Universal Sompo Health Insurance

Universal Sompo General Insurance is a private-public partnership venture in the Indian general insurance industry. It is a joint venture between Allahabad Bank, Karnataka Bank, Indian Overseas Bank, Dabur Investment Corporation, and Sompo Japan. Universal Sompo Health Insurance offered a variety of health insurance plans such as individual health insurance, family health insurance, critical illness, top-up health insurance, group health insurance, health insurance for corona, and more that provide the needful financial assistance in the time of medical emergencies. You can also easily buy Universal Sompo Health Insurance Plan online. Universal Sompo has 86 branch offices and tie-up with more than 4000 Network Hospitals across pan India.

Types of Universal Sompo Health Insurance Plans

Universal Sompo Health Insurance offers various health products to cater to the healthcare needs of every individual, the company offers a wide range of health plans, providing coverage to individuals, families, senior citizens, employees of an organization, and many more. The company at present offers 18 health insurance plans. Let's explore.

1. Universal Sompo Complete Healthcare Insurance

   The policy comes with comprehensive cover to bear the medical expenses at the time of hospitalisation in addition to value-added services. The plan offers easy steps to choose your plan type as per your needs and requirements. Moreover, to offer personalised coverage the plan comes in 3 different variants that are:

   • Basic
   • Essential
   • Privilege

   Eligibility

   Entry Age	For Adults: 18 years - 70 years For children: 91 days -70 years
   Policy Period	1 to 3 years
   Sum Insured	Rs. 1 Lakh to 10 Lakhs

   Features

   • Convalescence benefits (of Rs.10,000) for hospitalisation (over 10 days) are provided by the plan that can be utilized only once during the policy tenure.
   • In case of unavailability of a hospital room or, if you are not in a condition to be moved to the hospital, the plan offers 'Domiciliary hospitalisation', where all your medical expenses are reimbursed.

   What Is Covered Under Universal Sompo Complete Healthcare Insurance?

   Parameters	Values
   Day Care Treatments	Covers 141 procedures
   In-patient care	Covers room charges, nursing expenses, and intensive care unit charges to surgeon's fees, doctor's fees, anaesthesia, blood, oxygen, operation theatre charges, medicines, drugs, consumables, etc.
   Domiciliary Hospitalization	Covered
   Pre- Hospitalization Expenses	Covered up to 30 Days
   Post- Hospitalization Expenses	Covered Up to 60 days
   Ambulance Cover	Covered
   Dental Treatments	Covered in case of accidents
   AYUSH Treatment	Covered
   Maternity Benefits	Available
   New Born Baby Cover	Available

   Optional Covers
   Personal Accident	Covers accidental death or permanent total disablement on account of an accident
   Critical Illness	Illnesses Covered are: First Heart Attack - Of Specified Severity Cancer of specified severity Open Chest CABG Open Heart Replacement Or Repair Of Heart Valves Coma Of Specified Severity Kidney Failure requiring regular dialysis Major Organ /Bone Marrow Transplant Stroke resulting in permanent symptoms Kidney Failure requiring regular dialysis Permanent Paralysis Of Limbs Motor Neurone Disease With Permanent Symptoms
   Hospital Cash
   Sub-limit
   Treatment in tiered Network

2. Universal Sompo Super Healthcare Insurance

   As the name suggests, the plan takes care of your medical expenses during health emergencies when your basic cover is exhausted. Super Healthcare Insurance helps boost the existing coverage by offering higher sum insured options and enhanced protection to fulfil the health expenditure.

   Eligibility

   Entry Age	Up to 80 years
   Policy Term	1/2/3 years
   Sum Insured	Up to Rs. 1 Crore

   Features

   • No pre-policy medical health check-up is 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 weight by undergoing surgery, the expenses for the same will be covered by the plan.
   • The plan comes in two options. Top & Super Top Up. Look at the below table to get a better understanding.

