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FAQs on Lifeline


Questions about Lifeline Insurance Plan? Get your answers here

What are the Key Features of Lifeline Product?

Key design and service features of Lifeline are as mentioned below:
 
  • Wide range of Sum Insured – from Rs.2lacs to Rs.1.5cr
  • No upper age limit for enrolment in policy
  • Provides coverage for International Treatment for 11 specified illnesses upto Sum Insured along with return airfare upto Rs.3lacs
  • No worries in case of any Emergency Hospitalization while you are abroad during business/leisure trip
  • Access best class healthcare facilities with no capping in terms of Room Rent, disease specific sublimits, etc
  • Reload of Sum Insured – In case customer has utilized the entire sum insured, then sum insured will be automatically reloaded at no extra cost which can be used for different illness
  • Maternity Benefit including cover for New Born Baby and vaccination for new born baby
  • OPD Treatment covering the expenses incurred on doctor’s consultation, medicines, diagnostic tests, etc
  • Accelerated No Claim Bonus which helps in doubling your Sum Insured in 5 claim free year period (Supreme & Elite). In Classic, your sum insured will increase by 50%
  • Coverage not limited only to Allopathic treatment. You can also take treatment under Ayurveda, Homeopathy in case of hospitalization
  • Health check-up for insured members – irrespective of claims history
  • Health & Wellness benefits to proactively manage your health. Avail exciting offers across various services at our preferred network along with communication on latest health topics
  • Covers all day care procedures so that customer need not to worry if something is covered or not
  • Domestic Evacuation in case of emergency
  • Second Opinion for 11 specified Critical Illness
  • Cashless hospitalization across 3500+ network hospitals across India
  • Easy documentation and hassle free claim settlement
  • One sum insured covering all family members
  • Zonal Pricing depending upon the location of your stay. Pay less if you do not stay in Metro Cities and Gujarat State
  • Specified Network Hospitalization – You can further reduce your premium in certain geographies subject to specific condition
  • Hospital Cash Benefit to take care of miscellaneous expenses incurred during hospitalization
  • Top-up Plan to enhance your coverage. Choose the deductible on annual aggregate basis rather than per claim basis
Which all Plans are available under Lifeline?

Lifeline offers 3 different plans - Classic, Supreme and Elite. Sum Insured offered under these plans is as mentioned below:
 
  • Classic - Rs.2lacs, Rs.3lacs, Rs.4lacs
  • Supreme - Rs.5lacs, Rs.10lacs, Rs.15lacs, Rs.50lacs
  • Elite - Rs.25lacs, Rs.30lacs, Rs.50lacs, Rs.100lacs, Rs.150lacs

While Classic Plan offers similar benefits like other health insurance plans available in market, Supreme and Elite offer much more comprehensive coverages like Second Opinion for Critical Illness, International Treatment for 11 Critical Illness, Wordlwide Emergency Hospitalization, etc to provide a very comprehensive coverage to customer
Is Maternity benefit covered under Lifeline?

Maternity Benefit is covered in Lifeline in Elite Plan. It covers the expenses related to Maternity and also covers the New Born Baby till the next renewal. It also covers the vaccination for the new born baby in the first year. Maternity benefit is payable only when Husband and Wife both are covered under the policy after a continuous coverage of 3 years. Maternity Benefit can be claimed maximum upto 2 times.
Is OPD benefit covered under Lifeline?

OPD Treatment is covered in Lifeline in Elite Plan. OPD Treatment covers the consultation, diagnostic fees, medicines,etc. It also cover the expenses incurred on Dental OPD Treatment, Cost of Spectacles, Contact Lenses and Hearing Aids once in 2 years with a sublimit of 30% of OPD Treatment.
What is International Treatment for 11 critical illnesses in Lifeline?

If the customer is diagnosed with any of the 11 critical illnesses, customer can avail the treatment in any hospital of his choice across the world. The policy will cover the expenses incurred on the hospitalization for the treatment of the critical illness covered. It will also cover the return airfare upto Rs.3lacs of the insured person. This benefit is available on cashless basis only. Customer need to obtain a pre authorization from us by submitting the pre auth request along with diagnosis confirmed in India, before the treatment.
What is Worldwide Emergency Hospitalization benefit in Lifeline?

