{"uin":"UNIHLIP25016V042425","name":"Indian Bank Health Care Plus","url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425","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":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":"Revision","kind":"product","status":"active","approved_on":"2020-05-29","withdrawn_on":null,"summary":"Indian Bank Health Care Plus is a health indemnity policy for Indian Bank customers covering hospitalisation expenses with Plan A and Plan B family options. The sum insured options range from Rs 50,000 to Rs 5,00,000, with 30 days pre-hospitalisation, 60 days post-hospitalisation and an optional personal accident death cover.","analysis":{"state":"machine","analysed_at":"2026-10-19 22:46:07.631142+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":"quote-verified","value":["Plan A","Plan B"],"display":"Plan A and Plan B","note":"From the prospectus; the policy wording does not name the plans.","quote":"An individual may cover himself! herself and his! her spouse, dependent children under Plan A of the Policy and himself, herself, his, her spouse, dependent children and dependent parents under Plan B of the policy.","sources":[{"clause":"2","heading":"Eligibility","page":1,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17494#c-2"}],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"not-stated","value":null,"display":null,"note":"The wording refers to the Policy Period as set out in the Schedule, but no fixed policy term is printed in the supplied clauses.","quote":null,"sources":[],"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 non-network cashless treatment, prior intimation is required: minimum 48 hours before planned hospitalisation and within 24 hours of admission for emergency hospitalisation. Reimbursement claims can be registered through the web portal, helpline or email, but the wording does not print a separate reimbursement intimation deadline.","display":"Non-network cashless: 48 hours before planned admission; within 24 hours of emergency admission","note":null,"quote":"Prior Intimation is required for processing cashless from non-network hospitals: ➢ Inform us (Toll Free Helpline – 1800 200 4030) minimum 48 hours before admission for planned hospitalization and with 24 hours of admission for emergency hospitalization across India. ... Step I: Visit our Web Portal to register claim or Call our Health Helpline 1800 200 4030 or email us at contactus@universalsompo.com and inform about your claim.","sources":[{"clause":null,"heading":"Insurance Ombudsman","page":19,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-insurance-ombudsman"}],"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 (viz. X-ray, ECG, Blood test etc).","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 for electronic fund transfer.","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, doctor certificate, treatment papers, discharge card, investigation reports, bills and receipts, prescriptions, NEFT/cancelled cheque, photo ID, accident MLC/FIR and KYC/address proof","note":"The wording says the list is indicative and further documents may be asked for.","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.1(I)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-i-2"},{"clause":"F.1(II)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-ii-2"},{"clause":"F.1(III)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-iii-2"},{"clause":"F.1(IV)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-iv-2"},{"clause":"F.1(V)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-v-2"},{"clause":"F.1(VI)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-vi"},{"clause":"F.1(VII)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-vii"},{"clause":"F.1(VIII)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-viii"},{"clause":"F.1(IX)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-ix"},{"clause":"F.1(X)","heading":"For accident Cases","page":21,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-x"},{"clause":"F.1(XI)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-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 shall 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 the investigation not later than 15 days from the date of submission of claim; delay beyond 15 days carries interest at 2% above the bank rate from intimation to payment.","display":"Within 15 days from submission of the claim; investigation also within 15 days","note":null,"quote":"The Company shall settle or reject a claim, as the case may be, within 15 days from the date of submission of the claim. ... 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. ... In case of delay beyond stipulated 15 days the company shall be liable to pay interest at a rate 2% above the bank rate from the date of receipt of intimation to till the date of payment.","sources":[{"clause":null,"heading":"Company’s obligations","page":21,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-companys-obligations"}],"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":["Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months","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","Specific diseases/procedures are excluded until the expiry of 12 months of continuous coverage","Expenses related to any admission primarily for diagnostics and evaluation purposes.","Expenses related to any admission primarily for enforced bed rest and not for receiving treatment.","Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions","Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex.","Expenses for cosmetic or plastic surgery or any treatment to change