Health insurance will shield you and your family against any financial unforeseen event arising due to a medical crisis.
It is an Identity card which is issued to each and every person covered under the Health policy. This card would entitle you to avail cashless hospitalization facility at any of our network hospitals.
Policyholders are eligible for health card.
A health card mentions the contact details the TPA. In case of a medical emergency, you can call on these numbers for queries, clarifications and for seeking any kind of assistance. You need to show the health card at the hospital.
The health cards need to be renewed or re-issued during the policy tenure.
Third Party Administrator is a service provider appointed by your insurance company to provide various necessary services related to benefits mentioned in the health policy to you.
Any condition, ailment, injury or related condition(s) for which you had signs or symptoms, and / or were diagnosed, and/ or received medical advice / treatments within stipulated months as mentioned in your policy prior to your first policy with us.
Pre-existing diseases are covered subject to waiting period as mentioned in your policy.
Spouse
Dependent Children means all unmarried children, stepchildren or legally adopted children who are above 91 days and under 23 years of age and are financially dependent on Insured
Dependent Parents upto 70 years of age.
In case of a planned hospitalization or emergency services, use your Health ID Card at any of network hospitals and avail cashless service. In case the hospital is not listed in the network of hospital, then pay the cash and submit the claim to TPA for reimbursement with relevant documents and bills.
These are the hospitals that form part of the TPA's network to provide cashless service to you upon presentation of health-card.
Hospitals which are not part of TPA's hospital tie-up list are called Non-network hospital. The bills are settled by patient & the relevant documents and bills are then submitted to the TPA. The amount, accordingly, is reimbursed to the patient.
List is provided to you along with your health card which is issued by TPA. This list is subject to change and updated list is available on TPA website.
When you approach a hospital which is listed in the provider list of our network and disclose the health-card, hospital will pursue TPA for pre-authorization. Once the authorization is issued by TPA, you do not have to pay any money towards the covered services provided by the hospital. This is called as a cashless service.
It is a hospital request to TPA to confirm the pay ability of your illness.
In case of planned hospitalization:
Please contact your TPA helpline-Which is mentioned on the Health Identity Card. Obtain approval from the TPA.
In case of emergency hospitalization:
Family to contact TPA help-line as mentioned in the policy.
TPA will issue the letter of admissibility of the claim within 3-6 hours provided all the relevant documents are submitted.
Duly completed claim form
Original bills, receipts and discharge certificate/card from the hospital.
Original bills from chemists supported by proper prescription.
Information and evidences from the attending Medical
Practitioner/Hospital/Chemist/Laboratory as required.
The claim must be filed within 30 days from the date of discharge from the Hospital or completion of treatment.
Normally, the bills are settled within 7 working days of receiving the relevant documents.
Once you stop paying the premiums, the policy would be discontinued.
Once you stop paying the premiums, the policy would be discontinued.
Yes, there is a tax benefit available under Section 80D of the income tax act 1961. Every tax payer can avail an annual deduction of Rs. 15,000 from taxable income for payment of Health Insurance premium for self and dependants.
Yes, you can have more than one Health Insurance policy. In case of a claim, each company will pay ratable proportion of the loss.
You are allowed to claim insurance only once in a year?
Yes, foreigners living in India can be covered under a health insurance policy. However, the coverage would be restricted to India.
In case of an unfortunate event of accident to insured, first of all take care of your health and consult doctor. Notify police authorities wherever necessary. Please contact USGIC by any of the following convenient ways:
MODE OF CONTACT DETAILS
1. Email advise can be sent at contactclaims@universalsompo.com 2. Call on our Toll Free number 1-800-22-4030 (from MTNL & BSNL Lines) 3. Helpline number 022-41582900 - 41582999
In case of telephonic contact, our call centre executive shall note down the basic requirements and pass on the information to the concerned Claims Team who shall appoint an investigator(if required), to assess the case in stipulated time.
In case the claim is being notified by email, the attached I claim notification to be filled in and sent to enable the concerned claims handler to contact you immediately for further update.
In a rare case that you find it difficult to communicate through any of the above modes, you may immediately inform the loss to your nearest USGIC office or banker (for Banca policies) who shall contact us for further formalities.
You can do a self check to see if the answers to the following questions are "YES"
Premium - Is your premium check cleared by the bank?
Period - Whether the insurance is in force at the time of loss?
Peril - Whether the cause of loss is covered by the policy? (Perils are defined in the policy document)
If your answers to the above questions are "YES", then your loss stands covered by us, subject to policy terms and conditions.
The amount of claim generally payable depends on the type of policy, policy coverage and policy terms and conditions.However,in no circumstance will the total amount of claim exceed the sum insured of your policy.
We pay the amount to the Insured. In case of death claim, the amount is paid to the nominee of the policyholder. In case there is no nominee made under the policy, then USGIC will insist upon a succession certificate from a court of law for disbursing the claim amount. Alternatively, the USGIC can deposit the claim amount in the court for disbursement to the next legal heirs of the deceased.
It doesn't matter where the accident happens. We shall co-ordinate through our offices and network to ensure that you are guided through the procedures without any hassles.
Yes
We shall take the following steps immediately once the claim is notified to us:
The investigator shall be appointed.
The investigator, after inspection shall assess the loss and inform the assessment to the insurer.
Claim processing-Within seven working days from the date of receipt of all requisite documents.
Claims Payment- Within two working days from the finalization of claim.
