Universal Sompo Health Insurance FAQs

Universal Sompo Health Insurance

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Highlights

4,000+ Network Hospitals

2,67,221 Policies Issued

Lifelong Renewability

75.92% Claim Settlement Ratio

In-House Claim Management

Coronavirus (COVID-19) Cover

Claim Settlement

  • Within how many days do I have to file a claim in Universal Sompo Health Insurance?

    The claim must be submitted in the 30 days after the hospitalisation. 

  • How much time does Universal Sompo take to settle claims?

    After receiving the relevant documents, Universal Sompo settles the bills within  7 working days. 

  • What is the maximum number of claims that can be made in a year in Universal Sompo health insurance policies?

    There is no limit on the number of claims allowed during a policy term. Claims can be made up to the limit of sum insured under the policy. 

  • How does Universal Sompo settle claims if I buy more than one health insurance policy?

    Each company pays a relatable proportion of the loss in case the claims are made. 

  • Within how many days do I have to file a claim in Universal Sompo Health Insurance?

    The claim must be submitted in the 30 days after the hospitalisation. 

  • How much time does Universal Sompo take to settle claims?

    After receiving the relevant documents, Universal Sompo settles the bills within  7 working days. 

  • What is the maximum number of claims that can be made in a year in Universal Sompo health insurance policies?

    There is no limit on the number of claims allowed during a policy term. Claims can be made up to the limit of sum insured under the policy. 

  • How does Universal Sompo settle claims if I buy more than one health insurance policy?

    Each company pays a relatable proportion of the loss in case the claims are made. 

Critical Illness

  • Do I get a specific health insurance plan for critical illness in Universal Sompo Health Insurance?

    Yes, Universal Sompo provides a Critical Illness Policy that covers 11 critical illnesses. 

  • What is the eligibility for critical illness plan by Universal Sompo?

    You must be a resident of India and aged between 18 years to 65 years to be able to purchase Critical Illness Policy by Universal Sompo. 

  • Which diseases are covered under critical illness pan by Universal Sompo?

    Following diseases are covered up to the sum insured in Critical Illness Health Insurance Plan by Universal Sompo: Open Chest CABG, Cancer at a specific stage, First heart attack of a certain severity, Open heart replacement, Permanent paralysis for limbs, Coma of certain severity, etc.

  • What is not covered under the critical illness plan by Universal Sompo?

    Some of the plan exclusions are: Pre-existing diseases until the waiting period is served for 48 months with continuous coverage; convalescence, general debility, rest cure, lethargy etc.; cosmetic or plastic surgery is excluded from the plan. 

  • Do I get a specific health insurance plan for critical illness in Universal Sompo Health Insurance?

    Yes, Universal Sompo provides a Critical Illness Policy that covers 11 critical illnesses. 

  • What is the eligibility for critical illness plan by Universal Sompo?

    You must be a resident of India and aged between 18 years to 65 years to be able to purchase Critical Illness Policy by Universal Sompo. 

  • Which diseases are covered under critical illness pan by Universal Sompo?

    Following diseases are covered up to the sum insured in Critical Illness Health Insurance Plan by Universal Sompo:

    • Open Chest CABG
    • Cancer at specific stage
    • First heart attack of certain severity
    • Open heart replacement
    • Permanent paralysis for limbs
    • Coma of certain severity
    • Multiple Scelerosis with persisting symptoms
    • Major organ transplant
    • Kidney failure
    • Open heart replacement
    • Motor Neuron Disease with Permanent Symptoms

  • What is not covered under the critical illness plan by Universal Sompo?

    Some of the plan exclusions are:

    • Pre-existing diseases are not covered until the waiting period is served for 48 months with continuous coverage. 
    • Convalescence, general debility, rest cure, lethargy etc. are not covered.
    • Cosmetic or plastic surgery is excluded from the plan. 
    • Any experimental treatment performed by the Physician is excluded.

Family Floater

  • Does Universal Sompo offer any plan for a family or extended family?

    Yes, Universal Sompo offers health insurance plans for family or extended family. 

  • What are the sum insured options under Family floater plans provided by Universal Sompo?

    Family floater plans provided by Universal Sompo can be purchased for sum insured options of Rs. 1 Lakh, Rs. 2 Lakh, Rs. 3 Lakh, Rs. 4 Lakh, Rs. 5 Lakh, Rs. 6 Lakh, Rs. 7 Lakh, Rs. 8 Lakh, Rs. 9 Lakh, and Rs. 10 Lakh. 

