Royal Sundaram Individual Health Insurance

Licensed in 2001, Royal Sundaram Alliance Insurance Company Limited is the first general insurance company of the private sector in India. Royal Sundaram General Insurance provides health, motor, personal accident, and other products to individual customers. Royal Sundaram also provides specially developed products to small and medium firms and rural customers.

From basic Individual health insurance coverage to a specialist, Royal Sundaram Health Insurance offers a wide range of health insurance plans that include maternity benefits and an option to automatically recharge the sum assured every policy year even if a claim is made.

Royal Sundaram policies offer comprehensive coverage with a range of benefits including worldwide coverage, critical illness cover, no capping on room rent, 100% reload benefit, no claim bonus guarantee, and many more. Policies are best suited for family floater options. However, individuals and young couples can also enter the policy at an early age to maximize benefits.

Overview of Royal Sundaram Alliance Insurance

Royal Sundaram Alliance Insurance Co. Ltd., India’s first private insurance company (promoted by Sundaram Finance and RSA) commenced operations in the year 2001. It has evolved tremendously over the years to become a leading performer in the Indian insurance industry.

Their product portfolio includes various product lines ranging from auto to home insurance on the personal front and from fire to engineering to liability insurance on the corporate front.

Royal Sundaram was responsible for introducing many innovative services/offerings that have become the norm for most insurance companies today e.g. cashless claims processes, cash allowances for hospitalization, and value-add partnerships with top organizations to expand market reach.

Their efforts have led them to build a customer base of over 5 million customers, who are offered excellent customer service via a multi-channel distribution network of institutional tie-ups, agents, brokers, etc. The presence of the company is felt in more than 180 cities across the nation.

As part of its health insurance segment, the company provides the following health insurance plans:

1. Royal Sundaram Lifeline Health Insurance

2. Royal Sundaram Family Plus Health Plan

3. Royal Sundaram Hospital Cash Insurance Plan

4. Royal Sundaram Budget Health Insurance, Aarogya Sanjeevani Plan

5. Royal Sundaram Personal Accident Plan

6. Royal Sundaram Smart Cash Plan

Royal Sundaram Health Insurance Highlights

• Cashless Hospitals: 11,800 +
  
  
• Covid-19 Coverage: Yes
  
  
• Policy Renewability: Lifelong
  
  
• Grievances Solved: 99.74%
  
  
• Waiting Period for Pre-existing Disease: 3 years
  
  
• Covid-19 Coverage: All Plans
  
  
• Incurred Claims Ratio: 80.41%
  
  
• Minimum Age of Entry: 91 days (children) and 18 years (adults)
  
  
• Maximum Age of Entry: 25 years (children) and No limit (adults)

Types of Royal Sundaram Health Insurance Policies

1. Royal Sundaram Lifeline Plan

This is one of the most comprehensive indemnity schemes, covering individuals and their immediate families. The plan comes in three variants with a sum assured ranging from less than INR 2 lakh to INR 1.50 crore.

Key Features of Royal Sundaram Individual Health

There are three types of Lifeline plans:

Types of Plans	Classic Plan	Supreme Plan	Elite Plan
Sum Insured (SI)	Starting from Rs 2 lakh to Rs 4 lakh.	Starting from Rs 5 lakh to Rs 1 crore	Starting from Rs 25 lakh to Rs 1.50 crore
No claim bonus	10% up to 50% of Sum Insured for every claim-free year	20% up to 100% of Sum Insured for every claim-free year	20% up to 100% of Sum Insured for every claim free year
Pre-and post- hospitalization expenditures	30 and 60 days	60 and 90 days	60 and 180 days
Ambulance coverage	Up to Rs 3,000	Up to Rs 5,000	Up to Rs 10,000
Vaccination in case of an animal bite	Up to Rs 2,500	Up to Rs 5,000	Up to Rs 7,500
Worldwide emergency hospitalization coverage	NA	NA	50% of the Sum Insured, maximum up to Rs 20 lakh
OPD treatment	NA	NA	Up to Rs 10,000
Second opinion	NA	Yes	Yes
Critical illness cover	NA	Yes	Yes
International treatment of 11 listed critical Illnesses	NA	NA	Covered up to Sum Insured, airfare coverage up to Rs 3 lakh

Other Features

• Coverage of all inpatient hospitalization expenditures like room charges, operation theater charges, doctor’s fees and many more.
  
