Hospital Cash Insurance Policy

Eligibility Criteria of Universal Sompo Hospital Cash Insurance Policy

• Entry age for you (the proposer) is 18 years and you can opt for this policy up to the age of 70years.
• Entry age for dependent children is 6 months
• Policy renewals will be for your lifetime.
• No pre-acceptance medical tests up to 55 years of age, however, if you are above 55 years, then, you may require undergoing medical tests at our listed diagnostic centers, 50% cost of which will be borne by us in case of accepted proposals.
• Pre -Medical Tests:Fasting Sugar Blood, BP report and ECG may be required to be submitted to us on request. Validity period of theses test 15 days or less immediately prior to the acceptance your health proposal under this policy. Any tests carried out older than 15 days prior to acceptance of this proposal would not be considered for acceptance and fresh test of the current date i.e. the date of proposal would be taken into consideration.

Coverages of Universal Sompo Hospital Cash Insurance Policy

Other Benefits

Exclusions of Universal Sompo Hospital Cash Insurance Policy

• Pre-existing Diseases: Any condition , ailment or injury or related condition(s) for which You had signs or symptoms and/or Were diagnosed ,and / or received medical advice /treatment ,within 48 months prior to Your first Policy with Us.
• Death within 30 days following the diagnosis of the Critical Illness
• Treatment of following diseases within the first one year from the commencement of the Policy, will not be payable:
  • Cataract
  • Benign Prostatic Hypertrophy
  • Myomectomy, Hysterectomy unless because of malignancy
  • Hernia, Hydrocele
  • Fistula in anus, Piles
  • Arthritis, gout, rheumatism
  • Joint replacements unless due to accident
  • Sinusitis and related disorders
  • Stones in the urinary and biliary systems
  • Dilatation and curettage
  • Skin and all internal tumors/cysts/nodules/polyps of any kind including breast lumps unless malignant/ adenoids and hemorrhoids
  • Dialysis required for chronic renal failure
  • Surgery on tonsils and sinuses
  • Gastric and Duodenal ulcers
• Any Sickness that has been classified as an Epidemic by the Central or State Government.
• General debility, nervous or other breakdown, rest cure, congenital diseases or defect or anomaly, sterility, sterilisation or infertility (diagnosis and treatment), any sanatoriums, spa or rest cures or long term care or hospitalisation undertaken as a preventive or recuperative measure
• Sickness requiring Hospitalisation within the first 30 days from the commencement date of the Policy Period unless the Policy is renewed without interruption with the Company or the policy is a renewal of similar health insurance policy from any of the other Indian insurers and We have accepted your proposal with portability.
• Any payment in case of more than one claim under the Policy during any one period of insurance by which the maximum liability of the Company in that period exceeds the Sum Insured.
• Payment of compensation in respect of injury, hospitalisation resulting –
  • From intentional self-injury, suicide or attempted suicide.
  • Self-exposure to needless perils except in an attempt to save human life.
  • Whilst under the influence of liquor or drugs or other intoxicants.
  • Emotional distress
  • Whilst engaging in aviation or ballooning whilst mounting into, dismounting from or travelling in any aircraft or balloon other than as a passenger (fare paying or otherwise) in any duly licensed standard type of aircraft anywhere in the world.
  • Directly or indirectly, caused by venereal disease, AIDS or insanity.
  • Arising or resulting from committing any breach of law with criminal intent or participating in an actual or attempted felony, riot, crime, misdemeanor or civil commotion.
  • Whilst engaging in racing, hunting, mountaineering, ice hockey, winter sports and the like.
  • Due to war or ionizing radiation or nuclear perils.
  • Whilst working in underground mines or explosive mines, electric installation with high tension supply, or as jockey or circus personnel or any such occupations of similar hazard.
  • Congenital anomalies or any complications or conditions arising therefrom; or
  • Any loss resulting directly or indirectly, contributed or aggravated or prolonged by childbirth or from pregnancy (except Ectopic Pregnancy)
  • Any treatment not performed by a Physician or any treatment of a purely experimental nature.
  • Circumcision, cosmetic or aesthetic treatments of any description change of life surgery or treatment, plastic surgery (unless necessary for the treatment of Illness or accidental Bodily Injury as a direct result of the insured event and performed within 6 months of the same).
  • Dental treatment or surgery of any kind unless necessitated by Accidental Bodily Injury.
  • Hospitalisation for the sole purpose of traction, physiotherapy or any ailment for which hospitalisation is not warranted due to advancement in medical technology
  • Naval or military operations of the armed forces or air force and participation in operations requiring the use of arms or which are ordered by military authorities for combating terrorists, rebels and the like.
  • All kind of Alternate Treatment