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Universal Sompo Health Insurance

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Universal Sompo Health Insurance
Highlights
Claim SettlementAvailable
Claim Settlement Ratio96%
In-House Claim SettlementAvailable
Network Hospitals4,000+
Starting Premium for Rs. 5 lakh CoverageRs. 527/month
Starting Premium for Rs. 5 lakhs SIRs. 475/month

About Universal Sompo

Universal Sompo General Insurance Company is a private-public joint venture of Allahabad Bank, Indian Overseas Bank, Karnataka Bank Ltd., Dabur Investment Corp, and Sompo Japan Nipponkoa Insurance Inc. Headquartered in Mumbai, Universal Sompo is the first private-public partnership in the general insurance industry. The insurer has a range of general insurance products in its basket that fulfill varied requirements of different sections of people across India. These are health insurance, motor insurance, travel insurance, and home insurance.

One of the most promising products offered by Universal Sompo General Insurance is health insurance. The insurer offers affordable and easy-to-understand health insurance policies that you can purchase on an individual or floater basis. These policies are designed in a way that they offer the customer multiple benefits including both basic coverage features as well as advanced coverage benefits. All in all, the insurer protects you from burning a hole in your pocket in case of medical emergencies.

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Disclaimer : Actual Premium might vary basis your location, age and number of members

Universal Sompo Health Insurance Plan List

  • Individual (11)
  • Family (11)
  • Woman (11)
  • Parents (11)
  • Blood Pressure (11)
  • Kids (11)
  • Thyroid (11)
  • Diabetes (11)
  • Critical Illness (5)
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Universal Sompo Health Insurance Premium Calculation

Health insurance premium is the amount that you pay to the insurer in order to avail benefits under your Universal Sompo Health Insurance plan. You can pay the premium for your health insurance plans on a monthly, quarterly, half-yearly, or yearly basis via a secured payment gateway offered by InsuranceDekho. You can also use InsuranceDekho Health Insurance Premium Calculator to get an estimate of the premium to be paid for your shortlisted Universal Sompo Health Insurance plan. To see the factors that determine the premium for your Universal Sompo health insurance plans, read below:

  • Sum Insured Amount: The sum insured amount that you chose under your Universal Sompo health insurance plan not only increases your coverage, but also the premium that you will be required to pay. But you must not compromise on the sum insured amount in order to reduce your health insurance premium. This is because then you might not be able to make the best use of your policy when in need. The sum insured amount varies with different variants offered under Universal Sompo Health Insurance plans.
  • Age: It is advised to purchase a health insurance policy when young. This is because you are less vulnerable to illnesses/disease as you have a stronger immune system when you are young. But as you age, you are more prone to illnesses and hence are likely to make more health insurance claims. So, you will be required to pay a higher premium if you purchase Universal Sompo Health Insurance policy in the later years of life.
  • Number of Insured: The number of members you want to add under your Universal Sompo Health Insurance plan directly affects your health insurance premium. Higher the number of members added, higher will the premium be. Note that you may choose to buy Universal Sompo Health Insurance policy on an individual or floater basis. You will be required to pay a lesser premium if you purchase family floater health insurance policy in comparison to individual policy.
  • Lifestyle Habits: Lifestyle habits such as use of tobacco, consumption of alcohol, drugs, etc. affect your health and hence your premiums under Universal Sompo Health Insurance plans. You will be required to pay a higher premium if you are habitual to living an unhealthy lifestyle as then you are more likely to make health insurance claims.
  • The Choice Of Plan Variant: Some Universal Sompo Health Insurance plans come with different variants. For instance, Complete Healthcare Insurance Policy is available in three variants viz., Basic, Essential, and Privilege. All of them differ from each other in terms of coverage features and hence the health insurance premium. You will be required to pay a higher premium if you choose a variant with higher coverage and vice versa.

Top Universal Sompo Health Insurance Plan Types

Of all the health insurance plans offered by Universal Sompo Health Insurance, here are top 4 plans shortlisted by us:

1. Universal Sompo Complete Healthcare Insurance Policy: Universal Sompo Complete Healthcare Insurance Policy covers you and your family against most of the medical expenses incurred in case of hospitalisation, out-patient treatment, and various value-added services. The policy comes in three variants namely Basic, Essential, and Privilege. You can buy this policy on an individual or floater basis with sum insured options ranging between Rs. 1 lakh and Rs. 10 lakh. You can enjoy several coverage benefits under this policy such as cover for in-patient hospitalisation expenses, pre-hospitalisation and post-hospitalisation expenses, organ donor expenses, dental treatment, etc.

