Plan & Premium

Plan & Premium




Good health is extremely precious, and it is your duty to take measures to protect your health from all ailments, accidents, and critical medical conditions. However, health issues come unannounced, but if certain judicious measures are undertaken, the financial impact due to such health issues can be mitigated. We at Royal Sundaram have launched the Family Plus plan that offers significant health cover along with several healthcare benefits.

 

Who are covered?

 

  • Any person who is more than 18 years of age can be the proposer of the plan.
  • Proposer covering self is not mandatory.
  • Children above the age of 91 days can be covered.
  • Adults can be covered from 18 years onwards.
  • There is no restriction on maximum entry age.
  • Minimum of 2 members need to be covered in a policy. There is no restriction on the maximum number.
  • The below given relations can be offered cover in the policy.


Spouse as long as he or she continues to be married to you, Son, Daughter-in-law, Daughter, Father, Mother, Father-in-law as long as your spouse continues to be married to you, Mother-in-law as long as your spouse continues to be married to you, Grand father, Grand mother, Grand son, Grand daughter, Son-in-law, Brother, Sister, Sister-in-law, Brother-in-law, Nephew and Niece.
 

Policy Tenure:

 

Policy Tenure of 1 year, 2 years and 3 years are available. Avail 7.5% or 12% discount on premium by opting for 2 years or 3 years tenure respectively.
 

Premium Payable:

 

The Premium charged on the Policy will depend on the Sum Insured, Policy Tenure, Age, No. of Insureds, Zone of Cover and Optional Cover opted. Additionally the health status of the individual will also be considered.

 

Sum Insured Sum Insured
Individual Sum Insured Rs.2 lacs, Rs.3 lacs, Rs.5 lacs, Rs.10 lacs, Rs.15 lacs
Floater Sum Insured Rs.3 lacs, Rs.4 lacs, Rs.5 lacs, Rs.10 lacs, Rs.15 lacs, Rs.20 lacs, Rs. 25 lacs, Rs.50 lacs

 

Sum Insured is on Annual basis. Every family has to choose one base individual sum insured and a common floater sum insured. The base individual sum insured will have to be the same for all proposed persons for cover.
 

Zonal Pricing:

 

Your policy premium will vary depending on your place of residence that comes under ‘Zonal Pricing’. We have categorized insurance buyers into two zones:

Zone 1 - Delhi/NCR, Mumbai (including Thane and Vashi), Bengaluru, Chennai, Pune, Hyderabad, Kolkata and Gujarat.– 0% discount on the plan premium.

Zone 2 - Rest of India.–15% discount on the plan premium.

 

 

Product Benefits
Sum Insured (SI) INR(1) Individual Base Sum Insured 2 lacs | 3 lacs | 5 lacs | 10 lacs | 15 lacs
Floater Sum Insured 3 lacs | 4 lacs | 5 lacs | 10 lacs | 15 lacs | 20 lacs | 25 lacs | 50 lacs
BASELINE COVER(2)(3) Inpatient Care Covered up to Sum Insured
Pre And Post Hospitalisation Expenses 60/90 days, Covered upto Sum Insured
All Day Care Procedures Covered up to Sum Insured
Organ Donor Expenses Covered up to Sum Insured
OTHER BENEFITS Ambulance Cover Up to INR 4,000, per event of hospitalization for every insured member
No-Claim Bonus 20% of Base Sum Insured up to a max of 100%
Re-load of Sum Insured(4) Up to Base Sum Insured, once during the policy year
Vaccination in case of Animal Bite(5) Upto INR 5,000
Ayush Treatment(6) Government Hospitals – Covered upto Sum Insured Other Hospitals – Covered upto Rs. 30,000
Domiciliary Hospitalisation(7) Covered up to Sum Insured
Second Opinion for 11 specified CriticalIllness(8) Available Once During The Policy Year
Emergency Domestic Evacuation (Bed To Bed on Advise of Treating Doctor) Covered up to INR 100,000
HEALTH & WELLNESS Health Check - up Annual
Preventive Healthcare & Wellness(9) Available
MATERNITY BENEFITS Maternity Cover for up to 2 Deliveries(10) INR 50,000
New Born Baby Cover Base SI of mother
Vaccinations for New Born Baby in the first Year(#) Up to INR 10,000
Nutritional Allowance for Mother post discharge(11) Up to INR 10,000
CUSTOMER LEVEL OPTIONS Hospital Cash (For 30 Days in case of Hospitalisation Beyond 2 Days) INR. 2,000 per day

