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Universal Sompo Critical Illness Health Insurance

205 reviews Rate This
Universal Sompo Health Insurance
Critical Illness Policy
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 Critical Illness Health Insurance

Universal Sompo’s Critical Illness plan is a fixed benefit medical insurance plan which covers critical illnesses. The plan covers a specified list of illnesses and if the insured suffers from any of the covered illness during the coverage term, the sum insured is paid in one lump sum. The payment of sum insured would be irrespective of the actual medical costs incurred by the insured on treating the critical illness suffered.

The plan covers major illnesses and surgical procedures which pose a threat to the policyholder’s finances. The level of sum insured under the plan is also optimal allowing individuals to avail sufficient coverage against the rising cost of treatments of critical illnesses. The premiums are low and affordable and can be further reduced with discounts which are available under the plan.

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Key Inclusions and Exclusions of the Plan

What's Included

  • Coverage is available for one, two or three years
  • Common critical illnesses like cancer, heart attack, coma, stroke, permanent paralysis of limbs, etc.
  • Surgical procedures like open chest CABG, open heart replacement, transplant of major organ, etc.
  • 11 critical illnesses and surgical procedures are covered under the plan
  • The sum insured level starts at Rs. 2.5 Lakh and goes up to Rs. 20 Lakh

What's Not Included

  • Any illness or treatment other than those covered under the plan
  • Critical illnesses occurring within the first 90 days of buying the policy
  • Pre-existing illnesses are not covered in the waiting period of 48 months
  • Cosmetic treatments or elective cosmetic procedures
  • Illnesses due to self-inflicted injuries

11505 Universal Sompo Cashless Network Hospitals in India

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Critical Illness Policy User Reviews

4.6
Rating based on
205 User reviews
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What users are saying
  • All
  • Buy this for critical illness.

    There are many health insurance plans in the market that offer cover for critical illnesses. I chose his because of the trusted name of universal sompo and also because it has a good claim settlement ratio. I liked the benefits offered under it and brought it from a friend in insurancedekho   

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    M
    By Mustafa Rangwala
    On: Feb 24, 2020
  • No claim so cant say

    I had purchased this plan last year but did not take any treatment under this. It covers me for 11 critical illnesses, surgical procedures etc for a term of 1, 2, or 3 years at nominal premium. There is a wide choice of sum insured options under this plan ranging from Rs. 2.5 lakh to Rs. 20 Lakh.   

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    P
    By P N Rashmi
    On: Feb 24, 2020
  • Can see other critical illness...

    I dont think that this plan has done anything right to me since i brought it. Insurancedekho’s services were good, but i couldnt completely rely on my healthcare cover on this plan as they did not approve my claim refering it not included in the policy terms and conditions. I am disappointed  

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    S
    By Shridhar Gogoi
    On: Feb 11, 2020
  • Buy it from ID only

    I have no complaints from my critical illness policy until now. It offers me all the benefits i required like 2 years coverage, cover for common critical illnesses, wide sum insured range, and many other added advantages.   

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    J
    By Jaspal Thakur
    On: Feb 11, 2020
  • Gives great coverage

    Critical illness policies are offered by many insurance companies online but i chose universal sompo because of its good reputation in the market and also because it was available in affordable premium amount. this plan covers me for 11 critical illnesses for a sum insured of 2.5 lakh. Many sum insured options   

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    M
    By Macwan Poleshbhai
    On: Jan 31, 2020
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Universal Sompo Critical Illness Policy Expert Review

  • Expert Review

    Facing uncertainties is an inevitable part of our lives, which is why we want to secure it by preparing for the unexpected by getting covered with good health insurance plans. But where regular health insurance plans do not necessarily cover critical illnesses, it becomes essential to purchase a separate one for them. Such is a plan by Universal Sompo, i.e. Critical Illness Insurance Policy that helps to remove many of your financial worries and help you get better in case you become critically ill. 

