Universal Sompo General Health Insurance - Compare plans & reviews

Universal Sompo General Insurance, a joint venture firm, was set-up in the year 2007, after receiving approval from the Insurance Regulatory and Development Authority of India. The insurer offers a range of general insurance products, including health insurance, motor insurance, commercial insurance, and bancassurance policies to individuals, families and groups. The end-to-end insurance solutions offered by the insurer enable them to meet the varying needs of people.

Features and Benefits of Universal Sompo General Insurance

• Online Purchase of Policies: Prospective policy buyers can purchase Universal Sompo insurance policies directly from the insurer’s website. This cuts the middlemen out and makes the entire process hassle-free.
• Calculate Premiums Online: It is imperative that you know how much you will have to pay as your premium, in order to budget accordingly. You can calculate your premium on the insurer’s website, by simply inputting a few relevant details.
• 24x7 Customer Care: The insurer has a range of channels through which policyholders can reach them, including a 24x7 toll-free number, a dedicated email ID for general queries and one for any claims-related enquiries. Customers can also walk into any one of the insurer’s branches during the company’s working hours.
• Digital Renewal of Policies: A few Universal Sompo insurance policies can be renewed online, through the insurer’s website, in a time-efficient and convenient manner.
• Cashless Hospitalisation: Customers have the added advantage of availing cashless hospitalisation in any one of the insurer’s 4,000+ network hospitals across the country. If you choose to avail cashless hospitalisation, your medical bills will be settled by the insurer/TPA, and you won’t have to pay anything at the time of discharge.
• Tax Benefits: Policyholders are eligible to claim tax benefits for the premiums that they pay, under Section 80D of the Income Tax Act, 1961. This leads to your policy doubling-up as an insurance cover and as an investment for tax savings.

Health Insurance Plans offered by Universal Sompo General Insurance

Individual Health Insurance Policy

This policy will pay the policyholder any hospitalisation expense that he/she may have incurred due to an accident. The policy also covers domiciliary expenses incurred by the insured, inpatient medical treatment, pre- and post-hospitalisation costs, day-care procedures, etc.

Unique Features of the Individual Health Insurance Policy

• This policy can be purchased online.
• Maximum age of entry for this plan in 55 years.
• Children as young as 3 months of age can be enrolled under this plan.
• Only hospitalisation/treatments which happen in India will be covered.
• individuals over the age of 45 years will have to undergo a medical examination.
• An add-on cover can be purchased to include specific critical illnesses.

Plan Details

Policy term	1 year
Entry Age	3 months – 55 years
Plan Basis	Individual/Family Floater Plan
Sum Insured Range	Rs.1 lakh – Rs.5 lakh
Premium	Premiums will vary based on age at entry, sum insured, etc.
Medical Screening	Required for policy takers over the age of 45 years
Waiting Period	General claims: 30 days Specific ailments/surgeries: 1 year
Cumulative Bonus	The insured will receive a Cumulative Bonus at 5% of the Basic Sum Insured for every claim-free year. Up to a maximum of 30% can be accumulated as the Cumulative Bonus.

Group Health Insurance Policy

This policy is an ideal cover for groups of individuals, such as employees of an organization, members of associations/school/clubs, etc. As per this policy, if the insured meets with an accident, the insurer will cover the member’s hospitalisation and domiciliary expenses.

Unique Features of the Group Health Insurance Policy

• The policy only covers treatments that happen in hospitals across the country.
• Add-on covers, such as the Critical Illness Cover, Pre-Existing Illness Cover, in-built Hospital Cash Cover, Maternity Benefit Cover, and Family Floater Cover, can be purchased to enhance the protection accorded by this plan.
• Hospitalisation expenses include room rent charges, doctor fees, nursing charges, boarding costs, charges of oxygen, blood, etc.
• Domiciliary expenses are also payable, provide the treatment exceeds a minimum period of 3 days.
• The maximum amount that can be opted for as the sum insured is Rs.5 lakh.

Plan Details

Plan Basis	Group Plan
Sum Insured Range	Up to a maximum of Rs.5 lakh
Premium	Will vary based on the insured’s age at entry, the sum insured opted for, size of the insured’s family, etc.
Waiting Period	General claims: 30 days Specific conditions: 1 year

Individual Accident Policy

This policy provides a cover to the insured and his/her family against untimely accidents. The compensation that is payable depends on the nature of injury – permanent total disability, temporary total disability, temporary partial disability, or accidental death – sustained by the insured.

