{"uin":"UNIHLIP25030V012425","name":"Supreme Healthcare Policy","url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425","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":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"Supreme Healthcare Policy is a health indemnity policy with individual or floater sum insured from 5L to 6CR and policy term of 1/2/3 years. It has a 30-day initial waiting period, 36-month pre-existing disease waiting period, 24-month named ailment waiting period, no base room rent or ICU limit, 50% cumulative bonus up to 100%, and unlimited automatic recharge.","analysis":{"state":"machine","analysed_at":"2026-10-19 22:54:52.802746+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"not-stated","value":null,"display":null,"note":"The documents describe cover types and optional benefits, but do not name separate plan variants.","quote":null,"sources":[],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"1/2/3 Years","display":"1/2/3 Years","note":null,"quote":"Policy Term | 1/2/3 Years | 1/2/3 Years","sources":[{"clause":"1","heading":"Eligibility","page":1,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17495#c-1"}],"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":"The company must be notified within 48 hours from the date of occurrence of the event. For emergency hospitalization, notice is immediately and within 48 hours of hospitalization commencing or before discharge; for planned hospitalization, notice is at least 48 hours prior to planned admission.","display":"Within 48 hours; planned hospitalization at least 48 hours prior","note":null,"quote":"the Company shall be notified with full particulars within 48 hours from the date of occurrence of event either at the Company’s call center or in writing. ... In case of an Emergency Hospitalization, the Company shall be notified either at the Company’s call center or in writing immediately and in any event within 48 hours of Hospitalization commencing or before the Insured Person’s discharge from Hospital. ... In case of an Planned Hospitalization, the Company shall be notified either at the Company’s call center or in writing at least 48 hours prior to planned date of admission to Hospital","sources":[{"clause":null,"heading":"6.1.4. Claims Intimation","page":41,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-6-1-4-claims-intimation"}],"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":["Duly filled and signed Claim form by the Insured Person","Copy of Photo ID and address proof of Insured Person","Medical Practitioner’s first consultation paper and referral letter advising Hospitalization","Medical Practitioner’s prescription advising drugs or diagnostic tests or consultations","Original numbered bills, receipts and discharge summary from the Hospital/Medical Practitioner","Original numbered bills from licensed pharmacy/chemists","Original pathological/diagnostic test reports/radiology reports and payment receipts","Operation Theatre Notes(if applicable)","Emergency Notes, Initial Assessment Sheet and Indoor case papers(if applicable)","Original investigation test reports and payment receipts supported by Doctor’s reference slip","MLC/FIR report, Post Mortem Report if applicable and conducted","Ambulance Receipt","Any other document as required by the Company to assess the Claim, in case fraud is suspected"],"display":"Claim form, ID/address proof, medical papers, bills, reports, OT/emergency notes if applicable, MLC/FIR/post-mortem if applicable, ambulance receipt and other documents if fraud is suspected","note":null,"quote":"1. Duly filled and signed Claim form by the Insured Person;\n2. Copy of Photo ID and address proof of Insured Person;\n3. Medical Practitioner’s first consultation paper and referral letter advising Hospitalization;\n4. Medical Practitioner’s prescription advising drugs or diagnostic tests or consultations;\n5. Original numbered bills, receipts and discharge summary from the Hospital/Medical Practitioner;\n6. Original numbered bills from licensed pharmacy/chemists;\n7. Original pathological/diagnostic test reports/radiology reports and payment receipts;\n8. Operation Theatre Notes(if applicable);\n9. Emergency Notes, Initial Assessment Sheet and Indoor case papers(if applicable);\n10. Original investigation test reports and payment receipts supported by Doctor’s reference slip;\n11. MLC/FIR report, Post Mortem Report if applicable and conducted;\n12. Ambulance Receipt;\n13. Any other document as required by the Company to assess the Claim, in case fraud is suspected.","sources":[{"clause":null,"heading":"6.1.5. Documents to be submitted for registration of Claim","page":41,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-6-1-5-documents-to-be-submitted-for-registration"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"quote-verified","value":"The company says it shall settle or reject a claim within 15 days of intimation on receipt of all necessary documents or information. It then makes payment within 7 days from receipt of acceptance of the settlement offer.","display":"Settle or reject within 15 days of intimation on receipt of all necessary documents; pay within 7 days after acceptance","note":null,"quote":"The Company shall settle or reject any Claim within 15 days of intimation on receipt of all the necessary documents / information as required for settlement of such Claim and sought by the Company. The Company shall provide the Policyholder / Insured Person an offer of settlement of Claim and upon acceptance of such offer by the Policyholder / Insured Person the Company shall make payment within 7 days from the date of receipt of such acceptance.","sources":[{"clause":"15(c)","heading":null,"page":43,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-15-c-8"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"quote-verified","value":["Pre-Existing Diseases: Code- Excl01","Named Ailment Waiting Period: Code- Excl02","30-day waiting period- Code- Excl03","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)","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)","Unproven Treatments: (Code- Excl16)","Sterility and Infertility: (Code- Excl17)","Maternity: (Code Excl18)"],"display":"Waiting periods, investigation and evaluation, rest cure, obesity surgery outside conditions, change of gender, cosmetic surgery, hazardous sports, breach of law, excluded providers, substance abuse, unproven treatments, sterility/infertility and maternity","note":null,"quote":"Pre-Existing Diseases: Code- Excl01 ... Named Ailment Waiting Period: Code- Excl02 ... 30-day waiting period- Code- Excl03 ... 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) ... 5 Cosmetic or plastic Surgery: (Code- Excl08) ... 6 Hazardous or Adventure sports: (Code- Excl09) ... 7 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) ... 13 Unproven Treatments: (Code- Excl16) ... 14 Sterility and Infertility: (Code- Excl17) ... 