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Universal Sompo Individual Health Insurance

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Universal Sompo Health Insurance
Individual Health Insurance Plan
Claim SettlementAvailable
Claim Settlement Ratio96%
In-House Claim SettlementAvailable
Network Hospitals4,000+
Starting Premium for Rs. 5 lakh CoverageRs. 527/month
Starting Premium for Rs. 5 lakhs SIRs. 475/month

About Universal Sompo Individual Health Insurance

Universal Sompo Individual Health Insurance Plan is an indemnity-based medical insurance plan which pays for the medical expenses incurred on hospitalisation. The plan can be taken for covering only one individual or for covering the whole family. Basic hospitalisation expenses, domiciliary treatments, etc. are covered under the plan. The company has an in-house claim settlement department which helps in easy and quick settlement of all claims which are incurred under the policy.

The maximum sum insured which is available under the plan is limited to Rs. 5 Lakh and the premiums are affordable. Premiums depend on the sum insured chosen, members covered and the age of the insured members. Moreover, the policyholder can also claim tax benefits on the amount of premium paid for the plan up to Rs. 25,000 under Section 80D.

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Key Inclusions and Exclusions of the Plan

What's Included

  • Pre hospitalisation, post hospitalisation and inpatient hospitalisation expenses
  • Expenses incurred on domiciliary hospitalisation if such hospitalisation continues for more than 3 days
  • Daily hospital benefit if the insured is hospitalised for 24 hours or more
  • Day care treatments which do not require hospitalisation for 24 hours or more
  • Ambulance charges are covered by the policy

What's Not Included

  • Pre-existing conditions are not covered during the first 4 years of the policy
  • Injury or ailment suffered due to war or related contingencies
  • OPD expenses incurred on diagnostic tests, laboratory examinations, etc.
  • Circumcision, unless required to treat an illness, is not covered
  • Dental treatment or surgery of any kind unless hospitalisation is required is excluded

1872 Universal Sompo Cashless Network Hospitals in India

Individual Health Insurance Plan User Reviews

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What users are saying
  • All
  • InsuranceDekho's health insurance policy has given me tremendous peace of mind for the future. Knowing that my...

    Read More
    By Sumit Verma
    On: Jul 18, 2023
  • My purchase of the Universal Sompo- Individual Health Insurance Plan was admirable with InsuranceDekho. I boug...

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    By Khishi Batra
    On: Jun 22, 2023
  • I brought my health insurance plan from Gyan in Insurancedekho and he helped me understand all the pros and co...

    Read More
    By Ashish Kwatra
    On: Feb 24, 2020
  • Individual plan from universal sompo is a good one if you are not married. I purchased it for myself a year ba...

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    By Hirendran Duraiswami
    On: Feb 24, 2020
  • What I liked the most about this plan was easy buying, comprehensive coverage, and even nominal premium. I bro...

    Read More
    By Abhinav Jaiswal
    On: Feb 11, 2020

Add-ons to Enhance Benefits

  • Critical illness

    An additional critical illness rider is available under the plan. The rider covers five specific critical illnesses and pays the sum insured if the insured suffers from any of the covered illnesses.

Universal Sompo Individual Health Insurance Plan Expert Review

  • Expert Review

    Describe your new note here.Getting sick or injured may make a dent in your savings. It’s, therefore, essential to buy a health insurance policy, which financially supports and lets you avail the best possible treatment. Individual Health Insurance Policy by Universal Sompo is an indemnity based product, which has been designed to pay for the expenses incurred during hospitalisation. This policy is available for an individual or a family. Coming with Rs 1 Lakh - Rs 5 Lakh Sum Insured, the policy pays hospitalisation expenses as well as domiciliary hospitalisation benefits in case you or any insured member suffers from an illness or receives an accidental injury during the policy period.

    The Individual Health Insurance Policy not just covers the policyholder, but dependent family members as well. Anyone aged up to 55 years is eligible for coverage under this policy for 1 year. In so far as children are concerned, they are covered after 3 months. This policy of Universal Sompo comes with an additional critical illness rider, which enables you to extend coverage for certain critical illnesses such as Paralysis, Cancer, Stroke, Chronic Renal Failure, Major Organ Transplant (pancreas, kidney, lungs, bone marrow) and Coronary Artery Bypass.