Unique Features of the Individual Accident Policy

• This policy provides three kinds of cover – a Basic Cover, a Wider Cover, and a Comprehensive Cover.
• Cashless facility is offered in over 4,000 hospitals across the country.
• While the policy can only be purchased by an adult proposer, children as young as 5 years can be covered under this policy.
• The sum insured can be increased or decreased while renewing the policy, based on the insurer’s approval.
• Insurer offers lifetime policy renewability.

Plan Details

Policy term	1 year
Entry Age	5 years to 75 years Proposer: 18 years
Plan Basis	Individual/Family Floater Basis
Sum Insured Range	Individual Plans: Rs.1 lakh – Rs.5 lakh Family Floater Plans: Starts from Rs.2 lakh
Premium	Varies based on age of the proposer, plan basis, sum insured, etc.
Discounts	Family Discount: 10% discount if more than 3 members are covered 12.5% discount if more than 4 members are covered 15% discount if more than 5 members are covered Loyalty Discount, in terms of the premium, provided the policy is renewed within a period of 7 days: 1 Year: 5% 2 Years: 10% 3 Years: 15%

Janta Personal Accident Insurance Policy

This is a group plan that is apt for employees of companies/firms, members of co-operative clubs/societies, members of NGOs, and people belonging to APL and BPL groups, as identified by the government. The compensation that is payable by Universal Sompo will be based on the nature of the member’s accidental injury and the sum insured amount that was opted for at the inception.

Unique Features of the Janta Personal Accident Insurance Policy

• The risk cover only applies to accidental death and permanent total disability.
• The premium will have to be paid as a one-time instalment, at the time of purchasing the policy.
• Lifetime policy renewal is offered to policyholders.
• The policy can be purchased by anyone under the age of 65 years.
• Children who are 5 years and above can be covered under the policy.

Plan Details

Policy term	1 year
Entry Age	5 years to 65 years Proposer: 18 years
Plan Basis	Group Plan
Premium	Will be based on the sum insured opted for, the demography of the members of the group, discounts applicable, extensions, etc.
Discounts	Group discount (applicable on the total premium) is based on the number of people enrolled under the policy: 25 – 50 people: 5% 51 – 100 people: 10% 101 – 300 people: 15% 301 – 400 people: 20% 401 – 500 people: 25% > than 500 people: will be decided by the insurer Restricted On-Duty Cover Discount: up to 25% of the premium Restricted Off-Duty Cover Discount: up to 50% of the premium

Group Personal Accident Policy

This policy can be purchased for groups, such as employees of an organization or members of affinity groups. While this is a group plan, this policy can be extended to cover the family of the group members. The compensation payable is based on the capital sum insured and the severity of the injury.

Unique Features of the Group Personal Accident Policy

• The policy offers 3 kinds of covers – Basic Cover, Wider Cover, and Comprehensive Cover.
• The Comprehensive Cover can’t be extended to cover the member’s family.
• The policy provides additional benefits, such as reimbursement of the cost of clothing damaged in the accident, reimbursement of ambulance charges, education benefit to the member’s children, loss-of-employment benefit, etc.
• Add-on extensions can be purchased to cover medical expenses and to provide a daily cash allowance when the member is hospitalised.

Plan Details

Plan Basis	Group Plan; can also be extended to cover members’ family
Premium	Varies based on the Capital Sum Insured, and optional extensions purchased

Aapat Suraksha Bima Policy

This policy can be bought on an individual basis, and the cover can also be extended to enrol one’s immediate family members. The policy covers five critical illnesses, including Paralytic Stroke, Cancer, Coronary Artery Disease, Renal Failure, and Major Organ Transplant, accidental death, and permanent total disablement.

Unique Features of the Aapat Suraksha Bima Policy

• The policy guarantees a lump sum payout on diagnosis of a critical illness or if the individual meets with an accidental death or suffers from permanent total disablement.
• Pre-existing illnesses/diseases are not covered under the policy.
• The survival period after diagnosis of a critical illness is 30 days.
• Benefits payable will be based on the nature and severity of the injury sustained and the capital sum insured amount.

Plan Details

Plan Basis	Individual/Family Plan
Premium	Varies based on the Capital Sum Insured, age of the insured, etc.
Waiting Period	90 days for general claims

Loan Secure Insurance Policy

This policy is ideal for individuals who have an outstanding loan with a bank or financial institution. The insurer will provide a payout if the policyholder is diagnosed with a major illness (as specified in the policy brochure), meets with an accident, loses his/her job, etc.

