Universal Sompo is one of the general insurance companies in India that offers multiple insurance products in different domains. The company offers an extensive list of health insurance products for people of all age groups. Universal Sompo Senior Citizen Health Insurance is a policy specifically designed for the senior citizens in this country. This policy provides coverage against various potential health ailments commonly suffered by elderly people. This policy comes with a lot of flexible options, and it is worth considering if you are looking for a medical insurance cover for your elderly parents.
The following eligibility criteria applies to people who wish to enroll themselves in the Universal Sompo Senior Citizen Health Insurance Policy:
Some of the notable features of Universal Sompo Senior Citizen Health Insurance Policy can be listed as follows:
The range of benefits offered under Universal Sompo Senior Citizen Health Insurance Policy can be given as follows:
|Benefits||Extent of Coverage|
|Sub-limits for hospitalisation coverage||Up to 1% of the sum insured for room rent and boarding Up to 2% of the sum insured for admission in ICU Up to 25% of the sum insured for medical practitioner, consultants, nursing fees, etc. Up to 50% of the sum insured for blood, oxygen, surgical appliances, etc.|
|Day care treatment coverage||Covered for all the listed procedures up to the sum insured limit (15% copayment shall be applicable)|
|Domiciliary treatment coverage||Up to 50% of the sum insured|
|Cost of health check up||Up to 1.25% of the sum insured amount after every 3 claim-free years|
|Daily cash allowance||Up to Rs.250 per day subject to a maximum of Rs.2,500 per period|
|Emergency ambulance charges||Up to 1% of the sum insured amount subject to a maximum of Rs.1,500|
|Sub limits for specific conditions||Cataract per eye - Rs.10,000 Hernia related surgery - Rs.20,000 Stone in urinary system - Rs.20,000 Knee ligament reconstruction surgery - Rs.40,000 (Refer to the policy document for the complete list)|
|Cumulative bonus||5% increase in sum insured amount for every claim-free year subject to a maximum of 50% of the sum insured amount|
|Critical illness coverage (optional)||Lump sum payment of the sum insured amount following the first diagnosis of any of the named critical illness|
The company is not liable to provide any compensation for the following list of exclusions:
The claim can be initiated by contacting the customer service department of the company. It is better to inform the company about the hospitalisation right away without any delay. During emergency hospitalisation, the claim can be notified within 24 hours of hospitalisation.
The insured can initiate a cashless treatment claim by sending an authorisation request from the hospital. The customer care department of the insurer can guide you with the process. Once the authorisation form is sent along with the policy details, the insurer will verify the request and approve the same if it is valid.
Reimbursement requests can be filed after discharge from the hospital. All documents related to the claim must be submitted within a maximum of 30 days from the date of intimation. These documents include original bills, medical reports, diagnostic reports, physician certificate, etc. The company promises to communicate the acceptance or rejection of a claim within 30 days of the receipt of all documents. Once the claim is accepted, the settlement amount will be provided within 7 days.
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