appearance","Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports","Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent.","Expenses incurred towards treatment in any hospital or by any Medical Practitioner or any other provider specifically excluded by the Insurer","Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof.","Dietary supplements and substances that can be purchased without prescription","Expenses related to sterility and infertility.","Treatment taken outside the geographical limits of India"],"display":"PED 36 months, initial 30 days, specified diseases 12 months, diagnostics-only admission, rest cure, obesity surgery, change of gender, cosmetic surgery, professional hazardous/adventure sports, breach of law, excluded providers, alcoholism/drug abuse, dietary supplements, sterility/infertility and treatment outside India","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 ... Expenses related to the treatment of the following listed conditions, surgeries/treatments shall be excluded until the expiry of 12 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 ... Expenses related to any admission primarily for diagnostics and evaluation purposes. ... Expenses related to any admission primarily for enforced bed rest and not for receiving treatment. ... Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions: ... Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex. ... Expenses for cosmetic or plastic surgery or any treatment to change appearance ... Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports ... Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent. ... Expenses incurred towards treatment in any hospital or by any Medical Practitioner or any other provider specifically excluded by the Insurer ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. ... Dietary supplements and substances that can be purchased without prescription ... Expenses related to sterility and infertility. ... Treatment taken outside the geographical limits of India","sources":[{"clause":"Excl01","heading":"Pre-Existing Diseases (Code- Excl01)","page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl01"},{"clause":"Excl02(a)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl02-a"},{"clause":"Excl03","heading":"First Thirty Days Waiting Period (Code- Excl03)","page":12,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl03"},{"clause":"Excl04","heading":"Investigation & Evaluation(Code- Excl04)","page":13,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl04"},{"clause":"Excl05(a)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl05-a"},{"clause":"Excl06","heading":"Obesity/ Weight Control (Code- Excl06)","page":13,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl06"},{"clause":"Excl07","heading":"Change-of-Gender Treatments: (Code- Excl07)","page":13,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl07"},{"clause":"Excl08","heading":"Cosmetic or plastic Surgery: (Code- Excl08)","page":13,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl08"},{"clause":"Excl09","heading":"Hazardous or Adventure sports: (Code- Excl09)","page":13,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl09"},{"clause":"Excl10","heading":"Breach of law: (Code- Excl10)","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl10"},{"clause":"8","heading":"Excluded Providers: (Code-Excl11)","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-8"},{"clause":"9","heading":"Treatment for, Alcoholism, drug or substance abuse or any addictive condition and","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-9"},{"clause":"11","heading":null,"page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-11"},{"clause":"14","heading":"Sterility and Infertility: (Code- Excl17)","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-14"},{"clause":"E.2","heading":"Specific Exclusions","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#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 Customer Service at Universal Sompo General Insurance Co. Ltd. or visit a branch GRO. If not satisfied or no response is received, write or email the Grievance Redressal Officer at GRO@universalsompo.com.","display":"Customer Service / Branch GRO first; then Grievance Redressal Officer at GRO@universalsompo.com","note":null,"quote":"Write to:\nCustomer Service Universal Sompo General Insurance Co.Ltd. Unit No. 601 & 602, 6th Floor, Reliable Tech Park, Thane-Belapur Road, Airoli, Navi Mumbai, Maharashtra – 400708 Email: grievance@universalsompo.com ... Visit Branch Grievance Redressal Officer (GRO) - Walk into any of our nearest branches and request to meet the GRO. ... In case, the customer is not satisfied with the decision/resolution of the above office or have not received any response, he/she may write or email/mail to:\nCustomer Service Universal Sompo General Insurance Co.Ltd. Unit No. 601 & 602, 6th Floor, Reliable Tech Park, Thane-Belapur Road, Airoli, Navi Mumbai, Maharashtra – 400708 Email ID: GRO@universalsompo.com","sources":[{"clause":null,"heading":"Resolving Issue","page":19,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-resolving-issue"},{"clause":null,"heading":"Grievance Redressal Officer","page":19,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-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":"quote-verified","value":"Choice of Sum Insured ranges from Rs 50,000 to Rs 5,00,000 in multiples of Rs 50,000.","display":"Rs 50,000 to Rs 5,00,000 in multiples of Rs 50,000","note":"From the prospectus; the wording points to the Schedule for the sum insured.","quote":"Sum Insured: Choice of Sum Insured ranges from Rs 50,000 to Rs 5,00,000 in multiples of Rs 