Royal Sundaram Insurance

Royal Sundaram Health Insurance Plan

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Royal Sundaram provides affordable health insurance plans with a comprehensive range of benefits to take care of you and your family.

Key features of Royal Sundaram Lifeline health insurance

  • Room Rent: Payable at actuals upto Sum Insured.
  • Co - pay: NIL co-pay for all treatment / 20% for Treatment abroad.
  • Restoration Benefit: Sum Insured Reload available upto 100% Base SI.

Royal Sundaram Health Insurance Review

Royal Sundaram Health Insurance
Royal Sundaram Insurance sum insured
2 lacs − 150 lacs options available
Incurred Claims Ratio *
61.00%
Royal Sundaram Insurance tenure options
1 to 3 years
Claims Settlement Ratio **
80.13%
List of network hospitals
5,000+ hospitals
Number of policies issued *
185,450
Maximum family floater coverage
Self, Spouse + 4 dependent children
Number of lives covered *
1,406,000
* As per IRDAI report for 2018-19   |   ** As per NL25 data published on the Insurance Company website
Royal Sundaram General Insurance Co. Limited (formerly known as Royal Sundaram Alliance Insurance Company Limited), is the first private sector general insurance company in India to be licensed in October 2000 by the Insurance Regulatory and Development Authority of India. The company was initially promoted as a joint venture by Sundaram Finance, one of the most respected non-banking financial institutions (NBFCs) in India and other Indian Shareholders. In February 2019, Ageas Insurance International N.V. acquired 40% equity stake in Royal Sundaram from the existing Indian Shareholders after necessary Regulatory approvals. Consequent to this divestment, the stake of Sundaram Finance in our company is currently at 50%, Ageas Insurance holds 40% and the other Indian shareholders hold the remaining 10%.

Royal Sundaram has been providing innovative general insurance solutions to individuals, families and businesses directly as well as through its intermediaries and affinity partners. The company offers Motor, Health, Personal Accident, Home and Travel Insurance to individual customers and offers specialized insurance products in fire, marine, engineering, liability and business interruption risks to commercial customers. Royal Sundaram has over 2000 employees with 150 branches across India and its products are distributed through various channels-agents, distribution partners, affinity partners, brokers and online.

Royal Sundaram offers their best India health insurance customers the option of availing quality treatment at more than 5,000+ leading hospitals across the country. With an incurred claims ratio of 61.00%, they also covered 14.06 lac lives during the same year 2018-19, as per the data provided by IRDAI.

Why Should One insure themselves through Royal Sundaram India Health and Mediclaim Insurance plans?

  • Part of ‘Sundaram’ group, one of the most trusted brand in India- RSA operates with a set of values called the ‘Sundaram Way’.
  • Royal Sundaram is one of growing Private sector General Insurance companies overall and now aggressively ventured into the Health Insurance with over 4.5 million customers as on mid 2020.
  • Cashless Hospitalization Across the Large Network With More Than 5,000+ Hospitals in India for their insured customers offering Transparent and Trusted claims service.
  • Wide Range Of Health Insurance Products From Individual Plans to Family Floater Schemes with Sum Insureds ranging from ₹2 lacs to ₹150 lacs.
  • World class Customer Centric Support through its 24X7 service centre known for transparency and ease.
  • Their Accident and Health claims process has received ISO 9001-2015 for customer service. They have also won the ‘Celent Model Insurer Asia Award’ for intelligent claims management system.
Royal Sundaram Insurance is today one of the fastest growing insurance players in India with a lot of focus on both retail and group insurance products. Today the Royal Sundaram health insurance in India premium is one of the most competitive in the market across all their plans apart from being competitive in their benefit structure. They are also one of the players who have built a strong hospital network across India with a current strength of 5,000+. Most of the customer’s Royal Sundaram health insurance reviews have been positively influencing the growth of their business year on year. One can also follow the Royal Sundaram health insurance renewal link on https://www.eindiainsurance.com/ for renewal of their existing policies and if one needs to file a claim, all they need to do is to fill in the Royal Sundaram health insurance claim form available on the same website.

