Individual Health Insurance and Family Floater Plan

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About Lifeline

About Lifeline – Individual and Family Health Insurance Plan

Lifeline is a holistic indemnity plan from Royal Sundaram that covers the health insurance needs of you and your family.

Any individual above 18 years of age can purchase Lifeline. Lifeline is offered as an Individual plan and as a Family Floater plan for yourself, your spouse and children.

Who Can Be Covered ?

Any person who is more than 18 years of age can be the proposer of the plan.

Policy will cover the applicant, spouse and up to four dependent children aged between 91 days and 25 years.

There is no restriction on maximum entry age.

Lifeline Key Benefits

Key Benefits of Lifeline Plans

Royal Sundaram offers affordable medical insurance plans with a wide range of benefits to take care of you and your family.

Reload Sum Insured

100% Reload of Sum Insured at no extra cost

No Room Rent Capping

No Room Rent Capping or Disease Specific Limits

Double Your Sum Insured

Double Your Sum Insured in 5 claim free years with No Claim Bonus

This Health Insurance covers Ayush treatment & vaccination for animal bite

Coverages

Covers Ayush Treatment as well as vaccination in case of Animal Bite

Lifeline Brouchers

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Lifeline

Lifeline
Classic

Lifeline
Supreme

Lifeline
Elite

Policy Terms and Conditions

We request you to carefully read and understand the Terms and Conditions, before you buy the Policy. All claims are processed strictly according to it. Please speak or chat with our Customer Support Team, if you need any clarification.

Lifeline Plan Comparision

Lifeline Health Insurance Plan Comparison

These coverages are designed to enhance the level of protection offered in the basic cover.

Compare	Classic	Supreme	Elite
Sum Insured(SI) in Rs	2, 3, 4 lakh	5, 10, 15, 20, 50 lacs	25, 30, 50, 100, 150 lacs

Baseline Cover Benefits

Inpatient Care	Covered up to SI	Covered up to SI	Covered up to SI
Pre and post hospitalization expenses	30/60 days, Covered upto SI	60/90 days, Covered upto SI	60/180 days, Covered upto SI
All Day care procedures	Covered up to SI	Covered up to SI	Covered up to SI
Ambulance Cover	Up to Rs.3,000	Up to Rs.5,000	Up to Rs.10,000
Organ Donor Expenses	Covered upto SI	Covered upto SI	Covered upto SI

Other Benefits

Domiciliary Hospitalization	Covered upto SI	Covered upto SI	Covered upto SI
No Claim Bonus	10% of Base SI upto a max of 50% of SI	20% of Base SI upto a max of 100% of SI	20% of Base SI upto a max of 100% of SI
Re-load of Sum Insured	Upto Base SI	Upto Base SI	Upto Base SI
Ayush Treatment	Government Hospitals - Covered upto SI; Other Hospitals - Covered upto Rs.20,000	Government Hospitals - Covered upto SI; Other Hospitals - Covered upto Rs.30,000	Government Hospitals - Covered upto SI; Other Hospitals - Covered upto Rs.50,000
Vaccination in case of Animal Bite	Upto Rs.2,500	Upto Rs.5,000	Upto Rs.7,500
Emergency Domestic Evacuation (Bed to Bed on advise of treating doctor)	Not Covered	Covered upto Rs.1lac	Covered upto Rs.3lacs
Worldwide Emergency Hospitalization-Excluding US and Canada	Not Covered	Not Covered	50% of Base SI upto max of Rs.20lacs; Deductible of $1,000 per hospitalization
International Treatment abroad for specified 11 critical illnesses Excluding US and Canada	Not Covered	Not Covered	Covered upto SI Return Airfare covered upto Rs.3 lac

Health & Wellness Benefits

Health Check-up	Available once every 3rd policy year	Annual	Annual
Preventive Healthcare & Wellness	Available	Available	Available
Second Opinion for 11 specified Critical Illness	Not Covered	Available once during the policy year	Available once during the policy year
OPD Treatment	Not Covered	Not Covered	Upto Rs.10,000