50,000.","sources":[{"clause":null,"heading":"1. Additional Benefits under the Policy","page":4,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17494#c-1-additional-benefits-under-the-policy"}],"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":"Does not apply to covered accident claims; not applicable if the insured has continuous coverage for more than twelve months.","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.","sources":[{"clause":"Excl03","heading":"First Thirty Days Waiting Period (Code- Excl03)","page":12,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl03"}],"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":"For enhanced sum insured, the exclusion applies afresh to the increase; portability credit can reduce the waiting period.","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.","sources":[{"clause":"Excl01","heading":"Pre-Existing Diseases (Code- Excl01)","page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl01"}],"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":12},"display":"12 months","note":"If the disease/procedure falls under the PED waiting period, the longer waiting period applies.","quote":"Expenses related to the treatment of the following listed conditions, surgeries/treatments shall be excluded until the expiry of 12 months of continuous coverage, as may be the case after the date of inception of the first policy with us. This exclusion shall not be applicable for claims arising due to an accident.","sources":[{"clause":"Excl02(a)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl02-a"}],"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":["Cataract","Benign Prostatic Hypertrophy","Myomectomy, Hysterectomy","Hernia, Hydrocele","Fistula in anus, Piles","Arthritis, Gout, Rheumatism","Joint replacement unless due to accident","Sinusitis and related disorders","Stone in the urinary and biliary systems","Dilatation and Curettage","Skin and all internal tumors/cysts/nodules/polyps of any kind, including breast lumps unless malignant, adenoids and hemorrhoids","Dialysis required for renal failure","Surgery on tonsils and sinuses Gastric and duodenal ulcers"],"display":"Cataract, BPH, myomectomy/hysterectomy, hernia/hydrocele, fistula/piles, arthritis/gout/rheumatism, joint replacement, sinusitis, urinary/biliary stones, D&C, tumors/cysts/nodules/polyps, dialysis for renal failure, tonsils/sinuses surgery and gastric/duodenal ulcers","note":null,"quote":"List of specific diseases/procedures:\n• Cataract\n• Benign Prostatic Hypertrophy\n• Myomectomy, Hysterectomy\n• Hernia, Hydrocele\n• Fistula in anus, Piles\n• Arthritis, Gout, Rheumatism\n• Joint replacement unless due to accident\n• Sinusitis and related disorders\n• Stone in the urinary and biliary systems\n• Dilatation and Curettage\n• Skin and all internal tumors/cysts/nodules/polyps of any kind, including breast lumps unless malignant, adenoids and hemorrhoids\n• Dialysis required for renal failure\n• Surgery on tonsils and sinuses Gastric and duodenal ulcers","sources":[{"clause":"Excl02(f)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl02-f"}],"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 continuous months","note":"For enhanced sums insured, sixty continuous months applies from the date of enhancement only on the enhanced limits.","quote":"After completion of sixty continuous months of coverage (including portability and migration) in health insurance policy, no policy and claim shall be contestable by the insurer on grounds of non-disclosure, misrepresentation, except on grounds of established fraud. This period of sixty continuous months is called as moratorium period.","sources":[{"clause":"F.1(b)(ii)","heading":null,"page":18,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-b-ii"}],"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 has the option to port the policy to other insurers as per IRDAI portability guidelines and can transfer credits for sum insured, no claim bonus, specific waiting periods, PED waiting period and moratorium period.","display":"Yes, portability to other insurers with continuity credits","note":null,"quote":"The insured person will have the option to port the policy to other insurers as per IRDAI guidelines related to portability. ... The policyholder is entitled to transfer the credits gained to the extent of the Sum Insured, No Claim Bonus, specific waiting periods, waiting period for pre-existing disease, Moratorium period etc from the Existing Insurer to the Acquiring Insurer in the previous policy","sources":[{"clause":"F.1(b)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-b-2"}],"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":"quote-verified","value":true,"display":"Yes, renewable except on grounds of established fraud or non-disclosure or misrepresentation","note":"The wording does not print a maximum renewal age.","quote":"A health insurance policy shall be renewable except on grounds of established fraud or non-disclosure or misrepresentation by the insured.","sources":[{"clause":"F.1(b)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-b-2"}],"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":"quote-verified","value":"Renewal loading cannot be based on individual policy claim experience; loadings on renewal premium must be at portfolio level. Renewal also cannot be denied because claims were made in preceding policy years.","display":"No individual claim-based loading; portfolio-level loading only","note":null,"quote":"An insurer shall not deny the renewal of a health insurance policy on the ground that the insured had made a claim or claims in the preceding policy years ... For individual products, the loadings on renewal premium shall be at portfolio and not based upon any individual policy claim experience.","sources":[{"clause":"F.1(b)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-b-2"}],"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":"quote-verified","value":["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)","Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof.