8- Universal Health Insurance Policy from United India - Health Insurance Below Poverity Line (BPL) Families |
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Source: Website of Universal Sompo General Insurance Company Limited |
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(b) DISABILITY COMPENSATION FOR EARNING HEAD AND/ OR SPOUSE OF THE FAMILY |
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If the Earning head of the family/ spouse is hospitalized due to accident/ disease/ illness for which there is a valid claim admitted under Section I of the policy then after a waiting period of 3 days, the Company shall pay to the earning head of the family or spouse a compensation of Rs.50/- per day from the fourth day of hospitalization upto a maximum of 15 days per policy period. |
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Note: The maximum liability of the Company is limited to Rs.750/- in all during the policy period in respect of II (B) above. |
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(iii) DEFINITIONS |
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2. |
HOSPITAL/ NURSING HOME means any institution in India established for indoor care and treatment of sickness and injuries and which has been registered as a Hospital or Nursing Home with the local authorities and is under the supervision of a registered and qualified Medical Practitioner. |
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(a) Hospital/ Nursing Home run by NGOs/ Government |
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(b) Should comply with minimum criteria as under:- |
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(i) It should have at least 15 inpatient beds.
(ii) Fully equipped operation theatre of its own wherever surgical operations are carried out.
(iii) Fully qualified Nursing Staff under its employment round the clock.
(iv) Fully qualified Doctor (s) should be in-charge round the clock.
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N.B: In class 'C' towns condition of number of beds be reduced to 10. |
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The term 'Hospital/ Nursing Home' shall not include an establishment which is a place of rest, a place for the aged, a place for drug-addicts or place of alcoholics a hotel or a similar place. |
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2. |
'Surgical Operation' means manual and / or operative procedures for correction of deformities and defects, repair of injuries, diagnosis and cure of diseases, relief of suffering and prolongation of life. |
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3. |
Expenses on Hospitalisation for minimum period of 24 hours are admissible. However, this time limit is not applied to specific treatments, i.e, Dialysis, Chemotherapy, Radiotherapy; Eye Surgery, Dental Surgery, Lithotripsy (Kidney Stone removal), D&C, |
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Tonsillectomy taken in the Hospital/ Nursing Home and the Insured is discharged on the same day, such treatment will be considered to be taken under hospitalisation Benefit. This condition will also not apply in case of stay in Hospital of less than 24 hours provided: |
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The treatment is such that it necessitates hospitalisation and the procedure involves specialised infrastructural facilities available in hospitals. |
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Due to technological advances hospitalisation is required for less than 24 hours only. |
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Note: When treatment such as dialysis, Chemotherapy, Radiotherapy., etc is taken in the hospital/ nursing home and the insured is discharged on the same day the treatment will be considered to be taken under hospitalisation benefit section. |
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Liability of the company under this clause is restricted as stated in the Schedule attached hereto. |
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