How to File a Claim with Universal Sompo Health Insurance?

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      How to File a Claim with Universal Sompo Health Insurance?

      Universal Sompo General Insurance has earned a reputation for its efficient and customer-centric approach to health insurance claims. Universal Sompo stands out for its rapid response times and effective claim handling. The insurer has also developed comprehensive support systems, both online and offline, to assist policyholders through each phase of the claim filing process for all of their health insurance plans. As a policyholder of Universal Sompo health insurance, this guide aims to provide you with a detailed and easy-to-follow roadmap for navigating your claim, from initiation to completion, with ease and clarity.

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      Ways to File a Universal Sompo Health Insurance Claim

      Universal Sompo General Insurance provides two avenues for filing claims for their health insurance plans: cashless claims and reimbursement claims:

      1. Cashless Medical Insurance Claims

        The cashless claim process at Universal Sompo General Insurance is facilitated through its comprehensive network of partner hospitals. This feature allows insured individuals to undergo medical treatment without worrying about immediate payments, which is crucial during emergencies. The process is tailored for swift execution and hassle-free claim handling.

      2. Reimbursement Medical Insurance Claims

        For services received at non-network hospitals, Universal Sompo General Insurance offers an effective reimbursement claim process. After paying for their medical expenses, policyholders can reclaim these costs from the insurer. This option gives the liberty to choose from a broader spectrum of healthcare providers, catering to diverse medical requirements. The steps for reimbursement are meticulously planned to ensure smooth processing and timely settlement.

      How to File a Universal Sompo Health Insurance Claim Online with Policybazaar?

      To file a Universal Sompo medical insurance claim online, Policybazaar customers should adhere to these steps:

      Step 1: First, let the Policybazaar claim support team know about your hospitalization. Contact them at 1800-258-5881 or through email at care@policybazaar.com.

      Step 1: Inform Policybazaar's claim support team about your hospitalization as soon as possible by calling 1800-258-5881 or emailing care@policybazaar.com.

      Step 2: Log into your account on Policybazaar.com and navigate to the ‘File a New Claim’ option within the ‘Claims’ tab.

      Step 3: Select ‘Health Insurance’ and sign in using your mobile number along with the OTP/password.

      Step 4: Complete the process by following the instructions and selecting ‘File a new claim’.

      Your claim will be registered, and Policybazaar will coordinate with Universal Sompo General Insurance Company for your claim settlement.

      How to File a Claim with Universal Sompo Health Insurance?

      Navigate through the detailed steps for both cashless and reimbursement claims with Universal Sompo Health Insurance:

      1. Universal Sompo Health Insurance Cashless Claim Process:

        The procedure to file a cashless claim with Universal Sompo Health Insurance is outlined as follows:

        Informing the Insurer

        As soon as hospitalization is required, contact Universal Sompo General Insurance through their health helpline within 24 hours for emergency admissions or 48 hours before planned admissions. This initial step is crucial to activate the cashless claim process.

        Document Presentation at Hospital

        Present your Universal Sompo Health Serve Card along with a valid photo ID at the hospital's insurance/TPA desk. This is necessary for the hospital to verify your identity and insurance coverage.

        Submitting Cashless Request Form

        Fill out the 'Cashless Request Form' provided by the hospital and submit it back to the hospital's insurance helpdesk. This form is essential for the hospital to request payment authorization from Universal Sompo Health Insurance.

        Claim Processing

        The hospital will forward your Cashless Request Form to Universal Sompo Health Insurance. The insurer then assesses the claim based on policy terms and communicates the approval or denial back to both you and the hospital.

        Claim Settlement

        After treatment, the hospital sends the treatment bills to Universal Sompo Health Insurance. The insurer reviews these bills and directly settles the payment with the hospital, ensuring a hassle-free treatment experience for you.

      2. Universal Sompo Health Insurance Reimbursement Claim Process:

        The steps to initiate a reimbursement claim with Universal Sompo Health Insurance are detailed below:

        Notification to Insurer

        Immediately inform Universal Sompo Health Insurance about your hospital admission by calling their helpline or emailing them within 24 hours for emergency admissions or 48 hours before planned admissions. Prompt notification is important for a smooth claim process.

        Hospital Bill Payment and Document Collection

        After receiving treatment, settle all hospital bills and collect every relevant medical document. These documents, including bills, discharge summaries, and prescriptions, are critical for your claim.

        Claim Form Submission

        Complete the Reimbursement Claim Form and submit it along with all collected documents to Universal Sompo Health Insurance's specified office. Timely submission of these documents is key to ensuring the claim is processed without delay.

        Processing and Settlement of Claim

        Upon receiving your documents, Universal Sompo Health Insurance reviews them in line with your policy's terms and conditions. The insurer then processes the claim and communicates the outcome, following which the reimbursement is made to you.

      Documents Required to File a Universal Sompo Health Insurance Claim

      To ensure a seamless health insurance claim process with Universal Sompo Health Insurance, policyholders must submit the following documents:

      • Claim Form Duly signed
      • Copy of the claim intimation, if any
      • Hospital main bill
      • Hospital break-up bill
      • Hospital discharge summary
      • Pharmacy Bill
      • Operation Theatre Notes.
      • ECG and other Investigation reports (Including CT/MRI / USG / HPE)
      • Doctor's request for investigation
      • Doctor’s prescriptions

      FAQs

      Policybazaar exclusive benefits
      • 30 minutes claim support*(In 120+ cities)
      • Relationship manager For every customer
      • 24*7 claims assistance In 30 mins. guaranteed*
      • Instant policy issuance No medical tests*
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      Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in

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      *We will respond in the first instance within 30 minutes of the customers contacting us. 30-minute claim support service is for the purpose of giving reasonable assistance to the policyholder in pursuance of the claim. Settlement of claim (including cashless claim) is the responsibility of the insurer as per policy terms and conditions. The 30- minute claim support is subject to our operations not being impacted by a system failure or force majeure event or for reasons beyond our control. For further details, 24x7 Claims Support Helpline can be reached out at 1800-258-5881.

      *Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. Policybazaar does not provide any medical or surgical advice or diagnosis and is not responsible for your interactions / treatment by a medical practitioner/hospital. Please consult a registered medical practitioner for any medical or surgical advice. The Information that you obtain or receive from Policybazaar, and its employees, or otherwise on the Website is for informational purposes only. As per the Insurance guidelines, you are allowed to cancel the policy with-in 30 days from the date of Issuance of policy.This option is available incase of policies with a term of one year or more.

      *All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.

      **All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws. GST Exemptions depend on fulfilment of qualification criteria and submission of relevant documents.

      *₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.

      *₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases

      *₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.

      *₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.

      *No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.

      *The values taken for effective cost calculation are indicative values and may change as per the selected plan.

      *Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.

      *Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.

      *The scope of coverage may vary from plan to plan.

      ~Source: Google Review Rating available on:- http://bit.ly/3J20bXZ

      ##On ground claim assistance is available in 114 cities

      Tax Benefits are subject to changes in tax laws. GST Exemption depends on fulfilment of qualification criteria and submission of relevant documents as required by the insurers. For more details on risk factors, terms and conditions, please read the sales brochure and applicable rules and regulation carefully before concluding a sale.

      STANDARD TERMS AND CONDITIONS APPLY. For more details on risk factors, terms and conditions, please read the sales brochure carefully before concluding a sale.

      Policybazaar is a registered Composite Broker |Registration No. 742, Valid till 09/06/2024, License category- Composite Broker| Visitors are hereby informed that their information submitted on the website may be shared with insurers.

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