Complete Healthcare Insurance
  • Restoration Benefit
  • Second Medical Opinion
  • 3 Variants
Complete Healthcare Insurance
Network hospitals

Network hospitals

4000+

Incurred claim ratio

Incurred claim ratio

82.84%

Sum insured

Sum insured

Up to 25 Cr

No. of Plans

No. of Plans

1

Solvency Ratio

Solvency Ratio

1.7

Pan India Presence

Pan India Presence

96+

Customized Health Insurance Plan for you.

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Age of Eldest Member

Complete Healthcare Insurance

Universal Sompo Complete Healthcare Insurance is a comprehensive health insurance plan that takes care of your medical bills during the time of hospitalization. The policy enables the policyholder to buy family floater health insurance plans and add up to 5 family members and can increase the number up to 20. The Universal Sompo Complete Health Insurance Brochure can be downloaded from the link given below on this page and you can read all the unique features the policy provides.

With a healthy and reliable claims settlement ratio of 95.77%, Universal Sompo emphasizes transparency and exceptional customer service.

Features of Complete Healthcare Insurance Universal Sompo

The Universal Sompo Health Care Plan offers a multitude of advantages that ensure policyholders are well-protected against various medical expenses. Let us have a look at the features of the plan:

 

  • In-patient Hospitalization

    The policy covers expenses for hospitalization due to disease, illness, or injury during the policy period that requires an insured person's admission to a hospital as an inpatient.
  • Medical Expenses Coverage

    Complete Healthcare Insurance Universal Sompo covers medical expenses directly related to hospitalization, including room rent, boarding expenses, nursing services and many more.
  • Day Care Procedures

    The plan also covers medical expenses for any daycare procedures where the insured person undergoes a procedure or surgery as an inpatient for less than 24 hours in a hospital or standalone daycare centre.
  • Pre-Hospitalization Coverage

    The medical expenses incurred will be paid within 30 days of hospitalization, the person only has to submit all medical documents containing details about the illness and the proposed date and place of hospitalization at least 5 days before the hospitalization.
  • Post-Hospitalization Coverage

    The medical expenses incurred will be reimbursed within 60 days of hospitalization, the person only has to submit all documents at least 5 days after the hospitalization.
  • Restore Benefit

    If the base Sum Insured and No Claim Bonus (if any) are exhausted due to claims made and paid during the policy year, a Restore Sum Insured equal to 100% of the base sum insured will be automatically available for that particular policy year.
  • Cumulative Bonus

    For every claim-free year, a Cumulative Bonus of 10% of the Sum Insured is applicable and will accumulate up to 50% of the Sum Insured for up to 10 lacs of Base SI. The maximum cumulative bonus should not exceed 100% of the Inpatient Sum Insured.
  • Health Check-up

    The policy covers the reimbursement of the cost of a preventive health check-up for the insured person who was covered during the previous policy year. The coverage limits for health check-ups vary based on the Sum Insured chosen. No health check-ups up to the age of 55.

Complete Healthcare Insurance Specifications

To understand Complete Healthcare Insurance Insurance in detail, take a look at the below table:

Entry Age

Minimum 18 years, Maximum 75 years

Policy Type

Individual and Family Health Insurance

Sum Insured

10 L | 25 L | 50 L | 1 Cr | 2 Cr | 5 Cr | 10 Cr | 25 Cr

Initial Waiting Period*

30 days* Days

Renewability

Lifelong

Policy Term

1, 2, 3 years

*Initial Waiting Period is the time period between the issuance of the policy and the time it starts actively. During this period, a policyholder has to wait to avail of the benefits offered under a health insurance plan.

Read more specifications in the brochure.