  • Does the health insurance plan for family provide coverage for maternity and OPD?

    Yes, the health insurance plan for the family provides coverage for maternity and OPD. 

  • Can I buy such health insurance policies online?

    Yes, family floater health insurance plans can be purchased online. 

  • Does the family floater health insurance policy provide restoration benefit?

    The family floater health insurance policy provides restoration benefit to the policyholders. 

  • What are the options available for policy terms?

    The policy can be purchased for 1 year, 2 years and 3 years. 

Feature

  • Are pre-existing diseases covered in Universal Sompo Health Insurance?

    Yes, pre-existing diseases are covered. But, it’s subject to the waiting period mentioned in your health plan.

General Information

  • How long does TPA take to approve the claim?

    Generally, TPA approves the claim within 3-6 hours after receiving all relevant documents.

  • How long does it take to clear the bills?

    Once all the relevant documents are received, it normally takes 7 days to settle the bills.

  • What is a health card?

    A health card is an identity card issued to policyholders. It enables them to avail cashless treatment at every network hospital.

  • Does the health card serve permanently?

    No, you need to get your health card renewed or reissued during the policy tenure.

  • Who can get covered by a single policy?

    Depending on the policy you have bought, all family members, including spouse, dependent children (above 91 days under 23 years) are covered. Parents up to 70 years are also covered.

  • Where is the list of network hospitals available?

    Hospital list is provided to you with your health card. However, this list is subject to change. You can find the updated list on the TPA website.

  • Can foreigners buy a health policy if they are not Indian National but living in India?

    Yes, foreigners living in India are eligible for getting covered under a policy. But, the coverage is restricted to India only.

  • What is the toll-free number of Universal Sompo Health Insurance?

    The toll-free numbers of Universal Sompo Health Insurance are - 1800-200-4030 and 1800-200-5142.

Help to Buy

  • How to buy and apply for Universal Sompo Health Insurance plan?

    You can buy and apply for any Universal Sompo Health Insurance Policy online from the official website of Universal Sompo Health Insurance at www.universalsompo.com or through online broker’s website like insurancedekho.com.

Individual

  • Does Universal Sompo offer any plan for an individual?

    Yes, Universal Sompo offers individual health insurance plans. 

  • What are the options available for policy terms?

    The policy can be purchased for 1 year, 2 years and 3 years. 

  • What is the premium frequency under such plans?

    The single premium has to be paid. 

Kids

  • Can kids be covered under any health insurance plan provided Universal Sompo?

    Yes, a family floater plan offered by Universal Sompo can cover all the family members including self, spouse and children. 

  • Do kids have to undergo a medical examination before being covered under a health insurance plan?

    No, kids do not have to undergo any medical examination before they get covered under a health insurance plan. Only persons above 45 to 55 years of age depending upon the declaration of the pre-existing disease have to undergo the same. 

  • How many kids can be covered under Universal Sompo’s health insurance plan?

    Floater options available to you in Universal Sompo’s Complete Healthcare Insurance Plan are: 

    • 1 Adult+1 Child
    • 1 Adult+2 Child 
    • 2 Adult + 2 Child 
    • 1 Adult+ 3 Child 
    • 2 Adult + 3 Child 
    • 2 Adult
    • 2 Adult+1 Child
    • 2 Adult+4 Child 

  • What are the benefits that the kids get under health insurance plans by Universal Sompo?

    Some of the benefits that the children get under health insurance plans by Universal Sompo are: 

    • Pre and post hospitalisation expenses are covered
    • Dental treatments in case of accidents
    • Daily allowance to meet the non-medical expenses incurred for kids under 12 years if they are hospitalised for a minimum of 72 hours. 
    • Outpatient consultation expenses are covered after a waiting period of 3 years. 

Maternity

  • Does Universal Sompo provide maternity benefits under health insurance plans?

    Yes, Universal Sompo provides coverage for maternity expenses under different health insurance plans.  

  • Is there any waiting period under such plans?

    Yes, to avail maternity and new born benefits, you have to complete waiting period that differs with different plans. 

  • Can I buy maternity health insurance online?

    Yes, you can buy such health insurance plans online. 

  • What all is included under maternity coverage under these plans?

    Routine pregnancy, pre and post natal expenses, and baby care expenses are covered under maternity benefits. 