   Top-Up Plan (Application of deductible per claim basis)
   Options	Plan 1	Plan 2	Plan 3
   Sum Insured (in Rs.)	1, 1.5, 2, 3, 5 Lakhs	2, 3, 5, 7, 10 Lakhs	5, 7, 10, 15, 20 Lakhs
   Deductible (in Rs.)	50K, 1 Lakh	2, 3, 4, 5 Lakhs	6, 7, 8, 9, 10 Lakhs
   Super Top-Up Plan (Application of deductible on aggregate claim basis)
   Options	Gold	Diamond	Platinum
   Sum Insured (in Rs.)	2, 3, 5, 7, 10 Lakhs	3, 5, 7, 10, 15, 20 Lakhs	10, 15, 20, 30, 50, 100 Lakhs
   Deductible (in Rs.)	1, 2, 3, 4, Lakhs	6, 7, 8, 9, 10 Lakhs	10, 15, 20, 30, 40 Lakhs

3. Universal Sompo Aarogya Sanjeevani Insurance

   Universal Sompo Aarogya Sanjeevani Insurance offers you and your family complete protection in case of hospitalization due to any serious illness or accident. One can cover up to 7 family members: Self, Spouse, Dependent Children, Mother, Father, Mother-in-law, and Father-in-law.

   Eligibility

   Entry Age	For Adults: 18 years-65 years For children: 91 days-25 years
   Sum Insured	Rs. 1 Lakh to 5 Lakhs

   Features

   • The plan offers coverage for the expenses incurred on hospitalization for a minimum period of 24 hours.
   • The plan also offers coverage for the treatments under AYUSH.
   • Under this plan, a policyholder is also eligible to gain a 5% cumulative bonus (up to 50% of SI) for every claim-free year.

4. Universal Sompo Group Health Insurance

   Universal Sompo Group Health Insurance Policy is designed for the employees working in the trading & manufacturing sectors, social sectors, or members of any society or club. The policy offers coverage against hospitalization expenses with other comprehensive benefits. In some cases, the group health insurance coverage can be extended to the family members of the employees also.

   Features

   • The plan offers the maximum coverage of up to Rs. 5 Lakhs.
   • One can avail additional covers that offer wider coverage and benefits such as:
   • Critical Illness
   • Additional Ambulance Charges
   • Corporate Buffer
   • Organ Donor Expenses
   • Top-up Cover
   • Super Top-up Cover
   • Hospital Daily Cash Cover
   • Restoration of Sum Insured
   • Wellness Benefits
   • Emergency Assistance Services
   • Accident Benefit Cover
   • Dental Treatment Cover
   • Medically Advised Support Devices
   • Benefit Cover for Pandemic/Epidemic Diseases (including COVID-19)
   • External Congenital Ailment Cover

5. Universal Sompo Individual Accident Insurance

   The accidental death of the breadwinner of the family can shatter all the dreams of that family. Universal Sompo's Individual Accident Insurance, offers several benefits if the policyholder gets injured or dies in an accident during the policy tenure.

   Eligibility

   Entry Age	5-65 years
   Proposer's Age	18 years or above

   Features

   The plan comes in 3 options that allow the policyholder to choose the plan as per their requirements-

   • Basic cover that provides coverage against death.
   • The wider cover protects against death along with permanent total/partial disability and,
   • 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 the sum insured or Rs. 5000 (whichever is less up to 104 weeks).

   The plan comes with several additional covers such as Coverage of Transportation Cost for carriage of a dead body to Home including funeral charges, Cost of Clothing damaged in the Accident, Ambulance charges, Education Fund In the event of death, permanent total disablement, Loss of Employment in the event of an accident.

6. Universal Sompo Janta Personal Accident Insurance

   Universal Sompo's Janta Personal Accident Policy provides coverage to you and your family against the financial expenses that occur due to unforeseeable accidents. It's mainly offered to the employees of a firm, members of the association, NGOs, SHG's, Kisan Credit Card Holders, members of APL, and BPL segments of society.

   Eligibility

   Entry Age	5-65 years
   Proposer's Age	18 years or above

   Features

   • The policy offers benefits for death and permanent total disablement that are caused due to an accidental injury.
   • The plan also offers compensation benefits for the accidents resulting in death or permanent total disablement. Under this, the compensation equivalent to the full capital sum insured is provided.

7. Universal Sompo Group Personal Accident Insurance

   Universal Sompo Group Personal Accident insurance offers protection against the consequences of unforeseeable accidents to a group of employees/members. If needed, one has the flexibility to extend the coverage of their employees for dependent children/parents.

   Features

   The plan offers several add-on covers such as Lifestyle modification, Funeral Expenses, Medical Expense Cover, Marriage Expenses, etc.