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Choose Your Complete Healthcare Insurance

With wide coverage options available, Complete Healthcare Insurance Insurance Plan allows you to choose your ideal coverage as per your family’s health requirements. Take a look at the coverage under every SI option available and choose your ideal coverage:

In-patient & Out-patient coverage

Room Rent

Covered

ICU Charges

Covered

Pre-Hospitalization

Covered

Post-Hospitalization

Covered

Domiciliary Hospitalization

Covered

Daycare Treatment

Covered

OPD Charges

Covered

Coverage Terms

COVID-19 Treatment

Covered

Cataract

Covered

No Claim Bonus

Covered

Automatic Restoration

Covered

Daily Hospital Cash

Covered

Organ Donor

Covered

Maternity Cover

Not Covered

New Born Baby Cover

Not Covered

Alternative Treatments

AYUSH Treatment

Covered

IVF Treatment

Not Covered

Modern Treatment

Covered

Emergency Coverage

Ambulance

Covered

Air Ambulance

Not Covered

Compassionate Travel

Covered

Global Coverage

Not Covered

Wellness Programmes

E-Consultation

Covered

Health Check-Up

Covered

Second Medical Opinion

Covered

Vaccination

Covered

Limitations

Co-payment

Covered

Sub-limits

Covered

What is Room Rent?

The room rent limit is the maximum bed charge you can claim if you are hospitalised. Common Room categories covered under room rent are all kinds of rooms including single, private and AC rooms (except suite).

What are ICU Charges?

It is a special hospital department where patients with serious medical conditions are treated.

What is Pre Hospitalization?

Medical expenses incurred before hospitalisation of the policyholder.

What is Post Hospitalization?

Medical expenses incurred after the discharge of the policyholder from the hospital.

What is Domiciliary Hospitalization?

Domiciliary hospitalization or home care treatments are the arrangements for an insured individual due to the unavailability of medical amenities in hospitals, or in a case where an insured member can not be admitted to the hospital due to an inability. The treatment should last equal to or more than 72 hours to get financial coverage.

What is Daycare Treatment?

Treatments that can be completed within 24 hours of hospitalization like blood dialysis, cataracts, etc.

What are OPD charges?

Covers the cost of doctor consultations and prescribed medical tests that may not require hospitalization. .

What is COVID-19 Treatment?

It includes the treatment cost for COVID-19 with a confirmative diagnosis from a government-approved centre.

What is Cataract Treatment?

A common eye condition in which your vision gets blurred due to cloudy formation in your eyes.

What is a No-Claim Bonus?

For every claim-free year, insurance companies reward policyholders with an increase in the sum insured amount as a no-claim bonus or cumulative bonus on policy renewal. However, in the case of a claim, this bonus amount either lapses or is reduced by a certain percentage varying from one plan to the other.

What is Automatic Restoration?

It is a benefit in which an insurance company restores the amount of sum insured completely or up to a certain percentage after it gets fully exhausted in treatments. This restoration amount may vary from one plan to the other.

What is Daily Hospital Cash?

Daily hospital cash or Hospicash is a cash amount that you receive each day during the time of hospitalization to cover your non-medical expenses.

What is an Organ Donor Cover?

It is a cover that includes the cost of the procedure for removing the damaged or malfunctioning organs from the body. In most of the cases, the insurer pays for the hospitalization and transplant expenses for both the parties i.e. the donor and the receiver.

What is a Maternity Cover?

It refers to the cover that includes expenses for normal and c-section deliveries.

What is a New Born Baby Cover?

It takes care of the medical expenses that arise due to the hospitalisation of the newborn baby in case of any childbirth complications, medical challenges, and so on. Some of the common treatments that are covered under the newborn cover and these common treatments can vary from plan to plan:

  • Congenital anomaly (conditions since birth)
  • Acute condition
  • Chronic condition
  • Premature delivery
  • Birth asphyxia
  • Daycare treatment
What is AYUSH Treatment?

Refers to the cost of medicines and procedures used under AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) treatment.

What is IVF Treatment?

In Vitro Fertilization (IVF) is a method of assisted reproductive technology. The common expenses incurred under IVF and infertility treatments are settled or reimbursed for:

  • Full infertility
  • No fertility
  • Infertility diagnosis
  • Infertility diagnosis and limited fertility treatment
  • Medication (which may or may not include fertility drug prescriptions)
What is a Modern Treatment?

Medical treatments that demand the use of modern technology and advanced machinery such as robotic surgeries, stem cell therapy, etc.

What is an Ambulance Cover?

An ambulance is used to move the patient from home to the hospital, transfer them to another hospital, and take them for different tests outside the hospital.