Maternity Benefits

Maternity cover for up to 2 deliveries	Not Covered	Not Covered	For SI upto Rs.50lacs - Rs.2lacs For SI > Rs.50lacs - Rs.2.5lacs
New Born Baby Cover	Not Covered	Not Covered	25% of SI
Vaccinations for new born baby in the first year	Not Covered	Not Covered	Covered upto 10,000

Optional Benefits

Top-up plan on annual aggregate basis	Deductible of Rs.1, 2, 3, 4, 5 and 10 lacs	Deductible of Rs.1, 2, 3, 4, 5 and 10 lacs	Not Available
Hosptial Cash (for 30 days in case of hospitalization beyond 2 days)	Rs.1,000/day	Rs.2,000/day	Rs.5,000/day
Option to inlcude US and Canada for Worldwide Emergency Hospitalization and International Treatment for 11 specified Critical Illness	Not Available	Not Available	Available

Lifeline Coverages

Coverages

Lifeline comes with very useful features to cater to the different needs of our customers. Please find below the different features and benefits available under the Classic, Supreme and Elite plans.

Lifeline Classic

Lifeline Supreme

Lifeline Elite

Covered
Not Covered

If you are looking for a Comprehensive Health Insurance Plan for you and your family at an affordable price, then Lifeline Classic is the most suitable plan for you.

Any individual above 18 years of age can purchase Lifeline. Lifeline is offered as an Individual plan and as a Family Floater plan for self, spouse and children.

Cover Options:

Lifeline Classic caters to the health insurance needs of people looking for an affordable health insurance plan. This plan comes with sum insured options of Rs. 2 lacs, Rs. 3 lacs, and Rs. 4 lacs.

Key Benefits:

Lifeline Classic offers an array of benefits along with significant health cover for certain illnesses, medical conditions, and critical health situations.

Here are the list of key benefits covered and exclusions voided in the Lifeline Classic plan.

Lifeline Classic comes with the below key benefits:

Inpatient Hospitalization expenses
Pre and Post-hospitalization expenses amortized up to the amount of sum insured for 30 days and 60 days respectively
Coverage of all day care procedures up to the sum insured amount.
Ambulance cover up to Rs.3,000.
Expenses for Treatment of Organ Donor covered up to the sum insured.
Domiciliary hospitalization charges covered up to the sum insured.
No-claim bonus (NCB) starts from 10% of the sum insured and extends up to 50%. NCB is not reduced, even when a claim is filed during a particular year.
100% Reload of sum insured during the treatment of different illnesses in the event of complete exhaustion of sum insured and NCB.
AYUSH Treatment - Inpatient hospitalization cover up to Sum Insured in Government Hospitals and up to Rs.20,000 in other hospitals.
Covers Vaccination in case of animal bite up to Rs.2,500.
Provision of complete health check-up available once every 3rd policy year.
Preventive Healthcare and Wellness.

For certain medical conditions, the company will not be liable to pay any claim under the Lifeline Classic health insurance plan. Here is the illustrative list of Exclusions that are not covered under the policy:

Pre-existing medical conditions as mentioned in the policy and declared by the insured at the time of purchasing policy will be covered only after 48 months of uninterrupted policy coverage. Claims are void if there is any gap in policy renewal.
Diseases contracted by the insured person within first 30 days after the commencement of policy are excluded from claims.
Diseases such as Cataract, Benign Prostatic Hypertrophy, Knee/Hip Replacement, Chronic Renal Failure/ End Stage Renal Failure etc., will not be covered during the first two years of insurance.
Permanent exclusions include medical cover availed due to Addictive Conditions and Disorders, Adventure or Hazardous Sports, Ageing and Puberty, Alternative Treatment (except AYUSH), Artificial Life Maintenance, Charges for Medical Papers, Circumcision, Conflict and Disaster, Congenital Conditions, Convalescence and Rehabilitation, Cosmetic Surgery, Dental/Oral Treatment, Drugs and Dressing for OPD Treatment or Take-home use, Eyesight Treatment, Health Hydros, Nature Cure, Wellness Clinics, HIV and AIDS, Hereditary Conditions, Hospitalization for Observation or Investigative purpose only, Items of personal comfort and convenience, Psychiatric and Psychosomatic Conditions, Obesity, OPD Treatment, Preventive Care, Reproductive Medicine, Self-inflicted Injuries, Sexual problems and gender issues, Sexually Transmitted Diseases, Sleep Disorders, Speech Disorders, Stem Cell Implantation, Treatment for Alopecia, Treatment for Developmental Problems, Treatment received outside India, Unproven/Experimental Treatment, Treatment from Unrecognized Hospital or Physician, Unrelated Diagnostic, or Injury due to Unlawful Activity.

