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🏥🛡️ Micro Insurance· 4 Sections· Health + Home + PA· the insurer Miscellaneous

One Policy for Your Health, Home & Family — Hospitalization· Fire· Burglary· Personal Accident —
New Sampoorna Suraksha Bima, the insurer

the insurer's New Sampoorna Suraksha Bima is a 4-section Micro Insurance package — combining in-patient hospitalization cover (with AYUSH, day care, ICU benefit, ambulance charges, daily allowance) with fire & allied perils protection for household contents, burglary & theft cover, and worldwide personal accident insurance for your entire family. Entry from just 91 days of age. Renewable till 80 years.

✅ Section I — Full Hospitalization + Day Care + AYUSH ✅ Children from 91 Days to 25 Years Covered ✅ Section IV — Worldwide Personal Accident ✅ Daily Allowance + ICU Benefit + ₹1,000 Ambulance ✅ 7-Working-Day Claim Settlement Guarantee ✅ Migration Right if the insurer Withdraws Product
the insurer Micro Insurance· Families· Individuals· All India  |  IRDAI Licensed Broker — Lic. No. 528
NSSB
🏛️IRDAI Licensed Broker· Lic. No. 528
👶From 91 Days to 80 Years Renewal
🌍Worldwide PA + India Health & Home
📞Quote & Claims 022 4302 0000
An IRDAI Licensed Insurance Broker

the insurer Miscellaneous· Micro Insurance· 4 Sections· Health + Home + PA

What is the New Sampoorna Suraksha Bima?

the insurer's New Sampoorna Suraksha Bima is a Micro Insurance product — a simplified, low-premium bundled package designed for inclusive insurance access. It is the only the insurer product in this series that combines health (hospitalization), home contents (fire + burglary), and personal accident protection in a single, affordable policy.

🏥

One Policy — Health + Home + Personal Accident + Worldwide PA

  • Section I:Hospitalization — in-patient health cover for illness and injury, with pre/post hospitalization, day care, AYUSH, daily allowance, ICU benefit, ambulance
  • Section II:Fire & Allied Perils — household contents against fire, lightning, flood, earthquake, RSMD, storm and allied perils
  • Section III:Burglary & Robbery — household contents against burglary (unauthorized aggressive entry) AND theft (illegal taking of property)
  • Section IV:Personal Accident — death and disablement cover with education fund for children and body transport benefit. WORLDWIDE scope.
  • Geographic scope:Sections I, II, III = India only. Section IV (PA) = Worldwide — your family is covered for accidents anywhere in the world.
💡

Why "Micro Insurance"?

Micro Insurance is an IRDAI-designated product category offering simplified coverage at accessible premiums — designed to bring insurance protection to families who may find standard products unaffordable. The New Sampoorna Suraksha Bima combines four critical protection needs (health, fire, burglary, accident) into one easy-to-understand, low-cost package. Unlike commercial products, the focus is on inclusivity, simplicity, and broad family coverage rather than high sums insured.

Key Features
🏥

Full Hospitalization

In-patient + day care + pre/post hospitalization + AYUSH. Daily allowance, ICU benefit, and ambulance included — comprehensive health for the family.

Section I
👶

From 91 Days

Youngest entry age across all the insurer products in this series. Cover your newborn from just 91 days of age. Children covered to age 25 (unmarried).

Series Record
🌍

Worldwide PA

Section IV (Personal Accident) covers your family anywhere in the world — 24×7. Sections I, II, III are India-only. PA is global.

Section IV
⏱️

7-Day Claim Guarantee

All admissible claims paid within 7 working days of acceptance. the insurer owes you 2% above bank rate interest for any delay. Statutory commitment.

Legal Guarantee
🔄

Migration Right

If the insurer withdraws this product, you have an explicit IRDAI-backed right to migrate to the nearest substitute product with continuity benefits intact.

Consumer Protection
📅

Renew to Age 80

Renewable till 80 years of age — one of the highest renewal ages in the the insurer personal product series. Continuity benefits carried through renewals.