A form is included in the policy kit that you must have received. However for your convenience our representatives will supply the claim form for you. The claim form is available on our company website www.universalsompo.com
The benefits will depend on the extent and type of disability. (Please refer policy documents.)
No. This cover is applicable only if the disability is due to an accident. A disability caused due to a natural calamity is not covered.
No. This cover is applicable only if the death is due to an accident. A death caused due to a disease or natural death is not covered..
Basic cover - Death only
Wider cover - Death + Permanent Total Disability+ Permanent Partial Disability
Comprehensive cover - Death + Permanent Total Disability + Permanent Partial
Disability +Temporary Total Disability
Extra benefits under policy in addition to capital sum insured,
1) Transportation cost for carriage of dead body to home including funeral charges.
2) Cost of clothing damaged in the accident.
3) Ambulance charges for transportation of insured person to hospital following accident.
4) Education fund in the event of death, PTD of the proposer for up to two dependent children.
5) Loss of employment
ADD-ON Covers-(only on receipt of additional premium)
1) Medical expenses.
2) Hospital confinement amount.
THE SCOPE OF COVERAGE SHALL DEPEND ON THE BENEFIT SELECTED BY YOU AND AS DESCRIBED IN THE SCHEDULE.
No. This cover is applicable only if the death is due to an accident. A death caused due to a disease or natural death is not covered.
List of Documents Death | Death Claim | Temporary Total Disability(TTD) | Permanent Total Disability | Permanent Partial Disability |
---|---|---|---|---|
Duly filled original Claim Form | X | X | X | X |
Policy copy | X | X | X | X |
Claim Intimation | X | X | X | X |
FIR-Attested or Original | X | X | X | X |
Death Certificate | X | |||
Post Mortem report | X | |||
Inquest/Coroner's Report | X | |||
Final Police Report/Original Panchnama | X | X | X | X |
Legal Heir certificate /nominee certificate | X | |||
Confirmation of coverage letter | X | X | X | X |
Discharge summary of the treating hospital clearly indicating the Hospital Registration No. | X | X | X | |
Diagnostic reports | X | X | X | |
Leave certificate | X | |||
Certificate from government hospital doctor confirming the nature and degree of disability | X | X | X | |
Termination letter for claim under "Loss of Employment" | X | |||
Photograph of the injured with reflecting disablement | X |
As soon as your vehicle meets with an accident or injures a third party or damages the property of a third party, inform us on our contact centre (contact details below). Our claims executive will get in touch with you and guide you on the procedures and documents necessary to process your claim.
MODE OF CONTACT | DETAILS |
1. Email advise can be sent at | contactclaims@universalsompo.com |
2. Call on our Toll Free number | 1-800-22-4030 (from MTNL & BSNL Lines) |
3. Helpline number | +91-22-27639800 |
It is in your interest not to drive the damaged vehicle using its own power since any consequential damages after accident would not be admissible under the policy.
It doesn't matter where the accident happens. We shall co-ordinate through our offices and network to ensure that you are guided through the procedures without any hassles.
You need to obtain an FIR in any of the following cases:
Bodily Injury to any Third Party involved in the accident.
Theft of the entire vehicle or accessories, other vehicle parts.
Any loss or damage to the vehicle by miscreants, rioters, terrorists, arsonists, etc.
For all commercial vehicles.
Yes. Spot survey is compulsory for commercial vehicles.
Yes,provided you have 'Own Damage' coverage under your policy. This off-course will be subject to the terms, condition and exclusion of the policy.
As per the Motor Vehicle Act 1938, no vehicle can play on public roads without the Third Party insurance coverage; Third Party insurance covers the following:
Any injury / death of third person caused by your car.
Any damage caused to the property of some other individual by your vehicle.
Only third party insurance liability coverage does not cover loss or damage to your insured vehicle.
If you are having a Theft or Act only policy, accidental damages to your vehicle would not be covered. Only Theft of vehicle is covered under Theft Policy. Similarly third part liability will be covered under Act policy.
We shall take the following steps immediately once the claim is notified to us :
The surveyor shall be appointed within 24 hours from the time of notification.
The surveyor, after inspection shall assess the loss and inform the assessment to the insured.
The surveyor shall carry out the re-inspection after the repairs are completed. Post Repairs - Non Cashless Workshop Insured have to make the payment to the workshop.
Original repair invoice and payment receipt needs to be submitted to us.
Claim amount will be settled within seven working days after receiving the final documents.
Post Repairs - Cashless Workshop
In case of USGIC Cashless Workshops, you only have to pay the difference amount as informed to you by our surveyor and the workshop shall submit their bill for the balance amount directly to us.
A form is included in the policy kit that you must have received. However for your convenience our representatives will supply the claim form for you. The claim form would also be available on our company website www.universalsompo.com
Surveyor will come to the workshop where the vehicle will be left for repairs in case it is not a Spot survey.
No problems. Our call centre will assist you to get your vehicle towed to our Cashless Workshops. However if you choose to use a garage of your choice, you shall have to arrange for the towing of vehicle and reasonable towing charges shall be reimbursed based on the policy terms and conditions.
We have no problems, but there shall be no cashless facility and you will have to make the payment to the garage in full and submit the final bills and receipt to us for processing.
You shall have to bear:
The amount of depreciation as per the rate indicated in the policy document.
Compulsory deductible under the policy.