2. Universal Sompo Super Healthcare Insurance Policy: Universal Sompo Super Healthcare Insurance Policy is a health insurance policy that boosts your existing health insurance plan and covers you against the medical expenses worldwide. The policy comes in two options namely top-up and super top-up that are further available in different variants. The sum insured options available under the policy range between Rs. 2 lakh and Rs. 1 crore with specified deductible limits. You can take this policy for 1 year, 2 years, and 3 years, and need to renew it after the same period.

3. Universal Sompo Individual Health Insurance Policy: Universal Sompo Individual Health Insurance Policy covers you and/or your family against hospitalisation as well as domiciliary hospitalisation expenses incurred due to an illness or an accident during a policy term. You can be covered under this policy if you are aged less than 55 years. The policy is available for sum insured options ranging up to Rs. 5 lakh and covers you against several healthcare expenses such as pre-hospitalisation and post-hospitalisation expenses, in-patients hospitalisation expenses, domiciliary expenses, and daycare treatment expenses. The policy also offers you an add-on benefit of critical illness that you can purchase by paying a little extra premium.

4. Universal Sompo Arogya Sanjeevani Policy: Universal Sompo Arogya Sanjeevani Policy is an affordable policy that covers you and your family against basic healthcare expenses incurred due to an illness, disease, sickness, or an accident. You can be covered under this policy for sum insured options ranging between Rs. 1 lakh and Rs. 5 lakh if aged between 91 days and 65 years. The policy offers you several coverage benefits such as cover for pre-hospitalisation and post-hospitalisation expenses, in-patient hospitalisation expenses, daycare treatments, AYUSH treatments and modern treatments such as robotic surgery, oral chemotherapy, immunotherapy etc.

What Is A Health Insurance Top-up Plan and Why Should I Buy It?

A top-up plan offers you enhanced coverage over and above your existing health insurance plan when its coverage is insufficient against the incurred medical expenses. Top-up plans are comparatively cheaper than regular insurance plans and offer wide sum insured options so that you get financial protection during difficult times.

Universal Sompo Health Insurance offers Super Healthcare Insurance Policy that covers individuals and families against medical expenses that are above the sum insured of your other policy or the deductible amount. You can be covered under this policy if you are aged between 91 days to 80 years. The policy offers you several benefits such as free health check-up on every renewal, wellness reward programme, cover for pre-hospitalisation and post-hospitalisation expenses, in-patient hospitalisation expenses, organ donor expenses, daycare expenses, and 100% restoration of base annual sum insured.

You can also buy the best health insurance plans at home with InsuranceDekho.

Universal Sompo Health Insurance Top Up List

    Name of PlanSum Insured
    Super Healthcare Policy Min: 91 days; Max: 80 years1 Lakh - 1 Crore Check Premium

    Why Choose Universal Sompo Health Insurance?

    Read about the features below that make Universal Sompo a preferred choice for many:

    • Wide Network Of Over 4,000 Hospitals: Universal Sompo Health Insurance has a wide network of more than 4,000 hospitals pan India where you can avail cashless hospitalisation without having to worry about managing funds. The nature of the hospitalisation can be either planned or emergency.
    • Impressive Claim Settlement Ratio: Universal Sompo Health Insurance has a good Claim Settlement Ratio (CSR) of 70.75% for the financial year 2019-20. This depicts that the insurer is good at handling claim requests raised by the customers.
    • 24*7 Customer Care Assistance: Universal Sompo Health Insurance offers 24*7 customer care assistance. You can reach out to the insurer on the helpline number for customer care, health helpline, and claims helpline to seek insurance related help. The insurer also offers you the live chat facility where you can get your queries solved.
    • 135 IRDAI Approved Products: With 135 IRDAI (Insurance Regulatory and Development Authority of India) approved products in the market, Universal Sompo Health Insurance has a strong footprint in the insurance sector. The company offers a complete spectrum of products and efficient services through them.
    • In-House Claim Settlement Process: Universal Sompo Health Insurance Company has an in-house claim settlement process that enhances customer service in the event of any claim.