  • Major Attractions

    Individual Health Insurance Policy, being rightly named, makes sure proper care is given to the insured when they are hospitalised. The policy covers treatment taken in hospitals or nursing homes across the country. Cashless hospitalisation under this plan is available at more than 4,000 network hospitals. Some of the coverage benefits that you should know are:

    • Inpatient hospitalisation for more than 24 hours, including room rent, surgeon's fee, consultation fee, medicines, anaesthesia, diagnostic studies, blood, oxygen, operation theatre charges, etc.
    • Medical expenses like medicines, consultation fee, tests, etc. incurred up to 30-day before hospitalisation
    • Medical costs, including physiotherapy charges, consultation fee, medicines related to disease/accident 60-day post discharge from the hospital
    • Medical expenses for domiciliary hospitalisation for a period exceeding 3 days. This means an illness which normally requires treatment in a hospital, but actually taken at home because the patient can’t be taken to the hospital
    • Coverage for daycare procedures that require less than 24 hours of hospitalisation because of advanced technologies in the medical industry
    • Emergency ambulance charges are covered up to 1% of the basic sum insured subject to a maximum of Rs 1,000
    • Daily hospital cash benefit if the insured is hospitalised for 24 hours or more. The amount payable is equal to 0.1% of the basic sum insured or Rs. 250 per day, whichever is less - limited to a maximum of Rs 2,500/ in a policy period
    • The policy also covers the costs of organ donor transplant and procedure
  • What’s More?

    Apart from the coverage benefits, the Individual Health Insurance policy of Universal Sompo also provides you with some other benefits that make the plan apart. This includes:

    • No pre-medical checkup up to the age of 45 years
    • Hassle-free in-house claim management
    • Free health checkup once at the end of every four claim free policy years
    • Cumulative bonus of 5% of the basic sum insured for every claim free year. It can be accumulated to a maximum of 30%
    • Tax benefits under Section 80D of the Income Tax Act
  • Conclusion

    With the benefits of extensive coverage and features by Universal Sompo under the Individual Health Insurance, it ‘s good to buy this policy and cover yourself and your family. This can be a suitable policy available at a lower premium (premium is generally calculated based on the age of the insured and the sum insured selected.

    Moreover, the Individual Health Insurance policy can be bought online or through offline mode with minimum documentation. However, it’s advisable to opt for the online mode for fast issuance of the policy and utmost transparency. And to make the policy purchase experience more convenient and worthwhile, choose InsuranceDekho. At InsuranceDekho, experts can help you with when it comes to claim settlement support, policy portability support, and various other after-sale support.

Universal Sompo Individual Health Insurance Plan Brochure

  • 92.43 KB
  • PDF Document
  • Jun 08, 2019

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.

FAQs on Individual Health Insurance Plan Health Insurance Plan

  • What are day care treatments?

    Day care treatments are those treatments which do not require the insured to be hospitalised for 24 hours. The treatment is done within a few hours and discharge is given early. This is because of technological advancements in medicine which has resulted in advanced time-saving treatments which earlier required longer hospitalisations. 

  • What coverage is allowed for pre and post hospitalisation expenses?

    Pre hospitalisation expenses are covered for up to 30 days before actual hospitalisation and post hospitalisation expenses are covered for up to 60 days after being discharged from the hospital.

  • Which critical illnesses are covered under the critical illness rider?

    The rider covers cancer, paralytic stroke, chronic renal failure, coronary artery bypass surgery and major organ transplants.

  • Does room rent have any sub-limits?

    Yes, sub-limits are applicable on room rents. The sub-limit is 1% of the basic sum insured for normal hospital room and 2% of the basic sum insured for ICU room rent.

  • For up to what extent are domiciliary treatments covered?

    Domiciliary hospitalisation is covered for up to 20% of the basic sum insured and only when such hospitalisation is for more than 3 days.

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