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.

Universal Sompo Critical Illness Health Insurance Wordings

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Highlights

Claim Settlement	Available
Claim Settlement Ratio	96%
In-House Claim Settlement	Available
Network Hospitals	4,000+
Starting Premium for Rs. 5 lakh Coverage	Rs. 527/month
Starting Premium for Rs. 5 lakhs SI	Rs. 475/month

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Universal Sompo Critical Illness Policy Brochure

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Jun 02, 2019

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Universal Sompo Health Insurance Plan List

Family (2)
Kids (1)
Maternity (1)
Parents (1)
Woman (1)
Individual (3)
Critical Illness (1)
Senior Citizen (1)

Name of Plan	Sum Insured
Complete Healthcare InsuranceMin: 1 Day; Max: 70 YearsPopular	1 Lakh	Check Premium
A PlusPopular		Check Premium
Individual Health Insurance PlanMin: 3 Months; Max: 55 Years	1 Lakh	Check Premium
Critical Illness PolicyMin: 5 Years; Max: 65 Years	2.5 Lakh	Check Premium
Senior Citizen Health InsuranceMin: 60 Years; Max: 70 Years	1 Lakh	Check Premium
Arogya Sanjeevani PolicyMin: 3 Months; Max: 65 Years	1 Lakh - 5 Lakh	Check Premium
Corona Kavach PolicyMin: 1 day; Max: 65 years	50,000 - 5 lakh	Check Premium
Corona Rakshak PolicyMin: 18 Years; Max: 65 Years	50,000 - 2.5 lakh	Check Premium
Hospital Cash Insurance PolicyMin: 6 months; Max: 70 years		Check Premium

Universal Sompo Health Insurance Top Up List

Name of Plan	Sum Insured
Super Healthcare Policy Min: 91 days; Max: 80 years	1 Lakh - 1 Crore	Check Premium

11505 Universal Sompo Cashless Network Hospitals in India

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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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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.

Universal Sompo Health Insurance Contact Details

Reach us for help anytime

Insurance Dekho
755 1196 989Mon to Sun 10:00 AM to 7:00 PM
support@insurancedekho.com
Universal Sompo Health Insurance
1800-200-514224x7
contactus@universalsompo.com