Universal Sompo Claim Settlement Ratio
  • Check Claim Settlement Ratio
  • Importance of CSR
  • Explore the process of claim settlement
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Universal Sompo Claim Settlement Ratio

Choosing an ideal health plan is a tedious task, however, choosing an ideal health insurance company is more of a hectic task. With more than 20 health insurance companies claiming to offer you the best services, selecting the best one for you and your family can be quite confusing.

Thus, before zeroing down on your choice of one health insurance company, it is important for you to check the company's claim settlement history.

This factor not only helps you to understand the company's performance but will also give you a sense of understanding and will smoothen the selection process.

In the section below, let us explore the Universal Sompo Claim Settlement Ratio, and discuss its importance:

Health Insurance Claim Settlement Ratio

What is the Universal Sompo Health Insurance Claim Settlement Ratio?

As per the IRDAI, Universal Sompo Claim Settlement Ratio is 95.77%. Take a look at the below table to explore the Universal Sompo claim settlement ratio:

Status of Universal Sompo Health Insurance Claim Settlement ratio- 2021-22
Age Analysis of Number of Claims Paid (%) < 3 months 3 months to 6 months 6 months to <1 year 1 year to <3 year 3 years to <5 years 5 years
Claims Settled 95.77 2.78 0.97 0.38 0.08 0.02

Health Insurance Companies

Universal Sompo Health Insurance Network Hospital List

Types of Universal Sompo Health Insurance Claims

There are two types of health insurance claims you can choose from

  • Cashless Claim
  • Reimbursement Claim

Let us get a better understanding of the Universal Sompo's Claim Settlement Process.

What are Cashless Claims?

Ever been in a medical emergency and ran out of money? Such an unforeseeable medical situation might rip a hole in your wallet, forcing you to wipe off all your savings on hospital costs! This is where a health insurance plan that offers cashless claim settlement comes in handy. In a cashless facility, your insurer covers the medical payment directly with the hospital, eliminating the need for you to pay the expenses first. 

Cashless Claim Filing Process

  • Get hospitalized in any of your nearest network hospitals.
  • 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. 

What are Reimbursement Claims?

For a Reimbursement claim, you need to pay all hospital bills and expenditures out of pocket before filing a reimbursement claim. One is required to keep records of all hospital and pharmaceutical costs. The insurance company reimburses the policyholder/insured for their medical expenditures once the treatment is completed and the patient is released. The compensation is based on the insurance company receiving correct medical bills and expenditures.

Reimbursement Claim Filing Process

  • If by any chance you could not find a network hospital, you can still file for a reimbursement claim.
  • Intimate the insurer about the hospitalization at the earliest and pay the expenses post-discharge. 
  • Fill out 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.

Why Is Claim Settlement Ratio Important?

The claim settlement ratio is one of the most useful parameters that showcases the number of claims settled by the company in a financial year. It is an 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.

Prospective buyers might use the claim settlement ratio to determine how well the insurance company honours their claims. It is recommended to check the claim settlement ratio of all the 

plans having the lowest premiums and highest benefits.

A higher health insurance claim settlement ratio indicates the company's financial performance and its ability to pay off the claims made by its customers.

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.


Universal Sompo Complete Healthcare Insurance

A comprehensive health plan that comes with benefits and value-added services like Dial-a-Doctor, Health Educational Library for People, & many more.

Unique Features

  • Dental Treatment covered
  • Vaccination cover
  • Daily Cash for an Insured Child


Universal Sompo Aarogya Sanjeevani Insurance

A standard health plan that offers complete protection in case of hospitalization due to any serious illness or accident.

Unique Features

  • Treatment of Cataract covered
  • Dental Treatments covered
  • Plastic Surgery covered


Universal Sompo Saral Suraksha Bima

Saral Suraksha plan covers the insured on accidental death, disability, and diagnosis of listed critical illnesses, or permanent total disablement due to an accident.

Unique Features

  • Cumulative Bonus of up to 50%
  • Education Grant
  • All day care treatments


Universal Sompo Super Healthcare Insurance

The plan takes care of your medical expenses once your basic cover is exhausted. It boosts the existing coverage by offering an enhanced cover of up to 1 Cr.

Unique Features

  • No Medical tests up to 65 years
  • 100% restoration of Base SI
  • Bariatric Surgery Cover

Senior Citizen

Universal Sompo Senior Citizen Health Insurance Policy

This health plan is specially designed for senior citizens who are above 60 years of age and allows them to cover their spouse’s healthcare needs themselves.

Unique Features

  • Cost of Health Check-up Covered
  • Daily Allowance up to Rs. 2,500
  • Optional covers

Loan Repayment

Universal Sompo Loan Secure Insurance Policy

Repay your outstanding loan amount in the event of your diagnosis of listed critical Illnesses or in case of unfortunate accidental death.

Unique Features

  • 4 plan variants to choose from
  • 18 Major Medical Illnesses covered
  • Optional covers

Personal Accident

Universal Sompo Individual Accident Policy

Universal Sompo's Individual Accident Insurance offers several benefits if the policyholder gets injured or dies in an accident during the policy tenure.

Unique Features

  • Compensation Benefit
  • Hospital Confinement Allowance
  • Funeral charges covered

Critical Illness

Universal Sompo Critical Illness Insurance Policy

The plan provides the necessary coverage to fight against the 11 listed critical illnesses, and pays the sum insured to the family.