    Health Insurance Coverage Calculator

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    Disclaimer : Actual Coverage might vary basis your location, age and number of members

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    Network Hospitals of Universal Sompo Health Insurance

    A network hospital is a hospital that has a tie-up with an insurer and that allows you to avail cashless treatment on the basis of deferred payment. Universal Sompo has a wide network of more than 4,000 hospitals across India where you as an insured individual can avail of several healthcare benefits in a cashless manner in cases of both planned treatment as well as emergency treatment.

    11505 Universal Sompo Cashless Network Hospitals in India

    Universal Sompo Health Insurance Tax Benefits

    Along with many other benefits, Universal Sompo Health Insurance plans offer you tax benefits as well on the premiums paid for them under Section 80D of the Income Tax Act, 1961. To understand the tax deductions clearly, refer to the table given below:

    Situations

    Premium Paid

    Deduction under Section 80D of the Income Tax Act

    Self, Family, Children

    Parents

    When the policyholder as well as parents are less than 60 years of age

    Rs. 25,000

    Rs. 25,000

    Rs. 50,000

    When the policyholder and family members are aged below 60 years with parents aged over 60 years

    Rs. 25,000

    Rs. 50,000

    Rs. 75,000

    When the policyholder, family members, and parents are aged over 60 years

    Rs. 50,000

    Rs. 50,000

    Rs. 1,00,000

    Members of the Hindu Undivided Family (HUF)

    Rs. 25,000

    Rs. 25,000

    Rs. 25,000

    Non-Resident Individuals

    Rs. 25,000

    Rs. 25,000

    Rs. 25,000

    Tax Save
    Save Tax upto ₹75000*
    Under Section 80D

    *Tax benefits are subject to changes in Income Tax Act.

    Universal Sompo Health Insurance Claim Settlement Ratio

    Claim Settlement Ratio is the ratio of claims settled against the total number of claims received by an insurance company in a financial year. To see the CSR registered by Universal Sompo Health Insurance over the last few years, please refer to the table below:

    Financial Year

    Claim Settlement Ratio

    FY 2018-2019

    75.92%

    FY 2019-2020

    70.75%

    (Source: IBAI’s General Insurance Claim Insights Handbook For Policyholders - 4th & 5th Edition)

    Universal Sompo Health Insurance Claim Process

    You can make a claim under Universal Sompo Health Insurance plans in two ways viz, Cashless and Reimbursement. A cashless claim is when you, as the insured, do not have to pay for the medical expenses when hospitalised as the insurer will directly settle the bills at the network hospital. Whereas a reimbursement claim is when you settle the expenses on your own at the hospital and later file a claim for reimbursement. To know the process for both in detail, read below:

    How To Make A Universal Sompo Health Insurance Cashless Claim?

    Follow the steps given below to make cashless claim under your Universal Sompo Health Insurance plan:

    Step 1: Get Hospitalised
    Get hospitalised at a network hospital of your choice and show your Health Serve Card and a valid photo ID. Inform Universal Sompo General Insurance Company on the toll-free number 1800-200-5142. Note that you are required to inform the insurer at least 72 hours before hospitalisation if it is planned, and within 48 hours in case of emergency hospitalisation.

    Step 2: Submit A Cashless Claim Request Form
    Fill and submit the cashless claim form to Universal Sompo General Insurance company.

    Step 3: Document Verification
    The company will verify your documents and will then help you process the claim.

    Step 4: Claim Settlement
    The insurer will settle the medical bills directly at the network hospital. These will not include the amount for inadmissible expenses like telephone charges, food, etc. You will be required to pay for them from your own pocket.

    How To Make A Universal Sompo Health Reimbursement Claim?

    Follow the steps given below to avail reimbursement treatment under Universal Sompo Health Insurance plan:

    Step 1: Get Hospitalised and Avail Treatment
    Get hospitalised in any non-network hospital of your choice and avail the required treatment.
    Note that you are required to inform the insurer at least 72 hours before hospitalisation if it is planned, and within 48 hours in case of emergency hospitalisation.

    Step 2: Make Payment
    Settle the medical bills at the hospital.

    Step 3: Collect The Relevant Documents
    Collect origins bills along with the required documents and submit them to the address mentioned in your policy schedule.

    Documents Required For Reimbursement Claim Settlement

    You are required to submit the following documents in case of a reimbursement claim under your Universal Sompo Health Insurance plan:

    • Duly filled claim form along with doctor’s certificate
    • Medical bills
    • Prescriptions
    • Test reports (x-ray, CT scan, etc.)
    • Advanced and final receipts

    Step 5: Claim Settlement
    Your claim will be settled if the insurer finds it in accordance with the terms and conditions of your Universal Sompo Health Insurance plan.

