Universal-Sompo

Universal Sompo’s Individual Accident Policy helps you tide over the unfortunate consequences of an unforeseen accident. It also provides for coverage of medical expense incurred for treatment.

 

Eligibility Criteria

  • The enrolment age under the Policy is from 5 years to 65 years. Fresh proposals for persons above

65 years till 75 years of age may be accepted with 20% loading on premium.

  • No fresh proposal beyond 75 years.
  • Proposer needs to be aged 18 years or above.
  • No maximum renewal age under the Policy

 

Policy Term

The Policy shall be issued for a period of 12 months from date of commencement of Policy

What does this policy cover?

The policy provides for defined benefits based on the nature of injury sustained by the insured person in an accident during the Policy Period.

Coverage:

The policy provides for three different options as under:

Basic Covercovers against accidental Death only.

Wider Covercovers against Death, Permanent Total Disablement & Permanent Partial Disablement caused by an accident

Comprehensive Cover covers against Death, Permanent Total Disablement, Permanent Partial disablement and Temporary Total Disablement caused by an accident.

 

Benefits:

The compensation/benefits will depend upon the nature of injury and capital Sum Insured (CSI) {restricted to maximum CSI of 2 Lakhs} under the policy.

  • For accidents resulting in Death or Permanent Total Disablement, we will provide compensation equivalent to the full capital sum insured.
  • For Permanent Partial Disablement the compensation will depend on the nature of injury and corresponding percentage of capital Sum Insured as detailed in the “Table of Benefits” in the policy document
  • In respect of Temporary Total Disablement, we will provide compensation of 1% of Capital Sum Insured or Rs 5,000/- per week whichever is less for a maximum period of 104 weeks.

 

Additional Benefits under the Policy (Maximum CSI limited maximum up to 2 Lakhs)

In respect to the benefits stated above, we also undertake to provide compensation in respect of the following:

A) Transportation cost for Carriage of dead body to Home including funeral charges 1% of Capital Sum Insured or Rs 2500/- (two thousand five hundred) whichever is lower.
B) Cost of Clothing damaged in the Accident wherein liability for disablement in admitted by Us Actual expense subject to maximum of Rs 1000/-
C) Ambulance Charges for transportation of insured person to Hospital following Accident Actual Expense subject to maximum of Rs   1000/-
D) Educational Fund: In the event of death or Permanent Total Disablement of insured Person. We will pay towards Educational Fund up to 2 dependent children 5% of CSI subject to subject to maximum of Rs 15000/-
E) Loss of Employment: In the event of accident leading to loss of employment as a consequence of Permanent Total Disability as per the table of benefits in the Policy 2% of CSI subject to a maximum of Rs 25,000

 

Rate Chart:-

Nature of Cover/Category Normal Heavy Very Heavy
Basic 0.40%o 0.60%o 0.90%o
Wider 0.85%o 1.25%o 1.95%o
Comprehensive 1.40%o 2.0%o Not to be Covered

Exclusions:

  1. Self- Injury, Suicide, venereal diseases or insanity.
  2. Influence of intoxicating liquor or drugs.
  3. Death due to pregnancy or childbirth.
  4. Breach of law with criminal intent.
  5. War and Nuclear group of perils.
  6. Those on duty with armed forces.
  7. Injury/death while participating in adventurous sports.

 

Discounts Available under the policy

  1. Family package discount:-

 

More than 3 family Members 10.00%
More than 4 family Members 12.50%
More than 5 family Members 15.00%

 

NB: Family means Proposer, spouse, dependent children and dependent parents.

 

  1. Loyalty Discount

Loyalty discount on the premium in respect of individual and family package cover at the following rate shall be allowed in case the Policy is renewed with Us within 7 days after the expiry of the Policy:

1st year 05%
2nd year 10%
3rd year 15%

 

Documents required in event of a claim:

  • Duly filled up claim form
  • In the event of Death – Death Certificate and Post Mortem report.
  • Copy of FIR
  • Certificate of nature and extent of disability.
  • Leave and income certificate from employer.
  • Any other document as may be required on the merits of the case.

 

Renewal Criteria

This Policy shall ordinarily be renewable for lifetime except on grounds of fraud, moral hazard or misrepresentation or non-cooperation by You.

 

Claim Disclaimer

In the unfortunate event of any loss or damage to the insured property resulting into a claim on this policy, please intimate the mishap IMMEDIATELY to our Call Centre at Toll Free Numbers on 1800-200-5142 or on chargeable numbers at + 022 – 39635200 or email at contactclaims@universalsompo.com. Please note that no delay should be allowed to occur in notifying a claim on the policy as the same may prejudice liability.

 

Grievances

 

In case you are aggrieved in any way, You may register a grievance or Complaint by visiting Our website or write to us on contactus@universalsompo.com.

 

You may also contact on Our Toll Free Numbers: 1800-200-5142 or on chargeable numbers at + 022 – 39635200; and also send us fax at our toll free numbers: 1800-200-9134

 

  • You can also visit Our Company website/call at our toll free numbers and click under links Grievance Notification
  • If the issue still remains unresolved, You may, subject to vested jurisdiction, approach Insurance Ombudsman for the redressal of Your grievance
  • The updated details are also available on: http://www.irdaindia.org/ins_ombusman.htm

Universal Sompo IPA _CSC

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