  
• There is no capping on room rent and no sub-limits on diseases.
  
  
• Free yearly health check-ups.
  
  
• Coverage of all-day care procedures.
  
  
• Coverage for organ donor charges.
  
  
• Treatment expenses are covered for home care treatment.
  
  
• 100% of the sum assured can be reinstated in case of complete exhaustion of the coverage amount.
  
  
• AYUSH treatment coverage costs up to Rs 50,000.
  
  
• Facility to get insured treatment across international borders and US and Canada can be added to Elite Plan at an extra premium cost.
  
  
• Maternity cover for up to two deliveries and newborn-specific coverage are available in the Elite plan only.

Other Optional Covers For Supreme And Elite Plans:

• Optional covers hospital daily cash and several top-up plans.
  
  
• Facility to book private cabs as ambulance coverage.
  
  
• The insured can refill the sum assured once in the lifetime.
  
  
• Coverage for pre-existing disease in case of a fatal condition.
  
  
• Coverage for bariatric surgery.
  
  
• Coverage for outpatient treatment costs such as doctor’s consultations, pharmacy costs, and diagnostic test costs.
  
  
• Get a second opinion for in-network doctors for 22 critical illnesses.
  
  
• Coverage for in-vitro fertilization (IVF) treatment is available only in the Elite plan.

2. Royal Sundaram Family Plus Health Insurance Plan

Family Plus is a health insurance scheme that desires to provide comprehensive coverage at a low cost. The policy is specially designed for large families and covers up to 19 relations. It provides a special benefit where each insured member of the family will have an individual sum insured apart from the floater sum insured. It includes several offerings like maternity and newborn benefit, reload benefits, no claim bonuses, and no restriction of entry age.

Key Features

• A rare combination of personal and floater sum assured in the same plan.
  
  
• Sum Insured for Individuals: Starting from Rs 2 lakh to Rs 15 lakh.
  
  
• Sum Insured for the floater: Starting from Rs 3 lakh up to Rs 50 lakh.
  
  
• At least two members must be covered, with no limitation on the maximum number.
  
  
• Coverage for pre-hospitalization and post-hospitalization expenditures for 60 and 90 days respectively.
  
  
• Coverage for the treatment of organ donors and daycare procedures up to the sum insured amount.
  
  
• Costs related to vaccination due to animal bites are covered up to INR 5,000.
  
  
• Get a second opinion on the diagnosis and treatment of 11 serious diseases.
  
  
• No claim bonus which adds 20% additional sum insured for each claim-free year.
  
  
• Maternity coverage for two births, only if two adults are covered under the same family floater scheme.
  
  
• Maternity cover will also include newborn baby cover and vaccination for newborns in the first year.
  
  
• Offers nutritional allowance for mother post-discharge after delivery.
  
  
• AYUSH treatment expenditures are covered by up to Rs 30,000.
  
  
• Rs 2,000 Hospital cash per day for 30 days, if the insured is hospitalized for more than two days.
  
  
• Avail a discount of 15% for non-metro cities.

3. Royal Sundaram Hospital Cash Insurance Plan

Hospital cash plan is the most suitable way of supplementing the regular health plan with daily cash benefits. It covers all your expenses which are incurred during hospitalization such as charges for a patient’s diet, baby food, money spent on commuting from home to the hospital and back, and mobile or internet charges, among others. It may be noted that Royal Sundaram is the first private insurance business in India to invent products like Hospital Cash.

Key Features

• Coverage for self, spouse, dependent parents, and dependent children, who are aged between 1 year to 65 years.
  
  
• Offers daily cash benefit for the following conditions:
  • In case of emergency admission, a triple cash benefit is applicable if the insured is admitted to ICU.
  • In case of the accident, a double cash benefit is applicable, if admitted due to the accident.
  • Medical treatment If the cause for hospitalization is covered under the plan.