Parents

  • Does Universal Sompo provide cover for parents in any of its health insurance plans?

    Yes, Universal Sompo provides cover for parents on an individual as well as family floater basis under its Individual Health Insurance Plan. 

  • My parents are aged above 50 years but are fit and fine. Should I buy a health insurance plan for them?

    The older someone gets, the more difficult it gets to buy regular health insurance. So, it is better to purchase a specialized health insurance plan for them that address their hospitalisation or medical requirements.

  • My parents are above 55 years of age. Do they need to undergo a medical examination before being covered under a health insurance plan by Universal Sompo?

    Individuals above 45 to 55 years of age have to undergo a medical examination depending upon the declaration of pre-existing disease.  

  • What are the benefits provided to parents under health insurance plans offered by Universal Sompo?

    Parents covered under health insurance plans offered by Universal Sompo enjoy the following benefits:

    • Coverage for expenses related to domiciliary hospitalisation 
    • Option to cover critical illnesses 
    • In-patient hospitalisation expenses covered
    • Pre and post hospitalisation expenses are covered
    • Charges for blood, hospitalisation are covered

Portability

  • Will I get the existing benefits if I port my health insurance policy to Universal Sompo?

    Yes, the existing benefits that you have in your current health insurance policy will be added in the new health insurance policy according to the terms and conditions. 

  • How can I transfer my health insurance plan to Universal Sompo?

    To get your health insurance policy ported to Universal Sompo Contact Universal Sompo. You will have to fill an application form for porting the policy. Your application will then be processed.     

  • When should I inform Universal Sompo if I want to port my health insurance policy?

    You need to inform Universal Sompo at least 45 days prior to the expiry of your present period of insurance. You can avail the benefit at the time of renewal only. 

  • Can I port my health insurance policy any time during the policy period?

    No, you can avail the portability benefit only at the time of renewal of your existing policy.

Premium

  • How are the premiums for health insurance plans by Universal Sompo decided?

    Premiums for health insurance plans by Universal Sompo depends on factors such as family status, individual age, health condition, type of policy, add-ons, rider, etc.

  • How can I calculate the premium for health insurance policies of Universal Sompo?

    You can visit the official website of Universal Sompo (www.universalsompo.com) and click on the Get Quote tab after filling in your personal details to get an idea of the premium amount.  You can also visit the health insurance broker’s website like www.insurancedekho.com to get the best price. 

  • Will I get discount on premium paid for health insurance policies purchased from Universal Sompo?

    Yes, Star Health offers discount on premium on some of the health insurance plans available with it.  

  • Can I pay premiums online in Universal Sompo?

    Yes, Universal Sompo allows you to pay health insurance premiums online. 

  • Will I get the entire premium refunded if I cancel my Universal Sompo health insurance policy?

    Yes, you are entitled to the refund of premium on the pro rata basis for the unexpired period of the policy which Universal Sompo pays on demand.   

  • Will Universal Sompo refund me the entire amount if I cancel my policy after 15 days of its commencement?

    No. If you cancel your Universal Sompo Health Insurance Policy up to 1 month of its commencement, Universal Sompo retains 25% of the annual premium. 

Senior Citizen

  • Is there any health insurance policy specifically for the senior citizens provided by Universal Sompo?

    Yes, Universal Sompo provides health insurance policy especially designed for senior citizens by the name of Senior Citizen Health Insurance Policy. 

  • Who can take this policy?

    Any senior citizen aged above 60 years can purchase this policy to cover himself/ herself and his/her spouse.

  • Are pre-acceptance medical tests required under this policy?

    Yes. Senior citizens and their spouse (if proposed for insurance under the Policy) may be asked to undergo medical tests for purpose of consideration of Your proposal. If the proposal to purchase the policy has been accepted, 50% of the amount of the tests will be reimbursed. 

  • What are the additional benefits under this policy?

    The policyholders get several added benefits with this policy such as-cumulative bonus, family discounts, options for sum insured, portability, free look up period and so on. 

Top-up

  • What is the minimum and maximum entry age under top-up plans offered by United India Insurance?

    The minimum and maximum entry age under top-up plans offered by United India Insurance is 3 months and 80 years respectively. 

Woman

  • Does Universal Sompo provide coverage for women under any of its health insurance plans?

    Yes, Universal Sompo provides coverage for women and special benefits for them under its health insurance plans. 