15 Maternity: (Code Excl18)","sources":[{"clause":"4.1(a)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-4-1-a"},{"clause":"4.1(d)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-4-1-d"},{"clause":"4.1(f)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-4-1-f"},{"clause":"Excl04","heading":"Investigation & Evaluation: (Code- Excl04)","page":23,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-excl04"},{"clause":"Excl05","heading":"Rest Cure, rehabilitation and respite care: (Code- Excl05)","page":23,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-excl05"},{"clause":"Excl06","heading":"Obesity/ Weight Control: (Code- Excl06)","page":23,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-excl06"},{"clause":"Excl07","heading":"Change-of-Gender treatments: (Code- Excl07)","page":24,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-excl07"},{"clause":"5","heading":"Cosmetic or plastic Surgery: (Code- Excl08)","page":24,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-5"},{"clause":"6","heading":"Hazardous or Adventure sports: (Code- Excl09)","page":24,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-6"},{"clause":"7","heading":"Breach of law: (Code- Excl10)","page":24,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-7"},{"clause":"8","heading":"Excluded Providers: (Code- Excl11)","page":24,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-8"},{"clause":"9","heading":"Treatment for Alcoholism, drug or substance abuse or any addictive condition and","page":24,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-9"},{"clause":"13","heading":"Unproven Treatments: (Code- Excl16)","page":25,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-13"},{"clause":"14","heading":"Sterility and Infertility: (Code- Excl17)","page":25,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-14"},{"clause":"15","heading":"Maternity: (Code Excl18)","page":25,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-15"}],"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., Unit No. 601 & 602, 6th Floor, Reliable Tech Park, Thane-Belapur Road, Airoli, Navi Mumbai, Maharashtra – 400708, Email grievance@universalsompo.com, or visit a branch Grievance Redressal Officer. If not satisfied or no response is received, write to Customer Service at the same address on GRO@universalsompo.com before the Ombudsman route.","display":"Customer Service / branch GRO first; then GRO@universalsompo.com if not satisfied","note":null,"quote":"Resolving Issue Write to:\nCustomer Service Universal Sompo General Insurance Co.Ltd.\nUnit No. 601 & 602, 6th Floor, Reliable Tech Park,\nThane-Belapur Road, Airoli, Navi Mumbai,\nMaharashtra – 400708\nEmail: 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\nnot received any response, he/she may write or email/mail to:\nCustomer Service\nUniversal Sompo General Insurance Co.Ltd. Unit No. 601 & 602, 6th Floor, Reliable Tech Park,\nThane-Belapur Road, Airoli, Navi Mumbai,\nMaharashtra – 400708\nEmail ID: GRO@universalsompo.com","sources":[{"clause":null,"heading":"5.1.16. Grievances","page":31,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-5-1-16-grievances"}],"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":"Individual / Floater Sum Insured is available under the Policy. Sum Insured – <<5L - 6CR>>.","display":"5L - 6CR","note":null,"quote":"*Individual / Floater Sum Insured is available under the Policy. Sum Insured – <<5L - 6CR>>","sources":[{"clause":"Row 4","heading":"Sum Insured (Basis) (Along with amount)","page":1,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17496#c-row-4"}],"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 accident claims, and does not apply if the insured person 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":"4.1(a)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-4-1-a-4"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"quote-verified","value":{"unit":"months","amount":36},"display":"36 months","note":"The optional PED Wait Period Modification can modify the applicable 36 months to a specific time period mentioned in the Policy Schedule.","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 insurer.","sources":[{"clause":"4.1(a)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-4-1-a-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"quote-verified","value":{"unit":"months","amount":24},"display":"24 months","note":"The optional Named Ailment Wait Period Modification can modify the applicable 24 months to a specific time period mentioned in the Policy Schedule.","quote":"Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage, as may be the case after the date of inception of the first policy with the Company. This exclusion shall not be applicable for claims arising due to an accident.","sources":[{"clause":"4.1(a)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-4-1-a-3"}],"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":["Any treatment related to Arthritis (if non-infective), Osteoarthritis and Osteoporosis, Gout, Rheumatism, Spinal Disorders, Joint Replacement Surgery, Arthroscopic Knee Surgeries/ACL Reconstruction/Meniscal and Ligament Repair","Surgical treatments for Benign ear, nose and throat (ENT) disorders and surgeries (including but not limited to Adenoidectomy, Mastoidectomy, Tonsillectomy and Tympanoplasty), Nasal Septum Deviation, Sinusitis and related disorders","Benign Prostatic Hypertrophy","Cataract","Dilatation and Curettage","Fissure / Fistula in anus, Hemorrhoids / Piles, Pilonidal Sinus, Gastric and Duodenal Ulcers","Surgery of Genito-urinary system unless necessitated by malignancy","All types of Hernia & Hydrocele","Hysterectomy for menorrhagia or Fibromyoma or prolapse of uterus unless necessitated by malignancy","Internal tumours , skin tumours, cysts, nodules, polyps including breast lumps (each of any kind) unless malignant","Kidney Stone / Ureteric Stone / Lithotripsy / Gall Bladder Stone","Myomectomy for fibroids","Varicose veins and varicose ulcers","Parkinson's or Alzheimer's disease or Dementia"],"display":"Arthritis/joint and spinal disorders, ENT disorders, BPH, cataract, D&C, fissure/fistula/piles/ulcers, genito-urinary surgery, hernia/hydrocele, hysterectomy, tumours/cysts/nodules/polyps, stones, myomectomy, varicose veins/ulcers, Parkinson's/Alzheimer's/dementia","note":null,"quote":"1. Any treatment related to Arthritis (if non-infective), Osteoarthritis and Osteoporosis, Gout, Rheumatism, Spinal Disorders, Joint Replacement Surgery, Arthroscopic Knee Surgeries/ACL Reconstruction/Meniscal and Ligament Repair\n2. Surgical treatments for Benign ear, nose and throat (ENT) disorders and surgeries (including but not limited to Adenoidectomy, Mastoidectomy, Tonsillectomy and Tympanoplasty), Nasal Septum Deviation, Sinusitis and related disorders\n3. Benign Prostatic Hypertrophy\n4. Cataract\n5. Dilatation and Curettage\n6. Fissure / Fistula in anus, Hemorrhoids / Piles, Pilonidal Sinus, Gastric and Duodenal Ulcers\n7. Surgery of Genito-urinary system unless necessitated by malignancy\n8. All types of Hernia & Hydrocele\n9. Hysterectomy for menorrhagia or Fibromyoma or prolapse of uterus unless necessitated by malignancy\n10. Internal tumours , skin tumours, cysts, nodules, polyps including breast lumps (each of any\nkind) unless malignant\n11. Kidney Stone / Ureteric Stone / Lithotripsy / Gall Bladder Stone\n12. Myomectomy for fibroids\n13. Varicose veins and varicose ulcers\n14. Parkinson's or Alzheimer's disease or Dementia","sources":[{"clause":"4.1(f)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-4-1-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 runs 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":null,"heading":"5.1.12. Moratorium Period","page":30,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-5-1-12-moratorium-period"}],"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, with accrued continuity benefits in waiting periods if continuously covered without lapses. Credits can be transferred for sum insured, no claim bonus, specific waiting periods, PED waiting period and moratorium period.","display":"Can port to other insurers with accrued continuity benefits","note":null,"quote":"The insured person will have the option to port the policy to other insurers as per IRDAI guidelines related to portability at least 30 days before, but not earlier than 60 days from the policy renewal date as per IRDAI guidelines related to portability. lf such person is presently covered and has been continuously covered without any lapses under any health insurance policy with an Indian General/ Health insurer, the proposed insured person will get the accrued continuity benefits in waiting periods as per IRDAI guidelines on portability. A Policyholder has the choice to port his/ her policies from one Insurer to another. 