{"uin":"UNIHLGP24027V032324","name":"Group Health Insurance","url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324","insurer":{"slug":"universal-sompo-general-insurance","name":"Universal Sompo General Insurance Company Limited","url":"https://indiainsurances.com/insurer/universal-sompo-general-insurance"},"line":"health","category":"group-health","category_name":"Group health","irdai_type":null,"kind":"product","status":"active","approved_on":"2013-09-30","withdrawn_on":null,"summary":"This is a group health indemnity policy with hospitalization, top-up and super top-up base cover options. The standard waiting periods are 30 days for initial illness claims, 36 months for pre-existing diseases and 24/36 months for listed specific conditions, with many extensions and add-ons available for additional premium.","analysis":{"state":"machine","analysed_at":"2026-10-19 23:00:46.43963+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"not-stated","value":null,"display":null,"note":"No named base plan variants are stated in the policy wording; Silver, Gold, Platinum and Diamond appear under optional/restricted critical illness cover, not as base product plans.","quote":null,"sources":[],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"The policy period is normally annual, for 12 months from the date of commencement.","display":"Annual period [of 12 months]","note":null,"quote":"The policy period shall normally be an annual period [of 12 months] starting from the date of commencement of policy.","sources":[{"clause":"4","heading":"Policy Period","page":1,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-4"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"quote-verified","value":"For emergency hospitalisation, notice with full particulars must be sent within 24 hours from the date emergency hospitalisation is required or before discharge, whichever is earlier. For planned hospitalisation, notice must be sent at least 48 hours before admission.","display":"Emergency: within 24 hours or before discharge, whichever is earlier; planned: at least 48 hours prior","note":null,"quote":"Notice with full particulars shall be sent to the Company as under: ii Within 24 hours from the date of emergency hospitalization required or before the Insured Person’s discharge from Hospital, whichever is earlier. iii At least 48 hours prior to admission in Hospital in case of a planned Hospitalization.","sources":[{"clause":null,"heading":"3. Notification of Claim","page":52,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-3-notification-of-claim"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"quote-verified","value":["Claim form duly filled and signed by the Insured","Certificate from attending medical practitioner mentioning the first symptoms and date of occurrence of ailment","All treatment papers of current ailment including previous treatment papers if any","Original Discharge Card from the hospital, Indoor Case Papers","All original medical Investigation reports","Original hospital bill and receipts","Original bills of chemist, medical practitioner, medical investigation, etc. supported by the doctor’s prescription","NEFT details and Personalized cancelled cheque/ Passbook copy in the name of proposer","Valid Photo ID Proof of the patient","For accident Cases: MLC (Medico Legal Certificate) / FIR (First Information report)","Copy of latest valid address proof of proposer like electricity bill, water bill or telephone bill or updated bank statement along with copy of PAN card & Aadhaar Card as per AML/KYC Norms"],"display":"Claim form, medical certificate, treatment papers, discharge card, investigation reports, bills and receipts, NEFT details, photo ID, accident MLC/FIR, address proof and PAN/Aadhaar","note":"The list is stated to be indicative and further documents may be requested.","quote":"I) Claim form duly filled and signed by the Insured ... II) Certificate from attending medical practitioner mentioning the first symptoms and date of occurrence of ailment. ... III) All treatment papers of current ailment including previous treatment papers if any. ... IV) Original Discharge Card from the hospital, Indoor Case Papers. ... V) All original medical Investigation reports (viz. X-ray, ECG, Blood test etc). ... VI) Original hospital bill and receipts. ... VII) Original bills of chemist, medical practitioner, medical investigation, etc. supported by the doctor’s prescription. ... VIII) NEFT details and Personalized cancelled cheque/ Passbook copy in the name of proposer for electronic fund transfer. ... IX) Valid Photo ID Proof of the patient. ... X) For accident Cases: MLC (Medico Legal Certificate) / FIR (First Information report). ... XI) Copy of latest valid address proof of proposer like electricity bill, water bill or telephone bill or updated bank statement along with copy of PAN card & Aadhaar Card as per AML/KYC