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Universal Sompo Hospital Cash Insurance Policy

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Universal Sompo Hospital Cash Insurance Review

Universal Sompo’s Hospital Cash Insurance is a health plan which provides daily cash allowance if the insured is hospitalized.


Highlights of the Universal Sompo Hospital Cash Insurance

  • The policy provides a daily cash allowance for each day of hospitalization. 
  • No pre-entrance medical check-ups are required till 55 years of age. If the insured is above 55 years of age, medical check-ups are required 50% of the cost of which are reimbursed by the company on successful issuance of the policy. 
  • Three types of coverages are extended by the plan which includes Hospital Confinement Benefit, Intensive Care Benefit and Convalescence Benefit. 
  • The Sum Assured can be enhanced on renewals.
  • The policy offers attractive premium discounts.


Working of the Universal Sompo Hospital Cash Insurance

  • The policyholder chooses the Hospital Confinement Benefit option, the benefit period and states the members who are to be covered. 
  • The premium is then determined based on the above parameters.
  • On any contingency covered by the plan, compensation would be paid


Benefits and Features of Universal Sompo Hospital Cash Insurance

  • Hospital Confinement Benefit – A daily benefit is paid when the insured is hospitalized. There are six options and the daily amount payable depends on the option as selected by the proposer. The options and their corresponding benefit structure is as follows:
  Option I Option II Option III Option IV Option V Option VI
Amount payable per day of hospitalization Rs.500 Rs.1000 Rs.1500 Rs.2000 Rs.2500 Rs.3000
Maximum amount per policy period Rs.90,000 Rs.1.8 lakhs Rs.2.7 lakhs Rs.3.6 lakhs Rs.4.5 lakhs Rs.5.4 lakhs

A proposer can choose a period of 15, 30, 45, 60, 90 or 180 days of hospitalization for the hospital confinement benefit under any option selected.
  • Intensive Care Benefit – If the insured is admitted into the ICU of a hospital, double the benefit would be payable for each day of ICU confinement. The amount of benefit would be double of the hospital confinement benefit as per the option selected by the proposer. 
  • Convalescence Benefit – If the hospitalization of the insured exceeds 21 days, an additional benefit called the Convalescence Benefit would be paid. This benefit would be equal to Rs.10, 000 and would not be paid if the period of hospital confinement benefit selected is 30, 45, 60, 90 or 180 days.


 


Eligibility Criteria of Universal Sompo Hospital Cash Insurance

The plan can be bought only by Resident Indians. Individuals can buy the policy for themselves and their family. Family includes spouse, dependent children up to 25 years and dependent parents. The other eligibility criteria of the plan include:
  Minimum Maximum
Entry age (Last Birthday) of the insured Dependent children – 6 months Dependent children cannot be covered post 25 years of age
Entry age (Last Birthday) of the proposer 18 years 70 years
Plan tenure 1, 2 or 3 years
Premium payable Depends on the Hospital Confinement Benefit option, benefit period and members insured.
Premium payment mode Annually



Additional Benefits of Universal Sompo Hospital Cash Insurance

  • Premium rebates– The plan offers three types of rebates or discounts which are as follows:
    • Family Discount – If family members (spouse, children and dependent parents) are covered under the plan, a discount of 5% in the annual premium is allowed. 
    • Long term policy discount – If the policy is taken for 2 or 3 years, a discount of 10% and 15% is allowed in the premium rate. The premium computation for this discount would be twice and thrice of the annual premium payable, respectively. 
    • Group Discount – If the policy is issued as a group insurance policy, there is a discount offered by the company. 
  • Portability – If the proposer wants to port his existing health insurance plan taken from another company to this plan, he can do so. Such portability should be requested at least 45 days before the expiry of the previous policy which is being ported. 
  • Free Look Period – A cooling off period or a free look period of 15 days is granted to the policyholder after the policy issuance to review the policy terms and conditions. If found unsatisfactory, the plan can be cancelled within this period and the premium paid would be refunded after deducting the relevant mortality charge, service tax, cess and stamp duty paid.
  • Plan cancellation –The company can cancel the policy on grounds of fraud, misrepresentation or non-disclosure. In this case premiums paid are not refunded. The proposer can also cancel the policy if he wants and in this case premiums would be refunded after deducting the coverage cost for the period for which the policy was in force and other expenses. The proportion of premium refunded in a cancelled policy is as follows:
Coverage period Cancellation period
Within 1 month Within 1-3 months Within 3-6 months Within 6-12 months In the 2nd year In the 3rd year
1 year 75% 50% 25% 0% NA NA
2 years 75% 65% 50% 25% 0% NA
3 years 75% 70% 60% 45% 12% 0%



Premium Illustration

The following chart shows the sample premium rates payable by the proposer for different combinations of age, coverage option and benefit period selected.



The table below gives a quick tabular reference to the above chart:
Age Option I Option II Option III Option IV Option V Option VI
Period 45 days Period 60 days Period 45 days Period 60 days Period 45 days Period 60 days Period 45 days Period 60 days Period 45 days Period 60 days Period 45 days Period 60 days
26-40 years 788 1,050 1,598 2,100 2,363 3,240 3,321 4,200 3,938 5,250 4,725 6,300
41-50 years 1,125 1,500 2,264 3,000 3,375 4,635 4,662 6,000 5,625 7,500 6,750 9,000
 


Exclusions in Universal Sompo Hospital Cash Insurance

  • Pre-existing illnesses are covered only after a continuous coverage period of 48 months.
  • Specific treatments like cataract, hernia, fistula, joint replacement, etc. are not covered in the first year of the policy.
  • Hospitalization within the first 30 days of the policy is excluded. 
  • Epidemic ailments and debilitating ailments are excluded. 
  • Hospitalization due to suicide or self-inflicted injury, alcohol or drug abuse, participation in hazardous sports and activities, criminal act, war, commotion, consequential loss, pregnancy and related causes, defense related operations, curative treatments, aviation, radioactive contamination, circumcision, cosmetic treatments, STD or HIV, etc. would also be excluded.


 
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