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Indian Overseas Bank Unveils Health Insurance Policy With Universal Sompo General Insurance

Updated On Sep 04, 2023

Public sector Indian Overseas Bank launched 'IOB Health Care Insurance Policy' through an online platform in its branches in association with Universal Sompo General Insurance Co. Ltd to provide the insurer's policy. 

With the amalgamation of technologies offered by two institutions, the customers will be offered Indian Overseas Bank Health Care Plus Policy (IOB HCP) on a real-time basis across the branches of the bank. 

This one of a kind family floater policy is specially designed by the insurer for the customers of Indian Overseas Bank with the sum insured options ranging from Rs. 50,000 going up till Rs. 50 Lakh. 

As per a press release, the policy can cover policyholder, spouse, dependent children and dependent parents and the premium will be charged on the basis of the proposer's age. There is no medical check-up required under this policy for up to 50 years of age. 

The Managing Director and Chief Executive Officer of the Bank, Karnam Sekar introduced the plan in a formal meeting where the Chairman of the general insurer Universal Sompo, O N Singh was present as well. Sekar shared, "We are extremely delighted to offer our products to our customers by harnessing tools to minimise the waiting period of issuing a policy to bank customers.

" He also stated that the insurer's relationship with the bank is being carried since more than a decade now and the insurer is really glad to coordinate with the bank's customers. He expressed that IOB took the right step of investing in Universal Sompo that gave returns in the shortest period of time. Sekar gave a piece of advice to the bank's team to popularise Universal Sompo's policies that would lead to a considerable increase in non-interest income of the bank.

On the event, O N Singh shared, "Very few insurers have real-time integration with Bank's core system. This would be a win-win situation for both the bank and the insurance company."

Universal Sompo IOB Health Care Policy is a health insurance plan designed exclusively for IOB (Indian Overseas Bank) customers. It's made to meet the unique needs of IOB patrons. This policy extends its coverage to you, your spouse, two dependent children, and even dependent parents, ensuring comprehensive protection for your entire family. With a focus on healthcare within India, it covers expenses related to sudden illnesses, essential surgeries for covered conditions, and unexpected accidental injuries. 

Key Features of Universal Sompo Health Insurance

  • Comprehensive Family Coverage: The Universal Sompo IOB Health Care Policy provides extensive coverage for the entire family of the account holder through a Floater policy. This includes the account holder, their spouse, and two dependent children. Moreover, dependent parents can also be included in the policy for an additional premium.
  • Flexible Coverage Amounts: This policy offers a wide range of coverage amounts, from Rs. 50,000 to Rs. 5 lakh, allowing individuals to choose the coverage that best suits their needs and budget.
  • Pre-existing Disease Coverage: While pre-existing diseases are typically not covered initially, this policy offers a unique provision. If the insured person maintains four consecutive years without making any claims, pre-existing diseases can also be covered. 
  • Health Check-Up Benefit: After holding a claim-free policy for three consecutive years, the Universal Sompo IOB Health Care Policy provides a health check-up benefit at a rate of 1% of the total insured sum. 
  • Maternity and Baby Care Coverage: The policy includes coverage for maternity benefits and baby care expenses, extending up to 5% of the total insured amount. It's important to note that this benefit becomes valid after 9 months from the policy's starting date, ensuring comprehensive support during the crucial stages of family planning and childcare.

Inclusions of the Universal Sompo Health Insurance Policy 

  • Inpatient Treatment: The policy covers the expenses incurred during inpatient treatment, ensuring that medical costs related to hospitalisation, surgeries, and other essential treatments are taken care of. This includes hospital room charges, doctor's fees, and medication expenses.
  • Maternity: Universal Sompo's policy extends coverage to maternity-related expenses. Expectant mothers can benefit from coverage for pre and post-natal medical costs, making family planning and childbirth more financially manageable.
  • Health Check-Up: After holding a claim-free policy for a specified duration, policyholders are eligible for a health check-up benefit. This feature encourages regular health check-ups, contributing to early detection and prevention of potential health issues.
  • Organ Donor: The policy includes coverage for organ transplant expenses, both for the recipient and the organ donor. This provision helps alleviate the financial burden associated with life-saving organ transplant surgeries.
  • Pre-Post Hospitalisation Period: The policy covers medical expenses during hospitalisation and during the critical pre and post-hospitalisation period. This includes diagnostic tests, consultations, and recovery-related costs, offering comprehensive support for a full healthcare journey.
  • Funeral Expenses: In times of unfortunate loss, the policy provides coverage for funeral expenses. This compassionate inclusion helps ease the financial strain on families during difficult times, allowing them to focus on healing and coping with their loss.