Voluntary deductions under the policy, if you have opted for it.In case of any claim during the insured policy period, at the time of renewal, you will loose the NCB 'No Claim Bonus' that you have accrued over the years. Also there could be a loading on the premium at the time of renewal.
Immediately notify the loss to the nearest police station from the place where the vehicle was stolen and also intimate the same to us at our call centre. Our claims executive shall get in touch with you and assist you for further course of action.
If your vehicle is insured under comprehensive insurance policy and the person driving your vehicle holds a valid driving license, these damages are covered subject to terms and conditions of the policy.
Yes. If you have paid an additional premium to get coverage of Personal Accident to the insured or any named person other than paid driver or cleaner. This is usually applicable to private cars and motorized two wheelers.
If you have taken a comprehensive policy for your vehicle you are fully covered against all the accidental damages to your vehicle. Your are also covered for the Third Party liability subject to terms and conditions mentioned in the policy document.
If your vehicle under hire purchase or hypothecation is a total loss on account of accident damage or theft, the claim is paid to the hypothecator with whom the vehicle is leased/hypothecated. However, if the damage can be repaired, the claim is normally paid to the vehicle owner. If a cashless repair facility is used, then the amount is paid to the dealer where the vehicle has been repaired.
No, each loss has to be separately intimated to us and surveyed as per procedure.
No, your vehicle must first be repaired, after which we shall process and settle the claim based on the policy terms and conditions.
The insured vehicle shall be treated as a Constructive Total Loss, if the aggregate cost of retrieval and/or repair of the vehicle subject to the terms and conditions of the policy, exceeds 75% of the IDV of the vehicle. Total Loss also refers to accident damage to your vehicle where the cost of repairs amounts to more than 75% of the IDV on your policy.
The insured vehicle shall be treated as a Constructive Total Loss, if the aggregate cost of retrieval and/or repair of the vehicle subject to the terms and conditions of the policy, exceeds 75% of the IDV of the vehicle. Total Loss also refers to accident damage to your vehicle where the cost of repairs amounts to more than 75% of the IDV on your policy.
An excess is the amount first loss that you shall have to bear.
This is the amount you have opted to be deducted from claim amount at the time of purchase of insurance.
This is in addition to compulsory excess applicable by the policy.
In case of an unfortunate event of damage to your insured property or an injury to any third person consequent to use of your insured property, you need to immediately contact us. In a rare case that you find it difficult to communicate through any of the above modes, you may immediately inform of the loss to your banker who shall contact us for further formalities. your claim.
Unless it is required by local authorities, please do not disturb the location of loss so that the surveyor can get first hand information of the circumstances of loss. In cases like fire or burglary, please lodge requisite complaints immediately to the local authorities. It is very important that you take immediate and suitable actions to minimize the loss for all concerned. Remember, it is your property and it is in your interest to ensure the loss is restricted to a minimum.
Though we shall provide all assistance to you for assessing the loss, however, a delayed notification would mean alteration of pristine circumstance of the loss and hence will entail additional enquiries and documents by the surveyor. It is in your interest to report a loss immediately and leave the burden of further procedures on us.
A surveyor is an independent professional duly licensed by IRDA who is appointed based on the nature and quantum of estimated loss to visit the accident site and procure first hand information relating to the cause and extent of loss. He shall verify the damaged property and check documents related thereto. The sooner you submit the documents requested by surveyor, the faster he finalizes his report and our claims team shall process the claim without any delay.
Never mind, inform both of us simultaneously sharing insurance details and we shall take it up with your other insurer to ensure that there is no hindrance to your claims process.
You can do a self check to see if the answers to the following questions are "YES"
Premium -is your premium check cleared by the bank?
Period - whether the insurance is in force at the time of loss?
Peril - whether the cause of loss is covered by the policy? (perils are defined in the policy document)
Property - whether the property said to be affected is insured by the policy?
Place - whether the location of loss is covered by the policy?
Person - whether you have an insurable interest in the damaged property?
If your answers to the above questions are "YES", then your loss stands covered by us, subject to policy terms and conditions.
The amount of claim generally payable depends on the value of the affected property less residual value of damaged property less under-insurance, if any, less compulsory excess as defined in your policy. However, in no circumstance will the total amount of claim exceed the sum insured of your policy.
We pay the claim to the Insured. If the damaged property is hypothecated to your banker, then we pay in the name of your banker, however, if you can obtain an NOC from your hypothecator, we have no problem in paying the claim to you.
In case of an unfortunate event of damage to your insured property or an injury to any third person consequent to use of your insured property, you need to immediately contact us. In a rare case that you find it difficult to communicate through any of the above modes, you may immediately inform of the loss to your banker who shall contact us for further formalities. your claim.
Unless it is required by local authorities, please do not disturb the location of loss so that the surveyor can get first hand information of the circumstances of loss. In cases like Engineering or burglary, please lodge requisite complaints immediately to the local authorities. It is very important that you take immediate and suitable actions to minimize the loss for all concerned. Remember, it is your property and it is in your interest to ensure the loss is restricted to a minimum.
Though we shall provide all assistance to you for assessing the loss, however, a delayed notification would mean alteration of pristine circumstance of the loss and hence will entail additional enquiries and documents by the surveyor. It is in your interest to report a loss immediately and leave the burden of further procedures on us.