(Code- Excl12)","Treatments received in heath hydros, nature cure clinics, spas or similar establishments or private beds registered as a nursing home attached to such establishments","Dietary supplements and substances that can be purchased without prescription","Refractive Error:(Code- Excl15)","Unproven Treatments:(Code- Excl16)","Sterility and Infertility: (Code- Excl17)","Treatment taken outside the geographical limits of India","War (whether declared or not) and war like occurrence","Nuclear, chemical or biological attack or weapons"],"display":"Excl04 to Excl17 plus outside-India treatment, disclosed excluded ICD codes, war and nuclear/chemical/biological attack","note":"Excl18 maternity is printed as a 9-month waiting-period exclusion and is not listed here as a permanent exclusion.","quote":"Excl04 Investigation & Evaluation(Code- Excl04) ... Excl05 Rest Cure, Rehabilitation and Respite Care (Code- Excl05) ... Excl06 Obesity/ Weight Control (Code- Excl06) ... Excl07 Change-of-Gender Treatments: (Code- Excl07) ... Excl08 Cosmetic or plastic Surgery: (Code- Excl08) ... Excl09 Hazardous or Adventure sports: (Code- Excl09) ... Excl10 Breach of law: (Code- Excl10) ... 8 Excluded Providers: (Code-Excl11) ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and\nconsequences thereof.(Code- Excl12) ... Treatments received in heath hydros, nature cure clinics, spas or similar\nestablishments or private beds registered as a nursing home attached to such establishments ... Dietary supplements and substances that can be purchased without prescription ... Refractive Error:(Code- Excl15) ... Unproven Treatments:(Code- Excl16) ... Sterility and Infertility: (Code- Excl17) ... Treatment taken outside the geographical limits of India ... War (whether declared or not) and war like occurrence ... Nuclear, chemical or biological attack or weapons","sources":[{"clause":"Excl04","heading":"Investigation & Evaluation(Code- Excl04)","page":13,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl04"},{"clause":"Excl05","heading":"Rest Cure, Rehabilitation and Respite Care (Code- Excl05)","page":13,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl05"},{"clause":"Excl06","heading":"Obesity/ Weight Control (Code- Excl06)","page":13,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl06"},{"clause":"Excl07","heading":"Change-of-Gender Treatments: (Code- Excl07)","page":13,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl07"},{"clause":"Excl08","heading":"Cosmetic or plastic Surgery: (Code- Excl08)","page":13,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl08"},{"clause":"Excl09","heading":"Hazardous or Adventure sports: (Code- Excl09)","page":13,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl09"},{"clause":"Excl10","heading":"Breach of law: (Code- Excl10)","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-excl10"},{"clause":"8","heading":"Excluded Providers: (Code-Excl11)","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-8"},{"clause":"9","heading":"Treatment for, Alcoholism, drug or substance abuse or any addictive condition and","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-9"},{"clause":"10","heading":"Treatments received in heath hydros, nature cure clinics, spas or similar","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-10"},{"clause":"11","heading":null,"page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-11"},{"clause":"12","heading":"Refractive Error:(Code- Excl15)","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-12"},{"clause":"13","heading":"Unproven Treatments:(Code- Excl16)","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-13"},{"clause":"14","heading":"Sterility and Infertility: (Code- Excl17)","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-14"},{"clause":"E.2","heading":"Specific Exclusions","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-e-2"}],"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 policyholder may cancel the policy at any time during the term by giving 7 days' written notice. For terms up to one year, the insurer refunds proportionate premium for the unexpired period if no claim has been made; for terms over one year, it refunds premium for unexpired policy years where risk coverage has not commenced.","display":"7 days' notice; proportionate refund for unexpired period if no claim for terms up to one year","note":null,"quote":"The policyholder may cancel his/her policy at any time during the term, by giving 7 days notice in writing. ... refund proportionate premium for unexpired policy period, if the term of policy upto one year and there is no claim (s) made during the policy period. ... refund premium for the unexpired policy period, in respect of policies with term more than 1 year and risk coverage for such policy years has not commenced.","sources":[{"clause":"F.1(d)","heading":null,"page":16,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-d"},{"clause":"F.1(a)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-a-2"},{"clause":"F.1(b)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#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":"conflicting","value":"The policy wording covers hospitalisation in India and excludes treatment outside the geographical limits of India.","display":"India only","note":"The prospectus says: \"Expenses on hospitalization in Bhutan and Nepal are also covered but Cashless service is not available.