Long-Term Cover

All 4 Sections — Click Any to See

4 Sections — Health· Fire· Burglary· Personal Accident

All 4 sections can be opted independently or in combination. Sectional discounts apply when multiple sections are selected. Section IV (Personal Accident) has worldwide coverage — unique in this product.

🏥

Section I

Hospitalization / Health
🔥

Section II

Fire & Allied Perils
🔒

Section III

Burglary & Robbery
🌍 WORLDWIDE
🛡️

Section IV

Personal Accident

💰

Sectional Discounts — Confirmed from Policy Wording

  • Single section:Standard premium applies — any one section may be opted independently
  • Multiple sections:"If coverage for more than one section is opted under the Policy, sectional discounts can be provided."
  • Best value:All 4 sections together = comprehensive family protection at discounted premium
  • Contact us:Call 022 4302 0000 for current premium rates and applicable discount for your selected combination

Section I — In-Patient· Day Care· AYUSH· Pre/Post· Daily Allowance· ICU· Ambulance

Section I — Hospitalization & Health Cover Deep Dive

Section I is the most comprehensive section in this micro insurance package — covering in-patient hospitalization, pre and post hospitalization expenses, day care procedures, AYUSH treatment, daily allowance during hospital stay, ICU benefit, and emergency ambulance charges. A complete health cover for the whole family.

🏥

In-Patient Hospitalization

All medical expenses for illness/injury requiring minimum 24 hours hospital admission

Up to SI
📅

Pre-Hospitalization

Expenses 30 days before hospital admission — consultations, tests, medications

30 Days
🏠

Post-Hospitalization

Expenses 60 days after discharge — follow-up visits, medicines, physiotherapy

60 Days
🌿

AYUSH Treatment

Ayurveda, Yoga, Naturopathy, Unani, Siddha, Homeopathy — hospitalization covered

Covered
🏨

Day Care Procedures

Treatments not requiring 24-hour stay — dialysis, cataract, chemotherapy and others

Listed procedures
🛏️

Daily Allowance

Cash benefit per 24-hour completed period of hospitalization

1% of SI or ₹250 (lower)
💉

ICU Benefit

Additional benefit for days spent in Intensive Care Unit

Up to 2% of SI
🚑

Emergency Ambulance

Emergency ambulance charges per hospitalization event

₹1,000 per hospitalization

🧮 Daily Allowance & ICU Benefit Calculator

Enter your Section I Sum Insured and number of days hospitalized to see your daily allowance, ICU benefit, and total additional benefits (these are payable over and above actual hospitalization expenses).
Your declared health SI under Section I
Continuous and completed 24-hour periods
Days in Intensive Care Unit (enter 0 if not applicable)
Daily Allowance Rate (1% of SI or ₹250, whichever lower)Enter SI above
Total Daily Allowance (rate × hospitalization days)
ICU Benefit (2% of SI for ICU days)
Emergency Ambulance Charge₹1,000 per hospitalization
Total Additional Benefits (excl. hospitalization expenses)

⚠️ Daily Allowance and ICU Benefit are payable over and above your actual hospitalization expenses, subject to the Section I Sum Insured limit. These benefits reduce the remaining SI for the policy year.

Family Coverage — Who Can Be Insured

👨‍👩‍👧‍👦 Age Coverage Span — 91 Days to 80 Years Renewal

👶 Children
91 days–25 yrs
🧑 Proposer
Entry 18–65 yrs
🔄 Renewal
to 80 yrs
91 Days18 yrs25 yrs65 yrs80 yrs
👤
Proposer
Entry: 18–65 years
💑
Spouse
Coverable with proposer
👶
Children
91 days – 25 years
91 DAYS MINIMUM
👴
Dependent Parents
Coverable as dependants
💍
Married Child
Excluded at next renewal
after marriage
Waiting Periods — Section I (Health)

⏳ 30-Day Initial Waiting Period

Hospitalization expenses arising from any illness within the first 30 days of policy commencement are NOT covered.

