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Universal Sompo‟s Loan Secure Insurance Policy is a unique Policy that helps you transfer the burden of your loan in the event of an unforeseen contingency. This Policy is specially designed for customers of banks and financial Institutions. This Insurance Policy serves as safety net so that you and your near and dear ones are not worried about repayment of your loan in the event of your unfortunate diagnose of listed Major Medical Illnesses or undergoing of Surgical Procedures or witness Accidental Death, or Permanent Total Disablement on account of Accident resulting in inability to remain gainfully employed. This Policy also provides for Loss of Job and Cover of Dwelling and Content against Fire and Allied Perils.

1. WHO CAN TAKE THE POLICY?

The Policy can be taken by any person above 20 years of age holding loans with bank (including co-borrowers) till 50 years of age. The coverage can also be offered to SMEs- proprietorship and partnership concerns borrowing from banks. The Policy can also be issued to Banks on whole loan portfolio basis.

The Policy can be renewed till 55 years of age.

Pre Insurance Health Check up

Customer may have to undergo Medical test in following three cases:

1) Sum Insured more than Rs 1 Crore Or

2) If customer has declared a Preexisting diseases condition under the Proposal Form.

3) If customer is above 55 years of age as on last birthday.

The Proposer will have to undergo the following tests at his own cost. If the proposal is accepted, 50% cost of Health checkup will be refunded to Insured.

i)Complete Blood Count (CBC)

ii)Erythrocyte Sedimentation Rate (ESR)

iii) Fasting Blood Sugar (FBS)

iv) Serum Creatinine

v)SGPT

vi) Routine Urine Analysis

vii)Electrocardiogram (ECG)

viii)Medical Examination with Medical history and Blood Pressure Recordings-Conducted by a Registered Physician (MBBS/ MD)

2.WHAT IS COVERED UNDER THE POLICY?

Policy is offered with following coverages with various options varying in terms of extend of coverage available as under:-

Section 1 - Major Medical IllnessesSurgical Procedures: (Compulsory Section)

We will pay the Sum Insured if during the Policy Period the Insured Borrower unfortunately contracts with any of the following covered Major Medical Illnesses or undergoes Surgical Procedures for the first time during the Period of Insurance.

This Policy covers up to of 18 Major Medical IllnessesSurgical Procedures as per the Plan chosen.

We bring a wide range of options as below depending on the number of Major Medical Illness Procedures to be covered. The options range from 9, 12, 15 and 18 Major Medical Illness Procedures.

Silver Plan

a) First Diagnosis of the below-mentioned Illnesses more specifically described below:

1. Cancer of Specified Severity

2. Kidney Failure requiring regular dialysis

3. Multiple Sclerosis with Persisting Symptoms

b) Undergoing for the first time of the following Surgical Procedures, more specifically described below:

4. Cancer of Specified Severity

5. Kidney Failure requiring regular dialysis

6. Multiple Sclerosis with Persisting Symptoms

c) Occurrence for the first time of the following medical events more specifically described below:

7. Permanent Paralysis of Limbs

8. First Heart Attack of Specified Severity

9. Stroke resulting in Permanent Symptoms.

Gold Plan

a) First Diagnosis of the below-mentioned Illnesses more specifically described below:

1. Cancer of Specified Severity

2. Kidney Failure requiring regular dialysis

3. Multiple Sclerosis with Persisting Symptoms

4. Benign Brain Tumor

5. Parkinson‟s Disease

b) Undergoing for the first time of the following Surgical Procedures, more specifically described below:

6. Major Organ / Bone Marrow Transplant 7. Open Heart Replacement 8. First Heart Attack of Specified Severity

c) Occurrence for the first time of the following medical events more specifically described below:

9.Stroke resulting in Permanent Symptoms

10. Permanent Paralysis of Limbs

11. Stroke resulting in Permanent Symptoms.

12. Coma of Specified Severity

Platinum Plan

a) First Diagnosis of the below-mentioned Illnesses more specifically described below:

1. Cancer of Specified Severity 2. Kidney Failure requiring regular dialysis 3. Multiple Sclerosis with Persisting Symptoms 4. Benign Brain Tumor 5. Parkinson‟s Disease 6. End Stage Liver Disease 7. Alzheimer‟s Disease

b) Undergoing for the first time of the following Surgical Procedures, more specifically described below:

8. Major Organ / Bone Marrow Transplant

9. Open Heart Replacement

10. Coronary Artery Bypass Graft

11. Surgery of Aorta

c) Occurrence for the first time of the following medical events more specifically described below:

12. Stroke resulting in Permanent Symptoms

13. Permanent Paralysis of Limbs

14. Stroke resulting in Permanent Symptoms.

15. Coma of Specified Severity

Diamond Plan

a) First Diagnosis of the below-mentioned Illnesses more specifically described below:

1. Cancer of Specified Severity

2. Kidney Failure requiring regular dialysis

3. Multiple Sclerosis with Persisting Symptoms

4. Benign Brain Tumor

5. Parkinson‟s Disease

6. End Stage Liver Disease

7. Alzheimer‟s Disease

b) Undergoing for the first time of the following Surgical Procedures, more specifically described below:

