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Universal Sompo Health Insurance

With headquarters in Mumbai, Universal Sompo is the first private-public collaboration in the general insurance market. The company has been formed as a joint venture between Allahabad Bank, Indian Overseas Bank, Karnataka Bank Ltd., Dabur Investment Corp., and Sompo Japan Nipponkoa Insurance Inc. The insurer offers a variety of general insurance products, such as travel insurance, health insurance, automobile insurance, and house insurance, to meet the needs of various segments of the population in India. 

When we talk about Universal Sompo’s one of the most promising products, it is none other than its health insurance. The company sells individual and family floater health insurance policies that are both affordable and simple to understand. These plans are created in such a way that they provide the customer with a variety of benefits, including both basic and advanced coverage features. Overall, Universal Sompo Health Insurance plans to guard you against breaking your bank in the event of a medical emergency.

Key Facts Of The Company

Incurred Claim Ratio 73.41% (2019-2020)
Equity Share Capital 368.18 (As Of March 31, 2020)
Solvency Ratio 2.28 (March 2020)
Number Of Policies Sold 244,971 (2019-2020)
Network Hospitals 4000+
Claims Settled More Than 90%
Number Of Branches In India 86
Recent Awards & Recognition
  • Prestigious Award Of “Best Customer Service Provider Of The Year’ 2016”
  • Personal Line Broking Initiative Of The Year 2016-17- ABP News Channel Presented BFSI Ceremony
  • Awarded In “Fintelekt-Insurance Awards 2017” For The Leadership In Claim Service In General Insurance Industry For The Financial Year 2016-17.
Types Of Health Insurance Plans
  • Complete Healthcare Insurance
  • Super Healthcare Insurance
  • Arogya Sanjeevani Insurance
  • Corona Rakshak Policy
  • Corona Kavach Policy
  • Saral Suraksha Bima
  • Group Mashak Rakshak Policy
  • Group Health Insurance Policy
  • Individual Accident Policy
  • Janta Personal Accident Insurance
  • Group Personal Accident
  • Aapat Suraksha Bima Policy
  • Loan Secure Insurance Policy
  • Hospital Cash Insurance Policy
  • Senior Citizen Health Insurance Policy
  • Pravasi Bhartiya Bima Yojana
  • Surva Vidyarthi Bima Yojana
  • Swarna Gramin Bima Yojana – Individual
  • Swarna Gramin Bima Yojana – Group
  • Critical Illness Insurance Policy

What Are The Types Of Plans Offered By Universal Sompo Health Insurance?

1. Universal Sompo Complete Healthcare Insurance

In addition to value-added services, the Complete Healthcare Insurance includes complete coverage to cover medical expenses incurred during hospitalization. The policy is available in three different versions: Basic, Essential, and Privilege.

Key Features:

  • Hospitalization Expenses: In case of hospitalization of the insured person, medical expenses for the same are covered under the plan.
  • Daycare Procedures: The daycare procedures are also covered under the policy.
  • Domiciliary Expenses: When medical treatment is required for a period of more than three days for illnesses that would ordinarily be treated in a hospital or nursing home, but the insured individual is confined at home, domiciliary expenses are covered under the policy.

Eligibility:

Minimum Entry Age91 Days, 1 Day, & 18 Years
Maximum Entry Age70 Years
Policy Tenure1 To 3 Years
Sum Insured Options
  • Basic: Rs. 1 Lakh, Rs. 2 Lakhs
  • Essential: Rs. 3, 4, & 5 Lakhs
  • Privilege: Rs. 6, 7, 8, 9, & 10 Lakhs

2. Super Healthcare Insurance

The Universal Sompo Super Healthcare Insurance Policy is a health insurance policy that supplements your current health insurance plan and protects you from medical bills in case of medical exigencies. The policy is available in two variants, top-up and super-top-up, each with its own set of features.

Key Features:

  • No Medical Check-Up Up To 65 Years: Under the Universal Sompo Super Healthcare Insurance policy, there is no need to undergo any kind of medical check-up up to the age of 65 years.
  • AYUSH Treatment: The treatment done under the Ayurveda, Yoga, Unani, Siddha, and Homeopathy systems of medicine are covered under the policy.
  • Weight Loss Surgery: One of the unique features of Super Healthcare Insurance is its coverage for weight loss surgery. If you wish to lose weight by undergoing surgical treatment, the expenses for the same are covered under the policy.