A surveyor is an independent professional duly licensed by IRDA who is appointed based on the nature and quantum of estimated loss to visit the accident site and procure first hand information relating to the cause and extent of loss. He shall verify the damaged property and check documents related thereto. The sooner you submit the documents requested by surveyor, the faster he finalizes his report and our claims team shall process the claim without any delay.
What if I have a separate insurance policy with insurance company for the same property?
You can do a self check to see if the answers to the following questions are "YES"
Premium - is your premium check cleared by the bank?
Period - whether the insurance is in force at the time of loss?
Peril - whether the cause of loss is covered by the policy? (Perils are defined in the policy document)
If your answers to the above questions are "YES", then your loss stands covered by us, subject to policy terms and conditions.
The amount of claim generally payable depends on the type of policy, policy coverage and policy terms and conditions.However,in no circumstance will the total amount of claim exceed the sum insured of your policy.
We pay the claim to the Insured. If the damaged property is hypothecated to your banker, then we pay in the name of your banker, however, if you can obtain an NOC from your hypothecator, we have no problem in paying the claim to you.
In case of an unfortunate event of damage to your insured property or an injury to any third person consequent to use of your insured property, you need to immediately contact us. In a rare case that you find it difficult to communicate through any of the above modes, you may immediately inform of the loss to your banker who shall contact us for further formalities. your claim.
Unless it is required by local authorities, please do not disturb the location of loss so that the surveyor can get first hand information of the circumstances of loss. In cases like Engineering or burglary, please lodge requisite complaints immediately to the local authorities. It is very important that you take immediate and suitable actions to minimize the loss for all concerned. Remember, it is your property and it is in your interest to ensure the loss is restricted to a minimum.
Though we shall provide all assistance to you for assessing the loss, however, a delayed notification would mean alteration of pristine circumstance of the loss and hence will entail additional enquiries and documents by the surveyor. It is in your interest to report a loss immediately and leave the burden of further procedures on us.
A surveyor is an independent professional duly licensed by IRDA who is appointed based on the nature and quantum of estimated loss to visit the accident site and procure first hand information relating to the cause and extent of loss. He shall verify the damaged property and check documents related thereto. The sooner you submit the documents requested by surveyor, the faster he finalizes his report and our claims team shall process the claim without any delay.
What if I have a separate insurance policy with insurance company for the same property?
You can do a self check to see if the answers to the following questions are "YES"
Premium - is your premium check cleared by the bank?
Period - whether the insurance is in force at the time of loss?
Peril - whether the cause of loss is covered by the policy? (Perils are defined in the policy document)
If your answers to the above questions are "YES", then your loss stands covered by us, subject to policy terms and conditions.
The amount of claim generally payable depends on the type of policy, policy coverage and policy terms and conditions.However,in no circumstance will the total amount of claim exceed the sum insured of your policy.
We pay the claim to the Insured. If the damaged property is hypothecated to your banker, then we pay in the name of your banker, however, if you can obtain an NOC from your hypothecator, we have no problem in paying the claim to you.
In case of an unfortunate event of damage to your insured property or an injury to any third person consequent to use of your insured property, you need to immediately contact us. In a rare case that you find it difficult to communicate through any of the above modes, you may immediately inform of the loss to your banker who shall contact us for further formalities. your claim.
Unless it is required by local authorities, please do not disturb the location of loss so that the surveyor can get first hand information of the circumstances of loss. In cases like Engineering or burglary, please lodge requisite complaints immediately to the local authorities. It is very important that you take immediate and suitable actions to minimize the loss for all concerned. Remember, it is your property and it is in your interest to ensure the loss is restricted to a minimum.
Though we shall provide all assistance to you for assessing the loss, however, a delayed notification would mean alteration of pristine circumstance of the loss and hence will entail additional enquiries and documents by the surveyor. It is in your interest to report a loss immediately and leave the burden of further procedures on us.
A surveyor is an independent professional duly licensed by IRDA who is appointed based on the nature and quantum of estimated loss to visit the accident site and procure first hand information relating to the cause and extent of loss. He shall verify the damaged property and check documents related thereto. The sooner you submit the documents requested by surveyor, the faster he finalizes his report and our claims team shall process the claim without any delay.
What if I have a separate insurance policy with insurance company for the same property?
You can do a self check to see if the answers to the following questions are "YES"
Premium - is your premium check cleared by the bank?
Period - whether the insurance is in force at the time of loss?
Peril - whether the cause of loss is covered by the policy? (Perils are defined in the policy document)
If your answers to the above questions are "YES", then your loss stands covered by us, subject to policy terms and conditions.
The amount of claim generally payable depends on the type of policy, policy coverage and policy terms and conditions.However,in no circumstance will the total amount of claim exceed the sum insured of your policy.
We pay the claim to the Insured. If the damaged property is hypothecated to your banker, then we pay in the name of your banker, however, if you can obtain an NOC from your hypothecator, we have no problem in paying the claim to you.
In case of an unfortunate event of damage to your insured property or an injury to any third person consequent to use of your insured property, you need to immediately contact us. In a rare case that you find it difficult to communicate through any of the above modes, you may immediately inform of the loss to your banker who shall contact us for further formalities. your claim.
Unless it is required by local authorities, please do not disturb the location of loss so that the surveyor can get first hand information of the circumstances of loss. In cases like Engineering or burglary, please lodge requisite complaints immediately to the local authorities. It is very important that you take immediate and suitable actions to minimize the loss for all concerned. Remember, it is your property and it is in your interest to ensure the loss is restricted to a minimum.
