Universal Sompo offers two types of claim settlements – cashless and reimbursement. Follow the steps to raise a claim:
- Find the nearest network hospital of Universal Sompo
- Get admitted to the hospital
- Notify the insurance company about the hospitalization
- In case of pre-planned hospitalization, intimate the insurer before hospital admission.
- Fill up the pre-authorization form and submit it to the hospital staff
- The pre-authorization form will be sent to Universal Sompo for approval.
- Once approved, obtain medical treatment.
- At the time of discharge, sign all the medical documents.
- Pay for the items/services not covered under the Universal Sompo policy
- The network hospital will send the hospital bill to Universal Sompo.
- After review, the insurance company will pay the bill amount directly to the network hospital.
- Intimate Universal Sompo about the hospitalization
- In case of planned hospitalization, inform the insurance provider before hospital admission.
- Obtain medical treatment
- During discharge, pay the hospital bill in full.
- Collect all the medical documents, hospital bills and receipts
Our Claim specialists in below cities will reach your hospital or home in 30 minutes to support your health insurance claim
About Universal Sompo Health Insurance
Universal Sompo health insurance plans are offered by the Universal Sompo General Insurance Company. The company was started as a joint venture between the Indian Overseas Bank, Karnataka Bank, Indian Bank, Sompo Japan Insurance Inc and Dabur Investments in January 2007. These plans have been designed to meet all the medical requirements of individuals, families and senior citizens with customized plans to cover critical illnesses.
Besides, the Universal Sompo General Insurance Company follows a customer-first approach and has a quick claim process. Moreover, the company has also earned an incurred claim ratio of 113.39% in the year 2021-22.
Types of Universal Sompo Insurance Plans
Universal Sompo Complete Healthcare Insurance is a comprehensive plan that provides medical coverage to the insured while being hospitalized. It also comes with seven sub-types – Basic, Essential, Privelege, Plus, Premier, Executive and Digi-Pro.
Features and Benefits:
- Coverage for hospitalization expenses, OPD consultations and accidental dental treatments
- Mother and child care benefits are available, including pre and post-natal expenses
- Cost of domiciliary treatment, AYUSH treatment and vaccination post-bite is covered
- Convalescence benefit and daily cash for accompanying an insured child are available
- 100% restoration of the sum insured and health check-up facilities are available
- Personal accident, critical illness, emergency assistance services and global cover available as add-ons
- PED waiting period waiver, sterility & infertility treatment and premium waiver are also available as add-on covers
The Universal Sompo Super Healthcare Insurance plan provides financial coverage to the insured when the hospital bills cross the sum insured limit of the base policy. The plan offers both top-up and super top-up options.
Features and Benefits:
- Cost of hospitalization, day care treatments and bariatric surgeries are covered
- Maternity benefit, domiciliary hospitalization and assistance services are also available
- No pre-policy medical tests for up to 65 years and a sum insured of Rs 20 lakh
- Free health check-up facility is available every year
- Automatic restoration of the sum insured for up to 100%
- 20% cumulative bonus for up to 100% is granted for every claim-free year
- Option to add global care cover is also available
Universal Sompo A Plus Health Insurance is an extensive plan that covers the medical expenses of the insured arising out of an illness or injury.
Features and Benefits:
- Hospitalization, psychiatric illness and day care treatments are covered
- OPD expenses and global cover are available only under the Diamond plan
- Automatic restoration of the sum insured for up to 100% is available
- No pre-policy medical check-up is required for up to 55 years
- Preventive health check-ups and assistance services are also available
- Cumulative bonus is available after every claim-free year
- Day 1 coverage for diabetes and hypertension available as add-ons under the Diamond plan
- PED waiting period waiver, maternity cover and non-medical items are also available as add-on covers
Universal Sompo Senior Citizen health insurance is a senior citizen health plan designed to cover the medical expenses of elderly people above the age of 60 years.
Features & Benefits:
- In-patient, pre-hospitalization and post-hospitalization expenses are covered
- Domiciliary hospitalization and daily allowance benefit are available
- Ambulance charges and expenses incurred by accompanying person are also covered
- Cost of health check-ups is covered after every 3 claim-free years
- 5% cumulative bonus is granted for every claim-free renewal
- Critical illness cover is available as an optional cover
Universal Sompo Critical Illness Insurance is a customized plan that provides financial assistance to the insured on the first diagnosis of 11 critical diseases, including cancer and kidney failure.
Features and Benefits:
- Coverage available for 11 critical illnesses and surgical procedures
- No pre-policy medical examination for up to 55 years
- A survival period of 30 days is applicable
The Universal Sompo Loan Secure Insurance plan provides financial security to the insured in case he/she is diagnosed with a listed major illness and is, therefore, unable to pay the loan amount.
Features and Benefits:
- Coverage for up to 18 listed major diseases
- Personal accident cover, including accidental death and disability, is available as an optional cover
- Loss of job and fire & allied perils are also available as optional covers
- No pre-insurance health check-up is required for up to 50 years and the sum insured of Rs 1 crore
The Universal Sompo Individual Accident plan is designed to provide financial support in case the insured meets with an unforeseeable accident.