   The plan offers the compensation benefit that solely depends upon the nature of the injury and the Capital Sum Insured under the Policy. For accidents resulting in:

   • Death or Permanent Total disablement: The compensation equivalent to the full Capital Sum Insured is provided.
   • For Permanent Partial Disablement: The compensation will depend on the nature of the injury and the corresponding percentage of Capital Sum Insured.
   • For Temporary Total Disablement: The compensation at 1% of Capital Sum Insured or Rs. 5000 (whichever is less per week for a maximum period of 104 weeks) will be provided.

8. Universal Sompo Aapat Suraksha Bima Insurance

   Universal Sompo Aapat Suraksha Bima 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

   • It pays an amount equal to the capital sum insured in a one-time payment in case of the death of the insured due to an accident.
   • A percentage of the capital sum insured is payable on the total loss of limbs or eyes.
   • The plan further offer coverage against Critical Illnesses, Accidental Death Cover & Permanent Total Disablement

9. Universal Sompo Loan Secure Insurance

   Universal Sompo Loan Secure is meant to transfer the burden of a loan amount by offering coverage in the event of your diagnosis of listed critical Illnesses or in case of unfortunate accidental death, or Permanent Total Disablement on account of Accident resulting in an inability to remain gainfully employed.

   Features

   • The plan is liable to pay at the time of surgical procedures or on the diagnosis of listed critical illnesses, or if the policyholder is a victim of total permanent disability/death.
   • The plan comes with a Sum insured ranging from a minimum of Rs. 50000 to max Rs. 3 Crores.

10. Universal Sompo Hospital Cash Insurance

    Under this plan, a daily allowance benefit (as hospital cash) is provided to the policyholder at the time of hospitalisation. The entry age for this plan is 18 years to 70 years. Take a look at the benefit options available under the plan:

    Benefit Options
    Options	Option I	Option II	Option III	Option IV	Option V	Option VI
    Amount per day	Rs 500/ - per day	Rs 1000/ - per day	Rs 1500/- per day	Rs 2000 per day	Rs 2500 per day	Rs 3000 per day
    Maximum Amount per Policy Period	Rs 90,000	Rs 1,80,000	Rs 2,70,000	Rs 3,60,000	Rs 4,50,000	Rs 5,40,000

    Features

    • 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.

11. 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 insured on accidental death, disability, and diagnosis of listed critical illnesses, or permanent total disablement due to an accident.

    Eligibility

    Entry Age	For Adults: 18 years-65 years Dependent Children: 10 years - 25 years
    Policy Renewal	Lifetime
    Sum Insured	Rs.10,000 to Rs.1,00,000

    Features

    The five critical illnesses covered under this plan are:

    • Stroke resulting in permanent symptoms
    • Cancer of specified severity
    • Kidney Failure requiring regular dialysis
    • Open Chest CABG
    • Major Organ /Bone Marrow Transplant

    The policy also covers the organ transplantation expenses of the policyholder.

12. Universal Sompo Sampoorna Suraksha Bima Yojana (Micro Insurance Policy)

    Sampoorna defines 'complete' and Universal Sompo Sampoorna Suraksha Bima Yojana offers comprehensive health care protection that is designed to provide maximum coverage to the insured against loss or damage caused to the household valuables.

    The plan covers the individual against:

    • Fire
    • Lightning
    • Explosion / Implosion
    • Aircraft Damage
    • Riot, Strike, Malicious and Terrorism Damage
    • Storm, Cyclone, Typhoon, Tempest, Hurricane, Tornado, Flood, and Inundation
    • Impact Damage
    • Subsidence and Landslide including rock slide
    • Bursting and/or overflowing of Water Tanks, Apparatus and Pipes
    • Missile Testing operations
    • Leakage from Automatic Sprinkler Installations
    • Bush Fire
    • Earthquake
    • Terrorism

13. Universal Sompo Senior Citizen Health Insurance

    To make the second innings of an individual happy and hassle-free, Universal Sompo comes up with the Senior Citizen Health Insurance plan. This health plan is specially designed for senior citizens who are above 60 years of age. One has the flexibility to cover themselves and their spouses.

    Features

    • The plan takes care of the inpatient treatment expenses of the insured.
    • A portability option is available under this plan.
    • The plan offers the sum insured starting from 1 Lakh to 5 Lakhs.

14. Universal Sompo Critical Illness Insurance

    This plan provides necessary coverage to fight against the illness without worrying about your finances.