Covered
Not Covered

If you are looking for the Best Health Insurance Plan to cover yourself and your family, then Lifeline Supreme is the most suitable plan providing Comprehensive coverage including Health & Wellness benefits, Annual Health Check-up, Second Opinion for Critical Illness and much more!

Any individual above 18 years of age can purchase Lifeline. Lifeline is offered as an Individual plan and as a Family Floater plan for self, spouse and children.

Cover Options:

We have created this policy to offer substantial health cover along with additional healthcare benefits to cover treatment of severe health conditions and/or critical illness.

This plan comes with Sum Insured options of Rs. 5 Lacs, 10 Lacs, 15 Lacs, 20 Lacs and 50 Lacs.

Key Benefits:

This distinct insurance plan will take care of the medical treatment for critical illnesses, severe medical conditions, or any other serious health condition.

Here is a list of features that are covered and exclusions that are devoid of any cover.

Here are the key benefits offered by Lifeline Supreme plan.

Inpatient hospitalization expenses up to Sum Insured.
Pre and post-hospitalization expenses repayment up to the amount of sum insured for 60 and 90 days, respectively.
All day-care procedures up to the sum insured amount.
Ambulance cover of up to Rs. 5,000.
Coverage for the treatment of organ donor up to the amount of sum insured.
Domiciliary hospitalization expenses covered up to the sum insured amount.
No-claim bonus (NCB) starts from 20% of the sum insured and extends up to 100%. No reduction in NCB, even when a claim is filed during a particular year.
100% Re-load of sum insured in case the total sum insured and NCB is completely exhausted.
AYUSH Treatment - Inpatient hospitalization cover of the amount up to the sum insured in government hospitals and up to Rs. 30,000 in other hospitals.
Vaccination in case of animal bite - Expenses up to Rs. 5,000 covered
Annual health check-ups for every member more than 18 years old, irrespective of claim.
Second opinion for diagnosis and treatment of 11 specified critical illnesses.
Emergency domestic evacuation cover of up to Rs. 1 lac.

Royal Sundaram will not settle claims for treatment of certain medical conditions under the Lifeline Supreme health insurance plan. Following are the indicative list of exclusions under the policy:

Pre-existing medical conditions described in the policy and declared by the insured at the time of purchase will avail cover only after 36 months of continuous policy coverage. No claims will be settled if there is any gap in renewal of policy.
Diseases that are contracted by the insured person within first 30 days after the commencement of policy will not be considered for claims.
Critical Illness that are contracted by the insured person within first 90 days after the commencement of policy will not be considered for claims.
Diseases such as Cataract, Benign Prostatic Hypertrophy, Knee/Hip Replacement, Chronic Renal Failure/ End Stage Renal Failure etc., will not be covered during first two years of insurance.
Permanent exclusions include medical cover availed due to Addictive Conditions and Disorders, Adventure or Hazardous Sports, Ageing and Puberty, Alternative Treatment (except AYUSH), Artificial Life Maintenance, Charges for Medical Papers, Circumcision, Conflict and Disaster, Congenital Conditions, Convalescence and Rehabilitation, Cosmetic Surgery, Dental/Oral Treatment, Drugs and Dressing for OPD Treatment or Take-home use, Eyesight Treatment, Health Hydros, Nature Cure, Wellness Clinics, HIV and AIDS, Hereditary Conditions, Hospitalization for Observation or Investigative purpose only, Items of personal comfort and convenience, Psychiatric and Psychosomatic Conditions, Obesity, OPD Treatment, Preventive Care, Reproductive Medicine, Self-inflicted Injuries, Sexual problems and gender issues, Sexually Transmitted Diseases, Sleep Disorders, Speech Disorders, Stem Cell Implantation, Treatment for Alopecia, Treatment for Developmental Problems, Treatment received outside India, Unproven/Experimental Treatment, Treatment from Unrecognized Hospital or Physician, Unrelated Diagnostic, or Injury due to Unlawful Activity.