Though we shall provide all assistance to you for assessing the loss, however, a delayed notification would mean alteration of pristine circumstance of the loss and hence will entail additional enquiries and documents by the surveyor. It is in your interest to report a loss immediately and leave the burden of further procedures on us.
A surveyor is an independent professional duly licensed by IRDA who is appointed based on the nature and quantum of estimated loss to visit the accident site and procure first hand information relating to the cause and extent of loss. He shall verify the damaged property and check documents related thereto. The sooner you submit the documents requested by surveyor, the faster he finalizes his report and our claims team shall process the claim without any delay.
What if I have a separate insurance policy with insurance company for the same property?
You can do a self check to see if the answers to the following questions are "YES"
Premium - is your premium check cleared by the bank?
Period - whether the insurance is in force at the time of loss?
Peril - whether the cause of loss is covered by the policy? (Perils are defined in the policy document)
If your answers to the above questions are "YES", then your loss stands covered by us, subject to policy terms and conditions.
The amount of claim generally payable depends on the type of policy, policy coverage and policy terms and conditions.However,in no circumstance will the total amount of claim exceed the sum insured of your policy.
We pay the claim to the Insured. If the damaged property is hypothecated to your banker, then we pay in the name of your banker, however, if you can obtain an NOC from your hypothecator, we have no problem in paying the claim to you.
“Cashless facility” is a facility extended by the insurer to the insured where the payments of the costs of treatment undergone by the insured in accordance with the policy terms and conditions are directly made to the network provider by the insurer to the extent Cashless/ Pre-authorization approved
The insured or the network service provider seeks an approval and guarantee of payment from the insurer before the hospitalization for planned treatment and during Hospitalization for emergency treatment
You can avail the cashless hospitalization facility in any of our Network Hospital. Click here to Search Network Hospital.
Step I
Call our Health Helpline 1800 200 4030 and Intimate your Claim within 24 hrs in case of emergency admission and 48 hrs prior to hospitalization in case of planned admission.
Step II
Visit Network hospital and show your Health Serve Card issued by the company along with Valid Photo ID proof and get ‘Cashless Request Form’ from Insurance helpdesk of the hospital
Step III
Fill your details in the ‘Cashless Request Form’ & submit it to the Hospital Insurance helpdesk
Step IV
Hospital verifies the patient details and sends duly filled Cashless Request Form by mail to Universal Sompo Health team at healthserve@universalsompo.com
Step V
Universal Sompo – Health willreview and judge the admissibility of the Cashless Request as per Policy Terms &Conditions and the same will be communicated to you and hospital. You will be required to pay for expenses that are not payable as per the terms and condition of the policy.
Reimbursement claim is when the expenses incurred during Hospitalization or bills of Hospitalization are directly settled by the Insured with the Hospital and post discharge from Hospital claimed by the Insured from the Insurer for reimbursement.
Step I
Call our Health Helpline 1800 200 4030 or email at healthserve@universalsompo.com and inform about your Claim within 24 hrs in case of emergency admission and 48 hrs prior to hospitalization in case of planned admission.
Step II
Visit hospital and undergo your treatment. Settle your hospitalization bill and collect all original documents after discharge from hospital
Step III
Fill in Reimbursement Claim Form and submit all original documents to our below mention office for reimbursement.
Universal Sompo General Insurance Company Limited
Health Claims Management Office,
1st Floor, Plot No. C 56 A/13,
Block C, Sector- 62, Noida,
Uttar Pradesh- 201309
Step IV
On receipt of document your claim will processed as per Terms & Conditions of policy and the same will be communicated to you.
As soon as a claim occurs, please intimate to the TPA Help line/Toll free number as mentioned in your Health Card. For cashless hospital and more information kindly visit our TPA web site link mentioned below.
Our TPA will be glad to provide you services with a smile within the overall terms and conditions of your MEDICLAIM policy. Our TPA will provide you the following claims services:
Following information needs to be furnished by you while intimating a claim:
Kindly retain a copy of the documents sent to us, for your future reference. The above list of documents is indicative. In case of any further document requirement, Our Health Serve team will contact you on receipt of your claim documents by us
Particulars | Transaction Type | Turn Around Time (TAT) |
---|---|---|
Cashless Approval | Initial Authorization | 60 mins |
Discharge Request | 3 Hrs | |
Claim Settlement | 30 days |
Note: TAT would be calculated from the receipt of last document received.
Travel Insurance provides you and your family medical, financial and other assistance in case of an emergency or untoward circumstances while travelling on an International Trip.
No matter what you are: a business traveller or a leisure traveller: you are now safer with Overseas Travel Insurance which protects you from unfortunate events such as loss or delay in checked baggage, passport loss, a medical emergency or an Accident
Jurisdiction | Worldwide coverage for Medical & Travel related assistance | |
---|---|---|
TPA | Falck India Pvt Ltd | |
Location of centre | Haryana, India | |
Address |
Falck India Pvt Ltd Upper Floor The Peach Tree, Block – C Sushant Lok – I Sector 43, Gurugram Haryana – 122015 |
|
Toll-Free Numbers for assistance | 18775367264 | |
Other Telephone Numbers | +91 1244498766 | |
Fax Numbers | +91 1244006674 | |
Email id | UniversalSompo@falck.com | |
Website | www.falck.com |
The company shall appoint an independent surveyor to assess the loss.
