Simran is an insurance expert with more than 4 years of experience in the industry. An expert with previous experience in BFSI, Ed-tech, and insurance, she proactively helps her readers stay on par with all the latest Insurance industry developments.
Raj Kumar has more than a decade of experience in driving product knowledge and sales in the health insurance sector. His data-focused approach towards business planning, manpower management, and strategic decision-making has elevated insurance awareness within and beyond our organisation.
Updated on Jul 08, 2025 4 min read
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, you need 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:
What is the Universal Sompo Health Insurance Claim Settlement Ratio?
As per the IRDAI, the 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
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 Universal Sompo’s Claim Settlement Process.
What are Cashless Claims?
Ever been in a medical emergency and run 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. With a cashless health insurance plan, 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 to 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 the 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 Network Hospital List
Universal Sompo Health Insurance Network Hospitals are present in 31 states nationwide. With a wide network of hospitals, Universal Sompo Health Insurance ensures that you are medically secured, irrespective of the city you reside in.
To cater to the different medical needs of an individual & their family,
Universal Sompo Health Insurance offers
several Health Plans ranging from senior citizen plans to specialized plans for
autistic
children, to health insurance for cardiac patients, and many more.Take a look below
to Universal Sompo Health Insurance plans
explore more:
Universal Sompo Complete Healthcare Insurance is a comprehensive health insurance plan that takes care of your medical bills during the time of hospi...
'Beauty lies in the eyes of the beholder.' - Plato
This is the reason you should protect your eyes at any cost.
The eyes are one of the most sensitive...
Unique Features
Special Eyewear Coverage
Discounts on Premiums
Deductibles Available
Universal Sompo Eyewear Plan (Pros)
Fire and allied perils
Accidental Damage
Burglary including theft
Universal Sompo Eyewear Plan (Cons)
Damage due to mishandling
Defect in manufacturing
Replacement of the spectacles/lens
Universal Sompo Eyewear Plan (Other
Benefits)
Spectacles
Lenses & Sunglasses cover
Cover within India & Abroad
Universal Sompo Eyewear Plan (Eligibility
Criteria)
1. What is the claim settlement ratio of Universal Sompo health insurance company?
The CSR of Universal Sompo is 91.58% as per the IRDAI report of 2022-23.
2. How do I claim my Universal Sompo health insurance policy?
You can claim your Universal Sompo health policy either online from the company’s website of offline through one of the nearest branches.
3. Can I get a cashless hospitalization benefit with my Universal Sompo health policy?
Yes. A cashless hospitalisation facility is available under the Universal Sompo health insurance policy and you can avail of all the mentioned cover benefits.
Simran is an insurance expert with more than 4 years of experience in the industry. An expert with previous experience in BFSI, Ed-tech, and insurance, she proactively helps her readers stay on par with all the latest Insurance industry developments.
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