8. Major Organ / Bone Marrow Transplant

9. Open Heart Replacement

10. Coronary Artery Bypass Graft

11. Surgery of Aorta

c) Occurrence for the first time of the following medical events more specifically described below:

12. Stroke resulting in Permanent Symptoms

13. Permanent Paralysis of Limbs

14. Stroke resulting in Permanent Symptoms.

15. Coma of Specified Severity

16. Major Burns

17. Deafness

18. Loss of Speech

Please refer to the Policy Wordings for definitions of the Major Medical Illnesses and Surgical Procedures available with your banker/our Agent/our office

Section II - Personal Accident

This section covers the Insured Borrower against accidental risks as under:-

A. Death due to an Accident:

If You, the Insured Borrower, die within a period of 12 months from the date of bodily injury due to Accident and such bodily injury be the direct cause of Your death, then the Sum Insured, under the Policy shall become payable by Us.

B. Permanent Total Disablement due to an Accident:

We will pay Sum Insured upon your having met with an accidental bodily injury resulting in Permanent Total Disablement subject to the following that the disablement;

i. continues for a period of twelve (12) consecutive months, and

ii. is confirmed as total, continuous and permanent by a Medical Practitioner after the period of twelve (12) consecutive months, and

iii. entirely prevents you, the Insured Borrower from engaging in or giving attention to gainful occupation of any and every kind for the remainder of your life.

Section III – Loss of Job

We will pay 3 EMIs* corresponding to the loan insured in the event of

i. Termination/ Dismissal of employment of the Insured borrower.

ii. Temporary suspension or retrenchment from employment

Covers Loss or Damage directly caused to dwelling and household contents of Insured borrower at Insured premises by Insured Perils listed hereunder

i) Fire

ii) Lightning

iii) Explosion/Implosion

iv) Aircraft Damage

i) Impact Damage

ii) Subsidence and Landslide including Rock slide

iii) Bursting and/or overflowing of Water Tanks, Apparatus and Pipes

iv) Missile Testing operations

v) Leakage from Automatic Sprinkler Installations

vi) Bush Fire

vii) Riots, Strike, Malicious Damage

viii) Storm, Tempest, Flood, Inundation

ix) Earthquake (on payment of additional premium only

x) Terrorism (on payment of additional premium only

Special Conditions applicable to Section IV

1. Cover for Jewellery in case of Content Insurance will be restricted to 20% of Sum Insured subject to maximum of Rs. 2,00,000/-

2. Where the Sum Insured is declared for coverage of Building , the contents Sum Insured shall not be more than 40% of the Building Sum Insured (in any case not more than Rs. 10 lacs)

It is not compulsory to buy the Building coverage for buying cover for contents, in any case contents sum insured cannot be more than Rs. 10,00,000

3. ADDITIONAL BENEFITS UNDER THE POLICY

Sum Insured Options:You have the option of choosing Sum Insured on either of the basis as mentioned below (applicable to Section I and II only).

  • Fixed Sum Insured where Sum Insured is equal to Loan sanctioned at inception and it remains fixed throughout the Policy tenure. In the event of Claim under Section I and II, Outstanding loan amount at the time of Claim will be paid to the bank and balance amount will be paid to the Insured borrower or the nominee as the case may be.
  • Reducing Balance where Sum Insured goes on decreasing as the Loan outstanding decreases year on year. In the event of Claim under Section I and II, only the loan outstanding at the time of claim will be payable to the Bank.
Coverage Sum Insured
Section I: Major Medical illness and Surgical Procedure Fixed Sum Insured- Loan Sanctioned Amount. Reducing Balance- Loan Outstanding Amount.
Section II: Personal Accident Fixed Sum Insured- Loan Sanctioned Amount. Reducing Balance- Loan Outstanding Amount.
Section III: Loss of Job 3 EMIs as per the chosen Sum Insured
Section IV: Fire and Allied Perils- Dwellings and Contents Dwellings- As mentioned in the Proposal Form. Contents- As mentioned in the Proposal Form.

b) Policy Tenure

Maximum Policy Period is three years however Insured can renew the Policy (till the time the Loan continues) by payment of additional Premium for blocks of 3 years.

c) Multiple Applicants under one loan can be covered for their proportionate share under separate Policies. d) No medical examination required for buying this cover subject to exceptions explained above e) Policy is based on a one-time premium payment for the full Policy term. f) Except for Claim proceeds of Section IV, Policy is assignable to the lending institution. g) Free Look Period:

We shall give You a Free Look Period at the inception of the Policy and:

1. You will be allowed a period of at least 15 days from the date of receipt of the Policy to review the terms and conditions of the Policy and to return the same if not acceptable.

2. If You have not made any claim during the Free Look period, You shall be entitled to:

  • A refund of the premium paid less any expenses incurred by Us on Your medical examination and the stamp duty charges or;
  • where the risk has already commenced and the option of return of the Policy is exercised by You, a deduction towards the proportionate risk premium for period on cover or;
  • Where only a part of the risk has commenced, such proportionate risk premium commensurate with the risk covered during such period.

h) Discount(s) under the Policy

Group Discount: The Policy would provide discounts to the group policy as under when the numbers of loan holders are as below

No. of loan holders % of Discount
0 – 1000 10%
1001 – 2500 15%t
2501 – 5000 20%
5001 – 7500 25%
7501 – 10000 30%
Above 10000 To be decided by CO subject to maximum of 40%.

i) Flexibility of choosing covers

The Product has been so designed to give flexibility to insured Institution or insured borrower to buy the Policy for its group of borrowers or self, as a combination of Plan (Silver, Gold, Platinum and Diamond) under Section I along with other covers.