 

Key Notes:

 

(1) It is mandatory to choose 1 base sum insured & 1 floater sum insured. The chosen base sum insured will be same for all covered members.

 

(2) Baseline cover includes

  • 36 month waiting period for pre-existing conditions.
  • 2 year waiting period for specific 17 diseases/conditions.
  • 30 day Initial waiting period from inception.
  • Entry age for adults is 18 years onwards and children is from 91 days onwards. New born Children can be added to existing policies at renewal.
  • Zone 2 is priced 15% lower than zone 1 (For eg, if Zone 1 is priced as Rs.100, then zone 2 will be priced at Rs. 85)
  • Indicative list of day care procedures has been given in the policy document.

 

(3) Option of applying Disease specific loading or Co-pay for certain chronic diseases as a part of medical

underwriting.

 

(4) Re-load of Sum Insured - Reinstate sum insured up to base sum insured. Applicable for different illnesses. Reload will be triggered only once in a policy year and only after the base SI + Floater SI is exhausted. The reloaded SI can be jointly or severally used by all insured members, up to the available limit.

 

(5) Vaccination for Animal Bite (Post Bite Treatment) - OPD Benefit up to defined limit as part of Overall limit.

 

(6) AYUSH Treatment - Inpatient Treatment taken up in authorised Government Hospitals.

 

(7) If due to your health condition you cannot be moved to a hospital or a bed is not available in hospital, we will reimburse the medical expenses incurred for treatment taken at home as long as it involved medical treatment for a period exceeding 3 days.

 

(8) 2nd Opinion for following critical illnesses are covered: Cancer, First Heart Attack, Open Chest CABG, Open Heart Replacement or Repair of Heart Valves, Coma, Kidney Failure, Stroke, Major Organ/Bone Marrow Transplant, Permanent paralysis of Limbs, Motor Neuron Disease & Multiple Sclerosis.

 

(9) Preventive Healthcare & Wellness Benefit to offer various health related articles on your registered email Id and doctor on email chat.

 

(10) Maternity Benefit - Covers up to 2 deliveries if at least 2 adults are covered under the same policy. 24 month waiting period applies to maternity cover including all attached new born baby cover benefits.

 

(#) - Vaccinations would be covered till the next policy anniversary after which the new born baby has to be included in the policy for the coverage to continue.

 

(11) Nutrition allowance covers cost of nutritional food supplements & medicines which inter alia includes food supplements advised by medical practitioner for nutrition enriched diet viz calcium tablets, vitamins, tonics, fresh/dry fruits & vegetables to be given to mother post birth of child to recuperate. Fixed benefit payable in the form of a postdated cheque, 2 months after delivery. This is a first of its kind offering in the health insurance industry.

 

Note: Policy offers a combination of individual sum insured and floater sum insured in the same policy. Minimum 2 members need to be covered in the policy. The following relations of the proposer are allowed to be covered in the policy.

 

Spouse as long as he or she continues to be married to you, Son, Daughter-in-law, Daughter, Father, Mother, Father-in-law as long as your spouse continues to be married to you, Mother-in-law as long as your spouse continues to be married to you , Grandfather, Grandmother, Grandson, Granddaughter, Son-in-law, Brother, Sister, Sister-in-law, Brother-in-law, Nephew and Niece.