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

  • Cashless is available only in network hospitals of Insurer.
  • Dully filled pre-authorization form is to be submitted along with copy of cards/policy.
  • Insurer approves part of expected expenses known as Initial approval.
  • During discharge, on submission of final bill, Insurer approves final amount.
  • Care should be taken to reply to any query, if raised during the process. Unreasonable & Non medical expenses are not payable.
  • Cashless is available only in network hospitals of Insurer.
  • Dully filled pre-authorization form is to be submitted along with copy of cards/policy.
  • Insurer approves part of expected expenses known as Initial approval.
  • During discharge, on submission of final bill, Insurer approves final amount.
  • Care should be taken to reply to any query, if raised during the process. Unreasonable & Non medical expenses are not payable.
List of Documents

  • Copy of id card/Policy copy
  • Duly filled pre-auth form
  • KYC of insured
  • 1st consultation letter/Investigation reports (If Any)
Registered Address
Unit No. 401, 4th Floor, Sangam Complex, 127 Andheri Kurla Road, Andheri (East) Mumbai MH IN 400059.

Process of claim

1
Find out whether hospital is in network (https://www.universalsompo.com/cashless-hospitals)
2
Get in touch with TPA cell
3
Filled in Pre authorized form and policy details to be handed over to TPA cell
4
If a Query is raised, then it has to be replied and if satisfactory, initial approval is given
5
Details scrutinized by insurer
6
Details sent by TPA cell to Insurer.
7
During discharge, hospital TPA cell sends final bill with reports to Insurer
8
Insurer approves the final amount
9
Customer pays the difference of actual bill and approved amount(which are non approved expenses and take discharge
Retirement Plan Offer
+
-
  • Save ₹3,900/month & get
    up to ₹50 Lakhs on Retirement
    or ₹30,000 Pension/month
    CHECK NOW