    Claim Process at Universal Sompo Health Insurance

    • Network Hospital
    • Non-Network Hospital
    • 1

      Claim Assistance

      For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
    • 2

      Claim Intimation

      Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 72 hours prior to admission.
    • 3

      Claim Processing

      Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
    • 4

      Claim Settlement

      Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.
    • 1

      Claim Assistance

      For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
    • 2

      Claim Intimation

      Emergency hospitalisation needs intimation within 72 hours and for planned hospitalisation intimate within 48 hours prior to admission.
    • 3

      Claim Processing

      Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
    • 4

      Claim Settlement

      Once your request for reimbursement of expenses is approved, the claim will be settled.

    Benefits of Universal Sompo Health Insurance Plans

    You can choose Universal Sompo Health Insurance plans to avail the following benefits:

    • Wide Range of Sum Insured Available: Universal Sompo Health Insurance plans come with a wide range of sum insured. These start from as low as Rs. 1 lakh and go up to Rs. 1 crore so that you can avail maximum coverage benefits under your policy.
    • Plan Variants Enabling Customisation: Universal Sompo Health insurance plans are available with different variants that cater to varied requirements of the customers. The plan variants differ in terms of coverage features, sum insured amount, and deductibles (for top-up and super top-up plan).
    • Portability Benefit: Universal Sompo Health Insurance plans are available with portability benefit. This means that you can switch to Universal Sompo Health Insurance plans at the time of renewal if you are not satisfied with your existing insurer or health insurance policy. Also, you would not have to lose your accumulated benefits under the previous policy.
    • Lifetime Renewability Guaranteed: Universal Sompo Health Insurance plans offer you lifetime renewability benefit. This means that you can continue to avail the benefits under your health insurance plan throughout the lifetime provided you pay the health insurance premium timely.

    Universal Sompo Health Insurance User Reviews

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    What users are saying
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    Latest News on Universal Sompo Health Insurance

    What All Is Covered Under Universal Sompo Health Insurance Plans?

    Universal Sompo Health Insurance plans cover you against the following expenses arising due to medical treatment:

    • In-Patient Hospitalisation Expenses: Universal Sompo Health Insurance plans offer cover against medical expenses arising due to hospitalisation due to any illness/sickness/injury/disease. These may include expenses related to room rent, boarding, nursing, ICU/ICCU, anaesthesia, blood, oxygen, operation theatre, medicines and drugs, and diagnostic and surgical procedures.
    • Pre-Hospitalisation and Post-Hospitalisation Expenses: Universal Sompo Health Insurance plans offer cover against medical expenses incurred before 30 days and after 60 days of hospitalisation. These include expenses related to vaccination, medicines, medical tests, and doctor’s consultation fee.
    • Daycare Treatments: Daycare treatments are the treatments that require hospitalisation of less than 24 hours. These include surgeries or medical procedures such as surgery, dialysis, chemotherapy, etc. Universal Sompo Health Insurance plans offer you cover against such expenses.
    • Road Ambulance Cover: Universal Sompo Health Insurance plans cover the insured against expenses incurred on transportation of him/her to the network or non-network hospital either in case of emergency or non-emergency situation.
    • AYUSH Treatments: Universal Sompo Health Insurance plans offer you cover against AYUSH systems of medicines based on the notion of natural medicines. These include Ayurveda, Yoga, Unani, Siddha, and Homeopathy in order to cure specific diseases and help you stay healthy.

    What All Is Not Covered Under Universal Sompo Health Insurance Plans?

    Universal Sompo Health Insurance plans do not cover you against the following healthcare expenses:

    • Addictions And Substance Abuse: Universal Sompo Health Insurance plans do not cover you against any healthcare expense incurred due to addictions and substance abuse including drugs, alcohol, smoking, or tobacco intake.
    • Injuries Caused Due To Any Act Of Self-Harm: Universal Sompo Health Insurance plans do not cover the insured against any act of self-harm caused intentionally. For instance, attempt of suicide.
    • Injury Due To Participation In Adventure Sports: Universal Sompo Health Insurance plans do not cover the insured against any sports activity or otherwise that is adventurous in nature. for instance, rock climbing, paragliding, etc.
    • Any Injury Attributable To War: Universal SOmpo Health Insurance plans do not cover you against any injury or illness that is attributable to acts of war such as invasion, revolution, insurrection, or nuclear power damage.
    • Treatment For AIDS: Universal Sompo Health Insurance plans do not cover you against any expense incurred directly or indirectly due to AIDS (Acquired Immuno Deficiency Syndrome) if or not arising because of HIV or any other medical condition that is not covered under a particular policy.

