Universal Sompo Health Insurance

Universal Sompo Health Insurance
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About Universal Sompo Health Insurance

Universal Sompo General Insurance is a private-public partnership venture in the Indian general insurance industry. The joint venture is between Allahabad Bank, Indian Overseas Bank, Dabur Investment Corporation and Sompo Japan (which is a Fortune 500 company with a capital of 70 billion dollars). Universal Sompo Health insurance plans offer the insured person a vast range of healthcare products that provides the needful financial assistance in case of medical emergencies.

Highlights of Universal Sompo General Insurance Company

Number of Network Hospitals4000+
Incurred Claims Ratio92.20%
Pre-existing diseases4 years
Number of Branches in India86

Table Data updated on 21-09-2020

Universal Sompo Health Insurance Highlights

What Are the Types of Universal Sompo Health Insurance Plans?

1. Universal Sompo Super Healthcare Insurance

As the name suggests, the plan takes care of your medical expenses during health emergencies but with extra care. Super Healthcare Insurance helps to boost the existing coverage by offering higher sum assured options and enhanced protection so as to fulfil the health expenditure.

Features & Benefits

  • Unlike other health insurance plans, the entry age of this policy is up to 80 years of age.
  • The sum assured options are touching an extraordinary limit of Rs. 1 crore.
  • Avail discounts by including children of up to 30 years of age.
  • No pre-policy medical health check-ups are required until the age of 65 years.
  • The plan offers a unique feature like cover for weight loss surgery, i.e., if you want to lose your weight by undergoing surgery, the expenses for the same will be covered by the plan.

2. Universal Sompo Individual Health Insurance policy

This plan can be purchased on an individual basis. It provides coverage on hospitalization expenses, domiciliary hospitalization, illness and accidental injury during the policy tenure.

Features & Benefits

  • Expenses incurred towards oxygen, room, surgeon or consultant's fees, nursing, boarding, charges for blood, etc. are covered under the plan.
  • Hospitalisation at home exceeding a period of 3 days advised by the doctor is also covered.
  • Indemnity and sub-limits are restricted to the sum assured amount of the policy.
  • Tax benefits on the premiums paid towards the plan under Section 80C of the Income Tax Act of India, 1961.

3. Universal Sompo Individual Accident Policy

The policy offers several benefits if the policyholder gets injured or dies in an accident during the policy tenure.

Features & Benefits

  • 3 options are available under the plan; viz., basic cover that provides coverage against death, the wider cover provides protection against death along with permanent total/partial disability and the comprehensive cover provides coverage against the above-mentioned causes, together with temporary total disability.
  • A compensation benefit will be paid in case of temporary disablement equivalent to 1% of sum assured or Rs. 5000, whichever is less up to 104 weeks.
  • Get benefited with an education fund for dependent children due to an accident.

4. Universal Sompo Complete Healthcare Insurance

It is a one-stop solution for all health care insurance needs. The policy comes with comprehensive cover to bear the medical expenses at the time of hospitalisation in addition to value-added services.

Features & Benefits

  • Offers a choice of plans such as basic, essential or privilege.
  • The policy covers dependent children up to 25 years of age.
  • Convalescence benefits of Rs. 10,000 for hospitalisation over 10 days is provided by the plan that can be utilized only once during the policy tenure.

5. Universal Sompo Aapat Suraksha Bima Policy

This policy offers coverage to support the policyholder or the beneficiary during sudden and unexpected medical contingencies, i.e., on the diagnosis of major critical illnesses such as cancer, paralytic stroke, major organ transplant, renal failure or coronary heart disease.

Features & Benefits

  • It pays an amount equal to the sum assured in a one-time payment.
  • A percentage of the sum assured is payable on the total loss of limbs or eyes.

6. Universal Sompo Loan Secure Insurance

The plan is meant to transfer the burden of a loan amount by offering coverage in case of any medical emergency to the life insured.

Features & Benefits

  • The plan is liable to pay at the time of surgical procedures or on diagnosis of critical illness, or if the policyholder witnessed total permanent disability.
  • More than Rs. 1 crore coverage can be taken as the sum assured option.
  • One can renew the policy up to 55 years of age.

7. Universal Sompo Hospital Cash Insurance

A daily allowance benefit (as hospital cash) is provided by the plan at the time of hospitalisation of the policyholder.

Features & Benefits

  • Several options are offered by the plan as per your requirements.
  • A family discount of 5% can be availed under the policy.
  • On exceeding 21 days of hospitalisation, a convalescence benefit of Rs. 10,000 shall be payable.

