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.

Does the plan allow free health check-ups?

Yes, free health check-ups are allowed for up to 1% of the basic sum insured. These check-ups are allowed once in a block of four claim-free policy years.

What is the quantum of hospital daily allowance?

Hospital daily allowance is paid @ 0.1% of the basic sum insured subject to a maximum of Rs. 250 per day. The maximum benefit paid under the coverage would be restricted to Rs. 2500.

What is cumulative bonus?

Cumulative bonus means a cumulative increase in the sum insured of the policy if no claim is made in subsequent policy years. Under the Individual Health Insurance Plan, cumulative bonus of 5% of the basic sum insured would be allowed for each claim-free year subject to a maximum increase of 30% of the sum insured.

When would pre-acceptance medical check-up required?

Pre-entrance medical check-up would be required if the policyholder or any covered family member is aged 45 years or above.

What is the maximum entry age?

The plan allows individuals to buy the policy up to 55 years of age.

Universal Sompo Individual Health Insurance Wordings

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Highlights

Claim Settlement	Available
Claim Settlement Ratio	96%
In-House Claim Settlement	Available
Network Hospitals	4,000+
Starting Premium for Rs. 5 lakh Coverage	Rs. 527/month
Starting Premium for Rs. 5 lakhs SI	Rs. 475/month

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Universal Sompo Individual Health Insurance Plan Brochure

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Jun 08, 2019

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Universal Sompo Health Insurance Plan List

Family (2)
Kids (1)
Maternity (1)
Parents (1)
Woman (1)
Individual (3)
Critical Illness (1)
Senior Citizen (1)

Name of Plan	Sum Insured
Complete Healthcare InsuranceMin: 1 Day; Max: 70 YearsPopular	1 Lakh	Check Premium
A PlusPopular		Check Premium
Individual Health Insurance PlanMin: 3 Months; Max: 55 Years	1 Lakh	Check Premium
Critical Illness PolicyMin: 5 Years; Max: 65 Years	2.5 Lakh	Check Premium
Senior Citizen Health InsuranceMin: 60 Years; Max: 70 Years	1 Lakh	Check Premium
Arogya Sanjeevani PolicyMin: 3 Months; Max: 65 Years	1 Lakh - 5 Lakh	Check Premium
Corona Kavach PolicyMin: 1 day; Max: 65 years	50,000 - 5 lakh	Check Premium
Corona Rakshak PolicyMin: 18 Years; Max: 65 Years	50,000 - 2.5 lakh	Check Premium
Hospital Cash Insurance PolicyMin: 6 months; Max: 70 years		Check Premium

Universal Sompo Health Insurance Top Up List

Name of Plan	Sum Insured
Super Healthcare Policy Min: 91 days; Max: 80 years	1 Lakh - 1 Crore	Check Premium

11505 Universal Sompo Cashless Network Hospitals in India

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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.
Does the plan allow free health check-ups?
Yes, free health check-ups are allowed for up to 1% of the basic sum insured. These check-ups are allowed once in a block of four claim-free policy years.
What is the quantum of hospital daily allowance?
Hospital daily allowance is paid @ 0.1% of the basic sum insured subject to a maximum of Rs. 250 per day. The maximum benefit paid under the coverage would be restricted to Rs. 2500.
What is cumulative bonus?
Cumulative bonus means a cumulative increase in the sum insured of the policy if no claim is made in subsequent policy years. Under the Individual Health Insurance Plan, cumulative bonus of 5% of the basic sum insured would be allowed for each claim-free year subject to a maximum increase of 30% of the sum insured.
When would pre-acceptance medical check-up required?
Pre-entrance medical check-up would be required if the policyholder or any covered family member is aged 45 years or above.
What is the maximum entry age?
The plan allows individuals to buy the policy up to 55 years of age.

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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 Contact Details

Reach us for help anytime

Insurance Dekho
755 1196 989Mon to Sun 10:00 AM to 7:00 PM
support@insurancedekho.com
Universal Sompo Health Insurance
1800-200-514224x7
contactus@universalsompo.com