For a Group of borrowers of a financial Institution the package of Covers shall be fixed at inception of the Policy.

4. CONDITIONS UNDER THE POLICY

Terms of Cancellation under the Policy

By Us

We may cancel this Policy on the grounds of mis-representation, fraud, non-disclosure of material facts or non-cooperation by you by giving fifteen (15) days notice in writing by in which case we shall be liable to repay on demand a rateable proportion of the premium for the unexpired term from the date of cancellation.

By You

You may also cancel this Policy by giving fifteen (15) days notice in writing to us for the cancellation of this Policy, in which case we shall from the date of receipt of the notice cancel the Policy and retain the premium for the period his Policy has been in force at our short period scale as mentioned below provided that no refund of premium shall be made if any claim has been made under the Policy by or on your behalf.

Period of Insurance Premium Retained
Up to 1 month 25% of annual premium
Above 1 month and up to 3 months 50% of annual premium
Above 3 months and up to 6 months 75% of annual premium
Above 6 months 100% of annual premium

Expiry of the policy

The policy expires on occurrence of earlier of any one of the following

  • Payment of Claim under Section I and Section II of the Policy
  • Individual reaching max renewal age under the Policy
  • Prepayment/ foreclosure of the loan
  • Policy End Date
Continuity under the Policy

In the event that you have reached maximum renewal age under the policy or the policy has been discontinued, or you have repaid the loan, option shall be available to you to migrate to a suitable health insurance policy on individual basis offered by the Company. In all such cases waiting periods and other time bound exclusions as stipulated under the individual health insurance policy shall be applicable with due adjustments for the time covered under the Loan Secure Insurance Policy without interruption.

Refund under the Policy

In the event of full prepayment of the Loan by the Insured, the Company shall refund a portion of the premium subject to the terms and conditions of the Policy as per the rates mentioned below:

Policy Period 2 3 3 3 3 3 3 3 3 3 3 3 3
Loan Period 2 3 4 5 6 7 8 9 10 11 12 14 15
Year 1 25% 45% 50% 51% 51% 51% 51% 51% 52% 52% 52% 52% 52%
Year 2 . 11% 13% 14% 14% 14% 14% 14% 15% 15% 15% 15% 15%
Policy Period 3 3 3 3 3 3 3 3 3 3 3 3 3
Loan Period 16 17 18 19 20 21 22 23 24 25 26 27 28
Year 1s 53% 53% 53% 53% 53% 53% 53% 53% 53% 53% 54% 54% 54%
Year 2 16% 16% 16% 16% 16% 16% 16% 16% 16% 16% 17% 17% 17%
Policy Period 3 3 - - - - - - - - - - -
Loan Period 29 30 - - - - - - - - - - -
Year 1 54% 54% - - - - - - - - - - -
Year 2 17% 17% - - - - - - - - - - -
b) For Fixed Sum Insured basis
% Refund Premium
. Policy Period (Years)
Year Of Cancellation 2 3
Year 1 25% 45%
Year 2 . 11%

In event of part prepayment of the Loan, no refunds of premium shall be made under this Policy. No refunds of premium will be made under the Policy during the last year of the Policy Period.

Upon making any refund of premium under this Policy, the cover in respect of that Insured shall forthwith terminate and we shall not be liable thereafter.

No refunds of premium shall be made in respect of the Insured where any claim has been admitted by or lodged with us.

Premium under the Policy

The premium rates for the three sections viz. Loss of Job, Major Medical Illnesses and Personal Accident under the Policy for both Sum Insured options Reducing and Fixed are given in the Annexure to this Prospectus.

The premium for Section IV- Fire and Allied Perils is given below. Rates applicable to all Plans - both Fixed Sum Insured and reducing balance Sum Insured basis. (Premium in % excluding ST applicable to all plans)

No of Years 1 2 3
Structure 0.05 0.1 0.15
Content @ 40% 0.05 0.1 0.15
Earthquake 0.01 0.02 0.03
Terrorism 0.01 0.02 0.03
Long term discount* 0 0 15%
Other provisions as applicable in erstwhile Fire Tariff.