Norms.","sources":[{"clause":"F.2(I)","heading":null,"page":52,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-f-2-i-2"},{"clause":"F.2(II)","heading":null,"page":52,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-f-2-ii"},{"clause":"F.2(III)","heading":null,"page":52,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-f-2-iii"},{"clause":"F.2(IV)","heading":null,"page":52,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-f-2-iv"},{"clause":"F.2(V)","heading":null,"page":52,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-f-2-v"},{"clause":"F.2(VI)","heading":null,"page":52,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-f-2-vi"},{"clause":"F.2(VII)","heading":null,"page":52,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-f-2-vii"},{"clause":"F.2(VIII)","heading":null,"page":53,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-f-2-viii"},{"clause":"F.2(IX)","heading":null,"page":53,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-f-2-ix"},{"clause":"F.2(X)","heading":"For accident Cases","page":53,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-f-2-x"},{"clause":"F.2(XI)","heading":null,"page":53,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-f-2-xi"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"quote-verified","value":"The company says it will settle or reject a claim within 15 days from the date of submission of the claim. If investigation is warranted, it must initiate and complete it at the earliest and in any case not later than 15 days from submission of claim.","display":"Within 15 days from submission of the claim","note":"For delay beyond the stipulated 15 days, the company states it is liable to pay interest at 2% above the bank rate from intimation to payment.","quote":"i The Company shall settle or reject a claim, as the case may be, within 15 days from the date of submission of the claim. ... iii However, where the circumstances of a claim warrant an investigation in the opinion of the Company, it shall initiate and complete such investigation at the earliest in any case not later than 15 days from the date of submission of claim.","sources":[{"clause":null,"heading":"5. Claim Settlement (provision for Penal Interest)","page":53,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-5-claim-settlement-provision-for-penal-interest"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"quote-verified","value":["Pre-Existing Diseases excluded until 36 months","Specific listed conditions, surgeries/treatments excluded until 24/36 months","Illness within 30 days from the first policy commencement date except accident","Investigation & Evaluation","Rest Cure, Rehabilitation and Respite Care","Obesity/ Weight Control","Change-of-Gender Treatments","Cosmetic or plastic Surgery","Hazardous or Adventure sports","Breach of law","Excluded Providers","OPD treatment","Treatment taken outside the geographical limits of India","War, nuclear, chemical or biological attack or weapons"],"display":"PED 36 months, specific diseases 24/36 months, first 30 days illness, investigation/evaluation, rest cure, obesity, gender change, cosmetic surgery, adventure sports, breach of law, excluded providers, OPD, outside India, war/nuclear/chemical/biological attack","note":"Several exclusions may be changed only if the relevant extension is bought for additional premium.","quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with us. ... Expenses related to the treatment of the following listed conditions, surgeries/treatments shall be excluded until the expiry of 24/36 months of continuous coverage ... Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident ... Excl04 Investigation & Evaluation(Code- Excl04) ... Rest Cure, Rehabilitation and Respite Care (Code- Excl05) ... Obesity/ Weight Control(Code- Excl06) ... Change-of-Gender Treatments: (Code- Excl07) ... Cosmetic or plastic Surgery: (Code- Excl08) ... Hazardous or Adventure sports: (Code- Excl09) ... Breach of law: (Code- Excl10) ... Excluded Providers: (Code-Excl11) ... 1. Any expenses incurred on OPD treatment. 2. Treatment taken outside the geographical limits of India. ... 29. War (whether declared or not) and war like occurrence or invasion ... 30. Nuclear, chemical or biological attack or weapons","sources":[{"clause":"Excl01","heading":"Pre-Existing Diseases (Code- Excl01)","page":37,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-excl01"},{"clause":"Excl02(a)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-excl02-a"},{"clause":"Excl03","heading":"First Thirty Days Waiting Period (Code- Excl03)","page":38,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-excl03"},{"clause":"Excl04","heading":"Investigation & Evaluation(Code- Excl04)","page":39,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-excl04"},{"clause":"Excl05","heading":"Rest Cure, Rehabilitation and Respite Care (Code- Excl05)","page":39,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-excl05"},{"clause":"Excl06","heading":"Obesity/ Weight Control(Code- Excl06)","page":39,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-excl06"},{"clause":"Excl07","heading":"Change-of-Gender Treatments: (Code- Excl07)","page":39,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-excl07"},{"clause":"Excl08","heading":"Cosmetic or plastic Surgery: (Code- Excl08)","page":39,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-excl08"},{"clause":"Excl09","heading":"Hazardous or Adventure sports: (Code- Excl09)","page":40,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-excl09"},{"clause":"Excl10","heading":"Breach of law: (Code- Excl10)","page":40,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-excl10"},{"clause":"Excl11","heading":"Excluded Providers: (Code-Excl11)","page":40,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-excl11"},{"clause":"E.2","heading":"Specific Exclusions","page":41,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-e-2"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"quote-verified","value":"First write to Universal Sompo customer service. If the response does not meet expectations, write to the Grievance Cell, and if still not satisfied or no response is received within 15 working days, write or email the Chief Grievance Redressal Officer before approaching the Insurance Ombudsman.","display":"Step 1 Customer Service; Step 2 Grievance Cell; Step 3 Chief Grievance Redressal Officer","note":null,"quote":"Step 1: Contact us ... Write us at: ... Step 2: Grievance Cell ... If the resolution you received, does not meet your expectations, you can directly write to our Grievance Id. ... Step 3: Chief Grievance Redressal Officer ... In case, you are not satisfied with the decision/resolution of the above office or have not received any response within 15 working days, you may write or email to:","sources":[{"clause":null,"heading":"Step 1: Contact us","page":48,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-step-1-contact-us"},{"clause":null,"heading":"Step 2: Grievance Cell","page":48,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-step-2-grievance-cell"},{"clause":null,"heading":"Step 3: Chief Grievance Redressal Officer","page":48,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-step-3-chief-grievance-redressal-officer"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"not-stated","value":null,"display":null,"note":"The base policy wording points to the Policy Schedule for the Sum Insured. Annexure IV lists Top Up and Super Top Up sum insured amounts, but the base cover amount options are not stated.","quote":null,"sources":[],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"This exclusion does not apply to accident claims if covered. On payment of additional premium, the waiting period can be waived or modified to 15 days.","quote":"Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered. ... 30 days waiting period applicable for any claims in relation to a Hospitalization of the Insured Person including any Medical Expenses incurred there of: a) Is waived off. Or, b) Is modified to 15 days.","sources":[{"clause":"Excl03","heading":"First Thirty Days Waiting Period (Code- Excl03)","page":38,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-excl03"},{"clause":"9.3","heading":"Initial Waiting Period for Hospitalization Waiver","page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-3"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"quote-verified","value":{"unit":"months","amount":36},"display":"36 months","note":"The PED waiting period can be waived on payment of additional premium under the PED Waiting Period Waiver extension.","quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with us. ... on payment of additional premium, waiting period applicable to all Pre- Existing Diseases for each Insured Person before benefits are payable under the Policy is waived off.","sources":[{"clause":"Excl01","heading":"Pre-Existing Diseases (Code- Excl01)","page":37,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-excl01"},{"clause":"9.1","heading":"Pre-Existing Disease Waiting Period Waiver","page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-1"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"quote-verified","value":{"unit":"months","amount":24},"display":"24/36 months","note":"The 36 months tier applies to joint replacement, age-related osteoarthritis and osteoporosis, ARMD and neuro degenerative disorders. On payment of additional premium, the specific waiting period can be waived or modified to 12 months.","quote":"Expenses related to the treatment of the following listed conditions, surgeries/treatments shall be excluded until the expiry of 24/36 months of continuous coverage, as may be the case after the date of inception of the first policy with the insurer. ... i 24 Months waiting period ... ii 36 Months waiting period ... specific waiting period applicable for any claims in relation to listed conditions, surgeries/treatments as mentioned under Exclusion Code 02: a) Is waived off, Or b) Is modified to 12 months.","sources":[{"clause":"Excl02(a)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-excl02-a"},{"clause":"Excl02(e)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-excl02-e"},{"clause":"9.2","heading":"Specific Waiting Period Waiver","page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"quote-verified","value":["Benign ENT disorders","Tonsillectomy","Adenoidectomy","Mastoidectomy","Tympanoplasty","Hysterectomy","All internal and external benign tumours, cysts, polyps of any kind, including benign breast lumps","Benign prostate hypertrophy","Cataract and age related eye ailments","Gastric/ Duodenal Ulcer","Gout and Rheumatism","Hernia of all types","Hydrocele","Non Infective Arthritis","Piles, Fissures and Fistula in anus","Pilonidal sinus, Sinusitis and related disorders","Prolapse inter Vertebral Disc and Spinal Diseases unless arising from accident","Calculi in urinary system, Gall Bladder and Bile duct, excluding malignancy.","Varicose Veins and Varicose Ulcers","Treatment for joint replacement unless arising from accident","Age-related