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ROYAL SUNDARAM HEALTH INSURANCE

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Royal Sundaram Health Insurance

Overview
Royal Sundaram General Insurance Co. Ltd. (formerly known as Royal Sundaram Alliance Insurance Company Limited) is a subsidiary of Sundaram Finance. It is India’s first private sector general insurance company and earned its license on October 2000 from the IRDAI. The company provides general insurance, car insurance, travel insurance, health insurance and accident insurance. They currently have 5.20 million customers and 1700 employees in India. They are present in 125 cities across India.

Royal Sundaram Health Insurance at a Glance
  • Lifeline is the flagship health insurance product of the company
  • Cashless access to over 3000+ network hospitals
  • 181827 policies issues till date
  • Offers lifetime renewability
  • Approximately 99.16% grievances resolved.
  • The brand has an incurred claims ratio of 58.57%.
  • Claim settlement ratio of 90%.
Awards & Recognitions
  • Recognized by Celent for developing intelligent claims management system in 2014.
  • Recognized by Celent for Model Insurer Asia component in the area of Distribution/New Business in 2013.
  • Recognized by Celent for implementing a work flow enabled policy administration in 2011.
Documents needed to apply for Royal Sundaram Health Insurance
  • Age proof - (Any One)
    Driving License, Passport, Voter ID Card, Birth Certificate, etc
  • Identity proof – (Any One)
    Driving License, Passport, Voter ID card, PAN Card, Aadhar Card, or any document which proves citizenship
  • Income proof
  • Address proof – (Any One)
    Driving License, Passport and Utility Bill should clearly mention the permanent address
  • Income proof – (Any One)
    Salary Slip, Form 16, ITR
  • Recent passport size photograph
Why Royal Sundaram Health Insurance?
Here are some reasons why Royal Sundaram is the right insurance provider for you:

Sum Insured Sum insured ranging from Rs. 2 lakh toRs. 100 lakh available.
Cashless hospitalisation Royal Sundaram provides cashless access to over 3000+ network hospitals across India where you can avail cashless facility.
Claim process Royal Sundaram requests customers to inform three days prior to hospitalization so that they can start the process. Customer is required to show the Royal Sundaram health card at the hospital, while the rest will be taken care of by Royal Sundaram and the network hospital. Royal Sundaram has a claim settlement ratio of 90%.
Inpatient hospitalisation Expenses borne during hospitalization for more than 24 hours will be covered.
Pre-hospitalisation expenses Expenses borne during a specified period prior to hospitalisation for same illness is also covered.
Day Care Treatment In case the insured person needs to undertake treatment/procedures which do not require hospitalisation, the same will be covered.
Post-hospitalisation expenses Expenses borne during a specified period after to hospitalisation for same illness is also covered.
Organ Donor expenses In case the insured person donates an organ for transplantation, the treatment required will also be covered.
Domiciliary Treatment In case the insured person is unable to be hospitalised for treatment and the same treatment is then undertaken at home, the cost will be covered by the policy.
Re-load of Sum Insured In case the sum insured is exhausted due to illness during the policy term, the same will be reinstated.
No-claim Bonus Insured person gets bonus for every claim-free year upto a specified limit.

Types of Royal Sundaram Health Insurance Plans
Royal Sundaram offers insurance coverage in three variations: Individual Plans and Family Health Insurance Plans.

1: Royal SundaramLifeline Classic Health Insurance Plan- This is the star insurance plan of Royal Sundaram. It provides no-cap on room tariff and is available with 100% sum insured reload option. This is a value for money product.

2: Royal SundaramLifeline Supreme Health Insurance Plan: This plan is a variation of the flagship Lifeline Classic product and provides sum insured uptoRs. 50 Lacs. Second opinion in case of critical illness is also available.

3: Royal SundaramLifeline Elite Health Insurance Plan: This plan provides the highest sum insured available in Royal Sundaram Lifeline products. The plan also covers worldwide emergency hospitalisation and international treatment.

