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Universal Sompo Swarna Gramin Bima Yojana Health Insurance Plan

Universal Sompo Swarna Gramin Bima Yojana Health Insurance Plan - This is a health insurance plan that can be taken by a gramin, that is, a village dweller for himself and his family and/ or organizations such as financial institutions and NGO’s for covering its rural clientele with the following features:

  • Personal Accident which includes the following benefits - Death of the Insured or his/ her family members upon accident, Permanent Total Disablement of the Insured or his/her family members resulting from Accident and Permanent Partial Disablement of the Insured or his/ her family members resulting from Accident.
  • Critical illness where the following illnesses are covered - Cancer of specified severity, First Heart Attack of specified severity, Open Chest CABG, Open Heart Replacement, Coma of Specified Severity, Kidney Failure requiring regular dialysis, Stroke resulting in permanent symptoms, permanent paralysis of limb, Multiple Sclerosis with persisting symptoms, major organ /bone marrow transplant, Motor Neuron Disease with Permanent Symptoms.
  • The following extensions are available under the policy –
  • Pre-existing diseases cover where pre-existing diseases are covered by paying additional premium
  • The policy term ranges from one to three years
  • A family discount is provided when the insured person covers his or her family members under the policy plan.

Eligibility - Universal Sompo Swarna Gramin Bima Yojana Health Insurance Plan

  • The entry age is between 18 to 65 years
  • Entry age for dependent children is 6 months
  • There is lifetime renewability

Exclusions - Universal Sompo Swarna Gramin Bima Yojana Health Insurance Plan

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

  • Pre-existing diseases will not be covered under this plan unless specifically endorsed
  • Any expense on hospitalization or domiciliary hospitalization incurred because of any illness contracted during the first thirty days from the date of commencement of the insurance cover will not be covered. However, this exclusion is not applicable if hospitalization is required because of an accident
  • During the first year of the cover, the expense on treatment of diseases such as Cataract, Benign Prostatic Hypertrophy, Hysterectomy, Piles, Sinusitis and related disorders are not covered
  • 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, hearing aids are excluded
  • Dental treatment or surgery of any kind unless hospitalization is required is excluded
  • Any treatment directly or indirectly for treatment associated with AIDS
  • Cosmetic or aesthetic treatment are not covered
  • Venereal diseases, intentional self harm and the use of intoxicating drugs or alcohol are not covered
  • Voluntary termination of Pregnancy
  • Death or disablement due to pregnancy and Child-birth
  • Naturopathy or other forms of alternative treatment

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