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Universal Sompo Pravasi Bharatiya Bima Yojana is an insurance cover specifically designed for emigrants leaving India for employment in another country. This policy provides a combination of benefits including personal accident coverage, hospitalisation coverage, employment related contingencies, legal costs, etc. Despite the range of benefits offered, this policy is priced within the affordable range of the middle-class population of the country. This is a necessary protection cover to have if you are considering foreign travel for a particular period of time.
The following eligibility criteria applies to those who wish to take the Universal Sompo Pravasi Bharatiya Bima Yojana:
Some of the notable features of Universal Sompo Pravasi Bharatiya Bima Yojana can be listed as follows:
This micro insurance policy comes with 5 different types of benefits based on the level of coverage chosen by the insured person - personal accident coverage, transportation and airfare coverage for attendant, hospitalisation coverage, employment contingencies & repatriation expenses, and legal costs. The fixed benefits available under Universal Sompo Pravasi Bharatiya Bima Yojana can be given as follows:
|Benefits||Extent of Coverage|
|Personal accident coverage
||Lump sum payment up to Rs.10 lakh|
|Transportation of mortal remains and airfare of the attendant||Actual cost of transportation and actual economy class airfare for the attendant|
|Medical costs incurred by the insured person||Actual medical costs up to Rs.75,000|
|Maternity expenses (in India or in the country of employment)||Up to Rs.25,000|
|Medical costs incurred by the insured’s family members||Up to Rs.50,000|
|Day care treatment||Covered for up to 142 procedures (list of procedures covered can be obtained from the company website)|
|Employment related contingencies||Actual economy class airfare|
|Repatriation expenses related to medical condition||Actual economy class airfare|
|Legal costs related to the insured person’s employment abroad||Up to Rs.30,000|
Universal Sompo is not liable to provide any compensation for the following list of exclusions:
For accident claims, the company must be intimated within 14 days from the date of the eventuality. Sickness hospitalisation claims must be intimated within 7 days from the date of hospitalisation.
Personal accident claims: Death or disability resulting from an accident requires submission of proofs to the company within a reasonable period. The following documents must be submitted to the insurer following personal accident claims:
Once these documents are submitted to the insurer, the claim settlement process will begin. The insurer will evaluate the validity of the submitted documents before providing the settlement amount.
Hospitalisation claims: Cashless treatment facility is available in the network hospitals for hospitalisation claims. To avail this facility, it is necessary to intimate the company 48 hours ahead of planned hospitalisation or within 24 hours of emergency hospitalisation. Pre authorisation form can be obtained from the hospital counter. The authorisation form, along with the policy details, can be faxed to the third-party administrator (TPA) from the hospital. The TPA will verify the request and approve the cashless treatment request.
Reimbursement claims can be filed within 30 days from the date of discharge from the hospital. While filing reimbursement requests, it is necessary to submit the following list of documents to the insurer:
Once these documents are submitted, the insurer or TPA will process the claim request. Once the claim is validated, the company will provide the settlement amount.
Other claims: Transportation claims require necessary proofs and related documents. The cost of transportation must be provided in the form of bills and receipts. For airfare related claims, original air tickets, other receipts, and copy of passport must be submitted while filing the claim. Claims related to legal costs, employment contingencies, and repatriation costs must include a certificate from the India Mission/Post abroad. Legal cost related claims must also have a certificate from the appropriate ministry in the country of employment.
Claim settlement: The insured can file claim requests for any of the above mentioned claims. Once the request has been filed, the company will provide its response regarding the acceptance or rejection of the claim within a maximum of 30 days. In case of rejection, the company will provide the reason for rejection. Upon acceptance of the claim, the settlement amount will be provided within a maximum of 7 days.
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