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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(vi) |
AGE LIMIT:- This insurance is available to persons between the age of 5 to 70 years. Children between the age of 3 months and 5 years of age can be covered provided one or both parents are covered concurrently. |
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(vii) |
NOTICE OF CLAIM |
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Preliminary notice of claim with particulars relating to policy numbers, Name of Insured Person in respect of whom claim is made, Nature of illness/ Injury and Name and Address of the attending Medical Practitioner/ Hospital/ Nursing Home should be given by the insured person to the TPA immediately and in case of emergency hospitalisation within 24 hours from the date of Hospitalisation. In case of notice received beyond 24 hours from the time of hospitalisation etc., the matter may be referred to the insurer for considering waiver of the condition, wherever felt appropriate. |
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Final Claim along with receipted Bills/ Cash Memos, claim form and list of documents as listed in the claim form etc., should be submitted to the TPA within 7 days from the date of completion of treatment. |
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Note: Waiver of the Condition may be considered in extreme cases of hardship where it is proved to the satisfaction of the Company that under the circumstances in which the insurer was placed it was not possible for him or any other person to give such notice or file claim within the prescribed time limit |
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viii |
PAYMENT OF CLAIM: All claims under this policy shall be payable in Indian currency. All medical treatments for the purpose of this insurance will have to be taken in India only. Payment of claim shall be made by the TPA on behalf of the Company either to the Hospital/ Nursing Home or the Insured Person as the case may be. |
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ix |
DETAILS OF INSURED PERSON : The insured shall be required to furnish a complete list of insured persons in the following format. Any additions and deletions during the currency of the policy should be intimated to the Company in the same format. However, such additions and deletions will be incorporated in the policy from the first day of the following months subject to pro-rata premium adjustment. |
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Sr. No. |
Names of Insured persons |
Relation with Insured |
Age |
Sex |
1 |
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2 |
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3 |
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4 |
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NOTE: No refund of premium will be allowed for deletion of Insured person in the event of Insured Person having made/ recovered a claim under the policy. |
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x |
SUM INSURED |
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Section I: Hospitalisation Benefit : Rs.30,000/- per family – per policy period (Rs.30,000/- is inclusive of Maternity benefit of Rs. 2500/- for normal and Rs.5000/- for caesarean delivery)
(Total expenses incurred for any one illness is limited to Rs.15,000/-(other than Maternity Benefit) |
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Section II : (A) Accidental death of earning head of the family Rs.25,000/- |
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Section II: (B) Disability compensation payable due to hospitalisation of earning head and or spouse at the rate of Rs.50/- per day upto maximum of period of 15days in a policy tear with a time excess of 3 days. Maximum compensation is restricted to Rs.750/- in one policy year. |
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