Exception: Accidents are covered from Day 1 — no 30-day wait for accident-related hospitalization.

Subsequent renewals: This waiting period does not apply if the policy has been continuously renewed for 12+ months without a break.

⏳ 36-Month PED Waiting Period

Pre-existing diseases (PED) — any condition diagnosed or treated in the 36 months before policy inception — are covered only after 36 continuous months of coverage.

Portability benefit: If you port from another insurer, prior continuous coverage reduces the PED waiting period.

Key rule: PED must be declared truthfully at inception.

Section II — Fire & Section III — Burglary & Robbery

Home Contents Protection — Fire & Burglary

Sections II and III cover your household contents — your personal belongings, furniture, appliances, and family possessions. Section II protects against fire and allied perils; Section III against burglary and theft. Both use the average clause for underinsurance.

🏠

What Counts as "Household Goods"? — Confirmed Definition

"Household goods means the personal belongings to You and Your family members who permanently reside with You which includes all mechanical and electrical gadgets for personal use."

This includes: furniture, clothing, linen, utensils, crockery, bedding, curtains, televisions, refrigerators, washing machines, air conditioners, personal computers, cameras — all personal moveable possessions. Contents only — NOT the building structure.

🔥

Section II — Fire & Allied Perils

  • Fire, Lightning, Explosion of gas in domestic appliances
  • Aircraft and articles dropped therefrom
  • Riot, Strike and Malicious Damage (RSMD)
  • Storm, Cyclone, Typhoon, Tempest, Hurricane, Tornado, Flood, Inundation
  • Earthquake (Fire and/or Shock)
  • Subsidence and Landslide including Rockslide
  • Bursting and overflowing of water tanks, apparatus and pipes
  • Impact damage by rail/road vehicle or animal
  • Leakage from automatic sprinkler installations
  • Missile testing operations· Bush fire
Section III — Burglary vs Theft: Both Defined, Both Covered

🔒 BURGLARY — Definition

"The unforeseen and unauthorized entry to or exit from the insured premises by aggressive and detectable means with the intent to steal the contents therefrom."

Entry must be: unauthorized + aggressive + detectable. Less strict than Shopkeepers Policy which requires "forcible and violent" — here "aggressive and detectable" is the standard.

🤲 THEFT — Definition

"The illegal taking of property belonging to another person without his consent with the intention of permanently depriving the other of it."

Theft is separately defined and covered — broader than Burglary. Unlike the Shopkeepers Policy, theft (even without aggressive entry) is explicitly covered here.

24-Hour Reporting Rule — Most Critical Claim Condition for Section III

"In respect of loss or damage under Section 2 (Burglary and Theft) the loss must be reported within 24 hours of the happening of any insured event."

This means: if your home is burgled, you have just 24 hours to report the loss — to the police AND to the insurer. Missing this 24-hour window may result in claim rejection. Act immediately: lodge FIR and call 022 4302 0000 within 24 hours of discovering any theft or burglary.

⚠️

Average Clause — Both Sections II & III

Confirmed from GEN643: "If actual value of assets insured under this policy at time of loss be collectively greater than sum insured, then you will be considered as being your own insurer for the difference."

Always insure at full market value of all household contents to avoid underinsurance. Review your SI annually — as you acquire new furniture and appliances, your contents value increases.

🔑

Lock Replacement — Section III

If entry/exit locks are damaged during a burglary or attempted burglary, the cost of repairing or replacing damaged locks at entry/exit points is also covered.

Limit: "The cost of repair or replacement of locks shall not exceed 5% of the sum insured."

This is a useful additional benefit — lock replacement after a break-in is often forgotten at claim time.

Section IV — Worldwide· Death + Disablement· Education Fund· Body Transport

Section IV — Personal Accident (Worldwide)

Section IV is the only section with worldwide geographical coverage — protecting your family from accidental death and disablement anywhere in the world, 24×7. Includes education fund for children and body transport benefit.