8. Universal Sompo Saral Suraksha Bima (Micro Insurance Policy)

Saral Suraksha plan is liable to pay the one-time lump sum benefit of the chosen sum assured on accidental death, disability and diagnosis of listed critical illnesses.

Features & Benefits

  • Low premium rates are available under the plan.
  • A maximum of Rs. 1 lakh sum assured can be availed under the plan.
  • The policy also covers organ transplantation expenses of the policyholder.

9. Universal Sompo Sampoorna Suraksha Bima Yojana

Sampoorna defines 'complete' and this policy offers a comprehensive health care protection that is designed to provide maximum coverage to the insured.

Features & Benefits

  • Fire and allied perils are covered by this plan.
  • It provides protection against loss or damage caused to the household valuables.
  • Any damage due to storm, cyclone including landslide is covered under the Sampoorna Suraksha policy.

10. Universal Sompo Senior Citizen Health Insurance Policy

This health plan is specially designed for senior citizens whose age is above 60 years.

Features & Benefits

  • Hospitalization; including ICU admission, can be reimbursed with the help of this policy.
  • The plan takes care of inpatient treatment of the patient.
  • Portability option is available under the plan.

11. Universal Sompo Pravasi Bhartiya Bima Yojana

This plan provides health care insurance benefits and travel insurance benefits to immigrating individuals or individuals carrying a passport approved for 'Immigration check required'.

Features & Benefits

  • All the health care essentials (if prescribed by the doctor) are covered including doctor's fees.
  • The spouse can be added in the policy up to 65 years of age, whereas two children can also be added up to 21 years of age.
  • If the death of the policyholder happens outside the country, the plan will pay the compensation amount for the opted sum assured.

12. Universal Sompo Surva Vidyarthi Bima Yojana

The plan is primarily designed for students in order to meet their health care needs for a bright future.

Features & Benefits

  • If parents of the student or the student die due to an accident, this plan will pay the sum assured amount to the beneficiary.
  • It covers disablement of the policyholder.
  • Any loss of personal assets can be reimbursed through this policy.
  • Compassionate visit of the parents to the student's residence is also available under the plan.

13. Universal Sompo Swarna Gramin Bima Yojna for Individuals

Comprehensive health coverage for village dwellers or NGOs' who want to cover the rural localities in their area that provides financial protection against various odds of life.

Features & Benefits

  • The plan provides security against death due to an accident.
  • Total and partial permanent disability is covered under the policy.
  • Major critical illnesses like strokes, kidney failure and motor neuron diseases are inclusive under the coverage provided by the plan.

14. Universal Sompo Critical Illness Insurance Policy

A tailor-made plan for patients suffering from major and serious critical disorders. The plan offers coverage to the patients to fight against the illness with the help of this insurance policy.

Features & Benefits

  • Any individual can take this policy for self, spouse, parents or for their parents-in-law.
  • Cancer patients can avail the benefits of this policy as the plan also covers the medical expense for them.
  • Wide range of sum insured options in addition to portability option can be easily availed under the policy.

How To Purchase Universal Sompo Health Insurance Plans?

Offline Method:

  • Choose a health insurance plan as per your convenience and go to the nearest Universal Sompo General Insurance branch.
  • They will give you an insurance application form.
  • Fill the details and submit at the help desk.
  • They will process the application and will inform you about the confirmation.
  • The verification process will decide if the policy has been registered and you will receive the policy documents in your email id if the insurer finds everything true as per their terms and conditions.
  • Please contact the customer care services in case of any further queries.

Online Method:

  • Visit the official website of Universal Sompo General Insurance company and click on the 'products' tab.
  • Choose the 'health' category.
  • Check the plans as per your needs and choose one to proceed and tap the 'Buy' button.
  • Fill in the details required and make the payment.
  • On successful transaction of your payment, the policy documents will be shared automatically on your registered email id.

What Is the Renewal Process of Universal Sompo Health Insurance Plans?

Renewal Instructions by Universal Sompo General Insurance

  • If the policyholder has cleared his/her due premium payments in the policy year, only then the renewal of the policy will be approved by the company.
  • The receipt of renewal premium paid should consist of an authenticated signature of the insurer and should be in the printed form.
  • If the life insured is suffering from any health emergency before the renewal date of the policy, he/she should communicate the same to the company during the application for the renewal process. Hiding any information can obstruct and hold the renewal process.

