Nowadays Health expenses are increasing significantly and so are the health risks. Health Insurance, commonly known as Mediclaim in India, is a form of insurance that covers the costs caused by the medical treatment and hospitalisation. But with a wide range of health insurance policies available, the task of choosing the best health insurance policy as per your needs will be quite tough and confusing. For the sake of those policyholders, I have given the list of Universal Sompo Health Insurance plans in this article.
Universal Sompo Health Insurance Plans Review
Universal Sompo General Insurance Company Limited is a joint venture between Indian banks – Allahabad Bank, Karnataka Banka and Indian Overseas Bank, an Indian investment company, Dabur Investments and a Japanese insurance company, the Sompo Japan Insurance Company. In the case of sudden hospitalisation, illness or accident, Universal Sompo Health Insurance Plans takes care of the expenses on medicines, hospital room, various medical tests and almost all other costs were involved. By paying a small premium every year, you can ensure any significant medical expenses that have occurred in your life. The Health plans can be taken for the individuals or your family members. The only thing you have to do is just go through these USGI Health plans and choose according to your need. These Health Insurance plans cover the insured against any financial restrictions emerging from medical emergencies.
The Key features, Renewal Process, Inclusions, Exclusions, etc. of Universal Sompo Health Insurance Plans are mentioned in detail below. Refer our site www.policycorner.in for more information regarding Universal Sompo General Insurance Plans.
What are the Features of Universal Sompo Mediclaim Plans?
- Universal Sompo Mediclaim plans are offered to the individuals and/or his family members.
- There is coverage for a maximum of 6 members in a family with upto 2 adults and 4 children.
- Pre and Post hospitalisation cover of 30 days and 60 days are available for medical expenses.
- After the completion of four policy years, there is a facility of free Health check-ups.
- Can avail portability benefits through the intimation of complete details by the application at least 45 days before the expiry date of your policy.
- Cashless facilities are available at over 5000+ quality hospitals across India.
- Portability Benefits and Add-ons are available for these Universal Sompo Health Plans.
Inclusions of USGI Health Insurance Plans
The Inclusions or coverages of Universal Sompo Health Insurance Plans are as follows.
- Before your hospitalisation, the medical expenses were covered for 30 days.
- If you have provided the following at least five days before the Hospitalisation, Medical Expenses were incurred within the 60 days before the date of Hospitalisation.
- Medical documents with all details about the Illness.
- The Place and date of the proposed Hospitalisation.
- The Medical Expenses were incurred in the 60 days immediately after your date of discharge from Hospital.
- Medical Expenses were incurred in the 90 days immediately after you were discharged if you have provided the following at least 5 days before the Hospitalisation.
- Medical documents with all details about the Illness.
- The date and the place of the proposed Hospitalisation.
Day Care Procedures: Medical Costs or Expenses incurred for a day care procedure in Universal Sompo Health Insurance plan, where the procedure or surgery taken by the policyholder for less than 24 hours in a Hospital will be covered under day care procedures.
Domiciliary Treatment: Domiciliary Treatment is applicable for the following diseases.
Domiciliary Treatment is applicable for the following diseases.
- Asthma, Bronchitis, Cough and Cold, Influenza, Tonsillitis and Upper Respiratory Tract infection including Laryngitis
- Chronic Nephritis and Nephritic Syndrome.
- Arthritis, Gout, and Rheumatism.
Inpatient Treatment: Medical Expenses are availed under the Inpatient treatment for these following.
Medical Expenses are availed under the Inpatient treatment for these following.
- Room Rent, Boarding expenses.
- Diagnostic procedures.
- Oxygen, Anaesthesia, Blood, Surgical appliances, Operation theatre charges.
- Intensive Care Unit.
- Medicines, Drugs, and Consumables.
List of Universal Sompo Health Insurance Plans
Universal Sompo General Insurance Company offers various health plans to their customers. All these policies have different features & benefits according to different factors. The List of Universal Sompo Health Insurance Plans are
- Individual Health Insurance Policy.
- Individual Personal Accident Policy.
- Janta Personal Accident Policy.
- Aapat Suraksha Bima Policy.
- Loan Secure Insurance.