Eligibility:

Entry AgeUp To 80 Years
Sum InsuredUp To Rs. 1 Crore
Cumulative Bonus20% On Every Claim Free Year
Policy Term1/2/3 Years
Restoration Benefit100% Of Sum Insured

3. Universal Sompo Arogya Sanjeevani Policy

The Universal Sompo Arogya Sanjeevani Policy is a low-cost policy that protects you and your family from basic medical costs incurred as a result of an illness, disease, sickness, or accident.

Key Features:

  • Hospitalization Expenses: The Arogya Sanjeevani Insurance will reimburse the insured person’s medical expenditures for hospitalization throughout the policy year, up to the sum insured and cumulative bonus mentioned in the policy schedule.
  • AYUSH Treatment: During each policy year, the plan will reimburse medical expenses spent for inpatient care treatment at any AYUSH Hospital under the Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy systems of medicine up to the amount of sum covered as specified in the policy schedule.
  • Pre- & Post-Hospitalization Expenses: The plan will also cover the pre and post-hospitalization expenses of the policyholder.

Eligibility:

Minimum Sum InsuredRs. 50,000
Maximum Sum InsuredRs. 10 Lakhs
Entry Age18 To 65 Years
Pre-Hospitalization Expenses30 Days
Post-Hospitalization Expenses60 Days
Cumulative Bonus5% For Every Claim-Free Year
RenewabilityLifelong

4. Universal Sompo Corona Rakshak Policy

In light of the Covid-19 crisis, Universal Sompo’s ‘Corona Rakshak Policy’ is an individual benefit policy aimed at addressing individual consumers’ financial health difficulties. If the insured person is diagnosed with COVID and is hospitalized for more than 72 hours within the policy period, the plan will pay the agreed sum insured toward the coverage specified in the policy schedule.

Key Features:

  • COVID Coverage: On a positive diagnosis of COVID requiring hospitalization for a minimum of 72 hours, a lump sum payment equivalent to 100 percent of the sum insured will be paid under the Corona Rakshak Policy of Universal Sompo.
  • Waiting Period: A waiting period of 15 days from the commencement of the policy is provided to the policyholder.
  • Category Of Cover: The cover is available to the insured person on a benefits basis only.

Eligibility:

Entry Age18 To 65 Years
Sum Insured OptionsRs. 50,000 To Rs. 2.5 Lakhs,
Policy Period3.5/6.5/9.5 Months
Waiting Period15 Days

5. Universal Sompo Corona Kavach Policy

The Corona Kavach Policy from Universal Sompo provides coverage for COVID-19 treatment-related expenses. If you are hospitalized with COVID-19 after testing positive at a government-approved diagnostic center, you can file a claim.

Key Features:

  • Hospitalization Expenses: Medical expenses incurred during Covid’s hospitalization for at least 24 hours, including pre-hospitalization expenses for 15 days and post-hospitalization expenses for 30 days, are covered under the policy.
  • Homecare Treatment Expenses: The coverage covers the costs of treatment incurred by receiving treatment at home for a maximum of 14 days per admission, as per the policy terms and conditions.
  • AYUSH Treatment: Medical expenses occurring out of COVID treatment taken under AYUSH systems of medicine are also covered.

Eligibility:

Maximum Entry Age65
Minimum Entry Age18
Sum Insured OptionsRs. 50,000 To Rs. 5 Lakhs
Policy Period3.5/6.5/9.5 Months
Ambulance ChargesUp To Rs. 2000 Per Hospitalization

6. Saral Suraksha Bima

On accidental death, disability, permanent total disability owing to an accident, and diagnosis of certain critical illnesses, Saral Suraksha Bima pays the one-time lump sum benefit of the chosen sum insured to the policyholder.

Key Features:

  • Organ Transplant Expenses: The plan covers the organ transplantation expenses of the policyholder.
  • Basic Coverage: The plan provides basic coverage of accidental death, permanent total disablement, and permanent partial disablement.
  • Education Grant: The plan will pay a one-time educational grant of 10% of the base sum covered following an admissible claim of the insured person under the policy for death or permanent total disability of the insured person.

Eligibility:

Entry Age18 To 65 Years
Minimum Sum InsuredRs. 10,000
Maximum Sum InsuredRs. 1 Lakh
Cumulative Bonus5% Increase For Each Claim Free Year

7. Group Mashak Rakshak Policy

If an insured individual is diagnosed with any vector-borne disease covered by this policy during the policy period and is hospitalized for a minimum of 72 hours, the Group Mashak Rakshak policy will pay the agreed sum insured as specified in the policy schedule.

