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Universal Sompo General Insurance Pvt Ltd - Individual Personal Accident Policy

Individual Personal Accident Policy

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 Cover - covers against Death only
  • Wider Cover - covers against Death, Permanent Total Disablement & Permanent Partial Disablement
  • Comprehensive Cover - covers against Death, Permanent Total Disablement Permanent Partial Disablement & Temporary Total Disablement

Compensation Benefit

The compensation benefits will depend upon the nature of injury and the Capital Sum Insured 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 Benefit' under the Policy document or as per the medical advices of our appointed Medical Practitioner.

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In respect of Temporary Total Disablement, we will provide compensation at 1% of Capital Sum Insured or Rs 5000/- whichever is less per week for a maximum period of 104 weeks.

Additional benefits under the Policy

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

Transportation Cost for carriage of dead body to Home including funeral charges. 1% of Capital Sum Insured or 2,500/- (Two thousand five hundred) whichever is lower.
Cost of Clothing damaged in the Accident as described above and liability for disablement is admitted by Us. Actual expenses subject to maximum of Rs 1000/-
Ambulance charges for transportation of Insured person to Hospital following Accident Actual expenses subject to maximum of Rs 1000/-
Education Fund In the event of death, permanent total disablement i.e. 1 & 2 of Table of Benefit of Insured Person, We will approve compensation towards Education Fund up to 2 dependent children. -5% (Five percent) of C.S.I Subject to a maximum of Rs. 15000/-
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. 2% of CSI subject to a maximum of Rs 25000/-
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Optional Extension available under the Comprehensive Cover Policy

The Policy can be extended to cover the following by payment of additional Premium

Medical Expenses Extension: Cover the medical expenses reasonably and necessarily incurred by you towards medical expenses as a result an accident resulting in thebodyily injury, death or disablement. There are 4 options for extent of medical expenses cover, which you can choose from.

Hospital Confinement Allowance: Daily allowance of Rs 500/- per day to a maximum of 30 days if you or any of the insured person(s) is hospitalized as a result of an accident resulting in the bodily injury, death or disablement.

Exclusions

  • Self-injury, suicide, venereal disease or insanity
  • Influence of intoxicating liquor or drugs
  • Death due to pregnancy or childbirth
  • Breach of law with criminal intent
  • War and nuclear group of perils
  • On duty with armed forces
  • Injury/death while participating in adventurous sports

Documents required for settlement of claims

  • Claim form
  • Doctor's report, bills in case of temporary/permanent disablement
  • Police report/post mortem report in case of accidental death
  • Leave certificate from employer in case of temporary disablement
  • Any other relevant document if any

Note: The above are only the salient features of the Policy, for complete terms and conditions please refer to Policy Wordings.


Post a Comment

Comments should be on the topic and should not be abusive. The editorial team reserves the right to review and moderate the comments posted on the site.

Comments

atulmanju

i had your policy no 2824/52588757/02/0000 from karnataka bank, allahabad. for last 3 years, i was admitted at Nazareth hospital allahabad on 24th may 2015 at around 12.30 a.m. and was discharged on 25th may 2015 in the afternoon. i gave the claim to your representative Mr. Amit Jaiswal on 2nd june 2015 the claim was of around Rs.6000/-. It was promised that the claim will be settled within 15-20 days i.e. is around 20-25 th june 2015 when i contacted your representative at Allahabad Bank civil lines allahabad then i came to know that mr. amit jaiswal has left the job. Another person Mr. Akaram helped me in tracessing the documents. After two days of his labour he found the documents in the Almira. He processed the document around 30th june 2015 since then query after query are comming. I met your Brance Manage Mr. Rahul at your ashok nagar, allahabad office. He took all the required papers in around 15th july 2015 and after about one month later around 20th august 2015 a representative of e-meditk came and again took all the photocopy of all the papers again and letter from. He went to the Nazareth hospital for verification the hospital people told him that they don't put the time of discharge of the discharge certificate as the patients the discharged generally after the doctors visit either in the morning or in the evening. the claim is of just Rs.6000/- and it seems that your company use to harass the people who don't go on your listed hospitals for cashless treatment. Till date there is query and no settlement. this shows that the company have no faith in his own staff and the staff have no faith in the company that is why the staffs are leaving the company. It seems that the company is good but the management is very very bad or worst as they are interested in their listed hospital only so that their personal interests are met. the management of the company is not interested in the welfare of the company or of company customer

subhash.p.s

I have your IOB health policy of Rs.50000 sum assured since last 3 years. Can i increase the sum assured to 1 lakh or 2 lakh during next time renewal without affecting my policy seniority. no claims during last 3 years. please reply regards

dharmenderkambojadvocate

good achivement sir

mahendra31

provided various good things about your company, However, i took health policy from IOB, Bandra-Mumbai in April 2011, but yet not received any thing including policy documents as well as Medical card. so, i presumes that your service is not up to the mark, although, you claimed for it. i am not happy with your service. with regards,

gopalbb

I have taken IOB Health Care Plus from Decccan Gymkhana BrPune on 03.07.2010. I have received two cards from TPA service provider also. But still I have received neither the policy or the receipt of the premium collected which is required at time of filing of Itax return.
Please do needful

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