Royal Sundaram Health Insurance

Royal Sundaram Health Insurance offers pocket-friendly health insurance plans with a variety of benefits offering the best care to you and your family members. The plans offered are flexible and gives you an option to choose your sum insured as per your capability.

Lifeline Health Insurance Plans

• This is a type of health insurance plan that can be bought as an individual as well as family floater plan for your spouse, self and children. There are total 3 variants offered by the Royal Sundaram Lifeline Health Insurance Plans. Let’s have a look at the features of each of these plans.

Supreme Lifeline Health Insurance

• This plan is offered as both individual as well as family floater health insurance plan.

Elite Lifeline Health Insurance

• This plan is offered as both individual as well as family floater health insurance plan.

Royal Smart Cash Plan Insurance

• This plan offers a regular health cover wherein a certain amount is made available for 24 hours of hospitalization. This amount could be utilized for travel expenses, accommodation of the attendant and related expenses.

The features of Royal Sundaram Health Insurance are mentioned below:

• No. of members - The plan covers maximum 5 members of your family
• Lifelong Renewal – The plans offered are lifelong renewable, hence it saves you from the financial burden and stress caused by a medical emergency and keeps you well prepared to handle any situation.
• Room Rent – The room rent of 2% of the sum insured is applicable for Non ICU & 4% of sum insured on ICU
• Pre & Post hospitalization cover - The plan covers medical expenses for 30 days prior to hospitalization and 60 days post hospitalization only for related medical expenses.
• Health Check-ups – On successful completion of 4 claim-free years, the health check-up expenses are reimbursed subject to a maximum of Rs.750 per insured person
• Pre-existing diseases - Pre-existing diseases are covered after 3 years of waiting period.
• Co-payment - The plan has no co-payment policy.

The benefits of buying Royal Sundaram Insurance are mentioned below:

• Discounts: Royal Sundaram Health Insurance (रॉयल सुंदरम हेल्थ इन्शुरन्स) provides a discount of 7.5% or 12% if you opt for a 2 years and 3 years plans respectively.
• Coverage: Offers coverage to maximum 5 family members
• Cashless facility: Offers cashless facility with a wide Royal Sundaram Network Hospitals of 3000 + empaneled hospitals across the country
• Flexibility: Offers flexibility to make the premium payments via Netbanking, Debit/Credit card etc. as per your convenience
• Cumulative Bonus – Offers cumulative bonus if you have don’t make a claim each year. This bonus ranges from 5% up to 50%
• Mediclaim settlement: Offers quick and hassle-free claim settlement services
• Reload- Offers 100% reload free of cost
• Tax benefits: Section 80C and 10(10D) under the Income Tax Act, provides tax benefits for premiums paid regularly.
• Incurred Claim Settlement Ratio: The incurred claim settlement ratio of Royal Sundaram Health Insurance for F.Y. 2021 - 22 is 90.22%.

There are two ways to make claim under a Health Insurance Policy:

a.) Cashless basis

b.) Reimbursement basis

In simple terms, for making a claim on cashless basis, the treatment must be done only at a network hospital of the insurance company servicing your policy. For availing the treatment, you would have to first seek an authorization as per the procedures laid down and in the prescribed form.

In case of claims on reimbursement basis, the insurance company has to be informed as per their prescribed procedures. The policyholder has to ensure that documents such as claim form, discharge summary, prescriptions and bills to be submitted for the claim on reimbursement are obtained after hospitalization.

Royal Sundaram Health Insurance has a well-defined claim processing system.