Key Features:

  • Hospitalization Benefit: On a positive diagnosis of any of the listed vector-borne diseases, a lump sum reward of up to 100% of the total insured is payable.
  • Diseases Covered: The plan provides coverage to the following vector-borne diseases:
    • Dengue fever
    • Malaria
    • Filaria (Lymphatic Filariasis)
    • Kala-azar
    • Chikungunya
    • Japanese Encephalitis
    • Zika Virus
  • Diagnosis Cover: On the first positive diagnosis of any covered vector-borne disease within the coverage period, 2% of the sum insured will be paid.

Eligibility:

Hospitalization Benefit100% Of SI
Diagnosis Cover2% Of SI
Waiting Period15 Days
Cooling Off Period30 Days

8. Universal Sompo Group Health Insurance Policy

This is a health insurance plan that pays for hospitalization and domiciliary expenses for employees of social service organizations, manufacturing organizations, or members of institutions, associations, or clubs.

Key Features:

  • Pre- & Post-Hospitalization Expenses: The plan provides coverage for both pre and post-hospitalization expenses of the insured person.
  • AYUSH Treatment: The treatment taken under Ayurveda, Yoga, Unani, Siddha, and Homeopathy systems of medicines will be covered under the policy.
  • Day Care Procedures: The policy also provides coverage for daycare procedures.

Eligibility:

Policy Period12 Months
Road Ambulance CoverUp To 2% Of Sum Insured
Restoration Benefit100% Of SI

9. Individual Accident Policy

A family’s financial woes can be exacerbated if a breadwinner dies or is injured in an accident. The Individual Accident Policy from Universal Sompo protects you and your family from the financial effects of unanticipated accidents.

Key Features:

  • 3 Types Of Coverage: The policy offers three different types of coverage options to the policyholder: Basic Cover, Wider Cover, and Comprehensive Cover.
  • Compensation Benefit: In case of temporary disablement, a compensation benefit is provided to the policyholder.
  • Add-On Covers: The plan also provides various add-on covers to the policyholder, such as ambulance charges, education funds, etc.

Eligibility:

Family Discount
  • More Than 3 Members: 10%
  • More Than 4 Members: 12.50%
  • More Than 5 Members: 15%
Loyalty Discount
  • 1st Year: 5%
  • 2nd Year: 10%
  • 3rd Year: 15%
Ambulance ChargesUp To Rs. 1000 Per Hospitalization
Transportation Cost For Carrying Dead Body To Home1% Of Capital Sum Insured
Cost Of Clothing Damaged In The AccidentUp To Rs. 1000

10. Janta Personal Accident Insurance

The Janta Personal Accident Policy from Universal Sompo protects you and your family from the financial consequences of unforeseeable accidents.

Key Features:

  • Death: The plan provides coverage to the death of the policyholder.
  • Permanent Total Disablement: The policy provides coverage to the permanent total disablement of the insured person.
  • Compensation Benefits: The policy also provides compensation benefits in case of death or permanent total disablement of the insured person.

Eligibility:

Entry Age5 To 65 Years
Death Coverage100% Of Capital Sum Insured
Permanent Total Disability Coverage100% Of Capital Sum Insured
Group Discount
  • Up To 25 Persons: No discount
  • Between 25 & 50 Persons: 5% On Total Premium
  • Between 51 &100: 10% On Total Premium
  • Between 101 & 300 Persons: 15% On Total Premium
  • Between 301 & 400 Persons: 20% On Total Premium
  • Between 401 & 500 Persons: 25% On Total Premium
On Duty Cover Discount25% On Basic Premium
Off Duty Cover Discount50% On Basic Premium

11. Group Personal Accident Policy

Universal Sompo Group Personal Accident insurance protects a group of employees and members from the repercussions of unanticipated incidents. If necessary, one can extend their employees’ coverage to include dependent children and parents.

Key Features:

  • Death/Disappearance: The plan provides coverage to the death or disappearance of the insured person due to an accident.
  • Permanent Total Disablement: The plan also provides coverage to the permanent total disablement of the insured person due to an accident.
  • Add-On Covers: The policy provides various add-on covers, such as marriage expenses, funeral expenses, medical expense cover, etc.