Geographic Coverage Scope — Where Each Section Applies
🇮🇳

INDIA ONLY

  • 🏥 Section I — Hospitalization
  • 🔥 Section II — Fire & Allied Perils
  • 🔒 Section III — Burglary & Robbery
  • All property and health claims must relate to India-based events. Hospitalization in a foreign country is not covered under Section I.
🌍

WORLDWIDE — Section IV Only

  • 🛡️ Personal Accident — Death, Disablement
  • 🎓 Education Fund for children
  • 🚁 Body transport benefit
  • "Worldwide geographical eligibility for protection against personal accidents.". Covered anywhere in the world, 24×7, subject to Indian government travel restrictions.
Table of Benefits — Section IV
Benefit% of Sum Insured
Accidental Death100%
Loss of Sight of Both Eyes100%
Physical Separation of / Loss of Ability to Use Both Hands or Both Feet100%
Physical Separation of / Loss of Ability to Use One Hand AND One Foot100%
Loss of Sight of One Eye AND Loss of One Hand or One Foot100%
Permanent Total and Absolute Disablement (as certified by a qualified medical practitioner)100%
Loss of Sight of One Eye50%
Physical Separation of / Loss of Ability to Use One Hand or One Foot50%
🎓

Education Fund + Body Transport — Additional PA Benefits

  • Education fund:"Compensation towards education fund for up to two dependent children — 2.5% of SI per child." If the insured person dies in an accident, each dependent child receives 2.5% of the PA SI as an education grant (maximum 2 children).
  • Body transport:"Up to 2% of the Sum Insured or ₹1,000 whichever is lower towards the cost of transporting the insured's remains from the place of death to a hospital, residence or cremation or burial ground."
  • Contribution clause:Contribution clause is NOT applicable to Section IV (Personal Accident). This means you can hold other PA policies simultaneously and this policy will pay its full share independently, without deducting other insurer's share.

7-Day Guarantee· Migration Right· SI Reduction· Renewal to 80

Key Policy Conditions

The New Sampoorna Suraksha Bima has several consumer-protective conditions that set it apart — the 7-working-day claim payment guarantee, the SI reduction mechanic, and the migration right are the most important to understand before buying.

⏱️ 7-Working-Day Claim Payment Guarantee

Day 1
Claim accepted by the insurer
Day 2
Processing begins
Day 3-4
Document verification
Day 5-6
Settlement calculation
Day 7 ✓
the insurer must pay by this date — statutory deadline
Day 8+
the insurer owes you 2% above RBI bank rate interest on delayed amount

"All admissible claims under this policy shall be paid by Us within 7 working days from date of acceptance of such a claim. In case of delay in the payment, We shall be liable to pay interest at a rate which is 2% above bank rate prevalent at the beginning of the financial year." — This is a statutory written commitment, the strongest claim payment guarantee in the the insurer product series.

⚠️ Sum Insured Reduces After Each Claim — Buy Adequate Cover

Start of Policy Year — Section I SI₹2,00,000
After Hospitalization Claim 1 (₹45,000)₹1,55,000 remaining
After Hospitalization Claim 2 (₹30,000)₹1,25,000 remaining
If 3 more claims of ₹1.25L total₹0 — SI Exhausted

"Immediately upon happening of loss or damage under the Policy, the Sum Insured shall be reduced by the amount of loss or damage and such reduced sum insured shall be the limit in respect of further claims during the policy period." — Unlike standard health policies with SI restoration, this Micro Insurance does not auto-restore. Choose your SI wisely.

