About Royal Sundaram Health Insurance

Some key highlights of Royal Sundaram General Insurance

The highlights of the company are as follows:

Gross Direct Premium	Rs 2,867 Cr in F.Y 2021-22
Employees	2000+ employees
Branches	158 branches across India (as of 31 March 2022)
Customers	28 million customers across India

Royal Sundaram Awards and Achievements

In its journey to become the best insurance provider in the private sector and to become a one-stop solution for all insurance needs, Royal Sundaram has achieved various awards and accolades. Some of them are highlighted as follows: 

• Royal Sundaram won the ‘ET Award’ in 2020 for the Prompt GI Compact Category in the Health Segment by Economic Times.
• Royal Sundaram was awarded the ‘Best BFSI Brands of 2021’ for its innovative, affordable, and accessible products. 
•  The company received ‘The Celent Model Insurer Asia Award’ for 2013 & 2014 for its excellent claim management system. 

Features of Royal Sundaram health insurance plans

Some of the common coverage benefits of Royal Sundaram health insurance plans are as follows –

Coverage benefit	Description
Hospitalisation cover	If you are admitted to a hospital and you stay for 24 hours or more, the expenses incurred will be covered
Pre-hospitalization cover	Before you are admitted to a hospital, if you incur medical expenses on the diagnosis and treatment of the illness or injury, such expenses would be covered up to a specific number of days
Post-hospitalisation expenses	After you are discharged from the hospital if you incur medical expenses on recovery, such expenses would be covered for a specific number of days
Ambulance expenses	If you need an ambulance when being admitted to a hospital, the cost of the ambulance would be covered up to specified limits
Organ donor cover	If you receive organs from a donor, the hospitalization cost of the donor transplant and the cost of treatments for harvesting the organ would be covered
Daycare treatments	If you are admitted to a hospital wherein the treatment takes only a few hours, such hospitalization would be covered even when you are not admitted for 24 hours
AYUSH cover	Many plans of the company allow coverage for non-allopathic treatments that include Ayurveda, Unani, Siddha, and Homeopathy
Domiciliary treatments	If you are treated at your home because there are no empty hospital beds or because you cannot be shifted to the hospital in your condition, the underlying medical expenses would be covered
Free health check-ups	Royal Sundaram Health Plans allows free health check-ups at specific intervals so that you can monitor your health regularly

 

Exclusions in Royal Sundaram health insurance plans

Royal Sundaram health insurance plans do not cover all types of medical expenses that you might incur. Though the plans are comprehensive, some claims are beyond the scope of coverage. The actual instances that Royal Sundaram plans do not cover vary across plans. However, some of the common exclusions found in most plans are as follows –

• Illnesses occurring within the first 30 days of buying the policy 
• Some specific illnesses are not covered within the first 2 years
• Pre-existing conditions are excluded from coverage during the specified waiting period
• Cosmetic treatments and unnecessary medical expenses are not covered
• Sexually transmitted diseases, HIV, AIDS, and the like are excluded from coverage
• If you avail of treatments against the doctor’s recommendations, the cost of such treatments will not be covered
• Claims due to war, mutiny, nuclear perils, and chemical contaminations are excluded
• Claims due to self-inflicted injuries, breach of law, alcohol or drug addiction are not covered
• Claims due to participation in hazardous or adventure activities would be excluded 
• Unproven or unscientific treatments are not covered 

Royal Sundaram health insurance plans

As mentioned earlier, Royal Sundaram offers a range of health insurance plans. Some of its leading plans that are also available on PayBima are as follows –

• Lifeline Classic

A simple and basic health insurance plan that allows comprehensive coverage, Lifeline Classic boasts of the following features –

• Sum insured reload benefit

If you use your sum insured, partially or fully, on a previous claim within the same policy year, the policy would restore 100% of the sum insured back for any subsequent claim that you suffer. So, in the case of multiple claims, you don’t have to worry about your coverage running out.

• Vaccination for animal bites

If you get bitten by an animal, the cost of vaccination would be borne by the plan.

• No claim bonus enhances the sum insured

If you don’t claim your policy, the sum insured increases by 10% as a no-claim bonus. This bonus accrues every year and you can accumulate an enhanced sum insured, free of cost, up to a maximum of 50% of the basic sum insured.

• Health check-ups after every 2 years

After every second consecutive renewal, you can avail yourself of free health check-ups. The list of check-ups is specified under the plan and you can avail of such check-ups free of cost.

• Lifeline Supreme 

A more comprehensive version of the Lifeline plan compared to the Classic variant, Lifeline Supreme has the following coverage benefits allowed in addition to the benefits available under the Classic Plan –

• Enhanced no-claim bonus

For every claim-free year, you get a no-claim bonus of a 20% increase in the sum insured. You can enjoy up to a 100% increase in the sum insured if you don’t make any claim for 5 consecutive years.

