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Universal Sompo General Insurance Company Products

Health Insurance

Individual Health Insurance: This is a simple health insurance policy which can be taken by an individual or his family. The policy provides basic health insurance coverage features like hospitalization, domiciliary treatments, pre and post hospitalization coverage, etc. The maximum allowed Sum Insured is Rs.5 lakhs and the maximum entry age under the plan is restricted to 55 years.

Senior Citizen Health Insurance Policy: Individuals over 60 years of age can buy this policy for their health insurance requirements. The policy covers hospitalization including pre and post hospitalization expenses, day care treatments, day care procedures, domiciliary treatments, ambulance charges, daily allowance, expenses of accompanying person, etc. Free health check-ups are provided after every 3 years. There is also an optional critical illness cover which covers 6 major illnesses and pays the Sum Insured on diagnosis of any of the covered illness.

Complete Health Care Insurance: This is a comprehensive health insurance plan which can be taken for the entire family. You can opt based on individual sum insured or as a family floater. This plan comes under three variants: Basic, Essential and Privilege. The maximum Sum Insured available under the plan is Rs.10 lakhs. The salient coverage features allowed include accidental dental treatments, AYUSH treatments, out-patient treatments, post-bite vaccination, convalescence benefit, maternity cover, restoration of Sum Insured, etc. Various optional covers are also provided under the plan for customizing it and ensuring a comprehensive cover.

Hospital Cash Insurance Policy: An individual can buy this policy for self or for the entire family. The maximum per day hospital cash benefit starts from Rs.500/day to Rs.3000/day as per the plan you opt. The plan provides three types of benefits. One is a fixed lump sum amount which is payable if the insured is hospitalised. Second is another fixed amount payable, in case the insured is admitted to the ICU. Third, the plan pays a convalescence benefit if hospitalisation is for more than 21 days. Premium discounts are also allowed for choosing a long term, for covering family members and for covering a group.

Critical Illness Insurance Policy: This is a specialized fixed benefit health insurance plan which covers 11 critical illnesses. If the insured is diagnosed with any of the listed illness, the policy pays the Sum Insured to him irrespective of the actual costs of treatment of the illness. The policy is available both as an individual plan and/or a family. But the sum insured will be on individual basis only. This plan does not require medical check-ups up to 55 years of age. Entry age between 5 to 65 years old.

Individual Accident Policy: This policy covers an individual against accidental injuries suffered by him or her. There are three coverage options. The first one covers accidental death. The second one covers accidental death, permanent total and partial disability. The last one covers accidental death, permanent total and partial disability and temporary total disability. Various add-ons are also available like transportation cost, cost of clothing, ambulance costs, child education fund and loss of employment.

Other Health Insurance Plans

Group Health Insurance Policy
Group Personal Accident Policy
Janta Personal Accident Policy
Loan Secure Insurance Policy
Aapat Suraksha Bima
Sampoorna Suraksha Bima (Micro Insurance Policy)
Swarna Gramin Bima Yojna – Individual & Group
Surva Vidyarthi Bima Yojna
Saral Suraksha Bima (Micro Insurance Policy)
Pravasi Bhartiya Bima Yojana

Motor Insurance

Motor Private Car: This policy provides coverage to private cars against damages caused by any type of natural or man-made calamities and when the car is in transit by road, rail, water or air. Moreover, any financial liability faced due to bodily harm caused to a third party or for damaging third party property is also covered by the plan. There is an inbuilt Personal Accident cover for the owner-driver. There are optional extensions as well as optional add-ons which can be chosen to increase the scope of coverage offered by the plan.

Motor Two-wheeler Insurance: This policy provides comprehensive coverage for a two-wheeler and covers it against any damages faced through natural or man-made disasters. A third party liability cover is also present along with a Personal Accident cover for the owner-driver which covers accidental death and disabilities. Three types of policy extensions can be taken for loss of electrical and non-electrical accessories, legal liability to paid driver, cleaner or workman and personal accident cover for the pillion rider. Add-ons are also available for increasing plan coverage.