Eligibility:

What’s Covered Under The Policy?
Death/DisappearanceCovered
Permanent Total DisabilityCovered
Permanent Partial DisabilityCovered
Temporary Total DisabilityCovered

12. Aapat Suraksha Bima Policy

The Universal Sompo’s Apat Suraksha Bima Policy provides coverage to assist the policyholder or beneficiary in the event of an unexpected medical event, such as the diagnosis of a serious critical illness such as cancer, coronary heart disease, renal failure, major organ transplant, and so on.

Key Features:

  • Death Coverage: In case of the death of the insured person due to an accident, the policy pays a one-time payment of the amount equivalent to the capital sum insured.
  • Diagnosis Cover: If the insured person is detected/diagnosed for the first time during the policy period as suffering from a critical illness or surgical procedure described under the policy, the sum insured will become payable.
  • Critical Illnesses Covered: The plan provides coverage for the following critical illnesses:
    • Paralytic Stroke
    • Cancer
    • Renal Failure
    • Coronary Artery Disease
    • Major Organ Transplant

Eligibility:

Minimum Entry Age18 Years
Maximum Entry Age65 Years
Death100% Of Capital Sum Insured
Permanent Total & Absolute Disablement100% Of Capital Sum Insured

13. Loan Secure Insurance Policy

The Loan Secure Insurance Policy from Universal Sompo is a one-of-a-kind policy that allows you to transfer the burden of your loan in the event of an unanticipated incident. This policy is specifically tailored to the customers of the bank and financial institutions.

Key Features:

  • Medical Illnesses & Surgical Procedures: The plan provides coverage for various medical illnesses and surgical procedures.
  • Personal Accident: The plan provides personal accident coverage as an optional cover to the policyholder.
  • Loss Of Job: The policy also provides coverage to the loss of a job only for the salaried insured.

Eligibility:

Entry Age20 To 65 Years
Sum InsuredRs. 50,000 To Rs. 3 Crores
Policy Tenure1/2/3 Years

14. Hospital Cash Insurance Policy

Under the Universal Sompo’s Hospital Cash Insurance Policy, a daily allowance benefit is paid to the policyholder during hospitalization.

Key Features:

  • Hospital Confinement Benefit: A daily allowance, as specified in the schedule, for each continuous and completed 24-hour period of hospitalization is provided to the policyholder.
  • Convalescence Benefit: If a patient is admitted to the hospital for more than 21 days in a row, the benefit will be paid according to the schedule. For each insured incident, this benefit is paid once a year.
  • Intensive Care Benefit: If you or your family member is admitted to an ICU other than a regular hospitalization during the course of their treatment, the amount you choose will be quadrupled.

Eligibility:

Entry Age18 To 70 Years
Convalescence BenefitRs. 10,000
Long-Term Policy Discount

For 2 Years: 10% Less Premium

For 3 Years: 15% Less Premium

Family Discount5%

15. Senior Citizen Health Insurance Policy

The Senior Citizen Health Insurance plan from Universal Sompo covers hospitalization and medical expenditures for those over the age of 60. One has the option of covering themselves as well as their spouses under the plan.

Key Features:

  • In-Patient Treatment: The policy provides coverage of the in-patient treatment of the insured person.
  • Day Care Procedures: The treatment that does not require hospitalization of more than 24 hours are also covered under the policy.
  • Pre- & Post-Hospitalization Expenses: The policy covers both pre and post-hospitalization expenses occurring out of the treatment of the insured person.

Eligibility:

Entry AgeAbove 60 Years
Room, Boarding, & Nursing Expenses1% Of Sum Insured
ICU Expenses2% Of Sum Insured
Pre-Hospitalization Expenses30 Days
Post-Hospitalization Expenses60 Days
Daily Allowance0.1% Of Sum Insured
Ambulance Charges1% Of Sum Insured

16. Pravasi Bhartiya Bima Yojana

This is a health insurance plan that covers the medical expenses of people who are emigrating and have an “Emigration Check Required” stamp on their passports.

Key Features:

  • Hospitalization Expenses: Medical expenses occurring out of hospitalization are covered under the policy.
  • Day Care Procedures: The policy covers daycare procedures and surgeries that require less than 24 hours.
  • Death OR Permanent Disablement: The policy provides coverage to the death or permanent disablement of the insured person.