4. Royal Sundaram Budget Health Insurance, Aarogya Sanjeevani Plan

This policy is a basic health insurance policy that provides decent coverage at affordable rates. With Royal Sundaram, one can obtain this scheme of Rs 1 lakh up to Rs 5 lakh coverage at relatively low-cost premium rates.

Key Features

• From Rs 1 lac to Rs 5 lacs sum insured.
  
  
• Coverage for hospital costs.
  
  
• Room rent and nursing expenses are covered up to 2% of the sum insured, a maximum of INR 5,000/day.
  
  
• ICU and ambulance charges are covered up to 5% of the sum insured, a maximum of INR 10,000/day.
  
  
• AYUSH treatment coverage.
  
  
• Coverage for cataract treatment expenses is subject to a limit of 25% of the sum insured or INR 40,000, whichever is less.
  
  
• Coverage for medical expenditures for 30 days prior to the insured’s admission and 60 days after dismissal.
  
  
• Coverage for advanced and modern treatments like laser or robotic surgery.
  
  
• Facility to increase coverage by 5% post every year without a claim.
  
  
• Each claim is subject to a co-payment of 5% of claims.

5. Royal Sundaram Personal Accident Plan

The personal accident policy by Royal Sundaram Insurance provides financial help in case of accidental death and total or partial disablement arising out of accidental injuries.

Key Features

Coverage includes for:

• In case of accidental death, the entire sum insured amount is paid to the nominee of the insured.
  
  
• For permanent total disability, the whole sum assured is paid to the insured.
  
  
• If the insured individual is partly disabled, then a specific percentage of the sum insured is paid to the insured individual.
  
  
• Compensation is paid in terms of weekly income benefit up to 100 weeks in case of temporary total disability.
  
  
• Hospitalization expenditures up to 10% of the sum insured.
  
  
• Education fund of 10% of the sum insured for each child.

6. Royal Sundaram Smart Cash Plan

The Smart Cash Plan offered by the Company takes care of your daily expenses incurred in transportation, food, patient attendance, guest accommodation, etc. This is a daily cash benefit plan. The plan is particularly designed to cover your out-of-pocket expenses in treating injuries or illnesses. The Smart Cash plan has three types – Silver, Gold, and Platinum.

The Smart Cash Plan comes with a host of attractive features and benefits such as tax benefits, hospitalization benefits, emergency flight ticket reimbursement, and a grace period of 30 days to name a few. The plan provides cover for Hospitalization, ICU charges, Join Hospitalization, Critical Illnesses, Guest expenses, Childbirth, Travel expenses, Food expenses, and expenditures incurred in Urgent Family Member visits. This is an individual plan, but you can include children, spouses, parents, dependents, and self under this plan. Also, it provides cover for maternity and childbirth-related expenditures.

The minimum age of entry required for the Smart Cash Scheme is 91 days. The maximum entry age for the same is 70 years (applicable for Gold and Platinum variants). No maximum entry age is applicable for Silver Smart Cash policyholders. The maximum sum insured under this plan varies between Silver, Gold, and Platinum. No exit age is applicable for this plan.

What is Covered under Royal Sundaram Health Plans?

• In-patient hospitalization expenses
  
  
• Pre-and-post hospitalization expenditures
  
  
• All day care processes
  
  
• Domiciliary hospitalization costs
  
  
• Ambulance costs
  
  
• Yearly health check-up
  
  
• AYUSH treatment expenditures
  
  
• Vaccination in case of animal bite
  
  
• Newborn and Maternity cover

What is not covered under Royal Sundaram Health Plans?

• Dental treatment expenses.
  
  
• Injuries or death due to dangerous or adventurous sports.
  
  
• Self-injuries due to suicide attempts.
  
  
• Diseases arising from alcohol and drug abuse.
  
  
• Cosmetic surgery excluding reconstructive surgery for accidents and burns.

