Membership Terms and Conditions

Membership: This refers to the membership offered by Clinikk which includes a range of benefits for day to day healthcare needs.

Clinikk Health Hubs: These are primary care centers that are staffed by a Care Team comprising family-medicine trained doctors, nurses, and patient care coordinators.

Member: This refers to individuals listed under any Clinikk Health Plans who are entitled to the benefits of the membership and agree to be bound by the Terms and Conditions.

Membership fees: This refers to the total Membership fee for Your Clinikk membership. It consists of fees paid to Clinikk for managed care services and OPD benefits

Managed Care services: Managed care refers to help offered to access various healthcare and wellness services to improve Members health and well-being and prevent the onset of serious health problems. These services include unlimited Clinikk doctor consultations both in-person and over Tele-consultation, Care Team and Care Plans.

Primary care services refer to the range of basic health care services that are provided by Clinikk Health Hubs, including general check-ups, basic diagnostic tests, procedures and consultations with primary care physicians.

Care Team: This refers to the team of doctors, nurses, and patient care coordinators who staff the Clinikk Health Hubs and provide tele-consultation and care guidance.

Tele-consultation: This refers to the provision of healthcare services, including guidance, diagnosis, consultation, and prescription, using telecommunication technologies.

Group Health Insurance: This refers to the hospitalization insurance coverage provided by an IRDAI registered Insurance Provider that covers the cost of hospitalizations and day care services as per their terms and conditions if you have opted for it.

Outpatient Department (OPD) Benefits: This refers to the benefits provided by Clinikk memberships for tests and medicine prescribed by the Clinikk Doctor or a doctor referred by the Clinikk Doctor.

Activation Date: This refers to the date of successfully completing all the requirements for the activation and onboarding process for the Clinikk membership plan chosen.

Healthcare Partners: These refer to any third-party healthcare providers including laboratories, diagnostic centres, clinics and hospitals.

Day Care services: These are medical procedures that require hospitalisation for less than 24 hours.

Outpatient Department (OPD) services: These are doctor consultations, tests, medicines or procedures taken without hospitalization.

Clinikk Health Hubs are primary care centres staffed by a team (”Care Team”) of family-medicine trained doctors, nurses, and patient care coordinators.

Details about our Clinikk Health Hubs are provided in the link https://www.clinikk.com/clinics-bangalore with their respective timings

Members can consult Clinikk Doctors in-person by visiting the Clinikk Health Hubs or over tele-consultation through visiting the Clinikk app or Care Team Chat. Tele-consultation is available 24/7 with an on-call doctor with a maximum wait time of 30 minutes. For tele-consultation with a specific doctor, members need to book an appropriate time slot as per the doctors’ availability.

Members are entitled to unlimited and complimentary access to the Care Team chat service. This service allows members to ask follow-up questions about their condition, schedule visits, or seek assistance related to their membership. To connect with the Care Team support at any time, use the chat feature within the app or send a WhatsApp message to the number link provided.

Clinikk offers memberships for adults and children:

The Smart Silver and Smart Diamond memberships come with the option to avail group health insurance that can be opted as part of the memberships. The health insurance is provided by an IRDAI registered Insurance Provider as a group health insurance exclusively for the customers of Clinkk.

The terms and conditions for the health insurance provided by the insurer can be found at the provided link. If you have opted for a super-top, see the following terms and conditions at the provided link. While we facilitate access to the insurance coverage as a group administrator, we neither underwrite nor assume any risks associated with the policy. In the event of any claim made under the group insurance policy, it may be communicated to us for coordination purposes, however, it is imperative to note that the insurance provider shall be solely responsible for all claims processing and decision-making.

The Smart Silver and Smart Diamond memberships come with the option to avail group personal accident insurance that can be opted as part of the membership. The group personal accident insurance is provided by an IRDAI registered Insurance Provider as a group insurance exclusively for the customers of Clinikk. It covers accidental death, permanent total disability and permanent partial disability. (The terms and conditions for the personal accident insurance can be found at the provided link.While we facilitate access to the insurance coverage as a group administrator, we do not underwrite nor assume any risks associated with the policy. In the event of any claim made under the group insurance policy, it may be communicated to us for coordination purposes, however, it is imperative to note that the insurance provider shall be solely responsible for all claims processing and decision-making. )

The Smart Diamond membership come with annual Outpatient Department (OPD) Benefits, which covers consultations, tests and medicine prescribed by a Clinikk doctor (limited to details in section on OPD Benefits and Cover), and tests and medicine prescribed by referred specialists, and referred specialist consultation fee. For terms and conditions of these OPD benefits, please see the section OPD Benefits and Cover.

