India’s Universal Health Insurance Scheme

The Universal Health Insurance scheme is available to groups of 100 or more families. The policy provides for reimbursement of medical expenses up to Rs.30000/- towards hospitalisation floated amongst the members of the family, death cover due to an accident for Rs.25000 to the earning head of the family and compensation due to loss of earning head of the family at Rs.50/- per day upto a maximum of 15 days, after a waiting period of three days, when the earning head of the family is hospitalised.

The Universal Health Insurance scheme is available to groups of 100 or more families. The policy provides for reimbursement of medical expenses up to Rs.30000/- towards hospitalisation floated amongst the members of the family, death cover due to an accident for Rs.25000 to the earning head of the family and compensation due to loss of earning head of the family at Rs.50/- per day upto a maximum of 15 days, after a waiting period of three days, when the earning head of the family is hospitalised. This is a key scheme within the Indian insurance industry.[br]

The premium under the policy is Rs.1/- per day (i.e. Rs.365/- per annum) for an individual, Rs.1.50 per day for a family of five limited to spouse and children (i.e. Rs.548 per annum), and Rs.2/- per day (i.e. Rs. 730 per annum) for covering dependent parents within the overall family size of seven. A subsidy of Rs. 100 per year goes towards annual premiums for families living below the poverty line is also provided under the scheme.

For the purpose of this policy “hospital” means:[br]

• Any Hospital/Nursing home registered with the local authorities and under the supervision of a registered and qualified Medical practitioner.
• Hospital/ Nursing Home run by Government.
• Enlisted hospitals run by NGOs/ Trusts/ selected private hospitals with fixed schedule of charges.
• Hospitalisation should be for a minimum period of 24 hours. However, this time limit is not applied to some specific treatments and also where due to technological advancement hospitalisation for 24 hours may not be required.

Main Exclusions:

• All pre-existing diseases.
• Corrective, cosmetic or aesthetic dental surgery or treatment.
• Cost of spectacles, contact lens and hearing aid.
• Primarily diagnostic expenses not related to sickness/injury.
• Treatment for Pregnancy, Childbirth, Miscarriage, abortions etc.

Age Limitations:
This policy covers people between the age of 3 months to 65 years.

Floater Basis:
The benefit of family will operate on floater basis i.e. the total reimbursement of Rs. 30,000/- can be avalied of individually or collectively by members of the family.

For further details please refer the Prospectus or the Policy Document issued by the Insurance Company.