What is an Air Ambulance?

Air ambulances are specially prepared planes that transfer the patient from one place to another in case of a health emergency.

What is Compassionate Travel?

Refers to the travelling expenses of a family member who’s visiting the hospital to look after the patient when the policyholder gets admitted to a hospital outside his/her residential city.

What is Global Coverage?

Any kind of medical/health emergency when you are outside of India is covered for hospitalization expenses, modern and specific treatments, etc.

What is E-Consultation?

If a policy offers e-consultation it allows policyholders to connect with a doctor for medical consultation through video chat, audio call, or chatbot.

What is a Health Checkup?

A facility where the policyholder can avail of free health check-ups after fulfilling the company's eligibility criteria. In most cases, the insured member/s gets an annual health check-up cover.

What is a Second Medical Opinion?

If the policyholder wants, they may opt for a second medical opinion wherein the policyholder can consult another doctor within the company’s network of medical practitioners.

What is Vaccination cover?

Coverage against the expenses incurred on vaccinations of either the newborn baby, for an animal bite, etc is provided by the insurance companies.

What is Co-payment?

In the co-payment clause, policyholders have to pay a preset amount (either compulsorily or voluntarily) of the hospitalisation expense on their own and the insurer will pay the rest of the medical bill amount.

What is the Sub limit?

Sub limit is a condition in which the insurer will have to pay the medical expense up to a certain percentage and the remaining amount will have to be paid by the policyholder. For instance, if your policy covers room rent for upto 20% of the sum insured, but the expense of the same is more than 25%, you will have to pay the rest amount, i.e. 5%, for your room rent.

Universal Sompo Health Insurance Network Hospital List

Universal Sompo Health Insurance Network Hospitals are present in 31 states nationwide. With a wide network of hospitals, Universal Sompo Health Insurance ensures that you are medically secured, irrespective of the city you reside in.

Universal Sompo Complete Health Exclusions

Permanent Exclusions

 

Hospitalization out of war, riot, strike, and nuclear weapons

Intentional self-injury

AIDS

Miscarriage, and Abortion

Congenital disease

Infertility and in vitro fertilization

Coverage after Waiting Period

Certain diseases and treatments are covered under this plan after a certain period. Read the details below:

Maternity and Chilborn Benefits 24 Months

Pre-existing diseases after 36 Months

Critical Illness 90 Days

Add-On Services Provided by The Universal Sompo Health Care Plan

Universal Sompo is one of the top 10 health insurance companies that provides you with multiple add-on cover options, here are some of the standout add-on options under Universal Sompo:-

  • Dial-a-Doctor

    Experience the convenience of seeking medical advice from a doctor through telephonic or online consultations.
  • Health Educational Library for People (HELP)

    Gain exclusive access to the Health Education Library for People (HELP) of the company, they provide a help desk to ask health experts questions, watch health talks, access online health guides and videos, and engage in live chat sessions.
  • Second Medical Opinion

    If the insured person requires further reassurance or alternative perspectives on the treatment, this plan offers the option to obtain a second opinion on your health condition.
  • Specialist Consultation with Follow-Up Sessions

    Avail an e-consultation with a specialist, along with two follow-up sessions.
  • Wellness Package

    Get a discount on health and wellness products and services. Take advantage of cost-saving opportunities on various wellness offerings, including fitness products, wellness consultations, spa services, and more.

Explore other Universal Sompo Health Insurance

To cater to the different medical needs of an individual & their family, Universal Sompo Health Insurance offers several Health Plans ranging from senior citizen plans to specialized plans for autistic children, to health insurance for cardiac patients, and many more.Take a look below to Universal Sompo Health Insurance plans explore more:

Individual

‘Beauty lies in the eyes of the beholder.’ - Plato This is the reason you should protect your eyes at any cost. The eyes are one of the mo...