Unique Features of the Loan Secure Insurance Policy

• The policy can be renewed till the individual turns 55 years of age.
• Under Section I of the benefits payable, a maximum of 18 major illnesses can be covered. However, the insured will have to choose between a Silver plan, Gold plan, Platinum plan, or Diamond plan. Each plan covers a different number of major illnesses.
• The survival period for this policy is 90 days.
• The maximum age of entry is restricted to 50 years.
• Premium has to be paid as a one-time instalment.

Plan Details

Policy term	1 - 3 years
Entry Age	20 years – 50 years
Plan Basis	Group plan; can also cover family members of individuals
Sum Insured Range	Varies as per the loan amount Fixed Sum Insured: Sum Insured will match the loan amount Reducing Sum Insured: Sum Insured will decrease as the loan amount decreases
Premium	Varies based on sum insured, age of the insured, policy term, discounts (if applicable), etc.
Medical Screening	Individual will be required to undergo a medical exam, if: The sum insured opted for exceeds Rs.1 crore The member has a pre-existing disease/ailment The member is over the age of 55 years
Co-Payment	20% co-pay for members over the age of 55 years is compulsory
Waiting Period	General claims: 30 days Pre-existing diseases: 4 years Specific illnesses: 1 year
Cumulative Bonus	Not specified
Discounts	Group discount: 0 – 1,000 members: 10% discount 1,001 – 2,500 members: 15% discount 2,501 – 5,000 members: 20% discount 5,001 – 7,500 members: 25% discount 7,501 – 10,000 members: 30% discount Over 10,000 members: Will be decided by the company; maximum discount is 40% Long-term policy discount: 15% discount for a policy term of 3 years

Hospital Cash Insurance Policy

This policy can be purchased on an individual basis, and the cover can also be extended to the proposer’s spouse, dependent children and dependent parents. The policy offers a range of benefits and discounts to the policyholder and their nominees.

Unique Features of the Hospital Cash Insurance Policy

• Maximum age of entry for this policy is 70 years.
• Lifetime policy renewability is provided by the insured.
• Sum insured amount can be increased or decreased while renewing the policy.
• Children as young as 6 months can be covered by the policy.

Plan Details

Policy term	1, 2, or 3 years
Entry Age	6 months – 70 years Proposer: 18 years
Plan Basis	Individual/Family Plan
Sum Insured	Will vary based on options chosen. The following benefits will be payable: Hospital Confinement Benefit: up to a maximum of Rs.3,000 per day and Rs.5,40,000 per policy period Intensive Care Benefit: Double the Hospital Confinement Benefit Convalescence Benefit: up to Rs.10,000
Premium	Premiums will vary based on coverage required for hospital cash benefit, duration it is required for, age of the individual, etc. For an annual policy, premiums can start from Rs.188 and go up to Rs.64,800
Medical Screening	Required for individuals over the age of 55 years
Waiting Period	General claims: 30 days Specific treatment: 1 year Pre-existing: 4 years
Discounts	Long-Term Policy Discount: 10% or 15% if premiums for 2 or 3 policy years are paid as a lump sum Family discount: 5% Group discount

Saral Suraksha Bima (Micro Insurance Policy)

This policy can be purchased by groups, or by individuals provided they submit a request to the company. The policy is ideal for members for NGOs, shareholders of public limited companies/banks, SHGs, registered clubs, etc. The plan covers critical illnesses and personal accidents.

Unique Features of the Saral Suraksha Bima (Micro Insurance Policy)

• The policy can be extended to cover the member’s immediate family.
• Policy can be renewed for life.
• New policies cannot be purchased after the age of 65 years.
• Children can be covered under the policy, provided at least one parent is enrolled under the policy.

Plan Details

Entry Age	10 years – 65 years Proposer: 18 years
Plan Basis	Group/Individual Plan
Sum Insured Range	Critical Illness: Rs.10,000, Rs.20,000, or Rs.25,000 Personal Accident: Rs.20,000, Rs.40,000, or Rs.50,000
Premium	Rs.141 to Rs.290
Waiting Period	General claims: 90 days Pre-existing diseases: 48 month

Travel Insurance Policy

This policy is ideal for any individual who will be travelling abroad. The policy provides a risk cover against any medical expenses incurred due to an accident, or any travel-related losses, which might have happened when the insured travels abroad.

Unique Features of the Travel Insurance Policy

• Premiums payable towards this plan will have to be paid as a single instalment.
• The maximum age that an individual can be to purchase the policy is 70 years.
• The maximum age at entry for a Student Travel Plan is 35 years.
• The plan will only be valid if you travel within 14 days of purchasing the policy.
• This policy can be purchased online, through the insurer’s website.

