Royal Sundaram Health Insurance Claim Settlement - A Hassle-free Process

To have a seamless claim experience, most people prefer insurers with a good claim settlement ratio and an easy claim process. For instance, Royal Sundaram General Insurance Company offers comprehensive health coverage with an easy claim settlement process. Read on to know the claim process for Royal Sundaram health insurance plans.

Read More

Policybazaar exclusive benefits
30 minutes claim support##
(In 120+ cities)
Relationship manager
For every customer
24*7 claims assistance
In 30 mins. guaranteed*
Instant policy issuance
No medical tests~
People trust Policybazaar^
7.7 crore
Registered consumers
50
Insurance partners
4.2 crore
Policies sold
Policybazaar is one of India's leading digital insurance platform
0%
Find affordable plans with up to 25% Discount**

Select members you want to insure

  • More Members
  • Back
    Continue
    By clicking on “Continue”, you agree to our Privacy Policy and Terms of use
    Maximum child sum can be 4
    This will help us calculate the premium & discounts for your family
    Previous step
    Continue
    This will help us to find the network of Cashless Hospitals in your city

      Popular Cities

      Previous step
      Continue
      Get to plans directly next time you visit us
      Please provide your active international number
      Previous step
      Continue
      We will find you the plans that cover your condition.

      Do any member(s) have any existing illnesses for which they take regular medication?

      Get updates on WhatsApp

      Previous step

      When did you recover from Covid-19?

      Some plans are available only after a certain time

      Previous step

      Royal Sundaram Health Insurance claims can be made in two ways:

      • Cashless Health Insurance Claim
      • Health Insurance Reimbursement Claim

      The procedure for both is different. Let’s have a look

      For claiming cashless benefits, the insured must avail of the treatment from a network hospital only. Royal Sundaram health insurance hospital list is provided at the time of purchasing the policy. You need to fill an authorization form provided by the hospital authority or TPA and follow the given formalities in the prescribed form.

      If it is a reimbursement claim, then the insurer has to be informed about the incident and provide the estimate of the expenses incurred. The insured needs to fill and submit a claim form along with the discharge summary, doctor’s prescription, and the medical bills. 

      Important details required for claim intimation are:

      • Royal Sundaram mediclaim policynumber 
      • Name of the hospital 
      • Contact number, email id, residential address, landmark, etc. of the policyholder/applicant
      • Name of the patient or insured who is admitted in the hospital
      • Relationship of policyholder with the patient
      • Nature of illness
      • In case of an accidental hospitalization, details of the accident, date, time, and location are required
      • Starting date of the symptoms of the illness

      Step-Wise Cashless Claim Procedure 

      1. If the hospitalization was planned, you need to inform the TPA about it and get a cashless authorization in minimum of 72 hours before hospitalization.

      2. In case of an emergency, the TPA should be informed within 24 hours of the hospitalization.

      3. Fill the cashless authorization form provided by the TPA. The TPA will first check the coverage and your eligibility to avail the claim.

      4. Attach all the necessary documents along with the duly filled claim form and submit it to the TPA department. If there is any discrepancy, the TPA will coordinate with you within 4 hours of receiving the form.

      5. Pay the expenses that are not covered in the Royal Sundaram health insurance plan

      6. In case a specific ailment is not covered in this plan, a rejection letter will be issued to you within 2 hours.

      Royal Sundaram Health Insurance Claim Procedure for Cashless Facility (for Worldwide Hospitalization)

      1. In case of an emergency hospitalization overseas, inform the insurer within the 24 hours of the hospitalization

      2. The eligibility to file a claim would be verified by the company and you will receive a call from the insurer to initiate the claim

      3. If the pre-authorization request is approved, the hospital expenses will be directly compensated by the insurance company

      4. And if there is an additional cost attached to it, it has to be borne by you

      Claim Procedure for Reimbursement

      If the treatment was taken in a non-network hospital and you want to make a claim, then you need to follow these steps to file a claim

      1. Submit the duly filled and signed claim form within 30 days of discharge from the hospital.

      2. If the insurer finds everything appropriate, then the claim amount will be recompensed within 30 days of lodging the claim.

      3. In case of any discrepancy or rejection, a letter of rejection will be sent to you within 7 days of claim submission.

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

      5. All the documents need to be submitted at the branch office.

      Claim Procedure for International Treatment for Critical Illnesses

      Royal Sundaram health insurance also offers international treatment for some specified illnesses. Here is how to lodge claims under any such circumstances-

      1. Immediately inform the insurer upon diagnosis of any specified critical illness. If you are planning to travel overseas, you need to inform the insurance company and request for a pre-authorization to avail of the medical treatment abroad. 