Eligibility:

Entry Age18 To 65 Years
Room, Boarding, & Nursing ExpensesCovered
Day Care ProceduresCovered
Maternity ExpensesCovered

17. Surva Vidyarthi Bima Yojana

Surva Vidhyarthi Bima Yojana by Universal Sompo is a health insurance plan that educational institutions or schools can use for the benefit of students. The insured person can choose from three variants of the policy as per their needs: Section A, Section B, and Section C.

Key Features:

Section ASection BSection C

Benefits 

  • Death of the parent resulting from accident
  • Permanent Total Disablement of the parent resulting from accident
  • Permanent Partial Disablement of the parent resulting from accident
  • Death of student resulting from accident
  • Permanent Total Disablement of student following an accident
  • Permanent partial disablement of the student resulting from accident

Medical Cover

  • Cataract per eye
  • Other eye surgeries
  • ENT
  • Surgeries for – tumors/cysts/nodule/polyp
  • Stone in the urinary system
  • Hernia related
  • Appendectomy
  • Knee ligament reconstruction surgery
  • Hysterectomy
  • Fissures/piles/fistulas
  • Spine & vertebrae related
  • Cellulites/abscess
  • Other surgeries & procedures
  • All medical expenses for any treatment not involving surgery/medical procedure

Fire Cover

  • Fire
  • Explosion/implosion
  • Loss or damage by aircraft, other aerial or space devices, and articles dropped there from excluding those caused by pressure waves
  • Storm, cyclone, typhoon, tempest, hurricane, tornado, flood & inundation
  • Impact damage by any rail/ road vehicle or animal by direct contact
  • Subsidence and Landslide including rockslide excluding:
  1. the normal cracking, settlement, or bedding down of new structures
  2. the settlement or movement of made-up ground
  3. coastal or river erosion
  4. defective design or workmanship or use of defective materials
  5. Demolition, construction, structural alterations, or repair of any property or ground-works or excavations
  • Bursting and/or overflowing of water tanks, apparatus, and pipes
  • Missile testing operation
  • Leakage from automatic sprinkler installations excluding loss, destruction, or damage caused by:
  1. Repairs or alterations to the building or premises
  2. Repairs, removal, or extension of the sprinkler installation
  3. Defects in construction known to You
  • Bush fire, excluding loss, destruction, or damage caused by forest fire

Extensions

  • Loss of personal belongings
  • Pedal cycle – Cover for loss or theft of a pedal cycle
  • Cost of study in case of accidental death/ Permanent Total Disablement of parent
  • Ambulance Charges extension
  • Compassionate Visit
  • Reimbursement of examination fees

Medical Expenses Payable

  1. Room, boarding expenses as provided by the hospital/nursing home.
  2. Nursing expenses.
  3. Surgeon, anesthetist, medical practitioner, consultants, specialists’ fees.
  4. Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines & drugs, diagnostic materials and X-Ray, dialysis, chemotherapy, radiotherapy, cost of a pacemaker, artificial limbs, and cost of stents and implants.

Extensions

EXTENSION 1

    1. Death
    2. Permanent Total Disablement
  • Permanent Partial Disablement

EXTENSION 2

  1. Library Books


Eligibility:

Entry Age3 To 65 Years
Death Benefit100% Of Sum Insured
Permanent Total Disablement100% Of Sum Insured
Ambulance ChargesNot More Than 2% Of Accidental Sum Insured
Compassionate VisitNot More Than 2% Of Accidental Sum Insured
Group Discount
  • 101 To 5000 Persons: 10%
  • 5001 – 15000: 15%
  • 15001 – 25000: 20%
  • 25001 – 50000: 25%
  • 50001 & Above: 30%
Loyalty Discount5%
Direct Sourcing Discount10%
Multiple Benefit Discount10%

18. Swarna Gramin Bima Yojana – Individual & Group Plan

The Gramin can use the Universal Sompo Swarna Gramin Bima Yojana to cover himself and his family, or an organization like NGOs can use it. The plan is available on both an individual and group basis.

Key Features:

  • 3 Sections: The policy comprises of the following three sections:
    • Section A: Personal Accident
    • Section B: Critical Illness
    • Section C: Hospital Cash
  • Pre-Existing Disease Cover: The plan provides coverage to pre-existing diseases of the policyholder.
  • Family Discount: In case the insured person covers his or her family members under the plan, they will be provided with a family discount.