Motor Passenger Carrying Vehicles: This policy offers extensive coverage to vehicles used for carrying passengers for hire or as reward, with exceptions being speed testing, racing, reliability trial, pace making, and involvement in Motor Trade. It covers loss or damage caused due to man-made and natural calamities, and compulsory Personal Accident cover for owner driver. It also includes a cover for Legal Liability against third party personal injury and damage to property. Optional extensions include coverage for employed driver and cleaner, loss of accessories and Personal Accident cover for passengers.

Motor Goods Carrying Vehicles: Comprehensive coverage for this policy is applicable for vehicles used for carrying goods or used by the policyholder or his/her employees for hire or reward, except for racing, pace making, speed testing, reliability trial and used for any purpose that involves Motor Trade. It covers vehicles that have been lost or damaged due to man-made or natural disasters. It also provides a cover for Legal Liability to third party for property damage and personal injury, and a compulsory Personal Accident cover for the policyholder. There are also add-ons that can be availed on payment of additional charges.

Motor Miscellaneous Vehicles: This policy covers loss or damage of vehicles caused due to natural and man-made emergencies. These vehicles should be used by the policyholder for special purposes for hire or reward, excluding reliability trial, racing, speed testing or for any purpose related to the Motor Trade. Apart from a compulsory Personal Accident cover Legal Liability to third party on personal injury and damage, there are certain add-ons that can be availed on additional payments.

Two-wheeler Long Term Package Policy: This is a comprehensive two-wheeler insurance policy which can be taken either for 2 or 3 continuous years, thus eliminating the need of annual renewals. A 5% and 10% discount is given for buying the policy for 2 and 3 years respectively. The policy allows an incremental NCB discount on renewing a long term policy with another long term policy.

Bancassurance Plan

Allahabad Bank Health Care Plus: This is a comprehensive health insurance plan to account holders of Allahabad Bank. The policy covers the insured, his/her spouse, dependent children and dependent parents. It offers a family floater policy that extensively covers the entirely family under a single sum insured, saving customers from the hassle of opting for individual health insurance covers for each family member. The benefits of this policy include hospitalisation expenditures, on the maximum sum insured in the event of accidents, surgeries and sudden illnesses.

K Bank Health Care: This Mediclaim cover is applicable to account holders with a Current or Savings Bank Account at Karnataka Bank. The policyholder, who can be any individual within the age of 18 to 65 years of age, is eligible for including his/her spouse, dependent children and dependent parents in this scheme. The cover includes expenses incurred during hospitalisation, pre and post hospitalisation, maternity expenditures, ambulance charges, medical check-ups, funeral expenses, etc. there are extensions on payment of additional premium.

IOB Health Care Plus Policy (Revised): Applicable to customers of Indian Overseas Bank, this policy includes hospitalisation cover and optional extensions to the policyholder, his/her spouse, dependent children and dependent parents.

Universal Sompo General Insurance Claim Process

Personal Accident Insurance Claims

In case of any accidental death or disability, the company should be informed immediately at 1800 22 4030.
The company’s executive would guide the insured with the required process.
Relevant documents would have to be submitted for making a claim. These documents include claim form, policy copy, claim intimation, FIR, death certificate, post mortem report coroner’s report, etc.

Health Insurance Claims

Cashless Claims Process

Step I: Call our Health Helpline 1800 200 5142 and Intimate your Claim within 24 hrs in case of emergency admission and 48 hrs prior to hospitalization in case of planned admission.
Step II: Visit Network hospital and show your Health Serve Card issued by the company along with Valid Photo ID proof and get the ‘Cashless Request Form’ from the Insurance helpdesk of the hospital
Step III: Fill your details in the ‘Cashless Request Form’ & submit it to the Hospital Insurance helpdesk
Step IV: The hospital verifies the patient details and sends duly filled Cashless Request Form by Fax to Universal Sompo-Health Office toll-free fax 1800 200 9134
Step V: Universal Sompo – Health will review and judge the admissibility of the Cashless Request as per Policy Terms & Conditions and the same will be communicated to you and the hospital. You will be required to pay for expenses that are not payable as per the terms and conditions of the policy.

Reimbursement Claim Process

Reimbursement claim is when the expenses incurred during Hospitalization or bills of Hospitalization are directly settled by the Insured with the Hospital and post-discharge from Hospital claimed by the Insured from the Insurer for reimbursement.