Illustration of Premium working

Illustration of Premium under Fixed Sum Insured Basis
Name Mr. Agarwal
Age 32 Years
Loan Sanction Amt 200,000
Loan Tenure 15 Years
Plan Diamond
Policy Tenure 1 Year
Cover Applicable Rate Premium
Critical illness 0.27% 540
Personal Accident 0.062% 124
Loss Of Job 0.008% 16
Fire Structure 0.05% 60
Fire Content @ 40% of structure value 0.05% 40
Total Premium . 780
*Cover under this Section shall be applicable to Salaried Persons only.**Long Term discount is not applicable on Terrorism Premium

Three Months notice:

We shall give You notice in the event We may decide to revise, modify or withdraw the product. Such notice shall be given to You at least three months prior the date when such modification or revision or withdrawal comes into effect. We also promise You that

  • In case of modification or revision, the notice given to You shall detail the reasons for such revision or modification, in particular the reason for an increase in premium (if any) and the quantum of such increase.
  • The product shall be withdrawn only after due approval from the Insurance Regulatory and Development Authority. However, if You do not respond to Our intimation in case of such withdrawal, the Policy shall be withdrawn on the Renewal date and We shall provide You with an option to migrate to a substitute product offered by Us, subject to portability conditions.

Sum Insured enhancement:

The Sum Insured under the Policy cannot be enhanced during its term.

Renewal

a)Your Policy shall ordinarily be renewable till 55 years of age except on grounds of fraud, moral hazard or misrepresentation or non‐cooperation by You/ any of the Insured Persons.

b)The Renewal of a Policy sought by You shall not be denied arbitrarily. If denied, We shall provide You with cogent reasons for such denial of Renewal.

c)We shall provide for a mechanism to condone a delay in Renewal up to 30 days from the due date of Renewal without deeming such condonation as a Break in Policy . However coverage shall not be available for such period.

d)If You move into a higher age band, the premium will increase at the next Renewal. However, this Policy will not be subject to any alteration in premium rates generally introduced until the next Renewal.

e)If the Policy is not renewed within the Grace Period then We may agree to issue a fresh Policy subject to Our underwriting criteria and no continuing benefits shall be available from the expired Policy.

f)All premiums are payable in advance of any cover under this Policy being provided.

g)The basic premium applicable under the Policy may be revised at a later stage subject to approval from IRDA.

h)We shall provide You with a substitute similar health insurance product if You have reached maximum renewable age under the Policy and suitable credits (continuity benefits) for all the previous policy years that You have been covered shall be provided to You if the Policy has been maintained without break.

5. WHAT WE EXCLUDE IN THE POLICY?

Exclusions specific to Section I

We shall not be liable for any claim under the policy arising out of

a)Any Pre-Existing Illness– Any Insured Event arising on account of or in connection with any Pre-Existing Illness

b)Non-submission of medical proof evidencing diagnosis of Illness or Injury or occurrence of the medical event or the undergoing of the medical / surgical procedure in relation to the claim of the particular insured person.

c)Any Illness arising within the first 90 days of the commencement of the Policy

d)Any medical procedure or treatment, which is not medically necessary or not performed by a Medical Practitioner.

e)Any physical, medical or mental condition or treatment or service that is specifically excluded in the Policy

f)Treatment relating to birth defects and external congenital Illnesses.

g)Birth control procedures and hormone replacement therapy.

h)Any treatment/ surgery for change of sex or any cosmetic surgery or treatment/ surgery/ complications/ illness arising as a consequence thereof.

i)Treatment by a family member and self-medication or any treatment that is not scientifically recognized.

Exclusions specific to Section II

We shall not be liable under this Section for:

a)Payment under more than one of the categories specified (Death or Permanent Total Disablement) in the Benefit Payable in respect of the Insured Person.

b)Payment of compensation in respect of Insured Event which occurs whilst the Insured person is operating or learning to operate any aircraft, or performing duties as a member of the crew on any aircraft, or Scheduled Airlines or is engaging in aviation or ballooning, or whilst the Insured person is mounting into, or dismounting from or traveling in any balloon or aircraft other than as a passenger (fare-paying or otherwise) in any Scheduled Airline anywhere in the world;

c)Payment of compensation in respect of death, injury or disablement of Insured person (a) from engaging in or participation in adventure sports including but not limited to winter sports, skydiving/parachuting, hang gliding, bungee jumping, scuba diving, mountain climbing (where ropes or guides are customarily used), riding or driving in races or rallies using a motorized vehicle or bicycle, caving or pot-holing, hunting or equestrian activities, skin diving or other underwater activity, rafting or canoeing involving white water rapids, yachting or boating outside coastal waters, participation in any Professional Sports, any bodily contact sport or any other hazardous or potentially dangerous sport for which the Insured is untrained, unless specifically covered under the Policy (b) directly or indirectly caused by venereal disease or insanity;

d)Payment of compensation in respect of death or Permanent Total Disablement arising from or resulting directly or indirectly from any Illness to any Insured Person.

e)No sum shall be payable under this Section in case of any Permanent Total Disablement for which medical care, treatment, or advice was recommended by or received from a Medical Practitioner or from which the Insured person suffered or which was present before the commencement of the Policy Period.

Exclusions specific to section III

a)We shall not be liable to make any payment under this Section in the event of termination, dismissal, temporary suspension or retrenchment from employment of the Insured person being attributed to any dishonesty or fraud or poor performance on the part of the Insured person or his willful violation of any rules of the employer or laws for the time being in force or any disciplinary action against the Insured person by the employer.

b)We shall not be liable to make any payment under this Policy in connection with or in respect of:

i)Self-employed persons;

ii)Any claim relating to unemployment from a job which is casual, temporary, seasonal or contractual in nature or any claim relating to an employee not on the direct rolls of the employer;

iii)Any voluntary unemployment;

iv)Unemployment at the time of inception of the Policy Period or arising within the first 90 days of inception of the Policy Period.

c)Any unemployment from a job under which no salary or any remuneration is provided to the Insured person.

d)Any suspension from employment on account of any pending enquiry being conducted by the employer/ Public Authority

e)Any unemployment due to resignation, retirement whether voluntary or otherwise

f)Any unemployment due to non-confirmation of employment after or during such period under which the Insured was under probation.