Eligibility:

Entry Age18 To 65 Years
No Medical TestUp To 45 Years
Death of the insured or his/ her family members upon accident100% Of SI

Permanent Total Disablement of the

insured or his/her family members

resulting from accident

125% Of SI
Hospital Cash

Option1: Rs. 250 Per Day

Option 2: Rs. 500 Per Day

Option 3: Rs. 1000 Per Day

19. Critical Illness Insurance Policy

The Universal Sompo’s Critical Illness Insurance plan gives you the coverage you need to fight against critical illness without having to worry about your money.

Key Features:

  • Portability Option: If you have critical illness insurance with another company and want to switch to Universal Sompo’s Critical Illness Insurance after your policy expires, you can do so.
  • Free Look-Up Period: You will have at least 15 days from the date of receipt of the policy to evaluate the terms and conditions and return them if they are not acceptable to you.
  • Covers 11 Critical Illnesses: The plan provides coverage to the following 11 critical illnesses:
    1. Cancer of specified severity
    2. First heart attack of specified severity
    3. Open chest CABG
    4. Open heart replacement
    5. Coma of specified severity
    6. Kidney failure requiring regular dialysis
    7. Stroke resulting in permanent symptoms
    8. Major organ/bone marrow transplant
    9. Motor neuron disease with permanent symptoms
    10. Permanent paralysis of limbs
    11. Multiple sclerosis with persisting symptoms

Eligibility:

Entry Age18 To 65 Years
Long-Term Policy Benefit

For 2 Years: 10% Discount In Premium

For 3 Years: 15% Discount In Premium

Sum InsuredRs. 2.5 Lakhs To 20 Lakhs
Free Look-Up Period15 Days

Why Should Health Insurance Plans From Universal Sompo Deserve Your Attention?

Star Health and Allied Insurance is a popular health insurance provider for nearly 15 years. It has been servicing its clients faithfully with expertise in this field. You can choose this company for multiple reasons. Let’s have a look below to understand why Star Health is a smart choice.

  • Smooth claim settlement process – The claim settlement process under Star Health Insurance is not only hassle-free but also an in-house settlement process is also available with them. They promise to settle the cashless claim within just 2 hours. Their claim settlement ratio is also higher than many other companies. So, once you purchase any policy from them, you need not worry about your claim process.
  • Variety of plans – They have come up with 23 types of health plans and also always keep themselves updated with the various needs of the individuals. From this wide range of health plans, one can easily choose his/her desired one(s) according to their convenience and requirements.
  • Strong network hospitals – The Company has more than 11000 network hospitals where an insured can take the treatments to avail of the cashless facility. You can easily get a network hospital within your vicinity at the time of medical emergency and also will have the choice to select the desired one.
  • Solvency ratio – If a company has a higher solvency ratio that indicates that the company has the capability to pay in case of a lump-sum claim. For Star Health Insurance, this ratio is 1.69 in the financial year of 2019-2020, which is quite higher than many other insurance companies. So, you can faith in this insurer that your claim amount will be settled without any delay.
  • Customer support – Their customer support system is very strong. Its experts are always there, just a phone call away, to resolve your query. They are there to assist you 24×7.
  • Broad network – The Company has a large network to support its customers always. It has more than 640 official branches PAN India. So, you can always find them within your vicinity.
  • Availability – The plans are mostly available both online and offline. So policy-seekers can choose any of the modes according to their convenience.

How Can You Calculate Premium For Universal Sompo Health Insurance Plans?

  1. Visit the official website of the Universal Sompo General Insurance company.
  2. Click on “Products” and then click on the “Health” tab.
  3. Select the health insurance for which you want to calculate the premium, and then click on “Buy Now”.
  4. Enter the member information, and then click on “Continue”.
  5. The premium details will be displayed on the screen.

Eligibility:

NameAgeGenderSum InsuredPremium
Vansh50MaleRs. 5,00,000Rs. 18,127
Ritika28FemaleRs. 4,00,000Rs. 7125
Hitesh40MaleRs. 6,00,000Rs. 12,919
Avantika30FemaleRs. 7,00,000Rs. 10856

How To Purchase Universal Sompo Health Insurance Plans?

  1. Visit the official website of the Universal Sompo General Insurance company.
  2. Click on “Products” and then click on the “Health” tab.
  3. Select the health insurance you wish to buy and then click on “Buy Now”.
  4. Enter the member information, and then click on “Continue”.
  5. Enter your medical details, select your discounts, choose your add-on covers, and then click on “Continue”.
  6. Premium details will be displayed to you at the left corner. So, pay for the premium through the online method.

