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Universal Sompo’s Swarna Gramin Bima Yojana is a policy designed specifically for village dwellers in the country. The individual cover provides a combination of benefits for the primary insured as well as his/her family members. Its group variant provides similar benefits to customers, but this policy is mainly intended for organisations providing coverage for their rural clientele. For instance, a bank can take this cover to provide health insurance protection for its Kisan credit card holders. Similar to the individual cover, this policy comes with an affordable price tag.
This policy cover can be taken by people who meet the following eligibility criteria:
Some of the key features of Universal Sompo Swarna Gramin Bima Yojana (Group) can be listed as follows:
Similar to the individual policy, the benefits offered under this cover can be classified into three different sections. Section A concerns personal accident coverage, Section B concerns critical illness coverage, and Section C focuses on providing hospital cash benefits. The benefits available under this cover can be given as follows:
Benefits | Extent of Coverage |
Death of the insured or his/her family member | Lump sum payment of 100% of the sum insured amount |
Permanent total disablement of the insured or his/her family member | Lump sum payment of 100% of the sum insured amount |
Permanent partial disablement of the insured or his/her family member | Up to 50% of the sum insured amount (varies based on the severity of the damages) |
Benefits | Extent of Coverage |
Critical illness coverage | Coverage for the treatment of the named critical illness following diagnosis |
Option 1 | Cancer of specified severity First heart attack of specified severity Open chest coronary artery graft bypass Open heart replacement Coma of specified severity |
Option 2 (includes option 1) | Kidney failure Stroke resulting in permanent symptoms Permanent paralysis of limb Multiple sclerosis with persisting symptoms |
Option 3 (includes option 1 and option 2) | Major organ/bone marrow transplant Motor neuron disease with permanent symptoms |
Benefits | Extent of Coverage |
Daily cash following hospitalisation | Option 1: Rs.250 per day subject to a maximum of Rs.45,000 Option 2: Rs.500 per day subject to a maximum of Rs.90,000 Option 3: Rs.1,000 per day subject to a maximum of Rs.1.8 lakh |
Daily cash for ICU hospitalisation (for a maximum of 7 days) | Double the cash benefits of regular hospitalisation |
Hospital cash benefit can be chosen for 15, 30, 45, 90, and 180 days. Based on the number of days chosen, the coverage premium will change.
The list of exclusions named under this group policy is similar to that of the individual policy. These exclusions can be listed as follows:
The claim procedure begins with intimating the company about the unfortunate event. The insured can reach Universal Sompo’s customer care department and intimate the loss or damage resulting from an unfortunate event. After notifying the company, the supporting documents must be submitted to the company within a maximum of 30 days. The following documents and proofs may be requested by the company for various claims:
After the submission of the above mentioned documents, the company will proceed with processing the claim request. The acceptance or rejection of the claim will be communicated to the insured within a maximum of 30 days from the submission of the last necessary document. If the claim is accepted, the settlement amount will be provided within 7 days.
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