Universal Sompo Super Health Care Insurance
Universal Sompo Super Health Care Insurance is offered to both individuals and families. The policy includes two plans, namely the Top-Up and the Super-Top-up plan. The Top-Up plan has Plan 1, Plan 2 and Plan 3 subcategories. Similarly, the Super Top-up plan has three subcategories such as Gold, Diamond and Platinum. These plans vary in terms of premium payment terms, premium payment modes and benefits offered.
The policyholders can choose the plans based on their requirements and ability to invest. They can avail of optimum services from it by availing various bonuses and value-added benefits.
Universal Sompo Super Health Care Insurance: Key Highlights
Type
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Individual or Family Floater
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Medical Test
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Not required up to 65 years
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Maternity Cover
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After 9 months
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Cumulative Bonus
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20%
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Policy Tenure
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3 years
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Restoration of SI
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100%
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Coverage Offered
The interested individuals can get the following coverage if they buy Universal Sompo Health Insurance.
- In-patient Hospitalization: The policy covers medical, bedding, staff, equipment and other operational costs for in-patient hospitalization.
- Pre and Post Hospitalization: It covers 30 days for pre-hospitalization and 60 days for post-hospitalization expenses.
- Daycare Treatment: The policyholders can get coverage for daycare treatment as an in-patient for less than 24 hours of hospitalization.
- Organ Donor: Universal Sompo Super Health Care Insurance will cover the cost and benefit, up to the limit of sum insured, for organ donors or recipients if they are insured.
- Domiciliary Hospitalization: The policy will cover the expenses in this case if the hospitalization continued for at least 3 days.
- Emergency Ambulance Cost: The policyholders can get emergency ambulance cover per insured individual up to the maximum limit as mentioned in the policy schedule.
- Maternity Expenses: The policy will offer maternity cover, pre and post-natal expenses, newborn care as applicable.
- AYUSH Cover: Universal Sompo Super Health Care Insurance offers medical cover for alternative treatment such as Ayurveda, Siddha, Unani, Homeopathy etc.
- Bariatric Surgery Cover: Universal Sompo Health Insurance will cover bariatric surgery expenses if the member's age is not less than 18 years and have at least 40 BMI with other necessary conditions as applicable.
- Emergency Assistance Services: Universal Sompo Super Health Care Insurance Policy will offer this cover for insured individuals who stay within 150 km from the registered office of the insurer.
- Optional Coverage: As an optional cover, the policy offers Global Coverage for treatment taken outside India as per the policy norms.
Inclusions of the Policy
The list of inclusions of this policy includes the following:
- Universal Sompo Super Health Care Insurance has two plans, namely, Top Up and Super Top Up.
- The Top-Up plan includes three subcategories, namely Plan 1, Plan 2 and Plan 3. The Super top-up plan consists of three subcategories, namely Gold, Diamond and Platinum.
- Organ Donor, emergency assistance, automatic restoration and Ayush benefit cover are included in Plan 2, Plan 3, Diamond and Platinum plan.
- Universal Sompo Super Health Care Insurance will offer the yearly bonus of 20% of the sum insured, which can be accumulated at a maximum 100% of the sum insured if no amount is claimed during the respective policy years.
- Universal Sompo Super Health Care Insurance Policy offers optional coverage as Global Care if the insured individuals are required to take medical help outside of India through in-patient hospitalization or daycare hospitalization.
Exclusions of the Policy
The policy excludes cover for the following treatments or expenses.
- Drug addiction, obesity, maternity, infertility, aesthetic purposes etc.
- Injuries due to war, nuclear weapon, adventure sports etc.
- Unproven procedure, un-prescribed medication etc.
- Injuries due to suicide attempt or other self-injuries
- Medical cost for investigative diagnosis
- Treatment has taken outside India, or policy excluded practitioners or institutions do the treatment.
- Treatment arising from the act of breach of law
Features & Benefits of the Universal Sompo Super Health Care Insurance
- Universal Sompo Super Health Care Insurance Policy cover will start after 30 days from the date of policy issuance.
- If the Top Up and Super Top Up plan is purchased, then the policyholders must wait for 9 months to get maternity and child care cover.
- The insured individuals must wait for 36/24/12 months for any pre-existing diseases to initiate the health cover as applicable.
- The policyholders can get up to 1000 USGI coins per policy year if they maintain good health and follow prescribed health regimes.
- The poly offers Complete Wellness and Healthcare benefits, including health risk assessment, electronic health record management and health screening.
- The insurer will assign a health coach to manage better health care regimes as applicable.
Eligibility Criteria
The policy comes with the following eligibility criteria
Minimum Entry Age
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Adult: 18 years
Child: 3 months
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Maximum Entry Age
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Adult: 80 years
(30 years for dependent children)
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Number of people covered
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Individuals or Individual, spouse and upto 4 dependent children
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Residential Status
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Citizens and Residents of India.
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Cancellation of the Policy
The company can cancel the policy at any time by giving 15 days' notice. In case of any fraud, misrepresentation or unlawful act, the company will not refund any money. Otherwise, at the time of cancellation, the policyholders will be refunded with the premiums as applicable.
The policyholders can cancel the policy by giving 15 days' notice period. They can expect a refund of 0% to 75% of the premiums paid.
FAQs
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Ans: The interested individuals must visit the Online Universal Sompo Super Health Care Insurance platform of the insurer. They are required to calculate policy quotes, select premium options and make online payments to purchase the policy.
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Ans: The policyholders can port the policy with all accrued and expected benefits to other insurers by giving a notice 45 days before the policy renewal date.
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Ans: The policyholders can get family savings up to 10%, loyalty savings up to 5%, long term policy savings up to 10% and employee savings up to 15% as applicable. (*All savings are offered as per the IRDAI’s approval. Standard T&C Apply)
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Ans: The insured individuals can avail 100% of normal slab premium per medication as policy loading. (*Standard T&C Apply)
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Ans: As per the 2017-2018 data, the claim settlement ratio of Universal Sompo General Insurance Co. Ltd. is 100%.
Written By: PolicyBazaar - Updated: 14 January 2021