Filling a Claim for Royal Sundaram Health Insurance Policy

CASE 1: In case of a cashless claim, the insured is admitted directly to a network hospital, the listed hospital will send the insured individual’s documents and bills to the insurance company, and then the claim will be recompensed directly with them. For cashless claim settlement under Royal Sundaram Health Insurance Schemes, follow these steps –

• Find the nearest network hospital.
  
  
• Inform the insurance company at least 48 hours in advance in case of planned hospitalization and within 48 hours in case of emergency hospitalization.
  
  
• The insured must fill and submit a pre-authorization claim form at the insurance desk of the hospital.
  
  
• After the final evaluation of the claimant’s request, the insured gives final approval.
  
  
• Process and settle your claim.

CASE 2: In the case of a compensation claim, where the insured seeks treatment from a non-network hospital, the procedure for filing the claim is as follows:

• The insured is required to pay the expenses and bills and then file a reimbursement claim by informing the insurance company.
  
  
• After reporting the claim, the buyer needs to fill out the pre-authorization claim form available at the hospital and upload the relevant documents mentioned below to initiate the claim settlement procedure.
  
  
• Once the insurance company obtains the claim form and the needed documents, they proceed to start the claim settlement procedure and transfer the reimbursement amount straight to the registered bank account of the insured.

Documents Required for Claim Reimbursement

• Duly filled claim form with the signature of the applicant.
  
  
• Valid ID proof like PAN card, Aadhar card, passport, voter ID, and driving license.
  
  
• Prescription of a doctor advising diagnostic tests, hospitalization, and medicines.
  
  
• Medicine bills, case papers, discharge summaries, and ambulance receipts.
  
  
• Insurance policy showing the name, address, disease, and other information of the insured.

Buy Health Insurance Online

Health insurance policies provided by Royal Sundaram Health Insurance can be bought online via the official website of the company. You can get an instant quote on your chosen policy in a couple of minutes. Health insurance plans can be bought online without the hassle of the physical documentation procedure. Following are the guidelines for buying health insurance online:

• Visit the Royal Sundaram Health Insurance portal and check out the different benefits and features of the health insurance plans provided by the company.
  
  
• Choose a policy and click on the ‘Buy Now’ tab.
  
  
• Enter information regarding the insured member, the sum insured, and his/her dependents.
  
  
• Select the term of the policy, which is usually 1 or 2 years.
  
  
• You can use the online premium calculator to calculate the premium of your selected health insurance plan.
  
  
• Make a note of the instant quote.
  
  
• Click on ‘Proceed’ to buy a health insurance plan.
  
  
• Use a credit card, net banking, or debit card to pay the insurance premium online via the insurance company’s website.
  
  
• Policy documents will be mailed to your email id after successfully completing the premium payment.
  
  
• The health insurance plan becomes effective after the completion of the payment.
  
  
• Print policy documents to maintain a hard copy of your health insurance plan for future reference.

Royal Sundaram Health Insurance Renewal

Renew your health insurance plan prior to the expiry date. If you fail to renew on or prior to the due date, renew it within the grace period to avoid policy lapse and loss of policy benefits. Royal Sundaram Health Insurance plans can be renewed online via the insurance company’s website. Enter the policy number and expiry date to receive your renewal notification. Pay renewal premium online with a credit card, net banking, or debit card.

Royal Sundaram Health Insurance Policy Status

To review their health insurance policy status, registered customers can log in to the Royal Sundaram Health Insurance website with their valid credentials.

Royal Sundaram Health Insurance Contact Number

• Customer Service helpdesk number of Royal Sundaram Health Insurance is 1860 425 0000.
  
  
• For policy-related queries, you can mail to [email protected].
  
  
• You can also make service requests like requesting a policy copy or policy cancellation by submitting an online form on the company’s website. You will obtain a reply within 2 business days.
  
  
• The customer can submit a call-back request on the company’s website through a ‘Call Back’ option and the insurance agent will contact you back to resolve your question.
  
  
• Complaints can be registered on the company website.
  
  
• Claims can be reported over the phone or through the insurance company’s website.
  
  
• A customer can join a live chat with an insurance agent regarding health insurance schemes on the insurance company’s website.

FAQs for Royal Sundaram Health Insurance