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":null,"heading":"5.1.9. Portability","page":29,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-5-1-9-portability"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"quote-verified","value":true,"display":"Yes, adult exit age is Lifelong","note":"Child exit age is 25 Years.","quote":"Exit Age | Exit Age | Adult: Lifelong\nChild: 25 Years ... A health insurance policy is renewable provided the product is not withdrawn, except in case of established fraud or non-disclosure or misrepresentation by the Insured.","sources":[{"clause":"1","heading":"Eligibility","page":1,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17495#c-1"},{"clause":null,"heading":"5.1.10. Renewal of Policy","page":29,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-5-1-10-renewal-of-policy"}],"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":"No loading shall apply on renewals based on individual claims experience.","display":"No loading on renewals based on individual claims experience","note":null,"quote":"No loading shall apply on renewals based on individual claims experience.","sources":[{"clause":"Excl18(v)","heading":null,"page":20,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17496#c-excl18-v"}],"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":["Excl04 Investigation & Evaluation","Excl05 Rest Cure, rehabilitation and respite care","Excl06 Obesity/ Weight Control","Excl07 Change-of-Gender treatments","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","Dietary supplements and substances that can be purchased without prescription","Refractive Error: (Code- Excl15)","Unproven Treatments: (Code- Excl16)","Sterility and Infertility: (Code- Excl17)","Maternity: (Code Excl18)","Any item or condition or treatment specified in List of Non-Medical Items","Taking part or is supposed to participate in a naval, military, air force operation or aviation in a professional or semi-professional nature","Treatment taken from anyone who is not a Medical Practitioner","routine eye examinations and ear examinations, dentures, artificial teeth","external prosthesis, corrective devices, external durable medical equipment","Alopecia wigs and/or toupee and all hair or hair fall treatment and products","external Congenital Anomaly","mental retardation","Circumcision unless necessary for treatment of an Illness or as may be necessitated due to an Accident","All preventive care","Artificial life maintenance","Non-Allopathic Treatment, Hydrotherapy, Acupuncture, Reflexology, Chiropractic treatment or treatment related to any unrecognized systems of medicine","War","Act of self-destruction or self-inflicted Injury, attempted suicide or suicide while sane or insane","Any charges incurred to procure documents","Personal comfort and convenience items or services","RMO charges, Service charge, Surcharge, night charges","Nuclear, chemical or biological attack or weapons","Impairment of an Insured Person’s intellectual faculties by abuse of stimulants or depressants unless prescribed by a medical practitioner","Any treatment taken in a clinic, rest home, convalescent home for the addicted, detoxification center, sanatorium, home for the aged, remodeling clinic or similar institutions","Remicade, Avastin or similar injectable treatment which is undergone other than as a part of In- Patient Care Hospitalisation or Day Care Hospitalisation is excluded","Expenses related to any kind of Advance Technology Methods other than mentioned in the Clause 3.1.1(iii)","Hormone replacement therapy","Any Illness or Injury attributable to consumption, use, misuse or abuse of tobacco, intoxicating drugs, alcohol, hallucinogens, smoking","Any treatment or part of treatment or any expenses incurred under this Policy that is not reasonable and customary and/or not medically necessary"],"display":"Standard Excl04 to Excl18 and the policy's specific permanent exclusions apply","note":null,"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) ... 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\nconsequences 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 or where admission is arranged wholly or partly for domestic reasons. (Code- Excl13) ... Dietary supplements and substances that can be purchased without prescription, including but not limited to Vitamins, minerals and organic substances unless prescribed by a medical practitioner as part of hospitalization claim or day care procedure (Code- Excl14) ... Refractive Error: (Code- Excl15) ... Unproven Treatments: (Code- Excl16) ... Sterility and Infertility: (Code- Excl17) ... Maternity: (Code Excl18) ... 1. Any item or condition or treatment specified in List of Non-Medical Items (Annexure – I to Policy Terms & Conditions).\n2. Taking part or is supposed to participate in a naval, military, air force operation or aviation in a professional or semi-professional nature.\n3. Treatment taken from anyone who is not a Medical Practitioner or from a Medical Practitioner who is practicing outside the discipline for which he is licensed or any kind of self-medication.\n4. Charges incurred in connection with routine eye examinations and ear examinations, dentures, artificial teeth and all other similar external appliances and / or devices whether for diagnosis or treatment\n5. Any expenses incurred on external prosthesis, corrective devices, external durable medical equipment of any kind, like wheelchairs, walkers, glucometer, crutches, ambulatory devices, instruments used in treatment of sleep apnea syndrome and oxygen concentrator for asthmatic condition, cost of cochlear implants and related surgery.\n6. Alopecia wigs and/or toupee and all hair or hair fall treatment and products.\n7. Screening, counseling or treatment of any external Congenital Anomaly, Illness or defects or anomalies or treatment relating to external birth defects.\n8. Treatment of mental retardation, arrested or incomplete development of mind of a person, subnormal intelligence or mental intellectual disability.\n9. Circumcision unless necessary for treatment of an Illness or as may be necessitated due to an Accident.\n10. All preventive care (except eligible and entitled for Benefit: ‘Annual Health Check-up’), Vaccination including Inoculation and Immunizations (except in case of post-bite treatment) and tonics.\n11. Expenses incurred for Artificial life maintenance, including life support machine use, post confirmation of vegetative state or brain dead by treating medical practitioner where such treatment will not result in recovery or restoration of the previous state of health under any circumstances.\n12. Non-Allopathic Treatment, Hydrotherapy, Acupuncture, Reflexology, Chiropractic treatment or treatment related to any unrecognized systems of medicine.\n13. War (whether declared or not) and war like occurrence or invasion, acts of foreign enemies, hostilities, civil war, rebellion, revolutions, insurrections, mutiny, military or usurped power, seizure, capture, arrest, restraints and detainment of all kinds.\n14. Act of self-destruction or self-inflicted Injury, attempted suicide or suicide while sane or insane.\n15. Any charges incurred to procure documents related to treatment or Illness pertaining to any period of Hospitalization or Illness.\n16. Personal comfort and convenience items or services including but not limited to T.V. (wherever specifically charged separately), charges for access to cosmetics, hygiene articles, body care products and bath additives, as well as similar incidental services and supplies.