Health Insurance

Yes. There is a section 80 D benefit that is available for the person who is paying for the insurance policy. (Proposer)

He can avail a tax exemption of up to Rs25,000/- for the premium paid for self, spouse and children.

There is an additional Rs25,000/- for the premium paid for parents, who are aged below 60 years.

For parents aged above 60 years (senior citizens), there is an additional Rs25,000/- on offer. Thus the maximum exemption amount can go up to Rs75,000/-, depending upon the number of covered members in the family.

Yes. You can buy more than one health policy. But for the purpose of ease of administration, we will recommend that you buy one policy, with a higher sum insured, rather than multiple policies with smaller sum insureds.

For admission in Non-Network Hospital or into Network Hospital if cashless facility is not availed (Re-imbursement Claims)

• Notice of claim: Preliminary notice of claim with particulars relating to 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, should be given to the Insurer within 72 hours before admission in case of planned hospitalization, and not later than 48 hours or before discharge, in case of emergency hospitalization.
• Submission of claim: The insured shall submit the claim form along with attending physician’s certificate duly filled and signed in all respects with all the necessary claim documents not later than 30 days from the date of discharge.

The premium is calculated based on the age of the insured person, plan type / SI opted, tenure opted and the location of the proposer.

You will need to get in touch with our customer services team and share a request in writing to initiate the process. The request will be considered, subject to necessary medical underwriting process. They will guide you on the details of this process.

There is a 30 day grace period available, after the expiry date to renew the policy, with continuity benefits. However there will be no cover during this period of break in insurance. It is always advisable to renew the policy well before the date of expiry to ensure continuous coverage.

Yes. This can be done by porting the policy from one insurer to another by following the portability guidelines.

No. Medical test is generally needed only beyond the age of 45 or 50, depending upon the product / plan chosen by the customer. It may also be needed for members below this age, if they have any specific disease which needs to be medically underwritten.

Yes. The health insurance policy will be valid in all parts of India.

Health Insurance is an indemnity policy, where the insurer will pay up to the amount of claim, which can be lower than the opted sum insured. PA cover is a benefit plan where the entire sum insured is paid, in the event of a claim.

Royal Sundaram has 2 distinct products which are rich in features and benefits. Life Line and Family Plus offer very good coverage at very affordable premium rates.

The premium is calculated based on the age of the insured person, plan type / SI opted, tenure opted and the location of the proposer.

We will cover Medical Expenses for all of the below during the period of hospitalization.

• Medical Practitioners’ fees;
• Room Rent, boarding expenses;
• Intensive Care Unit charges;
• Diagnostics Procedures charges;
• Medicines, drugs and consumables;
• Nursing Charges;
• Intravenous fluids, blood transfusion, injection administration charges;
• Anesthesia, Blood, Oxygen, Operation theatre charges, surgical appliances;
• The cost of prosthetics and other devices or equipment if implanted internally during a surgical procedure.

In addition to the above our products come with a whole range of additional benefits such as,

• Pre-hospitalization Medical Expenses
• Post-hospitalization Medical Expenses
• Day Care Treatment
• Ambulance Cover
• Organ Donor Expenses
• Domiciliary Hospitalization
• No Claim Bonus
• Re-load of Sum Insured
• Ayush Treatment
• Vaccination in case of Animal Bite
• Health Checkup
• Preventive Healthcare & Wellness
• Second Opinion for Critical Illness
• Emergency Domestic Evacuation
• Worldwide Emergency Hospitalization
• International Treatment for 11 specified Critical Illness
• Maternity Benefits
• Nutritional Allowance for mother, post delivery
• New Born Cover
• Vaccination for New Born Baby
• OPD Treatment

You will need to call or write to our Customer Services and share your revised address to enable us to change the same in the policy. You can call on 1860 425 0000 or write to customer.services@royalsundaram.in

The chosen sum insured of Rs3 or Rs5 lakhs, will be available to the customer for a period of one year. The customer pays an annual premium for this. At the completion of this 1 year period, the policy will need to be renewed by paying the premium for the next block of 12 months.