What’s The Claim Process For Universal Sompo Health Insurance Plans?

CASHLESS CLAIM

  • Check Into A Hospital: Show your Health Serve Card and a valid photo ID when you go to a network hospital of your choice. Call the toll-free number to notify Universal Sompo General Insurance Company. It’s important to remember that you must notify your insurance at least 72 hours ahead of time if your hospitalization is planned, and within 48 hours if it’s an emergency.
  • Fill Out A Request For A Cashless Claim Form: Fill out the cashless claim form and send it to Universal Sompo General Insurance.
  • Verification Of Documents: The organization will verify your paperwork before assisting you with the claim process.
  • Settling The Claim: The medical bills will be paid immediately by the insurer at the network hospital. These will not include amounts for non-allowable expenses like phone calls, food, and so on. You’ll have to pay for them out of your own pocket.

REIMBURSEMENT CLAIM

  • Check Into A Hospital & Seek Treatment: Get admitted to any non-network hospital of your choice and receive the treatment you require. It’s important to remember that you must notify your insurance at least 72 hours ahead of time if your hospitalization is planned, and within 48 hours if it’s an emergency.
  • Pay The Bill: Pay the hospital for the medical bills.
  • Gather The Required Documents: Gather all original bills and other documentation and mail them to the address listed on your insurance schedule.
  • Settling The Claim: Once your documents are verified, the company will reimburse the amount to the registered bank account of the policyholder.

Documents Required

  • Duly filled claim form along with doctor’s certificate
  • Test reports (x-ray, CT scan, etc.)
  • Advanced and final receipts
  • Medical bills
  • Prescriptions

How To Renew Universal Sompo Health Insurance Plans?

  1. Go to Universal Sompo General Insurance Company’s official website and go to the ‘Health Insurance Renewal’ page.
  2. Enter your current policy number as well as your date of birth.
  3. Select the ‘Renew Now’ option from the drop-down menu.
  4. Choose your renewal quote and pay for it using a secure payment mechanism online.

Frequently Asked Questions

1. What are the critical illnesses covered under the Saral Suraksha Bima policy of Universal Sompo?

The Saral Suraksha Bima policy of Universal Sompo covers the following critical illnesses:

  1. Stroke resulting in permanent symptoms
  2. Cancer of specified severity
  3. Kidney Failure requiring regular dialysis
  4. Open Chest CABG
  5. Major Organ /Bone Marrow Transplant

2. In Universal Sompo health insurance policies, what is the maximum number of claims that can be made in a year?

During the policy period, there is no restriction on the number of claims that can be filed. Claims can be made up to the policy’s maximum on the sum insured.

3. What isn't covered by Universal Sompo's critical illness plan?

Universal Sompo’s Critical Illness plan doesn’t cover the following things:

  • Pre-existing disorders until the waiting time is completed with continuous coverage for 48 months
  • Convalescence, general debility, rest cure, lethargy, etc. 
  • Aesthetic or plastic surgery 
  • The physician’s experimental treatments

4. What are the extensions available under the Group Health Insurance Policy of Universal Sompo?

  • Pre-Existing Disease Waiting Period Waiver
  • Specific Waiting Period Waiver
  • Initial Waiting Period for Hospitalization Waiver
  • Obesity/ Weight Control Expenses Extension
  • Change-of-Gender Treatments Expenses Extension
  • Cosmetic or Plastic Surgery Expenses Extension
  • Hazardous or Adventure Sports Expenses Extension
  • Sterility and Infertility Treatment Expenses Extension
  • Maternity Expenses Extension with Baby-Day-One Cover
  • OPD Expenses Extension
  • Maternity OPD Expenses Extension
  • Global Coverage
  • Non-medical Expenses Cover

5. Who should get a family health insurance plan from Universal Sompo?

Universal Sompo’s family health insurance coverage is an excellent choice for families who desire financial security and peace of mind in the event of a medical emergency. So, if you have a family that you want to cover with a single sum insured, acquire Universal Sompo’s Complete Healthcare Insurance.

6. Is it possible to change the amount insured during my Universal Sompo family health insurance policy's term?

It is not possible to change the sum insured during the policy term of your Universal Sompo family health insurance because the company does not allow it. It’s better to wait until your policy is up for renewal to make the modifications you want.