The Universal Health Insurance Policy is the insurer's long-standing micro-insurance scheme launched nationwide in July 2003 under the Ministry of Health and Family Welfare's Universal Health Assurance Mission. Designed for Below Poverty Line (BPL) and Above Poverty Line (APL) families, it offers a basic ₹30,000 family hospitalisation benefit (inclusive of maternity), a ₹25,000 personal accident death benefit for the family's earning head, and disablement compensation — at extremely low premiums, heavily subsidised by the Government of India for BPL families.
the insurer Social Welfare Scheme· IRDAI PDF· GIPSA· Government of India Subsidised
The Universal Health Insurance Scheme (UHIS / UHIP) was launched nationwide on 14 July 2003 by the Ministry of Health and Family Welfare, with an objective to provide health care to the poorest sections of society. Following the Finance Minister's 2004 budget speech, the scheme was redesigned in consultation with GIPSA (General Insurance Public Sector Association) to improve access for BPL families specifically, while keeping an APL option for non-poor families wanting an extremely low-cost basic cover. the insurer's retail health policies, including UHIP, were revised with effect from 1 October 2024 with updated benefits and premium rates.
UHIP's benefit amounts (₹30,000 family hospitalisation, ₹15,000 per-illness cap) are dramatically smaller than the insurer's commercial retail health products (NMP, NYIMP, NNPMP — sums insured of ₹1 lakh to ₹50 lakh+). UHIP exists to provide basic protection to families who cannot afford comprehensive coverage — not to replace it. If your family income comfortably exceeds the BPL/APL thresholds and you can afford a retail health policy, the insurer's commercial products will give you vastly more protection for a modestly higher premium. Probitas can help you compare both honestly — call 022 4302 0000.
Launched under the Ministry of Health and Family Welfare's Universal Health Assurance Mission, July 2003. Designed by GIPSA — the same structure used by all 4 major PSU general insurers in India.
Since 2003"Rs.30,000 hospitalisation benefit per family per policy which includes the maternity benefit." — Confirmed across multiple sources. A modest but meaningful cushion against catastrophic basic hospitalisation costs for low-income families.
Inclusive of MaternityPersonal accident cover: if the family's earning head dies within 6 months of an accident caused by outward, violent, visible means, the family receives ₹25,000 — a basic safety net against loss of the breadwinner.
Earning Head OnlyBPL families pay as little as ₹100/year (individual) thanks to Government of India premium subsidy. The actual cost of cover is ₹300/year — GoI pays ₹200, the family pays only ₹100.
Govt. SubsidisedBelow Poverty Line (BPL) families get heavily subsidised premiums. Above Poverty Line (APL) families can still buy the same basic cover at a higher (non-subsidised) premium — useful as ultra-low-cost basic protection.
Two Eligibility TracksUHIP policyholders can migrate to the insurer's other health products (with continuity benefits preserved per IRDAI guidelines) by applying at least 30 days before renewal — a built-in upgrade path as family circumstances improve.
Upgrade Path AvailableTwo Eligibility Categories· from, BankBazaar, (Same GIPSA Scheme Terms)
UHIP eligibility is split into two categories with different age limits, income tests, and — most importantly — different premium subsidy treatment. Understanding which category you fall into determines both your eligibility documentation and your premium cost.
Across, Navi, BankBazaar,· Same GIPSA Benefit Structure
UHIP provides three core benefit types: a family hospitalisation pool (inclusive of maternity), a personal accident death benefit for the earning head, and disablement compensation. The benefit amounts are intentionally modest — designed for basic protection rather than comprehensive coverage.
Normal delivery: ₹2,500. Caesarean delivery: ₹5,000. Both across multiple sources and included within (not in addition to) the ₹30,000 family hospitalisation pool.
₹2,500 / ₹5,000"The Universal Health Insurance Scheme covers expenses incurred on ambulance transportation. The ambulance may be ground, air or water transportation."
Ground/Air/Water"If no claims are made by any insured member under the policy during that policy year, a 10% increase in the sum insured shall be offered during the next renewal."
10% SI Increase/Year"The Universal health insurance policy is available to both individuals as well as in a group. The individual policy will be in the name of the earning head of the family with details of other insured members." Group policies issued in the name of the institution buying on behalf of BPL families.
Individual, Family, Groupfrom, BankBazaar· Documentation Requirements
BPL: 5–70 years. APL: 5–65 years. Children 3 months–5 years are covered only if their parent(s) are also enrolled under the same policy.
BPL: family income must not exceed the sum insured amount. APL: family income should exceed the sum insured amount. The two tracks are deliberately inverse.
"Proof of Certificate from the local Tehsildar or BDO of the Revenue Department confirming that the family falls under the BPL category." — Required for BPL enrolment and subsidy eligibility.
