Universal Sompo General Insurance Company Limited

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About Universal Sompo General Insurance Company

Universal Sompo General Insurance Company Limited is a general insurance provider formed as a joint venture between Indian Overseas Bank, Indian Bank, Dabur Investment Corporation, Karnataka Bank Limited and Sompo Japan Insurance Incorporation. Universal Sompo General Insurance is the first non-life general insurance provider in India which has the support of credible private and public companies from both Japan and India. The company offers a wide range of insurance solutions for rural, retail, corporate and SME customer segments.

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Key highlights of Universal Sompo General Insurance Company

Some key highlights of Universal Sompo General Insurance Company are as follows: 

Profit before tax INR 30.73 crores for F.Y 2020-21
Premium achieved INR 3052.16 crores for F.Y 2020-21. 
Branches 97 branches and 17 zonal offices across India
Employees 1500+ employees as on 31st March, 2021. 
Network Hospitals 5000+ network hospitals
Gross Written Premium in F.Y. 20-21 INR 3,055.45 crores 

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Awards and Achievements of Universal Sompo General Insurance Company

Let us have a look at some of awards and achievements received by Universal Sompo General Insurance Company: 

  • The company was awarded as ‘The Best BFSI Brands of 2021’ for the year 2021-2022 by The Economic Times. 
  • Universal Sompo General Insurance Company received ‘Customer Service Award in 2020 by Insurance Alertss INDIA. 
  • Universal Sompo General Insurance received ‘Best Technology for Good Project Award’ in 2020. 
  • The company was bestowed with ‘FM Stars of the Industry- Excellence in General Insurance’ award in 2016-2017. 
  • Universal Sompo General Insurance won ‘Excellence in Financial Services Marketing

Key features of Universal Sompo health insurance plans

Here are some of the key coverage benefits found in Universal Sompo health insurance plans –

Features  Description 
Inpatient hospitalisation Under this cover the medical costs incurred on hospitalisation for 24 hours or more are covered. These costs can include room rent, doctor’s fee, nurse’s fee, medicines, oxygen, blood, etc.
Pre and post hospitalisation The medical expenses incurred before and after hospitalisation are called pre and post hospitalisation expenses. These expenses are covered under Universal Sompo health insurance plans for up to a specified number of days
Daycare procedures  In the case of some treatments, you don’t have to be hospitalised for 24 hours or more because of the advanced technology used for them. These treatments are called daycare treatments and they are covered under the policy
Organ donor treatment If you are receiving an organ donation, Universal Sompo health insurance plans would cover the cost of the donor’s hospitalisation and harvesting of the organ
Domiciliary hospitalisation If you are hospitalised at your own home either because there are no available hospital beds or because your condition is too critical for hospital transportation, such a home hospitalisation would be covered
AYUSH coverage AYUSH means non-allopathic treatments taken through Ayurveda, Homeopathy, Unani and Siddha medicine. These treatments are also covered under many Universal Sompo health insurance plans
Ambulance expenses The cost of an ambulance when you need hospitalisation is covered under Universal Sompo health insurance plans
Health check-ups Many Universal Sompo health plans allow free health check-ups at specified policy intervals. These check-ups help you monitor your  health regularly
No claim bonus  If you don’t claim your health insurance policy, Universal Sompo allows a no claim bonus. This bonus is policy-specific and, usually, increases the coverage free of cost

 

Common exclusions in Universal Sompo health insurance plans

The health plans offered by Universal Sompo have some common exclusions for which claims are not paid. The exact list of exclusion depends on the policy that you buy and is listed in the policy wordings. However, some of the common instances of exclusions are as follows –

  • Claims due to war, nuclear threats, mutiny, civil commotion, etc.
  • Claims due to self-inflicted injuries or attempted suicides
  • Pre-existing conditions are not covered during their waiting period
  • If you suffer from any illness within the first 30 days of buying the policy, coverage would not be allowed
  • Specific illnesses and treatments also have a specific waiting period. They are not covered during such period
  • Participation in hazardous or criminal acts is excluded from coverage
  • Unproven treatments or unscientific procedures are excluded
  • Medical expenses incurred without the recommendation of a medical practitioner would be excluded
  • Cosmetic procedures, circumcision and weight control measures are excluded 

Features of Universal Sompo health insurance plans

Universal Sompo offers a list of health insurance products for its customers. The popular plans of the company that you would find on PayBima include the following – 

1. Complete Healthcare Insurance

A comprehensive health insurance policy offered by Universal Sompo, Complete Healthcare Insurance has a range of coverage benefits and comes in three variants of Basic, Essential and Privilege. The salient features of the policy are as follows –

  • Inpatient dental treatments

If you are hospitalised and dental treatments are needed as a part of your hospitalisation, the plan would cover the cost of such treatments and that too without any sub-limits. 

  • Vaccination cover

You get covered for the cost of vaccines taken as a post-bit treatment. The coverage is allowed up to the sum insured without any sub-limits.

  • OPD coverage

The plan also allows coverage for medical expenses incurred on an outpatient basis after a waiting period of 3 years. Coverage is allowed for medical consultations, diagnostic treatments, dental treatments, and even for the cost of hearing aids, lenses or spectacles.