Worldwide Emergency hospitalization covers hospitalization expenses abroad ( out of India) subject to:
 
  • The treatment is Medically Necessary and has been certified as an Emergency by a Medical Practitioner, where such cannot be postponed until the Insured Person has returned to the India
  • Indicative conditions – what could be covered as inpatient – heart attack, stroke, major accident, paralysis, high grade fever, severe stomach ache, bleeding from nose etc
  • 2 yrs Pre-existing diseases waiting period and 2 yrs initial waiting period for 17specified diseases, and 30 day initial waiting period (except accidents) will be applicable in this benefit
  • Expenses payable shall be limited to Inpatient Hospitalization only – incase of small injuries, fractures, burns,  minor bleeding (cut on a finger not covered but if its bleeding from nose it may be covered), etc it is covered as OPD and hence not covered under policy
  • $1,000 deductible per claim
 
Overall liability will be limited to 50% of Sum Insured upto a max of Rs.20 lacs.
As Lifeline covers treatments abroad, will it also substitute for a Overseas travel insurance policy?

Lifeline covers Worldwide Emergency Hospitalization however it does not cover certain other benefits related to travel inconvenience like Passport Loss, Loss of Baggage, etc. Hence, we suggest that if a customer is travelling abroad, they should also take an oversea travel insurance policy as per their travel itinerary.

Lifeline Elite plan is a suitable offering for HNI customers who are frequently travelling or want the best of class treatment across the globe. This plan will help them to get the treatment done across the globe. 
Is Ayush treatment covered in Lifeline?

Yes, Lifeline also provide coverage for Ayush Treatment in case of Inpatient Hospitalization. Please note that OPD treatment undertaken in Ayush is not covered.
What is Organ Donor expenses? What is the sublimit in Lifeline for organ donor?

Organ Donor Expenses covers the expenses incurred on the hospitalization of the organ donor. All inpatient care expenses related to organ donor are covered, provided:
 
  • He fulfils the Transplantation of Human Organs Act,1994 and other applicable laws.
  • The organ donated is used by the insured person.
  • A claim is filed for inpatient care by the insured.

However, any other expenses related to acquisition of donor, related pre- and post-hospitalization expenses, and treatment of associated medical complications will not be covered.

Organ Donor Expenses are covered upto Sum Insured.
Please explain the Reload benefit in Lifeline? Is it same as Restore benefit of Apollo and Recharge benefit of Religare?

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 similar to Recharge benefit of Religare as it is trigerred when the claim amount exceeds the available sum insured including the NCB for a different illness or different person. In Optima Restore, sum insured is restored only when entire sum insured is exhausted (for eg, if the SI is Rs.3lacs, and initial claim was of Rs.2.5lacs, 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).
What is covered in Pre & Post hospitalization expenses? What is the limit to which its covered?

Pre Hospitalization covers the medical expenses incurred before hospitalization for Diagnostic Test, Medication, etc

Post Hospitalization covers the medical expenses incurred on follow up visit with doctor, medication, further investigative test, etc

Pre & Post Hospitalization expenses are covered upto Sum Insured.
What is Vaccination for Animal bite in Lifeline? Will it cover byte by Honey bees? are medicines & bandage covered under this for treatment?

Vaccination in case of Animal Bite covers the expenses incurred by you to take vaccination in OPD. For eg, in case of Dog Bite, you need to take Rabbies vaccination at regular interval which is an OPD procedure. Lifeline will cover the expenses incurred on vaccination upto the limit against your plan.

It does not cover the medicines, bandages or other expenses incurred while taking the vaccination.
Is Annual health check up available in Lifeline? If Yes, what all test are covered?

Lifeline offers annual health check-up for Supreme & Elite Plan and once in 2 years for Classic Plan. Health check-up is offered to all the insured above the age of 18 years irrespective of claims status. Please refer to grid below for covered medical test
 
Plan List of Medical Tests
Classic Complete Blood Count, Urine Routine, ESR, Fasting Blood Sugar, ECG, S Cholesterol, SGPT, Creatinine
Supreme Complete Blood Count, Urine Routine, ESR, Fasting Blood Sugar, Lipid Profile, Kidney Function Test,ECG, Complete physical examination be Physician
Elite Complete Blood Count, Urine Routine, ESR, Fasting Blood Sugar, Lipid Profile, Stress Test (TMT) or 2D Echo, Kidney Function Test,Complete physical examination be Physician
 
What is the coverage of ambulance in Lifeline? Does it cover the `Hearse van` expenses, if the insured dies during treatment and hospitalization is otherwise payable?

We will cover the expense incurred on an ambulance offered by a hospital or ambulance service provider for transferring you to the nearest hospital provided we accept the inpatient care claim for the given hospitalization. It is covered upto Rs.3000 in Classic, Rs.5000 in Supreme and Rs.10000 in Elite.

Expenses incurred on Hearse Van is not covered.
What are Prosthetic Implants? Are they covered in Lifeline?

