of the remaining provisions shall not be affected.

No failure or delay by Even Hospital in exercising any right or remedy under these Terms and Conditions shall operate as a waiver of that or any other right or remedy, nor shall any single or partial exercise preclude any further exercise of it.

Membership is personal to the Member and may not be assigned, transferred, or otherwise dealt with by the Member. Even Hospital may assign, transfer, or novate its rights and obligations under these Terms and Conditions to any entity within the Balloon Healthcare group, or to any successor in the operation of Even Hospital, upon notice to Members.

Nothing in these Terms and Conditions shall be construed as creating a partnership, joint venture, agency, or employment relationship between Even Hospital and any Member, or as constituting Even Hospital an insurer or insurance intermediary in relation to any Member.

Any notice to a Member under these Terms and Conditions may be given by SMS, WhatsApp, email, or in-app notification to the contact details provided by the Member at the time of Activation, and shall be deemed received on the day of transmission. Any notice to Even Hospital shall be sent to support@even.in and shall be deemed received upon acknowledgement by Even Hospital.

Clauses 2, 6, 8, 9, 10, and 11, together with any other provision that by its nature is intended to survive, shall continue in effect notwithstanding the cancellation, suspension, or termination of Membership or of the Programme.