\n17. Expenses related to any kind of RMO charges, Service charge, Surcharge, night charges levied by the hospital under whatever head or transportation charges by visiting consultant.\n18. Nuclear, chemical or biological attack or weapons ... 19. Impairment of an Insured Person’s intellectual faculties by abuse of stimulants or depressants unless prescribed by a medical practitioner.\n20. Any treatment taken in a clinic, rest home, convalescent home for the addicted, detoxification center, sanatorium, home for the aged, remodeling clinic or similar institutions.\n21. Remicade, Avastin or similar injectable treatment which is undergone other than as a part of In- Patient Care Hospitalisation or Day Care Hospitalisation is excluded.\n22. Expenses related to any kind of Advance Technology Methods other than mentioned in the Clause 3.1.1(iii).\n23. Hormone replacement therapy.\n24. Any Illness or Injury attributable to consumption, use, misuse or abuse of tobacco, intoxicating drugs, alcohol, hallucinogens, smoking.\n25. Any treatment or part of treatment or any expenses incurred under this Policy that is not reasonable and customary and/or not medically necessary.","sources":[{"clause":"Excl04","heading":"Investigation & Evaluation: (Code- Excl04)","page":23,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-excl04"},{"clause":"Excl05","heading":"Rest Cure, rehabilitation and respite care: (Code- Excl05)","page":23,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-excl05"},{"clause":"Excl06","heading":"Obesity/ Weight Control: (Code- Excl06)","page":23,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-excl06"},{"clause":"Excl07","heading":"Change-of-Gender treatments: (Code- Excl07)","page":24,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-excl07"},{"clause":"5","heading":"Cosmetic or plastic Surgery: (Code- Excl08)","page":24,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-5"},{"clause":"6","heading":"Hazardous or Adventure sports: (Code- Excl09)","page":24,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-6"},{"clause":"7","heading":"Breach of law: (Code- Excl10)","page":24,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-7"},{"clause":"8","heading":"Excluded Providers: (Code- Excl11)","page":24,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-8"},{"clause":"9","heading":"Treatment for Alcoholism, drug or substance abuse or any addictive condition and","page":24,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-9"},{"clause":"10","heading":null,"page":24,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-10"},{"clause":"11","heading":null,"page":24,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-11"},{"clause":"12","heading":"Refractive Error: (Code- Excl15)","page":25,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-12"},{"clause":"13","heading":"Unproven Treatments: (Code- Excl16)","page":25,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-13"},{"clause":"14","heading":"Sterility and Infertility: (Code- Excl17)","page":25,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-14"},{"clause":"15","heading":"Maternity: (Code Excl18)","page":25,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-15"},{"clause":"15(b)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-15-b"},{"clause":"15(c)","heading":"Biological attack or weapons","page":26,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-15-c"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"quote-verified","value":"The insured may cancel by giving 7 days’ written notice. If no claim has been made, the company refunds proportionate premium based on unexpired days; if a claim has been made, premium for remaining policy year(s) will be refunded on cancellation.","display":"7 days’ written notice; proportionate refund for unexpired days if no claim","note":"No refund if the company cancels on grounds of mis-representations, non-disclosure of material facts or fraud.","quote":"The Insured may cancel this Policy by giving 7 days’ written notice, and in such an event, the Company shall refund premium for the unexpired Policy Period as per the rates detailed below. ... If no claim has been made during the policy period, a proportionate refund of the premium will be issued based on the number of unexpired days. ... If the claim has been made in the current policy year, the premium for the remaining policy year(s) will be refunded on cancellation","sources":[{"clause":null,"heading":"5.1.7. Cancellation / Termination","page":29,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-5-1-7-cancellation-termination"},{"clause":"15(a)","heading":null,"page":29,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-15-a-5"},{"clause":"15(b)","heading":null,"page":29,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-15-b-5"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"quote-verified","value":"This policy covers only medical treatment taken entirely within India. All payments are made in Indian Rupees and within India.","display":"India only","note":null,"quote":"This Policy covers only medical treatment taken entirely within India. All payments under this Policy shall be made in Indian Rupees and within India.","sources":[{"clause":"15(a)","heading":null,"page":42,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-15-a-10"}],"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":"Applicable on new individual health insurance policies, not renewals or porting/migration, and 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":null,"heading":"5.1.15. Free Look Period","page":31,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-5-1-15-free-look-period"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"quote-verified","value":{"unit":"days","amount":15},"display":"15 days for monthly; 30 days in all other cases","note":"For instalment premiums, the policy wording also says 30 days for Half Yearly and Quarterly mode of payment and 15 days for monthly mode.","quote":"The grace period for payment of the premium for all types of insurance policies shall be: fifteen days where premium payment mode is monthly and thirty days in all other cases.","sources":[{"clause":"2.1.19","heading":"Grace Period","page":4,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-2-1-19"}],"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":"Minimum entry age is Adult– 18 years and Child – 90 Days. Maximum entry age is Adult: Lifelong and Child: 24 Years (last birthday).","display":"Adult 18 years to Lifelong; Child 90 Days to 24 Years","note":"Age calculations are as per Age Last Birthday.","quote":"Entry Age – | Adult– 18 years\nMinimum | Child – 90 Days\nEntry Age – | Adult: Lifelong\nMaximum | Child: 24 Years (last birthday)","sources":[{"clause":"1","heading":"Eligibility","page":1,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17495#c-1"}],"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":["Single","Monthly","Quarterly","Half-yearly"],"display":"Single/Monthly/Quarterly/Half-yearly","note":null,"quote":"Premium | Single/Monthly/Quarterly/Half-yearly\nPayment Term","sources":[{"clause":"1","heading":"Eligibility","page":1,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17495#c-1"}],"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":["Smart Select","Room Rent Modification","PED Wait Period Modification","Named Ailment Wait Period Modification","Instant Cover","Deductible","Co-payment","New Born cover","Plus Benefit","Cumulative Bonus Super","Annual Health check-up","Be-Fit Benefit","Wellness Benefit","Air Ambulance cover","Women care","Mental Health wellbeing","Claim Shield","Inflation Shield","Additional Sum Insured for Defined Critical Illnesses","Home Modification","Nursing Care"],"display":"Smart Select, Room Rent Modification, wait-period modifications, Instant Cover, Deductible, Co-payment, New Born cover, Plus Benefit, Cumulative Bonus Super, Annual Health check-up, Be-Fit, Wellness, Air Ambulance, Women care, Mental Health wellbeing, Claim Shield, Inflation Shield, Additional SI for defined critical illnesses, Home Modification and Nursing Care","note":null,"quote":"3.2 OPTIONAL BENEFITS ... 