Universal Sompo General Insurance Co. Ltd.

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Dear Customer,
To get instant policy of Universal Sompo Complete Health Insurance Policy, please fill “e-proposal form” below:

Policy Details

Policy Mode*    
   
Policy Duration*   Policy Start Date *   Policy End Date *
   

Personal Details

Title*   Proposer Name*   Date of Birth*
   
       
Mobile No*   Email Id *   Gender *
   
       
Phone No   ID Type *   ID No. *
   
       
Do you have EIA No.   EIA No.   Marital Status*
 
Please enter EIA No.
 

E-KYC Information

Get your document signed digitally ?*    
       

GST Details

Inward Credit For GST Number * Yes No
GST Number *

Proposal Details

Policy Type*  
Plan Type*   Sub Category

Discounts Details





 

(Exclusive of GST)