Group Health Insurance Policy of Universal Sompo is offered to Groups comprising of employees both in trading and manufacturing sectors/ social sector and/or members of an institution/society/association/club. The Policy is designed to pay the Insured person(s) the hospitalization expenses as well as domiciliary hospitalization benefits if he/she suffers an illness or accidental injury during the policy period.
- Treatments only in the Hospitals / Nursing homes in India are covered
- The coverage includes expenses incurred towards room, boarding expenses, nursing expenses, surgeon / specialist fees, charges for blood, oxygen etc
- Domicillary hospitalization benefit means Medical treatment for a period exceeding 3 days for such illness which in the normal course require treatment in a hospital but actually taken whilst confined at home in India since (1) the condition of the patient is such that he cannot be removed to a hospital or (2) the patient cannot be removed to the hospital for lack of accommodation
- The indemnity provided by the Policy is restricted to sum insured and the sub limits prescribed
- Premium is calculated depending on the age of the insured, family size and the sum insured selected
- Maximum coverage is Rs.5 lacs
The following additional covers can also be opted on payment of additional premium which shall depend upon the group size & its profile.
- Critical Illness Cover (Paralytic stroke/ Cancer/Chronic renal failure/Coronory Artery Bypass/Transplant of organs -
- Bone Marrow NB,
- Liver Transplant is not covered under this extension.
- Maternity Benefit Cover
- Hospital Cash Cover - is in built cover
- Pre existing
- Family Floater
- By choosing the add on, the coverage for such named critical illness beckons double the basic sum insured
Policy is subject to fullowing Exclusions
- Pre-existing diseases ? Unless covered by payment of additional Premium
- Any expense on hospitalization or domiciliary hospitalization incurred on account of any illness contacted during first 30 days from the date of commencement of an insurance cover is not covered. However this exclusion shall not be applicable if Hospitalization is required on account of an accident
- During the first year of the cover, the expense on treatment of diseases such as Cataract, Benign Prostatic Hypertrophy, Hysterectomy, Piles, Sinusitis and related disorders not payable
- Injury or disease directly or indirectly attributable to War, invasion, Act of Foreign enemy not payable
- Circumcision unless necessary for treatment of a disease is excluded
- Cost of spectacles, contact lenses, hearing aids are excluded
- Dental treatment or surgery of any kind unless hospitalisation is required is excluded
- Venereal diseases, intentional self injury and use of intoxicating drugs/alcohul is excluded
- Any treatment directly or indirectly for treatment associated with AIDS
- Cosmetic or aesthetic treatment is excluded
- Vuluntary termination of Pregnancy
- Pregnancy and child-birth
- Naturopathy Treatment
Note:The above are only the salient features of the Policy , for complete terms and conditions please refer to Policy Wordings.