3.2.1 Smart Select ... 3.2.2 Room Rent Modification ... 3.2.3 PED Wait Period Modification ... 3.2.4 Named Ailment Wait Period Modification ... 3.2.5 Instant Cover ... 3.2.6 Deductible ... 3.2.7 Co-payment ... 3.2.8 New Born cover ... 3.2.9 Plus Benefit ... 3.2.10 Cumulative Bonus Super ... 3.2.11 Annual Health check-up ... 3.2.12 Be-Fit Benefit ... 3.2.13 Wellness Benefit ... 3.2.14 Air Ambulance cover ... 3.2.15 Women care ... 3.2.16 Mental Health wellbeing ... 3.2.17 Claim Shield ... 3.2.18 Inflation Shield ... 3.2.19 Additional Sum Insured for Defined Critical Illnesses ... 3.2.20 Home Modification ... 3.2.21 Nursing Care","sources":[{"clause":"3.2","heading":"OPTIONAL BENEFITS","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2"},{"clause":"3.2.1","heading":"Smart Select","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-1"},{"clause":"3.2.2","heading":"Room Rent Modification","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-2"},{"clause":"3.2.3","heading":"PED Wait Period Modification","page":15,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-3"},{"clause":"3.2.4","heading":"Named Ailment Wait Period Modification","page":15,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-4"},{"clause":"3.2.5","heading":"Instant Cover","page":15,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-5"},{"clause":"3.2.6","heading":"Deductible","page":15,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-6"},{"clause":"3.2.7","heading":"Co-payment","page":16,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-7"},{"clause":"3.2.8","heading":"New Born cover","page":16,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-8"},{"clause":"3.2.9","heading":"Plus Benefit","page":16,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-9"},{"clause":"3.2.10","heading":"Cumulative Bonus Super","page":16,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-10"},{"clause":"3.2.11","heading":"Annual Health check-up","page":17,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-11"},{"clause":"3.2.12","heading":"Be-Fit Benefit","page":17,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-12"},{"clause":"3.2.13","heading":"Wellness Benefit","page":18,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-13"},{"clause":"3.2.14","heading":"Air Ambulance cover","page":19,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-14"},{"clause":"3.2.15","heading":"Women care","page":19,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-15"},{"clause":"3.2.16","heading":"Mental Health wellbeing","page":19,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-16"},{"clause":"3.2.17","heading":"Claim Shield","page":20,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-17"},{"clause":"3.2.18","heading":"Inflation Shield","page":20,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-18"},{"clause":"3.2.19","heading":"Additional Sum Insured for Defined Critical Illnesses","page":20,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-19"},{"clause":"3.2.20","heading":"Home Modification","page":21,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-20"},{"clause":"3.2.21","heading":"Nursing Care","page":21,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-21"}],"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":"Coverage need not be available during the period for which no premium is received, but coverage is available during the grace period if the premium is paid in instalments during the policy period.","display":"Available during grace period for instalment premiums","note":null,"quote":"Coverage need not be available during the period for which no premium is received. ... If the premium is paid in installments during the policy period, coverage will be available during such Grace period.","sources":[{"clause":"2.1.19","heading":"Grace Period","page":4,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-2-1-19"},{"clause":null,"heading":"5.1.13. Premium payment Installment","page":30,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-5-1-13-premium-payment-installment"}],"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":"quote-verified","value":"Base cover has no room rent limit: there is no separate restriction on room charges during hospitalization. If the optional Room Rent Modification is opted, room rent/category is modified to Single Private AC room or Twin sharing room as specified in the policy schedule.","display":"No limit","note":"Room Rent Modification is optional and can restrict the room to Single Private AC room or Twin sharing room as specified in the Policy Schedule.","quote":"The eligible Room Rent or Room Category applicable for the Insured Person under the Policy is ‘No limit’, which means that there is no separate restriction on Room Charges incurred towards stay during Hospitalization ... if this Optional Benefit is opted, the Company agrees to modify the Room Rent / Room Category to Single Private AC room / Twin sharing room as specified in Policy schedule.","sources":[{"clause":"3.1.1(v)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-1-1-v"},{"clause":"3.2.2","heading":"Room Rent Modification","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-2"}],"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":"quote-verified","value":"Base cover has no room category limit. Under the optional Room Rent Modification, the eligible room category can be Single Private AC Room or Twin Sharing Room as stated in the policy schedule.","display":"No limit; optional Single Private AC Room or Twin Sharing Room","note":"The room category restriction applies only if the optional Room Rent Modification is opted.","quote":"The eligible Room Rent or Room Category applicable for the Insured Person under the Policy is ‘No limit’, which means that there is no separate restriction on Room Charges incurred towards stay during Hospitalization ... Single Private AC Room If the Policy Schedule states ‘Single Private AC Room’ as eligible Room Category, it means the maximum eligible Room Category in case of Hospitalization of the Insured Person payable by the Company is limited for stay in a Single Private AC Room. ... Twin Sharing Room If the Policy Schedule states ‘Twin Sharing Room’ as eligible Room Category, it means the maximum eligible Room Category in case of Hospitalization of the Insured Person payable by the Company is limited for stay in a Twin Sharing Room.","sources":[{"clause":"3.1.1(v)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-1-1-v"},{"clause":"3.2.2(i)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-2-i"},{"clause":"3.2.2(ii)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-2-ii"}],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"quote-verified","value":"Base cover has no separate ICU charges restriction. No limit on ICU charges also applies under the optional Room Rent Modification.","display":"No limit","note":null,"quote":"Intensive Care Unit Charges (ICU Charges): The eligible ICU Charges applicable for the Insured Person under the Policy is ‘No limit’, which means that there is no separate restriction on ICU Charges incurred towards stay in ICU during Hospitalization. ... No limit on ICU charges under this Optional