Osteoarthritis & Osteoporosis","Age-related Macular Degeneration (ARMD),","All Neuro degenerative disorders"],"display":"24 months list includes benign ENT disorders, hysterectomy, cataract, hernia, piles and others; 36 months list includes joint replacement, osteoarthritis/osteoporosis, ARMD and neuro degenerative disorders","note":null,"quote":"i 24 Months waiting period 1. Benign ENT disorders 2. Tonsillectomy 3. Adenoidectomy 4. Mastoidectomy 5. Tympanoplasty 6. Hysterectomy 7. All internal and external benign tumours, cysts, polyps of any kind, including benign breast lumps 8. Benign prostate hypertrophy 9. Cataract and age related eye ailments 10. Gastric/ Duodenal Ulcer 11. Gout and Rheumatism 12. Hernia of all types 13. Hydrocele 14. Non Infective Arthritis 15. Piles, Fissures and Fistula in anus 16. Pilonidal sinus, Sinusitis and related disorders 17. Prolapse inter Vertebral Disc and Spinal Diseases unless arising from accident 18. Calculi in urinary system, Gall Bladder and Bile duct, excluding malignancy. 19. Varicose Veins and Varicose Ulcers ii 36 Months waiting period 1. Treatment for joint replacement unless arising from accident 2. Age-related Osteoarthritis & Osteoporosis 3. Age-related Macular Degeneration (ARMD), 4. All Neuro degenerative disorders","sources":[{"clause":"Excl02(e)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-excl02-e"}],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"quote-verified","value":{"unit":"months","amount":60},"display":"Sixty months","note":"For enhanced sum insured, the sixty continuous months run from the date of enhancement on the enhanced limits.","quote":"After completion of Sixty continuous months under this policy no look back would be applied. This period of Sixty months is called as moratorium period. ... After the expiry of Moratorium Period no claim under this policy shall be contestable except for proven fraud and permanent exclusions specified in the policy contract.","sources":[{"clause":null,"heading":"12. Moratorium","page":47,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-12-moratorium"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"quote-verified","value":"The insured person can port the policy to other insurers under IRDAI portability guidelines, applying at least 30 days before but not earlier than 60 days from the renewal date, and can get accrued continuity benefits in waiting periods if continuously covered without lapses.","display":"Can port to other insurers with accrued continuity benefits in waiting periods","note":null,"quote":"The insured person will have the option to port the policy to other insurers as per IRDAI guidelines related to portability at least 30 days before, but not earlier than 60 days from the policy renewal date as per IRDAI guidelines related to portability. lf such person is presently covered and has been continuously covered without any lapses under any health insurance policy with an lndian General/Health insurer, the proposed insured person will get the accrued continuity benefits in waiting periods as per IRDAI guidelines on portability.","sources":[{"clause":null,"heading":"7. Portability","page":45,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-7-portability"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"not-stated","value":null,"display":null,"note":"The wording says the policy may be renewed by mutual consent every year, but does not state lifelong renewal or no maximum renewal age.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"not-stated","value":null,"display":null,"note":"The wording states no-claim bonus/discount reductions after claims, but does not state whether premium is loaded at renewal because a claim was made.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"quote-verified","value":"The insured may cancel by giving 7 days’ written notice. If no claim has been made, the company refunds premium proportionately based on unexpired days; if a claim has been made, the premium for the remaining policy year(s) will be refunded on cancellation.","display":"7 days’ written notice; proportionate refund for unexpired days if no claim","note":null,"quote":"The Insured may cancel this Policy by giving 7 days’ written notice, and in such an event, the Company shall refund premium for the unexpired Policy Period as per the rates detailed below. ... If no claim has been made during the policy period, a proportionate refund of the premium will be issued based on the number of unexpired days. ... If the claim has been made in the current policy year, the premium for the remaining policy year(s) will be refunded on cancellation","sources":[{"clause":null,"heading":"5. Cancellation","page":45,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-5-cancellation"},{"clause":"F.1(a)","heading":null,"page":45,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-f-1-a-2"},{"clause":"F.1(b)","heading":null,"page":45,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-f-1-b-2"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"quote-verified","value":"Medical treatment must be taken in India only, except where Global Coverage applies. The Global Coverage extension reimburses medical expenses incurred outside India for not more than 180 consecutive days if diagnosis was made in India, the insured is referred abroad and