Universal Sompo Individual Basic Plan

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With rising healthcare expenses, having health insurance is imperative. Hence, individual health insurance plans are in great demand these days. In this regard, Universal Sompo Individual plan is quite popular for catering to the different needs of the individual.

Why Should You Consider Universal Sompo Individual Basic Plan

If we talk about leading insurers in India then Universal Sompo is one of them. The company is quite popular for the quality of services and products, rapport with customers, smooth claim settlement and providing comprehensive insurance coverage. The advantages of individual policy to be considered are:

  • Cashless healthcare services across India at network hospitals
  • Easy portability benefit without compromising on accrued benefits
  • Tax benefit to be earned as per the Income Tax Act
  • Free look-in period of 15 days to return the policy
  • Smooth claim intimation, registration and settlement
  • No TAT for claim settlement as all claims are paid through NEFT/RTGS process
  • Comprehensive coverage can be availed at a competitive rate of premium

Scope of Cover offered Under Universal Sompo Individual Basic Plan

The individual policy of Universal Sompo offers the following benefits:

Category Scope of Cover
In-patient Expense Cover Hospitalisation expenses including room rent, nursing expenses, ICU charge, OT charge, doctors consultation fee, surgeon’s fee, expenses of blood, oxygen, medicine, X-ray, laboratory etc.
Cashless Treatment At network hospitals across India
Domiciliary Treatment Covers treatment exceeding for 3 days while treatment is availing at home, which otherwise would have required hospitalisation, in conditions like if the patient is unable to move or if the patient can’t be moved to the hospital due to lack of accommodation
Extensive Sum insured A maximum of Rs. 5 lakh cover can be availed
Additional Cover The individual policy can be extended to cover the listed critical illness on payment of an extra premium
Medical Check-up No medical check-up is required up to the age 45 years.
Tax Benefits The premiums paid towards Universal Sompo Individual plan is exempted from tax deduction under Section 80D of Income Tax Act

 

Universal Sompo Health Insurance Premium

The premium is calculated considering the age of the insured person and the coverage opted. If the insured or the dependent’s age is more than 45 years, a medical test is required to avail this plan. The cost of such a test will be borne by the insured.

Eligibility Criteria

Minimum Entry Age    18 years
Maximum Entry Age 55 years
Maximum Sum Insured    Rs.5 lakh
Policy Tenure 1 year

 

Universal Sompo Individual Basic Policy Exclusions:

The policy doesn’t cover the insured person under below conditions:

  • No claim will be entertained arising out of a Pre-existing disease
  • Any expense incurred due to hospitalisation or domiciliary treatment for any illness during the initial 30 days of the policy. That means the insurer will not pay for the claims arising within the 30 days of policy initiation. However, if hospitalisation is required due to an accident, the claim can be registered under the accidental clause.
  • Coverage to some specific illnesses such as Benign Prostatic Hypertrophy (BPH), Cataract, Piles, Sinusitis, Hysterectomy or a related disorder is not offered during the first policy year.
  • Injury or loss directly caused by war, war-like situation, foreign invasion, use of nuclear weapon etc.
  • Circumcision unless essential for the treatment of an illness is not covered
  • No claim will be paid for expenses of contact lenses, spectacles, hearing aids etc.
  • Dental treatment or surgery is excluded unless hospitalisation is required or it is due to an accident.
  • Venereal diseases, intentional self-injury such as suicide or attempt to suicide
  • Injury due to the use of intoxicating drugs/alcohol are excluded
  • Any treatment directly or indirectly for treatment associated with AIDS/HIV or other sexually transmitted diseases
  • Expenses incurred towards cosmetic surgery are not covered
  • Miscarriage or abortion
  • Expenses related to maternity and childbirth
  • Naturopathy Treatment such as Ayurveda, Homeopathy, Sidha, Unani etc.

Waiting Period Clause

 The following waiting periods are applicable in case of Universal Sompo Individual Basic Plan:

  • Initial Waiting period: 30 days from the date of policy initiation
  • For Specific Illness Waiting Period: First policy year
  • Pre-existing Illness: Pre-existing illnesses are permanently excluded

Universal Sompo Individual Basic Claim Process

The insurer has in-house claim management process, which ensures a safe and fast settlement. In order to claim your Universal Sompo health insurance, kindly follow the below steps:

  • Step 1: Inform the insurer as soon as possible. In case of planned hospitalisation, notify them at least 48 hours prior to the hospitalisation. In case of emergency hospitalisation, the insurer needs to be informed within 24 hours post admission.
  • Step 2: A pre-authorisation letter has to be signed and submitted to the insurer seeking permission for cashless services. Submit the application along with relevant ID proof.
  • Step 3: If the insurer approves the request, avail cashless treatment immediately. Pay the related bills which are not covered by the insurer. The rest of the total hospital bill is settled directly with the hospital authority by the insurer.
  • Step 4: In case the insurer rejects the cashless request due to any reason, pay the hospital bills on your own. Collect the original bills, medical reports and discharge summary. Register a reimbursement claim with Universal Sompo. The insurer will verify the claim and reimburse the claim up to an admissible amount.

Universal Sompo Individual Basic Plan Renewal Process

To ensure contentious policy benefits timely renewal of health insurance is essential. You can renew Universal Sompo health insurance online or offline. However, online renewal is the most convenient way of doing so. To renew the policy online:

  • Visit the official website of Universal Sompo
  • Go to the ‘Policy Renewal’ option
  • Select the type of policy you want to renew
  • Provide the necessary information i.e. policy number, personal details, renewal due date etc.
  • Premiums to be paid will appear accordingly. You can compare the premiums online with other insurers.
  • If it suits you, pay the premiums through net banking or credit/debit card.
  • A renewal notification will be sent instantly once the amount is debited from your account.
  • The insurer will send the soft copy of the renewed policy to your registered email ID. You can download the policy anytime.
Written By: PolicyBazaar - Updated: 16 July 2019