Royal Sundaram Health Insurance Plans

1: Royal SundaramLifeline Classic Health Insurance Plan
Entry age 918 to 65 years. Dependent child from 91st day, maximum age for child is 25 years
Type of Plan Individual / Floater
Sum Insured 2-5 Lacs
Coverage for Self, spouse and dependent children - Maximum 2 adults and up to 4 children. Upto six people covered in family floater.
Policy term 1,2,3 years

Inclusions, Benefits and Features
  • In-Patient Hospitalisation-Medical expenses for hospitalisation for more than 24 hours will be covered with no limits on room rent.
  • Pre-Hospitalisation - Expenses incurred 30 days prior to the hospitalisation.
  • Post-Hospitalisation–Expenses incurred 60 days prior to the hospitalisation.
  • Day-Care Procedures–All day care procedures covered.
  • Domiciliary Treatment
  • Organ Donor
  • AYUSH Treatment –Ayurveda, Yoga, Unani, Siddha, and Homeopathy treatment covered upto sum insured in Government hospitals and upto Rs. 20,000 in other hospitals.
  • Animate Bite Vaccination – Covered upto Rs. 2500.
  • Preventive Health Checkup–Free once a year health checkup.
  • Reload Sum Insured
  • Ambulance cover – Expenses for transferring to nearest hospital by ambulance is also covered upto Rs. 3000.
  • No-claim Bonus - 10% of sum insured limit upto50%.
  • Hospital Cash – Rs. 1000 per day available for 30 days if hospitalised for more than 2 days
2: Royal Sundaram Lifeline Supreme Health Insurance Plan
Entry age 18 to 65 years. Dependent child from 91st day, maximum age for child is 25 years
Type of Plan Individual / Floater
Sum Insured 5-50 Lacs
Coverage for Self, spouse and dependent children - Maximum 2 adults and up to 4 children. Upto six people covered in family floater.
Policy term 1,2,3 years

Inclusions, Benefits and Features
  • In-Patient Hospitalisation
  • Pre-Hospitalisation - Expenses incurred 60 days prior to the hospitalisation.
  • Post-Hospitalisation– Expenses incurred 90 days prior to the hospitalisation.
  • Day-Care Procedures
  • Domiciliary Treatment
  • Organ Donor
  • AYUSH Treatment – Covered upto Rs. 30,000 in other hospitals.
  • Animate Bite Vaccination – Covered upto Rs. 5000.
  • Preventive Health Checkup
  • Reload Sum Insured
  • Ambulance cover– Upto Rs. 5000.
  • No-claim Bonus - 20% of sum insured limit upto 100%.
  • Hospital Cash – Rs. 2000 per day available.
  • Second opinion – In case of critical illness, insured person can undertake second opinion from Royal Sundaram’s panel of medical practitioners.
  • Emergency domestic evacuation – Cover upto Rs. 1lac
  • Preventive Health and Wellness – Access to network of gymnasiums, wellness centre, OPD consultations and articles for wellness.
3: Royal Sundaram Lifeline Elite Health Insurance Plan
Entry age 18 to 65 years. Dependent child from 91st day, maximum age for child is 25 years
Type of Plan Individual / Floater
Sum Insured 25-100 Lacs
Coverage for Self, spouse and dependent children - Maximum 2 adults and up to 4 children. Upto six people covered in family floater.
Policy term 1,2,3 years

