Health Insurance policy of Universal Sompo is offered to individuals and/or his family. 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.
- Domiciliary 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 provided in the schedule.
- Premium is calculated depending on the age of the insured and the sum insured selected.
- If Your age or Your dependant’s age is more than 45 years , You /Your dependents shall have to undergo medical tests as prescribed by Us and the cost of such expenses shall be borne by You.
- The entry age under the policy should be less than 55 years.
- Maximum coverage is Rs.5 lacs.
- As per Income Tax Act, the premium paid for this cover is exempted from tax under Section 80 D.
Add-on Cover:
The Policy can be extended to cover certain Critical Illness
Exclusions
The Policy covers loss or damage to the Insured Person arising out of:
- Pre-existing diseases are not covered.
- Any expense on hospitalization or domiciliary hospitalization incurred on account of any illness contracted during the 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 of treatment of diseases such as Cataract, Benign Prostatic Hypertrophy, Hysterectomy, Piles, Sinusitis and related disorders is 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, and hearing aids are excluded.
- Dental treatment or surgery of any kind unless hospitalization is required is excluded.
- Venereal diseases, intentional self-injury and use of intoxicating drugs/alcohol are excluded.
- Any treatment directly or indirectly for treatment associated with AIDS.
- Cosmetic or aesthetic treatment is excluded.
- Voluntary termination of Pregnancy.
- Pregnancy and Child-birth.
- Naturopathy Treatment.