Benefit.","sources":[{"clause":"3.1.1(v)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-1-1-v"},{"clause":"3.2.2(ii)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-2-ii"}],"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":"quote-verified","value":"There is no proportionate deduction for the base no-limit room rent. If the optional Room Rent Modification is opted and the insured uses a higher room category or room rent than eligible, the insured bears the ratable proportion of total Associate Medical Expenses in the stated proportion.","display":"Only if optional Room Rent Modification is opted and a higher room is used","note":"Base room rent is ‘No limit’; this clause is under the optional Room Rent Modification.","quote":"If the Insured Person is admitted in a Hospital room where the Room Category opted or Room Rent incurred is higher than the eligible Room Category/ Room Rent as specified in the Policy Schedule, then, the Policyholder/Insured Person shall bear the ratable proportion of the total Associate Medical Expenses (including applicable surcharge and taxes thereon) in the proportion of the difference between the Room Rent actually incurred and the Room Rent specified in the Policy Schedule or the Room Rent of the entitled Room Category to the Room Rent actually incurred.","sources":[{"clause":"3.2.2","heading":"Room Rent Modification","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-2"}],"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":"quote-verified","value":"There is no co-payment under the policy unless opted. If optional Co-payment is opted, the insured bears the co-payment specified in the policy schedule for each claim; if optional Smart Select is opted, 20% co-payment applies for treatment in hospitals other than those listed in Annexure III.","display":"No co-payment unless opted; Smart Select 20% outside listed hospitals","note":"Co-payment and Smart Select are optional benefits.","quote":"*There is no Co-payment under policy (unless opted) ... If this Optional Benefit is opted, then the Insured Person will have an option to bear a Co-payment, as specified in the Policy Schedule, and the Company’s liability shall be restricted to the balance amount payable. The Co-payment shall be applicable to each claim for each Insured member as defined in the Policy. ... If the Insured Person takes Medical Treatment in hospitals other than those listed in Annexure – III to the Policy Terms and Conditions, then the Policyholder/Insured Person shall bear a Co- Payment of 20% on each and every Claim arising in such regard, which will be in addition to any other co-payment (if any) applicable in the Policy.","sources":[{"clause":null,"heading":"SPECIFIC EXCLUSIONS","page":9,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17496#c-specific-exclusions"},{"clause":"3.2.7","heading":"Co-payment","page":16,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-7"},{"clause":"3.2.1(i)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-1-i"}],"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 unless opted. If the optional deductible is opted, the claim amount is reduced by the deductible specified in the policy schedule and it applies on an aggregate basis for all claims in a policy year.","display":"No deductible unless opted; optional aggregate deductible","note":"Deductible is an optional benefit.","quote":"*There is no Deductible applicable under policy (unless opted) ... The claim amount assessed by the Company for a particular claim shall be reduced by the Deductible as specified in the Policy Schedule and the Company shall be liable to make payment under the Policy for any Claim only when the Deductible on that Claim is exhausted.\nii) The Deductible shall be applicable on an aggregate basis for all Claims made by the Insured Person in a Policy Year.","sources":[{"clause":null,"heading":"SPECIFIC EXCLUSIONS","page":9,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17496#c-specific-exclusions"},{"clause":"3.2.6","heading":"Deductible","page":15,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-6"}],"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":["There is no Sublimit under policy (unless opted)"],"display":"No Sublimit under policy (unless opted)","note":null,"quote":"*There is no Sublimit under policy (unless opted)","sources":[{"clause":null,"heading":"SPECIFIC EXCLUSIONS","page":9,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17496#c-specific-exclusions"}],"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":60},"display":"60 days","note":"Payable only through reimbursement facility and for the same illness or injury for which the hospitalization claim is accepted.","quote":"For a period of 60 days immediately prior to the Insured Person’s date of admission to the Hospital","sources":[{"clause":"3.1.1(i)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-1-1-i-3"}],"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":180},"display":"180 days","note":"Payable only through reimbursement facility and for the same illness or injury for which the hospitalization claim is accepted.","quote":"For a period of 180 days immediately after the Insured Person’s date of discharge from the hospital and claim documents to be submitted within 30 days after the completion of 180 days from the date of discharge from the hospital.","sources":[{"clause":"3.1.1(i)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-1-1-i-3"}],"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":"All Day Care Treatments are covered through cashless or reimbursement facility up to the Sum Insured, where treatment in a hospital or day care centre does not exceed 24 hours but would otherwise require inpatient admission.","display":"All Day Care Treatments covered up to Sum Insured","note":null,"quote":"The Company will indemnify the Insured Person for Medical Expenses incurred on all Day Care Treatments through Cashless or Reimbursement Facility, maximum up to the Sum Insured ,as specified in the Policy Schedule, provided that the period of treatment of the Insured Person in the Hospital/Day Care Centre does not exceed 24 hours, which would otherwise require an in-patient admission","sources":[{"clause":"3.1.1(ii)","heading":"Benefit","page":10,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-1-1-ii"}],"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":"quote-verified","value":"Domiciliary hospitalization is covered through reimbursement up to the Sum Insured when medically necessary treatment is taken at home and continues for more than 3 consecutive days.","display":"Covered up to Sum Insured if treatment at home exceeds 3 consecutive days","note":"Domiciliary expenses are not payable for listed diseases including Asthma, Bronchitis, Diabetes Mellitus and Diabetes Insipidus, Hypertension, psychiatric or psychosomatic disorders, and others listed in the policy.","quote":"The Company will indemnify the Insured Person, only through Reimbursement Facility, up to the Sum Insured ,as specified in the Policy Schedule, for the Medical Expenses incurred towards Domiciliary Hospitalization, i.e., Coverage extended when Medically Necessary treatment is taken at home ... The Domiciliary Hospitalization continues for a period exceeding 3 consecutive days.","sources":[{"clause":"3.1.1(iv)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-1-1-iv"}],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"quote-verified","value":"AYUSH treatment is covered through cashless or reimbursement facility up to the Sum Insured for treatment at AYUSH Hospitals or health care facilities for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems.","display":"Covered up to Sum Insured","note":"Claim must be admissible under Hospitalization