Useful Information

Uni.Sompo

TPA Information

Complete Health Care Individual

Synopsis:

The Complete Healthcare Insurance is comprehensive health insurance plan that reimburses medical expenses incurred in a hospital and also the out-patient charges and provides various value added services.

Highlight:

  • Upto 13 Relationships covered in Single policy.
  • Upto 141 Day Care procedures covered.
  • Dental Treatment in case of Accidents.
  • Value added Benefits like Wellness package,HELP, Dial a Doctor, NewsLetter, 24X7 customer service.
  • Variety Of Product Options available like Critical illness,Personal Accident,Sub limits Applicability.

Benefit:

Title
Description
Room Rent Limit
No Sub limits
ICU Daily Rent Limit
No Sub limits
Pre-Hospitalization Expenses
30 Days
Post Hospitalization Expenses
60 Days
Minimum Hospitalization Period
24 Hrs
Day Care Procedure Coverage
141 Day Care Procedures covered
Additional Cover for Critical Illness
Yes (Optional)
Automatic Restoration of Sum Insured
Available on payment of additional premium
Pre-Existing Disease / Illness coverage
After continuous coverage of 3 years
Waiting Period for New Policy
One years for any illness except for accident
Co-Payment
A person who avails the option ?Treatment in tiered network‘ and does not get treated in the tiered networks has to pay a Co pay of 10%.
Free Health Checkup
health check-up coupon on every claim free renewal under Essential and Privilege Plans. And once every two claims free renewal under the Basic Plan.
Ambulance Expenses
Actuals or 1% of SI, or Rs.1000/2000/3000
Non-Allopathic Treatments
Covered, upto SI
New Born Baby Cover
Up to Basic SI from 1st Day till expiry of Policy or the child is 91 days old whichever is earlier under Essential and Privilege plans
Daily Hospitalization Allowance
Rs.200/500/1000 per day (Optional)
Donor Expenses
Covered, Upto SI
Nursing Allowance
Covered
No Claim Bonus
10% of SI, max.50%