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Health Insurance

Process of Claim

Claim Process

Universal Sompo General Insurance

Instant Help With Emergency Claim

For any emergency claim call us on 8659986599

Steps

Navigating Claims Made Simple: Your Guide to a Hassle-Free Process.

  1.  Intimation
  2.  Availing Treatment
  3. Submition of Claim File

Intimate claim process

How to intimate health claim with Universal Sompo General Insurance

E-Mail
contactus@universalsampo.com
Claim Helpline
1800-200-4030/1800-22-4030
Click Here
Register Claim Online
Click Here
WhatsApp Insurer
91 7400446339
Click Here
Planned Treatment - At least 48 Hrs prior to hospitalization
Emergency Treatment - Within 24 Hrs of hospitalization

Details required for Registration/ Intimation of Claim

To Register claim by calling on above contact point, you will need to provide the following information to the customer support executive:-
  • Policy Number.
  • Name of the Policy holder.
  • Name of the Insured in respect of whom the claim is being made.
  • Nature of illness or Injury.
  • Name and Address of the attending Medical Practitioner and Hospital.
  • Date of Admission to Hospital or proposed date of admission to hospital for Planned Hospitalization.
  • Date of Discharge
  • Email ID
  • Approximate Claim Amount
  • Any other Information, documentation or details requested by the company.
Once the claim is registered, the customer support executive will provide you

Types of Claims

How to intimate health claim with Bajaj Allianz General Insurance

Points to Remember

  • Every claim should be intimated & file should be submitted within time, as non adherence can lead to delay in claim settlement.
  • The claim is decisioned only when all required & necessary documents are submitted.
  • NEFT & KYC details should be updated with the Insurer for easier & faster claim settlement.
  • Pre hospitalization expenses may be claimed along with main hospitalization expenses.
  • Unreasonable & Non medical expenses are not payable.
  • Every claim should be intimated & file should be submitted within time, as non adherence can lead to delay in claim settlement.
  • The claim is decisioned only when all required & necessary documents are submitted.
  • NEFT & KYC details should be updated with the Insurer for easier & faster claim settlement.
  • Pre hospitalization expenses may be claimed along with main hospitalization expenses.
  • Unreasonable & Non medical expenses are not payable.
List of Documents

  • Claim form consist of two parts (Part A to be filled by Insured and Part B to be filled by Hospital).
  • Xerox of Health Serve Card & Valid Photo ID proof of patient.
  • Original bills and receipts or prescriptions in support of any amount claimed
  • Original medical reports, Investigation reports, treatment papers, doctor reference slips
  • Original Discharge summary
  • Original Hospital Bill giving detailed break up of all expense heads mentioned in the bill
  • Original Advance or final receipts
  • NEFT Form along with Cancelled cheque for disbursement of payments through ECS
  • For accident Cases: MLC (Medico Legal Certificate) / FIR (First Information report) if available

Points to remember

  • Please retain copies of all the documents submitted 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.
Registered Address
Unit No. 401, 4th Floor, Sangam Complex, 127 Andheri Kurla Road, Andheri (East) Mumbai MH IN 400059.

Process of claim

1
The treatment is to be intimated within prescribed timelines.
2
Post completion of treatment, documents are to be collected from hospital during discharge.
3
The claim file is to be prepared with reference to check list. (The claim form part B is to be filled by hospital)
4
Post receiving of all required info, the claim will be processed within 30 days.
5
Universal sompo will inform about any deficiency within 7 days.
6
Duly filled claim forms along with all necessary documents are to be submitted within prescribed timelines.
7
If the claim is approved, amount will be transferred within 30 days.
8
If the claim is rejected, letter with details are to be shared with Insured.
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