\" The policy wording prevails.","quote":"hospitalization for medical/surgical treatment in any Nursing Home/ Hospital in India as defined in the policy ... Treatment taken outside the geographical limits of India","sources":[{"clause":"B","heading":"PREAMBLE","page":1,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-b"},{"clause":"E.2","heading":"Specific Exclusions","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-e-2"},{"clause":"3","heading":"What is covered under the Policy? 1. Basic Coverage","page":1,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17494#c-3"}],"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":"30 days","note":"Available for policies with a term of one year or more.","quote":"A period of 30 days (from the date of receipt of the policy document) is available to the policyholder to review the terms and conditions of the policy.","sources":[{"clause":"F.1(b)(ii)","heading":null,"page":18,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-b-ii"}],"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":"15 days monthly; 30 days quarterly/half-yearly/annual","note":"Value and norm use the non-monthly grace period; monthly instalments have fifteen days.","quote":"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, to pay the premium.","sources":[{"clause":"F.1(a)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-a-3"}],"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":"quote-verified","value":"Indian Bank account holders with minimum age 18 years are eligible to take the policy. Dependent children below 3 months can be covered with at least one parent; the documents do not state a maximum entry age for the account holder.","display":"Minimum 18 years for account holders; dependent children below 3 months with at least one parent; maximum entry age not stated","note":"From the prospectus.","quote":"All account holders of Indian Bank with the minimum age of 18 years(Adult) are eligible to take the Policy. ... Dependent children below 3 months can be covered with at least one parent under the Policy.","sources":[{"clause":"2","heading":"Eligibility","page":1,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17494#c-2"}],"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","quarterly","half-yearly","annual"],"display":"Monthly, quarterly, half-yearly and annual","note":null,"quote":"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, to pay the premium.","sources":[{"clause":"F.1(a)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-a-3"}],"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":["Personal Accident- Death only benefit"],"display":"Personal Accident Death Cover for additional premium","note":"The prospectus says the PA cover is not available for parents.","quote":"In case you have opted for additional cover against Personal Accident- Death only benefit and have paid additional premium, We will pay a lump sum amount as mentioned in the table below in the event of Accidental Death of the Insured","sources":[{"clause":null,"heading":"ADDITIONAL EXTENSION","page":30,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-additional-extension"}],"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":"If the premium is paid in instalments during the policy period, coverage is available for the grace period. The general definition also states that coverage need not be available during a period for which no premium is received.","display":"Coverage during grace period if premium is paid in instalments during the policy period","note":null,"quote":"Coverage need not be available during the period for which no premium is received. ... Provided the insurers shall offer coverage during the grace period, if the premium is paid in instalments during the policy period. ... If the premium is paid in instalments during the policy period, coverage will be available for the grace period also.","sources":[{"clause":null,"heading":"Grace period","page":4,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-grace-period"},{"clause":"F.1(c)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-f-1-c-2"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for the hospital room, or the room category allowed. If you take a costlier room, other bills can be cut in proportion.","status":"not-stated","value":null,"display":null,"note":"The wording covers room, boarding and nursing expenses but does not print a per-day room rent amount or percentage limit in the supplied clauses.","quote":null,"sources":[],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"not-stated","value":null,"display":null,"note":"No room category such as shared room or single private room is stated in the supplied clauses.","quote":null,"sources":[],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"not-stated","value":null,"display":null,"note":"The supplied clauses define ICU charges but do not state a per-day ICU limit.","quote":null,"sources":[],"law":[]},{"key":"proportionate_deduction","label":"Proportionate deduction","section":"Limits and co-pay","meaning":"If you choose a room above your limit, whether the insurer reduces associated charges (doctor fees, tests, procedures) by the same proportion.","status":"not-stated","value":null,"display":null,"note":"No proportionate deduction rule for taking a room above entitlement is printed in the supplied clauses.","quote":null,"sources":[],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"conflicting","value":"A 20% co-payment applies on each and every claim of an insured person who is above 55 years of age under the policy.","display":"20% on each claim for insured persons above 55 years","note":"An older CIS says: \"There is no Co-payment applicable under policy.