Expenses, treatment must be by a registered AYUSH practitioner, and treatment must be within India.","quote":"The Company will indemnify the Insured Person, through Cashless or Reimbursement Facility, up to the Sum Insured, as specified in the Policy Schedule, towards Medical Expenses incurred with respect to the Insured Person’s medical treatment undergone at any AYUSH Hospitals or health care facilities for any of the listed AYUSH treatments namely Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems","sources":[{"clause":"3.1.1(i)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-1-1-i-3"}],"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":"quote-verified","value":"Advanced technology methods are covered up to the Sum Insured under hospitalization expenses, including Uterine Artery Embolization and HIFU, Balloon Sinuplasty, Deep Brain stimulation, Oral chemotherapy, Immunotherapy, Intra vitreal injections, Robotic surgeries, Stereotactic radio surgeries, Bronchical Thermoplasty, Vaporisation of the prostrate, IONM and listed hematopoietic stem cell therapy.","display":"Covered up to Sum Insured for listed advance technology methods","note":null,"quote":"The Company will indemnify the Insured Person up to the Sum Insured, as specified in the Policy Schedule, for expenses incurred under Benefit ‘Hospitalization expenses’ for treatment taken through following advance technology methods:\nA. Uterine Artery Embolization and HIFU B. Balloon Sinuplasty C. Deep Brain stimulation D. Oral chemotherapy E. Immunotherapy- Monoclonal Antibody to be given as injection F. Intra vitreal injections G. Robotic surgeries H. Stereotactic radio surgeries ... I) Bronchical Thermoplasty J. Vaporisation of the prostrate (Green laser treatment or holmium laser treatment) K. IONM - (Intra Operative Neuro Monitoring) L. Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered.","sources":[{"clause":"3.1.1(iii)","heading":"Benefit","page":10,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-1-1-iii"},{"clause":"3.1.1(I)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-1-1-i-2"}],"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":"Organ donor medical expenses are covered through cashless or reimbursement facility up to the Sum Insured for the donor for organ transplant surgery, where the donor is eligible under transplant law and the insured person is the recipient.","display":"Covered up to Sum Insured","note":"Pre-hospitalization, post-hospitalization and other donor expenses consequent to harvesting are not paid.","quote":"The Company will indemnify the Insured Person, through Cashless or Reimbursement Facility, up to the Sum Insured, as specified in the Policy Schedule, for the Medical Expenses incurred in respect of the donor, for any organ transplant surgery during the Policy Year, subject to the conditions specified below:\n(i) The Organ donor is an eligible donor in accordance with The Transplantation of Human Organs Act, 1994 (amended) and other applicable laws and rules.\n(ii) The Insured Person is the recipient of the Organ so donated by the Organ Donor.","sources":[{"clause":"3.1.1(v)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-1-1-v"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Road ambulance is covered through cashless or reimbursement facility up to the Sum Insured when related to an accepted hospitalization claim and medically necessary for transport to the nearest hospital or between hospitals.","display":"Road ambulance up to Sum Insured","note":"Air Ambulance cover is an optional benefit, up to the amount specified in the Policy Schedule.","quote":"The Company will indemnify the Insured Person, through Cashless or Reimbursement Facility, up to the Sum Insured, provided that the Medical Expenses so incurred are related to the Illness or Injury for which the Company has accepted the Insured Person’s Claim under Benefit ‘Hospitalization Expenses’ ... Such Transportation is from the place of occurrence of Medical Emergency of the Insured Person, to the nearest Hospital; and/or ... Such Transportation is from one Hospital to another Hospital for the purpose of providing advanced/better equipped medical support/aid to the Insured Person which is medically necessary","sources":[{"clause":"3.1.2","heading":"Road Ambulance Cover","page":12,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-1-2"}],"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":"quote-verified","value":"If a claim is payable, the company automatically reinstates up to the base Sum Insured unlimited times in a policy year after base Sum Insured, applicable cumulative bonus, Cumulative Bonus Super and Plus Benefit are exhausted. The recharge can be used for the same illness as well as different illnesses, only for that policy year.","display":"Up to base Sum Insured, unlimited times in a policy year, for same or different illness","note":"Recharge can be used only for Hospitalization Expenses and Road Ambulance Cover; unused recharge cannot be carried forward.","quote":"If a Claim is payable under the Policy, then the Company agrees to automatically make the re-instatement of up to the base Sum Insured unlimited times in a policy year which is valid for that Policy Year only ... The Recharge shall be utilized only after the base Sum Insured, applicable Cumulative Bonus, Cumulative Bonus Super (if applicable) and Plus Benefit (if applicable) have been completely exhausted in that Policy Year. ... Recharge amount can be utilized for same illness as well as different Illnesses.","sources":[{"clause":"3.1.4","heading":"Unlimited Automatic Recharge","page":13,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-1-4"}],"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":"quote-verified","value":"The policy enhances the Sum Insured by 50% flat at the end of each completed and continuous Policy Year, up to 100% of the Sum Insured. It is not claim-free dependent, because the policy says a claim has no impact on accrual.","display":"50% flat per year, maximum 100%; no impact from claims","note":"Optional Cumulative Bonus Super gives a flat 100% increase per year up to 500% if opted.","quote":"At the end of each Policy Year, the Company will enhance the Sum Insured by 50% flat, on a cumulative basis, as a Cumulative Bonus for each completed and continuous Policy Year ... In any Policy Year, the accrued Cumulative Bonus, shall not exceed 100% of the Sum Insured available in the expiring Policy or renewed Policy, wherever Sum Insured is lower. ... In the event of a Claim there is no impact on the accrual of Cumulative Bonus.","sources":[{"clause":"3.1.3","heading":"Cumulative Bonus","page":13,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-1-3"}],"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":"Non-medical items are excluded under the base policy. If the optional Claim Shield benefit is accepted for a claim, items not payable as per List-I under Annexure I related to that claim become payable, limited to applicable Sum Insured.","display":"Excluded unless optional Claim Shield is opted","note":"Claim Shield is an optional benefit.","quote":"Any item or condition or treatment specified in List of Non-Medical Items (Annexure – I to Policy Terms & Conditions). ... If a claim has been accepted under this benefit, then the items which are not payable as per List-I under Annexure I related to the particular claim, will become payable. The maximum claim payout under this benefit shall be limited to applicable Sum Insured under the Policy.","sources":[{"clause":"15(b)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-15-b"},{"clause":"3.2.17","heading":"Claim Shield","page":20,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-17"}],"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 are excluded, including medical treatment traceable to childbirth, except ectopic pregnancy, and expenses towards miscarriage unless due to an accident and lawful medical termination of pregnancy during the policy period.","display":"Excluded, except ectopic pregnancy and miscarriage due to accident","note":null,"quote":"Maternity: (Code Excl18) ... Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; ... Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period.","sources":[{"clause":"15","heading":"Maternity: (Code Excl18)","page":25,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-15"},{"clause":"15(a)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-15-a"},{"clause":"15(b)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-15-b"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"New born baby cover is available only as an optional benefit; if chosen, the company allows addition of New Born baby from day 1, with all applicable waiting periods remaining valid.","display":"Optional New Born baby from day 1","note":"Premium for this optional benefit is payable at the time of addition of the newborn and is pro-rated for the exposure period.","quote":"Notwithstanding anything to the contrary in the Policy, by choosing this Optional Benefit, the Company will allow the addition of New Born baby from day 1.\nNote: All the applicable waiting period shall stand valid for this benefit.","sources":[{"clause":"3.2.8","heading":"New Born cover","page":16,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-8"}],"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 documents define Mental Illness and have an optional outpatient Mental Health wellbeing benefit, but do not state a specific in-patient mental illness cover.","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":"Annual Health check-up is listed under optional benefits. On request, through cashless facility, the company arranges an annual health check-up at its network once during a policy year per insured person, and it does not reduce the Sum Insured.","display":"Annual Health Check-up once per Policy Year per Insured Person","note":"This appears under OPTIONAL BENEFITS in the policy wording.","quote":"On the Insured Person’s request, through Cashless Facility, the Company will arrange for the Insured Person’s Annual Health Check-up for the list of medical tests specified below at its Network to provide the services, in India, subject to the conditions specified below:\na) This Benefit shall be available only once during a Policy Year per Insured Person; and\nb) This benefit does not reduce the Sum Insured.","sources":[{"clause":"3.2.11","heading":"Annual Health check-up","page":17,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-2-11"}],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"quote-verified","value":"The policy offers unlimited e-consultations with qualified General Physicians at its network during the policy year. Health Services also provide Discount Connect for access to special rates for OPD, diagnostics, maternity and pharmacy through the network; no general OPD reimbursement limit is stated.","display":"Unlimited e-consultations; special rates for OPD through network","note":"Women Care and Mental Health wellbeing are optional outpatient benefits with limits as specified in the Policy Schedule.","quote":"The Company shall offer unlimited e-consultations with qualified General Physicians at our network during the Policy Year through any mode of communication (Voice/ Video Call / Chat / Email Chat/ etc.) ... Discount Connect: The Insured Person may access to Special rates for OPD, Diagnostics, maternity, Pharmacy etc. through Network as available on the Company’s website.","sources":[{"clause":"3.1.5","heading":"Unlimited E-Consultation","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-1-5"},{"clause":"3.1.6","heading":"Health Services","page":14,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-3-1-6"}],"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":"quote-verified","value":"Pricing is split into Zone 1 and Zone 2. Zone 1 includes Delhi NCR, Mumbai Metropolis Area, Gujarat State, Aligarh and Mathura; Zone 2 is ROI.","display":"Pricing Zone 1 and Zone 2","note":"The cited clause states pricing zones, not a treatment-city co-pay. Optional Smart Select has hospital-list based co-payment.","quote":"Pricing | Pricing | Zone 1: Delhi NCR, Mumbai Metropolis Area (including Mumbai suburban, Thane,\nPalghar, Raigad, any other city defined by Government), Gujarat State, Aligarh, Mathura ... Zone 2: ROI Zone 2: ROI","sources":[{"clause":"1","heading":"Eligibility","page":1,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17495#c-1"}],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"quote-verified","value":"Cashless facility is available at Network Providers. The insured receives a health card and the network provider submits the pre-authorization form to the company; cashless facility can be availed at a network hospital only after company approval.","display":"Available at Network Providers with pre-authorization approval","note":null,"quote":"The Company extends Cashless Facility as a mode to indemnify the medical expenses incurred by the Insured Person at a Network Provider. ... Only upon due approval from the Company, Cashless Facility can be availed at any Network Hospital.","sources":[{"clause":"15(a)","heading":null,"page":38,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-15-a-7"},{"clause":"15(a)(i)","heading":"Submission of Pre-authorization Form","page":38,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-15-a-i"}],"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":"All claims incurred in India are serviced by the Company directly.","display":"Company directly","note":null,"quote":"All claims incurred in India are serviced by the Company directly.","sources":[{"clause":"15(d)","heading":null,"page":42,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498#c-15-d-3"}],"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, Floater Sum Insured available","note":"Prospectus states Floater: max up to 2A2C.","quote":"Floater Sum Insured-Where all members under the policy have a single sum insured limit which may be utilized by any or all members. *Individual / Floater Sum Insured is available under the Policy.","sources":[{"clause":"Row 4","heading":"Sum Insured (Basis) (Along with amount)","page":1,"url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17496#c-row-4"}],"law":[]}],"documents":[{"kind":"wording","label":"Supreme Healthcare Policy - Policy Wordings","pages":52,"fetched_at":"2026-10-17 20:05:21+00","source_url":"https://www.universalsompo.com/assets/file/supreme-healthcare-policy/supreme-healthcare-policy-wordings.pdf","url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17498"},{"kind":"prospectus","label":"Supreme Healthcare Policy - Prospectus / Brochure","pages":36,"fetched_at":"2026-10-17 20:05:22+00","source_url":"https://www.universalsompo.com/assets/file/supreme-healthcare-policy/supreme-healthcare-policy-prospectus.pdf","url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17495"},{"kind":"cis","label":"Supreme Healthcare Policy - CIS","pages":23,"fetched_at":"2026-10-17 20:05:24+00","source_url":"https://www.universalsompo.com/assets/file/cis/supreme-healthcare-policy-cis.pdf","url":"https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425/document/17496"}],"versions":[],"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":"Supreme Healthcare Policy (UIN UNIHLIP25030V012425), IndiaInsurances, https://indiainsurances.com/policy/universal-sompo-general-insurance/supreme-healthcare-policy-unihlip25030v012425"}