🔄 Migration Right — Your Consumer Protection if the insurer Withdraws This Product

📅

Other Key Policy Conditions

  • Renewal age:Ordinarily renewable till 80 years of age, except on grounds of fraud, moral hazard or misrepresentation. One of the highest renewal ages in the series.
  • Married children:"In case child gets married, the child will not be covered for next renewal." — children exit the policy at the next renewal following marriage.
  • Contribution clause:Applies to Sections I, II, III (property and health). Does NOT apply to Section IV (Personal Accident).
  • Average clause:Applies to Sections II and III (property). If household contents are underinsured at time of loss, claim is proportionately reduced.
  • Moratorium:After 60 continuous months of health coverage, no claim can be contested on grounds of non-disclosure (except fraud).

What the Policy Does NOT Cover

Key Exclusions — Section by Section

Exclusions confirmed from the insurer policy wording and the original GEN643 IRDAI wording — the standard for all PSU versions of this micro insurance product including the insurer.

Sec I — PED (First 36 Months)

Pre-existing diseases and their direct complications are excluded for 36 months from first policy inception. Must be declared truthfully at proposal stage. Portability from other insurer reduces this wait.

Sec I — 30-Day Initial Wait

Illness arising within first 30 days of commencement excluded. Accidents are covered from Day 1. Not applicable if policy continuously renewed for 12+ months.

Sec I — Dental & Cosmetic

Dental treatment (unless from accident), cosmetic/aesthetic surgery, plastic surgery (unless from injury/disease), vaccination and circumcision (unless medically necessary) — all excluded.

Sec I — Investigation-Only Stays

"Hospitalization for only investigations and diagnosis" — if admitted solely for tests without any treatment or procedure, hospitalization expense is not covered.

Sec I — Drug & Alcohol

Treatment for drug addiction, alcoholism, or any conditions arising from substance abuse excluded from the health section. Adventure sports injuries also excluded.

Sec I — War & Terror

Injury or disease arising from war, terrorism, nuclear contamination, radiation — excluded from the health section and from all property sections.

Sec III — 24-Hour Report Miss

Burglary/theft loss NOT reported within 24 hours of the event — claim excluded. This is the most common rejection reason for Section III claims. Act immediately.

Sec II/III — Underinsurance

If household contents at time of loss exceed the declared SI, the claim is reduced proportionately. You become your own insurer for the difference. Review SI annually.

Sec IV — Self-Inflicted

Compensation under PA section excluded for: suicide/self-injury, being under influence of intoxicating liquor, drug addiction/alcoholism, engagement in adventure sports.

All Sections — Nuclear

Ionizing radiation, radioactive contamination, nuclear fuel, nuclear waste — excluded from all sections. Standard exclusion across all the insurer products.

Sec I — Specific Diseases Wait

Certain specified diseases have a specific waiting period (up to 36 months) from commencement of first health policy. Refer to the policy document for the complete list of named diseases.

Sec I — Multiple Claims Over SI

SI reduces after each claim. Once SI is exhausted for the policy year, no further claims are payable — unlike standard health policies with restoration features.

7-Working-Day Guarantee· Section-Specific Steps

Claim Process

Section III (burglary/theft) has the strictest reporting window: 24 hours. Section I (health) has cashless facility at network hospitals. All claims must be settled within 7 working days — with statutory interest for any delay.

📞

Step 1 — Notify the insurer Immediately

Health claim: call TPA/the insurer before or during hospitalization for cashless. Burglary (Sec III): call the insurer AND lodge police FIR within 24 hours. PA (Sec IV): notify the insurer as soon as possible after the accident.

🚔

Step 2 — Police Complaint (Sec III)

Burglary/theft: lodge FIR with local police IMMEDIATELY — within 24 hours of event. For fire/RSMD (Sec II): get fire brigade report if applicable. For PA deaths: FIR if accidental death by external violence.

🏥

Step 3 — Cashless or Reimbursement

Health (Sec I): opt for cashless at the insurer network hospital — pre-authorize before planned hospitalization. For non-network or emergency: pay and claim reimbursement with original bills, discharge summary, and prescriptions.

Step 4 — Submit Claim Form

Complete the insurer's claim form for the specific section. Attach: FIR/fire report (if applicable), hospital bills (Sec I), photographs (Sec II/III), purchase invoices for lost items (Sec III), medical/death certificate (Sec IV).

