Universal Sompo Super Healthcare Policy

The following are the key features and benefits of choosing the Universal Sompo Super Healthcare Insurance Policy..

• Medical Expenses

If the insured members are hospitalised on the advice of a doctor due to the illness or accidental bodily injury sustained or contracted during the policy period, the policy will reimburse the insured for reasonable medical expenses incurred more than the deductible stated in the schedule.

• Day Care Treatment

When the insured person receives daycare treatment or surgical procedures while a patient for less than 24 hours in a hospital or daycare facility, but not in the facility’s outpatient department, the company will cover the associated medical costs.

• Pre-Hospitalization Expenses

For the period specified in the policy schedule just before the insured person was hospitalised, the company will cover any medical expenses incurred during the policy period.

• Post-Hospitalization Expenses

Immediately following the insured’s discharge from the hospital following their hospitalisation, the company will cover any medical expenses incurred during the policy period for the duration specified in the policy schedule.

• Organ Donor Expenses

Up to the sum insured stated in the policy schedule, the insurance will cover the in-patient hospitalisation medical costs for a successful organ transplant, including pre-transplant medical tests for a legitimate donor and for harvesting the organ.

• In-Patient AYUSH Hospitalization

The policy will cover any medical costs incurred as part of an in-patient AYUSH treatment as per the guidelines for reimbursement/settlement of AYUSH treatment expenditure claims under insurance coverage.

• Domiciliary Hospitalization

When an insured person receives medical care at home that would have otherwise required in-patient hospitalisation, the company will cover the associated medical costs.

• Ambulance Expenses

If a claim is accepted under “In-patient hospitalisation,” the company will pay the ambulance expenses incurred for transportation of the insured member(s) to the closest hospital with adequate facilities, up to the maximum amount as specified in the policy schedule. These expenses include those for air ambulance, special cardiac ambulance, and road ambulance.

• Maternity Cover

With a lifetime maximum of two deliveries or terminations, the policy will cover the medical costs associated with an inpatient delivery (including a caesarian section) or a legal medical termination of pregnancy during the policy period.

• Automatic Restoration

If the opted Base Sum Insured and the Cumulative Bonus (if any) are insufficient due to prior claims in that policy year, the Company will once offer a 100% restoration of the Base Annual Sum Insured chosen by the Insured.

• Emergency Assistance Services

When the insured or insured member(s) is more than 150 kilometres from their residential address listed on the proposal form, the company will offer the services. With prior notification and acceptance by the company, the services would be rendered by the company or through our designated Service provider.

• Complete Wellness & HealthCare

To maintain the insured person’s health and general well-being, the company provides a thorough complete wellness and healthcare program. The Company offers the insured person personal access to a web-based health portal on the Company’s website and/or a wellness mobile application, where he or she can carry out various healthcare tasks.

• Global Care

Provided that the diagnosis was made in India and referred by a medical practitioner for which the insured member(s) travels abroad for treatment, the Company will reimburse for Medical Expenses of the Insured Person incurred outside India up to the Sum Insured, but not for more than 180 consecutive days.

• Free Health Check-Ups

Through the appointed Service Provider, the company will offer the insured person free medical examinations at each renewal. The policyholder’s claim history has no bearing on the availability of this free health checkup.