Universal Sompo Complete Healthcare Health Insurance

Universal Sompo’s Complete Health Insurance plan is offered on both individual and family floater basis. The plan is designed to pay the insured person’s hospitalisation expenses, in-patient treatment, AYUSH expenses, and a lot more. The Universal Sompo Complete Health Insurance plan is available in three variants, Plus, Premiere, and Executive. Read on to find out all about the Universal Sompo Complete Health Insurance plan.

Universal Sompo Complete Health Insurance Plan at a Glance

Key Features of Universal Sompo Complete Health Insurance Plan

Some of the key features of the Universal Sompo Complete Health Insurance plan are as follows:

• Extensive Family Plan: As already stated, the Universal Sompo Complete Health Insurance is a family as well as an individual plan. If you choose the family option, you can get coverage for up to 6 members which can also be increased up to 20, depending on your requirements.

• Policy Period: The policy term of the Universal Sompo Complete Health Insurance plan can be either 1, 2, or 3 years. The policyholder can also enjoy lifelong renewability with the Universal Sompo Complete Health Insurance plan.

• Value Added Services: With the Universal Sompo Complete Health Insurance plan, you can also enjoy the benefit of value-added services. This includes second e-opinion coverage, telephonic consultations, a health educational library, and a lot more.

• Out-patient Dental Treatment: The Universal Sompo Complete Health Insurance plan also provides coverage for outpatient treatment. Any dental treatment will thus be covered under this.

Eligibility Criteria of Universal Sompo Complete Health Insurance Plan

Listed below are the eligibility criteria for the Universal Sompo Insurance's Complete Healthcare Plan:

Benefits of Buying Universal Sompo Complete Health Insurance Plan

The Universal Sompo Complete Health Insurance Plan offers a bunch of benefits such as those listed below:

• Variants: The Universal Sompo Complete Health Insurance Plan is available in three different variants, Plus, Premiere, and Executive. While most of the coverage offered under all of the three variants are same, there are a few differences. For instance, the Plus variant has a sum insured between Rs.15-20 lakhs, the Premier has between Rs.25-30 lakhs, and the Executive variant has a sum insured between Rs.40-50 lakhs.

• Basic Coverage: The Universal Sompo Complete Health Insurance Plan provides coverage for in-patient treatment, daycare procedures, pre and post hospitalisation, domiciliary treatment, organ donor expenses, AYUSH benefits, outpatient dental treatment, and a lot more. The coverage offered is dependent on the sum insured you have opted for with your Universal Sompo Complete Health Insurance Plan. The best part is that all of these coverage is available at very affordable premiums.

• Mother and Child Care Benefit: The Universal Sompo Complete Health Insurance Plan provides coverage for the delivery-related expenses of a newborn child. It includes both cesarean and normal delivery. The pre and post-natal expenses are also included along with newborn baby cover. The newborn baby cover is offered till the expiry of the policy term or when the child turns 91 years old or whichever is earlier.

• Health Check-ups: The Universal Sompo Complete Health Insurance Plan also provides coverage for preventive health check-ups. The annual health check-up benefit is applicable for all the members covered under the Universal Sompo Complete Health Insurance Plan.

• Global Coverage: With the Universal Sompo Complete Health Insurance Plan, you can also enjoy global coverage. This means that if you require hospitalisation outside the country, then all the expenses will be covered under the Universal Sompo Complete Health Insurance Plan.

Riders Available with Universal Sompo Complete Health Insurance Plan

Some of the optional riders you can include in your Universal Sompo Complete Health Insurance Plan are as follows:

• Personal Accident Cover: This add-on provides coverage to the policyholder in case of accidental death, or permanent disablement due to an accident.

• Critical Illness Cover: This add-on provides coverage for critical illness as listed on the policy document. This includes heart attack, cancer, paralysis, and others.

• Hospital Daily Cash: With this add-on, you can get coverage for daily hospital expenses.

• Consumable Cover: This includes coverage for non-consumables as listed on the policy document.

• Pre-existing Waiting Period Waiver: With this add-on, you can get the waiting period for pre-existing medical conditions waived off.

Variants Available with Universal Sompo Complete Health Insurance Plan

There are three variants you can include in your Universal Sompo Complete Health Insurance plan such as Plus, Premier, and Executive. In the section below, listed below are the few differences between the three:

Inclusions and Exclusions of Universal Sompo Complete Health Insurance Plan

Inclusions:

• In-patient Treatment: This includes room rent expenses, nursing, ICU, diagnostic procedures, etc
• Daycare Procedures: All the daycare procedures listed on the policy document are covered
• Pre-hospitalisation Expenses: Covered for up to 30 days
• Post-hospitalisation Expenses: Covered for up to 60 days
• Domiciliary Hospitalisation: All the expenses related to treatment at home is covered under this
• AYUSH Treatment: Up to the sum insured
• Organ donor: Organ donor expenses are covered up to the sum insured
• Vaccination: Up to the sum insured
• Dental Out-patient Treatment: Up to the SI

Exclusions:

• Obesity or weight control treatment
• Rest cure or rehabilitation and respite care
• Change of gender treatment
• Cosmetic or plastic surgery
• Any injury due to involvement in adventure activities
• Breach of law
• Any unproven treatment
• Sterility or infertility treatment
• Dietary supplement expenses

Documents Required to Buy Universal Sompo Complete Health Insurance

Listed below are the documents required to buy the Universal Sompo Complete Health Insurance plan:

• A duly-filled proposal form
• Aadhaar card
• Pan card
• Income proof
• Bank account details
• Pre-existing medical report
• Previous health insurance company

How to Buy Universal Sompo Complete Health Insurance Plan?

Here are the steps in which you can buy this Universal Sompo Health Insurance plan:

• Visit the “Health Insurance” section on the official InsuranceDekho website.
• Choose "Universal Sompo Health Insurance" from the list of health insurance companies.
• Then, select "Complete" from the available health insurance plans.
• Read the policy documents carefully
• Upload all the necessary documents to complete the KYC process
• After finishing the KYC process, pay the premium online
• Finally, you will receive the policy document in your registered email

Claim Process of Universal Sompo Complete Health Insurance Plan

There are two types of claims you can raise with Universal Sompo Complete Health Insurance plan, cashless claim and reimbursement claim. Under a cashless claim, your medical bills will be directly settled by the insurance company. On the other hand, in a reimbursement claim, the medical expenses incurred will be later reimbursed by the insurance company.

Cashless Claim

• Get the treatment at any network hospital associated with Universal Sompo Health Insurance.
• Inform the insurer about the hospitalization
• Download the pre-authorization form from the company’s official website.
• Duly fill out the pre-authorization form and attach all the documents to it.
• Submit the form to the insurer. Universal Sompo will verify the information and documents submitted by you.
• Once the verification process is complete, an insurer will either process or reject your claim request.

Reimbursement Claim

• Visit any nearby hospital
• Inform the insurance company in case of both planned and unplanned hospitalisation
• Pay for medical bills and treatment costs from your own pocket.
• Go to the official website of Universal Sompo to download the claim application form.
• Fill out the claim form thoroughly
• Attach all the necessary documents to the form and submit them to your insurance provider
• Universal Sompo Health Insurance will assess the documents you submitted.
• Once all the documents have been approved, your claim request will be settled by the insurance company