Plan Details

Policy tenure	Varies based on plan chosen: Travel Worldwide Plan: 180 days Student Travel Plan: 365 days Travel Asia Plan: 47 days
Entry Age	Day 1 to 70 years of age Proposer: 18 years Student Travel Plans: 16 years – 35 years
Plan Basis	Individual/Family Floater Plan
Sum Insured Range	Travel Worldwide Plan: Specific Plan: Silver: $50,000 Gold: $200,000 Platinum: $500,000 Annual Plan: Gold: $200,000 Platinum: $500,000 Student Travel Insurance Plan: Primary: $50,000 Buddy: $100,000 Intellectual: $200,000 Travel Asia Plan: Gold: $20,000 Platinum: $25,000
Premium	Premium amounts will vary based on the age of the individual, travel duration, plan option chosen, and destination of travel. Refer to your brochure for more details
Medical Screening	Only required if the individual/proposer is over the age of 60 years

Sampoorna Suraksha Bima (Micro Insurance Policy)

This is an affordable plan that can be bought on an individual basis or as a group plan. The plan covers four sections, which are expenses incurred due to a fire/explosion, reimbursement of damage/loss incurred due to robbery, personal accident cover, and a health insurance cover.

Unique Features of the Sampoorna Suraksha Bima (Micro Insurance Policy)

• Dependent children under the age of 25 years can be covered under the policy.
• The policy also provides additional benefits, such as cover for pre- and post-hospitalisation expenses, domiciliary expenses, ambulance charges, etc.
• The maximum age at entry to purchase a new policy is 65 years.
• The policy can be renewed till the individual reaches 80 years of age.

Plan Details

Entry Age	91 days – 65 years Proposer: 18 years
Plan Basis	Individual/Group Plan
Sum Insured Range	Section 4 (Health Cover): Rs.10,000 to Rs.30,000
Premium	Will vary based on age of the proposer, policy tenure, etc.
Waiting Period	For Section 4 (Health Cover): General claims: 30 days Domiciliary expenses: 30 days Specific ailments: 1 year
Discounts	Sectional discount: 10% discount if cover for more than one section is chosen by the proposer (only valid for individual policies) Group discount: 201 – 500 people: 10% discount > than 500 people: 15% discount on the total premiums payable

Senior Citizen Health Insurance Policy

This policy can be purchased by any individual over the age of 60 years. The plan provides a range of benefits, including a cover for hospitalisation expenses, pre- and post-hospitalisation expenses (provided they fall within the limits set by the insurer), domiciliary benefits, reimbursement of ambulance charges, etc.

Unique Features of the Senior Citizen Health Insurance Policy

• Policyholder’s spouse can be covered under the policy.
• Insurer offers lifetime policy renewals.
• The medical tests that you will be required to undergo will vary based on the sum insured opted for.
• Ailments/surgeries that are covered under the policy come with sub-limits.

Plan Details

Policy term	1 year 2 years 3 years
Entry Age	60 – 70 years
Plan Basis	Individual/Family floater plan
Sum Insured Range	Rs. 1 lakh – Rs.5lakh
Premium	Hospitalisation premium for 1 adult: Rs.4,358 to Rs.48,694 Hospitalisation premium for 2 adults (Individual sum insured basis): Rs.8,279 to Rs.92,519 Hospitalisation premium for 2 adults (Floater basis): Rs.6,101 to Rs.68,171 Critical Illness Premium: Rs.2,179 to Rs.24,347
Medical Screening	Medical tests to be taken will vary as per the sum insured chosen. A higher sum insured will entail more tests.
Co-Payment	All claims: 10% co-pay Pre-existing diseases: 20% co-pay Day-care treatments: 15% co-pay
Waiting Period	General claims: 30 days Pre-existing diseases: 24 months Specific illnesses: 24 months
Cumulative Bonus	The sum insured will be increased by 5% for every claim-free year, up to a maximum of 10 years
Discounts	Long-Term Family Discount, provided the premiums are paid in advance: 2 years: 10% discount 3 years: 15% discount Family Discount: 10%, if the insured’s spouse is also covered under the individual sum insured

Complete Healthcare Insurance Policy

This policy can be purchased on an Individual or Family Floater Basis. The policy comes with three plan options – Basic, Essential, and Privilege. Policy buyers can also choose to enhance their coverage by opting for add-on sections by paying an extra premium.

