Universal Sompo Complete healthcare Policy - Benefits, Coverage, Features
Universal Sompo Health Insurance Universal Sompo Health Insurance ★ 4.4

Complete Healthcare Insurance

Comprehensive health insurance covers basic to advanced healthcare fac ...Read More

Up to 25 Cr
Sum insured
1
No. of plans
96+
Pan India presence
91.58%
Claim settlement ratio
🛡️ IRDAI Approved
4.4/5 · 2,690 reviews
🏥 4,000+ hospitals
📊 1.97 solvency ratio
91.58% claim settlement

About Complete Healthcare Insurance

A quick read on what this Universal Sompo Health Insurance plan covers and why it might be a fit for you.

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.

Plan at a glance

Eligibility, sum insured options and policy mechanics — pulled straight from the policy wording.

Entry age
Minimum 18 years, Maximum 75 years
Plan type
Individual and Family Health Insurance
Sum insured options
₹10 L, ₹25 L, ₹50 L, ₹1 L, ₹2 L, ₹5 L, ₹10 L, ₹25 L
Waiting period
30 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.

Pros & cons

A quick honest summary — the strengths and the trade-offs.

Pros

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

Cons

  • Maternity benefit
  • Newborn baby cover
  • IVF not covered
  • Global coverage

What's covered

Every CMS-driven coverage flag from the plan wording — only items with a published value render below.

Hospitalization

  • Room rent Covered
  • ICU charges Covered
  • Pre-hospitalization Covered
  • Post-hospitalization Covered
  • Domiciliary hospitalization Covered
  • Day-care treatment Covered
  • OPD charges Covered
  • Covid-19 treatment Covered
  • Cataract Covered

Bonuses & restoration

  • No-claim bonus Covered
  • Automatic restoration of SI Covered
  • Daily hospital cash Covered

Family & special care

  • Maternity cover Not covered
  • New-born baby cover Not covered
  • IVF treatment Not covered
  • AYUSH treatment Covered
  • Organ donor expenses Covered

Modern & preventive care

  • Modern treatment Covered
  • Road ambulance Covered
  • Air ambulance Not covered
  • E-consultation Covered
  • Health check-up Covered
  • Second medical opinion Covered
  • Vaccination Covered

Conditions & global

  • Co-payment Covered
  • Sub-limits Covered
  • Compassionate travel Covered
  • Global coverage Not covered

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.

Know More About Network Hospitals →

Inclusions & exclusions

What the plan pays for, and what it doesn't.

Exclusions

  • Hospitalization out of war, riot, strike, and nuclear weapons
  • Intentional self-injury
  • AIDS
  • Miscarriage, and Abortion
  • Congenital disease
  • Infertility and in vitro fertilization
  • 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

Who can buy this plan

Eligibility criteria pulled straight from the policy wording.

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

Other features & benefits

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.

Universal Sompo Complete Healthcare: FAQ’s

The 11 most-asked questions about Complete Healthcare Insurance, answered.

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.
The minimum sum insured is 1 lakh rupees, and the maximum sum insured is 50 lakh rupees.
The policy period options available are 1 year, 2 years, and 3 years.
Yes, there is a waiting period of 48 months for pre-existing diseases.
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.
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.
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.
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.
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.
The grace period of the Universal Sompo Complete Healthcare Insurance Plan is 30 days.
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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