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universal sompo health insurance

Individual Health Insurance Plans

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Universal Sompo Super Healthcare Policy

Universal Sompo Super Healthcare policy provides the option of both top-up health insurance coverage and Super top-up health insurance coverage. Universal Sompo Super Healthcare Insurance Top-up and Super Top-Up Plan come in multiple variants. The top-up plan comes in three variants i.e., Plan 1, Plan 2, and Plan 3. The Super top-u plan comes in Gold, Diamond, and Platinum variants. The coverage amount kicks in once the deductible amount is exhausted i.e., over and above the policy deductible limit.

The Super Healthcare Insurance plan will cover all of your medical costs. The Super Healthcare insurance plan supplements your current one by giving you the choice of a higher Sum Insured and extended coverage to pay for your medical costs. The main selling point of Universal Sompo’s Super Healthcare Insurance is that it offers a higher Sum Insured with a deductible that applies to claims, making a higher range Sum Insured more affordable than a regular mediclaim policy with a higher Sum Insured(s).

Eligibility Criteria

Here are the eligibility criteria for the Universal Sompo Super Healthcare Insurance Policy.


Minimum: Proposer/Adult 18 years

Maximum: Proposer/Adult 80 years

Dependent Children Maximum Entry Age: 30 years under Family Floater Plan

Entry age for children-3 months

Renewal AgeLifetime
Pre- Medical TestUnder certain circumstances such as declaration(s) in the proposal form or if insured member/s are/is above 65 years and SI is greater than 20 lakhs, we may ask you to undergo mentioned medical check-ups to help us understand your health condition in a better way
Policy Tenure1 year/ 2 Years/ 3 Years.
Sum InsuredUp to Rs. 100 Lacs (in Platinum Variant)
Members CoveredFamily Floater: Self, Spouse, 4 dependent Children under this policy

Coverage Details

Here are the coverage details for the Super Healthcare Insurance Policy by Universal Sompo.

Pre-hospitalizationUp to 120 days (Under Platinum Variant)
Post-hospitalizationUp to 150 days (Under Platinum Variant)
Ambulance ExpensesActuals or maximum up to Rs. 4000
Maternity Expenses Including newborn BabyCovered – Limit Rs. 75,000
Bariatric Surgery CoverCovered – Limit 5 Lakhs
Long Term Discount
  • 2-year annual premium in advance less 7.5% discount
  • 3-year annual premium in advance less a 10% discount
Loyalty Discount5%
Employee Discount15%

What are the Key Features and Benefits of the Universal Sompo Super Healthcare Insurance Policy?

The following are the key features and benefits of choosing the Universal Sompo Super Healthcare Insurance Policy..

  • Medical Expenses

If the insured members are hospitalised on the advice of a doctor due to the illness or accidental bodily injury sustained or contracted during the policy period, the policy will reimburse the insured for reasonable medical expenses incurred more than the deductible stated in the schedule.

  • Day Care Treatment

When the insured person receives daycare treatment or surgical procedures while a patient for less than 24 hours in a hospital or daycare facility, but not in the facility’s outpatient department, the company will cover the associated medical costs.

  • Pre-Hospitalization Expenses

For the period specified in the policy schedule just before the insured person was hospitalised, the company will cover any medical expenses incurred during the policy period.

  • Post-Hospitalization Expenses

Immediately following the insured’s discharge from the hospital following their hospitalisation, the company will cover any medical expenses incurred during the policy period for the duration specified in the policy schedule.

  • Organ Donor Expenses

Up to the sum insured stated in the policy schedule, the insurance will cover the in-patient hospitalisation medical costs for a successful organ transplant, including pre-transplant medical tests for a legitimate donor and for harvesting the organ.

  • In-Patient AYUSH Hospitalization

The policy will cover any medical costs incurred as part of an in-patient AYUSH treatment as per the guidelines for reimbursement/settlement of AYUSH treatment expenditure claims under insurance coverage.

  • Domiciliary Hospitalization

When an insured person receives medical care at home that would have otherwise required in-patient hospitalisation, the company will cover the associated medical costs.

