Universal Sompo Group Health Insurance Plan

About Universal Sompo General Insurance Company Ltd.

Universal Sompo General Insurance Co. Ltd. collaborates with Indian Bank, Indian Overseas Bank, Karnataka Bank Ltd., Dabur Investment Corporation, and Sompo Japan Insurance Inc., a prominent general insurer from Japan. The company provides an extensive portfolio of products designed to meet the needs of Retail, Rural, SME, and Corporate customer segments.

Universal Sompo Group Health Insurance Key Features and Coverage

• The policy offers a wide coverage sum insured up to Rs.5,00,000.
• This policy is restricted to the hospitals/nursing homes of India only.
• The coverage includes expenses incurred towards room, boarding expenses, nursing expenses, surgeon/specialist fees, charges for blood, oxygen etc.
• The premium is calculated based on factors such as the insured's age, family size, and the sum insured selected.

Add-ons in Universal Sompo Group Health Insurance

Universal Sompo Group Health Insurance offers flexible add-on covers to provide extended protection for employees and their families, ensuring comprehensive health security by paying an additional premium based on group size.

Here are the available add-ons:

• Critical Illness Cover (e.g., Paralytic Stroke, Cancer, Chronic Renal Failure, Coronary Artery Bypass, Organ Transplants excluding Liver Transplant).
• Maternity Benefit Cover
• Hospital Cash Cover (In-built Cover)
• Pre-Existing Disease Cover
• Family Floater Option

Universal Sompo Group Health Insurance Policy details

• Sum Assured - Maximum sum assured of 5 lac.
• Policy termination - Policyholder is allowed to terminate the policy at any time by giving a 15 day written notice. In case no claim has been made under the policy, percentage of premium will be refunded.
• Free look period - If you are not happy with the coverage, terms and conditions of the policy, you have the option of cancelling the policy within 15 days of receipt of the policy documents, provided there has been no claim.

Universal Sompo Group Health Insurance Exclusions

The exclusions under Universal Sompo Group Health Insurance are as follows:

• Contraction of any disease during the first 30 days of commencement of the policy.
• Waiting period of 1 year from commencement of Policy for certain diseases like cataract, and hysterectomy.
• Any illness or disease contracted due to intake of alcohol or other addictive substances will not be covered.
• Any illness or disease due to war or invasion.

Universal Sompo Group Health Insurance Claim Process

Here are the simple steps to file cashless and reimbursement claims under Universal Sompo Group Health Insurance:

Steps to File Cashless Claim

1. Initiation: The insured requests cashless approval at a network hospital. Universal Sompo then assesses the request and either approves or declines it.
2. Hospitalisation: Following approval, the insured proceeds with hospital admission.
3. Claim Settlement: Upon discharge, Universal Sompo settles the claim directly with the hospital.

Steps to File Reimbursement Claim

1. Initiation: Settle the hospital bill and submit the original documents and invoices to Universal Sompo.
2. Verification: Universal Sompo verifies and authenticates the submitted documents.
3. Claim Settlement: Upon approval, the reimbursed amount is deposited directly into the insured's bank account.

Universal Sompo Group Health Insurance Plan FAQs