Covered
Not Covered

If you are a globe trotter and looking for a Health Insurance Plan which provides best coverage in India as well as Abroad, then Lifeline Elite is the plan for you.

Any individual above 18 years of age can purchase Lifeline. Lifeline is offered as an Individual plan and as a Family Floater plan for self, spouse and children.

Cover Options:

In an effort to give you the best of current day medical and healthcare facilities, Royal Sundaram has launched the Lifeline Elite Health Insurance Plan which offers comprehensive health cover with Sum Insured options of Rs.25 lacs, Rs.30 lacs, Rs.50 lacs, Rs.1 crore and Rs.1.5 crores.

In addition to high Sum Insured options, Lifeline Elite comes with a wide range of medical benefits covering critical illnesses, international treatment, maternity expenses (covers up to 2 deliveries if both husband and wife are covered under the same family floater policy), severe medical conditions and accidents.

Key Benefits:

The Lifeline Elite Plan is a holistic health insurance plan that offers extensive health cover along with an assortment of medical care benefits. Such comprehensive health cover ensures that you and your loved ones receive a wide range of exclusive health benefits.

List of Covers and Exclusions Lifeline Elite plan has to offer is as follows:

Here are the key benefits offered by Lifeline Elite plan.

Inpatient Hospitalization
Pre and post-hospitalization expenses repayment up to sum insured for 60 days and 180 days, respectively
Coverage for all types of day care procedures up to the sum insured. International treatment of 11 specified critical illnesses including return airfare up to Rs.3 lacs. Base cover is excluding US and Canada, however you can opt to include US and Canada at the inception of first policy
Worldwide Emergency Hospitalization up to 50% of Sum Insured limited up to Rs.20 lacs. Base cover is excluding US and Canada, however you can opt to include US and Canada at the inception of first policy. Deductible of $1000 per claim is applicable.
Maternity Benefit cover for up to 2 deliveries if both husband and wife are covered under the same family floater policy including New Born Baby Cover and Vaccination for New Born in first year
OPD Treatment Cover of up to Rs.10,000
Emergency Ambulance Cover of up to Rs.10,000.
Organ donor treatment available up to the amount of sum insured.
Domiciliary hospitalization expenses reimbursed up to the amount of sum insured.
No-claim bonus (NCB) starts from 20% of the sum insured and extends up to 100% of the total sum insured. NCB is not deducted, even when a claim is filed during a particular year.
Provision of re-load of sum insured during treatment of different illnesses in event of complete exhaustion of sum insured and NCB.
AYUSH Treatment - Inpatient hospitalization cover up to Sum Insured in Government Hospitals and up to Rs.50,000 in other hospitals
Vaccination in case of animal bite - Expenses up to Rs.7,500 covered
Annual Health Checkups
Second opinion for diagnosis and treatment of 11 specified critical illnesses.
Emergency domestic evacuation cover of up to Rs.3 lacs.