    Eligibility

    Entry Age	Proposer: 18-65 years Others: 5-65 years
    Sum Insured (in Rs.)	2.5 Lakhs to 25 Lakhs
    Policy Tenure	1-3 years

    Features

    • Any individual can take this policy for self, spouse, parents, and parents-in-law.
    • The plan offers coverage for 11 critical illnesses, where after meeting the conditions, the plan will pay the sum insured to the family.

    The conditions are:

    • Such Critical Illness first occurs or manifests itself during the policy period; and
    • The signs or symptoms of such Critical illness commence after 90 days from the date of commencement of the Policy and
    • You/the Insured Person survives for a minimum period of at least 30 days from the date of diagnosis of such Critical Illness for the claim to be admissible

15. Corona Rakshak Policy

    Corona Rakshak Policy addresses the financial expenses that occur due to the hospitalization of COVID-19. As per the norms specified by the Ministry of Health and Family Welfare, the company is liable to pay the sum insured if the insured is diagnosed with the virus and gets hospitalized for at least seventy-two continuous hours (following medical advice of a duly qualified government medical practitioner).

    Eligibility

    Entry Age	18 years-65 years
    Sum Insured	Rs. 50,000 to Rs. 2,50,000
    Policy Period	3.5 months, 6.5 months, and 9.5 months

16. Corona Kavach Policy

    Corona Kavach policy offers coverage against the expenses that arise at the time of COVID-19 treatment. One can file a claim if they are hospitalized for COVID-19 after testing positive at a government-authorized diagnostic centre.

    Eligibility

    Entry Age	Adults: 18 years-65 years Dependent Children: 1 Day-25 years
    Sum Insured	Rs, 50,000 to Rs. 5,00,000
    Policy Period	3.5 months, 6.5 months, and 9.5 months

    Features

    • Under this plan, one can get coverage for the treatments under Ayurveda, Unani, Siddha, Yoga, and Homeopathy.
    • One can opt for Individual or Family Floater coverage and can cover self, legally wedded spouse, dependent children, parents, and parents-in-law

17. Universal Sompo Surva Vidyarthi Bima Yojana

    Universal Sompo Surya Vidyarthi Bima Yojana is taken by an Educational Institution/School for the benefit of the students. The insured can opt for any Section/Benefit and Extension as per their needs.

    Benefit Table
    Section A	Section B	Section C
    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 - Tumours/Cysts/Nodule/Polyp Stone in Urinary System Hernia Related Appendectomy Knee Ligament Reconstruction Surgery Hysterectomy Fissures/Piles/Fistulas Spine & Vertebrae related Cellulitis/Abscess Other Surgeries & Procedures All Medical Expenses for any treatment not involving surgery/medical procedure	Fire Explosion/Implosion Loss or damage by aircraft, other aerial or space devices, and articles 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: 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, a) Repairs or alterations to the building or premises b) Repairs, Removal or Extension of the sprinkler installation c) Defects in construction known to You Bush Fire, excluding loss, destruction, or damage caused by Forest Fire

18. Universal Sompo Swarna Gramin Bima Yojna (Individuals & Groups)

    Universal Sompo Swarna Gramin Bima Yojana can be taken up by the Gramin (Village Dweller) for covering himself and his family or by an organisation such as NGOs, Financial Institutions for covering its rural clientele. The Policy comprises three sections:

    • Section A: Personal Accident
    • Section B: Critical Illness

    Illnesses covered under this section are:

    • Cancer of specified severity
    • First Heart Attack of specified severity
    • Kidney Failure requiring regular dialysis
    • Major Organ /Bone Marrow Transplant
    • Open Chest CABG Stroke resulting in permanent symptoms
    • Motor Neurone Disease with Permanent Symptoms
    • Open Heart Replacement Permanent Paralysis of Limb
    • Coma of Specified Severity Multiple Sclerosis with persisting symptoms
    • Section C: Hospital Cash

Key Features of Universal Sompo Health Insurance Company

Choosing an ideal health insurance company is a hectic task. With around 29 health insurance companies selecting the best one for you and your family can be quite confusing.

Before choosing your health insurance company, evaluate the Universal Sompo Health Insurance performance based on the universal sompo claim ratio, solvency ratio, annual premium, and availability of network hospitals, so that you can choose the best policy as per your needs and requirements.

Let us see where Universal Sompo stands on these factors:

1 Network Hospitals

To ensure to avail the benefit of your health insurance policy at the time of need it is essential for you to consider buying health insurance from a company that offers the benefit of cashless hospitalization.