\" The policy wording states the 20% co-payment and prevails.","quote":"A co-payment of 20% shall be applicable on each and every claim of Insured Person who is above 55 years of age under the Policy","sources":[{"clause":"7(d)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-7-d"},{"clause":"7","heading":"Cost of Health Checkup: Insured Person shall","page":2,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17491#c-7"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"An amount of each claim or each year that you bear before the policy pays.","status":"quote-verified","value":"There is no deductible applicable under the policy.","display":"No deductible","note":"The policy wording does not print a deductible clause; the CIS states there is no deductible.","quote":"*There is no Deductible applicable under policy,","sources":[{"clause":"Excl13","heading":null,"page":3,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17695#c-excl13"}],"law":[]},{"key":"disease_sublimits","label":"Disease or procedure sub-limits","section":"Limits and co-pay","meaning":"Caps on what is paid for named treatments (cataract, knee replacement...), even if the sum insured is higher.","status":"quote-verified","value":["Maternity and newborn treatment: up to 5% of the sum insured","Hospitalization expenses for treatment of any one illness under agreed package charges of the Hospital/ Nursing Home: restricted to 75% of the Sum Insured"],"display":"Maternity/newborn up to 5% of sum insured; agreed package charges for any one illness restricted to 75% of sum insured","note":null,"quote":"The medical expenses on treatment arising from or traceable to pregnancy, childbirth and expenses on the treatment of the newly born child up to 5% of the sum insured ... The Hospitalization expenses incurred for treatment of any one illness under agreed package charges of the Hospital/ Nursing Home will be restricted to 75% of the Sum Insured.","sources":[{"clause":"4","heading":null,"page":10,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-4"},{"clause":"7(b)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-7-b"}],"law":[]},{"key":"pre_hospitalisation","label":"Pre-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days before admission that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Nursing expenses during pre-hospitalisation are considered only if a qualified nurse is employed on the advice of the attending medical practitioner for the duration specified.","quote":"The Medical Expenses incurred in the 30 days immediately prior before the date You were Hospitalized","sources":[{"clause":"5","heading":"The Medical Expenses incurred in the 30 days immediately prior before the date You","page":10,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-5"}],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days after discharge that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":60},"display":"60 days","note":"Nursing expenses during post-hospitalisation are considered only if a qualified nurse is employed on the advice of the attending medical practitioner for the duration specified.","quote":"The Medical Expenses incurred in the 60 days immediately after Your date of discharge from Hospital","sources":[{"clause":"6","heading":"The Medical Expenses incurred in the 60 days immediately after Your date of","page":10,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-6"}],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital (chemotherapy, dialysis, cataract) and whether all or only listed ones are covered.","status":"quote-verified","value":"Hospitalisation expenses normally require at least 24 hours, but the time limit does not apply to listed treatments such as dialysis, chemotherapy, radiotherapy, eye surgery, lithotripsy, D&C and tonsillectomy, or to treatment requiring hospitalisation and specialised hospital infrastructure where technological advances require less than 24 hours.","display":"Covered for specified and qualifying less-than-24-hour treatments","note":null,"quote":"Expenses on hospitalization for a minimum period of 24 hours are admissible. However, this time limit is not applied to specific treatments, i.e. Dialysis, Chemotherapy, Radiotherapy, Eye Surgery, Lithotripsy (Kidney stone removal), D&C, Tonsillectomy ... This condition will also not apply in case of stay in Hospital for less than 24 hours provided (a) the treatment is such that it necessitates hospitalization and the procedure involves specialized infrastructural facilities available in hospitals (b) due to technological advances hospitalization is required for less than 24 hours only.","sources":[{"clause":"7(f)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-7-f"}],"law":[]},{"key":"domiciliary","label":"Treatment at home","section":"Cover","meaning":"Whether treatment at home is covered when hospital admission is not possible or a doctor advises it.","status":"not-stated","value":null,"display":null,"note":"Domiciliary Hospitalization is defined, but the supplied benefit clauses do not state a domiciliary treatment cover.","quote":null,"sources":[],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"not-stated","value":null,"display":null,"note":"AYUSH terms are defined, but the supplied benefit clauses do not state an AYUSH treatment cover or limit.","quote":null,"sources":[],"law":[{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 1","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 2","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 1","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II A.I(1)","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"modern_treatments","label":"Modern treatments","section":"Cover","meaning":"Robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and the like, and any cap on them.","status":"not-stated","value":null,"display":null,"note":"The supplied clauses do not state coverage or caps for modern treatments such as robotic surgery, immunotherapy, oral chemotherapy or stem cell therapy.