Unique Features of the Complete Healthcare Insurance Policy

• The policy comes with a large sum insured range.
• Premium has to be paid as a one-time instalment.
• Dependent children can be insured under an individual policy.
• Additional benefits, such as pre- and post-hospitalisation expenses, domiciliary expenses, organ donation, etc. will also be covered by the policy.

Plan Details

Policy term	1 to 3 years
Entry Age	Adults: 18 – 70 years Dependent Children: 91 days – 25 years Children under Family Floater Plans: Day 1
Plan Basis	Individual/Family Floater Basis
Sum Insured Range	Basic Plan: Rs.1 lakh or Rs.2 lakh Essential Plan: Rs.3 lakh, Rs.4 lakh, or Rs.5 lakh Privilege Plan: Rs.6 lakh, Rs.7 lakh, Rs.8 lakh, Rs.9 lakh, or Rs.10 lakh
Premium	Varies based on plan option chosen, plan basis, age of the insured, additional sections opted for, etc.
Medical Screening	Will be required if the individual is over 55 years of age. List of tests vary for each plan option.
Co-Payment	If the insured undergoes hospitalisation at non-network hospital, 10% co-pay will be applicable.
Waiting Period	General Claims: 30 days Maternity and Childcare benefits: 3 years Critical Illnesses: 90 days Surgeries: 1 year Specific Illnesses: 1 year Pre-existing diseases: 3 years Outpatient treatment: 3 years
Cumulative Bonus	Sum Insured will be increased by 10% for each year that the insured doesn’t make a claim. The maximum cumulated bonus is restricted to 50%.
Discounts	5% discount if hospitalisation happens at a network hospital Long-term policy discount: 2 years: 5% discount 3 years: 7.5% discount E-Policy discount: Rs.110 If family members are covered under the individual sum insured: 2-3 members: 5% discount 4-5 members: 7% discount > 5 members: 10% discount Healthy lifestyle discount: 2.5% Discounts on choosing sub-limits: Basic Plan: Sub-limit A: 7.5% discount, Sublimit B: 5% discount Essential/Privilege Plans: Sub-limit A: 10% discount, Sublimit B: 7.5% discount, Sublimit C: 5% discount

Pravasi Bhartiya Bima Yojana

This product will only cover individuals who have purchased this policy before emigrating from India, in order to work abroad. This policy can also be used to cover the individual’s spouse and children.

Unique Features of the Pravasi Bhartiya Bima Yojana

• The cover can be extended to one’s spouse and dependent children.
• The policy offers a range of benefits to individuals living outside India, for the purpose of employment.
• Individuals over the age of 45 years are required to undergo medical tests, and the validity of these tests are 30 days.

Plan Details

Policy term	2-3 years
Entry Age	18-65 years
Plan Basis	Individual/Family Plan
Sum Insured Benefits	The following benefits are payable, as per this policy: Accidental death or permanent total disability: Rs.10 lakh Hospitalisation expenses caused by an injury/disease: up to Rs.75,000 Maternity expenses: Rs.25,000 Hospitalisation expenses of family: Rs.50,000 Legal costs: Rs.30,000 Airfare for repatriation, employment contingencies, and attendant: Economy class
Premium	2-Year Policy Tenure: Rs.275 3-Year Policy Tenure: Rs.375
Medical Screening	Required if the individual is over 45 years
Waiting Period	General claims: 30 days Specific illnesses: 12 months Pre-existing diseases: 48 months

Surva Vidyarthi Bima Yojana

This is a group plan that can only be purchased by educational institutions. Both students and staff can be covered under this policy. This policy can be enhanced by choosing additional extensions.

Unique Features of the Surva Vidhyarthi Bima Yojana

• While certain benefits are fixed, other benefits can be opted for by purchasing additional extensions.
• This is an annual policy.
• The policy can be used to cover children and adults.
• Premiums must be paid in advance.

Plan Details

Policy term	1 year
Entry Age	3 years – 65 years
Plan Basis	Group Plan
Premiums	Will vary based on the sum insured, group demography, extensions opted for, etc.
Waiting Period	Pre-existing diseases: 48 months General claims: 30 days
Discounts	Policy purchased on “On Premises Basis”: 25% discount Voluntary Deductible: 5% of the claim amount: 5% discount 10% of the claim amount: 10% discount 15% of the claim amount: 15% discount Group discount: 101 – 5,000 persons: 10% discount 5,001 – 15,000 persons: 15% discount 15,001 – 25,000 persons: 20% discount 25,001 – 50,000 persons: 25% discount Over 50,001: 30% discount Appliances to extinguish fire: 5% or 10%, as per type of installation chosen Loyalty discount: 5% If policy is directly sourced: 10% discount Selection of multiple benefits: 20% discount

Swarna Gramin Bima Yojana – Individual Plan

This plan can be purchased by any individual residing in an Indian village. This plan offers a range of benefits, including a cover for personal accidents, critical illness, and hospital cash.