- Hospital Cash Insurance.
- Saral Suraksha Bima.
- IOB Health Care Plus.
- Overseas Travel Insurance Policy.
- Sampoorna Suraksha Bima.
- Senior Citizen Health Care.
- Complete Health Care Insurance.
- Sampoorna Swasthya Kavach.
- Pravasi Bharatiya Bima Yojana.
- Surva Vidyarthi Bima Yojana.
- Individual Swarna Gramin Bima Yojana.
- K Family Care.
About Universal Sompo Individual Health Insurance Policy
Universal Sompo Individual Health Insurance Policy is offered to the individuals and/ or his family. This plan will pay the hospitalisation expenses along with the domiciliary hospitalisation benefits if he/ she suffers from an illness or accidental injury during the policy period. Under this Individual Health Insurance Policy, treatments in the Nursing Homes or Hospitals of India are only covered, and the Maximum Cover is 5 Lakhs. Check the brochure for more details.
Coverage Benefits: Along with the above mentioned inclusions, the following coverages are also available under this plan.
- Daily Cash benefit – An additional Daily Allowance amount equivalent to 0.1% of the Basic Sum Insured or Rs. 250/- per day for the duration of hospitalisation towards the miscellaneous expenses is payable.
- Expenses for Organ Donor – At the time of organ transplant process, the cost of treatment for the organ donor was covered.
- Pre-existing Diseases – These are covered after continuous 4yrs of the policy cover with USGIC.
- Tax Benefits – The Life Assured can also get the Tax benefits for premiums paid under section 80D of Income Tax Act.
Age of Entry: The Entry age for this Individual Health Insurance Plan should be below 55 years.
Portability Benefits: The insured can avail the portability benefits at least 45 days before the expiry of the registered policy.
Add-on for the Individual Health Insurance Policy
Critical-illness Coverage: In case you have opted for additional cover against the following five named Critical Illness and have paid an additional premium, Your Sum insured for the treatment of the said disease/ medical condition becomes double.
- Paralytic Stroke.
- Chronic renal failure.
- Coronary Artery Bypass.
- Major Organ Transplant – Kidney, Lungs, Pancreas, Bone marrow.
Universal Sompo Individual Personal Accident Policy Details
Personal Accident Policy provides you and your family mitigation against the financial consequences of unforeseeable accidents. The age of the proposer should be 18 years or above. Check the Individual Personal Accident Policy brochure for further details.
- Basic Cover – covers against Death only.
- Wider Cover – covers against Death, Permanent Total Disablement Permanent Partial Disablement.
- Comprehensive Cover – covers against Death, Permanent Total Disablement Permanent Partial Disablement Temporary Total Disablement.
Compensation Benefit: These benefits will depend on the nature of the injury and the Capital Sum Insured under the Policy.
Aapat Suraksha Bima Policy
Universal Sompo Aapat Suraksha Bima Policy provides a cover on lump sum against a sudden and unexpected expenditure on diagnosis of the following major diseases like
- Paralytic Stoke.
- Renal Failure.
- Coronary Artery Disease.
- Major Organ Transplant.
Under this plan, the nominee gets a one-time payment equal to the Capital Sum Insured if the insured dies in an accident.
Janta Personal Accident Policy
The Universal Sompo Janta Personal Accident policy provides benefits for Death, and Permanent Total Disablement caused as a result of the accidental injury sustained by Insured Persons, in the Accident during the Policy Period. The enrollment age under the Policy is from 5 years to 65 years.
Loan Secure Insurance
The Loan Secure Insurance of USGI covers up to 18 Major Medical Illnesses Surgical Procedure. This plan is specially designed for the banks and financial Institutions customers. The policy also provides Loss of Job and Cover of Dwelling and Content against Fire and Allied Perils.
Hospital Cash Insurance
Universal Sompo Hospital Cash Insurance plan is designed for the spouse, dependent children upto 25 years of age and dependent parents. The policyholder can get Family discount of 5% towards total the total premium of the policy. The Entry age for dependent children is 6 months.
