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Swarna Gramin Bima Yojana (Group) Policy 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 Swarna Gramin Bima Yojana (Group) Policy
Benefit under section A Section 2- Critical Illness The following Critical Illnesses and Surgical Procedures shall be covered up to the Sum Insured: 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. 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 2. Basic Premium Rate For Critical Illness 3. Basic Premium for Section – Hospital Cash ( for 30 days) *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. 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: 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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