General Exclusions applicable to Section I, Section II and Section III of the policy

We shall not be liable for any claim

1.Arising or resulting from the Insured person committing any breach of the law with criminal intent

2.Due to, or arising out of, or directly or indirectly connected with or traceable to, war, invasion, act of foreign enemy, hostilities (whether war be declared or not) civil war, rebellion, revolution, insurrection, mutiny, military or usurped power, seizure, capture, arrests, restraints and detainment of all Heads of State and citizens of whatever nation and of all kinds and acts of terrorism, Riots, Strike, Malicious Acts etc.

3.Directly or indirectly caused by or contributed to/by or arising from ionising radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste or from the combustion of nuclear fuel. For the purpose of this exclusion, combustion shall include any self-sustaining process of nuclear fission

4.Directly or indirectly caused by or contributed to/by or arising from nuclear weapon materials

5.Directly or indirectly caused by or contributed to/by or arising out of usage, consumption or abuse of alcohol and/or drugs.

6.Arising out of or as a result of any act of self-destruction or self-inflicted injury, attempted suicide or suicide.

7.Any sexually transmitted diseases. Acquired Immune Deficiency Syndrome (AIDS), AIDS related complex syndrome (ARCS) and all diseases caused by and/ or related to the HIV.

8.Any consequential or indirect loss or expenses arising out of or related to any Insured Event.

9.Arising out of or resulting directly or indirectly due to or as a consequence of pregnancy or treatment traceable to pregnancy and childbirth, abortion, Miscarriage and its consequences, tests and treatment relating to infertility and invitro fertilization.

10.Arising out of or resulting directly or indirectly while serving in any branch of the Military or Armed Forces of any country during war or warlike operations.

11.Arising out of or resulting directly or indirectly caused by, resulting from or in connection with any act of terrorism/sabotage regardless of any other cause or event contributing concurrently or in any other sequence to the loss. The Policy also excludes loss, damage, cost or expenses of whatsoever nature directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to action taken in respect of any act of terrorism/sabotage.

Exclusions specific to Section IV

1.Damage caused by Pressure waves.

2.Destruction or damage caused to the property by its own fermentation, natural heating or spontaneous combustion or its undergoing heating or drying Process

3.Burning of property Insured by order of any Public Authority.

4.Explosion/implosion losses to boilers (other than domestic boilers), economizers or other vessels, machinery or apparatus (in which steam is generated) including their contents.

5.Destruction or damage to property caused by centrifugal forces.

6.Damages caused by

a)Permanent or temporary dispossession of any building resulting from the unlawful occupation by any Person of such building or Prevention of access to the same.

b)Burglary, housebreaking, theft, larceny or any other such attempt or any omission of any kind of any Person (whether or not such act is committed in connection with the disturbance of Public Peace) in any malicious act.

c)Total or Partial cessation of work or the retardation or interruption or cessation of any Process or operations or omissions of any kind

7.Damage by vehicle/animals belonging to or owned by You or Your Family.

8.Damages caused by:

a)Normal cracking, settlement or bedding of structures.

b)Settlement or movement of made up ground.

c)Coastal or river erosion.

d)Defective design or workmanship or Use of defective material

e)Demolition, construction, structural alteration or repair of any property or ground work or excavation.

9.Damage caused by

a)Repairs or alteration to Your Home.

b)Repairs, removal or extension of the sprinkler installation.

c)Defects in construction known to You.

10.Damages caused to the Insured property by Pollution or contamination.

11.Expenses necessarily incurred on Architect, Surveyor and Consulting Engineer‟s fees and Debris Removal following Damage to property Insured by an Insured Peril in excess of 3% and 1% of the claim amount respectively.

12.Loss of earnings, loss by delay, loss of market or other consequential or indirect loss or damage of any kind or description whatsoever.

13.Loss, destruction damage to any electrical machine, apparatus fixture or fittings arising from or occasioned by overrunning excessive pressure short circuiting , arcing, self-heating or leakage of electricity from whatever cause (lightning included Provided that this exclusion will apply only to the Particular electrical machine, apparatus, fixture or fittings which may be destroyed or damaged by fire so set up.

14.Livestock or Pets.

15.CashValuables as defined under the Policy, unless specifically covered.

16.Loss or damage to property Insured if removed to any building or Place other than in which it is herein stated, except machinery and equipments temporarily removed for repairs, cleaning, renovation or other similar purposes for a Period not exceeding 60 days.

17.Any Loss or damage occasioned by or through or in consequence directly or indirectly due to earthquake, volcanic eruption or other convulsions of nature unless specifically covered and mentioned on the Schedule.