  • Maternity cover

The Essential and Privilege variants allow coverage for childbirth and pregnancy. Both normal and Caesarean deliveries are covered up to specified limits. There is, however, a waiting period of 3 years for maternity cover

  • Restoration of the sum insured

If you use the sum insured on a previous claim and then suffer another claim, the plan would restore the original sum insured back to its full amount.  This would help you meet the costs of subsequent claims without worrying about the coverage running out. 

  • A range of value-added benefits

A range of health-related value-added benefits is offered by Complete Healthcare Insurance. You can get a telephonic consultation, second opinion, newsletter, wellness package, 24*7 customer assistance, among other benefits.

 

  • A range of optional coverage benefits

There are optional coverage benefits available too which help you customise the policy as per your needs. You can opt for one or more of the optional coverage features at an additional premium.

Eligibility conditions

Entry age  Adults – 18 years to 70 years

Children – 1 day onwards under a floater plan or 91 days onwards under the individual plan

Term of the plan 1,2 or 3 years
Sum insured  Rs.1 lakh to Rs.10 lakhs
Premium paying frequency Single premium

Annually

Half-yearly

Quarterly

Monthly

Pre-existing waiting period 36 months

 

2. Corona Kavach

Corona Kavach is a COVID-specific health insurance plan which was launched as per the directive issued by the IRDAI. The policy covers COVID-related hospitalisations and has the following features –

  • Coverage without sub-limits

If you are hospitalised after being diagnosed with COVID, the cost of hospitalisation and the necessary treatments would be covered under the policy without any sub-limits.

  • Home care coverage

If you are hospitalised at your own home, the costs incurred on such hospitalisation and necessary treatments would be covered by the policy.

  • AYUSH cover

Besides coverage of allopathic treatments, the plan also covers non-allopathic alternative treatments for COVID.

  • Optional cover for hospital daily cash

You can choose to avail of a daily cash benefit per day of 24-hour hospitalisation.

Eligibility conditions

Entry age  Adults – 18 years to 65 years

Children – 1 day to 25 years

Term of the plan 3.5 months, 6.5 months, 9.5 months
Sum insured  Rs.50,000 to Rs.5 lakhs
Premium paying frequency Single premium

Annually

Half-yearly

Quarterly

Monthly

Pre-existing waiting period 15 days

 

3. Super Healthcare Insurance

This is a super top-up health insurance policy that pays a claim if the total claims made in a year exceed the deductible amount. The salient features of the policy are as follows –

  • Different coverage variants

The plan allows you to avail of coverage under three different variants which have different combinations of the sum insured and deductible limits. You can avail of coverage up to Rs.1 crore and choose a variant that best matches your coverage needs.

  • Easy availability

No pre-entrance health check-ups are needed till 65 years of age if your sum insured is up to Rs.20 lakhs. This helps you buy the plan instantly without hassles.

  • Obesity coverage

Certain variants of the plan allow coverage for bariatric surgeries if they become medically necessary in morbidly obese conditions.

  • Sum insured restoration

This feature provides you with an additional sum insured if the existing sum insured is exhausted on a previous claim. If you suffer multiple claims within the same policy year, this coverage can come in handy.

  • Maternity cover

Many variants of the plan also allow coverage for maternity-related expenses like childbirth and pre and post-natal care. You can avail of coverage for both normal and C-Section deliveries.

  • Optional global coverage

The plan allows an optional benefit to extend your coverage internationally. If you travel outside India to avail of medical treatments for an illness that was diagnosed in India, the cost of hospitalisation would be covered by the policy. 

Eligibility conditions

Entry age  Adults – 18 years to 80 years

Children – up to 30 years under a floater plan or 91 days onwards under the individual plan

Term of the plan 1,2 or 3 years
Sum insured  Rs.2 lakhs to Rs.100 lakhs
Deductible limit Rs.1 lakh to Rs.40 lakhs
Premium paying frequency Single premium

Annually

Half-yearly

Quarterly

Monthly

Pre-existing waiting period 12 months to 36 months

 

The process to buy Universal Sompo Health Insurance Plans

You can buy Universal Sompo health plans both offline by visiting the branch of the insurance company and online through PayBima.com. PayBima provides a very quick and easy process to buy a health plan with the benefit to compare the coverage benefits and premiums with other plans. The process to buy Universal Sompo health insurance policy is as follows: 

  • Visit PayBima

Visit the official website of PayBima or simply click on www.paybima.com to begin the process of buying a health plan. After visiting the website, select ‘Health Insurance.’

  • Fill in the details

On selecting health insurance, a form will appear in which you would have to fill in the basic personal and medical information such as your name, age, dependents, amount of coverage, gender, contact details, location, pin code of the location, etc. PayBima will calculate the premium based on your eligibility and coverage requirements and show a list of available plans. 

  • Compare available plans

After filling in your details, a list of available plans will be shown as per your requirements. You will also find Universal Sompo health plans on the list. Compare the plans based on their coverage benefits and premiums with other leading health plans available in the market. You can easily select the best suitable plan at an affordable and competitive premium. 