Exclusions of Universal Sompo Health Insurance Policy

  • Pre-Existing Illness: One of the primary exclusions of this policy is coverage for pre-existing illnesses. Medical conditions that existed before purchasing the policy are typically not covered during the initial waiting period.
  • Dental Check-Up: This policy usually does not cover Dental check-ups and routine dental care. Dental treatments often require a separate dental insurance policy or may be covered under specialised dental plans.
  • Outpatient Expenses: The policy typically does not cover outpatient expenses. This means that doctor's consultations, diagnostic tests, and treatments that do not require hospitalisation are not included in the coverage.
  • Voluntary Termination of Pregnancy: Expenses related to voluntary termination of pregnancy are usually excluded from coverage under this policy. However, medical complications arising from such procedures may be covered if they meet the policy's terms and conditions.
  • Riots, Strikes, or Malicious Attacks: Damage or injuries resulting from events like riots, strikes, or malicious attacks are often excluded. These situations may fall under specific insurance categories like property or personal injury coverage.
  • Pre and Post-Natal Expenses: While the policy covers maternity benefits and related expenses, it may exclude certain pre and post-natal expenses, depending on the policy's terms. Policyholders should carefully review these exclusions to understand what is covered.

Benefits to Customers

This policy empowers customers by providing them with a financial safety net in times of medical emergencies. It covers a wide range of medical expenses, including hospitalisation, surgeries, diagnostic tests, and post-operative care. By supporting a substantial portion of these costs, the policy ensures that individuals and families can seek timely medical treatment without the burden of expensive bills. This is particularly important in a country where healthcare expenses can often financially strain households.

Claim Settlement Process

Read on to find out the claim settlement process of Universal Sompo Health Insurance in detail:

Cashless Claim Process:

  • Initiation: When you need medical treatment at a network hospital, you can initiate a cashless claim. You must inform your insurer about your hospitalisation and the estimated expenses in advance. 
  • Hospitalisation: Once the claim is initiated, you can proceed with hospitalisation. The network hospital will work directly with the insurance company for the billing and settlement process. 
  • Claim Settlement: The insurer reviews the bills and medical records to ensure they align with the policy terms and coverage. Once verified, the insurer settles the claim directly with the hospital, and you don't have to worry about reimbursement.

Reimbursement Claim Process:

  • Initiation: In the case of non-network hospitals or if you couldn't avail cashless services, you can initiate a reimbursement claim. You pay for the medical expenses out of your pocket and collect all the original bills, receipts, and medical records.
  • Verification: The insurer will review the documents to ensure they meet the policy's terms and conditions. This process may involve verifying the authenticity of the expenses and medical necessity.
  • Claim Settlement: Once the verification process is complete and the claim is found valid, the insurer will reimburse you for the eligible medical expenses. The reimbursement is typically deposited directly into your bank account.

Conclusion

This policy empowers customers by providing financial security during medical emergencies, reducing the burden of healthcare costs. The claim settlement process offers cashless and reimbursement options, ensuring convenience and support when needed. It's a valuable tool for safeguarding the well-being of IOB customers and their families.

FAQs:

  1. Who is eligible for the Universal Sompo IOB Health Care Policy?

This policy is exclusively designed for Indian Overseas Bank (IOB) customers. It covers the primary account holder, their spouse, two dependent children, and dependent parents.

  1. What is the coverage amount range for this health insurance policy?

The coverage amount for the Universal Sompo IOB Health Care Policy ranges from Rs. 50,000 to Rs. 5 lakh.

  1. Can pre-existing diseases be covered under this policy?

Initially, pre-existing diseases are not covered. However, if the policyholder maintains four consecutive claim-free years, these conditions can become eligible for coverage, provided they are on the list of covered diseases specified by the policy.

  1. How does the health check-up benefit work?

After holding a claim-free policy for three consecutive years, policyholders can avail of a health check-up benefit. 

  1. When do maternity benefits become valid under this policy?

Maternity benefits and baby care expenses become valid after 9 months from the policy's starting date. 

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