Certain medical conditions will not receive any claims from the company under the Lifeline Elite health insurance plan. Here is the illustrative list of Exclusions this policy carries:

Pre-existing medical conditions as defined in the policy and declared by the insured at the time of purchasing policy will be covered only after 24 months of uninterrupted policy coverage. Any gap in policy renewal will void such claims.
Any claim other than accidents arising within the first 30 days after the policy commences will be exempted from claims.
Critical Illness that are contracted by the insured person within first 90 days after the commencement of policy will not be considered for claims.
Diseases such as Cataract, Benign Prostatic Hypertrophy, Knee/Hip Replacement, Chronic Renal Failure/ End Stage Renal Failure etc., will not be covered during first two years of insurance.
Permanent exclusions include medical cover availed due to Addictive Conditions and Disorders, Adventure or Hazardous Sports, Ageing and Puberty, Alternative Treatment (except AYUSH), Artificial Life Maintenance, Charges for Medical Papers, Circumcision, Conflict and Disaster, Congenital Conditions, Convalescence and Rehabilitation, Cosmetic Surgery, Dental/Oral Treatment, Drugs and Dressing for OPD Treatment or Take-home use, Eyesight Treatment, Health Hydros, Nature Cure, Wellness Clinics, HIV and AIDS, Hereditary Conditions, Hospitalization for Observation or Investigative purpose only, Items of personal comfort and convenience, Psychiatric and Psychosomatic Conditions, Obesity, Preventive Care, Reproductive Medicine, Self-inflicted Injuries, Sexual problems and gender issues, Sexually Transmitted Diseases, Sleep Disorders, Speech Disorders, Stem Cell Implantation, Treatment for Alopecia, Treatment for Developmental Problems, Unproven/Experimental Treatment, Treatment from Unrecognized Hospital or Physician, Unrelated Diagnostic, or Injury due to Unlawful Activity.

Lifeline Claims

Lifeline - Claims Procedure

Please review your Lifeline policy and familiarize yourself with policy benefits, terms and conditions and exclusions which will help you during claims.

All claims for 4 benefits - Second Opinion for 11 Critical Illness / Emergency Domestic Evacuation / Worldwide Emergency Hospitalization / International Treatment for 11 Specified Critical Illness will be serviced through Europ Assistance India Pvt. Ltd.

All claims for benefits other than 4 benefits will be serviced through Paramount Health Services & Insurance TPA Pvt.Ltd

Claim Intimation

1.You should intimate Royal Sundaram atleast 72 hours prior to hospitalization in case of planned hospitalization or within 48 hours in case of any emergency hospitalization

24 x 7 Toll Free: 1800-425-6645
Email: customer.services@royalsundaram.in

2.Provide the following details during intimation:

Name of the patient (insured person)
Diagnosis
Hospital Details â€“ Name, Address, Contact No
Treating Doctor Details â€“ Name & Contact No
Date of Hospitalization
Expected Discharge

Contact Details of Service Provider:

The following 2 benefits are serviced through the below mentioned service provider.

Second opinion for critical illness.
Emergency domestic evacuation
Worldwide Emergency Hospitalization
International Treatment for 11 Specified Critical Illness

Europ Assistance India Pvt Ltd

301, C Wing, Business Square, Andheri Kurla Road,

Chakala, Andheri (East), Mumbai â€“ 400093

Contact No: + 91-22-67347878

Email: royalsundaram@europ-assistance.in

Cashless claims will be serviced by one of the following TPAs (please refer policy schedule):

Paramount Health Services & Insurance TPA Pvt.Ltd.

Plot No A 442, Road no:28, MIDC Industrial Area,

Wagle Estate, Ram Nagar, Thane West - 400 604

Contact details:+91-22-66444600

Toll Free Help Line Number:1800 22 6655

Medi Assist Insurance TPA Private Limited

IBC Knowledge Park, 4th Floor, Tower D, Bannerghatta Road,

Bangalore 560 029

Toll Free Number :1800 419 1172

Email :royalsundaram@mediassist.in

Procedure to avail Pre-Authorization for Cashless facility

1.For any planned hospitalization, kindly intimate to TPA and seek cashless authorization atleast 72 hours prior to the start of the hospitalization.

2.2. For any emergency hospitalization, inform TPA within 48 hours of the hospitalization.

3.3. TPA will check your coverage as per the eligibility and send a cashless authorization letter to the hospital within 3 hours post receipt of complete documents. In case there is any deficiency in the documents sent, the same will be communicated to the hospital within 3 hours of receipt of documents.

