Universal Sompo Complete Healthcare Health Insurance Wordings

The age criteria for Universal Sompo’s Complete Health Insurance policy is up to 70 years.

Follow the below steps to get cashless healthcare treatment: 1. In case of an emergency hospitalisation, call their helpline number and lodge your claim within 24 hours of hospitalisation. 2. In case of a planned hospitalisation, inform the insurer 48 hours prior to the hospital admission. 3. Visit a nearby network hospital and show the company's health card number, along with your valid photo ID. 4. Collect the ‘Cashless Request Form’ from hospital/TPA desk. 5. Fill in the required details and give it to the TPA desk in the hospital. 6. Hospital authority will verify the details and will send the filled ‘Cashless Request Form’ to the concerned insurer by fax. 7. Universal Sompo will review the request, approve or reject it as per the policy terms and conditions and you will be communicated about the same. 8. You will need to pay the deductibles and any extra amount that is not covered in the policy. 9. You can check your claim status by using your claim reference number.

When you avail the treatment at a non-network hospital and pay the medical bills on your own, you can file for its reimbursement. Post-discharge from the hospital, this amount can be claimed from the insurer. Below are the steps for filing reimbursement of your hospitalisation expenses: 1. Call at their health helpline number 1800-200-5142 or email at healthserve@universalsompo.com. 2. Remember to lodge your claim within 24 hours in case of emergency admission and 48 hours prior to hospitalisation in case of planned hospitalisation 3. Get admitted and avail the treatment. Settle your bills and collect all the original documents when getting discharge. 4. Fill the claim reimbursement form 5. Submit the form with all the original documents containing all the hospital bills at the registered address of the insurer 6. On receipt of all the documents, Universal Sompo will process your claim as per the terms and conditions. Intimation will be sent to you regarding the same.

When you avail the treatment at a non-network hospital and pay the medical bills on your own, you can file for its reimbursement. Post-discharge from the hospital, this amount can be claimed from the Following details are required by the policyholders: 1. Your contact details 2. Universal Sompo health insurance number and membership ID number mentioned on the Health Card 3. Name of the patient 4. Nature of illness/accident 5. Date and time of loss in case of an accidental hospitalisation or starting date of a symptom of disease in case of an ailment 6. Location of loss/accident 7. Geographical details