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The TPA then takes it up with the hospital or Nursing
home to get his dues from the insurer. This makes the
life of the insurer easy and hassle free.

If the insured or his family member chooses any hospital
or Nursing Home other than the listed ones, he can avail
of the treatment and apply to the TPA for
reimbursement. The TPA then takes it up with the
insurers and pays the insured.

Q5.c) Describe Universal Health Insurance
Scheme?

Ans: Universal Health Insurance policy was launched to
cover the economical weaker section of the society.
This policy has a very low premium and the maximum
sum insured is Rs 30,000 only. This Policy is available
to Groups of 100 or more Families.

Benefits

1. Medical reimbursement
The policy provides reimbursement of
hospitalization expenses upto Rs.30,000/- to an

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