🔍

Step 5 — Assessment

Health (Sec I): TPA verifies and approves. Property (Sec II/III): surveyor inspects. PA (Sec IV): medical evidence and FIR reviewed. Cooperate fully — provide all documents requested without delay.

Step 6 — Settlement (7 Days)

All admissible claims paid within 7 working days of acceptance. If delayed beyond 7 working days, the insurer must pay 2% above RBI bank rate interest on the claim amount. Your SI reduces by each claim paid.

📁

Section-Specific Documents

  • Section I (Health):Hospital discharge summary· All original bills and receipts· Doctor's prescription· Diagnostic reports· Claim form
  • Section II (Fire):FIR (if RSMD or theft)· Fire brigade report· Photographs· Inventory of damaged items· Purchase invoices
  • Section III (Burglary):FIR (within 24 hours — CRITICAL)· Police investigation report· Photographs· List of stolen/damaged items with values· Purchase invoices
  • Section IV (PA — Death):Death certificate· FIR (if accidental death)· Post-mortem report· Nominee details· Education fund: children's birth certificates and school/college enrollment proof

Micro Insurance Questions

Frequently Asked Questions

the insurer's New Sampoorna Suraksha Bima is a Micro Insurance product — an IRDAI-designated product category offering simplified coverage at accessible premiums, designed for inclusive insurance access.

The product combines 4 sections:
→ Section I: Hospitalization / Health Cover — in-patient + day care + AYUSH + pre/post hospitalization + daily allowance + ICU + ambulance
→ Section II: Fire & Allied Perils — household contents against fire, lightning, flood, earthquake, RSMD and allied perils
→ Section III: Burglary & Robbery — household contents against burglary (unauthorized aggressive entry) AND theft
→ Section IV: Personal Accident — death and disablement with education fund and body transport, WORLDWIDE coverage

Why "Micro Insurance"?
Micro Insurance is an IRDAI regulatory product tier designed to make insurance accessible to families who may find standard products unaffordable. Key characteristics: simplified structure, accessible premiums, broad family coverage, single policy combining multiple risks. The "New" Sampoorna Suraksha Bima is the insurer's updated version of the original GEN643-filed product — expanding the health cover from Critical Illness (original) to full Hospitalization (current, much broader).
All 4 sections can be opted independently or in any combination. None is compulsory in the way that the Shopkeepers Policy or Office Package Policy have mandatory sections.

Section I — Hospitalization: Health cover for you and your family — the most important section for most families
Section II — Fire & Allied Perils: Household contents protection against fire, flood, earthquake, RSMD
Section III — Burglary & Robbery: Household contents against theft and burglary — reported within 24 hours
Section IV — Personal Accident: Worldwide death and disablement cover with education fund

Why take all 4?
All 4 sections are designed to complement each other — health for you, property for your home, accident for your family. Sectional discounts apply when multiple sections are opted. All 4 together gives comprehensive family protection at the most economical combined premium.

Note on Section IV: The contribution clause does NOT apply to Section IV (PA). This means you can hold other PA policies simultaneously and this policy pays its full share independently.
The 91-day minimum — the youngest eligible age in the the insurer product series:
"Cover children from 91 days to 25 years."

Who can be covered:
→ Proposer: 18–65 years (entry age for new policy)
→ Spouse: coverable alongside proposer
→ Children: 91 days to 25 years, unmarried
→ Dependent parents: coverable as dependants
→ Parents-in-law: coverable as dependants

Important rules:
→ "In case child gets married, the child will not be covered for next renewal." — married children exit at the next renewal following marriage
→ Children who reach age 25 and remain covered: when they exit this policy (age limit), they can migrate to a substitute individual health product with continuity benefits
→ Renewal: the policy can be renewed up to age 80 — meaning a proposer who enters at 55 can continue the policy until 80

