Benefits for Elderly Parents Under Universal Sompo’s Complete Healthcare Plan

In India today, there is very little social security for its citizens. The responsibility of taking care of elderly parents inevitably falls on the shoulders of the working generation.  Along with searching for a plan for yourself, you find yourself looking for an inclusive plan that covers your family members for whom you are responsible as buying individual covers for each is far more expensive. In addition, it is difficult to manage multiple plans and often when the need comes, you find yourself going through stacks of documents trying to locate the plan taken out in the name of the person hospitalized.

Thus, it makes practical sense to purchase health insurance plan that is available as a family floater and provides coverage for conditions generally associated with old age as well.

The Comprehensive Healthcare Insurance (CHI) of Universal Sompo General Insurance is one such plan. Family under this plan includes twenty relationships including oneself and extends to the mother, father, mother-in-law, father-in-law, grandfather, grandmother, niece, nephew and others. What is more, even if all members are not staying in the same city, they can still be covered under the same policy. The policy is available in several variants, the Basic Essential, Privileged, Plus, Premier, Essential and Digi-Pro

Features

Coverage of Day Care procedures along with inpatient, pre and post hospitalization charges up to 30 and 60 days respectively from the date of admission and the date of discharge. In special cases, if documents are provided at least 5 days before hospitalization, pre-hospitalizations charges up to 60 days are payable.

Domiciliary Expenses: Expenses for treatment which generally would have required hospitalization but are treated at home, on the advice of a medical practitioner, are covered under the policy, subject to the condition that this treatment should be for a minimum of 3 days. Conditions related to asthma, bronchitis, hypertension, influenza, epilepsy, psychiatric disorders, etc. however, will not be covered for domiciliary expenses.

Outpatient Treatment: Consultations of medical practitioners as out patients is coverable up to 50%

Diagnostic Tests: If these are recommended by a medical practitioners, the tests are coverable under the policy up to 50%.

Dental Treatment:  X-Rays, composite filings, root canal treatment, amalgam and drugs prescribed by a registered Dental practitioner will also be covered up to 50%. In case it is required as a result of an accident, the CHI policy of Universal Sompo provides 100% coverage. However, these are also subject to the sub-limits specified in each personal schedule and a waiting period.

Convalescence Benefit:  A lumpsum amount is paid as a convalescence benefit, if the insured is hospitalized for a minimum of 10 days. This facility is available only once in a policy year.

Vaccinations for Post Bite Treatment: Subject to sub-limits as specified in your personal policy schedule, these expenses will also be covered.

Restore Benefit: With elderly parents and frequent hospitalizations, this benefit is especially useful. Should the Sum Insured (SI) be exhausted during any policy year, the sum insured is restored by the insurer and may be used again during the policy year. This is only available for use in inpatient hospitalization and for hospitalization for illnesses that have no relationship with the illness for which the sum insured was exhausted.

Free Medical Check Up: This is available for the persons covered for every claim free year. Costs are reimbursed in the case of the Plus, Premier, Essential and Digi-Pro. For the remaining, coupons are issued.

No Claim Bonus (NCB): If no claim has been made during a policy year, the SI will be increased by 10% the following year subject to there being no break in the policy. The NCB will be increased for every claim free year up to 50% of the SI. Should a claim be made after the provision of NCB, the SI will be decreased by 10%

Special Value Added benefits for Basic, Essential and Privileged Plans

Dial a Doctor: Services of empaneled doctors are available through a call on the helpline.

Second Opinion: Available once in a policy year, Universal Sompo will arrange a second opinion in case of diagnosis that does not require emergency hospitalization or if a surgery is recommended.

Specialist Consultation for diagnosis of Chronic Disease: A specialist consultation is arranged by Universal Sompo, if the insured is diagnosed with a chronic disease. Two follow-up sessions are also provided.

Add- on Covers

Universal Sompo Health General Insurance also provides their customers with the option to purchase add on covers as required.

Critical Illness Cover: Coverage under this add-on policy can only be availed after 90 days of its purchase.

Hospital Daily Cash: This makes available a cash amount for every day of hospitalization, for general expenses not related to the hospital bill, if the insured is hospitalized for a minimum of three days.

Pre-existing Disease Waiting Period Reduction: If this add-on is available, the waiting period for coverage of conditions related to pre-existing diseases is reduced to 12 months. This again is a useful add-on for the elderly.

To conclude, Universal Sompo General Insurance’s Complete Healthcare Insurance has several features that make it especially attractive if one has to cover elderly parents in their sixties. Depending on their state of health you may choose the plan, whether Basic, or Essential etc. and then add on the optional covers.