Medical Expenses incurred immediately before and after the Insured Person is hospitalized, provided that:

• Such Medical Expenses are incurred for the same condition for which the Insured Person’s Hospitalization was required and;
• The In-patient Hospitalization claim for such Hospitalization is admissible by the Insurance Company.

Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the Network Provider by the insurer to the extent pre-authorization approved.

Pre-existing Disease means 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 48 months prior to the first Policy issued by the insurance company. Such PED’s will not be payable for a period of 2, 3 or 4 years depending upon the waiting period applicable in that particular plan chosen by the customer.

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.

In a family floater policy, a common sum insured can be shared by all members of a family. This is more cost effective as compared to an individual sum insured policy, where each member of the family will have a separate sum insured for him or her, which cannot be shared with other family members.

When you sign up for health insurance, one of the key questions that you are asked is whether you smoke or not. It’s important that you disclose the right state to the company while buying mediclaim insurance because that can hamper your cover and claim later. When the claims are made, the hospital reports are submitted to the insurance company and the reports make the smoking habit obvious. In a situation of non-disclosure of smoking habit, there is a good reason for insurance companies to deny the claim legally.

For people who regularly smoke, the premium of their policy is slightly on the higher side. The reason why such mediclaim policies exist is because people who smoke are more prone to the diseases. The illness caused by the habit of smoking is usually quite dangerous and often come with huge medical bills. Even the best health insurance companies understand that smoking is something one does voluntarily and they still have to cover the diseases caused due to smoking. Hence, it’s only fair for health insurance plans to have a provision of higher premiums for people who have smoked as part of their lifestyle.

In order to extensively understand the smoking provisions in the policies of Royal Sundaram and how it impacts your premium, you can call on 1860 425 0000.

Sum assured in a health insurance policy is the maximum amount that the insurance provider will cover in case of hospitalization of the policyholder. If the bill amount exceeds the sum assured, the balance amount needs to be paid by the policyholder. Sum assured is one of the key factors when one decides the policy they want to buy for their mediclaim insurance. With medical expenses only rising with time, it’s always advisable to go for best health insurance policies that offer a large sum assured value. The sum assured in a mediclaim policy directly impacts the premium you pay for it. Higher the sum assured, higher will be the premium of the policy but it will come with a lot more protection and peace of mind.

With Royal Sundaram there are number of health insurance plans to choose from with different premiums, facilities and assured sum amounts. If you’re looking for a new policy and need to discuss premiums, sum assured or any other aspect related to taking decision of your new policy, you can call 022-50061088 or simply click on ‘Get Quote’ on company’s website. You can also call 1860 425 0000 in order to revise your policy or any other help required.

When an individual signs up for a health insurance, in most cases the policy comes with a waiting period. This is the time-gap when all or certain benefits of the policy can’t be claimed by the policyholder. Mediclaim insurance has different kinds of waiting periods. They can be an initial waiting period, pre-existing condition specific or it can be disease specific too. Even in case of hospitalization of the patient in order to go under certain treatment, the mediclaim policies do not cover it if it’s in the waiting period.

The first time policy buyers are put under the initial waiting period. This usually doesn’t allow the policyholder to make claims in the first 30-90 days from the starting date of the policy. The policyholders who disclose their pre-existing conditions have a waiting period of a few years before claiming the treatment for those conditions. They can otherwise claim for the rest of the medical treatments. There are also certain diseases that are pre-mentioned in the policy that will not be covered for a specific period of time.

It’s advisable to read the documents and understand waiting periods before signing up for health insurance plans. Royal Sundaram has policies with pre-existing cover after 2/3-year waiting period. In order to understand more on the subject and receive the best health insurance, you can call 1860 425 0000.

In today’s stress filled life, life style diseases such as diabetes and high blood pressure have become very common in our country. As we age, the chances of these illness affecting us increase. Hospitalization for a period of even 7 days can be very expensive and erodes our savings. This period of admittance and treatment cost increases if we are affected by any critical illness such as cancer or kidney failure. The cost varies anywhere between Rs10 to Rs15 lakhs to treat such major life threatening diseases. Health Insurance is the only solution to protect our savings, against such unforeseen medical costs.