    Universal Sompo Critical Illness Insurance Policy aims to provide critical illness cover for 11 diseases, including Kidney failure, Stroke, Coma, Paralysis, Multiple Sclerosis, Heart Attack, and Motor Neuron Disease. It is a fixed benefit health plan that pays you in a lump sum if you get diagnosed with any critical illness during the policy period. The policy may be short on providing added advantages to the policyholders but offers a greater sum insured options if compared to critical illness products offered by other leading companies such as Star Health and a few others. The policy provides for a wide range of sum insured starting from Rs. 2.5 Lakh to Rs. 20 Lakh. Also, any resident of India who is aged between 5 years to 65 years can be covered under this policy. However, the minimum age limit for the Proposer is 18 years. 

  • Major Attractions

    This policy by Universal Sompo gets you covered with a specified list of critical illnesses during the policy term. The company may ask any proposed person for the insurance to undergo some specified medical tests for consideration. But if your proposal gets accepted, then 50% of the cost incurred in conducting these tests will be borne by the company. 

    • A fixed benefit health insurance plan
    • Provides cover for 11 critical illnesses 
    • Policy terms of 1 to 3 years available 
    • Free look-up period for 15 days
    • Portability benefit offered to the potential customers
    • Sum insured options ranging from Rs. 2.5 Lakh to Rs. 20 Lakh
    • Cover for Surgical procedures including open-chest CABG, open heart replacement, and organ transplant 
    • Low and affordable premiums available under this plan

  • What’s More?

    Some other advantages come along on purchasing this plan from Universal Sompo. These are-

    • 10% discount if 2 years premium is paid in advance
    • 15% discount if 3 years premium is paid in advance 
    • Tax benefits under Section 80D of the Income Tax Act 1961

  • Conclusion

    So, that was all about the benefits of getting a Critical Illness Health Insurance plan by Universal Sompo. You can go for this plan even if you already have a health insurance plan. 

    These days, healthy competition is being witnessed among the health insurance companies, web aggregators and brokers. This makes it essential for you to resort to the best option to buy a plan. To make the right choice, you can shortlist a few from the leading companies in the market that meet your requirement. Soon get in touch with them, compare and get the best deal for yourself and your dear ones.     

Universal Sompo Critical Illness Policy Brochure

  • 436.28 KB
  • PDF Document
  • Jun 02, 2019
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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.

FAQs on Critical Illness Policy Health Insurance Plan

  • Can family members be covered under the plan?

    Yes, the policy can be taken for spouse, dependent children and dependent parents. However, coverage for each family member would be on an individual sum insured basis.

  • What are the eligibility criteria of buying the policy?

    Policyholders should be resident Indians aged 18 years and above. Coverage can be taken from 5 years of age till 65 years of age.

  • Is pre-policy medical check-up required to buy the policy?

    Pre-policy medical check-ups would be required if the insured’s age is 55 years or above or if the insured has disclosed about some medical condition in the proposal form and the company wants to find more about such condition.

  • Who pays for the pre-policy medical check-ups?

    The policyholder would have to bear the cost of pre-policy medical check-ups when applying for the policy. However, if the policy is issued, 50% of the cost of such tests would be reimbursed by the insurance company. 

  • Is there a survival period for payment of claim?

    Yes, the policy specifies a survival period of 30 days after the diagnosis of the covered critical illness. Only when the insured survives this period is the claim payable.

  • What premium discounts are available under the plan?

    If the policyholder chooses a policy term of 2 years, 10% premium discount is allowed. Similarly, if a term of 3 years is chosen, the premium discount increases to 15%.

  • Are there any premium loadings?

    Yes, the premium is loaded at specified rates if the insured is engaged in high or medium risk occupations as defined by the insurance company. In case of medium risk occupations, the loading is @15% and in case of heavy risk occupations the premium is loaded by 20%.

  • Does the policy allow porting?

    Yes, porting is available under the plan. You can port out of the plan or port into the plan by giving a written request at least 45 days before the expiry of your current health insurance policy.

  • Can the policy be cancelled?

    Yes, the policy can be cancelled either by the policyholder or by the insurance company itself. If the policyholder cancels the plan, the premium would be refunded depending on the coverage period after which the policy has been cancelled. However, if the insurance company has cancelled the plan, no premium refund would be allowed.

  • Is the premium paid towards the policy tax deductible?

    Yes, the premium paid towards this policy is allowed as a deduction under Section 80D.

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