prior approval is taken.","display":"India only, except Global cover for outside India up to 180 consecutive days","note":null,"quote":"All medical treatment for the purpose of this insurance will have to be taken in India only (except in case of Global cover). ... The Company will reimburse for Medical Expenses of the Insured Person incurred outside India for not more than 180 consecutive days up to the sum insured, provided that a] the diagnosis was made in India and referred by Medical Practitioner for which the insured member(s) travels abroad for treatment and b] prior approval from the Company is taken before travelling abroad for treatment.","sources":[{"clause":null,"heading":"5. Territorial Limit","page":50,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-5-territorial-limit"},{"clause":"9.12","heading":"Global Coverage","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-12"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"thirty days","note":"The clause states this applies to new individual health insurance policies and not to renewals or at the time of porting/migrating.","quote":"The Free Look Period shall be applicable on new individual health insurance policies and not on renewals or at the time of porting/migrating the policy. The insured person shall be allowed free look period of thirty days from date of receipt of the policy document to review the terms and conditions of the policy, and to return the same if not acceptable.","sources":[{"clause":null,"heading":"13. Free Look Period","page":47,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-13-free-look-period"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"thirty (30) days","note":"For instalment premiums, the grace period is fifteen days for monthly instalments and thirty days for quarterly, half-yearly or annual instalments.","quote":"A Grace Period of thirty (30) days is allowed for Renewal of the policy. ... The grace period of fifteen days (where premium is paid on a monthly instalments) and thirty days (where premium is paid in quarterly/half-yearly/annual instalments) is available on the premium due date","sources":[{"clause":null,"heading":"8. Renewal of Policy","page":46,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-8-renewal-of-policy"},{"clause":"F.1(b)(i)","heading":null,"page":46,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-f-1-b-i"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"not-stated","value":null,"display":null,"note":"The overall youngest and oldest entry ages for buying the policy are not stated. The wording only defines dependent children as between 3 months and 30 years.","quote":null,"sources":[],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"quote-verified","value":["monthly instalments","quarterly instalments","half-yearly instalments","annual instalments"],"display":"monthly, quarterly, half-yearly or annual instalments","note":"The wording also says premium must be paid in full in advance, unless instalment payment is opted as mentioned in the Policy Schedule / Certificate of Insurance.","quote":"Premium for the policy must be paid in full in advance. ... The grace period of fifteen days (where premium is paid on a monthly instalments) and thirty days (where premium is paid in quarterly/half-yearly/annual instalments) is available on the premium due date","sources":[{"clause":"5","heading":"Payment of Premium","page":2,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-5"},{"clause":"F.1(b)(i)","heading":null,"page":46,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-f-1-b-i"}],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"quote-verified","value":["Pre-Existing Disease Waiting Period Waiver","Specific Waiting Period Waiver","Initial Waiting Period for Hospitalization Waiver","Obesity/ Weight Control Expenses Extension","Change-of-Gender Treatments Expenses Extension","Cosmetic or Plastic Surgery Expenses Extension","Hazardous or Adventure Sports Expenses Extension","Sterility and Infertility Treatment Expenses Extension","Maternity Expenses Extension with Baby-Day-One Cover","OPD Expenses Extension","Maternity OPD Expenses Extension","Global Coverage","Non-medical Expenses Cover","Restoration Condition Waiver","Critical Illness","Additional Ambulance Charges","Corporate Buffer","Organ Donor Expenses","Daily Cash Cover","Restoration of Sum Insured","Wellness Benefits","Emergency Assistance Services","Accident Benefit Cover","Dental Treatment Cover","Medically Advised Support Devices","Benefit Cover for Pandemic/Epidemic Diseases (including COVID-19)","External Congenital Ailment Cover","Cost of Health Check up","Hospital Cash to Parents","Funeral Expenses","No Claim Bonus","Second Opinion","Home Care Treatment","Loss of Income","EMI Protection","Errors & Ommission"],"display":"Extensions in Section 9 and add-ons in Section 10, including waiting-period waivers, maternity, OPD, global coverage, critical illness, accident benefit and other add-ons","note":"The extension clauses state they are on payment of additional premium; Section 10 is titled Add-Ons.","quote":"9.1 Pre-Existing Disease Waiting Period Waiver ... 9.2 Specific Waiting Period Waiver ... 9.3 Initial Waiting Period for Hospitalization Waiver ... 9.4 Obesity/ Weight Control Expenses Extension ... 9.5 Change-of-Gender Treatments Expenses Extension ... 