Universal Sompo Personal Accident Insurance

Universal Sompo Personal Accident Insurance

Universal Sompo General Insurance Company Limited is a joint venture between Indian banks – Allahabad Bank, Karnataka Banka and Indian Overseas Bank, an Indian investment company, Dabur Investments and a Japanese insurance company, the Sompo Japan Insurance Company. Universal Sompo has its headquarters at Mumbai.

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The Sompo Japan Nipponkoa Insurance Inc. is a leading Japanese insurance provider and is the largest property and casual insurance company in the country of Japan. Universal Sompo is a rapidly growing insurance provider in India. It started operations in India in the year 2007 when it received its Licence and Certificate of Registration from the Indian Regulatory and Development Authority (IRDA). When it comes to Personal Accident Insurance, the company offers its customers comprehensive personal accident insurance plans.

Why Personal Accident Insurance?

A personal accident insurance plan protects the individual and his or her family members in the event of the unfortunate demise of the insured or if there is a serious accident or injury. Accidents are unpredictable and an accident can create a significantly huge financial burden on the customer and his or her family. Accidents may not be prevented, but an individual can take concrete steps towards protecting him or herself and his or her loved ones by securing their future and providing financial stability. While many people have taken out life insurance policies, a standalone personal accident policy is highly recommended as it will cover the insured person at a nominal premium rate, especially when compared to life insurance policy and also provides the advantage of covering minor injuries and the loss of income.

Universal Sompo Personal Accident Insurance Plan

The Universal Sompo Personal Accident Insurance plans protect the insured person and his or her family against various scenarios that ranges from minor or major injuries to even death. These plans aim to provide financial stability and security for the insured person and his or her family in the event of an accident.

• There are three options for coverage under the Universal Sompo Personal Accident Insurance Plan –
• Basic cover plan  – that covers against accidental death only
• Wider cover plan – that provides coverage against accidental death, Permanent Total Disablement and Permanent Partial Disablement
• Comprehensive cover plan – that provides coverage against accidental death, Permanent Total Disablement, Permanent Partial Disablement and Temporary Total Disablement
•  Permanent Total Disablement [PTD] Benefit - A lump sum payment would be made, as per the scale provided in the policy, in the event of Permanent Total Disability of the person insured due to an accident.
• Permanent Partial Disablement [PPD] Benefit - A lump sum payment would be made, as per the scale provided in the policy, in the event of Permanent Partial Disability of the person insured due to an accident.
• Accidental Death [AD] Benefit - A lump sum payment would be made in the event of the Death of the person insured, due to an accident.
• Temporary Total Disablement Benefit - A weekly compensation of 1% of the capital Sum Assured or Rs. 5000 (whichever is lower) is made to the insured to compensate for the loss of income because of Temporary Total Disability caused by an accident up to a maximum of 104 weeks.

Additional benefits under theUniversal Sompo Personal Accident Insurance Plan –

• Transportation cost – This is for the carriage of the mortal remains to the home, and includes the funeral charges. 1% of the sum assured or Rs. 2500, whichever is lower.
• Clothing cost – The cost of clothing that has been damaged in the accident is covered. Up to a maximum of Rs. 1000 is covered.
• Ambulance charges – Up to a maximum of Rs. 1000 is covered for ambulance charges.
• Education Fund Benefit – In the event of the unfortunate death or Permanent Total Disablement, a compensation is paid for the education for the dependent children. An amount of 5% of the capital sum assured is paid, up to a maximum of Rs. 15000.
• Loss of employment– In the event of an accident that causes the loss of employment because of Permanent Total Disablement, an amount of 2% of the capital sum assured is paid, subject to a maximum of Rs. 25000.

Eligibility

• The enrollment age under the Universal Sompo Personal Accident plan is from 5 years to 65 years. Fresh proposals for individuals above 65 years until the age of  75 years may be accepted with 20% loading on premium.
• Universal Sompo does not accept fresh proposals from individuals above the age of 75 years.
• A proposer needs to be 18 years or above to be eligible for the Universal Sompo Personal Accident plans.
• There is no maximum renewal age under the Universal Sompo Personal Accident policy plans.

Optional Covers/Extensions under the Universal Sompo Personal Accident Insurance Plans

By paying an additional premium the following additional extensions/covers may be purchased -

• Medical Expenses Extension: This covers the medical expenses reasonably and necessarily incurred by the insured person towards medical expenses because of an accident that results in bodily injury, death or disablement. The compensation under this extension cover is restricted to 40% of Personal Accident Claim or actual medical expenses whichever is lesser.
• Hospital Confinement Allowance: A daily cash allowance of Rs 500/- per day to a maximum of 30 days if the insured person is hospitalized as a result of an accident that results in the bodily injury, death or disablement.

 Additional Features of the Universal Sompo Personal Accident Insurance Plans

• Universal Sompo offers a discount as under for covering more than 2 family members under an individual plan
• Discount for having more than 3 family members  - 10%
• Discount for having more than 4 Family Members - 12.50%
• Discount for having more than 5 Family Members - 15%
• Universal Sompo provides a loyalty discount on the premium in respect of individual and family package covered
• The plan has no maximum cover ceasing age. Therefore, the plan has lifelong renewability.
• There is no medical examination required for availing of the Universal Sompo personal accident plans.
• The plan is very flexible as the insured person can cover his or her spouse and children as well.
• An existing Personal Accident Policy may be ported to Universal Sompo at no extra cost.
• There is a Free Look Period of 15 days from the date of receiving the policy documents. If the person is not satisfied with the coverage or the terms and conditions of the policy plans, then he or she may opt to return the same, provided that no claim has been made. Universal Sompo will refund the premium paid as per the terms and conditions.
• If Universal Sompo decides to revise, modify or withdraw the personal accident plan, they will give the customer three months notice period prior to the date from when the modification, revision or withdrawal gets into effect.
• In case the company decides to withdraw the personal accident plan, a substitute plan will be provided to the customer.
• The sum assured may be enhanced if the customer so wishes, when renewing their policy plan.
• The Universal Sompo Personal Accident plan has provisions for nomination. If the customer does not nominate anyone then the benefits will be given to the legal heirs or dependents of the customer.
• A customer may cancel their policy by providing a minimum of 15 days of written notice. If the customer has not made any claim then the premium is refunded on short term rates for the unexpired policy period as per the rates mentioned in the table below