Unique Features

  • Sum insured up to 20 L
  • Free look-up period
  • Portability option

Daily Cash

Hospital Cash Insurance Policy

A daily allowance benefit (as hospital cash) is provided to the policyholder at the time of hospitalization.

Unique Features

  • Convalescence Benefit
  • Long-Term Policy Discount
  • No pre-medical tests up to 55 years

Travel Plan

Pravasi Bhartiya Bima Yojana

The policy is designed only for those emigrants who bought this policy before leaving India and have their passports under “Emigration Check Required”.

Unique Features

  • Transportation and Airfare Charge
  • Maternity expenses
  • Repatriation Expenses

Student Oriented

Universal Sompo Surva Vidyarthi Bima Yojana

The plan 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 .

Unique Features

  • Coverage for the Death of the Parent
  • Reimbursement of Examination Fees
  • Loss of Personal Belongings Cover

Rural Insurance

Universal Sompo Swarna Gramin Bima Yojana (Individual)

Universal Sompo Swarna Gramin Bima Yojana can be taken up by the Gramin (Village Dweller) for covering himself and his family.

Unique Features

  • Coverage against personal accident
  • Coverage against critical illness
  • Optional covers available

Critical Illness

Universal Sompo Aapat Suraksha Bima Policy

The policy offers coverage to support the policyholder during sudden and unexpected medical contingencies, i.e., on the diagnosis of major critical illnesses.

Unique Features

  • Accidental Death Cover
  • Coverage against 5 critical illnesses
  • 100% payout in accidental death

Micro Insurance

Universal Sompo Sampoorna Suraksha Bima

The plan is designed to meet the insurance needs of sections that are eligible for credit from microfinance institutions such as self-help groups, NGOs, etc.

Unique Features

  • Fire & Allied Perils (contents) cover
  • Burglary and Robbery cover
  • Personal accident and health cover

Group Vector Insurance

Universal Sompo Group Mashak Rakshak Policy

The policy offers coverage for vector-borne diseases such as Dengue, Malaria etc.

Unique Features

  • 2% of the SI on a positive diagnosis
  • Lump sum benefit
  • Coverage for hospitalization

Group Comprehensive

Universal Sompo Group Health Insurance Policy

The plan is designed for the employees working in the trading & manufacturing sectors, social sectors, or members of any society or club.

Unique Features

  • Domiciliary Hospitalization covered
  • Optional Covers
  • AYUSH Treatment covered

Group Personal Accident

Universal Sompo Group Personal Accident

The plan offers protection against the consequences of unforeseeable accidents to a group of employees/members.

Unique Features

  • Restricted Contingency Cover
  • Adventure Sports Inclusion Cover
  • Carriage of Mortal Remains

Group Rural Insurance

Universal Sompo Swarna Gramin Bima Yojana (Group)

Universal Sompo Swarna Gramin Bima Group Yojana can be taken up by an organization such as NGOs, Financial Institutions for covering its rural clientele.

Unique Features

  • Coverage against personal accident
  • Coverage against critical illness
  • Optional covers available


Corona Rakshak Policy

Corona Rakshak Policy addresses the financial expenses that occur due to the hospitalization of COVID-19.

Unique Features

  • Affordable Premium
  • Flexible Sum Insured
  • Annual Health Check-Up


Corona Kavach Policy

Corona Kavach policy offers coverage against the expenses that arise at the time of COVID-19 treatment.

Unique Features

  • Emergency Ambulance
  • Post-Hospitalization Expenses
  • AYUSH Healthcare

Universal Sompo Health Insurance Reviews

Read what our customers have to say about Universal Sompo Health insurance company and Universal Sompo Health mediclaim policy.

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October 3, 2023

Universal Shompo is the best company, according to me, they are very fast responding. They are very friendly to their customer.

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October 3, 2023

I was nervous about buying the plan, but Policyx helped me to get through the process and Universal Shompo has the best plan as well.

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Himanshu Raina


May 31, 2022

I bought Universal Sompo Health Insurance back in 2020. Since then, I have not faced any issues with my policy. Moreover, in Jan 2021, my wife was diagnosed with Covid-19, and the company settl...

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Sita Dewan


September 7, 2021

My friend refers me to Universal Sompo to buy a health policy, and I am very much satisfied with their services.

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Sheersha Devi


September 2, 2021

I bought a Universal sompo complete healthcare insurance I am renewing my policy for the last 2 years. And from the last 2 years No complaints from anyone.

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Kavita kumari


September 1, 2021

Good plans at affordable prices, amazing customer support, timely settled my claim. Thanks Universal Sompo

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Devendra Singh Negi


June 7, 2021

Universal Sompo is not just a health insurance company, but also a friend that assists you at every stage in the time of medical emergency. I must say, if you are looking for a health insurance...

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Vidhya Mukherjee


June 7, 2021

It is a very good company that looks after its customer s health needs. I recently got my claims settled without facing any hassles and worries. Thank-you Universal Sompo.

View All Universal Sompo Health Insurance Reviews

Naval Goel

Reviewed By: Naval Goel

Naval Goel is the CEO & founder of PolicyX.com. Naval has an expertise in the insurance sector and has professional experience of more than a decade in the Industry and has worked in companies like AIG, New York doing valuation of insurance subsidiaries. He is also an Associate Member of the Indian Institute of Insurance, Pune. He has been authorized by IRDAI to act as a Principal Officer of PolicyX.com Insurance Web Aggregator.