9.6 Cosmetic or Plastic Surgery Expenses Extension ... 9.7 Hazardous or Adventure Sports Expenses Extension ... 9.8 Sterility and Infertility Treatment Expenses Extension ... 9.9 Maternity Expenses Extension with Baby-Day-One Cover ... 9.10 OPD Expenses Extension ... 9.11 Maternity OPD Expenses Extension ... 9.12 Global Coverage ... 9.13 Non-medical Expenses Cover ... 9.14 Restoration Condition Waiver ... 10 Add-Ons ... 10.1 Critical Illness ... 10.2 Additional Ambulance Charges ... 10.3 Corporate Buffer ... 10.4 Organ Donor Expenses ... 10.5 Daily Cash Cover ... 10.6 Restoration of Sum Insured ... 10.7 Wellness Benefits ... 10.8 Emergency Assistance Services ... 10.9 Accident Benefit Cover ... 10.10 Dental Treatment Cover ... 10.11 Medically Advised Support Devices ... 10.12 Benefit Cover for Pandemic/Epidemic Diseases (including COVID-19) ... 10.13 External Congenital Ailment Cover ... 10.14 Cost of Health Check up ... 10.15 Hospital Cash to Parents ... 10.16 Funeral Expenses ... 10.17 No Claim Bonus ... 10.18 Second Opinion ... 10.19 Home Care Treatment ... 10.20 Loss of Income ... 10.21 EMI Protection ... 10.22 Errors & Ommission","sources":[{"clause":"9.1","heading":"Pre-Existing Disease Waiting Period Waiver","page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-1"},{"clause":"9.2","heading":"Specific Waiting Period Waiver","page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-2"},{"clause":"9.3","heading":"Initial Waiting Period for Hospitalization Waiver","page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-3"},{"clause":"9.4","heading":"Obesity/ Weight Control Expenses Extension","page":12,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-4"},{"clause":"9.5","heading":"Change-of-Gender Treatments Expenses Extension","page":12,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-5"},{"clause":"9.6","heading":"Cosmetic or Plastic Surgery Expenses Extension","page":12,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-6"},{"clause":"9.7","heading":"Hazardous or Adventure Sports Expenses Extension","page":12,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-7"},{"clause":"9.8","heading":"Sterility and Infertility Treatment Expenses Extension","page":13,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-8"},{"clause":"9.9","heading":"Maternity Expenses Extension with Baby-Day-One Cover","page":13,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-9"},{"clause":"9.10","heading":"OPD Expenses Extension","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-10"},{"clause":"9.11","heading":"Maternity OPD Expenses Extension","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-11"},{"clause":"9.12","heading":"Global Coverage","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-12"},{"clause":"9.13","heading":"Non-medical Expenses Cover","page":15,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-13"},{"clause":"9.14","heading":"Restoration Condition Waiver","page":15,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-14"},{"clause":"10","heading":"Add-Ons","page":15,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10"},{"clause":"10.1","heading":"Critical Illness","page":15,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-1"},{"clause":"10.2","heading":"Additional Ambulance Charges","page":20,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-2"},{"clause":"10.3","heading":"Corporate Buffer","page":21,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-3"},{"clause":"10.4","heading":"Organ Donor Expenses","page":21,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-4"},{"clause":"10.5","heading":"Daily Cash Cover","page":21,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-5"},{"clause":"10.6","heading":"Restoration of Sum Insured","page":22,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-6"},{"clause":"10.7","heading":"Wellness Benefits","page":22,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-7"},{"clause":"10.8","heading":"Emergency Assistance Services","page":24,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-8"},{"clause":"10.9","heading":"Accident Benefit Cover","page":25,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-9"},{"clause":"10.10","heading":"Dental Treatment Cover","page":29,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-10"},{"clause":"10.11","heading":"Medically Advised Support Devices","page":30,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-11"},{"clause":"10.12","heading":"Benefit Cover for Pandemic/Epidemic Diseases (including COVID-19)","page":30,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-12"},{"clause":"10.13","heading":"External Congenital Ailment Cover","page":30,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-13"},{"clause":"10.14","heading":"Cost of Health Check up","page":31,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-14"},{"clause":"10.15","heading":"Hospital Cash to Parents","page":31,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-15"},{"clause":"10.16","heading":"Funeral Expenses","page":31,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-16"},{"clause":"10.17","heading":"No Claim Bonus","page":31,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-17"},{"clause":"10.18","heading":"Second Opinion","page":32,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-18"},{"clause":"10.19","heading":"Home