Exclusions

There are certain factors that are excluded from the scope of coverage of personal accident insurance plans. The exclusions are as follows:

• Natural Death
• Consequential loss of any kind and/or legal liability
• Committing any breach of law with criminal intent
• Pregnancy including child birth, miscarriage, abortion or complication arising there from
• Participation in any Naval, military or air force operations
• HIV or related illness
• Venereal or sexually transmitted diseases
• Whilst under influence of intoxicating liquor or drugs
• Drug Addiction or alcoholism

Claims procedure under the Universal Sompo Personal Accident Plan

• In the event of any accident and/or Injury which may give rise to a claim under the Universal Sompo Personal Accident plans, the customer has to take the following steps for the claims procedure:
• The customer has to give a notice to the Universal Sompo call centre immediately and intimate in writing to our Policy issuing office. In case of the unfortunate event of a death, a written notice of the death is necessary. The exception is unless reasonable cause is shown, be given before internment/ cremation and in any case, within one calendar month after the death, and in the event of loss of sight or amputation of limbs, written notice thereof must also be given within one calendar month after such loss of sight or amputation.
• All certificates, information and evidence from the attending Medical Practitioner has to be provided by the customer.

• On receipt of intimation from the customer regarding a claim under the Policy, Universal Sompo is entitled to carry out examination, ascertain details, and in the event of death get the post-mortem examination done in respect of deceased person.

• The steps for lodging the claim are as given below:
• The customer has to notify the company immediately on the occurrence of a claim and within 7 days giving a full description of the medical treatment undertaken and the cause.
• The customer has to submit the completed and signed claim form, providing all the relevant documents in support of their claim not later than 30 days from the date of intimation.

Documents required for the claims procedure under the Universal Sompo Personal Accident Plans

• For Death Claim
• Duly filled up claim form
• Death Certificate
• Original FIR
• Original Panchnama
• Post mortem report
• For Permanent Total disablement/Permanent Partial Disablement
• Duly filled up claim form
• Original FIR
• Panchnama
• Hospitalization Report
• Hospital discharge card
• Original Certificate from Doctor of Govt. Hospital stating the degree of disability

• For Temporary Total Disablement
• Duly filled up claim form
• Original FIR
• Panchnama
• Hospitalization Report
• Hospital discharge card
• Original Certificate from Doctor of Govt. Hospital stating the degree of disability
• Termination letter for claim under “Loss of Employment”

Universal Sompo shall settle the claim(s), including its rejection, within thirty days of the receipt of the last necessary claim document

Claim Payment under the Universal Sompo Personal Accident Plans

The company shall pay all admissible claims under this Policy within seven working days from the date of acceptance of a claim. In case of delay in the payment, the company shall be liable to pay interest at a rate, which is at a rate of 2% above bank rate prevalent at the beginning of the financial year in which the claim is reviewed by Universal Sompo.

Applying for Personal Accident Insurance Plans from Universal Sompo

The Personal Accident Insurance plans offered by Universal Sompo can be applied to through multiple channels. A person who wishes to avail of a Personal Accident Insurance Plan from Universal Sompo may opt for any of the following ways to do so:

• Individuals desirous of availing the personal accident insurance plans offered by Universal Sompo can simply call the Sales helpline of the company and speak to the customer service representative.
• Interested individuals can mail their queries at the following email ID contactclaims@universalsompo[dot]com or contactus@universalsompo[dot]com to find out more about the personal accident plans.
• Lastly, customers may also visit the company’s branches or get in touch with an agent to buy the plans required.

Universal Sompo Personal Accident Insurance- FAQs

1. How to pay premium? What are the modes of payment available?

Universal Sompo General Insurance offers three ways to pay the premium

• Direct debit from your bank
• Credit card payment
• Cheque payment

You need to sign a debit mandate for the direct debit. Thus, you don’t have the stress to remember the premium due date.

2. How can I check policy status for Universal Sompo personal accident insurance?

You can check the policy details online or via toll free number.

If you are a registered user, simply login to e-Portal with your username and password.

3. What is the policy renewal process for Universal Sompo personal accident insurance?

There are three ways of renewing your policy with the company.

• Debit mandate- Automatic bank transfer on the date as agreed in the Policy T&C.
• Call helpline of the company to inquire about the renewal process. Submit the payment in the acceptable bank branch.
• If you have an online insurer profile, directly pay the insurance premium.

4. What is the company’s process to settle claim for Universal Sompo personal accident insurance?

Universal Sompo General Insurancetakes 7 business days to settle claims for minor accidents. You need to submit the mandatory hospitalization bills and reports in addition to the claims application and submit the same to the Claims department. The claim amount will be directly debited into the bank account of the policyholder.

5. What is the policy cancellation process for Universal Sompo personal accident insurance?

You get a free look period of 15-days in which you can cancel the policy and premium will be deposited in your bank account, post deduction of incurred charges on your medical examination and the stamp duty charges.

You can cancel your policy by

E-mail: contactus@universalsompo[dot]com

Letter: Universal Sompo General Insurance Company Ltd.,

Plot No - EL-94,KLS Tower, TTC Industrial Area,

MIDC, Mahape,

Navi Mumbai 400710.