DO'S | DONT's |
---|---|
Do make sure you take out your insurance before you travel. It can be very difficult to arrange once your holiday has started. Normally, insurers will not grant cover once a journey has commenced, leaving you exposed to a significant financial risk and a delay in the assistance you may desperately need. | Don't think that buying travel insurance is an unnecessary extra expense on top of your holiday cost. At worst it can help you get the assistance you need - at best it could help save your life. |
Do make sure that you have disclosed any pre-existing medical conditions to your insurer when you take out the policy (including yourself and your dependent family). | Don't arrange your own evacuations/repatriation unless your life is in danger without it and you and your companions cannot talk to the insurer in time. Otherwise, they won't pay if evacuation is self-arranged. |
Do ensure that you take all documentation of your travel policy with you on holiday, especially the emergency assistance telephone number. | Don't keep your properties, travel documents unattended. Keep your valuables in hotel lockers/safe deposit vaults. |
Do be aware that a 'low cost' policy may not provide a level of cover you require; often 'low cost' means 'low cover' and a less-than-reassuring service when you most need it! | Don't accept lavish hospitality extended by strangers/ unknown persons especially while shopping for jewellery and expensive items. |
DO contact the Assistance & claim-settling Co. for assistance and inform immediately, with full details. The insured can contact Falck India Pvt Ltd which will provide emergency assistance and claims administration services guidance. | Don't get admitted in a hospital merely for investigation, evaluation or health checkups- It will not be approved. |
In extreme emergency medical conditions prohibiting getting in touch with assistance co., get admitted to the nearest facility/hospital. Request your representative to contact the assistance and claim settling co for further process. | Don't forget to record the details of damage caused to any property or injury to anyone involved.. |
For reimbursement claim please intimate ASAP to Falck India Pvt Ltd via fax/ email and seek documentation advice before return from abroad. | Don't claim the following expenses:- Telephone/fax , food and beverages , documentation charges, |
DO keep all Original bills and receipts, travel documents, original medical reports for easy process of reimbursement claim. | Don't panic, If you receive a bill or notice from a provider or collection agency, simply forward it to Falck India Pvt Ltd by the quickest means possible (fax or e-mail), and to take action directly with the provider. |
Loss of baggage must be reported to the carrier and a Property Irregularity Report to be obtained. You may also claim from the carrier for they negligence. | Don't admit any liability without written consent of Falck India Pvt Ltd to any party in what so ever form. |
In case of loss of passport, the police authorities to be informed, contact the nearest Indian embassy for further guidelines? | Don't be reckless and always safeguard yourself from unhealthy event or circumstance as if the insurance is not in force. |
Do- in case of financial emergency, the insured can contact the claim-settling co. stating details of insurance policy, Police report, and a written statement narrating the incident of loss. | Do not call Falck India Pvt Ltd without policy details available. |
In case of Out Patient treatment (OPD) kindly forward the original papers to Falck India Pvt Ltd Haryana office. | |
Do take and keep detailed notes of all conversations with insurance company representatives, and get names, phone numbers, and job titles of people you speak with. | |
Do take pictures, if possible, of damage to your vehicle, the accident scene, and your injuries. | |
DO be honest and forthcoming with your insurer. Even if it is embarrassing, it is better if your insurer knows all the facts. Failing to be candid with your insurer might invalidate your policy or cause a denial of coverage. | |
Please send claim papers for reimbursement cases within 30 days from the date of return to India. |
In event of any claim arising due to accident, please intimate immediately to
Our claims officials shall soon get in touch with you and shall be happy to help you with the claim procedures.
Details of our offices can be found in the USGICL Office Locator in our Website.
Following information needs to be furnished by you while intimating a claim:
(Accidental Death, Permanent Total Disability & Critical Illness)
List of Documents for Accidental Death Claim:
List of Documents for Temporary Total Disability (TTD) Claim
List of Documents for Permanent Total Disability (PTD) Claim
List of Documents for Permanent Partial Disability (PPD) Claim
List of Documents for Medical Expenses (ME) Claim
(Accidental Death, Permanent Total Disability & Critical Illness)
List of Documents for Permanent Total Disability (PTD) Claim:
List of Documents for Critical Illness Claim:
Generic Documents for all claims (Accidental Death, Permanent Total Disability & Critical Illness)
List of Documents for Accidental Death Claim:
List of Documents for Permanent Total Disability (PTD) Claim:
List of Documents for Critical Illness Claim
Claim Form
Original Vehicle Registration Certificate
OR duly filled and signed Form26 by Insured triplicate copies,
Driving License of last driver of vehicle
Vehicle Particular Blacklist /Stolen/ No use status update by concern RTO
OR Acknowledgment receipt by concern RTO about Vehicle Stolen / No Use / To Be blacklist
Original Sale Invoice in case of First Owner,
Sale / Purchase Deed in case other than first owner
In case of 2nd owner without Hypothecation then may require ITR copy.
Previous Policy verification
Insured Statement about theft
Last user statement about theft with Identity Proof
Police FIR / Final Chargesheet.
Duly filled and signed Form28 by Insured triplicate copies
All Key Set
If Lock set has been changed then Lock set changed bill
If Full Key set not available, then any intimation to concern Insurer / Police authority about Key Loss.