Care Treatment","page":32,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-19"},{"clause":"10.20","heading":"Loss of Income","page":33,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-20"},{"clause":"10.21","heading":"EMI Protection","page":33,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-21"},{"clause":"10.22","heading":"Errors & Ommission","page":33,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-22"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"For renewal grace period, coverage is not available for the period for which no premium is received and the insurer has no liability for claims arising during that period. If premium is paid in instalments, coverage will be available during the grace period.","display":"Renewal: no coverage during unpaid grace period; instalments: coverage available during grace period","note":null,"quote":"Coverage is not available for the period for which no premium is received and Insurer has no liability for the claims arising during this period. ... If the premium is paid in installments during the policy period, coverage will be available during such Grace period.","sources":[{"clause":null,"heading":"8. Renewal of Policy","page":46,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-8-renewal-of-policy"},{"clause":"F.1(b)(ii)","heading":null,"page":46,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-f-1-b-ii"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"Daily room limit, if any.","status":"quote-verified","value":"The base wording covers room rent, boarding and nursing expenses, with any specific limit stated in the Policy Schedule or Certificate of Insurance. If Limited Hospitalization Cover applies, room rent has a per day upper limit up to 5% of Sum Insured and ICU/ICCU expenses have a per day upper limit up to 10% of Sum Insured.","display":"As per schedule; Limited Hospitalization Cover: room rent up to 5% of SI per day, ICU/ICCU up to 10% of SI per day","note":"The actual base room-rent sub-limit, if any, is schedule-dependent.","quote":"Room Rent, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home. ... Limit under any specific cover 8.a. (i) to 8.a.(v) if any is as mentioned in the Policy Schedule / Certificate of Insurance. ... Room Rent, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home – With a per day upper limit up to 5% of Sum Insured ii) Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses - With a per day upper limit up to 10%of Sum Insured","sources":[{"clause":null,"heading":"8.a. Hospitalization","page":8,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-8-a-hospitalization"},{"clause":"8(III)(c)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-8-iii-c"},{"clause":"11.3","heading":"Limited Hospitalization Cover","page":34,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-11-3"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Childbirth cover and any waiting period.","status":"quote-verified","value":"Maternity expenses are excluded unless the Maternity Expenses Extension with Baby-Day-One Cover is bought for additional premium. Under that extension, childbirth and miscarriage/lawful medical termination expenses are covered up to the schedule limit, either without waiting period or with a 9 months waiting period.","display":"Excluded unless optional maternity extension is bought; extension can be without waiting period or with 9 months waiting period","note":null,"quote":"Maternity Expenses (Code – Excl 18) i Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; ii Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period. ... 9.9 Maternity Expenses Extension with Baby-Day-One Cover ... a) Without waiting period. ... b) With waiting period of 9 months. ... Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; ii Expenses towards miscarriage and the related lawful medical termination of pregnancy during the policy period. are included under the scope of cover up to the limit specified in Policy Schedule.","sources":[{"clause":"15","heading":"Maternity Expenses (Code – Excl 18)","page":41,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-15"},{"clause":"9.9","heading":"Maternity Expenses Extension with Baby-Day-One Cover","page":13,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-9"},{"clause":"9.9(a)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-9-a"},{"clause":"9.9(b)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-9-b"}],"law":[]},{"key":"ped_cover_group","label":"Pre-existing diseases","section":"Waiting periods","meaning":"Whether pre-existing diseases are covered from day one for the group.","status":"quote-verified","value":"Pre-existing diseases are not covered from day one under the base wording; PED treatment and direct complications are excluded until 36 months of continuous coverage. Day-one PED cover is available only if the Pre-Existing Disease Waiting Period Waiver extension is bought for additional premium.","display":"No, excluded until 36 months unless PED waiting period waiver is bought","note":null,"quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with us. ... on payment of additional premium, waiting period applicable to all Pre- Existing Diseases for each Insured Person before benefits are payable under the Policy is waived off.","sources":[{"clause":"Excl01","heading":"Pre-Existing