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 2","url":"https://indiainsurances.com/law/irdai-health-mc-2024"}]},{"key":"organ_donor","label":"Organ donor expenses","section":"Cover","meaning":"Whether the donor's hospital costs for an organ transplant are paid.","status":"quote-verified","value":"The policy covers cost of organ harvesting as part of hospitalisation medical expenses.","display":"Cost of organ harvesting covered","note":"The wording uses \"Cost of Organ harvesting\" and does not separately describe all donor expenses.","quote":"The Medical Expenses incurred on Anesthesia, Blood, Oxygen, Operation Theatre, Surgical Appliances, Medicines and Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs, Cost of Organ harvesting and similar expenses.","sources":[{"clause":"3","heading":null,"page":10,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-3"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Ambulance charges in connection with an admissible claim are covered up to Rs.1000/- per policy period.","display":"Rs.1000/- per policy period","note":null,"quote":"Ambulance charges in connection with any admissible claim limited to Rupees 1000/- per policy period.","sources":[{"clause":null,"heading":"Additional benefits","page":10,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-additional-benefits"}],"law":[]},{"key":"restoration","label":"Restoration of sum insured","section":"Cover","meaning":"Whether the sum insured is refilled after it is used up in a year, how much, how often, and whether it works for the same illness.","status":"not-stated","value":null,"display":null,"note":"No restoration or refill of sum insured benefit is printed in the supplied clauses.","quote":null,"sources":[],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"not-stated","value":null,"display":null,"note":"No rate or maximum for a no-claim/cumulative bonus is printed in the supplied clauses, though continuity credits refer to No Claim Bonus.","quote":null,"sources":[],"law":[]},{"key":"consumables","label":"Consumables and non-medical items","section":"Cover","meaning":"Gloves, PPE, syringes and other items hospitals bill that standard policies exclude; whether this policy pays them.","status":"quote-verified","value":"Items listed in Annexure A List I are not covered, including items such as gloves, mask and other non-medical items. Other listed items are to be subsumed into room charges, procedure charges or costs of treatment rather than separately paid.","display":"Non-medical items in List I not covered; some items subsumed into room/procedure/treatment costs","note":null,"quote":"List I — Items for which coverage is not available in the policy ... 56 | GLOVES ... 60 | MASK ... List II — Items that are to be subsumed into Room Charges ... List III — Items that are to be subsumed into Procedure Charges ... List IV — Items that are to be subsumed into costs of treatment","sources":[{"clause":"Annexure A","heading":null,"page":22,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-annexure-a"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"quote-verified","value":"Maternity expenses for pregnancy and childbirth are covered up to 5% of the sum insured, subject to the treatment not being carried out before completion of 9 months from commencement of the policy.","display":"Covered up to 5% of sum insured after 9 months","note":null,"quote":"The medical expenses on treatment arising from or traceable to pregnancy, childbirth and expenses on the treatment of the newly born child up to 5% of the sum insured, subject to such treatment not being carried out before the completion of 9 months from the commencement of the policy.","sources":[{"clause":"4","heading":null,"page":10,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-4"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"Expenses on treatment of the newly born child are covered up to 5% of the sum insured; the policy defines a new born baby as a baby born during the policy period and aged up to 90 days.","display":"Covered up to 5% of sum insured; new born baby aged upto 90 days","note":"The maternity/newborn benefit is subject to completion of 9 months from policy commencement.","quote":"expenses on the treatment of the newly born child up to 5% of the sum insured ... New Born Baby means baby born during the Policy Period and is aged upto 90 days.","sources":[{"clause":"4","heading":null,"page":10,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-4"},{"clause":null,"heading":"New Born Baby","page":6,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-new-born-baby"}],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"not-stated","value":null,"display":null,"note":"The supplied clauses do not state a cover for in-patient treatment of mental illness.