Universal Sompo Swarna Gramin Bima Yojana (Individual) Insurance

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Universal Sompo Swarna Gramin Bima Yojana (Individual) Insurance Overview

Universal Sompo’s Swarna Gramin Bima Yojana (Individual) offers full protection against any illness, accidents and critical illnesses. Gramin (Village Dweller) can benefit from this policy by covering himself, his family, organizations such as NGOs and Financial Institutions with rural clientele to have monetary support in times of distress.

Key Features of Universal Sompo Swarna Gramin Bima Yojana (Individual) Insurance

  • 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

Benefits of Universal Sompo Swarna Gramin Bima Yojana (Individual) Insurance

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

Here is a list of Critical Illnesses and Surgical Procedures that shall be covered up to the Capital 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 stay 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 9,0000/- Rs 1,80,000/-


Double Benefit:
The amount as chosen by you from the above options shall be doubled when you/ your family member is admitted in an ICU. Such double benefit shall be available under the Policy for a maximum of 7 days.

Premium details of Universal Sompo Swarna Gramin Bima Yojana (Individual) Insurance

1. 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

 

2. 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

 

3. 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

Long Term Policy: The Policy can be taken for a period of two/ three years and discount as under would be provided

Duration of policy Premium to be charged
2 years 2 year premium in advance less 10% discount
3 years 3 year premium in advance less 15% discount

 

Family discount: Family discount as under would be provided when you to cover your family members under the policy.

Number of Family Members Discount
Self None
Self + Spouse 5%
Self + Spouse + 1 Child 7.5%
Self + Spouse + 2 Children 10%


Maximum discount inclusive of all the discounting factors shall not exceed more than 40%.

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 (Individual) Insurance

Free look period: In case you are not happy with the policy terms and conditions,  you have the option of cancelling the policy within 15 days of receipt of the policy documents, provided there has been no claim.

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 (Individual) Insurance?

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 (Individual) Insurance

In case of Death

  1. Policy Copy
  2. Post Mortem Report (certified copies) - as applicable
  3. F.I.R. or Death report or Inquest Panchnama (in original or certified copies)
  4. Spot Panchnama (certified copies)- if applicable
  5. Death certificate (in original or certified copy)

In case of Permanent Total Disablement/Permanent Partial Disablement

  1. Policy Copy
  2.  Disability certificate - Authorized Medical Practitioner of the district/ units concerned, (certificate) stating percentage of disablement
  3. F.I.R. and Panchnama wherever applicable (original or certified copies)
  4. Medical report
  5. Investigation reports like laboratory test, X-rays and reports essential of confirmation of the type and percentage of disability
  6. Original medical bills

In case of Critical Illnesses and Surgical Procedures

  1. 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)
  2. All reports, including but not limited to all medical reports, case histories, investigation reports, treatment papers, discharge summaries.
  3. A precise diagnosis of the treatment for which a claim is made.
  4. A detailed list of the individual medical services and treatments provided and a unit price for each.

In case of Hospital Cash

  1. Photo copy of bills, receipt and discharge certificate/card from the Hospital.
  2. Photocopy of F.I.R. copy in case of an accident.
  3. Complete set of Hospital/medical records

Eligibility Criteria For Universal Sompo Swarna Gramin Bima Yojana for Individual

  • 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.