Unique Features

  • Special Eyewear Coverage
  • Discounts on Premiums
  • Deductibles Available

Universal Sompo Eyewear Plan (Pros)

Universal Sompo Eyewear Plan
  • Fire and allied perils
  • Accidental Damage
  • Burglary including theft

Universal Sompo Eyewear Plan (Cons)

Universal Sompo Eyewear Plan
  • Damage due to mishandling
  • Defect in manufacturing
  • Replacement of the spectacles/lens

Universal Sompo Eyewear Plan (Other Benefits)

Universal Sompo Eyewear Plan
  • Spectacles
  • Lenses & Sunglasses cover
  • Cover within India & Abroad

Universal Sompo Eyewear Plan (Eligibility Criteria)

Universal Sompo Eyewear Plan
  • SI - 500 - 50000
  • Policy Term - 1 Year
  • Initial Waiting Period - Coverage from day 1
  • Plan Type - Individual/ Group

Individual and Family Health Insurance

Universal Sompo Complete Healthcare Insurance is a comprehensive health insurance plan that takes care of your medical bills during the time of hospi...

Unique Features

  • Restoration Benefit
  • Second Medical Opinion
  • 3 Variants

Complete Healthcare Insurance (Pros)

Complete Healthcare Insurance
  • E-consultations
  • Second medical opinions
  • Vaccination
  • Daily hospital cash
  • Compassionate travel

Complete Healthcare Insurance (Cons)

Complete Healthcare Insurance
  • Maternity benefit
  • Newborn baby cover
  • IVF not covered
  • Global coverage

Complete Healthcare Insurance (Other Benefits)

Complete Healthcare Insurance
  • In-patient hospitalization
  • Pre & post-hospitalization
  • Daycare procedures
  • Domiciliary care

Complete Healthcare Insurance (Eligibility Criteria)

Complete Healthcare Insurance
  • Minimum: 18 years
  • Maximum: 75 years
  • SI - 1 - 10 L
  • Initial Waiting Period - 30 Days

Universal Sompo Complete Healthcare: FAQ’s

1. What is the entry age for this insurance plan?

The minimum entry age for adults is 18 years, and the maximum entry age is 75 years. For dependent children, the minimum entry age is 91 days, and the maximum entry age is 25 years.

2. What is the minimum and maximum sum insured under this plan?

The minimum sum insured is 1 lakh rupees, and the maximum sum insured is 50 lakh rupees.

3. What is the policy period available for Universal Sompo Complete Healthcare Insurance?

The policy period options available are 1 year, 2 years, and 3 years.

4. Is there a waiting period for pre-existing diseases?

Yes, there is a waiting period of 48 months for pre-existing diseases.

5. What does the policy cover during hospitalization?

The policy covers expenses related to in-patient hospitalization, including room rent, boarding expenses, nursing services, ICU charges, medical practitioner fees, surgeries, medicines, and diagnostic procedures.

6. Does the policy cover pre and post-hospitalization expenses?

Yes, the policy covers pre-hospitalization expenses incurred within 30 days before hospitalization and post-hospitalization expenses incurred within 60 days after discharge from the hospital.

7. Are there any additional benefits offered by the policy?

Yes, the policy offers benefits such as restored sum insured, cumulative bonus, health check-up coverage, domiciliary treatment coverage, ambulance coverage, dental treatment in case of accidents, AYUSH benefit, daily cash for accompanying an insured child, vaccination coverage, and more.

8. Are there any exclusions under the Universal Sompo Complete Healthcare Insurance?

Yes, some exclusions include ongoing diagnostic expenses, obesity/weight control treatments, cosmetic or plastic surgery, hazardous or adventure sports injuries, and treatment for the temporomandibular joint.

9. What are the add-on services provided by Universal Sompo Complete Healthcare Insurance?

The add-on services include Dial-a-Doctor for telephonic or online consultations, Health Educational Library for People (HELP) for access to health experts and educational resources, second medical opinion, specialist consultation with follow-up sessions, and wellness package discounts.

10. What is the grace period of the Universal Sompo Complete Healthcare Insurance Plan?

The grace period of the Universal Sompo Complete Healthcare Insurance Plan is 30 days.

11. Does Universal Sompo Complete Healthcare Insurance provide portability?

Yes, this palm provides a portability option. The person may transfer his current health insurance policy from another firm to this one if he so chooses. Requests for such portability must be made at least 45 days prior to the expiration of the prior policy being migrated.

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