  • Ambulance Expenses

If a claim is accepted under “In-patient hospitalisation,” the company will pay the ambulance expenses incurred for transportation of the insured member(s) to the closest hospital with adequate facilities, up to the maximum amount as specified in the policy schedule. These expenses include those for air ambulance, special cardiac ambulance, and road ambulance.

  • Maternity Cover

With a lifetime maximum of two deliveries or terminations, the policy will cover the medical costs associated with an inpatient delivery (including a caesarian section) or a legal medical termination of pregnancy during the policy period.

  • Automatic Restoration

If the opted Base Sum Insured and the Cumulative Bonus (if any) are insufficient due to prior claims in that policy year, the Company will once offer a 100% restoration of the Base Annual Sum Insured chosen by the Insured.

  • Emergency Assistance Services

When the insured or insured member(s) is more than 150 kilometres from their residential address listed on the proposal form, the company will offer the services. With prior notification and acceptance by the company, the services would be rendered by the company or through our designated Service provider.

  • Complete Wellness & HealthCare

To maintain the insured person’s health and general well-being, the company provides a thorough complete wellness and healthcare program. The Company offers the insured person personal access to a web-based health portal on the Company’s website and/or a wellness mobile application, where he or she can carry out various healthcare tasks.

  • Global Care

Provided that the diagnosis was made in India and referred by a medical practitioner for which the insured member(s) travels abroad for treatment, the Company will reimburse for Medical Expenses of the Insured Person incurred outside India up to the Sum Insured, but not for more than 180 consecutive days.

  • Free Health Check-Ups

Through the appointed Service Provider, the company will offer the insured person free medical examinations at each renewal. The policyholder’s claim history has no bearing on the availability of this free health checkup.

Major Exclusions Under the Universal Sompo Super Healthcare Policy

Here is the list of the things not covered under the Universal Sompo Super Healthcare plan.
  • Expenses associated with any form of treatment, including surgical intervention, to change a person’s physical characteristics to those of the other sex.
  • Costs associated with cosmetic or plastic surgery, as well as any other procedure intended to alter the appearance, unless necessary for reconstruction following an accident, burn, or cancer, or if they are part of a medically necessary procedure to eliminate a direct or immediate threat to the insured’s health.
  • Treatment costs resulting directly from or as a result of any insured person breaking the law with criminal intent or attempting to do so.
  • The cost of any medical care required as a result of a professional athlete’s participation in risky or adventure sports, such as skydiving, deep-sea diving, hand gliding, motor racing, mountaineering, rafting, parachuting, rock climbing, and others.
  • Treatment for alcoholism, drug abuse, or any other addictive condition, as well as its effects.
  • Treatments received in health hydros, nature cure clinics, spas, or comparable facilities, or private beds registered as nursing homes attached to those facilities, or admission arranged entirely or partially for domestic purposes.
  • Vitamins, minerals, and organic substances are just a few examples of dietary supplements and substances that are available without a prescription unless a doctor has prescribed them as part of a hospitalisation claim or daycare procedure.
  • Expenses for any treatment that hasn’t been proven effective, as well as services and supplies used in conjunction with treatments. Unproven treatments are those that do not have a substantial body of medical evidence to support their efficacy.
  • War (whether declared or not), invasions, hostilities, civil war, uprisings, revolutions, insurrections, mutinies, military or usurped power, as well as all types of seizure, capture, arrest, restraint, and detention.

Buying Process Of Super Healthcare Policy

Each of us strives to secure our financial futures through planning investments and savings, but if you want to safeguard your financial security, you cannot discount the significance of health insurance.

Your Universal Sompo Super Healthcare Insurance policy will shield you from such unforeseen events because, in the event of a medical emergency, you might end up having to abandon your investments or savings. That is to say, you can receive high-quality medical care without being concerned about your financial situation. If you are interested in buying the Super Healthcare Insurance policy by Universal Sompo, then listed below are the steps to follow.

