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Universal Sompo Pravasi Bharatiya Bima Yojana Health Insurance Plan

Universal Sompo Pravasi Bharatiya Bima Yojana Health Insurance Plan - This is a health insurance plan that covers the medical expenses of the individuals who are emigrating and whose passports are endorsed with “Emigration check required”. These are the features of this plan:

  • Personal accident is covered where a personal bodily injury by accident solely and directly causes the death or permanent disablement of the insured person.
  • In the event of the accidental death of the insured person while on employment outside of the country, the company will reimburse the actual cost of transporting the mortal remains of the deceased individual back to India. The cost of an economy class return airfare for one attendant to accompany the mortal remains from the place of death to India will also be covered.
  • Medical expenses in case of hospitalization are covered
  • The hospitalization expenses of the insured’s family members are covered. This covers the spouse up to the age of 65 and two children up to the age of 21. The following expenses are included for coverage :
  • Room, board and nursing expenses
  • Medical practitioner, anesthetist, consultant fees
  • Expenses on anesthesia, blood, oxygen, operation theatre, surgical appliances, medicines, diagnostic materials, X-ray, dialysis, chemotherapy, radiotherapy, cost of pacemaker, artificial limbs, cost of organs and other such expenses
  • Cost of vitamins and tonics when prescribed by the attending medical practitioner
  • Daycare procedures are covered where the procedures or surgeries require less than 24 hours hospitalization
  • The maternity expenses of a woman insured will be covered
  • Domiciliary expenses are covered where medical treatment is required for a period that exceeds three days for illnesses that normally would be treated in a hospital/nursing home, but the insured individual is confined at home due to the following reasons:
    • The condition of the patient is such that he or she cannot be removed to a hospital
    • The patient cannot be moved to the hospital as there is a lack of accommodation available
  • The airfare for one way economy class ticket will be covered under the following circumstances:

(a) Insured Person is/has not been received on behalf of employer, when he/she arrives at his/her workplace or destination abroad i.e. employer refuses the job/employment to the Insured Person

(b) If there is any substantive change in the job/employment contract/agreement to the disadvantage of the Insured Person.

(c) If the employment is prematurely terminated within first three months of Period of Insurance for no fault of the Emigrant (Insured Person)

(d)When the emigrant (insured individual) falls sick or is declared medically unfit to  commence or continue working and the contract if terminated by the employer within first twelve months of the start of cover under the policy

  • Coverage under this plan includes expenses incurred on room rent charges, boarding charges, nursing, surgeon/specialist fees, charges for blood, oxygen, etc.
  • Medical tests are required for insured individuals who are above the age of 45 year.

Eligibility - Universal Sompo Pravasi Bharatiya Bima Yojana Health Insurance Plan

  • The entry age is restricted to 18 to 65 years for Indian citizens who are staying abroad and having a valid visa for employment.

Exclusions - Universal Sompo Pravasi Bharatiya Bima Yojana Health Insurance Plan

The policy will not cover loss, damage, illnesses or diseases that arise due to the following:

  • If the insured person is travelling against the advice of a medical practitioner
  • If the insured person is on a waiting list for a specific medical treatment
  • If the insured person has received  a terminal prognosis of a medical condition
  • If the insured person takes part in a naval, military or air force operation
  • If the insured person works in a different profession or occupation or in a different country or for a different employer than what is declared in the  proposal form
  • A claim will not be covered when there is war or military action occurring against the country or internal conflict in the country where the insured individual has gone to work
  • If a claim arises after the expiry of the insured individuals’ passport or visa
  • Circumcision unless necessary for treatment of a disease is excluded
  • Any treatment directly or indirectly for treatment associated with AIDS
  • Venereal diseases, intentional self harm and the use of intoxicating drugs or alcohol are not covered
  • War or any act of war, invasion, act of foreign enemy, war like operations, civil war, public defense, rebellion revolution, insurrection, military or usurped acts, riot, terrorism, chemical, radioactive or nuclear contamination.
  • Participation or involvement in naval, military or air force operations, racing, diving, aviation, scuba diving, parachuting, hang-gliding, rock or mountain climbing.

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