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Why Universal Sompo

Claim Settled more than 90%
Associated with more than 4000+ Network hospitals
86 Branches in India
FAQ's related to CHI
Product Details

Instant Policy can be bought online or through agents with minimum documentation without pre-medical checkup up to age of 55 years for healthy individuals. Read More

Coverage and Benefits

We will provide benefits for the following subject to the level of Sum Insured chosen and the benefits detailed in Your Policy Schedule. All costs incurred must be Medically Necessary and subject to Reasonable and Customary Charges. Read More

Exclusion

We are not liable for any treatment which begins during waiting periods except if you suffer an accident. Read More

Frequently Asked Questions


Yes, your spouse and children can be added as a dependant under the floater plan. The policy can also be taken for your father, mother, father-in-law, mother-in-law, son, daughter-in-law, daughter, grandparents, and grandchildren on individual basis. Your unmarried children, under the age of 18, are eligible as dependants under the policy. Your children enrolled as full-time education students are eligible until the age of 25.

No, all benefits shall be payable when incurred in India only, in Indian rupees.

Generally, No. In the instances where any of the applicants is above 55 years of age or based on declaration in proposal form, we feel that we require additional information for fair and accurate underwriting purposes, we will ask you to undergo medical tests or ask you previous medical records. Medical Examination reports validity period is 6 months

Cover for all pre-existing medical conditions are excluded during the first three years of insurance. If you were covered under a health insurance policy from us or any other Indian insurer and we have accepted your request for portability, we shall make due adjustments towards pre-existing diseases and all other time-bound exclusions.

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%.

Generally, No. In the instances where any of the applicants is above 55 years of age or based on declaration in proposal form, we feel that we require additional information for fair and accurate underwriting purposes, we will ask you to undergo medical tests or ask you previous medical records. Medical Examination reports validity period is 6 months

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, you have access to claim forms as well as all value added services information at www.universalsompo.com

Yes, you have access to claim forms as well as all value added services information at www.universalsompo.com

Your policy is directly underwritten and serviced by us only..

Duration of the policy is 1 year, 2 year or 3 year. The insured can avail any of the options.

You have a choice of paying premium by direct debit, credit card or cheque.

Yes, any person buying this policy should be at least 18 years of age or above. The policy also has a maximum entry age limit of 70. Once you are covered, there is no exit age under the policy.

We review our premiums annually to reflect the overall cost of claims and medical inflation. Our plans are priced using age bands, reflecting that people are more likely to claim as they get older. This means that you could see an age-related increase in your premium in addition to our general review of the portfolio. Your premium can be influenced by other factors such as change in your risk profile – occupation/ health status. But your premium shall not be increased at renewal on the basis that you made claims under the policy.

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.
Automatic Cancellation

a. Individual policy:

The policy shall automatically terminate in the event of your death

b.For Family Floater Policies:

The policy shall automatically terminate in the event of the death of all covered members of the family.

c. Refund:

A refund in accordance with the cancellation short period rate table above shall be payable if there is an automatic cancellation of the policy provided that no claim has been made under the policy by or on behalf of any of the covered members.

d. Cancellation by Us:

We reserve the right to terminate this policy by sending 30 days prior written notice without refund of any premium, if in our opinion:

i) You or any person acting on behalf of either has acted in a dishonest or fraudulent manner in relation to this policy

ii) You or any other applicant have not disclosed the material facts or misrepresented in relation to the policy; and/or

iii)You or any other applicant have not co-operated with us.

Yes, you can renew your policy with us for as long as you desire on following terms.

i) Your policy shall ordinarily be renewable for lifetime on an yearly basis except on grounds of fraud, moral hazard or misrepresentation or non‐cooperation by you

ii) The renewal of the policy sought by you shall not be denied arbitrarily. If denied, we shall provide you with cogent reasons for such denial.

iii) We shall not deny the renewal of the policy on the ground that you had made a claim or claims in the previous or earlier years, except for the optional benefit covers where the coverage under the benefits viz. critical illness cover and personal accident shall terminate following payment.

iv) We shall provide for a mechanism to condone a delay in renewal up to 30 days from the due date of renewal without deeming such condonation as a break in policy. However coverage shall not be available for such period.

v) If you move into a higher age band, the premium will increase at the next renewal. However, this policy will not be subject to any alteration in premium rates generally introduced until the next renewal.

vi) If the policy is not renewed within the grace period then we may agree to issue a fresh policy subject to our underwriting criteria and no continuing benefits shall be available from the expired policy.

vii) All premiums are payable in advance of any cover under this policy being provided.

viii) The basic premium applicable under the policy may be revised at a later stage subject to approval from IRDAI.

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.