Online Renewal Process

Just follow the below-mentioned steps to renew your policy

  • Step 1: Visit the official website of Universal Sompo General Insurance company and click on the 'Products' tab present at the top-right corner of the page.
  • Step 2: Choose the 'Health' category and your plan from the list given.
  • Step 3: Click on the 'Renew Now' option, enter the required details and tap on 'Renew Now'.
  • Step 4: A summary of your policy details will pop up in front of you. Complete the payment process.
  • Step 5: You will receive the confirmation on your registered email address.

What All Is Excluded Under Universal Sompo Health Insurance Plans?

  • Not liable to pay any compensation in case of death or injuries arising out of strikes, riots or any malicious acts.
  • A terrorist act, wars, nuclear attacks, active participation in riots due to which accidents or injuries may happen are not covered.
  • Disorders diagnosed due to any radioactive contamination from nuclear wastes.
  • During the first year of the policy, diseases like cataract, hysterectomy, sinusitis and related complications will not be payable.
  • Self-injury, health issues arising out of the intoxication of drugs or alcohol in the body are also excluded.

What Is the Claim Process for Universal Sompo Health Insurance Plans?

For Cashless Claims:

  • You need to intimate the insurer within 24 hours of emergency hospitalization and 48 hours before a planned admission in the hospital.
  • Make sure to admit the patient in a network hospital only to avail cashless treatment facility.
  • Show your health card along with valid ID proof and fill the details in the cashless request form.
  • Submit the form at the hospital insurance helpdesk.
  • Then the hospital will verify the information provided and send the form to the company health office.
  • Your cashless treatment will be communicated by the company on the basis of terms and conditions.

For Reimbursement Claim:

  • Intimate the insurer within 24 hours of hospitalisation.
  • Reimbursement claims can be raised post-discharge.
  • Fill the reimbursement form with required details and submit.
  • The insurer will ask you to submit all the hospital bills, prescriptions and receipts.
  • Submit the documents and they will verify the same.
  • On successful completion of the verification procedure, the claim will be directly settled by the hospital with the insured person.

**Note: Please ensure to keep all the necessary documents as it needs to be furnished by you prior to claim intimation.

How To Contact Universal Sompo General Insurance?

Contact Address: Universal Sompo General Insurance Company Ltd., Plot No. EL-94, KLS Tower, TTC Industrial Area, MIDC, Mahape, Navi Mumbai, 400710.

Customer Care Helpline: 1800-22-4030, 1800-200-4030, 022-2763-9800,022-3913-3700

Health Product Customers Helpline: 1800-200-5142, 022-3963-5200

Fax: 1800-200-9134

Email: contactus@universalsompo.com,

For Claims: contactclaims@universalsompo.com

Universal Sompo Health Insurance: FAQs

1. Is there any limit for filing claims for my Universal Sompo health plan?

No, there is no limit on filing claims. You can file claims anytime up to the sum assured limit during the entire policy tenure.

2. What are the sum assured options if I want to buy a family floater health insurance plan from Universal Sompo?

There are many sum assured options under the family floater plan of Universal Sompo. You can choose from Rs. 1 lakh to 10 lakhs.

3. Do the family floater health plans of Universal Sompo provide coverage for OPD expenses and maternity?

Yes, both OPD expenses and maternity are covered under the family floater health plans of Universal Sompo.

4. If I want to buy a Universal Sompo health insurance plan for my parents above 55 years of age, is there any need to do pre-policy medical check-ups?

Yes, individuals above 55 years of age have to undergo medical check-ups before buying health insurance from Universal Sompo.

5. Will the company refund me the whole premium amount for cancellation of my health insurance policy?

Yes, Universal Sompo is entitled to refund the premium amount on cancellation of the policy by deducting the applicable charges, if any.

6. Will the Universal Sompo Super Health Care plan provide coverage for senior citizens?

Super Health Care by Universal Sompo allows the entry of a person up to 65 years and no pre-policy medical test is required for the same, however, specifically the plan does not cover senior citizens.

7. My child is 10 years old, does the Universal Sompo Complete Healthcare plan provide daily allowance benefits for his hospitalisation?

Yes, if a child under 12 years is hospitalised for a minimum period of 3 days, daily allowance to fulfil the non-medical expenditure will be provided by the company under the Universal Sompo Complete Healthcare plan.

8. If I want to port my Universal Sompo Pravasi Bhartiya Bima Yojana, when should I inform the company?

You need to inform the company at least 45 days prior to the expiration date of the policy to successfully port your Universal Sompo Pravasi Bhartiya Bima Yojana to some other insurance company.

Page updated on 21-09-2020