Royal Sundaram Health Insurance benefits

  • Benefits
  • How to buy?
  • Claim Process
  • Exclusions

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.

Royal Sundaram Assurance Health Insurance Products

Lifeline is a holistic and comprehensive indemnity plan from Royal Sundaram that covers the health insurance needs of the insured and their family.
Family Plus is a unique health insurance plan which provides the most comprehensive health coverage to large families.

Policy can be availed by persons between the age of 18 years up to 65 years, as Proposer

Royal Sundaram Health Insurance FAQ’s

The earlier the better, typically, everyone should consider buying a health insurance policy in their early 20's and one has just started earning. Health insurance also helps in planning within a family to ensure there is financial coverage in case of an unexpected health emergency. It also offers wider coverage at a lower premium.

Looking at the healthcare inflation cost coupled with the lifestyle disease epidemic, health insurance is needed to help you pay for health care in the event of an unexpected illness or injuries. Health insurance covers medical uncertainties and ensures quality medical treatment at the time of need.

You can buy 2 years or 3 years policy in Lifeline. You get a discount of 7.5% for 2 year policy tenure and 12% for 3 year policy tenure.

Every insured person will have to answer the medical questions as mentioned in proposal form. Basis the response to those medical questions, underwriters will decide on the medical test to be undertaken.
Apart from that, every insured person will be subject to medical test as per below grid:
Age/Sum Insured Sum Insured upto Rs.5lacs Sum Insured Rs.10lacs, 15lacs & Rs.20lacs Sum Insured above Rs.20lacs
Upto 5 years No Check-up# No Check-up# No Check-up#
6 years to 18 years No Check-up# No Check-up# MER
19 years to 45 years No Check-up# CBC, ESR, URA, MER, FBS/HbA1C,S Cholesterol, ECG, SGPT, S Creatinine CBC, ESR, URA, MER, HbA1C, Lipid Profile, TMT or 2D Echo, LFT with GGT, RFT, HBsAg, S Creatinine
46 years and above CBC, ESR, URA, MER, FBS/HbA1C, S Cholesterol, ECG, SGPT, S Creatinine CBC, ESR, URA, MER, HbA1C, Lipid Profile, TMT or 2D Echo, LFT with GGT, RFT, HBsAg, S Creatinine CBC, ESR, URA, MER, HbA1C, Lipid Profile, TMT or 2D Echo, LFT with GGT, RFT, HBsAg, S Creatinine

Your ideal sum insured or total coverage would highly depend on factors such as your current age, lifestyle, medical history, income and place of residence. Looking at the medical inflation, most of our customers prefer a health insurance policy with a sum insured of 5 lacs and above.

  • Initial Waiting Period is the cooling period applied at the start of new policy. This waiting period is not applicable for renewal policy or portability policy. Only Accidents are covered in the Intial Waiting period.
  • Pre Existing Disease waiting period is the waiting period applied for any of the existing disease customer is suffering from. It might vary from 4 years in Classic to 2 years in Elite Plan. With each policy year, the pre existing disease waiting period reduces by 1 year. Any claim related to pre existing disease hospitalization will not be covered in the policy during waiting period.

If you ever exhaust your health cover due to claims in a given year and there is a further claim either by you for a different illness or your insured family member, we will reload the entire sum insured of your policy at no extra cost. Reloaded sum insured will help you to settle those claims. Reload of Sum Insured is triggered when the claim amount exceeds the available sum insured including the NCB for a different illness or different person. Restore will not be triggered for second claim (of different illness or different person) of Rs.1lac and only Rs.50,000 will be paid. Whereas, Reload will be triggered and entire Rs,1lac will be paid).