The Smart Silver membership has discounts on medicines and tests available in Clinikk Health Hub as prescribed by the doctor. Clinikk general physician doctor consultations are available at a 100% discount for an unlimited number of consultations.

The Smart Silver membership offers discounts on medicines and tests available at the Clinikk Health Hub when prescribed by a Clinikk doctor. Discounts do not apply to medicines or tests prescribed by external doctors or taken outside Clinikk.

The Smart Diamond membership include an annual outpatient department (OPD) Benefits for doctor consultations, tests and medicines, subject to the following conditions:

For Smart Diamond members, the (OPD) Benefits also pays for specialist fees, tests, and medicines prescribed by the specialist, provided the specialist was referred by a Clinikk doctor.

For Smart Diamond members, Consultations, tests and medicines at Clinikk will be charged at MRP. (OPD) Benefits will cover expenses for these tests, consultation fees, and medicines up to an annual limit. Tests and medicines at Clinikk will be charged at MRP. The OPD Benefit annual limit for each membership can be found on clinikk.com or by asking on the Care Team Chat.

For Smart Diamond members, once the (OPD) Benefits are exhausted, members will be eligible for benefits under the Smart Silver membership. Any unused (OPD) Benefits in an annual period will not carry forward to the next year.

The (OPD) discounts and benefits does not cover any cosmetic procedures, dental procedures or treatments, therapeutic procedures, or daycare procedures and/or admissions. Certain treatments and services, available at Clinikk or outside, are not eligible for OPD Benefits, including but not limited to: wellness products, supplements, medical equipment, vaccinations, fertility-related treatments/tests, maternity (except as specified below), mental health, physiotherapy, speech therapy, and other non-allopathic therapies.

The Company reserves the right to limit coverage for specific tests or tests based on medical necessity or membership limitations.

If a reimbursement is requested without having consulted a Clinikk doctor first, the reimbursement request may be denied. Clinikk reserves the right to deny referrals that are requested by the patient. Clinikk Medical Team’s clinical judgment with regards to referral will be final.

For Smart Diamond members, specialist fees is only covered if referred by Clinikk doctors for the treatment of the original problem. Fresh referral has to be taken for treatments lasting more than 60 days. If multiple specialists are seen for the same issue, these fees may not be covered if they are deemed medically unnecessary by the Clinikk medical team.

Smart Diamond can reimburse medicines or tests taken outside Clinikk in the following cases:

Consult a Clinikk doctor in-person or via tele-consultation

Get the prescribed test or medicine from Clinikk and use the (OPD) Benefits to cover the cost. Only if the prescribed test or medicine is not available at the Clinikk Health Hub, or if your nearby Clinikk Health Hub is shut, purchase it elsewhere and apply for reimbursement.

If you are referred to a specialist by Clinikk and you are a Smart Diamond member, apply for reimbursement of specialist fees, medicines and tests prescribed by the specialist.

Smart Diamond members can reimburse medicines or tests taken outside Clinikk in the following cases:

Members shall initially pay out-of-pocket for eligible doctor fees, medicines and tests and then raise a request for reimbursement from their (OPD) Benefits for Clinikk doctor prescribed services that are availed outside of Clinikk Health Hub.

Members must make the reimbursement request within a stipulated period of 30 days from the date mentioned in the Clinikk doctor's prescription in order to be eligible for reimbursement, if any. Reimbursement requests submitted after 30 days may be denied. The reimbursement request needs to be accompanied by documents including but not limited to: the Clinikk prescription, the bill/receipt and reports of tests and/or the bill/receipt of medicines and the referred doctor's prescription.

The Company will review and process your reimbursement request within 14 days from the date of submission of the last required document. Each reimbursement request will be reviewed for eligibility, and the Company reserves the right to approve or reject reimbursement requests based on these terms and conditions.

All reimbursements are subject to the approval of Clinikk and membership coverage.

All memberships are valid for a year from the Purchase Date. Members can opt for flexible payment options including monthly, quarterly, semi-annually, and annually if available for the particular membership chosen. Membership purchases less than Rs 15,000 may require auto-pay setup.

Members must pay the applicable membership fee in a timely manner, within 7 days of their due date.

Failure to pay the membership fee may result in the termination of the Member’s membership and loss of benefits coverage.