Saral Suraksha Bima
The Saral Suraksha Bima policy is one of the Universal Sompo Health Insurance Plans with a special feature called the renewal of the policy will be available for the lifetime. This health plan is designed to target a group of members of SHG’s, NGOs, MFIs, Co-operative Banks, FCIs, Shareholders of Banks/Public Ltd Companies, Members of Registered Service Clubs and Employee.
IOB Health Care Plus
The Indian Overseas Bank Health Care Plus can be bought online or through agents with minimum documentation without pre-medical check-up upto the age of 45 years for healthy individuals. The Entry age under this scheme is 5 to 65 years. Under this Universal Sompo Health Insurance Plans, you can choose upto two children and two adults. Refer the IOB Health Care Plus brochure for more details.
Sampoorna Suraksha Bima
The Sampoorna Suraksha Bima is one of the Universal Sompo Health Insurance Plans. It is also called Micro Insurance Package Policy. The entry age of proposer should be from 18 years to 65 years. Children from 91 days to 25 years can be covered if any one of the Parent is Insured under the Policy. Unmarried children can also be covered up to a maximum of 25 years of age only.
Senior Citizen Health Care
Universal Sompo Senior Citizen Health Care is designed especially for the Senior Citizens, i.e., whose age is above 60 years. This policy is covered for himself/ herself and his/her spouse. The renewals under this plan shall be provided for the lifetime. The Maximum entry age under the Policy for the Insured and his spouse is restricted to 70 years.
Sampoorna Swasthya Kavach
The Sampoorna Swasthya Kavach is one of the Universal Sompo Health Insurance Plans. The Entry Age under this scheme is between 5 years and 65 years. The Sum Assured will be from 1 to 5 Lakhs for this plan. Sampoorna Swasthya Kavach Policy can be renewable up to the age of 80 years only. For further details, click the brochure.
Pravasi Bharatiya Bima Yojana
This Pravasi Bharatiya Bima Yojana covers only to those emigrants who have availed this Policy before leaving India and whose passport is endorsed as Emigration Check Required. The Hospitalisation expenses incurred for treatment of anyone Illness in Hospital/ Nursing Home will be covered up to the Sum Insured.
Surva Vidyarthi Bima Yojana
The Surva Vidyarthi Bima Yojana is one of the Universal Sompo Health Insurance Plans that can be taken by an Educational Institution/ Schools for the benefit of the Students. The Eligibility Age of the Student/ Staffs can be enrolled under the policy from 3 years to 65 years. This policy has 3 different sections. The insured can opt any Section / Benefit and Extension as detailed below and the premium would be charged for the chosen option. Check the Brochure for more details regarding the plan.
Individual Swarna Gramin Bima Yojana
Universal Sompo Swarna Gramin Bima Yojana Individual Policy is designed mainly for the Gramin (Village Dweller). This policy is covered for himself and his family and/ or an organisation such as NGOs, Financial Institutions for covering its rural clientele. The Entry age of the proposer is from 18 years and can opt for this policy up to the age of 65 years. Refer the Universal Sompo Swarna Gramin Bima Yojana brochure.
K Family Care
In this Universal Sompo K Family Care policy, you can choose one from the available 5 Plan options A, B, C, D and E based on the number of members chosen to be covered. The entry age for this plan is between 3 months to 65 years. This Policy covers you and your dependent’s health-related expenses right from consultation to hospitalisation for covered treatment to the Post-Hospitalization. Click the brochure for more details.
Universal Sompo Health Plans Buying Procedure
The Buying procedure of USGI policy is very simple if you have all the information regarding documents with you. The Life Assured can buy the Universal Sompo Health Insurance Plans either in online or offline mode. In Online mode, the insured have to visit the direct website and fill the application form or proposal form for the relevant policy. Whereas in Offline mode, you have to visit the nearest branch office and pay the premium by Cash/ Cheque/ Demand Draft.
USGI Health Insurance Plans Claim Process
The Universal Sompo Health Insurance Claim Process can be done through three ways, i.e., Cashless Claim Process, Reimbursement Claim Process, and Claim Process through TPA (Third Party Administrator). The insured have to follow the steps mentioned below for intimation of the claim.
Cashless Claim Process of Universal Sompo Health Insurance
- Intimate about the claim through the Tollfree number 1800 200 5142 within 24 hours in case of emergency admission and 48 hours before hospitalisation in the case of planned admission.