  • Fill and submit the proposal form

After shortlisting the policy, provide details in the online proposal form. Fill the form correctly and completely and submit it to the insurance company. 

  • Pay the premium for the plan

Pay the premium online through the payment gateways provided by PayBima. Your policy will be issued instantly on payment of premium if there are no adverse declarations made in the proposal form about lifestyle habits and medical history. 

  • Undertake pre-entrance health check-up

Based on age, lifestyle habits, medical history, gender and coverage limit, you might be required to undergo medical screening before issuance of the plan. You can avail of health-check-up or medical screenings at the nearest network facility of Universal Sompo General Insurance Company. 

The process to renew Universal Sompo Health Insurance Plans

Health Insurance plans come with lifelong renewal. You can not only buy a health insurance plan from PayBima but also renew it online. The renewal should be done within the due date to enjoy non-stop coverage.

Renewal of health insurance policy is an online process in which you would be required to provide your policy number and other policy details. Once you provide your policy number, all the details of your policy will be shown. You can check the details of the plan and make changes to it if required. You can add riders with your plan at the time of renewal. The premium will be adjusted on the addition of riders. After making changes, if any pay the premium and your policy will be renewed instantly. For any assistance about the renewal of your health insurance policy, you can contact PayBima at 1800267 67 67 or drop an email at paybima.care@mahindra.com 

The process to claim Universal Sompo Health Insurance Plans

Claiming a Universal Sompo health insurance policy is easy and can be done through www.paybima.com.  The claim process is discussed as follows: 

  • Locate the network hospital

The very first thing that you need to do is locate the nearest network hospital to avail cashless claim facility. You can locate the nearest network hospital from the official website of the insurance company and can also call the PayBima helpline to get assistance for the same. 

  • Admission

Once you have located the network hospital, get admitted to it by showing your identity proof and health card. 

  • Fill up the pre-authorisation claim form

A pre-authorisation claim form is to be filled and submitted for approval of your cashless claim. The form is available both on the insurer’s website and at the insurance desk of the hospital. Fill up the form stating your claim details and submit it at least 3 to 4 days before your planned hospitalization. In case of emergencies, the form can be submitted within 24 hours of being hospitalized. 

  • Get the approval

Universal Sompo will verify the form and send approval to the concerned hospital, after which the hospital will proceed with the treatment. All the bills will be directly settled by the insurer. 

  • Reimbursement claim facility

In the reimbursement facility, pay the bills and then get them reimbursed by submitting the claim form and original bills. A reimbursement facility can be availed if you get admitted to a non-network hospital or if the insurer rejects your cashless claim application. The company will verify your claim and reimburse the cost that you have incurred on the treatment.

You can contact PayBima to get through the claim process smoothly. Call 1800 267 67 67 or email paybima.care@mahindra.com and we would provide you with a hassle-free claim settlement experience. 

The following documents are required to be submitted for the successful settlement of claim: 

  • Pre-authorization claim form for cashless claim settlement facility
  • Original medical reports and hospital bills
  • Filled and signed claim form
  • Valid Identity proof of the insured
  • Doctor’s prescription advising hospitalization
  • Consultation notes and other medical reports
  • Bank account details or NEFT details to credit the reimbursement claims

Review of Universal Sompo Health Insurance Plans

Universal Sompo Health plans are quite comprehensive in their scope of coverage and are competitively priced. Other highlights of its plans are as follows: 

  • The company provides hassle-free customer services to buy or claim health insurance
  • The company actively organises health camps and awareness roadshows for the empowerment of knowledge and the overall well-being of its customers.  
  • The company has tie-up with leading health provides across India which assures you of easy locating and best treatment without pinching your pocket. 
  • The company has made steady progress towards its mission along with sustaining customer centricity which forms the core of its services. 
  • The company provides highly customised and efficient pre and post insurance sales services to its customers and is available to provide customer service 24*7. 

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Frequently Asked Questions

Q: Does the Complete Healthcare policy offer any optional riders?

Yes, there are 5 additional riders available with the Complete Healthcare insurance policy. These riders include the personal accident cover, critical illness cover, submit waiver, tiered hospital cover, and hospital cash allowance.

Q: What is the maximum coverage age?

There is no maximum coverage age. Universal Sompo health insurance plans allow lifelong renewals.

Q: What discounts are allowed under Universal Sompo health insurance plans?

You can get discounts for insuring your family members on an individual basis, for buying the long-term policy, for being an existing customer of the company and for being an existing employee. Also, in some plans, you might get a discount for buying the policy online. 

Q: Does the Corona Kavach policy cover normal hospitalisation?

No, the Corona Kavach policy does not cover normal hospitalisations. It is designed to cover hospitalisations only due to COVID.

Q: Do I get any grace period for renewing the policy?

Yes, a grace period of 30 days is allowed under Universal Sompo health insurance plans to renew the coverage. You would not get covered during the grace period but the renewal benefits would be allowed if you renew the policy during the said period.

Jan 17, 2022
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PayBima Team
PayBima is an Indian insurance aggregator on a mission to make insurance simple for people. PayBima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 17 years of experience. PayBima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.

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