ADDITIONAL CLAUSES

AC1: For Reducing Sum Insured covers

Notwithstanding anything contrary stated in the Policy, the Sum Insured under the Policy on the date of the Insured Event covered under Sections III for the purpose of calculation of claim shall be the least of the following:

i)The Principal Outstanding in the books of the Bank/Financial Institution as on the date of occurrence of the Insured Event; or

ii)The Principal Outstanding as per the amortization Schedule prepared by Bank/Financial Institution. In the event the Sum Insured as appearing against Section III of the Schedule of the Policy is less than the total of the actual Loan disbursed upto the date of the occurrence of the Insured Event, then the Amortization Schedule shall be calculated as if the actual Loan disbursed was equivalent to the Sum Insured; or

iii)The Sum Insured as appearing against Section III of the Schedule.

AC2: Premium Refunds:

Notwithstanding anything to the contrary contained in the Policy, the refund of premium under the Policy shall be as under

In the event of full prepayment of the Loan by the Insured, the Company shall refund a portion of the premium subject to the terms and conditions of the Policy as per the rates mentioned below:

c) For Reducing Sum Insured basis-

Policy Period 2 3 3 3 3 3 3 3 3 3 3 3 3
Loan Period 2 3 4 5 6 7 8 9 10 11 12 14 15
Year 1 25% 45% 50% 51% 51% 51% 51% 51% 52% 52% 52% 52% 52%
Year 2 . 11% 13% 14% 14% 14% 14% 14% 15% 15% 15% 15% 15%
Policy Period 3 3 3 3 3 3 3 3 3 3 3 3 3
Loan Period 16 17 18 19 20 21 22 23 24 25 26 27 28
Year 1s 53% 53% 53% 53% 53% 53% 53% 53% 53% 53% 54% 54% 54%
Year 2 16% 16% 16% 16% 16% 16% 16% 16% 16% 16% 17% 17% 17%
Policy Period 3 3 - - - - - - - - - - -
Loan Period 29 30 - - - - - - - - - - -
Year 1 54% 54% - - - - - - - - - - -
Year 2 17% 17% - - - - - - - - - - -

d) For Fixed Sum Insured basis

% Refund Premium
. Policy Period (Years)
Year Of Cancellation 2 3
Year 1 25% 45%
Year 2 . 11%

In event of part prepayment of the Loan, no refunds of premium shall be made under this Policy. No refunds of premium will be made under the Policy during the last year of the Policy Period.

Upon making any refund of premium under this Policy in accordance with the terms and conditions hereof in respect of the Insured, the cover in respect of that Insured shall forthwith terminate and the Company shall not be liable hereunder.

Notwithstanding anything contained herein or otherwise, no refunds of premium shall be made in respect of the Insured where any claim has been admitted by the Company or has been lodged with the Company.

AC3: Survival Period:

Notwithstanding anything to the contrary stated herein the Company shall not be liable to make any payment arising out of any claim under Section I for any Insured if the Insured does not survive a period of at least 90 days after the date of occurrence Insured Event. It is hereby declared and agreed that:

i)from the Policy Start Date, the monies payable by the Company to the Insured and all rights, title, benefits and interest of the Insured under this Policy stand assigned in favour of the "Bank / Financial Institution as named in the Schedule of this Policy";

ii)upon any monies becoming payable under this Policy the same shall be paid by the Company to the "Bank/Financial Institution as named in Schedule of this Policy" without any reference / notice to the Insured, but not exceeding the Principal Outstanding as defined under the Policy. In the event of any monies payable under this Policy exceeding the Principal Outstanding, the Company shall pay such amount as exceeding the Principal Outstanding to the Insured;

iii)the receipt of such monies in the manner aforesaid by the Bank/Financial Institution as named in the Schedule of this Policy and the Insured shall completely discharge the Company from all liability under the Policy and shall be binding on the Insured and the heirs, executors, administrators, successors or legal representatives of the Insured, as the case may be.

Endorsements – Available with Section IV on payment of additional Premium

AC 6: Earth quake (Fire and Shock) Coverage Clause

“In consideration of the payment by the Insured to the Company of the sum of __________additional premium, it is hereby agreed and declared that notwithstanding anything stated in the printed exclusions of this Policy to the contrary, this Insurance is extended to cover loss or damage (including loss or damage by fire) to any of the property Insured by this Policy occasioned by or through or in consequence of earthquake including flood or overflow of the sea, lakes, reservoirs and rivers and/or Landslide/Rockslide resulting there from.

Provided always that all the conditions of this Policy shall apply (except in so far as they may be hereby expressly varied) and that any reference therein to loss or damage by fire shall be deemed to apply also to loss or damage directly caused by any of the perils which this insurance extends to include by virtue of this endorsement.”