Features and Benefits:
- Coverage for accidental death and permanent total/partial disablement are available
- Cost of transportation, ambulance and damaged clothing is also covered
- Temporary total disablement cover is also available
- Education fund and loss of employment cover is also available
- Option to add medical expenses extension and hospital confinement allowance
The Universal Sompo Hospital Cash Insurance plan pays a daily hospital cash allowance to the insured to cover ancillary expenses, such as the cost of food, travel, etc.
Features and Benefits:
- Hospital confinement benefit is paid for each day of hospitalization
- Twice the daily cash amount is paid under the ICU benefit
- Convalescence benefit is paid if the insured is hospitalized for more than 21 days
- No pre-acceptance medical tests for up to 55 years
The Universal Sompo Aapat Suraksha Bima plan offers medical coverage to the insured against the sudden diagnosis of a listed critical illness or accidental death & disability.
Features and Benefits:
- Coverage for 5 critical illnesses are available
- Both accidental death and permanent total disablement are covered
- A survival period of 30 days applies to critical illness cover
Universal Sompo Swarna Gramin Bima Yojana (Individual) is a customized plan that covers people living in villages against personal accidents and critical illnesses.
Features and Benefits:
- Coverage for accidental death and permanent total/partial disablement are available
- Lump payment is made on the diagnosis of 11 critical illnesses
- Daily hospital cash is paid in case of more than 2 days of hospitalization
- Twice the daily hospital cash amount is paid in case of ICU hospitalization
- Coverage for pre-existing diseases are available as an optional cover
Key Benefits of Universal Sompo Health Insurance
or select from popular citiess In case of emergency we are just a call away. Take care of your family, we will do the rest. Our claim specialists will reach your location & complete the formalties from filing the claim to documentation to coordinating with insurer, TPA & hospital. Available in New Delhi and 114+ cities View cities list ›Search Universal Sompo Cashless Network Hospital list
Policybazaar Claim Process
Here is the list of documents required to file a Universal Sompo health insurance claim:
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Claim FormDuly filled and signed Universal Sompo health insurance claim form
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Health Card/Policy CopyHealth card or a copy of Universal Sompo health insurance policy
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Medical DocumentsHospital discharge card, doctor’s prescriptions, test reports, etc.
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Medical Bills & Payment ReceiptsMedical test and investigation reports with payment receipts, Surgeon's bills and payment receipts
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KYC DocumentsNEFT and KYC details
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Legal DocumentsFIR/Self-declaration/ Medico Legal Certificate (MLC) in case of an accidental hospitalization
Note: The exact list of claim documents varies from case to case. Contact the customer support team for the complete list.
The process to buy a Universal Sompo Health Insurance plan is given below:
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Visit the Health Insurance SectionGo to the ‘Health insurance’ section on Policybazaar.com
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Fill in Personal DetailsProvide necessary details like age, mobile number, city, medical history, gender, etc.
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Pay the Premium OnlineChoose your preferred Universal Sompo health insurance policy and pay the premium online
The process to renew a Universal Sompo Health Insurance plan is given below:
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Go to the Renewal SectionNavigate to the ‘Renew Your Policy’ tab on Policybazaar.com and select ‘Health Renewal’
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Verify Your IdentityEnter your registered mobile number and the OTP sent to your device
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Pay the Renewal Premium OnlineSelect the Universal Sompo health insurance policy you want to renew and pay the premium online
Explore Universal Sompo Health Insurance
Take a look at the Universal Sompo Health Insurance contact number below:
| Categories | Contact Details |
|---|---|
| Toll-free No | 1800-22-4030 1800-200-4030 |
| Senior Citizen Toll-free No | 1800-267-4030 |
| Email Id | contactus@universalsompo.com contactclaims@universalsompo.com |
Universal Sompo Health Insurance: FAQs
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Q1. Is Universal Sompo health insurance cashless?
Ans: Yes. The Universal Sompo health insurance plans offer cashless hospitalization facilities across all network hospitals of the insurance company.
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Q2. Where can find the Universal Sompo health insurance hospital list?
Ans: You can find the Universal Sompo health insurance hospital list for cashless treatment with the policy document issued by the insurance company. You can also visit Policybazaar.com to check the list of network hospitals of the Universal Sompo General Insurance Company.
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Q3. How can I get the Universal Sompo health insurance claim form?
Ans: You can download the claim form for Universal Sompo health insurance from the website of the insurance company.
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Q. What is the advantage of selecting a policy with a duration of more than 1 year?
Ans: If one buys Aditya Birla Health Insurance for more than a year, one can save 7.5 % and 10% on the 2 and 3 years premium, respectively.
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Q. How is an Individual cover different from a Floater cover?
Ans: In an Individual cover, coverage is offered to each individual in the family separately. In a Family Floater health insurance plan, each family member is covered based on a floater sum insured.
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Q. How is an Individual cover different from a Floater cover?
Ans: In an Individual cover, coverage is offered to each individual in the family separately. In a Family Floater health insurance plan, each family member is covered based on a floater sum insured.
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Q. What is a waiver of a mandatory co-pay cover?
Ans: This benefit is covered on payment of an additional premium. Therefore, any mandatory co-payment that is applicable under the Aditya Birla Activ Health Essential Plan will be waived off.
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