Universal Sompo health Insurance Plans

Universal Sompo Critical Illness Insurance

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Coverage City
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Date of birth
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* Name, Email Id & Mobile No. are optional 

Key highlights of Universal Sompo Critical Illness insurance

With many uncertainties that we face in life, we would like to secure it by preparing for the unexpected. Critical Illness Insurance Policy can help in reducing financial burden and concentrate on getting better treatment on diagnosis with Critical Illness.

Universal Sompo Health Insurance Review

Universal Sompo Health Insurance
Number of lives covered *
1,137,000
Incurred Claims Ratio *
97.00%
Universal Sompo Insurance tenure options
1 or 2 years options available
Claims Settlement Ratio 20-21**
65.04%
List of network hospitals
5,000+ hospitals
Number of policies issued *
2,75,370
Maximum family floater coverage
Self, Spouse + 4 dependent children
Number of lives covered *
2,425,322
* As per IRDAI report for 2020-21   |   ** As per NL25 data published on the Insurance Company website

Universal Sompo Critical Illness Insurance benefits

  • Eligibility
  • Coverages
  • Exclusions

Eligibility Criteria of Universal Sompo Critical Illness

  • sum Insured - 250000 INR,500000 INR, 750000 INR, 1000000 INR, 1250000 INR, 1500000 INR, 1750000 INR, 2000000 INR
  • Covered for - Self Spouse, Dependent parents or Parents-in-law, Dependent children
  • Entry Age 18-65 years
  • Dependent Children can be covered from - 5 years – 25 years
  • Renewal - Lifetime
  • Policy Period - 1 years
  • Policy Type - Individual
  • Medical check up required Above 55years & on Positive declaration
  • Long Term Discount - 10% for 2 years & 15% for 3 years

Coverages of Universal Sompo Critical Illness

If you or any person insured in the policy suffer from any of the listed Critical Illnesses or undergoes a listed Surgical Procedures during the policy period and while the policy is in force, we will pay the Sum Insured specified as opted by you provided that:
  1. Such Critical Illness first occurs or manifests itself during the policy period; and
  2. The signs or symptoms of such Critical illness commence after 90 days from the date of commencement of the Policy and
  3. You/the Insured Person survives for a minimum period of at least 30 days from the date of diagnosis of such Critical Illness for the claim to be admissible
Critical Illnesses and Surgical Procedures The coverage shall be up to the Sum Insured as selected by you under the Policy.
  • Cancer of specified severity
  • First Heart Attack of specified severity
  • Open Chest CABG
  • Open Heart Replacement
  • Coma of Specified Severity
  • Kidney Failure requiring regular dialysis
  • Stroke resulting in permanent symptoms
  • Major Organ /Bone Marrow Transplant
  • Motor Neurone Disease with Permanent Symptoms
  • Permanent Paralysis of Limbs
  • Multiple Sclerosis with persisting symptoms

Exclusions of Universal Sompo Critical Illness

  • Any Illness, sickness or disease, other than specified as Critical Illness, as mentioned in the Policy schedule, or
  • Any Critical Illness of which, the signs or symptoms first occurred prior to or within Ninety (90) days following the Policy Issue Date or the last Commencement Date, whichever is later, or
  • Any Critical Illness based on a diagnosis made by the you or your Immediate Family Member or anyone who is living in the same household as you or by a herbalists, acupuncturist or other non-traditional health care provider; and
  • Cosmetic or plastic surgery or any elective surgery or cosmetic procedure that improve physical appearance, surgical and non-surgical treatment of obesity (including morbid obesity) and weight control programs, or treatment of an optional nature;
  • Special nursing care, routine health checks or convalescence, Custodial Care, general debility, lethargy, rest cure;
  • Any investigation(s) or treatments not directly related to a Covered Illness or Covered Injury or the conditions or diagnosis necessitating hospital admission;

Universal Sompo Health Insurance FAQ’s

A person who avails the option ‘Treatment in tiered network’ and does not get treated in the tiered networks has to pay a Co-pay of 10%.

No. The level of cover can only be changed at the renewal date. At that time, we will work with you to ensure any benefit level changes are appropriately adjusted.

Yes, we have negotiated with a large number of hospitals all over India to avail you best of medical facilities and have access to quality care when and where you may need it.

Yes, you may cancel your policy by telephoning us, by email or in writing (see contact us for details). You may cancel your policy during the 15 day free look period. This period commences on the day you receive your policy documentation. We will refund any premium paid at the date of cancellation deducting any charges we incurred towards your medical examination and the stamp duty charges and Proportionate risk premium if cover has already covered, provided you have not used any of the services available on your cover and no claims have been made. After the free look period, refunds will only be given if no incident has occurred which has led to an eligible claim, If you decide to cancel your policy before your renewal date and outside of the free look period, you must give us 7 days notice and you will be eligible for refunds on a pro rata basis.

Prospectus

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Policy wordings

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CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2025
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