Universal Health Insurance Scheme:
This policy is geared towards reimbursement of hospital expenses up to Rs.30,000 to an individual or a family. It is subject to the following sub–limits:
- Hospital room, boarding expenses: up to Rs.150 per day
- If admitted in the ICU: up to Rs.300 per day
- Surgeon, Anaesthetist, consultant, specialists fees, Nursing expenses: up to Rs.4,500 per illness or injury
- Anaesthesia, Blood, Oxygen, OT charges, Medicines, Diagnostic material & X–Ray, Dialysis, Radiotherapy, Chemotherapy, Cost of pacemaker, Artificial limb, etc: up to Rs. 4,500 per illness or injury
- Total expenses incurred for any one illness: up to Rs. 15,000
It has a Personal Accident Cover whereby a sum of Rs. 25,000 can be reimbursed upon the death of the earning head of the family (as named in the policy papers) due to an accident.
If the earning head of the family is hospitalized due to an accident or an illness, a compensation of Rs.50/– per day will be paid for every day of hospitalization up to a maximum of 15 days after a waiting period of 3 days.
The following medical treatments will not be covered:
- Corrective, cosmetic or aesthetic dental surgery or treatment.
- Cost of spectacles, contact lens and hearing aid.
- Vaccination, inoculation, cosmetic treatment or surgery, HIV, AIDS, Sterility, Venereal Disease, Intentional Self injury, use of intoxicating drugs or alcohol.
- Diagnostic expenses not related to sickness or injury
- This policy offers compensation in case of death or bodily injury to the insured person, directly and solely as a result of an accident, by external, visible and violent means. Death or injury due to any illness or disease is not covered by the policy.
- The policy operates worldwide and is a 24 hours cover.
- Different coverages are available ranging from a restricted cover of Death only, to a comprehensive cover covering death, permanent disablements and temporary total disablements.
- Family Package cover is available to individuals whereby the proposer, spouse and dependent children can be covered under a single policy with a 10% discount in premium.
- Group personal accident policies are also available for specified groups with a discount in premium depending upon the size of the group.
- Expenses incurred for carriage of dead body from place of accident to the residence subject to a limit of 2% of the capital sum insured or Rs.2,500 whichever is less.
- Under an Individual Personal Accident policy or Family Package Policy, an education fund is payable for a maximum of 2 dependent school going children, in case of death or permanent total disablement of the insured person.