Special conditions: 1.Excess clause 5% of each and every claim subject to a minimum of Rs. 10,000/- 2. Extension cover shall be granted only if the entire property in one complex/compound/location covered under the Policy is extended to cover this risk and the Sum Insured for this extension is identical to the Sum Insured against the risk covered under main Policy except for the value of the plinth and foundations of the building(s). Onus of proof: In the event of the Insured making any claim for loss or damage under this Policy, he must (if so required by the Company) prove that the loss or damage was occasioned by or through or in consequence of earthquake. AC7: Terrorism Damage Cover Endorsement (Material Damage only) A. Insuring Clause

Subject otherwise to the terms, exclusions, provisions and conditions contained in the Policy and in consideration of the payment by the Insured to the Company of additional premium as stated in the Schedule, it is hereby agreed and declared that notwithstanding anything stated in the „Terrorism Risk Exclusion” of this Policy to the contrary, this Policy is extended to cover physical loss or physical damage occurring during the period of this Policy caused by an act of Terrorism, subject to the exclusions, limits and excess described hereinafter.

For the purpose of this cover, an act of Terrorism means an act or series of acts, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organisation(s) or government(s), or unlawful associations, recognized under Unlawful Activities (Prevention) Amendment Act, 2008 or any other related and applicable national or state legislation formulated to combat unlawful and terrorist activities in the nation for the time being in force, committed for political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public or any section of the public in fear for such purposes.

This cover also includes loss, damage, cost or expense directly caused by, resulting from or in connection with any action taken in suppressing, controlling, preventing or minimizing the consequences of an act of Terrorism by the duly empowered government or Military Authority.

Provided that if the Insured is eligible for indemnity under any government Compensation plan or other similar scheme in respect of the damage described above, this Policy shall be excess of any recovery due from such plan or scheme.

For the purpose of the aforesaid inclusion clause, "Military Authority" shall mean armed forces, para military forces, police or any other authority constituted by the government for maintaining law and order.

B. Losses Excluded

This cover shall not indemnify loss of or damage to property caused by any or all of the following:-

i)loss by seizure or legal or illegal occupation;

ii)loss or damage caused by:

  • voluntary abandonment or vacation,
  • confiscation, commandeering, nationalisation, requisition, detention, embargo, quarantine, or any result of any order of public or government authority, which deprives the Insured of the use or value of its property;

iii)loss or damage arising from acts of contraband or illegal transportation or illegal trade;

iv)loss or damage directly or indirectly arising from or in consequence of the seepage and or discharge of pollutants or contaminants, which pollutants and contaminants shall include but not be limited to any solid, liquid, gaseous or thermal irritant, contaminant or toxic or hazardous substance or any substance the presence, existence or release of which endangers or threatens to endanger the health, safety or welfare of persons or the environment;

v)loss or damage arising directly or indirectly from or in consequence of chemical or biological emission, release, discharge, dispersal or escape or chemical or biological exposure of any kind;

vi)loss or damage arising directly or indirectly from or in consequence of asbestos emission, release, discharge, dispersal or escape or asbestos exposure of any kind;

vii)any fine, levy, duty, interest or penalty or cost or Compensation/damages and/or other assessment which is incurred by the Insured or which is imposed by any court, government agency, public or civil authority or any other person;

viii)loss or damage by electronic means including but not limited to computer hacking or the introduction of any form of computer virus or corrupting or unauthorised instructions or code or the use of any electromagnetic weapon. This exclusion shall not operate to exclude losses (which would otherwise be covered under this Policy) arising from the use of any computer, computer system or computer software programme or any other electronic system in the launch and/or guidance system and/or firing mechanism of any weapon or missile;

ix)loss or damage caused by vandals or other persons acting maliciously or by way of protest or strikes, labour unrest, riots or civil commotion;

x)loss or increased cost occasioned by any public or government or local or civil authority‟s enforcement of any ordinance or law regulating the reconstruction, repair or demolition of any property insured hereunder;

xi)any consequential loss or damage, loss of use, delay or loss of markets, loss of income, depreciation, reduction in functionality, or increased cost of working;

xii)loss or damage caused by factors including but not limited to cessation, fluctuation or variation in, or insufficiency of, water, gas or electricity supplies and telecommunications or any type of service;

xiii)loss or increased cost as a result of threat or hoax;

xiv)loss or damage caused by or arising out of burglary, house - breaking, looting, theft, larceny or any such attempt or any omission of any kind of any person (whether or not such act is committed in the course of a disturbance of public peace) in any action taken in respect of an act of Terrorism;

xv)loss or damage caused by mysterious disappearance or unexplained loss;

xvi)loss or damage directly or indirectly caused by mould, mildew, fungus, spores or other micro-organism of any type, nature or description, including but not limited to any substance whose presence poses an actual or potential threat to human health;

xvii)total or partial cessation of work or the retardation or interruption or cessation of any process or operations or omissions of any kind.

C. Limit of Indemnity

The limit of indemnity under this cover shall not exceed the Total Sum Insured given in the Policy Schedule or INR 7500,000,000 whichever is lower. In respect of several insurance policies within the same compound/location with one or different insurers, the maximum aggregate loss payable per compound/location by any one or all insurers shall be INR 7500,000,000. If the actual aggregate loss suffered at one compound/location is more than INR 7500,000,000, the amounts payable under individual policies shall be reduced in proportion to the Sum Insured of the policies.

