Universal Sompo General Insurance Network Hospitals
Find the state-wise list of network hospitals for UNIVERSAL SOMPO GENERAL INSURANCE.
Search for details of UNIVERSAL SOMPO GENERAL INSURANCE network hospitals in India.
Incorporated in the year 1938, United India Insurance Company Limited was nationalised in India in the year 1972. They are one of the leading health insurance providers in India since then. With United India Insurance Company Limited, there is a health insurance plan for every kind of customer. Listed below are the 10 types of health insurance plans that are offered by United India Insurance Company Limited.
Family Medicare: United India Insurance Company offers a floater insurance type called the Family Medicare under which all the members of the family are covered under a single plan. The sum insured can be used by all the family members including self, spouse, and dependent children. The policyholder can be between 18 and 80 years.
Family Medicare 2014: Under this policy, children between the age of 3 months and 18 years are covered if the parents have a health insurance cover with United India Insurance Company Limited. The sum insured under Family Medicare 2014 can range between Rs.2 lakhs and Rs.10 lakhs(in multiples of Rs.50,000 up to Rs.5 lakh and from Rs.5 lakh to Rs.10 lakh in multiples of Rs.1 lakh)
Gold: This policy covers hospitalisation expenses and day care procedures. This is applicable for treatment of illness and injury suffered by an insured person in India when the insurance policy is in active status. The minimum entry age for this policy is 36 years and the maximum entry age is 60 years. The sum insured under this plan can range between Rs.1 lakh to Rs.5 lakh in multiples of Rs.50,000.
Individual Mediclaim: This policy is ideal for individuals who are looking for a comprehensive health insurance cover. If the insured person is hospitalised, the insurance company will cover the medical bills up to the sum insured. This insurance plans covers expenses like hospital room expenses, medicine bills, lab test charges, OT charges, and other cardio treatments.
Platinum: This policy covers hospitalisation expenses and day care procedures. This is applicable for treatment of illnesses and injuries suffered by an insured person in India when the insurance policy is in active status. The minimum entry age for this policy is 18 years and the maximum entry age is 35 years. The sum insured under this plan can range between Rs.1 lakh to Rs.10 lakh in multiples of Rs.50,000. The main feature of this policy is that the insured person, even after attaining 35 years of age will be covered under the United India Platinum Insurance policy if the policy was renewed on a timely basis without any break.
Senior Citizen Health Insurance Plan: This health insurance policy is focused on providing financial assistance during medical emergencies to insured people aged between 61 to 80 years. Once the insured person attains 80 years of age, he/she will continue to be covered under the United India Senior Citizen Health Insurance Plan if the policy was renewed on time without any breaks. The sum insured under this plan can vary between Rs.1 lakh to Rs.3 lakh in multiples of Rs.50,000.
Super Top-up Health Insurance Plan: Under this plan, any claim made shall be payable only if the aggregate of covered hospitalisation expenses exceeds the threshold level or any amount received/receivable under any Health Insurance policy/Reimbursement scheme, whichever is higher.
Top-up Health Insurance Plan: The Policy covers expenses that are incurred in India in respect of hospitalisation during the policy period exceeding the threshold level or any amount reimbursed or reimbursable under any Health Insurance Policies/Reimbursement Scheme, whichever is higher, up to the Sum Insured stated in the policy.
UNI Criticare: This policy can be opted by anyone between 21 to 65 years of age. UNI Criticare Health Insurance Plan covers 11 critical illness which will be defined in the policy document. This policy provides for the payment of a lump sum amount if the insured person is diagnosed with any one of the critical illnesses defined during the period of the insurance for the first time.
Workmen Medicare Policy: This policy covers the hospitalisation expenses incurred on account of an accident resulting to injury of the workmen during the course of the employment. People like factory owners and contractors stand to benefit from this plan. The person opting for this insurance can choose an optional sum assured of Rs.50,000, Rs.1 lakh, or Rs.1.5 lakh.
United India Health Insurance Claim Procedure
If the insured person gets hospitalised, notice of intimation about the hospitalisation or claim should be sent to the insurer at the address mentioned in the policy document.
If it is an emergency hospitalisation, notice of intimation about the hospitalisation should be sent within 24 hours from the time of hospitalisation.
In case of reimbursement claims, the claim form with the necessary medical documents regarding the hospitalisation should be submitted to the TPA (Third-party Administrator) within 15 days from the discharge date.
In case of cashless claims, the insured person or the insured person’s representative should submit the pre-authorization cashless form to the TPA through the treating hospital. No other kinds of intimation are required if the pre-authorization form is submitted.
All claims will be paid in Indian Rupees only.
