Universal Sompo Health Insurance
Universal Sompo is an entity jointly held by a few Indian banks (Karnataka Bank, Indian Bank, and Indian Overseas Bank), Dabur Group and Japan-based Sompo Insurance. Being in the general insurance business, they offer insurance for Health, Motor, Commercial, Marine, and many more segments. In Health, the company primarily has one policy with three different variants providing decent benefits. It will even offer health check-ups once in a while.
Universal Sompo Health insurance plans
Complete Healthcare Basic
While you might not have access to a huge cover, the plan is reasonably comprehensive. It doesn't have any egregious conditions, covers outpatient consultations (upto 1% of the Sum Insured) and the plan doesn't make you wait too long before covering pre-existing diseases. All in all, a decent policy
Complete Healthcare Privilege
Complete Healthcare privilige is a pretty comprehensive plan. It doesn't have any egregious conditions, covers outpatient consultations (upto 1% of the Sum Insured), and even offers maternity benefits. And while you could find more affordable options, it's still a solid plan, all in all.
Complete Healthcare Essential
3 Lakh to 5 Lakh might not be suffficient for you. But the plan as it stands is pretty comprehensive. It doesn't have any egregious conditions, covers outpatient consultations (upto 1% of the Sum Insured), and offers maternity benefits. And while it isn't the most economical policy out there, it is still a good plan overall.
Universal Sompo Health insurance claim process
Universal Sompo Health Insurance claims can be of different types based on the hospital in which you are getting the treatment. If it’s part of Universal Sompo's network hospitals, you can get a “Cashless claim” in which insurance company directly pays the bills to the hospital. But if your choice of hospital is not part of their network, then you have to pay the bills and apply for reimbursement claim. Here’s a brief process for both types of claims:
Inform the Hospital Desk
All network hospitals have an insurance desk. You can submit your policy copy (even soft copy works), ID proof, initial diagnosis report and the insurance desk will request the insurance company for “pre-authorization”. In case of planned treatments, you need to do this process 2 days before hospitalization
Based on the provided documents, insurance company approve the claim and the hospital will start the treatment and they will co-ordinate with insurer for the treatment costs. In case of Cashless claim rejection, you can still go ahead with the treatment. In this case, you will need to pay the bills initially and can file for a reimbursement claim later
If your cashless claim is approved, at the time of discharge, the insurance company will do the final settlement with the hospital and once that is sorted, you are good to go.
Inform the insurance company
For any planned treatments, you need to inform the insurance company 2 days before hospitalisation. In case of emergency, you can inform within 24 hours of admission. Insurance company will acknowledge the intimation.
You need to submit a insurance claim form along with original copies of hospital bills, doctor consultation reports, and diagonstic reports.
File the claim
Within 30 days post discharge, you can initiate the claim online or at any of the registered offices of the insurance company. You need to fill a claim form and attach all the reports and bills.
Based on the claim form and submitted documents, insurance company will settle the claims as per policy terms and conditions.
Universal Sompo Customer Care
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