    Kindly note that inclusions and exclusions under Universal Sompo health insurance plans vary from plan to plan.

    Universal Sompo Health Insurance Policy Terms

    Universal Sompo Health Insurance plans are available with the following terms:

    Minimum Entry Age

    91 days

    Maximum Entry Age

    65 years

    Policy Renewal

    Lifetime renewability offered

    Renewal Premiums

    Premiums paid on health insurance renewals are subject to change.

    General Waiting Period

    A waiting period of 30 days is applicable starting from the date of policy issuance. You are eligible to avail policy benefits only after the waiting period has been served.

    Note that the terms and conditions vary with different Universal Sompo Health Insurance plans.

    How to Purchase Universal Sompo Health Insurance Policy at InsuranceDekho?

    You can purchase Universal Sompo Health Insurance plans at InsuranceDekho in online as well as offline modes. The process for both is explained below.

    Buy Universal Sompo Health Insurance Plan Online At InsuranceDekho

    Follow the steps given below to buy Universal Sompo Health Insurance plan online at InsuranceDekho:
    Step 1: Visit insurancedekho.com. Click on the ‘health’ tab.
    Step 2: Select your Gender and enter your personal details like Name and Mobile Number. We will send an OTP (One Time Password) on your mobile number. Please enter that.
    Step 3: Answer the question ‘When do you want to buy the policy’ by choosing one of the options listed. Click on the ‘View Quotes’ button.
    Step 4: Select your family members whom you want to add to your policy. Click ‘Continue’.
    Step 5: Select the age of your family members.
    Step 6: Enter your Email ID and City. Click on ‘Submit and View Quotes’. The most relevant quotes for you will be displayed on your screen. Shortlist the one you wish to purchase.
    Step 7: Select the policy term for your shortlisted policy. Fill in the required details and pay the premium online via a secured payment gateway.

    Buy Universal Sompo Health Insurance Plan Offline At InsuranceDekho

    You can also purchase Universal Sompo Health Insurance plans offline from InsuranceDekho. For that, you need to call on the toll-free number 7551-196-989 and share your requirements with the knowledgeable customer care experts. You can call us any day between 9:30AM to 6:30 PM. You can also write to us at customersupport@insurancedekho.com in case of any doubt, query or support required.

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    Why to Buy Health Insurance Policy Online from InsuranceDekho

    • Tax benefit upto 75,000*
    • Claim support everyday 10AM-7PM
    • 66 Lacs+ happy customers

    Universal Sompo Health Insurance Renewal Process

    Universal Sompo Health Insurance plans are required to be renewed on intervals depending on the policy term chosen. It can be 1 year, 2 years, or 3 years. Renewing your health insurance policy allows you to avail continuation benefits and also offer you uninterrupted peace of mind. to renew your Universal Sompo Health Insurance plans, follow the simple steps given below:

    Step 1: Visit the official website of Universal Sompo General Insurance Company and navigate to the ‘Health Insurance Renewal’ page.

    Step 2: Enter the current policy number and Date of Birth.

    Step 3: Click on the ‘Renew Now’ button.

    Step 4: Select your renewal quote and pay for the same online via a secured payment gateway.

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    FAQ About Universal Sompo Health Insurance

    • How to buy and apply for Universal Sompo Health Insurance plan?

      You can buy and apply for any Universal Sompo Health Insurance Policy online from the official website of Universal Sompo Health Insurance at www.universalsompo.com or through online broker’s website like insurancedekho.com.

    • Are pre-existing diseases covered in Universal Sompo Health Insurance?

      Yes, pre-existing diseases are covered. But, it’s subject to the waiting period mentioned in your health plan.

    • How long does TPA take to approve the claim?

      Generally, TPA approves the claim within 3-6 hours after receiving all relevant documents.

    • How long does it take to clear the bills?

      Once all the relevant documents are received, it normally takes 7 days to settle the bills.

    • What is a health card?

      A health card is an identity card issued to policyholders. It enables them to avail cashless treatment at every network hospital.

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