Inclusions, Benefits and Features
  • In-Patient Hospitalisation
  • Pre-Hospitalisation - Expenses incurred 60 days prior to the hospitalisation.
  • Post-Hospitalisation– Expenses incurred 180 days prior to the hospitalisation.
  • Day-Care Procedures
  • Domiciliary Treatment
  • Organ Donor
  • AYUSH Treatment – Covered upto Rs. 50,000 in other hospitals.
  • Animate Bite Vaccination – Covered upto Rs. 7500.
  • Preventive Health Checkup
  • Reload Sum Insured
  • Ambulance cover– Upto Rs. 10,000
  • No-claim Bonus – 20% of sum insured limit upto 100%.
  • Hospital Cash – Rs. 5000 per day available.
  • Second opinion
  • Emergency domestic evacuation – Cover upto Rs. 3 Lacs
  • Preventive Health and Wellness
  • Worldwide Emergency Hospitalization – Rs. 20 Lacs available. Deductible of $1000 per hospitalisation available.
  • Outpatient treatment – Covered upto Rs. 10,000
  • Maternity Cover – Available for upto 2 deliveries; Rs. 2 Lacs sum insured available for maternity for total sum insured upto Rs. 50 Lacs; Rs. 2.5 Lacs sum insured available for maternity for total sum insured above Rs. 50 Lacs.
  • Treatment Abroad–Covered in case treatment abroad is needed. Covers 11 critical illnesses.
  • New Born Baby Cover – Covered upto 25% of sum insured.
  • Vaccinations for the new born – Covered upto Rs. 10,000.
Royal Sundaram Exclusions:
  • Pre-existing medical conditions will be covered after 36 months
  • Diseases contracted within first 30 days after entry into policy will not be covered.
  • Diseases contracted within first 90 days after entry into policy will not be covered.
  • Diseases such as Cataract, Benign Prostatic Hypertrophy, Knee/Hip Replacement, Chronic Renal Failure/ End Stage Renal Failure etc., will not be covered during first two years of insurance.
  • Permanent exclusions include medical cover availed due to Addictive Conditions and Disorders, Adventure or Hazardous Sports, Ageing and Puberty, Alternative Treatment (except AYUSH), Artificial Life Maintenance, Charges for Medical Papers, Circumcision, Conflict and Disaster, Congenital Conditions, Convalescence and Rehabilitation, Cosmetic Surgery, Dental/Oral Treatment, Drugs and Dressing for OPD Treatment or Take-home use, Eyesight Treatment, Health Hydros, Nature Cure, Wellness Clinics, HIV and AIDS, Hereditary Conditions, Hospitalization for Observation or Investigative purpose only, Items of personal comfort and convenience, Psychiatric and Psychosomatic Conditions, Obesity, OPD Treatment, Preventive Care, Reproductive Medicine, Self-inflicted Injuries, Sexual problems and gender issues, Sexually Transmitted Diseases, Sleep Disorders, Speech Disorders, Stem Cell Implantation, Treatment for Alopecia, Treatment for Developmental Problems, Treatment received outside India, Unproven/Experimental Treatment, Treatment from Unrecognized Hospital or Physician, Unrelated Diagnostic, or Injury due to Unlawful Activity.
Royal Sundaram Health Insurance Renewal:
  • Sign up and log into the Royal Sundaram Insurance customer portal and choose the policy to be renewed by clicking on the relevant listed policy at https://www.royalsundaram.in/
  • Renewals can also be made offline by calling Royal Sundaram health insurance on their toll free 1860-425-0000 or by mailing or delivering the cheque for renewal to their nearest branch.
Royal Sundaram Health Insurance Claim Settlement:
Cashless Claim Reimbursement Claim
Visit a network hospital and call TPA helpline and provide Royal Sundaram membership card and other details. Insured person will need to communicate policy number, name of the Insured Person in respect of whom claim is made, nature of illness/injury and name and address of the attending hospital within 72 hours of planned hospitalization or 48 hours after discharge in case of unplanned.
Provide TPA the details of hospitalization like diagnosis, name of hospital, duration of stay in hospital, estimated expenses of hospitalization etc. via fax or email. The insured shall submit the claim form along with attending physician’s certificate duly filled and signed in all respects with the following claim documents not later than 30 days from the date of discharge.
After verification TPA will provide pre-authorization to hospital.  

Royal Sundaram Health Insurance FAQs:
1) Is maternity benefit covered under Lifeline?
Maternity benefit is provided in Elite plan. It also covers expenses for the new born baby till next renewal.

2) Is OPD benefit available in Lifeline?
Outpatient treatment is provided in Lifeline Elite and covers consultation, diagnostic fees and pharmacy costs.

3) Is annual health check-up available in Lifeline?
Annual health check-up is available every year in Supreme and Elite plan, while Classic plan holder can available the benefit once every three policy years.

4) Are prosthetic implants covered in Lifeline?
Prosthetic implants are covered in Lifeline.

5) Does lifeline price stay the same throughout India?
Premium is calculated based on Sum Insured, Policy Tenure, Age, Policy Type, Zone of Cover and Optional Covers opted. India is divided into 2 zones for the purpose of calculating premium - Zone 1: Delhi/NCR, Mumbai (inc. Thane and Vashi), Bengaluru, Chennai, Pune, Hyderabad, Kolkata and Gujarat; Zone 2: Rest of India.

6) What is domestic evacuation benefit?
In case of emergencies, like a flood, if you are rescued an put up in an Army or Government hospital, Royal Sundaram will arrange for transport and put you up in a better hospital. The emergency can be of any kind or due to illness or accident.

7) Can diabetic patients be covered in Lifeline?
If a customer with diabetes or hypertension can be offered Lifeline subject to underwriting criteria. Underwriter will evaluate the medical history and accept the case either on standard rates or with loading/co-payment.

8) Is portability available?
Lifeline supports internal and external portability. You can port from a third-party policy or another Royal Sundaram policy.

9) Is a suite in the hospital available to be covered in Lifeline ?
Yes, room rents have no limits in Lifeline.

10) Is ventilator treatment covered in Lifeline?
Ventilator treatment is available if the person is not brain-dead.