Unique Features of the Swarna Gramin Bima Yojana – Individual Plan

• This policy can be renewed for life.
• Up to two adults and two children can be covered under the policy.
• Dependent children under the age of 25 years can be enrolled.
• The sum insured can be enhanced while renewing the policy.

Plan Details

Policy term	1 – 3 years
Entry Age	Adults: 18 years – 65 years Children: 6 months
Plan Basis	Individual/Family Plan
Sum Insured Range	Rs.50,000 – Rs.2 lakh
Premium	Will vary as per the age of the member, sum insured opted for, etc.
Medical Screening	Required if the individual purchasing the policy is over 45 years of age
Waiting Period	Pre-existing diseases: 48 months General claims: 30 days Specific illness: 2 years Pre-existing diseases: 48 months
Discounts	Long-Term Policy Discount: 2 years: 10% discount 3 years: 15% discount Family Discount: Self and spouse: 5% discount Self, spouse, and one child: 7.5% discount Self, spouse, and two children: 10% discount

Swarna Gramin Bima Yojana – Group Plan

This plan can be purchased by groups, such as NGOs, banks, and financial institutions to provide a cover for their customers who live in rural areas.

Unique Features of the Swarna Gramin Bima Yojana – Group Plan

• Lifetime policy renewability is offered by the insurer.
• The sections/benefits covered by this policy include a cover for personal accidents, hospital cash, and critical illnesses.
• Pre-existing illnesses can be included in your cover if you pay an extra premium.

Plan Details

Policy term	1-3 years
Entry Age	Adults: 18-65 years Dependent children: 6 months
Plan Basis	Group Plan
Sum Insured Range	Rs.50,000 to Rs.2 lakh
Medical Screening	Will be required for individuals who purchase the policy after 45 years of age
Waiting Period	General claims: 30 days Specific illnesses: 2 years Pre-existing diseases: 48 months
Discounts	Group discount (applicable on the total premium): 25 to 50 individuals: 5% discount 51 to 100 individuals: 10% discount 101 to 300 individuals: 15% discount 301 to 400 individuals: 20% discount 401 to 500 individuals: 25% discount > 500 individuals: 35% discount

Critical Illness Insurance Policy

This is an individual plan, and the cover can be extended to one’s spouse, children, parents, and parents-in-law. The policy provides a cover against some of the major and most common critical illnesses.

Unique Features of the Critical Illness Insurance Policy

• Survival period for this policy is 30 days.
• Premium loading may be applicable based on the type of occupation one undertakes.
• Children as young as 5 years of age can be enrolled under the policy.

Plan Details

Policy term	1, 2 , 3 years
Entry Age	Adults: 18 years – 65 years Children: 5 years
Plan Basis	Individual Plan
Sum Insured Range	Rs.2.5 lakh – Rs.20 lakh
Premium	One-year policy: Rs.902 – Rs.47,896 Two-year policy: Rs.1,714 – Rs.91,002 Three-year policy: Rs.2,571 – Rs.1,36,504
Medical Screening	Will be required if one is over the age of 55 years, or on the basis of your previous medical condition
Waiting Period	Critical illness claims: 90 days Pre-existing diseases: 48 months
Discounts	Long-Term Policy Discount (if premiums are paid in advance): 2 years: 10% discount 3 years: 15% discount

Domestic Travel Insurance Policy

This policy is applicable only to individuals travelling within India. The policy comes with a cover for any hospitalisation expense that one might incur while travelling, personal accidents, or any travel-related losses.

Unique Features of the Domestic Travel Insurance Policy

• This policy is valid only for 91 days.
• Individuals can choose between a range of sub-plans, including the Platinum Plan, Gold Plan, Silver Plan, Corporate Plan, and Multi Annual Trip Plan.
• The cover can be extended to include the proposer’s spouse, parents, and dependent children.
• Children can be enrolled under this plan, provided at least one parent has purchased this plan.