The Company reserves the right to revise the annual membership fee on annual renewal.

You can get a full refund for your Clinikk membership within the first 15 days of your membership activation if you find the terms and conditions not acceptable. To be eligible for a refund, you must provide a reason for cancellation in writing or by calling our support line. This refund is only applicable to customers who made an annual payment for their Clinikk membership. No refund is applicable once membership activation is complete if flexible payment options including monthly, quarterly, semi-annually are chosen. If you use any OPD Care services or claim insurance benefits during this period, there will be no refund of your Membership Fees. The refund of insurance premium, if opted for, will be governed by the terms and conditions of the group insurance coverage provided by the IRDAI registered Insurance Company.

After the 15-day period, You can cancel your Clinikk membership at any time by informing us in writing or by calling our support line. If you pay non-annually, you will not get a refund and your OPD and IPD benefits will continue till the end of the payment period. If you paid annually and did not use any OPD services or insurance benefits, you will get a partial refund based on a pro-rata basis according to how long you were a member. The pro-rata basis of refund shall be as such:

Clinikk reserves the right to cancel your Clinikk membership without a refund if it is discovered that you have provided false or incomplete information at the time of buying or activating the Clinikk membership. You shall extend all reasonable cooperation with Clinikk or Our associates (including any third-parties involved in the investigation) in this regard. If you refuse to disclose information in Your possession or to cooperate with an investigation we will reserve the right to terminate your Membership without refund.

In order to ascertain your eligibility Clinikk reserves the right to ask you to undergo medical evaluation before your membership is purchased. The expense of these evaluations will have to be borne by You.

After purchasing a Clinikk membership, but prior to its activation, a medical evaluation may be necessary. The expenses of these evaluations if necessary, will have to be borne by you.

We reserve the right to cancel your Clinikk membership without refund under the circumstances mentioned below. The following are conditions for cancellation without refund:

If you do not pay your membership fee installment on time, your Clinikk membership will be cancelled after a 7-day grace period past your due date. If you do not pay within this grace period, your membership will lapse and your benefits will cease. If you previously cancelled a membership with non-annual payment mode, you may be required to pay in annual mode for a new membership purchase.

Your group insurance cover(s) with the Insurance Provider may continue to be active for the remainder of its term provided the terms and conditions of the insurance cover(s) have not been breached.

The Company reserves the right to amend these Terms at any time. Members will be notified of any changes, and continued use of the membership after such notification constitutes acceptance of the revised Terms.

The Company shall ensure that you are informed and kept up-to-date in the event of any changes to your membership, our operations, or any other changes that may be relevant to your membership. You can access the latest information about our services on the application and our website.

We agree to keep all Your information confidential, subject to the terms of this Agreement. We shall not, without obtaining Your written consent, disclose such information, including any medical information, to any third parties except Healthcare Partners and Our Insurance Provider and for any purposes other than for Clinikk’s internal research and scientific assessment and those contemplated under this Agreement. This obligation shall not extend to any information that is already in the public domain or which We are under an obligation to disclose pursuant to the applicable law or orders of any court or governmental or regulatory body.

The Insurance Provider may use Your information, including Your medical information, for their clinical and claim review purposes, subject always to applicable law in force.

Dispute Resolution: This Agreement is subject to Indian law. The courts in Bengaluru shall have the exclusive jurisdiction over any disputes or differences arising under or in relation to this Agreement.

Assignment: You shall not assign any of its rights and obligations under this Agreement, except with Our prior written consent.

Notices: Any notice, request, demand, approval, consent, or other communication under this Agreement shall be delivered in writing.

Force Majeure: Notwithstanding anything to the contrary in this Agreement, We or Our Healthcare Partners shall not be liable by reason of any failure or delay in the performance of any duties and obligations under this Agreement if such failure or delay is caused by natural disasters, strikes, lock-outs, embargoes, war, riots, civil commotion, virus outbreaks any orders of governmental, quasi-governmental or local authorities, or any other similar cause beyond Our control and without any fault or negligence of Our own.

We shall inform You and keep You updated in the event of any changes to Your Clinikk membership, Our operations, or any other changes relevant to Your membership of the Clinikk membership. All up to date information about Our services can be accessed on the Clinikk App and Our website at Clinikk.com.

I hereby understand and agree that by consenting to purchase this Clinikk Plan, I have read and understood the contents of this Terms and Condition, and freely provide the declarations below: