Claim Process - Universal Sompo General Insurance

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

How to intimate health claim with Universal Sompo General Insurance

Planned Treatment - At least 48 Hrs prior to hospitalization
Emergency Treatment - Within 24 Hrs of hospitalization
E-Mail
healthserve@universalsompo.com
Claim Helpline
1800-200-5142
Nearest Branch

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:-
  • Your Contact Numbers
  • Policy Number and Membership ID number (as reflecting on the Health Card)
  • Name of Insured person who is Sick or Injured,
  • Nature of Sickness / Accident,
  • Date & Time of Loss in case of accident, commencement date of symptom of disease in case of sickness,
  • Location of Loss,
  • Place & contact details of the Insured Person.
Once the claim is registered, the customer support executive will provide you

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.
Courier Address
Universal Sompo General Insurance Company Limited Health Claims Management Office 5thFloor,Assotech One C-20/1 A, Block- C Sector- 62, Noida Uttar Pradesh, Pincode:201309




List of Documents

List of claim submission documents are as below

  • 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.

Process of Claim

01
The treatment is to be intimated within prescribed timelines.
02
Post completion of treatment, documents are to be collected from hospital during discharge.
03
The claim file is to be prepared with reference to check list. (The claim form part B is to be filled by hospital)
06
Post receiving of all required info, the claim will be processed within 30 days.
05
Universal sompo will inform about any deficiency within 7 days.
04
Duly filled claim forms along with all necessary documents are to be submitted within prescribed timelines.
07
If the claim is approved, amount will be transferred within 30 days.
08
If the claim is rejected, letter with details are to be shared with Insured.
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