  • Simply open the official website of Universal Sompo using your laptop or smartphone.
  • On the top, you will see the “Products” section. Click on it and under “Health Insurance”, you will need to click on “Explore All Plans”.
  • When the page opens, you will see a list of health plans. Then locate the Super Healthcare Insurance. When you find it, click on “Show More”.
  • The plan page will open. After that, you will need to enter your full name, mobile number, email ID, Age band, State, City, and Pin code. Once you are done entering all the details, click on “Get Quote”.
  • After that, you will again need to enter your name, contact number, and email address, and select your age band. Then, click on the “Continue” button.
  • The next step requires you to choose the sum insured, choose the policy tenure, enter your home address, and complete any other required fields before clicking “Save & Continue”.
  • When you click it, a payment page will open where you can use your credit/debit card, nett banking, EMI, or UPI. Click “Proceed to Pay” after that.
  • The final step will involve sending you a message and the policy documents via email and your registered mobile number.

Claim Process Of Super Healthcare Insurance Policy by Universal Sompo

The claim can be settled in two ways:

1. Cashless Claims:

Below are steps you need to follow to claim for cashless health insurance:

  • Contact the Insurer through Toll-Free Healthline

So that the health-relationship manager can assist you with the procedure, get in touch with the insurance provider three days beforehand. Within 24 hours of being hospitalised, get in touch with the insurer in case of an emergency.

  • Verify Your Identity at the Hospital in the Network

The hospital authorities will require you to present your health insurance card, issued by the insurer. The information provided on the card—such as your policy number, card number, name, age, etc.—will then allow the network hospital to get in touch with the insurance provider.

  • Cashless Hospitalization Claim Request Form

There is a claim request form that must be completed. The form asked for information about the patient’s medical history, course of treatment, and estimated costs. With these details, the hospital will assist you.

  • Insurance Company Contacts Network Hospital

The insurer issues the authorisation letter for the claim after examining the data it has received from the hospital. If there are insufficient papers, the insurer asks the hospital for more, and after receiving satisfactory documentation, the authorisation letter is given.

  • Claim Service Associates

The insurer can offer you a claim service representative to help you navigate the paperwork and other documents if you request one.

  • Final Request for Authorization

The hospital sends a final request for authorisation along with the final hospital bill and discharge summary once the treatment is finished. Only after receiving final approval from the insurer will the discharge be granted.

  • Payment to the Network Hospital

The network hospital is required to give the insurer the original paperwork used to evaluate the claim and make the payment.

  • Pre-Post Hospitalization Payouts

If you have chosen a comprehensive health insurance policy, you must submit pre- and post-hospitalization costs as well as medical bills from your end to be reimbursed for the money you spent out of pocket.

Reimbursement Claims:

Below are the steps you need to follow to claim reimbursement under your health insurance:

  • Contact the Insurer through Toll-Free Healthline

For the health-relationship manager to assist you with the process, you must contact the insurance company three days before the hospitalisation, just like with cashless treatment. Within 24 hours of admission, get in touch with the insurer in case of an emergency.

  • Hospitalization

Take advantage of the hospital’s services and pay all associated costs. Along with pre- and post-hospitalization expenses, the charges assessed during the period of admission may be reimbursed. Gather all the required paperwork, including case files, hospital bills, discharge summaries, investigation reports, pharmacy invoices, etc.

  • Submit Your Claim

The correctly completed claim form must be submitted with the above-mentioned list of supporting documents. You can download the form from the insurer’s website or find a copy of it in the policy kit you receive when the term first begins. Send the claim form and all supporting documentation to the insurer’s corporate office or the closest office. After discharge, you have 15 days to complete this.

  • Claim Assessment

The insurer accepts the request and handles the claim after examining the data you have provided. The insurer may ask you to provide additional information or documentation in cases where there is not enough of either. The claim may be rejected if the required documents are not submitted within the allotted time.

  • Claim Service Representative

The insurer can offer you a claim service representative to help you navigate the paperwork and other documents if you request one.

  • Claim Settlement

You will receive the claimed amount in your bank account via NEFT or through a DD/Cheque once the insurer has approved the claim.

Frequently Asked Questions

The Universal Sompo Super Healthcare Insurance Plan offers deductible options ranging from Rs 50,000 to Rs 40 lakh.

The Universal Sompo Super Healthcare Insurance Plan offers sum insured options ranging from Rs 1 lakh to Rs 1 crore.

The health card is good for the duration of the policy.

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