Terms of Use

# Terms of Use

**Effective Date:** January 1, 2025

Welcome to Zion Insurance. These Terms of Use ("Terms") govern your access to and use of our insurance assistance services, website, mobile applications, and related platforms (collectively, the "Services"). By accessing or using our Services, you agree to be bound by these Terms.

## 1. Service Description

Zion Insurance provides insurance assistance services including:

- Pre-authorization support and submission - Cashless treatment coordination with network hospitals - Reimbursement claim management and processing - Document verification and validation - Insurance company and policy identification - Claim settlement tracking and follow-up - Customer support and case management

We act as an intermediary service provider and facilitator. We do NOT provide insurance coverage, underwrite policies, or guarantee claim approvals — those decisions rest solely with your insurance company.

## 2. Eligibility and Account Registration

To use our Services, you must:

- Be at least 18 years of age or have parental/guardian consent - Provide accurate, current, and complete registration information - Maintain the security of your account credentials - Notify us immediately of any unauthorized access - Hold a valid insurance policy with a recognized insurance company

You are responsible for all activities that occur under your account.

## 3. User Responsibilities

You agree to:

- Provide accurate and truthful information regarding your insurance policy, medical condition, and treatment details - Upload clear, legible, and complete documents as requested - Respond promptly to requests for additional information or documentation - Inform us of any changes to your policy, contact information, or treatment plan - Comply with your insurance policy terms and conditions - Pay all applicable service fees as agreed - Use the Services only for lawful purposes

You must NOT:

- Submit fraudulent claims or falsified documents - Misrepresent your medical condition or treatment requirements - Share your account credentials with unauthorized persons - Attempt to circumvent security measures or access restricted areas - Use the Services to harass, abuse, or harm others - Upload malicious software, viruses, or harmful code - Violate any applicable laws or regulations

## 4. Service Limitations and Disclaimers

**No Guarantee of Approval:** While we work diligently to prepare strong cases, we cannot guarantee that insurance companies will approve pre-authorization requests or claims. Approval decisions are made solely by insurance companies based on policy terms, medical necessity, and their internal guidelines.

**Not Insurance Providers:** We are a service provider that assists with insurance processes. We do not issue insurance policies, assume financial liability for medical expenses, or provide medical advice.

**Document Accuracy:** While our AI-powered systems help verify documents, ultimate responsibility for accuracy lies with you. Ensure all uploaded information is correct and complete.

**Hospital Network:** Cashless treatment availability depends on your insurance company's network hospitals. We assist in coordination but cannot guarantee cashless approval at any specific facility.

**Processing Times:** Timelines for pre-authorization, claim processing, and settlement depend on insurance company procedures and case complexity. We provide estimates but cannot control insurer response times.

**Medical Decisions:** We do not provide medical advice, diagnoses, or treatment recommendations. All medical decisions should be made in consultation with qualified healthcare professionals.

## 5. Service Fees and Payments

Service fees vary based on:

- Type of assistance required (pre-authorization, claim submission, full case management) - Complexity of the case - Claim amount and processing requirements - Additional services requested

Fees will be communicated clearly before you commit to using our services. Payment terms, refund policies, and cancellation conditions will be specified in your service agreement.

You are responsible for all hospital bills and medical expenses. Insurance claim reimbursements are paid by insurance companies directly to you or the hospital, not through Zion Insurance.

## 6. Intellectual Property

All content on our platform including text, graphics, logos, software, and design elements are owned by or licensed to Zion Insurance and protected by intellectual property laws. You may not copy, modify, distribute, or create derivative works without explicit permission.

You retain ownership of documents and information you upload, but grant us a license to use, process, and share this information as necessary to provide our Services.

## 7. Third-Party Services

Our Services may integrate with or link to third-party services (insurance companies, hospitals, payment processors, communication platforms). We are not responsible for the content, policies, or practices of these third parties. Your interactions with them are governed by their respective terms and policies.

## 8. Limitation of Liability

To the fullest extent permitted by law:

- Zion Insurance is not liable for insurance claim denials, delayed approvals, or reduced settlement amounts - We are not responsible for hospital billing errors, treatment complications, or medical outcomes - Our liability is limited to the service fees you paid for the specific case - We are not liable for indirect, incidental, consequential, or punitive damages - We do not guarantee uninterrupted or error-free service availability

Nothing in these Terms excludes liability for fraud, gross negligence, or matters that cannot be excluded under applicable law.

## 9. Indemnification

You agree to indemnify and hold harmless Zion Insurance, its employees, agents, and partners from any claims, damages, losses, or expenses (including legal fees) arising from:

- Your violation of these Terms - Your misuse of the Services - Fraudulent or false information you provide - Your violation of any laws or third-party rights

## 10. Termination

We reserve the right to suspend or terminate your access to the Services at any time for:

- Violation of these Terms - Fraudulent activity or misrepresentation - Non-payment of service fees - Abusive behavior toward our staff or partners - Any other reason at our sole discretion

You may terminate your account at any time, subject to completion of ongoing cases and payment of applicable fees.

Upon termination, we will retain your information as required by law and for the completion of any pending cases.

## 11. Dispute Resolution

Any disputes arising from these Terms or use of our Services shall be resolved through:

1. Good faith negotiation between the parties 2. Mediation if negotiation fails 3. Binding arbitration under Indian Arbitration and Conciliation Act 4. Exclusive jurisdiction of courts in [City], India

You agree to resolve disputes individually and waive any right to participate in class action lawsuits.

## 12. Governing Law

These Terms are governed by the laws of India, without regard to conflict of law principles. Any legal proceedings shall be conducted in English.

## 13. Changes to Terms

We may modify these Terms at any time. Significant changes will be communicated through email, app notifications, or website announcements. Continued use after changes constitutes acceptance. If you disagree with modifications, discontinue use of the Services.

## 14. Severability

If any provision of these Terms is found invalid or unenforceable, the remaining provisions shall continue in full force and effect.

## 15. Contact Information

For questions about these Terms:

Zion Insurance — Legal Team Email: legal@zioninsurance.com

For service-related inquiries, use our customer support channels outlined in the Help & Support section.

**By using Zion Insurance Services, you acknowledge that you have read, understood