D. Excess

0.5% of the Sum Insured for each and every claim subject to –

i)A minimum of INR 100,000 and a maximum of INR 100,000,000 (for industrial risks)

ii)A minimum of INR 25,000 and a maximum of INR 1,000,000/- (for non-industrial risks) / a minimum of INR 10,000 and maximum of INR 500,000 (for shops and residences)

E. Cancellation Clause

Notwithstanding the cancellation provisions relating to the basic insurance Policy on which this endorsement is issued, there shall be no refund of premium allowed for cancellation of the Terrorism risk insurance during the Period of Insurance except where such cancellation is done along with the cancellation of the basic insurance. Where a Policy is cancelled and rewritten mid-term purely for the purpose of coinciding with the accounting year of the Insured, pro-rate refund of the cancelled Policy premium will be allowed.

If the cancellation is for any other purpose, refund of premium will only be allowed after charging short term scale rates.

Note: The definitions, terms and conditions of main Policy save as modified or endorsed herein shall apply.

6. CLAIMS PROCEDURE

1. Claim Intimation

In the unfortunate event of any medical contingency resulting into a claim on this policy, please intimate the mishap IMMEDIATELY to our Call Centre at Toll Free Numbers on 1-800-22-4030 (for MTNL/BSNL users) or 1-800-102-4030 (other users) or on chargeable numbers at +91-22-26748600/ +91-22-41582900/ +91-22-41582999 or email at This email address is being protected from spambots. You need JavaScript enabled to view it."> This email address is being protected from spambots. You need JavaScript enabled to view it. Please note that no delay should be allowed to occur in notifying a claim on the policy as the same may prejudice liability.

2. Submission of documents

Insured must submit any or all of the below mentioned document(s) as requested by us for settlingInsured‟s claim within 30 days from date of intimating the claim.

Claim Documents for Section I a.Certificate from the attending Medical Practitioner of the Insured Person confirming, inter alia,

  • Name of the Insured person;
  • Name, date of occurrence and medical details of the Insured Event
  • Confirmation that the Insured Event does not relate to any Pre-Existing Illness or any Illness or Injury which existed within the first 90 days of commencement of Period of Insurance.

b.Certificate, if applicable, from the Bank/Financial Institution stating the amortization schedule, the EMI Amounts, Principal Outstanding, etc.

c.Duly completed claim forms;

d.Original Discharge Certificate/ Card from the hospital/ Medical Practitioner;

e.Original investigation test reports, indoor case papers;

f.Any other documents as may be required by the Company.

If required, You, the Insured, must agree to be examined by a Medical Practitioner of Our choice at Our expense.

Claims documents for Section II

1.Duly completed claim form;

2.Medical Practitioner‟s Report;

3.First Information Report and Final Police report, wherever necessary;

4.Death certificate/ Post Mortem Report, wherever applicable;

5.Investigation Reports like Laboratory test, X-rays and reports essential of confirmation of the Injury etc.;

6.Disability certificate from a Medical Practitioner or hospital confirming the extent and nature of disability;

7.Post mortem report, if the same was conducted;

8.Certificate, from the Insured stating the amortization schedule, the EMI Amount, Principal Outstanding, etc. ;

9.Any other supporting documents as may be required by the Company.

Claim Documents for Section III

1.Duly completed claim form;

2.Certificate if applicable from the Bank stating the amortization schedule, the EMI Amounts, Principal Outstanding, etc.

3.Certificate from the employer of the Insured person confirming the termination, dismissal, temporary suspension or retrenchment from employment of the Insured person furnishing the date of termination, dismissal, temporary suspension or retrenchment from employment of the Insured person with the reasons for the same. In case of temporary suspension the period of suspension should also be mentioned in such certificate.

4.Any other document as may be required by the Company.

Claim Documents for Section IV

1.Duly completed Claim form;

2.Copy of FIR

3.Estimate of loss / repairs

4.Invoice/ Bills/Receipts

5.FR

6.Any other details/documents called for a specific loss

The Company shall have no liability under this Policy, once the Maximum Limit of Liability (Sum Insured) with respect to any of the Sections, is exhausted by the Insured. The Company shall be relieved of its liability under the Policy once a claim has been paid under Section I and Section II of the Policy (except for Section IV)

For all your service requests e-mail us at This email address is being protected from spambots. You need JavaScript enabled to view it."> This email address is being protected from spambots. You need JavaScript enabled to view it.

*Cover available for Salaried Employees only

**Long Term Discount not applicable on Terrorism Risk Premium

Statutory Warning: No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take out or renew or continue an insurance in respect of any kind of risk relating to lives or property in India, any rebate of the whole part of the commission payable or any rebate of the premium shown on the policy nor shall any person taking out or renewing or continuing a policy accept any rebate, except such rebates as may be allowed in accordance with the published prospectuses or tables of the Insurer. Any person making default in complying with the provisions of this section shall be punishable with fine which may extend to Ten Lakh Rupees

Please note: The prospectus contains only an indication of cover offered, for complete details on terms, conditions, coverages and exclusions please get in touch with us or our agent and read policy wordings carefully before concluding a sale. Insurance is a subject matter of solicitation. Universal Sompo General Insurance Co. Ltd., Express IT Park, Plot No EL 94, T.T.C. Industrial Area, M.I.D.C., Mahape, Navi Mumbai-400710, Toll Free Numbers: 1-800-224030 (For MTNL/BSNL users) or 1-800-1024030.


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