"Members cannot be insured under multiple health insurance schemes simultaneously." — A UHIP enrollee cannot also be covered under another government health scheme at the same time.
Available to individuals, families (in the name of the earning head), and groups (issued in the name of an institution buying on behalf of BPL families).
Pre-existing conditions are excluded for the first 2 years of continuous coverage. After 2 years, new illnesses and accidents are covered without this restriction.
Within the ₹30,000 Pool· Earning Head Protection
from IRDAI Prospectus and Multiple Aggregators
Pre-existing conditions are excluded for the first 2 years of continuous coverage. New illnesses or accidents occurring after policy inception are covered without this restriction from Day 1 (subject to standard claim assessment).
2-Year PED WaitThe Temporary Total Disablement benefit (₹50/day) requires the earning head to have completed a 3-month waiting period on the policy before the benefit becomes payable.
3-Month Wait"At the end of the Policy Period, the Policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without Break in Policy. Coverage is not available during the Grace Period."
No Coverage During Grace"No loading shall apply on renewals based on individual claims experience." Your premium will not increase due to having made claims — a meaningful protection for low-income policyholders.
Loading-Free Renewal"Sum Insured can be changed only at the time of Renewal subject to discretion of the Company." SI adjustments are not available mid-policy-term.
Renewal-Only Changes"Disease or injury due to war, an act of terrorism, or invasion" is excluded — confirmed across multiple sources as a standard exclusion under this scheme.
Standard Exclusionfrom IRDAI Prospectus· Built-In Upgrade Pathway
UHIP includes an explicit migration provision allowing policyholders to move to the insurer's other (more comprehensive) health insurance products as their circumstances improve, while preserving continuity benefits already accrued. This is a responsible and valuable feature for any family whose income or needs grow beyond UHIP's basic scope.
Across Multiple Sources
Disease or injury arising from war, an act of terrorism, or invasion is excluded from coverage.
Non-allopathic (e.g. unrecognised alternative) treatment is excluded unless that specific form of treatment has been explicitly agreed for coverage under the policy's terms and definitions.
Circumcision is excluded except where medically necessary due to disease, or required as a result of an accident.
Conditions existing before policy inception are excluded for the first 2 years of continuous coverage.
Insured members cannot simultaneously hold coverage under multiple health insurance schemes — UHIP enrolment is exclusive while active.
Without a valid BPL certificate from the Tehsildar/BDO, BPL-tier subsidy and enrolment cannot be processed or maintained.
Reimbursement-Focused Process Given UHIP's Benefit Tier
UHIP's low benefit tier and broad rural/semi-urban target population mean claims are typically processed on a reimbursement basis at the policy-issuing office, rather than through extensive TPA cashless networks common in commercial products.
For hospitalisation, maternity, or accident-related treatment, obtain and retain: hospital bills, discharge summary, doctor's prescriptions, diagnostic reports, and (for accident claims) a police report or medical certificate confirming the nature of injury.
Inform the the insurer branch or policy-issuing office where the UHIP policy was purchased, providing the policy number and details of the hospitalisation, maternity event, or accident as soon as reasonably possible.
Complete the claim form (available from the policy-issuing office) and submit it along with original bills, discharge summary, and (for personal accident death claims) the death certificate and accident documentation, to the policy-issuing office or nearest the insurer office.
the insurer assesses the claim against the relevant benefit: the ₹30,000 family hospitalisation pool (with the ₹15,000 per-illness cap, excluding maternity), the ₹25,000 personal accident death benefit, or the ₹50/day disablement compensation, as applicable.
Hospitalisation and maternity claims are reimbursed to the insured/earning head. Personal accident death benefit is paid to the nominated family member. For exact claim form requirements and your nearest policy-issuing office, call Probitas at 022 4302 0000 or the insurer's toll-free number 022 4302 0000.
Universal Health Insurance Policy — Frequently Asked Questions
Check Eligibility & Enquire — Universal Health Insurance Policy
Tell us a little about your family's situation and we'll confirm whether BPL or APL applies to you, the exact premium for your family size, and — if your circumstances suggest you'd benefit more from comprehensive coverage — honestly advise you on the insurer's retail alternatives too.
By submitting you agree to our Privacy Policy and Terms & Conditions. Universal Health Insurance Policy (UHIP)· the insurer· IRDAI This is a basic government-aligned welfare scheme with modest benefit amounts (₹30,000 family hospitalisation, ₹15,000 per-illness cap, ₹25,000 personal accident death benefit). If your needs exceed this scope, our specialist will also discuss the insurer's comprehensive retail health products with you. Probitas Insurance Brokers Pvt. Ltd.· IRDAI Lic. No. 528.