Step I: Call our Health Helpline at 1800 22 4030/1800 200 4030 or email at healthserve@universalsompo.com and inform us about your Claim within 24 hrs in case of emergency admission and 48 hrs prior to hospitalization in case of planned admission.
Step II: Visit a hospital and undergo your treatment. Settle your hospitalization bill and collect all original documents after discharge from the hospital
Step III: Fill in the Reimbursement Claim Form and submit all original documents to our belowmentioned office for reimbursement.
Universal Sompo General Insurance Company Limited
Health Claims Management Office
5thFloor, Assotech One
C-20/1 A, Block- C
Sector- 62, Noida
Uttar Pradesh, Pincode:201309
Step IV: On receipt of the document, your claim will be processed as per the Terms & Conditions of policy and the same will be communicated to you.

Claims Settlement Ratio: 98.27%

Frequently Asked Questions

What are the benefits of a health card?

A health card enables you to access the cashless treatment facilities at the enlisted network hospitals of the insurer and TPA. Along with the details of the Insured person, it also mentions the contact information of the Insurer and TPA (Third Party Administrator). In case of a medical emergency, you can get in touch with the Insurer and TPA (Third Party Administrator), whose contact information is mentioned in your health card. This will enable you to get your doubts and queries addressed and you can also ask for assistance that you might need. This health card has to be shown to the relevant authorities at the hospital at the time of admission.

Where can I get network hospital list?

When the insurer issues your health card, it also provides you with an extensive list of network hospitals. However, this list is subject to change and the updated list is made available on TPA website.

You can access the network hospital list of Universal Sompo on their official website universalsompo.com

Within how many days should I submit the claim?

It is mandatory for the health cardholder to file the claim within 30 days from the date of discharge from the hospital or after the completion of treatment.

Is there any tax benefit that one can avail of while purchasing Health Insurance?

Those insured under a health insurance policy is eligible for a tax benefit under Section 80D of the Income Tax Act, 1961. Every taxpayer can avail an annual deduction of Rs. 25,000 from his/her taxable income for the payment of premium towards Health Insurance for self and dependants.

How do I know if my loss is covered under the policy?

For any queries or clarifications regarding insurance plans of Universal Sompo, you can call Coverfox at 1800-209-9970 or visit the insurer’s website.

What are the benefits I would get in case of partial permanent disability due to an accident?

For Permanent Partial Disablement, the compensation will be determined based on the nature of the injury and your percentage of Sum Insured as mentioned under the head 'Table of Benefit' in the policy document or according to the suggestions/recommendations of the Medical Practitioner appointed by Universal Sompo.

Whom to contact in case of a claim/hospitalisation on the Policy?

In case of emergency services or planned hospitalisation, the Health ID Card has to be shown at any of network hospitals of Universal Sompo to be eligible for cashless service. In case the hospital is not recognised as one of the network hospitals, the insured has to make payments and then submit a claim to the insurer or TPA (Third Party Administrator) for reimbursement, along with other necessary bills and documents.

Are accidental damages to my vehicle covered under the policy?

Yes, Universal Sompo offers an extensive range of covers that are customised to meet unique individual requirements. The Motor Insurance Plans offers cover against Legal Liability to third party property damages caused as a result of an accident as per the Motor Vehicle Act.

What are the claim documents necessary for car insurance claim settlement?

The essential documents for processing car insurance claims are:

Proof of the Insured’s Declared Value
Payment proof of Road Tax
Registration Charges as applicable for the class/make of the model of the insured vehicle indicated by the invoice received from the insurer during the purchase of the insurance policy

Burglary Policy	Farmer's Package Policy	All Risk Insurance Policy
Workmen's Compensation Policy	Shopkeepers Insurance Policy	Standard Fire and Special Perils Policy
Fidelity Guarantee	Cattle Insurance Policy	Marine Cargo - Specific Policies (Inland & Export/Import)
Money Insurance	Householder's Insurance Policy	Machinery Breakdown Policy
Office Package Policy	Jewelers Block Insurance Policy	Electronic Equipment Insurance
Contractors All Risk Insurance	Erection All Risk Insurance	Boiler Pressure Plant Insurance
Industrial All Risk Insurance	Public Liability (Act) Insurance	Public Liability (Industrial & Storage Risks)

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Universal Sompo General Insurance Claim Process

Cashless Claims Process

Reimbursement Claim Process

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