Plan Details

Policy term	1 – 91 Days
Entry Age	Adults: 18 years – 65 years Dependent Children: 5 years – 23 years
Plan Basis	Individual/Family Plan
Sum Insured Range	Rs.1 lakh – Rs.5 lakh
Premium	Premiums will vary based on the sum insured opted for, policy tenure, and the deductible amount
Medical Screening	Individuals over the age of 65 years will have to undergo a medical screening
Waiting Period	No waiting period
Discounts	Family Discount (will be applicable on the premium): Enrolling parents: 50% discount Enrolling spouse: 60% discount Enrolling children: 75% discount

Checklist before buying Universal Sompo Health Insurance Policies

• Decide on whether you want to purchase a policy just for yourself, or extend the policy to cover your dependents.
• Take your family’s size, needs, and average age into consideration.
• Research various health insurance plans that are offered by your insurer, and find one that perfectly matches your needs.
• Make sure you go through the policy brochure and meet with an insurance advisor, so you can familiarise yourself with the terms and conditions of the policy.
• Work out an optimum amount as the sum insured with affordable premium payments.
• Visit your insurer’s website for their list of network hospitals.
• Purchase any additional riders that are being offered by your insurer, if you would like to enhance the cover.

Documents required to Purchase Universal Sompo Health Insurance Policies

Generally, the following documents are required to purchase health insurance policies from insurance providers:

• ID proof, such as Passport, Aadhaar, Driver’s Licence, PAN card, etc.
• Address proof, such as Passport, Aadhaar, Electricity bills, etc.
• Medical screening documents (if applicable)

Reasons to choose Universal Sompo General Insurance

• Universal Sompo has a very high claim settlement ratio of 99.23%.
• The insurer has a range of health insurance products.
• A few policies can be bought and renewed online, through the insurer’s website.
• The insurer has over 4,000 network hospitals, where you can avail cashless treatment.
• Medical screening is only required if the policy buyer is over a certain age (between 45 to 55 years, in most cases).

Incurred Claim Ratio of Universal Sompo General Insurance

The incurred claim ratio is the overall value of all the claims settled by the insurer in a given financial year against the total value of premiums that they collected in the same year. Every prospective policy buyer must consider the incurred claim ratio of an insurance company before purchasing a policy. Universal Sompo’s incurred claim ratio, for the financial year 2015 - 2016, is 85.07%.

Year	Incurred Claim Ratio
2016-2017	86.14%

Additional Benefits from Universal Sompo General Insurance

Cashless Hospitalisation	The insurer has a network of over 4,000 hospitals across the country, where individuals can avail cashless hospitalisation.
Grace Period	Most policies come with a grace period of 30 days, before which one must pay the premium in order to keep the policy from lapsing.
Free-Look Period	A 15-day free-look period is provided to policy buyers, during which time they can review their policy and return it if they don’t find the policy term and conditions to be satisfactory.
Nomination	Policy buyers can choose a nominee at the time of purchasing the policy.
Portability	Most health insurance plans come with a portability option, wherein you can port your insurance policy to another insurer, within a period of 45 days.
Tax Benefits	The insured can claim tax benefits for the premiums paid towards the policy, as per Section 80D of Income Tax Act, 1961

Universal Sompo Policy Renewal

Universal Sompo provides customers the option to renew a few policies directly through their official website by entering a few relevant details and making the necessary premium payments. However, you can also choose to walk into the nearest insurer branch to renew your policy.

Universal Sompo Network Hospitals for Cashless Treatment

Universal Sompo has a network of over 4,000 hospitals across the country. Any customer with a Universal Sompo health insurance policy can avail cashless treatment at any one of these hospitals. To locate your nearest network hospital, visit the insurer’s official website or contact their customer care helpline.

Claim Procedure for Universal Sompo General Insurance

Process to avail Cashless Hospitalisation:

• Firstly, you will have to call the insurer’s helpline and intimate them of the upcoming claim.
• Intimation of claims should be done within 24 hours for emergency procedures and 48 hours for planned hospitalisation.
• At the hospital registration desk, show the health card issued to your by the insurer and a photo ID proof.
• Once you receive your Cashless Request Form, you will need to fill it and submit it at the registration desk.
• The hospital will verify your details and send your Cashless Request Form to the insurer.
• The insurer will review your request against your policy terms, and communicate their decision to you and the hospital.

Reimbursement Claims:

• Through the insurer’s in-house Health Claims Management:

• You will first have to intimate the insurer of the claim by reaching out to them on their helpline number or their dedicated email ID.
• This will have to be done within 24 hours if it is an emergency hospitalisation and before 48 hours if it’s a planned procedure.
• After your treatment and discharge, you will have to pay the hospitalisation bills in full and collect all relevant medical documents from the hospital.
• Next, you will have to fill the Reimbursement Claim Form and submit the form along with the supporting documents to the insurer.
• The insurer will process your claims as soon as they receive all your documents.