- Now Visit any of the Network hospitals and collect the cashless request form at the helpdesk.
- The hospital will send the form to the insurer office and then you can pay the bills.
USGI Reimbursement Claim Process
- You should Intimate about the claim through Tollfree number or email at firstname.lastname@example.org
- Pay the bill and collect documents after discharging from any of the network hospitals.
- Finally send the duly filled form to the Noida office address.
Universal Sompo Health Insurance Claim Process through TPA
- Firstly, intimate through Tollfree/ Helpline of TPA.
- TPA will provide Cashless Service for all conditions at all the Insurer Network Providers.
By choosing one of these options, you can claim your Universal Sompo Health Insurance Plans. But you have to furnish the following information while intimating a claim.
- Your Contact Numbers.
- Policy Number and Membership ID number.
- Name of Insured person who is Sick or Injured.
- Nature of Sickness/ Accident.
- Date & Time, Location of Loss in case of accident, commencement date of symptom of disease in case of sickness,
- Place & contact details of the Insured Person.
How can I renew my Universal Sompo Health Insurance Plan?
Universal Sompo Health Insurance Renewal process is possible in two ways, i.e., offline and online. For offline renewal, you have to visit the Universal Sompo General Branch Office within the grace period. The Policyholder should fill the corresponding forms regarding the policy and make payment. Universal Sompo Health Insurance Renewal process through Offline is a time taking process. So to reduce the effort and save the customer’s time, the company has introduced online renewal process.
Universal Sompo Health Insurance Online Renewal Process
- Visit the official website and go to products section.
- Select Health plans and click the relevant policy.
- Enter your policy details and tap on pay now button.
- Pay your premium through internet banking/ debit card/ credit card.
- Take the printout of the payment receipt.
- With this, your renewal process has completed.
Universal Sompo Health Insurance Premium Calculator
Universal Sompo General Insurance Premium Calculator is used to calculate the premium amount that has to be paid to get all the benefits available under this policy. The USGI Premium Calculator is available on the official website. The data required for calculating premium amount using Universal Sompo Health Insurance Maturity Calculator are Name, Date of Birth, Sum Insured, Type of the plan etc.
Exclusions of Universal Sompo Health Plans
The health insurance policies of Universal Sompo General Insurance Company covers the loss or damage to the policyholders excluding the following.
- Pre-existing diseases are not included.
- Voluntary Termination of Pregnancy.
- Pregnancy and Childbirth.
- Cosmetic or aesthetic treatment is excluded.
- Any expense on hospitalisation or domiciliary hospitalisation incurred on account of any illness during first 30 days from the date of commencement is not covered. However, this will not be applicable if Hospitalisation is required on a result of an accident.
- The Cost of spectacles, contact lenses and hearing aids are excluded.
- Injury or disease directly or indirectly attributable to War, Invasion, Act of Foreign Enemy not payable.
- Circumcision unless necessary for treatment of a disease is excluded.
- Venereal diseases, intentional self-injury and use of intoxicating drugs/ alcohol are eliminated.
- During the first year of the cover, the expense of treatment of diseases such as Cataract, Benign Prostatic Hypertrophy, Hysterectomy, Piles, Sinusitis and related disorders are not payable.
- Dental treatment or surgery of any kind unless hospitalisation is required is excluded.
- Naturopathy Treatment.
- Any treatment directly or indirectly for treatment associated with AIDS.
Free Look period:
The Free look period of the Health Insurance Plans shall be applicable at the initiation of the policy. You can return the policy if you are not satisfied with the terms and conditions but should be returned within 15 days from the date of receipt of the Policy.
The compensation benefits will depend on the nature of the injury and the Capital Sum Insured under the Policy. For accidents resulting in Death/ Permanent Total disablement, you will get compensation equivalent to the full Capital Sum Insured.
Rating for Add-on Covers: The Add-on covers rating for the Individual Personal Accident Policy are
- Medical Expenses Extension: The additional Premium for this extension is 25% of the base PA premium.
- Hospital Confinement Allowance: The additional premium for this extension is Rs 300/- per person.