About Universal Sompo A Plus Health Insurance Plan
Universal Sompo A Plus Health Insurance is a comprehensive policy that offers 100% restoration of the sum insured once in a policy year with the Auto Restore benefit. It covers the outpatient treatment costs for diabetes and hypertension from day 1 of the policy. Moreover, the plan comes with the option to reduce the pre-existing disease waiting period to 1 year.
Universal Sompo A Plus Health Insurance Plan: Key Highlights
| Categories | Specifications |
|---|---|
| Sum Insured | ₹1 lakh to ₹1 crore |
| Pre-Policy Medical Check-ups | Not required for up to 55 years |
| PED (Pre-existing Disease) Waiting Period | 2 years |
| Discounts | 15% direct policy discount Up to 7.5% long term policy discount Up to 7.5% family discount 5% women discount 2.5% donor discount 2.5% health life combi discount Up to ₹500 discount with wellness services |
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Key Benefits of Universal Sompo A Plus Health Insurance Plan
Universal Sompo A Plus Health Insurance Plan Inclusions, Exclusions & Optional Covers
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In-Patient TreatmentIt pays for the medical expenses incurred on hospitalization of at least 24 hours.
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Pre-Hospitalization ExpensesIt covers the medical costs incurred up to 90 days before the date of admission, depending on the variant.
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Post-Hospitalization ExpensesIt pays for the medical expenses incurred up to 180 days from the date of discharge, depending on the variant.
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Modern TreatmentIt covers the cost of new-age medical procedures like robotic surgeries, immunotherapy, stem cell transplants, stereotactic radiosurgery, etc.
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Day Care ProceduresIt pays the medical expenses incurred on day care procedures that do not require 24 hours of hospitalization.
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AYUSH TreatmentIt covers the in-patient hospitalization expenses for AYUSH treatment under Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy systems of medicine.
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Obesity and Weight Control TreatmentsIt does not pay the cost of obesity or any weight-control treatments.
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Treatment for Alcoholism or Drug AddictionIt does not cover the treatment cost of alcohol, drugs or any other substance abuse or addictive condition.
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Sterility and InfertilityIt does not pay for the treatment of infertility and sterility.
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Cosmetic or Plastic SurgeriesIt does not cover the cost of availing cosmetic or plastic surgery.
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Unproven TreatmentsIt does not pay for any unproven treatments availed by the insured.
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Pre-Existing Disease Waiting Period WaiverThe waiting period for pre-existing diseases for each insured will be reduced to 12 months from 36 months. However, this cover is not available in the Basic variant.
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Maternity CoverIt covers the maternity expenses incurred on the delivery of a baby or any complications of pregnancy. However, this cover is not available in the Basic variant.
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Non-Medical Items CoverIt pays for the non-medical expenses, such as cotton, bandages, surgical tape, etc., used during the in-patient treatment of the insured. However, this cover is not available in the Basic variant.
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Diabetes Day 1 CoverIt covers the cost of outpatient treatment for diabetes from day 1 of the policy. This cover is only available under the Diamond variant.
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Hypertension Day 1 CoverIt pays for the cost of outpatient treatment for hypertension from day 1 of the policy. This add-on is only available under the Diamond variant.
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Hospital Cash BenefitIt provides a daily hospital cash amount of up to ₹1,000 for a maximum of 10 days, provided the insured is admitted for at least 3 days. This cover is only available under the Basic variant.
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 ›Policybazaar Claim Process
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Universal Sompo A Plus Health Insurance Plan: FAQs
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Q1. How to check the Universal Sompo A Plus Health Insurance plan cost?
Ans: You can check the Universal Sompo A Plus Health Insurance plan price by going through its premium chart on the official website of the insurer. You can also use the health insurance premium calculator on policybazaar.com to know the plan cost. -
Q2. Is there any room rent limit under the Universal Sompo A Plus Health Insurance plan?
Ans: No, there is no hospital room rent limit under the Universal Sompo A Plus Health Insurance plan. -
Q3. Are critical illnesses covered by the Universal Sompo A Plus Health Insurance plan?
Ans: No, the Universal Sompo A Plus Health Insurance plan does not cover critical illnesses. However, it does cover the cost of a second opinion for specific critical diseases.
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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.
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.
- Inform the insurance company about the hospitalization
- In case of planned hospitalization, notify the insurer before hospital admission.
- Receive medical treatment
- At the time of discharge, pay the entire hospital bill in full.
- Collect all the medical documents, bills and payment receipts
Our Claim specialists in below cities will reach your hospital or home in 30 minutes to support your health insurance claim