4.4. Please pay the non medical and expenses which are not covered to the hospital prior to the discharge.

5.In case the ailment/treatment is not covered under the policy, a rejection letter would be sent to the hospital Within 2 hours

Note:

You are entitled for cashless only in our Network Hospitals, list of which can be referred on our website. Rejection of cashless in no way indicated rejection of the claim.

Contact Details of Service Provider:

The following 4 benefits are serviced through the below mentioned service provider.

Second opinion for critical illness.
Emergency domestic evacuation
Worldwide Emergency Hospitalization
International Treatment for 11 specified Critical Illness

Europ Assistance India Pvt Ltd

Star Hub Building No. 2, 7THFloor, Near ITC Maratha Hotel,

Sahar, Andheri East, Mumbai â€“ 400 059

24 hour dedicated landline number is +91-22-67872035

Email: royalsundaram@europ-assistance.in

Cashless claims will be serviced by one of the following TPAs (please refer policy schedule):

Paramount Health Services & Insurance TPA Pvt.Ltd.

Plot No A 442, Road no:28, MIDC Industrial Area,

Wagle Estate, Ram Nagar, Thane West - 400 604

Contact details:+91-22-66444600

Toll Free Help Line Number:1800 22 6655

Medi Assist Insurance TPA Private Limited

IBC Knowledge Park, 4th Floor, Tower D, Bannerghatta Road,

Bangalore 560 029

Toll Free Number :1800 419 1172

Email :royalsundaram@mediassist.in

Procedure for Reimbursement Claims

1.Please send the duly filled and signed claim form and all the information/documents mentioned* therein to Royal Sundaram within 30 days from the date of discharge. * Please refer to claim form for complete documentation.

2.If there is any discrepancy in the documents/information submitted by you, Royal Sundaram will send the deficiency letter within 7 days of receipt of claim documents.

3.On receipt of the complete set of claim documents, Royal Sundaram will make the payment for the admissible amount (as per Policy Terms & Conditions), along with a settlement letter within 30 days.

4.The payment will be made in the name of the proposer.

5.Claim documents can be sent on:

Health Claims Department
Royal Sundaram General Insurance Co Ltd
Vishranthi Melaram Towers,
No.2/319, Rajiv Gandhi Salai (OMR)
Karapakkam, Chennai â€“ 600097

Contact Details of Service Provider:

The following 2 benefits are serviced through the below mentioned service provider.

Second opinion for critical illness.
Emergency domestic evacuation
Worldwide Emergency Hospitalization
International Treatment for 11 Specified Critical Illness

Europ Assistance India Pvt Ltd

301, C Wing, Business Square, Andheri Kurla Road,

Chakala, Andheri (East), Mumbai â€“ 400093

Contact No: + 91-22-67347878

Email: royalsundaram@europ-assistance.in

Cashless claims will be serviced by one of the following TPAs (please refer policy schedule):

Paramount Health Services & Insurance TPA Pvt.Ltd.

Plot No A 442, Road no:28, MIDC Industrial Area,

Wagle Estate, Ram Nagar, Thane West - 400 604

Contact details:+91-22-66444600

Toll Free Help Line Number:1800 22 6655

Medi Assist Insurance TPA Private Limited

IBC Knowledge Park, 4th Floor, Tower D, Bannerghatta Road,

Bangalore 560 029

Toll Free Number :1800 419 1172

Email :royalsundaram@mediassist.in

Procedure to avail Pre-Authorization for Cashless facility (for Worldwide Emergency Hospitalization)

1.You need to notify the Service Provider within 24 hours of hospitalization.

2.Our Service Provider will evaluate the request and the eligibility of the Insured Person under the Policy and call for more information or details, if required.

3.Our Service Provider will communicate directly to the Hospital whether the request for pre-authorization has been approved or denied.

4.If the pre-authorization request is approved, Our Service Provider will directly settle the claim with the Hospital. Any additional costs or expenses incurred by or on behalf of the Insured Person beyond the limits pre-authorized by the Service Provider shall be borne by the Insured Person.