Service History or Any other documentary/ digital evidence like recent CCTV footage of vehicle which can show vehicle existence just before theft,
Honorable Court approved Final Untrace report,
Duly signed and Notarized Indemnity Bond,
Duly signed and Notarized Subrogation Letter,
Address Proof,
Identity Proof,
CKYC form,
Discharge Voucher,
Duly signed Neft Mandate form / Cancel CTS Cheque / Bank Passbook
Above documents plus following addition documents-
Permit Copy,
Authorization Copy,
Fitness Copy,
Road Tax Copy,
Passenger Details,
Trip Sheet
Above documents plus Load Challan / Builty except Passenger Details, Trip Sheet
Pls Note-Insured and Driver Google Timeline, Fast Tag Statement, Vehicle GPS / Blue link history as provided by OEM, Toll receipts will require to confirm Loss Place date, time
Non repossession Letter by concern Financer,
Loan Account Statement,
NEFT details of Financer Loan Account,
Foreclosure Letter
Bank NOC and Form 35 duly stamped and signed by Financer
Please Note-Any other requirement on basis of merits of claim then insurer may ask for additional document if any
Visit our website www.universalsompo.com. For Intimation click on Motor Claim Intimation. Answer a few questions and the claim will be registered
Alternatively you call our toll free number and intimate the claim
Following information needs to be furnished by you while intimating a claim:
Your Contact Numbers
Policy Number
Name of Insured person
Date & Time of accident
Location of Loss
Brief description on how the accident took place
Extent of loss
Place & contact details of the Insured Person (in case person intimating the claim is other than the insured person
Driver Name
Intimate the claim through the various channels available for intimation.
Get the spot survey done in case the vehicle is Goods carrying or passenger carrying. In case of PVT vehicle if possible, take photograph at the spot along with the details of other vehicle involved.
Submit duly filled and signed claim form. Please mention the correct cause of loss.
Loss falling within the definition of named peril in the policy will be covered for any insurance claim.
Furnish all information and documentary evidence as required.
It is recommended to submit an estimate of repair to ascertain the cost of parts which keeps on changing. In absence of the same the surveyor can prepare an estimate as per the last available price.
We will appoint a surveyor immediately after receipt of intimation to assess the loss as per IRDAI guidelines.
The surveyor shall inspect the damaged vehicle, discuss the cost of repair or replacement with the repairers and submits his report to the insurance company having assessment as below criteria
The vehicle should not be left unattended without proper precautions taken to prevent further loss or damage.
Description | Turn Around Time |
---|---|
Surveyor appointment | within 24hrs from Claim Intimation |
Survey Completion | within 24hrs of Surveyor appointment |
Surveyor report submission | within 15 days from Date of Survey |
Settlement / Claim decision | within 7 days from date of receipt of surveyor report |
Claim Payment to Insured in case of NonCashless | 30 days from the receipt of Last Document |
Give immediate written notice to the insurance company about an accident to third party.
Furnish all information and documentary evidence as the insurance company may require.
As soon as the insurance company receives intimation about the third party claim, investigation is carried out about the accident.
To collect the relevant data with the objective to quantify reasonable and just compensation, a trained investigator is appointed by the insurance company.
At the same time you should be submit claim form along with relevant documents.
On receipt of intimation form Court or MACT, a competent Advocate from the panel may be appointed.
Name of the company: Universal Sompo General Insurance Company Limited
Registered & Corporate Office: Office No. 103, 1st Floor, Ackruti Star, MIDC Central Road, Andheri (East), Mumbai 400093, Maharashtra. Tel: 02241659800/ 900
Website: www.universalsompo.com.
E-mail: contactus@universalsompo.com
Customer Service: Toll Free Numbers: 1800 22 4030 / 1800 200 4030
Note: Please note that above is the gist. Please read the policy wordings in detail
Sr No |
Products |
Final UINs with revisons |
1 |
Motor Private Car |
IRDAN134RP0004V02200708 |
2 |
Motor Two Wheeler Insurance |
IRDAN134RP0007V02200809 |
3 |
Motor Passenger Carrying Vehicle |
IRDAN134RP0008V02200809 |
4 |
Motor Goods Carrying Vehicle |
IRDAN134RP0009V02200809 |
5 |
Motor Misc. Vehicle |
IRDAN134RP0010V02200809 |
6 |
Motor Trade Insurance Policy |
IRDAN134RP0028V02200809 |
7 |
Third Party Long Term Two Wheeler Insurance Policy |
IRDAN134RP0047V01201415 |
8 |
Two Wheeler Long Term Package Policy (TWLTPP) |
IRDAN134RP0007V02201617 |
9 |
Motor Private Car - Bundled |
IRDAN134RP0001V02201819 |
10 |
Motor Two Wheeler - Bundled |
IRDAN134RP0002V02201819 |
11 |
Third Party Private Car Policy - 3 Years |
IRDAN134RP0005V01201819 |
12 |
Third Party Two Wheeler Policy - 5 Years |
IRDAN134RP0006V02201819 |
13 |
Compulsory Personal Accident (Owner-Driver) under Motor Insurance Policies |
IRDAN134RP0067V02201819 |
14 |
Stand-Alone Motor Own Damage Policy - Private Car |
IRDAN134RP0001V01201920 |
15 |
Stand-Alone Motor Own Damage Policy - Two Wheeler |
IRDAN134RP0002V01201920 |
16 |
Standalone Motor Third Party Insurance – Two Wheeler |
IRDAN134RP0001V01202122 |
17 |
Standalone Motor Third Party Insurance - Goods Carrying Vehicle |
IRDAN134RP0002V01202122 |
18 |
Standalone Motor Third Party Insurance - Passenger Carrying Vehicle |
IRDAN134RP0003V01202122 |
19 |
Standalone Motor Third Party Insurance – Miscellaneous Vehicle |
IRDAN134RP0004V01202122 |
20 |
Standalone Motor Third Party Insurance - Private Car |
IRDAN134RP0005V01202122 |
Note: Please note that above is a gist, please read the policy wordings in detail
In event of any claim arising in case of any contingency/ happening of loss, please intimate immediately to
Details of our offices can be found in the USGICL Office Locator in our Website.