• Emergency domestic evacuation

In the case of life-threatening medical emergencies, coverage is allowed for domestic evacuation if you are to be shifted to another hospital or city.

• Annual health check-ups

You can avail of free health check-ups every year after you renew the policy. 

• A second opinion for critical illnesses

Lifeline Supreme covers 11 specific critical illnesses. If you are diagnosed with any of these illnesses, you can avail of a free medical second opinion. 

• Lifeline Elite

This is the most comprehensive Lifeline variant which enhances the coverage available under the Supreme variant. The unique coverage benefits of this variant are as follows –

• Worldwide emergency hospitalisation

You can get coverage for international hospitalization, anywhere in the world except USA and Canada. The cost of such hospitalization would be covered under the policy provided it is due to an emergency medical condition. 

• International treatment for critical illnesses

11 critical illnesses are covered by the policy. If you suffer from any of the covered illnesses, you can avail of international treatments for them. Such international treatments, availed in any country except the USA and Canada, would be covered by the policy

• Maternity cover

Maternity coverage is allowed as an inbuilt benefit under the policy. Under this coverage, the cost of childbirth, coverage for the newborn baby, and the cost of the baby’s first-year vaccinations are covered.

• Coverage for OPD treatments 

Doctor’s consultations and diagnostic tests that are taken on an outpatient basis, i.e. without being admitted to the hospital, are covered under the policy. You also get coverage for the cost of hearing aids, spectacles, contact lenses, and dental treatments for up to 30% of the coverage allowed for OPD treatments 

Comparative analysis of Royal Sundaram Health Insurance plans

Here is a comparative table underlining the coverage benefits and eligibility of all three plan options –

Detail	Lifeline Classic	Lifeline Supreme	Lifeline Elite
Inpatient hospitalization	Covered Up to the sum insured	Covered Up to the sum insured	Covered Up to the sum insured
Pre- and post-hospitalization	30 and 60 days	60 and 90 days	60 and 180 days
Daycare treatments	Covered Up to the sum insured	Covered Up to the sum insured	Covered Up to the sum insured
Ambulance cover	Up to Rs.3000	Up to Rs.5000	Up to Rs.10,000
Domiciliary hospitalisation	Covered Up to the sum insured	Covered Up to the sum insured	Covered Up to the sum insured
Organ donor cover	Covered Up to the sum insured	Covered Up to the sum insured	Covered Up to the sum insured
Sum insured reload	Available  100% of the sum insured	Available  100% of the sum insured	Available  100% of the sum insured
No claim bonus	10% of the sum insured up to 50%	20% of the sum insured up to 100%	20% of the sum insured up to 100%
Vaccination for animal bite	Up to Rs.2500	Up to Rs.5000	Up to Rs.7500
AYUSH treatment	Government hospitals – up to the sum insured Private hospitals – up to Rs.20,000	Government hospitals – up to the sum insured Private hospitals – up to Rs.30,000	Government hospitals – up to the sum insured Private hospitals – up to Rs.50,000
Emergency domestic evacuation	Not covered	Up to Rs.1 lakh	Up to Rs.3 lakhs
Worldwide emergency hospitalisation	Not covered	Not covered	Up to 50% of the sum insured, subject to a maximum of Rs.20 lakhs
International treatment for critical illnesses	Not covered	Not covered	Up to the sum insured Airfare – up to Rs.3 lakhs
Health check-ups	On second renewals	Annually	Annually
Second opinion for critical illnesses	Not covered	Available once every policy year	Available once every policy year
Preventive healthcare and wellness benefits	Available	Available	Available
Maternity cover	Not available	Not available	Rs.2 lakhs to Rs.2.5 lakhs Newborn baby cover – Rs.6.25 lakhs to Rs.37.5 lakhs First-year vaccinations – up to Rs.10,000
OPD treatments	Not available	Not available	Up to Rs.10,000
Sum insured levels	Rs.2 lakhs to Rs.4 lakhs	Rs.5 lakhs to Rs.1 crore	Rs.25 lakhs to Rs.1.5 crores
Pre-existing waiting period	48 months	36 months	24 months
Entry age	Adults – 18 years onwards Children – 91 days to 25 years
Policy term	1 to 3 years

 

How you can buy the Royal Sundaram Health Insurance Plan?

Royal Sundaram Health plans are available online in a very simple manner through PayBima.com. PayBima offers a very smooth and hassle-free buying experience with the benefit of easy comparison to select the most suitable plan. The process to buy Royal Sundaram health plans is as follows:

• Visit PayBima website

Go online and visit the official website of PayBima or just click on www.paybima.com and then select the option ‘Health Insurance’

• Fill in relevant details to calculate the premium

PayBima helps you find health plans based on your requirements. Once you select ‘health insurance,’ PayBima will ask you to fill out a form with certain personal as well as medical details to assess your coverage requirements. Details such as your age, gender, number of dependents, location PIN code, lifestyle habits, pre-existing illness, sum assured, etc. are to be filled in. Then, provide your contact number to get a personalized consultation from PayBima which will help you in buying a suitable health plan easily. 

