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1. RESEARCH
OBJECTIVES
TInsurance Company Activity Analysis
• Settlement of claims.
• Policy creation.
• Underwriting.
• Rate setting
Performance evaluation based on loss,
expense, combined, investment income,
and overall accounting ratios.

2. DESIGN
RESEARCH
Design
Descriptive Research: enhancing understanding of insurance company
operations through the description of certain attributes.
Data Sources
Company Website Financial Statements (e.g., Balance Sheet, P&L), Cash Flow
Statement, and Information from Other Studies Employing Case Studies,
Qualitative and Quantitative Analyses, and Data from Other Studies
Methods Adopted
Top-down analysis involves focusing on micro variables after establishing the
macro level.

3. Underwriting
Eligibility
Who can obtain the policy?
Person between the ages of 18
and 65 years
What is the minimum and
maximum entry age?
Minimum Entry Age:
(Proposer/Adults) 18 years old;
dependent. Children's-91 days
Maximum entry age (Adult): 65
years.
The maximum entry age for
dependent children is 25 years.
Who can be covered?
Self, partner, dependent children,
mother, father, mother-in-law, and
father-in-law.
*Medical tests for people over 55
years.
Sum insured: You can choose a sum insured between 50,000 and 1,000,000 in
increments of 50,000.
Premium: It depends on how much is protected and how many family members
are covered.
The company can cancel the insurance at any time if the insured lies, doesn't tell
the company important facts, or commits fraud.
Claim Payment: The company has 30 days from the date it receives the last
document to settle or deny a claim. They may also look into the claim if they
think it's necessary.
Exclusions: The policy does not cover admissions mainly for investigation and
evaluation or for rest, cure, rehabilitation, and respite care. It also does not cover
costs related to surgery to treat obesity, costs related to cosmetic surgery, or
costs related to any treatment because of participation in adventure sports.

4. Claim Management
A "cashless facility" is a service
that an insurance company offers
to an insured person where the
insurance company pays your
network provider straight for the
treatment you receive
Claim for Payment :
Payment claims for repayment happen
when the insured person pays for their
hospital stays directly with the hospital
and then files a claim with their
insurance company to get their money
back after they leave the hospital.
Settlement of claims through a third party
administrator :
TPA should be scared as soon as a claim is made. TPA
will provide services as long as they follow the
policy's overall terms and conditions.
The TPA will handle the processing and settlement
of insurance claims without charging any cash. They
will do this in a timely manner.
REAL-TIME
ESTIMATIONS
The value of the
damages are
estimated in real-time
HIGHEST QUALITY EVIDENCE
The evidence collected is of
the highest quality and in
various kinds of media
forms,including text, audio,
photo and video
REDUCE FRAUD WITH
IMPROVED SECURITY
All evidence is stored in a high
graded security standard,
eliminating the possibility if
fraudalent
REMOTE CLAIMS
SETTLEMENT
Claims expert working
closely with customer
remotely through voice &
video communication to
complete the claim
settlement
CUSTOMER SATISFACTION
Improve customer
satisfaction via smooth and
efficient process. A great
claims experience helps to
retain clients and convert
claimants
Video Claim Settlement Process

5. Policy Processing
THE CENTRALIZED POLICY PROCESSING CENTER ENSURES SPEEDY
POLICY AND ENDORSEMENT ISSUANCE & OTHER REQUIREMENTS OF
OUR CUSTOMERS THROUGH INNOVATIVE TECHNOLOGY ENABLED
SOLUTIONS.
UNIVERSAL SOMPO HAS IMPLEMENTED NEW AGE TECHNOLOGIES
(INCLUDING ARTIFICIAL INTELLIGENCE, MACHINE AND CHATBOTS)
WHICH OFFERS CUSTOMIZED & TECH-ENABLED SOLUTIONS TO
AUTOMATE PROCESSES & OFFER SUPERIOR EXPERIENCE TO OUR
CUSTOMERS AT ALL STAGES STARTING FROM POLICY PURCHASE TO
CLAIM SETTLEMENT & HANDLING CUSTOMER QUERIES.
UNIVERSAL SOMPO HAS ALREADY LAUNCHED AI ENABLED VOICE
ASSISTANT, OFFERING REGIONAL LANGUAGE SUPPORT TO FACILITATE
CLAIM INTIMATIONS FOR FARMERS COVERED UNDER PRADHAN
MANTRI FASAL BIMA YOJANA, WHICH ENABLED HANDLING LARGE
VOLUME CLAIM INTIMATIONS WITHOUT AFFECTING THE CUSTOMER
SERVICE TO NON-CROP CUSTOMER.

6. Cashless Facility
“Cashless facility” is a facility
extended by the insurer to the
insured where the payments of the
costs of treatment undergone by
the insured are directly made to the
network provider by the insurer.
Claim settlement through Third Party
Administrator
• As soon as a claim occurs, TPA is to be intimidated.
TPA will provide services within the overall terms
and conditions of policy.
• TPA will provide with Cashless Service,processing
and settlement of claims under policy with a time
bound approach.
Claim Management
The following methods are generally used for managing claim settlement. The method chosen differs based on the type
of insurance policy.
Reimbursement Claim
Reimbursement claim is when the
expenses incurred during Hospitalization
or bills of Hospitalization are directly
settled by the Insured with the Hospital
and post discharge from Hospital claimed
by the Insured from the Insurer for
reimbursement
REAL-TIME
ESTIMATIONS
The value of the
damages are
estimated in real-time
HIGHEST QUALITY EVIDENCE
The evidence collected is of
the highest quality and in
various kinds of media
forms,including text, audio,
photo and video
REDUCE FRAUD WITH
IMPROVED SECURITY
All evidence is stored in a high
graded security standard,
eliminating the possibility if
fraudalent
REMOTE CLAIMS
SETTLEMENT
Claims expert working
closely with customer
remotely through voice &
video communication to
complete the claim
settlement
CUSTOMER SATISFACTION
Improve customer
satisfaction via smooth and
efficient process. A great
claims experience helps to
retain clients and convert
claimants
Video Claim Settlement Process

7. Product Market Mix
Health Insurance:
Universal Sompo has different types of
health insurance for people families
and groups. These goods cover things
like hospital bills, critical illnesses,
injuries from accidents and more.
Car Insurance:
The company sells both
comprehensive and third-party auto
insurance policies that protect against
damage to the insured car and third-
party claims.
Travel Insurance:
Universal Sompo has travel insurance
plans that cover things like medical
crises, trip cancellation , lost luggage
and more.
Home Insurance:
There are different types of home
insurance plans from this company
that cover both the structure of the
house and its contents against
different risks
Commercial Insurance:
Universal Sompo provides a range of
business insurance options including
liability insurance, fire insurance, ship
insurance, and engineering insurance

8. Production
Sales and distribution strategy: To sell its insurance goods, it uses a multichannel distribution strategy. To get in
touch with customers and give them the best insurance options, the company uses a mix of direct sales,
bancassurance, and agency methods.
Direct sales:
• Sales executives who work hard
to get in touch with possible
customers and offer them
insurance options.
• Has a strong online presence
and sells insurance goods on its
website and mobile app.
• Customers can then compare
plans and buy them online
whenever it's convenient for
them.
Bancassurance:
• It works with a number of India's
biggest banks to give insurance
to their customers.
• Customers can buy insurance
policies through bank branches
through the bancassurance
channel, which is how it sells its
insurance goods.
The Agency Channel:
• People all over the country can
buy its insurance through a
network of agents.
• The company gives its agents a
lot of training and help to make
sure they can give people the
best insurance options.