Prosthetic Implants are artificial substitutes for body parts, and materials inserted into tissue for functional, cosmetic, or therapeutic purposes. Prostheses can be functional, as in the case of artificial arms and legs, or cosmetic, as in the case of an artificial eye. Implants, all surgically inserted or grafted into the body, tend to be used therapeutically.

These are covered in Lifeline.
What is 2 yrs waiting period for 17 diseases? what all diseases are not covered in this period?

There are certain conditions for which customer can wait for treatment and does not need immediate medical treatment. Lifeline has 2 years waiting period for 17 conditions as mentioned below:
 
  • Cataract
  • Stones in biliary and urinary systems
  • Hernia / Hydrocele
  • Hysterectomy for any benign disorder
  • Lumps / cysts / nodules / polyps / internal tumours
  • Gastric and Duodenal Ulcers
  • Surgery on tonsils / adenoids
  • Osteoarthrosis / Arthritis / Gout / Rheumatism / Spondylosis / Spondylitis / Intervertebral Disc Prolapse
  • Fissure / Fistula / Haemorrhoid
  • Sinusitis / Deviated Nasal Septum / Tympanoplasty / Chronic Suppurative Otitis Media
  • Benign Prostatic Hypertrophy
  • Knee/Hip Joint replacement
  • Dilatation and Curettage
  • Varicose veins
  • Dysfunctional Uterine Bleeding / Fibroids / Prolapse Uterus / Endometriosis
  • Diabetes and related complications
  • Chronic Renal Failure or end stage Renal Failure
What is the difference between Pre-existing waiting periods & Initial waiting periods?

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.
Does Lifeline price remain same throughout India?

The Premium charged on the Policy will depend on the Sum Insured, Policy Tenure, Age, Policy Type, Zone of Cover and Optional Covers opted. Additionally the health status of the individual will also be considered and premium might be loaded depending on the health condition.

For the purpose of calculating premium, the country has been divided into 2 Zones.

Zone 1: Delhi/NCR, Mumbai (inc. Thane and Vashi), Bengaluru, Chennai, Pune, Hyderabad, Kolkata and Gujarat.

Zone 2: Rest of India.

A discount of 15% for members in Zone 2 will be applicable. Grid as below:


ZONE

Discount

Zone 1

 0%

Zone 2

15%


Eg: Premium for a 35 year old for a Sum Insured of Rs.5lacs is Rs.5549 in Mumbai (Zone 1) and Rs.4717 in Nasik (Zone 2).
What is Hospital cash benefit in Lifeline? Is it optional or compulsory?

There are many out of pocket expenses like Cab charges, Attendant Food expenses, etc which are not covered under the normal Hospitalization policies. Hospital Cash pays a lump sum amount to cater to these miscellaneous expenses. We will pay for upto 30 days of hospitalization in a policy year if the stay of hospitalization is more than 2 days.

It is a optional cover and customer can opt for the Hospital Cash benefit at the time of new purchase or renewal.
What is the Top Up option in Lifeline? is it Per claim or annual aggregate? what is the difference between 2 types?

“ You can choose from one of six optional deductibles of Rs 1 lac, Rs 2 Lacs, Rs 3 lacs, Rs. 4 Lacs, Rs 5 Lacs and Rs.10 Lacs. By doing so you will receive a discount in the premium calculation of your Policy. You can choose the top up cover under Classic & Supreme variant “

If a top-up plan (on annual aggregate deductible) is chosen then the insured person shall bear all assessed claim amounts payable under the policy up to the deductible amount, under his policy for any Policy Year.  Our liability to make payment under the Policy in respect of any claim made in that Policy Year will only commence once the Deductible has been exhausted.

In case of per claim deductible, top up plan is applicable if the claim amount exceeds the deductible amount. In Lifeline, deductible is on aggregate basis and not per claims basis.
What is 2nd opinion in Critical illness in Lifeline? Can I consult any doctor of my choice and tell RS to cover these expenses for second opinion?

If you are suffering from 11 critical illnesses as mentioned below and feel uncertain about your diagnosis or wish to get a second opinion of an expert/doctor, we arrange one for free of cost for you:
 
  • Cancer of Specified Severity
  • First Heart Attack of Specified Severity
  • Open Chest CABG
  • Open Heart Replacement or Repair of Heart Valves
  • Coma of Specified Severity
  • Kidney Failure requiring Regular Dialysis
  • Stroke resulting in Permanent Symptoms
  • Major Organ/Bone Marrow Transplant
  • Permanent paralysis of Limbs
  • Motor Neurone Disease with Permanent Symptoms
  • Multiple Sclerosis with Persisting Symptoms

To avail this benefit, you need to contact us and we will arrange for the second opinion. You can choose from our empanelled doctors/hospitals. Please note that this benefit is not on reimbursement basis.
What is Domestic Evacuation benefit in Lifeline? If I am trapped in a tragedy like Kashmir Floods, will RS cover me?

