Universal Sompo General Insurance Company

Universal Sompo General Insurance Company

A private-public joint venture between Allahabad Bank, Karnataka Bank Ltd., Indian Overseas Bank, Dabur Investment Corp, and Sompo Japan Nipponkoa Insurance Inc., Universal Sompo General Insurance Company is the first private-public partnership in the general insurance sector. Headquartered in Mumbai, Universal Sompo offers a wide range of general insurance products, including health insurance, home insurance, motor insurance, and travel insurance, fulfilling varied requirements of different sections of people across the country.

Universal Sompo’s health insurance plans are among the most promising products, which are affordable, easy to understand, and can be purchased on an individual and family floater basis. In addition, the health insurance policies are carefully designed to offer multiple benefits to the policyholders, such as coverage features and advanced coverage benefits.

Facts about Universal Sompo General Insurance Company

Incurred Claim Ratio (F.Y. 2019-20) 76.68%
Network Hospitals 4000+
Renewability Lifelong

Why opt for Universal Sompo General Insurance Company?

  • Universal Sompo Health Insurance features a vast network of over 4,000 hospitals across India where the policyholders can avail themselves of cashless hospitalization without worrying about medical expenses.
  • Universal Sompo Health Insurance provides 24X7 customer care assistance. The policyholders can reach out to the insurer through customer care number, health helpline, and claims helpline number seeking insurance-related help. The insurer also offers a live chat facility where customers can get their queries solved.
  • Impressive Claim Settlement Ratio: Universal Sompo Health Insurance has an impressive Claim Settlement Ratio (CSR) of 70.75% for 2019-20, depicting it as a responsible insurer handling claim requests.
  • Universal Sompo has a strong footprint in the insurance sector with its 135 products approved by IRDAI. The company provides 360-degree products and services through them.
  • Universal Sompo Health Insurance Company has an in-house claim settlement process which further enhances customer service during any claim process.

Universal Sompo Health Insurance Plans

Universal Sompo General Insurance company offers a host of health insurance plans to match the different necessities of individuals and families. Below is the list:

  • Complete Healthcare Insurance
  • Super Healthcare Insurance
  • Arogya Sanjeevani Insurance
  • Corona Rakshak Policy
  • Corona Kavach Policy
  • Saral Suraksha Bima
  • Individual Accident Policy
  • Hospital Cash Insurance Policy
  • Senior Citizen Health Insurance Policy
  • Critical Illness Insurance Policy

Universal Sompo Health Insurance Claim Settlement Process

The health insurance claim settlement process is a procedure to raise a claim against medical expenses to the insurers. There are two ways to do it – cashless claim and reimbursement claim.

Universal Sompo Health Insurance Cashless Claim Settlement Process

In case the policyholder gets treated in the insurer’s network hospital, the claim is processed in a cashless manner. Below are the steps to be followed under Universal Sompo Health Insurance:

  • Step 1: Get hospitalized at any network hospital, show a Health Serve Card and a valid photo ID. Inform Universal Sompo General Insurance Company at least 72 hours before hospitalization if it is planned one and within 48 hours in case of emergency hospitalization.
  • Step 2: Submit the duly filled cashless claim form to Universal Sompo General Insurance company.
  • Step 3: The company will then verify the submitted documents and start processing the claim.
  • Step 4: The insurer will settle the medical bills directly with the network hospital deducting the amount for inadmissible expenses such as telephone charges, food, etc. 

Universal Sompo Health Insurance Reimbursement Claim Settlement Process

If the policyholder gets treated at a non-network hospital, then they can claim reimbursement under Universal Sompo Health Insurance plans. Below are the steps to raise reimbursement claim with Universal Sompo Health Insurance:

  • Step 1: Get hospitalized in any non-network hospital and avail of the required treatment. Inform the insurer at least 72 hours prior to hospitalization if it is planned and within 48 hours for emergency hospitalization.
  • Step 2: Settle all the medical bills at the hospital.
  • Step 3: Collect relevant and original bills and other required documents like reports and certificates and submit them to the address mentioned in your policy schedule.
  • Step 4: If all the details and documents submitted are in accordance with the Universal Sompo Health Insurance plan’s terms and conditions, the insurer will reimburse the claim amount.

Documents required for Universal Sompo Health Insurance Reimbursement Claim Settlement Process

The document required for reimbursement claim under your Universal Sompo Health Insurance plan are:

  • Duly filled claim form along with doctor’s certificate
  • Medical bills
  • Prescriptions
  • Test reports (x-ray, CT scan, etc.)
  • Advanced and final receipts

Universal Sompo Health Insurance Renewal Process

Universal Sompo Health Insurance plans need to be renewed at regular intervals based on the policy term chosen to avail its continuous benefits. Below are the steps to renew Universal Sompo Health Insurance plans:

  • Step 1: Visit the Universal Sompo General Insurance Company website and navigate to the ”Health Insurance Renewal’ page.
  • Step 2: Enter the policy number and Date of Birth.
  • Step 3: Click on the ”Renew Now” button.
  • Step 4: Select the renewal premium quote and pay for it online via a secured payment gateway.

 

FAQs:

Within how many days the claim needs to be raised under Universal Sompo Health Insurance?

The claim must be submitted within 30 days after the hospitalization.

How much time does Universal Sompo take to settle claims?

Upon receiving all the relevant details and documents, Universal Sompo settles the bills within 7 working days.

Does Universal Sompo Health Insurance cover pre-existing diseases?

Yes, Universal Sompo Health Insurance covers pre-existing conditions; however, they are subject to the waiting period mentioned in the health insurance plan.

How long does TPA take to approve the claim?

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

How long does TPA take to clear the bills?

Upon receiving all the relevant documents, Universal Sompo typically takes 7 days to settle the bills.

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