• Through the insurer-appointed TPA:

You will have to intimate the TPA as soon as the claim has occurred. You will find the contact number to reach your TPA on your health card. Your claims will be settled in a time-efficient manner by the TPA.

Terms and Conditions of Universal Sompo General Insurance

• The policy will be annulled if the policy buyer has concealed or misrepresented any information while purchasing the policy.
• If the policyholder has made a fraudulent claim, any benefits received due to the policy will be forfeited.
• The policy will be valid only for treatments that happen within the geographical area specified in the policy.
• All claims will be settled in Indian National Rupees (INR), unless mentioned otherwise.
• The sum insured can only be enhanced while renewing the policy.
• Three months’ notice will be given to the policyholder in case the insurer is withdrawing the product.

FAQs - Frequently Asked Questions while buying Universal Sompo General Insurance Policies

1. Are pre-existing diseases covered under health insurance plans?

   Most health insurance plans will cover pre-existing diseases, provided the policy is renewed without any breaks for a few years (48 months, in most cases).

2. What is a family floater plan? How many members can be covered under family floater plans?

   Opting for a family floater plan will enable you to cover yourself, your spouse, dependent children, and dependent parents, under the same plan. There will be a floater sum insured available that can be used by all members in varying amounts.

3. What is the difference between network and non-network hospitals?

   Hospitals that fall within your insurer’s network are called network or tiered hospitals. You can avail cashless treatment at these hospitals. Any hospital that’s out of your insurer’s network is called a non-network hospital. If you avail treatment at a non-network hospital, you will have to pay the medical bills in full and later claim for a reimbursement.

4. Is there a time limit to submitting a claim after discharge?

   Yes, you will have to submit your claim with all supporting documents within 30 days of your discharge from the hospital.

5. How long will the insurer take to settle my claims?

   If the insurer receives all supporting documents on time, they will settle your claim within a period of 7 days.

6. Is the travel insurance plan applicable for travel outside and inside India?

   Universal Sompo offers policy buyers two travel insurance plans. One covers individuals travelling abroad and the other covers individuals travelling domestically. You will have to purchase your travel insurance policy accordingly.

7. What is the necessity of a health insurance plan?

   Health insurance plans will provide you a cover against any expense that you may incur due to your hospitalisation. Most health insurance plans also provide members several other benefits, such as a cover for day-care procedure, pre- and post-hospitalisation expenses, treatment for pre-existing/specific illnesses after the waiting period, etc., making them a viable choice.

8. What is domiciliary hospitalisation?

   Domiciliary hospitalisation includes any treatment that would have normally been done at a hospital, but was treated at the insured’s house due to certain conditions. The period of treatment should also be over 3 days, in order for it to qualify as domiciliary treatment.

9. What is cashless hospitalisation?

   Provided your cashless hospitalisation request/pre-authorisation has been approved by the insurer/TPA, the medical expenses that fall within your insurer’s criteria will be settled directly by the insurer. Cashless hospitalisation can only be availed at network hospitals.

10. Is there a limit to the number health insurance plans that can be purchased by one individual?

    No, you can have more than one health insurance policy. As long as you have paid your due premiums for each policy, the claim amount will be payable to you by each insurer, as per your policy terms and conditions.

11. How many claims can I make in a year?

    There are no limit to the number of claims you can make in a year. However, you will have to ensure that they fall within the sum insured that you opted for. If your claim exceeds the sum insured, you will have to pay the difference amount.

12. I am an international citizen residing in India currently. Can I purchase a Universal Sompo health insurance policy?

    Yes, international citizens living in India can purchase health insurance plans. However, your health insurance plan will be valid only in India.

13. I already have a health insurance cover provided to me by my company. Is there a need to purchase another one?

    Health insurance policies that are provided to employees by corporates are usually not very comprehensive. Hence, it is recommended that you purchase a health insurance policy that perfectly matches your needs to cover yourself and your immediate family, for an optimum sum insured.

14. How do I file a claim directly with Universal Sompo?

    In order to file a claim with Universal Sompo, you will first have to intimate the insurer of the upcoming claim. Post your discharge from the hospital and settling your hospitalisation bills, you will have to submit the filled claim form and all supporting documents to your insurer. On receipt of these documents, Universal Sompo will start processing your claim.

15. What is a TPA, and what role does it play?

    A TPA, or third-party administrator, is a service provider that is appointed by your insurer. Your TPA will help you with claims processing, pre-authorisation, cashless hospitalisation, and other value-added services.