Practical family coverage:
A family of 2 adults + 3 children (including one infant aged 91 days) can all be covered under a single Sampoorna Suraksha Bima policy — health, fire, burglary, and worldwide PA — for the whole family in one affordable policy.
Section I (Hospitalization) covers all of the following:

In-patient hospitalization: Medical expenses for illness/injury requiring minimum 24-hour hospital stay
Pre-hospitalization (30 days): Consultations, tests, medications in the 30 days before admission
Post-hospitalization (60 days): Follow-up visits, medicines, physiotherapy in the 60 days after discharge
Day care procedures: Treatments not requiring 24-hour stay — dialysis, cataract surgery, chemotherapy, specified procedures
AYUSH: Hospitalization under Ayurveda, Yoga, Naturopathy, Unani, Siddha, Homeopathy — all covered
Daily allowance: "1% of sum insured or ₹250 whichever is less for each continuous and completed period of 24 hours of hospitalization" — cash benefit on top of hospitalization expenses
ICU benefit: "Up to 2% of sum insured if admitted in IC unit" — additional benefit for ICU days
Emergency ambulance: ₹1,000 per hospitalization event for emergency ambulance charges

Important: cashless facility available
Health claims can be processed cashlessly at the insurer network hospitals — show your health card at the network hospital, pre-authorize, and the insurer pays the hospital directly without you having to pay upfront.
Pre-existing diseases (PED) are conditions diagnosed or treated in the 36 months before your policy start date.

What is PED?
"Any condition, ailment, injury or disease:
(a) that is/are diagnosed by a physician not more than 36 months prior to the date of commencement of the policy, or
(b) for which medical advice or treatment was recommended by, or received from, a physician, not more than 36 months prior to the date of commencement of the policy."

The waiting period:
PED hospitalization expenses are excluded for the first 36 consecutive months of continuous coverage. After 36 months of unbroken coverage, PED is covered.

Portability benefit:
If you are porting from another health insurer, prior continuous coverage reduces this 36-month PED waiting period. Only the remaining balance needs to be served with the insurer.

There is also a 30-day initial waiting period:
Any illness (not an accident) arising within the first 30 days of the policy is excluded. Accidents are covered from Day 1. This 30-day wait does not apply on continuous renewals after 12+ months.

Declare all PED truthfully at inception. Non-disclosure of a known condition can void the policy under the fraud clause.
Both Burglary AND Theft are separately defined and covered under Section III — this is broader than the Shopkeepers Policy which covers only Burglary.


"The unforeseen and unauthorized entry to or exit from the insured premises by aggressive and detectable means with the intent to steal the contents therefrom."
→ Entry must be: unauthorized + aggressive + detectable
→ More accessible definition than Shopkeepers Policy's "forcible and violent"


"The illegal taking of property belonging to another person without his consent with the intention of permanently depriving the other of it."
→ No forced/aggressive entry required for Theft to be covered
→ A broader definition — if someone walks in and takes your belongings without force, that could qualify as Theft

WHY 24 HOURS IS CRITICAL:
"In respect of loss or damage under Section 2 (Burglary and Theft) the loss must be reported within 24 hours of the happening of any insured event."

This 24-hour window is strict. If you discover a burglary and wait 36 hours to report, your claim may be rejected. Act immediately:
1. Lodge FIR with local police within 24 hours
2. Call the insurer on 022 4302 0000 within 24 hours
3. Photograph everything before disturbing the scene
Yes — Section IV (Personal Accident) covers you anywhere in the world, 24×7.

"Worldwide geographical eligibility for protection against personal accidents."

What this means in practice:
→ If you are injured in a road accident in Dubai — Section IV responds
→ If you die in an accident while on holiday in Europe — your family's death claim is valid under Section IV
→ If you suffer permanent disablement from an accident in the USA — Section IV pays

Geographic scope by section:
→ Section I (Health): India only — hospitalization in a foreign country is not covered
→ Section II (Fire): India only — your household contents in India
→ Section III (Burglary): India only — your home in India
→ Section IV (PA): WORLDWIDE — 24×7, anywhere


"Subject to the travel and other restrictions that the Indian Government may impose." If the Government of India has imposed travel restrictions to a specific country (e.g., conflict zone advisory), accidents in those areas may be excluded.

