Universal Sompo Swarna Gramin Bima Yojana (Group) Policy
Universal Sompo Swarna Gramin Bima Yojana Overview
Swarna Gramin Bima Yojana (Group) is an all-round health insurance plan for Gramin (Village Dweller) that covers the medical expenses incurred in case of illness or accident. You can also add your family members under this plan. It is the perfect Health protection for you, your family, people of your organization or NGO and also rural clientele of Financial Institutions.
Key Features for Universal Sompo Swarna Gramin Bima Yojana (Group) Policy
- No pre-acceptance medical tests up to 45 years of age , however, if you are above 45 years, then, you may require to undergo medical tests ( BP, Fasting Sugar, ECG) at our listed diagnostic centers, 50% cost of which will be borne by us in case of accepted proposals.
- The policy consists of 3 sections:
- Section A - Personal Accident
- Section B - Critical Illness
- Section C - Hospital Cash
- Policy renewals will be for your lifetime.
Benefits of Universal Sompo Swarna Gramin Bima Yojana (Group) Policy
Benefit under section A
|Sr. No.||Benefits||Payable Amount|
|Benefit 1||Death of the Insured or his/ her family members upon accident||100% of Sum Insured|
|Benefit 2||Permanent Total Disablement of the Insured or his/her family members resulting from Accident||125% of Sum Insured|
|Benefit 3||Permanent Partial Disablement of the Insured or his/ her family members resulting from Accident||Depending on % of disablement|
Section 2- Critical Illness
The following Critical Illnesses and Surgical Procedures shall be covered up to the Sum Insured:
|Option 1||Option 2||Option 3|
|Cancer of specified severity||Option 1 +||Option 2+|
|First Heart Attack of specified severity||Kidney Failure requiring regular dialysis||Major Organ /Bone Marrow Transplant|
|Open Chest CABG||Stroke resulting in permanent symptoms||Motor Neurone Disease with Permanent Symptoms|
|Open Heart Replacement||Permanent Paralysis of Limb|
|Coma of Specified Severity||Multiple Sclerosis with persisting symptoms|
Section C- Hospital Cash
This column shows you the options you have as paid amount upon hospitalization, subject to your minimum hospital stays of 2 days.
|Maximum Amount||Option 1||Option 2||Option 3|
|Rs 250/ - per day||Rs 500/- per day||Rs 1000/- per day|
|Rs 45000/-||Rs 90,000/-||Rs 1,80,000/-|
Double Benefit - If the insured person is admitted in an ICU, the amount mentioned in the optio0ns listed above shall be subsequently doubled for the maximum stay of 7 days.
Premium details of Universal Sompo Swarna Gramin Bima Yojana (Group) Policy
1. Basic Premium Rate for Personal Accident
|Age Band||SUM INSURED|
2. Basic Premium Rate For Critical Illness
3. Basic Premium for Section - Hospital Cash ( for 30 days)
|Age Band||250 per day||500 per day||1000 per day|
|36- 45 Yrs||209||417||834|
|45- 55 Yrs||225||450||900|
|56- 65 Yrs||263||525||1050|
*The above rates may change. Please check the policy wordings for more details.
Discount under the Policy - Group discount as per below when the number of persons covered under the Policy exceeds 25.
|Number of Persons covered||Applicable discount|
|Up to 25 persons||No discount|
|Between 25 and 50 persons||5% on total premium|
|Between 51 and 100 persons||10% on total premium|
|Between 101 and 300 persons||15% on total premium|
|Between 301 and 400 persons||20% on total premium|
|Between 401 and 500 persons||25% on total premium|
|Over 500 persons||35% on total premium|
Tax Benefit - Avail of tax benefit under section 80D of Income Tax Act on the premium applicable for Critical Illnesses & Surgical Procedures cover.
Policy Details of Universal Sompo Swarna Gramin Bima Yojana (Group) Policy
Free Look period - You will be allowed a period of at least 15 days from the date of receipt of the Policy to review the terms and conditions of the Policy and to return the same if not acceptable
Sum Insured enhancement - The Sum Insured under the Policy can only be enhanced on renewal subject to approval from underwriter.
Renewal - Your Policy shall ordinarily be renewable for lifetime except on grounds of fraud, moral hazard or misrepresentation or non‐cooperation by you/ any of the Insured Persons.
How to cancel Universal Sompo Swarna Gramin Bima Yojana (Group) Policy?
By You: You may terminate this Policy at any time by giving us written notice, and the Policy shall terminate when such written notice is received. If no claim has been made under the Policy, then we will refund premium in accordance with the table below:
|Cover Period||Within 1 month||From 1 month to 3 months||From 3 months to 6 months||From 6 months to 1 year||During 2nd Year||During #rd Year|
By Us: We may at any time terminate this Policy on grounds of misrepresentation, fraud, non-disclosure of material facts or non-cooperation by you or any Insured Person or anyone acting on your behalf or on behalf of an Insured Person upon 30 days notice by sending an endorsement to your address shown in the Schedule without refund of premium.
Documents Required for Universal Sompo Swarna Gramin Bima Yojana (Group) Policy
In case of Death
- Policy Copy
- Post Mortem Report (certified copies) - as applicable
- F.I.R. or Death report or Inquest Panchnama (in original or certified copies)
- Spot Panchnama (certified copies)- if applicable
- Death certificate (in original or certified copy)
In case of Permanent Total Disablement/Permanent Partial Disablement
- Policy Copy
- Disability certificate - Authorized Medical Practitioner of the district/ units concerned, (certificate) stating percentage of disablement
- F.I.R. and Panchnama wherever applicable (original or certified copies)
- Medical report
- Investigation reports like laboratory test, X-rays and reports essential of confirmation of the type and percentage of disability
- Original medical bills
In case of Critical Illnesses and Surgical Procedures
- Original Bills or their copies (including but not limited to pharmacy purchase bill, consultation bill, diagnostic bill and any attachments thereto like receipts or prescriptions in support of any amount claimed)
- All reports, including but not limited to all medical reports, case histories, investigation reports, treatment papers, discharge summaries.
- A precise diagnosis of the treatment for which a claim is made.
- A detailed list of the individual medical services and treatments provided and a unit price for each.
In case of Hospital Cash
- Photo copy of bills, receipt and discharge certificate/card from the Hospital.
- Photocopy of F.I.R. copy in case of an accident.
- Complete set of Hospital/medical records
Eligibility Criteria For Universal Sompo Swarna Gramin Bima Yojana (Group) Policy
- Entry age for the proposer is 18 years and he can opt for this policy up to the age of 65 years.
- Entry age for dependent children is 6 months.
- Maximum of 2 Adults and 2 Dependent Children (up to 25 years of age) can be covered under the Policy.
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