Contact Details of Service Provider:

The following 2 benefits are serviced through the below mentioned service provider.

Second opinion for critical illness.
Emergency domestic evacuation
Worldwide Emergency Hospitalization
International Treatment for 11 Specified Critical Illness

Europ Assistance India Pvt Ltd

301, C Wing, Business Square, Andheri Kurla Road,

Chakala, Andheri (East), Mumbai â€“ 400093

Contact No: + 91-22-67347878

Email: royalsundaram@europ-assistance.in

Cashless claims will be serviced by one of the following TPAs (please refer policy schedule):

Paramount Health Services & Insurance TPA Pvt.Ltd.

Plot No A 442, Road no:28, MIDC Industrial Area,

Wagle Estate, Ram Nagar, Thane West - 400 604

Contact details:+91-22-66444600

Toll Free Help Line Number:1800 22 6655

Medi Assist Insurance TPA Private Limited

IBC Knowledge Park, 4th Floor, Tower D, Bannerghatta Road,

Bangalore 560 029

Toll Free Number :1800 419 1172

Email :royalsundaram@mediassist.in

Procedure for International Treatment for 11 specified Critical Illness

1.In the event of the diagnosis of a Specified Critical Illness, the Insured Person should call Our Service Provider immediately and in any event before the commencement of the travel for treatment overseas, on the helpline number specified in the Schedule of Insurance Certificate requesting for a pre-authorization for the treatment.

2.â€¢ Our Service Provider will evaluate the request and the eligibility of the Insured Person the Policy and call for more information or details, if required.

3.Our Service Provider will communicate directly to the Hospital and the Insured Person whether the request for pre-authorization has been approved or denied.

If the pre-authorization request is approved, Our Service Provider will directly settle the claim with the Hospital. Any additional costs or expenses incurred by or on behalf of the Insured Person beyond the limits pre-authorized by the Service Provider or at any Non-Network Hospital shall be borne by the Insured Person.

Contact Details of Service Provider:

The following 2 benefits are serviced through the below mentioned service provider.

Second opinion for critical illness.
Emergency domestic evacuation
Worldwide Emergency Hospitalization
International Treatment for 11 Specified Critical Illness

Europ Assistance India Pvt Ltd

301, C Wing, Business Square, Andheri Kurla Road,

Chakala, Andheri (East), Mumbai â€“ 400093

Contact No: + 91-22-67347878

Email: royalsundaram@europ-assistance.in

Cashless claims will be serviced by one of the following TPAs (please refer policy schedule):

Paramount Health Services & Insurance TPA Pvt.Ltd.

Plot No A 442, Road no:28, MIDC Industrial Area,

Wagle Estate, Ram Nagar, Thane West - 400 604

Contact details:+91-22-66444600

Toll Free Help Line Number:1800 22 6655

Medi Assist Insurance TPA Private Limited

IBC Knowledge Park, 4th Floor, Tower D, Bannerghatta Road,

Bangalore 560 029

Toll Free Number :1800 419 1172

Email :royalsundaram@mediassist.in

Lifeline Faq

FAQs

Questions about Lifeline Insurance? Get your answers here.

What are the Key Features of Lifeline Product?

Key design and service features of Lifeline are as mentioned below:

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.2 lacs, Rs.3 lacs, Rs.4 lacs
Supreme - Rs.5 lacs, Rs.10 lacs, Rs.15 lacs, Rs.50 lacs
Elite - Rs.25 lacs, Rs.30 lacs, Rs.50 lacs, Rs.100 lacs, 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.

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.

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).

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 available once every 3rd policy year in 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 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?

TThe 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%

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.

If initially customer opted for two years policy, can he/she extend the same for the third year?

No customer cannot extend his 2 year policy to 3 year policy. He can cancel his 2 year policy and take a new 3 year policy.

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 are the modes of premium payment?

All the existing modes of premium payment will be applicable for Long Term Policy as well.

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 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

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 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 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 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

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.

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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