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Universal Sompo Complete Healthcare Insurance is a comprehensive health insurance plan that takes care of your medical bills during hospitalization. The policy enables the policyholder to buy family floater health insurance plans and add up to 5 family members, with an option to extend coverage to up to 20 members.
With a healthy and reliable claims settlement ratio of 95.77%, Universal Sompo emphasizes transparency and exceptional customer service.
The Universal Sompo Health Care Plan offers a multitude of advantages that ensure policyholders are well-protected against various medical expenses. Let us look at the features of the plan:
The policy covers expenses for hospitalization due to disease, illness, or injury during the policy period that requires an insured person's admission to a hospital as an inpatient.
Complete Healthcare Insurance Universal Sompo covers medical expenses directly related to hospitalization, including room rent, boarding expenses, nursing services, and more.
The plan also covers medical expenses for any daycare procedures where the insured person undergoes a procedure or surgery as an inpatient for less than 24 hours in a hospital or standalone daycare centre.
Medical expenses incurred will be paid within 30 days of hospitalization. The insured must submit all medical documents detailing the illness, proposed date, and place of hospitalization at least 5 days prior to admission.
Medical expenses incurred will be reimbursed within 60 days of hospitalization, provided all documents are submitted within 5 days post-discharge.
If the base Sum Insured and No Claim Bonus (if any) are exhausted due to claims made and paid during the policy year, a Restore Sum Insured equal to 100% of the base sum insured will be automatically available for the remainder of that policy year.
For every claim-free year, a Cumulative Bonus of 10% of the Sum Insured is applicable and will accumulate up to 50% of the Sum Insured, for base Sum Insureds up to ₹10 Lakh. The maximum cumulative bonus will not exceed 100% of the Inpatient Sum Insured.
The policy covers the reimbursement of the cost of a preventive health check-up for the insured person who was covered during the previous policy year. The coverage limits for health check-ups vary based on the Sum Insured chosen. No health check-ups are covered for individuals up to age 55.
| PLAN DETAILS |
Complete Healthcare Policy |
Sarvah Plan |
| Product Type | Individual and Family Health Insurance | Individual and Family Health Insurance |
| Key Features (Key features of the plan) |
|
|
| OPD Details (In some policies, OPD (Out patient department) expenses are also covered.) |
Covered | Not Covered |
|
Room Rent (A limit of room rent cover during hospitalization if any) |
Covered | Covered |
| Domicillary Hospitalization (It is the expenses incurred on treatment of the patient at home) |
Covered | Covered |
| Pre-hospitalization (Expenses before the insured is hospitalized) |
Covered | Covered |
| Post-hospitalization (Expenses after discharge from the hospital) |
Covered | Covered |
| Day Care Treatment Covered (Day care treatments refers to the treatments that do not necessarily require 24hrs of hospitalization like MRI.) |
Covered | Covered |
| Hospital_network (Number of Hospital Network in city) |
4000 | 15000 |
| Organ Donor Expenses (Expenses incurred on organ donor in case of organ transplants) |
Covered | Covered |
|
Hospital Daily Allowance (Some plans offer daily allowance to take care of expenses like food, etc) |
Covered | Not Covered |
| Ambulance Charges (Expenses incurred on ambulance charges) |
Covered | Covered |
|
Maternity Benefits (All Hospitalization cost covered at the time of pregnancy.) |
Not Covered | Covered |
| New Born Baby Covered (Newborn babies can be covered under the insurance plan after a certain period) |
Not Covered | Covered |
| Health Checkup (An added benefit of one time full health checkup of policy holder.) |
Covered | Covered |
|
Sub Limit (Sub-limit is a monetary capping that applies on specific diseases like cataract) |
Covered | Not Covered |
| Co-pay (Mentioned %, if any is to be borne by Insured and rest will be borne by insurer) |
Covered | Not Covered |
| Plan Entry Age | Minimum 18 years, Maximum 75 years | 91 days to no maximum age limit |
| Plan Premium Entry Age and S/A | 8,700 | 4804 |
| Plan Waiting Period | 30 days* | 30 |
| Plan Coverage | Individual and Family floater coverage | Hospitalization up to ₹3 Cr, Personal Accident Cover up to ₹3 Cr, Maternity & Newborn expenses, Unlimited Sum Insured Restoration, Pre-Existing Disease coverage |
| Plan Sample Premium | NA | 4804 |
| Plan Brochure | Brochure URL | Brochure URL |
| Policy Term | 1, 2, 3 years | 1/2/3 Years |
| ICU Charges | Covered | Covered |
| Covid-19 Treatment | Covered | Covered |
| Cataract | Covered | Covered |
| Automatic Restoration | Covered | Covered |
| Ayush Treatment | Covered | Covered |
| Modern Treatment | Covered | Covered |
| E Consultation | Covered | Covered |
| Air Ambulance | Not Covered | Covered |
| Global Coverage | Not Covered | Not Covered |
| Claim Ratio | 91.58 | 98 |
| Solvency Ratio | 1.97 | 1.76 |
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