Universal Sompo Swarna Gramin Bima Yojana (Group) Policy

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*Tax benefit is subject to changes in tax laws. Standard T&C Apply

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      Universal Sompo Swarna Gramin Bima Yojana (Group) Policy

      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.

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      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.

      Benefit Options
       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

      Basic Premium Rate for Personal Accident

      Age Band SUM INSURED
      (Years) 50,000 75,000 1,00,000 1,25,000 1,50,000 1,75,000 2,00,000
      0.5-25 15 20 25 32 41 52 64
      26-35 20 25 33 42 53 67 84
      36-45 25 33 43 54 69 87 109
      46-55 33 43 55 71 90 113 141
      56-65 43 56 72 92 117 147 184
      66-75 72 94 121 155 197 249 311
      76-80 94 122 158 202 257 323 404
      >80 years* 141 183 237 303 385 484 606


      Basic Premium Rate For Critical Illness

      Age Band 50000 75000 100000 125000 150000 175000 200000
      5-25 Yrs 180 271 361 451 541 631 722
      26-35 Yrs 219 329 438 548 658 767 877
      36-45 Yrs 329 493 657 822 986 1150 1314
      46-55 Yrs 378 567 756 945 1133 1322 1511
      56-65 Yrs 692 1038 1384 1730 2075 2421 2767
      66-75 Yrs 1071 1606 2141 2677 3212 3747 4282
      76-80 Yrs 1369 2053 2738 3422 4106 4791 5475
      80 Yrs 1750 2625 3500 4375 5250 6125 7000


      Basic Premium for Section - Hospital Cash ( for 30 days)

      Age Band 250 per day 500 per day 1000 per day
      5-25 Yrs 188 377 753
      26-35 Yrs 196 392 783
      36- 45 Yrs 209 417 834
      45- 55 Yrs 225 450 900
      56- 65 Yrs 263 525 1050
      66-75 Yrs 300 600 1200
      76-80 Yrs 375 750 1500
      >80 Yrs 413 825 1650

      The above rates may change. Please check the policy wordings for more details.

      Additional Benefits

      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:

      Cancellation Period
      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
      1 year 75% 50% 25% 0% NA NA
      2 year 75% 65% 50% 25% 0% NA
      3 year 75% 70% 60% 45% 11% 0%


      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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