• Compare the plans

No sooner do you submit your requirements and details a list of health plans will be displayed with their features and premiums. You will find all the leading health plans with their key highlights and features. You can easily compare the coverage of the plans vis-à-vis the premium and select one that best suits your requirements at an affordable premium. 

• Fill out and submit an online proposal form

The proposal form is an application to the insurance company to issue you the selected plan. After finalizing your health plan, fill out the proposal form correctly and completely. Then, affix your signature and submit it online. 

• Pay policy premium

Payment of premium is the last step of buying a health plan. You can easily pay the premium online through secured payment modes offered by PayBima. Once you make the payment the policy will be issued instantly provided there are no adverse declarations about medical illness and lifestyle habits in the proposal form. 

• Pre-issuance medical check-up

Based on the sum insured, your age, lifestyle habits, existing illness, medical history, and health conditions, you might have to undergo a pre-entrance health check-up. You can avail of pre-entrance check-ups at the insurer’s networked facility.    How to Renew Royal Sundaram Health Insurance Plans? PayBima offers the facility to not only buy a health plan but also to renew it. Health insurance policies come with lifelong renewal benefits. As such, if you renew your Royal Sundaram health insurance plan within the due date of the plan, you can enjoy non-stop coverage benefits.  Renewal of a health plan is an online process in which you just have to provide your policy number and other details of the policy, pay the premium and your policy will be renewed instantly. You can also check the coverage and other details of your plan and make changes to it if required. You can also add riders to your plan at the time of renewal. For any help renewing your Royal Sundaram health insurance plan, you can call PayBima at 1800 267 6767 or drop a mail at paybima.care@mahindra.com.  

How you can claim the Royal Sundaram Health Insurance plan?

Claiming your Royal Sundaram Health Insurance plan is very simple and easy. PayBima provides a hassle-free claim settlement experience to its customers in which the entire process can be done online. The claim process of the Royal Sundaram health insurance plan through PayBima is discussed as follows: 

• Locate the nearest network hospital

The first step is getting admitted to a network hospital after locating one nearest to your place. You can locate a network hospital either on the website of the insurance company or by contacting PayBima. Royal Sundaram General Insurance has tie-ups with leading hospitals in the country making it easy to avail of cashless facilities. You can get admitted by showing your identity and health card issued by Royal Sundaram.

• Intimation to the company through the pre-authorization claim form

You should fill out and submit a pre-authorization claim form to inform the company of your claim. Fill in the details such as your name, diagnosis, date of hospitalization, hospital, and treating doctors’ details and submit them at least 48 hours before your planned hospitalization or within 24 hours after hospitalization in case of emergencies. 

• Cashless Approval

Royal Sundaram will check your coverage according to your eligibility and then approve a cashless authorization letter to the concerned hospital within three days after which the hospital will proceed with your treatment. All the bills will then be paid directly to the hospital by the insurer. However, if the insurance company rejects the cashless settlement of the claim, you can opt for a reimbursement claim facility. 

• Reimbursement claims

If you are hospitalized in a hospital that does not have a tie-up with Royal Sundaram or if the cashless claim has been rejected, you can claim on a reimbursement basis. In such cases, you will have to pay all the bills. After discharge send a duly filled claim form along with all original bills and relevant documents to the insurer within 30 days. On receipt of claim documents, Royal Sundaram will reimburse the cost incurred.  You can call PayBima at 1800 267 6767 to help you with the easy settlement of the claim. You can also drop your query in an email at Paybima.care@mahindra.com and our executive will resolve your query. List of documents that are required to make a successful claim of Royal Sundaram health insurance plan:

• Duly filled original claim form with signature
• Doctor’s prescription recommends hospital admission.
• Original hospital and pharmacy bills
• Valid Identity proof
• Diagnostic test reports and consultation note
• Pre-authorisation claim form in cashless claims
• Bank mandate of Insured for payment of reimbursement claims

Royal Sundaram Health Insurance Review

Royal Sundaram health insurance plans are quite innovative and comprehensive in their scope of coverage and competitively priced. Other highlights of its health plans include:

• Royal Sundaram General Insurance is the first insurance company to introduce a cashless settlement mode for health claims and innovative health products like hospital cash.
• Royal Sundaram General Insurance Company offers specially designed and customized products to rural and small and medium enterprises. 
• The company is the first insurance provider that has long-standing tie-ups with various NBFCs and reputed banks making it a pioneer in the bancassurance segment 
• The company’s health and accident claim process was certified as ISO 9001-2015 for its effective customer service and customer satisfaction.