Diseases (Code- Excl01)","page":37,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-excl01"},{"clause":"9.1","heading":"Pre-Existing Disease Waiting Period Waiver","page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-9-1"}],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"quote-verified","value":"Cashless facility is available through the in-house Health Claims Management process at network hospitals, where Universal Sompo reviews the cashless request and communicates admissibility. Cashless Anywhere can also be availed from non-network hospitals with prior intimation.","display":"Cashless at network hospitals; Cashless Anywhere from non-network hospitals with prior intimation","note":null,"quote":"Procedure for Cashless claims: Follow below steps to avail Cashless facility through our In house Health Claims Management: ... Visit Network hospital and show your Health Serve Card issued by the company ... Universal Sompo Health team will review and judge the admissibility of the Cashless Request as per Policy Terms &Conditions ... Cashless Anywhere You can now avail cashless facility from non-network hospitals. ... Prior Intimation is required for processing cashless from non-network hospitals:","sources":[{"clause":null,"heading":"G. Claims Procedure","page":50,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-g-claims-procedure"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"quote-verified","value":"Claims are handled through Universal Sompo's in-house Health Claims Management.","display":"In house Health Claims Management","note":null,"quote":"Follow below steps to avail Cashless facility through our In house Health Claims Management: ... Follow below steps to avail reimbursement facility through our In house Health Claims Management:","sources":[{"clause":null,"heading":"G. Claims Procedure","page":50,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-g-claims-procedure"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"quote-verified","value":true,"display":"Yes, Individual or Floater Sum Insured","note":null,"quote":"Maximum liability of the Company under all such Claims during each Policy Year shall be the Sum Insured (Individual or Floater) opted specified in the Schedule. ... In case of a Family floater the Cumulative Bonus so applied will only be available in respect of claims made by those Insured Members(s)who were Insured Member(s)in the immediate preceding claim free Policy Year and continue to be Insured Member(s) in the subsequent Policy Year.","sources":[{"clause":"6","heading":"Operative Clause","page":2,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-6"},{"clause":"10.17(a)","heading":null,"page":31,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834#c-10-17-a"}],"law":[]}],"documents":[{"kind":"wording","label":"Group Health Insurance Policy - Policy Wordings","pages":94,"fetched_at":"2026-10-17 20:05:38+00","source_url":"https://www.universalsompo.com/assets/file/group-health-insurance-policy/policy-wording.pdf","url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17512"},{"kind":"wording","label":"Group Health Insurance - Policy Wordings","pages":84,"fetched_at":"2026-10-17 20:17:00+00","source_url":"https://www.universalsompo.com/assets/file/group-health-insurance/group-health-insurance-policy-wordings.pdf","url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17834"},{"kind":"wording","label":"Group Health Insurance Policy (IRDAI copy)","pages":19,"fetched_at":"2026-10-20 02:24:19+00","source_url":"https://irdai.gov.in/documents/37343/931203/Group+Health+Insurance+Policy_2013-09-30.pdf/acc6d3ea-e83d-093e-7336-48ec9141af3d?version=1.1&t=1668248000500&download=true","url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/28242"},{"kind":"prospectus","label":"Group Health Insurance Policy - Prospectus / Brochure","pages":62,"fetched_at":"2026-10-17 20:05:30+00","source_url":"https://www.universalsompo.com/assets/file/group-health-insurance-policy/prospectus.pdf","url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324/document/17503"}],"versions":[{"uin":"IRDA/NL-HLT/USGI/P-H/V.I/70/13-14","version":null,"approved_on":null},{"uin":"UNIHLGP26043V062526","version":null,"approved_on":null},{"uin":"UNIHLGP24027V032324","version":null,"approved_on":null}],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"Universal Sompo General Insurance official website","url":"https://www.universalsompo.com/","note":"Buy directly from the insurer."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"insurer","name":"Claims","url":"https://www.universalsompo.com/claims/","note":null},{"purpose":"claim","kind":"insurer","name":"Motor claim intimation","url":"https://www.universalsompo.com/claimintimation/","note":null},{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"insurer","name":"Grievance redressal","url":"https://www.universalsompo.com/resourse-grievance-redressal/","note":null},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"renew","kind":"insurer","name":"Renew now","url":"https://www.universalsompo.com/renew-now/","note":null}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"Group Health Insurance (UIN UNIHLGP24027V032324), IndiaInsurances, https://indiainsurances.com/policy/universal-sompo-general-insurance/group-health-insurance-unihlgp24027v032324"}