Universal Sompo Complete Health Care Insurance Plan
Universal Sompo Complete Health Care Insurance Plan - This is a health insurance plan that covers the hospitalization and medical expenses of the individual with the following features:
- There are three types of plan options, which are Basic, Essential, and Privilege.
- The plan can be taken on an Individual Sum Insured Basis and Floater Basis.
- Medical expenses in case of hospitalization are covered
- Daycare procedures are covered
- Post hospitalization expenses are also covered
- Organ donor treatment is 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.
- Ambulance charges are reimbursed
- Dental treatment is reimbursed if is required as a treatment for accidental injuries
- Alternate in-patient treatments such as ayurveda, unani, homeopathy, siddha are reimbursed
- If the insured child of an age less than 12 years is hospitalized for more than 72 hours then Universal Sompo will provide a daily allowance as per the chosen medical plan to meet any non-medical expenses
- In the event of being bitten, vaccination charges are covered
- Outpatient charges are covered.
- Diagnostic tests are covered
- Outpatient dental treatment is covered by the plan
- One pair of spectacles or one pair of contact lenses are covered on the condition that it has been prescribed Consultation charges are reimbursable
- Convalescence Benefit – Rs. 10,000 is paid if the insured person is hospitalized or their family member is hospitalized for more than 10 days.
- Pre and post maternity expenses are covered
- Coverage is provided for the new born baby till the policy expires or till the baby is 91 days old, whichever is earlier
- Coverage can be enhanced or waived as per the customers ‘choice. The following 5 options are offered for enhancement or waiver:-
- Personal Accident
- Critical Illness
- Hospital Cash
- Sublimit
- Treatment in tiered network
- A single premium can be paid for a three years coverage
- There is an E policy discount when the customer opts to receive his or her policy in electronic form
- There is a family discount when covering family members under a single policy
- There is a “Dial-a-doctor” facility where the customer can get medical advice from a doctor through telephonic or online modes
- Customers get access to the company’s “Health Educational Library for People” (HELP)
- Customers get a monthly newsletter with diet and health tips and similar information
- Customers get a second opinion on their health condition
- Customers receive a specialist e-consultation with two follow-up sessions for seeking expert opinions on any chronic conditions
- Customer can avail a wellness package where they get discounts on health and wellness products and services listed
Eligibility - Universal Sompo Complete Health Care Insurance Plan
- The entry age is 18 to 70 years
- Dependent children from the age of 91 days may be covered
- Entry age for dependent children under the floater plan is 1 day
Exclusions - Universal Sompo Complete Health Care 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 until 36 months have passed
- Circumcision unless necessary for treatment of a disease 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
- Psychiatry is not covered
- Sleep disorders and sleep problems are not covered
- Treatment of infertility is not covered
- Treatment of developmental delay is not covered
- Unproven and experimental treatment is not covered
- Treatment of sexual dysfunction is not covered
- Private duty nursing will not be covered
- Weight loss surgery is not covered
- Birth control is not covered
- Artificial life maintenance will not be covered
- Unrelated expenses and vitamins/nutritional expenses are not covered
- Cost of artificial limbs are not covered.
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