Royal Sundaram | Family Plus
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  • 1CALCULATE PREMIUM
  • 2PROPOSAL INFORMATION
  • 3PAYMENT DETAILS
  • Welcome to Family Plus!

    Select family members to be Insured

    Select up to 20 members

    CONTINUE

  • Enter Proposer Details

    Select your City of Residence

    Chennai

    Mumbai

    Delhi

    Kolkata

    Pune

    Hyderabad

    Bengaluru

    Are you including yourself in the Family Plus health insurance plan?


    CONTINUE

  • Number of
    Members

    Individual
    Sum Insured

    RS5 Lakhs

    Floater
    Sum Insured

    RS5 Lakhs

    Details of Insured Members

    Insured Member 1

    Insured Member 1

    EDIT PREMIUM DETAILS

  • Number of Members

    Individual Sum Insured

    RS

    Floater Sum Insured

    RS

    Premium for RS

    Hospital Cash Premium RS

    Total Premium RS ---- (inclusive of all applicable taxes)

     

    Premium Details

    Select Premium

    Premium for 1 Year

    RS

    Premium for 2 Years

    RS

    Inclusive of
    7.5% discount

    Premium for 3 Years

    RS

    Inclusive of
    12% discount

  • 1

  • 2

  • 3

  • 4

  • 5

Please fill in Proposer Details

  • First Name

  • Last Name

  • Gender

    Male Female
  • Nationality

  • Educational Qualification

  • Marital Status

    Single Married
  • Occupation

  • Pan No.

  • Date of Birth

  • Family Physician details:

  • Family Physician's Name

  • Mobile Number

  • Phone Number

Please fill in the below medical details:

  • Within the last 2 years have you consulted a doctor or healthcare professional?
    (other than Preventive or Pre-Employment Health Check-up)?

  • Within the last 2 years have you undergone any detailed investigation other than Preventive or Pre-Employment Health Check-up (e.g. X-ray, CT Scan, biopsy, MRI, Sonography, etc)?

  • Within the last 5 years have you been to a hospital for an operation/medical treatment?

  • Do you take tablets, medicines or drugs on a regular basis?

  • Within the last 3 months have you experienced any health problems or medical conditions which you/proposed insured person have/has not seen a doctor for?

  • Have any of the person(s) proposed to be insured ever suffered from or taken treatment, or been hospitalized for or have been recommended to undergo / take investigations / medication / surgery or undergone a surgery for any of the following - Diabetes; Hypertension; Ulcer / Cyst / Cancer; Cardiac Disorder; Kidney or Urinary Tract Disorder; Disorder of muscle / bone / joint; Respiratory disorder; Digestive tract or gastrointestinal disorder; Nervous System disorder; Mental Illness or disorder, HIV or AIDS?

Please fill in Additional Medical Details

Insured Member 1 - Kumar

  • Name of illness/injury suffering from or suffered in the past

  • Date of first diagnosis

    Month

    Year

  • Treatment/Medication

    Received Receiving
  • Treatment outcome

Please fill in your lifestyle details:

Insured Member 1 - Kumar

  • Do you consume Alcohol?

  • Please specify the Quantity(Beer - No. of Pints/week, Wine & Spirit - ml/week)

  • No. of Years

  • Do you smoke?

  • Please specify the Quantity (No. of Cigarettes per day)

  • No. of Years

  • Do you consume Tobacco/Gutka/Pan/Pan masala?

  • Please specify the Quantity (Pouch per day)

  • No. of Years

  • Do you consume Narcotics?

  • Please specify the Quantity

  • No. of Years

  • If you had any of these habits in the past, please mention the year of stopping and the reason for doing the same

Plan Details

  • Number of Members

  • Individual Sum Insured

  • Floater Sum Insured

Premium Details

  • Premium for 1 year

    RS0

  • Total Premium

    RS0

    (inclusive of all applicable taxes)

  • First Name

  • Last Name

  • Gender

  • Nationality

  • Educational Qualification

  • Martial Status

  • Occupation

  • Business

  • Designation

  • Pan No.

  • Date of Birth

  • Family Physician details:

    Family Physician's Name

  • Mobile Number

  • STD Code

  • Phone number

  • Address 1

  • Address 2

  • Address 3

  • City

  • State

  • Pincode

  • Mobile Number

  • Residence Phone

  • Email Id

  • Insured Member 1

  • Relationship with Proposer

  • First Name

  • Last Name

  • Gender

  • Date of Birth

  • Height (Cms)

  • Weight (Kgs)

  • BMI

  • Occupation

  • Business

  • Designation

  • Within the last 2 years have you consulted a doctor or healthcare professional? (other than Preventive or Pre-Employment Health Check-up)?

  • Insured name1

  • Within the last 2 years have you undergone any detailed investigation other than Preventive or Pre-Employment Health Check-up (e.g. X-ray, CT Scan, biopsy, MRI, Sonography, etc)?

  • Insured name1

  • Within the last 5 years have you been to a hospital for an operation/medical treatment?

  • Insured name1

  • Do you take tablets, medicines or drugs on a regular basis?

  • Insured name1

  • Within the last 3 months have you experienced any health problems or medical conditions which you/proposed insured person have/has not seen a doctor for?

  • Insured name1

  • Have any of the person(s) proposed to be insured ever suffered from or taken treatment, or been hospitalized for or have been recommended to undergo / take investigations / medication / surgery or undergone a surgery for any of the following - Diabetes; Hypertension; Ulcer / Cyst / Cancer; Cardiac Disorder; Kidney or Urinary Tract Disorder; Disorder of muscle / bone / joint; Respiratory disorder; Digestive tract or gastrointestinal disorder; Nervous System disorder; Mental Illness or disorder, HIV or AIDS?

  • Insured name1

  • Insured name1

  • Name of illness/injury suffering from or suffered in the past

  • Date of first diagnosis

  • Month

  • Year

  • Treatment/Medication

  • Treatment outcome

  • Insured Name 1

    Do you consume Alcohol?

  • Quantity(Beer - No. of Pints/week, Wine & Spirit - ml/week)

  • No. of Years

  • Do you smoke?

  • Quantity (No. of Cigarettes per day)

  • No. of Years

  • Do you consume Tobacco/Gutka/Pan/Pan masala?

  • Quantity (Pouch per day)

  • No. of Years

  • Do you consume Narcotics?

  • Quantity

  • No. of Years

  • If you had any of these habits in the past, please mention the year of stopping and the reason for doing the same

Hi

Congratulations on buying Family Plus Health Insurance Plan. Please visit our Health & Wellness Portal for health bytes & more.

We trust that your online experience of buying this product on www.royalsundaram.in was quick and hassle-free.

Premium Amount
RS (Inclusive of all taxes)
Quote ID
Policy Start Date
Policy End Date
No. of Members

I have read the declaration completely and agree with it

I hereby agree and confirm that I have read and understood the policy features, exclusions, Terms & Conditions and Disclaimers as mentioned in the website

IMPORTANT MESSAGE:

  • Please make sure that you have provided the correct address. Address details will be verified at the time of claims and claims can be repudiated.
  • Please make sure that you have provided the correct date of birth. Age proof will be verified at the time of claims and claims can be repudiated.
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  • Payment Through Cheque or Demand Draft

Important message: By submitting this information you are agreeing to be contacted by our Customer Service Representative. | Insurance is the subject matter of solicitation.

Royal Sundaram General Insurance Co. Ltd. All Rights Reserved.

IRDA Registration No. 102. Granted on October 23,2000. | Registered Office: No.21, Patullos Road, Chennai - 600 002.