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.
Claim settlement ratio 96%
NCB* 50%, up to 100%*
PED Waiting# 36 months
Network Hospital 4000+
Paybima's Right Advisor = Expert Solutions
| Universal Sompo Health Insurance Plan(s) | Plan Type | Entry Age |
|---|
Some key highlights of Universal Sompo General Insurance Company are as follows:
| Profit before tax | INR 250.40 crores for F.Y 2020-21 |
| Premium achieved | INR 4103.09 crores for FY 2022-23. |
| Branches | 109 branches and 17 zonal offices across India |
| Employees | 1800+ employees as of 31st March 2023. |
| Network Hospitals | 11,300+ network hospitals |
| Gross Written Premium in F.Y. 22-23 | INR 4,169 crores |
Let us have a look at some of the awards and achievements received by Universal Sompo General Insurance Company:
Here are some of the key coverage benefits available under Universal Sompo health insurance plans –
| Features | Description |
| Inpatient hospitalization | Under this cover, the medical costs incurred on hospitalization 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 hospitalization are called pre- and post-hospitalization 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 hospitalized 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 hospitalization and harvesting of the organ |
| Domiciliary hospitalisation | If you are hospitalized 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 hospitalization 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 hospitalization 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 |
The health plans offered by Universal Sompo have some common exclusions for which claims are not paid. The exact list of exclusions depends on the policy that you buy and is listed in the policy wording. However, some of the common instances of exclusions are as follows –
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 -
Corona Kavach: Corona Kavach is a COVID-specific health insurance plan that was launched as per the directive issued by the IRDAI. The policy covers COVID-related hospitalizations and has the following features –
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 |
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 –
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 |
Complete Healthcare Insurance Basic: A comprehensive health insurance policy offered by Universal Sompo, Complete Healthcare Insurance has a range of coverage benefits and comes in three variants one of which is Complete Health Insurance Basic. The salient features of the policy are as follows –
Complete Healthcare Insurance Essential: Complete Healthcare Insurance Essential as its name suggests is a complete healthcare plan that provides 360-degree coverage to you and your family. A step up from the Basic variant, the Essential variant offers additional coverage benefits both inbuilt as well as optional. Here are some silent features of the plan option.
| Features | Basic | Essential | Privilege |
| Room rent | Covered | Covered | Covered |
| Pre-hospitalization | Covered up to 30 days before hospitalization | Covered up to 30 days before hospitalization | Covered up to 30 days before hospitalization |
| Domiciliary hospitalization | Covered | Covered | Covered |
| Post hospitalization | Covered for up to 60 days or 90 days (if you inform 5 days before hospitalization) | Covered for up to 60 days or 90 days (if you inform 5 days before hospitalization) | Covered for up to 60 days or 90 days (if you inform 5 days before hospitalization) |
| Daycare treatments | Covered | Covered | Covered |
| Organ donor treatments | Covered | Covered | Covered |
| Ambulance expenses | Covered up to Rs.1000, 1% of the sum insured or the actual cost, whichever is lower | Covered up to Rs.2000, 1% of the sum insured or the actual cost, whichever is lower | Covered up to Rs.3000, 1% of the sum insured or the actual cost, whichever is lower |
| Dental treatments due to accidents | Covered on an inpatient basis. Up to the sum insured | Covered on an inpatient basis. Up to the sum insured | Covered on an inpatient basis. Up to the sum insured |
| AYUSH benefit | Covered | Covered | Covered |
| Daily cash for accompanying an insured child | Not covered | Rs.300 per day up to a maximum of Rs.9000 | Rs.500 per day up to a maximum of Rs.15,000 |
| Vaccination for animal bite | Covered on an inpatient basis up to the sum insured | Covered on an inpatient basis up to the sum insured | Covered on an inpatient basis up to the sum insured |
| Outpatient expenses | Covered up to 1% of the sum insured, Rs.2500 or actuals, whichever is lower | Covered up to 1% of the sum insured, Rs.5000 or actuals, whichever is lower | Covered up to 1% of the sum insured, Rs.7500 or actuals, whichever is lower |
| Convalescence benefit | Rs.10,000 | Rs.10,000 | Rs.10,000 |
| Maternity cover | Not covered | Normal delivery – up to Rs.15,000 Cesarean delivery – up to Rs.25,000 which also includes pre- and post-natal expenses | Normal delivery – up to Rs.15,000 Cesarean delivery – up to Rs.25,000 which also includes pre- and post-natal expenses |
| Newborn baby cover | Not covered | Covered up to the sum insured for 91 days or till renewal, whichever is earlier | Covered up to the sum insured for 91 days or till renewal, whichever is earlier |
| Restore benefit | Available | Available | Available |
| PLHA cover | Not available | Not available | Available |
| Cumulative bonus | 10% of the sum insured up to a maximum of 50% | 10% of the sum insured up to a maximum of 50% | 10% of the sum insured up to a maximum of 50% |
| Health check-ups | Available after 2 claim-free years | Available every year | Available every year |
| Value-added benefits | Available | Available | Available |
| Personal accident cover | Optional | Optional | Optional |
| Critical illness cover | Optional | Optional | Optional |
| Hospital daily cash | Optional Rs.200/day for a maximum of 7 days | Optional Rs.500/day for a maximum of 7 days | Optional Rs.1000/day for a maximum of 7 days |
| Choosing sub-limits | Optional Discount of 7.5% for choosing sub-limit A and 5% for choosing sub-limit B | Optional Discount of 10% for choosing sub-limit A, 7.5% for choosing sub-limit B, and 5% for choosing sub-limit C | Optional Discount of 10% for choosing sub-limit A, 7.5% for choosing sub-limit B, and 5% for choosing sub-limit C |
| Treatment in a tiered network | Optional 5% discount for treatment in tiered network and 10% co-payment for non-networked hospital | Optional 5% discount for treatment in tiered network and 10% co-payment for non-networked hospital | Optional 5% discount for treatment in tiered network and 10% co-payment for non-networked hospital |
| Sum insured | Rs 1 lacs and Rs 2 Lakhs for both individual and floater sum insured | Rs 3 Lacs, Rs 4 lacs, and Rs 5 lacs for both individual and floater basis | Rs 6 lacs, Rs 7 lacs, Rs 8 lacs, Rs 9 lacs, and Rs 10 lacs for both individual and floater basis |
| Age at entry | 18 to 70 years for adults 91 days to 70 years for dependent children (Minimum one day for children under floater plan) | ||
| Policy term | 1 to 3 years | ||
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 of comparing the coverage benefits and premiums with other plans. The process to buy a Universal Sompo health insurance policy is as follows:
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 to your plan at the time of renewal. The premium will be adjusted with 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
Process to make a claim for 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:
You can contact PayBima to get through the claim process smoothly. Call 1800 267 67 67 or email paybima.care@mahindra.com and we will provide you with a hassle-free claim settlement experience.
The following documents are required to be submitted for the successful settlement of the claim:
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 accumulated cumulative bonus or the NCB shall not exceed 100% of the Sum Insured on the Renewed Policy as specified in the policy terms.
# Ailments diagnosed within 36 months before the policy issuance date or any medical treatment received within 36 months before the issue date of policy
# Can be reduced to 12 months by paying an extra premium