With this facility, you can get yourself treated without worrying about the hospital's bills. At present, Universal Sompo offers 4,000+ network hospitals across India, allowing customers to enjoy hassle-free cashless hospitalization.

2 Claim Support

The claim support ratio is one of the useful parameters that showcases the number of claims settled by the company in the last three months. It is another important factor that helps you to evaluate how soon the company will settle your claims in the time of need. Before buying health insurance, one should always check the history of claims settled by that company.

In the case of Universal Sompo, the company has an average claim support ratio of above 90%. Take a look at the chart given below that shows a claim support ratio of the company in the last four years:

Claim Support Ratio of Universal Sompo from 2016-2020

**Data from IRDAI Annual Reports

3 Solvency Ratio

Apart from the network hospitals and claim support, another factor that should be considered while buying a health insurance policy is the solvency ratio, which indicates the financial soundness.

It helps the individual in assessing the ability of the company to meet its long-term financial obligations.

To make this task easier for the potential buyer, IRDAI has made it mandatory for all insurance companies in India to maintain a minimum solvency ratio of 1.5.

When it comes to Universal Sompo, the company has been able to match this criterion. At present, the solvency ratio of the company is 2.15. Take a look at the below graph, to get an insight into the solvency ratio of the company from 2016. to 2020.

Solvency Ratio of Universal Sompo From 2016-2020

**Data from IRDAI Annual Reports

4 Annual Premium

The bar graph below shows the Annual Premium of Universal Sompo Health Insurance across India from 2016-2020. Let's have a look.

Annual Premium of Universal Sompo from 2016-2020

**Data from IRDAI Annual Reports

5 PAN India Presence

The company offers a PAN India presence with 7700 Bank Branches.

What is Not Covered Under Universal Sompo Health Insurance?

Some conditions are generally not included under Universal Sompo Health Insurance. Following are the general exclusions under Universal Sompo Policy:

• Any illness diagnosed within the first 90 days of the inception of the policy.
• Any accident resulting from self-injury, or under any influence of intoxication or suicide.
• The insured dies or suffers from other injuries while participating in adventurous sports.
• Self-exposure to needless perils except in an attempt to save human life.
• Injuries due to war or ionizing radiation or nuclear perils.

How To Purchase Universal Sompo Health Insurance Plans?

Buying Universal Sompo Health Insurance is an easy and hassle-free process. One has the option to directly buy the policy through the company's website, or purchase via PolicyX.com. Let's look at both the procedures:

Through the Company's Website

• Visit the official website of Universal Sompo Insurance company and click on the 'Products' tab.
• Choose the 'Health' category.
• Check the plans as per your needs and tap the 'Buy' button.
• Fill in all the details required and make the payment.
• Your policy-related documents will be mailed to you at your registered e-mail address.

Note: You can also buy Universal health plans from the nearest branch of the company.

Through PolicyX.com

• Scroll up to the top of this page and fill in the details in the 'Calculate Universal Sompo Health Insurance Premium' form.
• Out of all the quotes shown to you, choose the desired Universal Sompo health plan and click on 'Buy Now'.
• Pay the premium and your policy documents will be shared with you on your registered email.

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

For Cashless Claim:

• You need to intimate the insurer within 24 hours of emergency hospitalization and 48 hours before a planned admission in the network hospital.
• Show your health card along with valid ID proof and fill in the details in the cashless request form.
• Submit the form at the hospital insurance helpdesk.
• The hospital will then verify the information provided and send the form to the company.
• The company will verify the details and communicate its decision to you and the hospital.
• On acceptance, the company will directly settle the expenses with the hospital.

For Reimbursement Claim:

• Intimate the insurer about the hospitalization at the earliest and pay the expenses post-discharge.
• Fill the reimbursement form with the required details and submit it.
• The insurer will ask you to submit the hospital bills, prescriptions, and receipts.
• On successful completion of the verification procedure, the company will reimburse the amount in the claimant's registered account.

How To Contact Universal Sompo General Insurance?

Universal Sompo's Customer care is available 24*7. We have mentioned all the means by which one can contact the company:

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 200 4030, 022 - 27 63 9800,022 - 39133700

Health Product Customers Helpline: 1800 200 5142, 022 - 39 63 5200

Fax: 1800-200-9134

Email: contactus[at]universalsompo[dot]com,

For Claims: contactclaims[at]universalsompo[dot]com