Important details required for claim intimation

• Health Insurance Policy number
• Phone no., email id, address, landmark etc. of the insured/claimant
• Name of Insured/claimant who is admitted in the hospital
• Relationship of insured with the person who is hospitalized.
• Name of the hospital
• Nature of ailment (For health claims)
• Nature of accident, date, time and location of the incident (For accident cases)
• Commencement date of the symptom of ailment

Contact details for Claim intimation

The contact details for successful, quick and hassle-frees claim settlement are mentioned below:

• 24 x 7 Toll Free: 1800-425-6645
• Email: customer.services@royalsundaram.in
• Health Claims Department , Royal Sundaram General Insurance Co Ltd, Vishranthi Melaram Towers, No.2/319, Rajiv Gandhi Salai (OMR) Karapakkam, Chennai – 600097
• Contact details of Service Provider: Europ Assistance India Pvt Ltd, 301, C Wing, Business Square, Andheri Kurla Road, Chakala, Andheri (East), Mumbai – 400093, Contact No: +91-22-67872035 Email: rsalifeline@europ-assistance.in

Claim Process - Cashless Service (For Domestic Claims)

• In case of a planned hospitalization, kindly intimate the TPA. It is important to seek cashless authorization at least 72 hours prior to hospitalization.
• In case of any emergency hospitalization, it is important to inform TPA within 24 hours of the hospitalization.
• Fill in the cashless authorization form within 3 hours given by the TPA post checking your coverage. Your eligibility for the claim too would be verified. Attach your documents and send the form within 3 hours back to the TPA. The TPA would get in touch with you within 4 hours of your receipt of the documents in case of a deficiency
• Immediately make the payment of the non-medical charges and expenses which are not covered to the hospital prior to the discharge
• You would receive a rejection letter within 2 hours in case your ailment or treatment is not covered under the health insurance plan

Claim Procedure for Cashless facility (for Worldwide Emergency Hospitalization)

• Inform the service provider within 24 hours of hospitalization.
• Your eligibility as per the request made would be verified by the Service Provider and you will receive a call for more information or details, if required.
• The Service Provider will get in touch with the hospital immediately in case the pre-authorization request has been approved or denied.
• In case of approval of the pre-authorization request, your bill will be settled directly with the hospital by the service provider.
• Any additional charges approved by the service provider would be paid by the insured

Claim Procedure for Reimbursement

• The claim form duly filled and signed needs to be sent to the Royal Sundaram Health Insurance within 30 days from the date of discharge
• In case of any discrepancy in the documents/information submitted by you, you will receive a deficiency letter within 7 days from the date of receipt of the documents from Royal Sundaram Health Insurance
• If there is no deficiency of the received documents, Royal Sundaram Health Insurance would make the payment of your admissible amount within 30 days as per the policy terms and conditions
• The payment will be made in the name of the proposer.
• You need to send across the Claim documents to: Health Claims Department , Royal Sundaram General Insurance Co Ltd, Vishranthi Melaram Towers, No.2/319, Rajiv Gandhi Salai (OMR) Karapakkam, Chennai – 600097

Claim Procedure for International Treatment for 11 specified Critical Illnesses

• The insured should immediately inform the service provider post diagnosis of a Specified Critical Illness. The same needs to be informed also before travelling overseas for the treatment. You may call on the helpline number specified in the Schedule of Insurance Certificate requesting for a pre-authorization for the treatment.
• Your eligibility as per the request made would be verified by the Service Provider and you will receive a call for more information or details, if required.
• The Service Provider will get in touch with the hospital immediately in case the pre-authorization request has been approved or denied.
• In case of approval of the pre-authorization request, your bill will be settled directly with the hospital by the service provider.
• Any additional charges approved by the service provider would be paid by the insured

In case of any emergencies, you need to inform Royal Sundaram Health Insurance within 24 hours of the admission. In case of planned emergencies, the notification has to reach the company 48 hours prior to the hospitalization.

Note: If you are a Coverfox customer, you can directly reach out to us for all your claim-related issues and queries.

Royal Sundaram Health Insurance offers an array of reasonably priced health insurance policies. Their plans are made-to-measure to shield you against your mounting financial responsibilities towards your family during and after hospitalization and medical treatments. They boast of a very good claim settlement ratio amongst other private insurers. Their continuous efforts to offer excellent customer service is their ultimate performance. Royal Sundaram General Insurance Company was one of the first private insurance company to tie up with banks to sell their retail products.

Hence, if you are scouting for an insurer who will deliver dependability, competence and brilliant post sales services in consort with the products specific to your requirements, Royal Sundaram Health Insurance (रॉयल सुंदरम हेल्थ इन्शुरन्स) is a won over alternative.