  • Does Universal Sompo provide any discounts for women under its women-centric health insurance plans?

    Yes. Universal Sompo provides special discounts for women under its women-centric health insurance plans. 

  • What are the benefits provided by Universal Sompo under its women-centric health insurance plans?

    Universal Sompo provides the following benefits under its women-centric health insurance plans-

    • Pre and post maternity expenses are covered 
    • Coverage for a newborn baby is provided
    • Day care procedures are covered 
    • Pre and post hospitalisation expenses covered
    • Out patient consultation expenses are covered
    • Convalescence benefit is provided

  • Is the health insurance plan for women in Universal Sompo available on individual or family floater basis?

    Health insurance plan for women in Universal Sompo is available on both individual and family floater basis. 

Universal Sompo Health Insurance Plan List

Name of PlanSum Insured
Complete Healthcare InsuranceMin: 1 Day; Max: 70 Years1 Lakh Get Quotes Now
Individual Health Insurance PlanMin: 3 Months; Max: 55 Years1 Lakh Get Quotes Now
Critical Illness PolicyMin: 5 Years; Max: 65 Years2.5 Lakh Get Quotes Now
Senior Citizen Health InsuranceMin: 60 Years; Max: 70 Years1 Lakh Get Quotes Now
Arogya Sanjeevani PolicyMin: 3 Months; Max: 65 Years 1 Lakh - 5 Lakh Get Quotes Now
Corona Kavach PolicyMin: 1 day; Max: 65 years50,000 - 5 lakh Get Quotes Now
Corona Rakshak Policy Min: 18 Years; Max: 65 Years50,000 - 2.5 lakh Get Quotes Now

Claim Process at Universal Sompo Health Insurance

  • Network Hospital
  • Non-Network Hospital
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 72 hours prior to admission.
  • 3

    Claim Processing

    Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
  • 4

    Claim Settlement

    Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 72 hours and for planned hospitalisation intimate within 48 hours prior to admission.
  • 3

    Claim Processing

    Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
  • 4

    Claim Settlement

    Once your request for reimbursement of expenses is approved, the claim will be settled.

Universal Sompo Health Insurance User Reviews

  • Paid online without worries

    When I decided to buy Universal Sompo Arogya Sanjeevani Policy from InsuranceDekho online, I was not sure if I should buy it in online or offline mode...

    Read More
    D
    Disha Mahana
    On: Jun 17, 2020 | Views
  • Good job team!

    I really appreciate and thank InsuranceDekho’s team for suggesting and helping me buy Universal Sompo Arogya Sanjeevani Policy online. This plan...

    Read More
    S
    Suraj D.
    On: Jun 15, 2020 | Views
  • Good..!!

    Excellent service under my Universal Sompo health insurance plan. 

    N
    Narottam bhardwaj
    On: Jun 10, 2020 | Views
  • Amazing plan as well as services.

    There is no doubt that InsuranceDekho offers the best services ever. I purchased Universal Sompo’s individual health insurance policy from them ...

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    S
    Sneha Singhal
    On: Jun 05, 2020 | Views
  • Great features

    Universal Sompo complete healthcare insurance has great features. It covers me against all the hospitalisation expenses in case of illness, sickness, ...

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    K
    Kritika Khurana
    On: Jun 04, 2020 | Views
  • Got timely assistance

    Universal Sompo has a great claim settlement process and therefore I bought their policy from InsuranceDekho. I got timely assistance and paid online ...

    Read More
    M
    Megha Bhandari
    On: Jun 02, 2020 | Views
  • Can pay online too

    Individual health insurance policy by Universal Sompo is not only easy to buy online from Insurance Dekho, but also easy to understand too. I had a fe...

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    V
    Vishakha Sabharwal
    On: May 30, 2020 | Views
  • Trustable Health plan

    I purchased a plan via InsuranceDekho for my friend's family health protection by Universal Sompo and it was good. He wanted to take it for his pa...

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    K
    Keshav
    On: May 28, 2020 | Views
  • Easy renewal process

    I purchased Universal Sompo’s Individual health insurance policy last year and was satisfied with the plan so decided to renew it this year. The...

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    R
    Ravi Prakash
    On: May 26, 2020 | Views
  • Good and wide coverage

    This policy covers me and my family against many healthcare expenses due to illness or accident. I really liked the plan.    ...

    Read More
    A
    Aseem Chaturvedi
    On: May 26, 2020 | Views

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