Lifeline offers 10% of Sum Insured upto a max of 50% of Sum Insured for Classic Plan and 20% of Sum Insured upto a max of 100% for Supreme and Elite plan. Unlike NCB offered by other policies, there is no penalty in case of claim. Thus NCB earned by you remains as is even if you claim. For eg, if you have a policy with SI of Rs.5lacs (Supreme Plan) and there has been no claim in the first year, then at the time of renewal you will get a NCB of 20% (Rs.1lac). In second year, if you claimed then on second renewal your NCB of Rs.1lac will remain intact and it will not be reduced.

Absolutely! With employee health cover the major drawbacks come in picture when you leave your job that's when your policy goes out of action and exposes you to health risks. Your new employer may or may not cover you sufficiently. Also, having your own policy means a better buying decision and complete control to buy a cover which suits your requirement from time to time.

Under cashless hospitalization, the insured person does not settle the hospitalization expenses at the time of discharge from hospital. The settlement is done directly by us for treatment that the insured person is eligible to receive under the terms of his/her policy. This is for your convenience. However, it is important to note here that prior approval is required from us before admission into the hospital. In some cases, you may have to pay for all or part of the treatment if it is not fully covered under the terms of the policy. However, in case of emergency hospitalization, you can obtain approval post-admission. Please note that the cashless facility is available only at our Network Hospitals.

No. There is no capping on room rent category and customer can choose from any of the room available in hospital.

Royal Sundaram has an extensive network of 5,000+ network hospitals across India growing steadily over the years. One must get admitted to a network hospital in order to avail cashless treatment for their illness. One can get the hospital closest to them by going through the Royal Sundaram network hospital list available on https://www.eindiainsurance.com/royal-sundaram/health/

There is no upper limit on the number of claims during the policy period. However, the total cumulative claim amount cannot exceed the Policy Sum Insured.

A pre-existing disease is any condition, ailment or injury or related condition(s), for which the insured person had signs or symptoms, and /or were diagnosed, and / or received medical advice / treatment within 36/48 months prior to 1st health insurance policy issued by Us under which the insured person was covered.

It refers to payment of the Medical Expenses incurred by the insured while undergoing Specified Day Care Procedures/ Treatment (as mentioned in the Day Care Surgeries list), which require less than 24 hours Hospitalization.

Individual plan has to be separate for every individual. Floater covers all in family (max. 2 Adults and Children upto 25 years and Dependent parents) and provides one sum insured to all, hence there is saving of premium.

There is No maximum exit age for this policy.

The premium paid on a health insurance policy is eligible for deduction under Section 80D of the Income Tax Act. So save with your policy now!

The duration only after which a claim can be made is called the waiting period.

Co-payment is a cost-sharing requirement under a health insurance policy, where the Policy Holder / insured will bear a specified percentage of the admissible costs

A ‘Free Look Period’ is a period of 15 days from the date of receipt of the policy that a policyholder, in this case you, have to review the entire health insurance plan. If you disagree with any of the terms or conditions mentioned in the policy, you have the option of returning the policy by stating the reasons for the objection. Following this, you are entitled to a refund of the premium paid, provided no claim has been made under this mediclaim insurance policy (subject only to a deduction of the expenses incurred by the company on medical examination and the stamp duty charges). Please note that this facility is not applicable on renewal and portability cases.

Sub limit defines the capping of insurance amount, for specific surgeries and medical procedures, which reduces the premium of the plan. You can also opt for an add on cover by paying extra premium to remove the sub- limits under the policy.

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Royal Sundaram Health Insurance useful links

How to buy online?

You can buy insurance online by using a credit/debit card, direct funds transfer using NEFT or RTGS or by using a cheque

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Network hospitals

Royal Sundaram Network hospitals list. Cashless & Hassle-free direct claim settlement with us at 5,000+ Hospitals

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Health insurance benefits

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Portability

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Keep in touch

  • Address

    InstantCover Insurance Web Aggregator Private limited
    710, 6th B Cross, 16th Main Road, Koramangala 3rd Block, Bangalore - 560 034.

  • +91-(80)-41744345
  • Send an email
CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2022
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