Benefits under Royal Sundaram Health Insurance plans include:
Some of the benefits under the Royal Sundaram Health insurance are below…
- Cashless facility – Royal Sundaram processes all cashless claims across 5,000 + quality hospitals in their network across India.
- 200 Day Care procedures covered which are listed in the policy kit - Medical/Technology advancements have helped in conducting important surgeries and treatments in less than 24 hours, and this policy covers the listed day care procedures.
- Hospitalisation expenses : Coverage for room rental expenses up to the sum insured for most of their plans. Pre and post hospitalisation expenses are covered up to the sum insured, 30 days prior and 180 days post hospitalisation depending on the plan opted for.
- Inpatient Treatment Covered expenses include: Hospital room rent, Boarding expenses and doctor fees, Operation Theatre and Intensive Care charges, Nursing expenses and Medicines that you consume during the hospital stay.
- Cumulative bonus for every claim free years up to 100% of the base sum insured..
- Sum Insured Reload at No Extra Cost : This benefit recharges your exhausted health cover to treat the next hospitalization of a new illness or injury, the recharge is upto 100% of the Sum insured..
- Pre-existing cover after 3 year waiting period.
- AYUSH cover under the plan.
- Lifelong Renewability : Royal Sundaram assures you renewability for life without any extra loadings based on the claims.
- Worldwide Emergency Hospitalization-Excluding US and Canada under specific plans.
- International Treatment abroad for specified 11 critical illnesses Excluding US and Canada under specific plans.
- Income Tax Exemption under section 80D if the Income Tax Act.
How can one Buy a Royal Sundaram Health Insurance policy online?
There are many distribution channels that distribute Royal Sundaram Health insurance products that include Agents, Banks and Brokers. One of the key distributors is the Web Aggregators which are online distributors of insurance and the advantage is that they offer a comparison of all insurance products to the customer, to allow them to compare the plans before opting for a health insurance plan that most suits his/her needs.
- Step 1- Visit a product comparison website https://www.eindiainsurance.com/ to review and compare policy benefits, coverage and premium details online.
- Step 2 - Seek information and clarity on the charges, inclusions, exclusions, other terms and conditions under the policy.
- Step 3 - Fill the Royal Sundaram online Health Insurance proposal form stating your personal details and health profile while ensuring the information given is complete and accurate.
- Step 4 – If this is a Straight through proposal, the premium remitted online will be transferred directly to the insurance company, and the policy will be issued, dispatched and will reach you in 7 working days.
- Step 5 – For Non Straight through cases, Royal Sundaram will process the application forwarded to them. Based on the information provided, one may be required to undergo pre-policy tests at designated diagnostic centers or they may just levy a loading based on the health report.
- Step 6 - If the proposal is accepted, the same will be issued accordingly..
- Step 7 - The Policy Schedule, Policy Wordings, Cashless Cards and Health Guide will be sent to the insured’s mailing address mentioned on the proposal form in the prescribed Turn around time.
Claim Process for Royal Sundaram health insurance
You can contact Royal Sundaram Insurance through :
- 24 x 7 Toll Free : 1860-425-0000
- Email: customer.services@royalsundaram.in
| Cashless Hospitalisation |
| Step 1 |
For any planned hospitalization, kindly intimate to TPA and seek cashless authorization atleast 72 hours prior to the start of the hospitalization. |
| Step 2 |
For any emergency hospitalization, inform TPA within 48 hours of the hospitalization. |
| Step 3 |
TPA will check your coverage as per the eligibility and send a cashless authorization letter to the hospital within 3 hours post receipt of complete documents. In case there is any deficiency in the documents sent, the same will be communicated to the hospital within 3 hours of receipt of documents. |
| Step 4 |
Please pay the non medical and expenses which are not covered to the hospital prior to the discharge. |
| Step 5 |
In case the ailment/treatment is not covered under the policy, a rejection letter would be sent to the hospital Within 2 hours. |
Contact Details of Service Provider:
The following 4 benefits are serviced through the below mentioned service provider:
- Second opinion for critical illness.
- Emergency domestic evacuation.
- Worldwide Emergency Hospitalization.
- International Treatment for 11 specified Critical Illness.
Europ Assistance India Pvt Ltd
Star Hub Building No. 2, 7THFloor, Near ITC Maratha Hotel,
Sahar, Andheri East, Mumbai – 400 059
24 hour dedicated landline number is +91-22-67872035
Email: royalsundaram@europ-assistance.in
Cashless claims will be serviced by one of the following TPAs (please refer policy schedule):
Paramount Health Services & Insurance TPA Pvt.Ltd.
Plot No A 442, Road no:28, MIDC Industrial Area,
Wagle Estate, Ram Nagar, Thane West - 400 604
Contact details:+91-22-66444600
Toll Free Help Line Number:1800 22 6655
Medi Assist Insurance TPA Private Limited
IBC Knowledge Park, 4th Floor, Tower D, Bannerghatta Road,
Bangalore 560 029
Toll Free Number :1800 419 1172
Email: royalsundaram@mediassist.in
| Reimbursement Claims Process |
| Step 1 |
In case of hospitalization notify Royal Sundaram within 24-48 hours of your admission in our network or non network hospital. After getting admitted settle bills directly to the hospital.
|
| Step 2 |
On discharge, please ensure you collect all relevant documents, invoices, medical reports and discharge certificate from the Hospital in originals. |
| Step 3 |
Send these documents and the completely filled and signed claim form to us along with your valid ID proof and age proof. The claim form is available on the company website and in your policy document kit as well. |
| Step 4 |
We review your claim request and the supporting documents provided along with the claim form. Accordingly based on policy terms & conditions, Royal Sundaram will approve, query or reject the same. |
| Step 5 |
Subject to the claim being approved, Royal Sundaram will settle the claim (as per policy terms & conditions) and reimburse the approved amount to the insured. |
List of documents needed for registering claim
- Duly filled and signed claim form with Royal Sundaram policy number Claim Form.
- Original discharge summary.
- Original final bill with detailed breakup, payment receipt and,original pharmacy invoices supported by prescriptions.
- Original investigation reports (eg. blood reports, X-Ray, etc).
- Implant sticker/invoice, if used (eg. for stent in angioplasty, lens cataract, etc.).
- In cases of accident, Medico Legal Certificate (MLC) or FIR.
- Other relevant documents, if any.
- NEFT details for payment: Cancelled cheque in the name of the proposer or passbook copy attested by bank 6) For all claims amounting to 1 lakh and above: KYC form along with photocopy of any one KYC document (eg. aadhar card, passport, driving license, voter ID, etc).
- For all claims amounting to ₹1 lac and above: KYC form along with photocopy of any one KYC document (eg. aadhar card, passport, driving license, voter ID, etc) KYC Form.
Exclusions Under the Royal Sundaram health insurance
For certain medical conditions, Royal Sundaram will not be liable to pay any claim under the Lifeline Classic health insurance plan. Here is the illustrative list of Exclusions that are not covered under the policy:
- Pre-existing medical conditions as mentioned in the policy and declared by the insured at the time of purchasing policy will be covered only after 48 months of uninterrupted policy coverage. Claims are void if there is any gap in policy renewal.
- Diseases contracted by the insured person within first 30 days after the commencement of policy are excluded from claims.
- Diseases such as Cataract, Benign Prostatic Hypertrophy, Knee/Hip Replacement, Chronic Renal Failure/ End Stage Renal Failure etc., will not be covered during the 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.