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"quote-verified","value":"The insured person is entitled to reimbursement of the cost of medical checkup once at the end of a block of every three claim free policies, not exceeding 1% of the average Basic Sum Insured during the block.","display":"Once after every three claim-free policies, up to 1% of average Basic Sum Insured","note":null,"quote":"Insured Person shall be entitled for reimbursement of cost of medical checkup once at the end of a block of every three claim free Policies. The reimbursement shall not exceed the amount equal to 1% of the average Basic Sum Insured during the block of three claim free Policies.","sources":[{"clause":"7","heading":"Cost of Health Checkup: Insured Person shall be entitled for reimbursement of cost","page":10,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-7"}],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"not-stated","value":null,"display":null,"note":"OPD treatment is defined, but the supplied benefit clauses do not state OPD consultation, tests or medicine cover.","quote":null,"sources":[],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"not-stated","value":null,"display":null,"note":"No city or zone based premium or treatment co-pay is printed in the supplied clauses.","quote":null,"sources":[],"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 for treatment carried out in network hospitals/nursing homes through the nominated TPA. Cashless treatment can also be availed from non-network hospitals with prior intimation, including 48 hours before planned hospitalisation and within 24 hours of emergency admission.","display":"Network cashless available; non-network cashless with prior intimation","note":null,"quote":"Cashless facility for the medical treatment carried out in Network Hospital/ Nursing home is available through our nominated Third Party Administrator (TPA) ... You can now avail cashless facility from non-network hospitals. ... Prior Intimation is required for processing cashless from non-network hospitals: ➢ Inform us (Toll Free Helpline – 1800 200 4030) minimum 48 hours before admission for planned hospitalization and with 24 hours of admission for emergency hospitalization across India.","sources":[{"clause":"7(c)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-7-c"},{"clause":null,"heading":"Insurance Ombudsman","page":19,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-insurance-ombudsman"}],"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 processed through Universal Sompo's in-house health claims management, while the wording also states that network hospital cashless facility is available through the nominated Third Party Administrator.","display":"Universal Sompo in-house health claims management; nominated TPA for network cashless","note":"The same wording mentions both the nominated TPA and Universal Sompo's in-house health claims management.","quote":"Cashless facility for the medical treatment carried out in Network Hospital/ Nursing home is available through our nominated Third Party Administrator (TPA) ... Follow below steps to avail Cashless facility through our In house Health Claims Management: ... Universal Sompo Health team will review and judge the admissibility of the Cashless Request as per Policy Terms & Conditions","sources":[{"clause":"7(c)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-7-c"},{"clause":null,"heading":"Insurance Ombudsman","page":19,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492#c-insurance-ombudsman"}],"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, family floater available","note":"The prospectus also describes Plan A and Plan B family compositions.","quote":"this unique family floater gives you the flexibility of taking one policy that covers the entire family under a single sum insured.","sources":[{"clause":null,"heading":"INDIAN BANK HEALTH CARE PLUS PROSPECTUS","page":1,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17494#c-indian-bank-health-care-plus-prospectus"}],"law":[]}],"documents":[{"kind":"wording","label":"Indian Bank Health Care Plus - Policy Wordings","pages":31,"fetched_at":"2026-10-17 20:05:12+00","source_url":"https://www.universalsompo.com/assets/file/bancassurance/indianbank-policy-wordings.pdf","url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17492"},{"kind":"wording","label":"Indian Bank Health care plus (IRDAI copy)","pages":19,"fetched_at":"2026-10-20 02:38:09+00","source_url":"https://irdai.gov.in/documents/37343/931203/UNIHLIP21044V022021_2020-2021.pdf/8ceb5b65-a706-4c53-0994-66b5b93cd71a?version=1.1&t=1668156051413&download=true","url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/28999"},{"kind":"prospectus","label":"Indian Bank Health Care Plus - Prospectus / Brochure","pages":19,"fetched_at":"2026-10-17 20:05:13+00","source_url":"https://www.universalsompo.com/assets/file/bancassurance/indianbank-prospectus.pdf","url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17494"},{"kind":"cis","label":"Indian Bank Health Care Plus - CIS","pages":12,"fetched_at":"2026-10-17 20:05:15+00","source_url":"https://www.universalsompo.com/assets/file/bancassurance/cis-indian-bank-healthcare-plus.pdf","url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17491"},{"kind":"cis","label":"Indian Bank Health Care Plus - CIS","pages":13,"fetched_at":"2026-10-17 20:13:37+00","source_url":"https://www.universalsompo.com/assets/file/cis/cis-indian-bank-healthcare-plus.pdf","url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425/document/17695"}],"versions":[{"uin":"UNIHLIP21044V022021","version":null,"approved_on":null},{"uin":"UNIHLIP25016V042425","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":"Indian Bank Health Care Plus (UIN UNIHLIP25016V042425), IndiaInsurances, https://indiainsurances.com/policy/universal-sompo-general-insurance/indian-bank-health-care-plus-unihlip25016v042425"}