Note: All claims are settled in Indian Rupees regardless of where the accident occurs. Section IV does not cover medical expenses abroad — it covers death and disablement compensation. For overseas medical expenses, a separate overseas travel insurance policy is recommended.
YES — this is one of the most important features to understand about Micro Insurance.

"Immediately upon happening of loss or damage under the Policy, the Sum Insured stated in the Schedule shall be reduced by the amount of loss or damage and such reduced sum insured shall be the limit in respect of further claims during the policy period."

What this means:
If your Section I (Health) SI is ₹2,00,000 and you make a hospitalization claim for ₹60,000, your remaining SI for the rest of the year is ₹1,40,000. A second claim can only be paid up to ₹1,40,000. A third claim reduces it further.

This is DIFFERENT from standard health insurance:
Most standard health policies (like Mediclaim) offer SI restoration — the SI is restored after a claim (either fully or to a limited extent). This Micro Insurance product does NOT auto-restore. Once SI is exhausted, no more claims for that policy year.

Practical advice:
→ Buy the highest SI you can afford — especially for Section I (Health)
→ Review your family's typical annual healthcare needs
→ Consider this policy as a complementary cover alongside a standard health policy if you have significant healthcare needs
→ The same SI reduction applies to Sections II and III (property)
The Migration right is a specific consumer protection built into the policy wording.

"Continuity — In case company decides to withdraw Sampoorna Suraksha Bima Policy, option shall be available to migrate to nearest substitute product."

What "migration" means:
If the insurer decides to withdraw or discontinue the New Sampoorna Suraksha Bima product:
1. the insurer must offer you the nearest substitute product
2. All continuity benefits (PED waiting period credits, renewal history) are carried to the substitute product
3. You do NOT lose the years of coverage you've built up under the PED waiting period

Migration for children reaching maximum age (25 years):
"The children, who have attended the maximum age under eligibility, can opt for nearest substitute health product offered by the Company on individual basis. Continuity benefits in all such cases shall be carried to the individual health insurance policy."
→ When your child turns 25, they can port to their own individual health policy with the the insurer PED waiting period credits intact

This is a strong consumer protection:
Most insurance products simply stop covering children at the maximum age or are discontinued without migration pathways. This product explicitly protects continuity — making it a suitable foundation health policy for young families.
Section I — Health Exclusions (most important):
1. PED: First 36 months (declared PED covered only after 36 months of continuous coverage)
2. First 30 days of illness (accidents excluded from this wait)
3. Cosmetic surgery, dental treatment (unless accident-related)
4. Hospitalization for investigations only (no treatment, no cover)
5. Drug/alcohol addiction treatment
6. Adventure sports injuries
7. War, terrorism, nuclear contamination
8. Specified diseases with individual waiting periods (e.g., cataracts, hernia — check policy for complete list)
9. SI exhaustion — no more claims once SI is used up for the year

Section II (Fire) Exclusions — most important:
1. Electrical/mechanical breakdown of appliances (only Fire & allied perils covered — breakdown not covered here)
2. War, terrorism, nuclear
3. Normal cracking/settlement of building structures
4. Consequential losses (loss of income, business loss, market loss)

Section III (Burglary) Exclusions — most important:
1. Failure to report within 24 hours of the event
2. Underinsurance (average clause applies)
3. Mysterious disappearance, unexplained shortage
4. War, terrorism
5. Employee complicity (household help involved in theft)

Section IV (PA) Exclusions:
1. Suicide or self-inflicted injury
2. Under influence of alcohol or drugs
3. Adventure sports (bungee jumping, sky diving, racing, mountaineering)
4. Drug addiction or alcoholism
5. War, terrorism, nuclear

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