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Universal Sompo Group Health Insurance

Universal Sompo Group Health Insurance

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Key highlights of Universal Sompo Group Health Insurance

Group Health Insurance policy of Universal Sompo GIC Ltd. is offered to Groups comprising of employees both in trading and manufacturing sectors / social sector and/or members of an institution / society / association / club. The policy is designed to pay the Insured persons the hospitalization expenses as well as domiciliary hospitalization benefits if he / she suffers an illness or accidental injury during the policy period.

Universal Sompo Health Insurance Review

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

Eligibility of Universal Sompo Group Health Insurance

The enrollment age under the policy is from 5 years to 70 years. Children between the age of 3 months and 5 years of age can be covered provided one or both parents are covered concurrently.
Proposer needs to be aged 18 years or above.
An individual may cover himself/ herself and his/ her spouse, dependent children up to 23 years of age and/ or dependent parents / dependent parents in laws under the policy.
The renewal shall under the policy shall be given lifetime.
The Company may ask Insured to undergo medical check-up if he/she is above 45 years of age.
50% medical examination costs shall be reimbursed by us, if their proposal is accepted.

Pre - acceptance Medical Check Ups:

The Company may require submission of Medical Reports for ECG and Blood Sugar (Fasting+ PP) for acceptance of your proposal, if you are above 45 years. This requirement will only be for fresh Proposals, when the Sum Insured is enhanced at the time of renewal or when there is break in insurance for more than 15 days.

Universal Sompo Health Insurance FAQ’s

What do I do if I have any complaints?

To avoid misunderstandings, you must read the information supplied when taking up your cover. If you are unsure about any aspect, you should contact our sales representative. We aim to provide a high level of service to all our clients but occasionally things can go wrong. When this happens we will do what we can to put things right. If you have a complaint about our service or the administration of your policy, please contact us in the first instance by telephoning our Customer Care or by emailing us or writing to us. The details of the various reach points are given in the Contact Us. We will aim to resolve your complaint over the telephone within 24 hours of receipt of your compliant.

What is the claim settlement ratio for Universal Sompo mediclaim insurance? What are the reasons for the denial of the claim for health insurance?

Claim Settlement ratio is the ratio of claims settled against claims reported during thce year. Universal Sompo health insurance claim settlement ratio is 92% for FY 2018-19.

Why do I need Health Insurance?

Health insurance covers you and your family against expenses incurred in a medical emergency. With medical bills on the rise, insurance helps in reducing the financial burden during hospitalization. Also, the cases of critical illnesses and lifestyle-related ailments have increased rapidly. Health insurance allows you to be better prepared for such events. The premium that you pay for your health insurance is eligible for tax deduction under Section 80D of the Income Tax Act.

How is the premium calculated for Universal Sompo Health Insurance?

The premium payable on your health insurance policy is based on the following factors:

Sum insured option is chosen
The number of family members to be covered
The age of the senior most person in the family to be covered
The type of policy you opt for - Basic, Premium, Optimum, Smart Super Health Insurance Policy