FAQs - Smart Cash Plan
Smart Cash Plan is a product that offers daily cash benefit to the insured for each completed and consecutive 24 hours of hospitalization due to sickness or accident. This product is not a substitute for Health Insurance but a supplement to Health Insurance covering out of pocket expenses associated with sickness/accidental hospitalization like special diet, conveyance expenses to the Hospital and back, expenses incurred by a family member staying with the patient and so on.
Health Insurance reimburses inpatient hospital bills. Smart Cash Plan offers you fixed daily benefits per every completed and consecutive 24 hours spent in hospital. This is aimed in covering the incidental expenses during hospitalisation which are normally not covered under health insurance.
What is the age limit for availing Smart Cash Plan?
The required entry age for an adult is minimum 18 yrs. and that of children is 91 days onwards. While there is no maximum entry age under a silver plan, the maximum entry age for gold and platinum plans is up to 70 years.The policy is renewable lifelong.
Do I have to undergo any medical tests to avail the Policy?
Yes. Persons who are above 60 years of age who opt for platinum plan or who request for conversion from existing plan to another plan, shall be required to submit their medical examination reports.
Following shall be the medical tests required:
Mandatory Medical Examination Report, HBA1C, ECG Printout, Lipid Profile, Hb, S.Creatinine, Liver Function Tests will have to be submitted.
For accepted proposals, the cost of medical check-up undertaken shall be reimbursed by the Company @ 100% for policies with more than 1 year tenure and @ 50% for policies with tenure of 1 year.
If a family member covered by the Insurance is hospitalized, to whom will the benefit be paid?
Payments shall be made to the Proposer or to the nominee of the proposer if proposer is no more.
How will the cash be paid? How frequently will it be paid?
This Insurance plan includes cash benefit. The payment will be made by way of NEFT transfer for the period of hospitalisation found admissible after we receive the completed Claim Form with supporting documents. Additional benefits if applicable shall also be paid along with the claim settlement.
Is hospitalisation always necessary to get a claim?
Yes. This is a pre-requisite. Hence, unless the insured person is hospitalized for a condition warranting hospitalization, no claim is payable under this policy.
How many days of benefit will be covered by the policy for instance if a person is hospitalised on 10th May and discharged on 20th May?
Every consecutive and completed 24 hours shall be counted as a day. Hence the time of admission and time of discharge are crucial to decide on count of days for claim settlement. In the example under reference, if the person was admitted at 5 pm on 10th May and discharged at 10 am on 20th May, then 9 days of hospitalisation shall be considered for claim admissibility.
What happens when I have to undergo a procedure like Dialysis, and got discharged on the same day?
Daily benefit is not payable in this case, as there is no complete 24 hours of hospitalisation. However if the stay exceeds 24 hours due to complications arising out of the procedure, the claim is admissible. Please also note that daily benefit for day care procedures is not covered under the policy.
Do I need a Health Insurance Policy to avail Smart Cash Plan?
No, you need not have a Health Insurance Policy to avail Smart Cash Plan. However it is prudent to cover yourself and your loved ones and let not medical expense affect your savings.
I already have a Health Insurance Policy with another Insurance company. Can I avail Royal Sundaram's Smart Cash Plan?
Yes, you can.
Will Smart Cash Plan cover maternity?
A lump sum benefit amount of Rs.10000/- and Rs.20000/- is payable under Gold and Platinum Plan respectively in the event of hospitalisation resulting in Child Birth.
What is the coverage provided under pre-existing disease benefit?
A chosen daily benefit or Rs.5000/- whichever is lower is payable under Gold & Platinum plans for a maximum of 5 days per policy year for hospitalisation due to pre-existing diseases.
Explain "Emergency Family Member visit from abroad"?
Under this benefit, when a claim is admissible under critical illness benefit for insured parents, spouse or children, the flight ticket charges incurred for emergency travel from abroad to India up to a maximum of Rs.1lakh is payable per person per policy year. This benefit is available only for platinum plan customers.Please note even though policy allows dependent relatives to be covered this benefit does not apply to them.
Does Smart Cash plan operate worldwide?
What are the exclusions under Smart Cash Plan?
A few important exclusions are
Disease contracted during the first 30 days of commencement of policy
Certain treatment/diseases/procedures during first year of policy such as: Treatment of Congenital Internal Anomaly, Cataract, Benign Prostatic Hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Fistula in anus, Piles, Sinusitis & related disorders and Knee/Hip replacement. These are covered from subsequent renewals
Convalescence, general debility, `Run-down’ condition or rest cure, Congenital External Disease or defects or anomalies, Venereal disease, intentional self injury or attempted suicide
Hospitalisation for evaluation and / or diagnostic purposes.
Treatment of obesity and any other weight control programs, services or supplies
Treatment of psychiatric and psychosomatic disorders, mental or nervous conditions, insanity.
Any other Alternative Treatments except Allopathy (Modern Medicine)
For more detailed information about the coverage and exclusions, please refer the Terms and Conditions
of the Policy.
Is there any other benefit of availing Smart Cash Plan?
Yes. You can get a relief on your Income Tax under section 80 D, Income Tax Act 1961(Please note premium paid for optional personal accident benefit shall not be entitled for IT relief).
If I wish to cancel my Policy, will I get a refund for the same?
If for any reason you wish to opt out of the Insurance, the premium for the period at risk shall be retained as per the short period rates and balance shall be refunded. No refund shall happen on policies where a claim is notified or settled. Please refer to our Terms and Conditions page for more information on this.
What is the procedure to make a claim?
To make a Claim, inform our customer support, 72 hours prior to admission in case of planned hospitalisation and not later than 48 hours after admission in case of an emergency hospitalisation, with details 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 Hospital/Nursing Home. We will forward you the Claim Form. You can also download it from our website.
You need to submit the duly filled Claim Form with requisite documents within 30 days from the date of discharge.
Does the critical illness benefit require a survival period for a claim to be admissible?
No. Critical Illness benefit does not require a survival period.