United India Insurance Company Limited cashless network hospitals
United India Insurance Company Limited has over 1,500 cashless network hospitals located across India. Their PPN network hospitals are located at Ahmedabad, Chandigarh, Chennai, Delhi, Hyderabad, Mumbai, Indore, Coimbatore, Kolkata, Bangalore, Jaipur, and Pune. Customers can walk into any of the cashless network hospitals and get treated without having to pay for the medical bill from his/her own pocket. There will be a dedicated insurance SPOC in the cashless network hospitals who will communicate with the insurance company directly and get the claim processed while the insured person is being treated. Once the claim is approved, the insured person will have to pay only for the medical expenses that weren’t covered by the insurance company.
Types of claims that are made under United India Insurance Company Limited
Cashless claims and reimbursement claims are the two types of claims that can be made with United India Insurance Company Limited. Cashless treatment claims at united india insurance are made when the insured person plans his/her hospitalisation and gets treated in one of the network hospitals. In this scenario, the insured person or his/her representative will submit the pre-authorization form to the TPA (Third-party administrator). The TPA then communicates with the insurance company on behalf of the insured person and obtains permission for cashless facility. The insured person, through TPA, will have to submit all the medical documents, receipts, doctor’s letter, and any other document requested by the insurance company. The insurance company then verifies the claim and either approves or rejects it based on the findings. If the claim is approved, the insurance company directly settles the bills with the hospital. The medical expenses that are not covered by the insurance company should be borne by the insured person.
Reimbursement claims are made when the insured person gets hospitalised in any hospital without pre-authorisation from the insurance company. The insured person pays the bill and gets discharged. Later, the insured person intimates the insurance company about the hospitalisation and submits the claim form with all the medical documents required. The insurance company verifies the documents and approves it if it is covered under the policy up to the sum insured amount. The amount is then reimbursed to the insured person.
Procedures covered under United India Health Insurance
National Health Insurance covers hospitalisation expenses like room charges, ICU charges, doctor’s fees, and lab tests. Apart from that, the insurance plan covers orthopaedic implants, pre and post-hospitalisation expenses, infra cardiac valve replacement, eye operation, nose and ear operations, tonsils operation, breast operation, skin and skin tissue treatment, tongue surgeries, radiotherapy for cancer, chemotherapy for cancer, and lithotripsy.
Exclusions under National Health Insurance
Listed below are some of the general exclusions under the health insurance plans offered by National Health Insurance:
Any pre-existing conditions diagnosed within the first 48 months after purchasing the policy
Any disease contracted by the Insured person during the first 30 days from the commencement date of the policy
Dental treatment that does not require hospitalisation
Cost of spectacles, contact lenses and hearing aids
Hormone replacement therapy
Genetic disorders and stem cell implantation/surgery
Home visit charges
Infertility, subfertility, and assisted conception procedure
Psychiatric and psychosomatic disorders
Treatment for sexually transmitted diseases like AIDS
Treatment for diseases caused by use of alcohol or drugs
Treatment that is required due to self-inflicted injury or due to a suicide attempt will not be covered.
When will I be able to renew my insurance policy?
The insurance policy can be renewed only before 30 days before the expiry date.
Why am I not able to renew my insurance policy?
If you do not get renew option for your insurance policy it is either because you have made claims in the past or one of the insured person is more than 60 years or has some adverse medical history and your case is sent for approval.
Will I be able to renew my expired policy online?
No. Expired policies cannot be renewed online. There is a 30 days grace period that is available but the policy can be renewed only through an agent or directly in the insurance office.
How do I get a refund if I made a duplicate payment and my bank account is debited twice?
Note down the details such as the transaction ID, date of transaction, transaction amount, and name of the payer.
Email these details to: email@example.com
The refund process will be initiated within 5 working days
How do I cancel the health insurance policy online?
You can cancel policies numbers starting with 311101/011101 online by sending a cancellation request email to firstname.lastname@example.org.
Will I receive hard copies of my health insurance policy?
No hard copies of health insurance policy will be sent. The policy document will be sent to the registered Email ID.
What do I do if I have not received my health card?
If you have not received your health card within 20 days from the policy purchase date, send the policy document you received via email along scanned photos of the insured person to email@example.com.
What is waiting period?
Waiting period is the timeframe mentioned in the policy document within which no claims will be entertained.
What are the payment options available?
You can make the payment through internet banking, debit card, credit card, and IMPS.
How can I make corrections to my policy?
Corrections can be made to policies purchased online. If your policy number starts with 311101 or 011101, corrections will be taken care by our online support team if you send an email to firstname.lastname@example.org. If your policy starts with any other digits, corrections can be made at the respective branch.