If you are stuck in an emergency due to accident or illness in India, we will assist to transport you safely from one hospital to another hospital to provide a suitable medical treatment.

For eg, in case of a natural calamity like Kashmir Flood, you are rescued by Army and admitted in a hospital in one of the relief camp. Royal Sundaram will arrange for Domestiv Evacuation from this hospital to another hospital having better medical facilities for treatment.

This benefit is available for Supreme and Elite only. Any expenses beyond the limit (Rs.1lac for Supreme and Rs.3lacs for Elite) has to be paid by you.
How much No claim bonus will I get in Lifeline?

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.
What are the Medical tests / health criterion in Lifeline?

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

# - Subject to no adverse health condition.
Can a Diabetic or Hypertensive patient be given Lifeline?

If a customer with diabetes or hypertension can be offered Lifeline subject to underwriting criteria. Underwriter will evaluate the medical history and accept the case either on standard rates or with loading/co-payment.
Is new born baby covered in Lifeline?

Medical expenses incurred on the treatment of New Born Baby is covered if claim for maternity benefit (covered only under Elite Plan) is payable. New Born Baby is covered till the renewal of the policy.
Are first year vaccinations covered in Lifeline for children?

First year vaccinations for New Born Baby is covered if claim for maternity benefit (covered only under Elite Plan) is payable.
I have my wife + 2 kids + my parents in laws and an aunt in my house, can you cover all of us in Lifeline?

Lifeline allows coverage for maximum of 2 Adults and 4 Children and relationship between the insured has to be Self, Spouse and Dependent Children.

However, you can take 2 different policies of Lifeline to cover all of them.
 
  • Policy 1 – Self, Wife and 2 Kids
  • Policy 2 – Parents in Law
  • Policy 3 - Aunt
What is Doctor on Chat in Lifeline? If I have high fever, can I contact your Doctor on Chat?

Lifeline not only takes care of your medical expenses but also provide benefits which help you in proactively manage your good health. You can obtain opinion from a doctor using our Health & Wellness Program. You can email your query on fever and you will get a response within 24 working hours. Please note that this does not substitute the medical treatment you would have otherwise taken.
For Doctor on Chat is it necessary to have internet connection? I don`t have internet at home so can I chat with your doctors on Phone?

Doctor on Chat facility is through email which can be accessed through Internet either on computer or mobile phone.
Can I buy 2 yr or 3 yr policy in Lifeline? Will I not be a looser for such policies as I will block my money for 2/3 Yrs?

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.
If I have a National Insurance policy from a Bank for the last 4 yrs, will you Port me in Lifeline?

Lifeline will support the external as well as internal portability. You can port your existing policy from National Insurance subject to underwriting.
I am already having royal sundaram policy of 2 lakhs sum insured but its a old policy for the last 5 yrs, if I have to buy Lifeline can I buy additionally or can I port from existing RS policy?

You can either buy a fresh policy of Lifeline or port the existing policy.
Is Ventillator treatment covered in Lifeline?

Ventillator treatment is covered if the person is not brain dead.
Are natural calamities like Hurrican Hudhud covered in Lifeline?

Any hospitalization due to these natural calamities like Hudhud is covered.
I am covered in a Family policy taken by my father - 5 lakhs for say 3 yrs, and I meet a girl after 3 yrs who is also covered in Lifeline alongwith her father in a policy of say 10 lakhs, and if we decide to marry, how will NCB be transferred to the new Lifeline policy for me and my wife?

If 2 individual policies of Lifeline are converted into Family Floater, the NCB transferred will be the lower of the 2 policies.
I have a Piles problem and I go abroad frequently. If I start facing Piles problem when I am abroad can I claim under Lifeline?

Worldwide Emergency Hospitalization covers treatment abroad due to any emergency. Treatment of Piles is not an emergency hospitalization and customer can wait to return back to India and take treatment. Generally, Piles is under 2 year waiting period.
If I get admitted to a Suit in a Hospital will you pay me full?

Yes. There is no capping on room rent category and customer can choose from any of the room available in hospital.
In Lifeline, what all expenses in a hospital not covered in the Policy?

Expenses which are not related to hospitalization are normally not covered. Please refer to policy document for details of exclusion.
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