Following information needs to be furnished by you while intimating a claim:
As soon as a loss is noticed, please intimate immediately to our nearest office or on our call centre number or on toll free number 1-800-22-4030 (from MTNL & BSNL Lines.) Our claims officials shall soon get in touch with you and shall be happy to help you with the claim procedures. Details of our offices can be found in the USGICL Office locator.
Following information needs to be furnished by you while intimating a claim:
As soon as a loss is noticed, please intimate immediately to our nearest office or on our call centre number or on toll free number 1-800-22-4030 (from MTNL & BSNL Lines.) Our claims officials shall soon get in touch with you and shall be happy to help you with the claim procedures. Details of our offices can be found in the USGICL Office locator.
Following information needs to be furnished by you while intimating a claim:
As soon as a loss is noticed, please intimate immediately to our nearest office or on our call centre number or on toll free number 1-800-22-4030 (from MTNL & BSNL Lines) for inland transit claims or to our Overseas worldwide Claims Settling Agent, W.K. Webster & Co. Ltd. by electronic notification of loss on their website www.wkwebster.com / "report new claim". Our claims officials shall soon get in touch with you and shall be happy to help you with the claim procedures. Details of our offices can be found in the USGICL Office locator.
Following information needs to be furnished by you while intimating a claim:
MODE | FIRST NOTIFICATION, WITHIN | FORMAL MONETARY CLAIM, WITHIN | TIME BAR |
Road | 7 days from delivery | 6 months from LR date | 3 years from LR date |
Railways | 7 days from delivery | 6 months from LR date | 3 years from LR date |
Air | 7 days for damage and 14 days for Non Delivery | Formal monetary claim on Carrier / Custodian should be filed immediately on final quantification of loss. | 3 years from LR date |
Ocean | 3 days from discharge of break bulk or receipt of delivery order for containerized cargoes | 1 year from B/L date | |
1 year from B/L date | |||
1 year from B/L date | |||
2 year from B/L date | |||
1 year from B/L date | |||
Ports | 7 days from discharge | 6 months from discharge | |
Postal | 1 month from booking for damage and 3 months for Non Delivery | 3 years from booking |
As soon as a loss is noticed, please intimate immediately to our nearest office or on our call centre number or on toll free number 1-800-22-4030 (from MTNL & BSNL Lines.) Our claims officials shall soon get in touch with you and shall be happy to help you with the claim procedures. Details of our offices can be found in the USGICL Office locator.
Following information needs to be furnished by you while intimating a claim:
As soon as a loss is noticed, please intimate immediately to our nearest office or on our call centre number or on toll free number 1-800-22-4030 (from MTNL & BSNL Lines.) Our claims officials shall soon get in touch with you and shall be happy to help you with the claim procedures. Details of our offices can be found in the USGICL Office locator.
Following information needs to be furnished by you while intimating a claim:
Please drop your query here and we will email you back
Sr.No | TPA Name | TPA Registration No. | Product Name | Location | TPA Website Link |
---|---|---|---|---|---|
1 | Health India Insurance TPA Services Private Limited | 022 | Group Health Insurance | Pan India | www.healthindiatpa.com |
2 | Vidal Health Insurance TPA Private Limited | 016 | Group Health Insurance | Pan India | www.vidalhealthtpa.com |
3 | Paramount Health Insurance Services & Insurance TPA Private Limited | 006 | Group Health Insurance | Pan India | www.paramounttpa.com |
4 | Ericson Insurance TPA Private Limited | 035 | Group Health Insurance | Pan India | www.ericsontpa.com |
5 | Family Health Plan Insurance TPA Limited | 013 | Group Health Insurance | Pan India | www.fhpl.net |
6 | MD India Health Insurance TPA Private Limited | 005 | Group Health Insurance | Pan India | www.mdindiaonline.com |
7 | Genins India Insurance TPA Private Limited | 020 | Group Health Insurance | Pan India | www.geninsindia.com |
8 | Volo Health Insurance TPA Private Limited | 018 | Group Health Insurance | Pan India | www.eastwestassist.com/home/volohealth |
9 | Medi Assist Insurance TPA Private Limited | 003 | Group Health Insurance | Pan India | www.mediassisttpa.in |
It shall be the duty of every Licensed Surveyor and Loss Assessor to investigate, manage, quantify, validate and deal with losses (whether insured or not) arising from any contingency, and report thereon to the insurer or insured, as the case may be., All Licensed Surveyors and Loss Assessors shall carry out the said work with competence, objectivity and professional integrity and strictly adhere to the code of conduct as stipulated in these Regulations.
Insurance is the subject matter of solicitation. IRDAI Registration Number - 134. CIN # U66010MH2007PLC166770.
Developed & Maintained by Universal Sompo General Insurance Co.Ltd