      2. Depending on your eligibility the request will be processed.

      3. The insurer will coordinate with the hospital authorities to seek approval.

      4. If the pre-authorization request is approved, the expenses will be directly settled by Royal Sundaram General Insurance Company.

      5. You just need to pay the additional charges ( if any).

      6. In case of emergency hospitalization, you need to inform Royal Sundaram General Insurance Company within 24 hours of the admission.

      7. And if it is a planned hospitalization, the company should be informed within 48 hours prior to hospitalization.

      Documents Required for Royal Sundaram Health Insurance Claims

      Here is a list of documents that you need to furnish to lodge a claim with Royal Sundaram health insurance. For a detailed list please refer to the policy wordings. 

      1. Hospital bills/receipts/cash memos ( in original).

      2. Reports of medical test/ doctor prescriptions/ medical consultations for related illness.

      3. All reports related to the treatment such as ECG, MRI, X-rays, and Pathology etc.

      4. Hospital discharge summary/ case history/ discharge and admission summary, reports of the treatment is given, and medical advice issued by the hospital.

      5. In case of death submit the death summary issued by the hospital.

      Takeaway

      As you can see filing a claim for Royal Sundaram health insurance plans with Royal Sundaram General Insurance Company is a detailed process. The insurer follows the claim settlement process that is laid out in the policy wordings. Hope with this article you will provide you with prior knowledge of registering your Royal Sundaram health claims. You can speak to Policybazaar’s health insurance customer care team for any clarifications and grievance redressal. Our team of health insurance experts will take you through the entire process.

      book-home-visit
      Search
      Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in

      Health insurance Articles

      • Recent Article
      • Popular Articles
      26 Sep 2024

      Can You Get Maternity Insurance If Already...

      Pregnancy is one of the most beautiful phases of a woman’s life

      Read more
      12 Aug 2024

      Moratorium Period in Health Insurance

      Getting a health insurance claim accepted for pre-existing

      Read more
      30 Jul 2024

      Is Dengue Covered by SBI Health Insurance?

      Dengue, a common vector-borne disease, causes high fever, severe

      Read more
      30 Jul 2024

      Is Dengue Covered by Reliance Health Insurance?

      Dengue fever can negatively impact you physically and financially

      Read more
      29 Jul 2024

      Modern Treatments in Health Insurance

      Modern treatments have transformed the healthcare industry with

      Read more

      Zero Waiting Period in Health Insurance Plans

      Every medical insurance plan comes with a few terms & conditions, and the waiting period is one of them. A

      Read more

      10 New IRDAI Health Insurance Guidelines in 2024

      Health insurance penetration in India is far lower than it should be. A significant chunk of the Indian population

      Read more

      List of Health Insurance Plans for Senior Citizens

      Senior citizens are the most prone to diseases. Considering the medical inflation in India, buying health insurance

      Read more

      10 Major Benefits of Ayushman Bharat Yojana

      Pradhan Mantri Jan Arogya Yojana (PM-JAY) is the second component under Ayushman Bharat Scheme. PM Narendra Modi

      Read more

      Heart Surgery Cost in India

      Heart diseases are the leading cause of death across the globe. As per a survey by the World Health Organisation

      Read more

      *We will respond in the first instance within 30 minutes of the customers contacting us. 30-minute claim support service is for the purpose of giving reasonable assistance to the policyholder in pursuance of the claim. Settlement of claim (including cashless claim) is the responsibility of the insurer as per policy terms and conditions. The 30- minute claim support is subject to our operations not being impacted by a system failure or force majeure event or for reasons beyond our control. For further details, 24x7 Claims Support Helpline can be reached out at 1800-258-5881.

      *Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. Policybazaar does not provide any medical or surgical advice or diagnosis and is not responsible for your interactions / treatment by a medical practitioner/hospital. Please consult a registered medical practitioner for any medical or surgical advice. The Information that you obtain or receive from Policybazaar, and its employees, or otherwise on the Website is for informational purposes only. As per the Insurance guidelines, you are allowed to cancel the policy with-in 30 days from the date of Issuance of policy.This option is available incase of policies with a term of one year or more.

      *All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.

      **All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws. GST Exemptions depend on fulfilment of qualification criteria and submission of relevant documents.

      *₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.

      *₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases

      *₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.

      *₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.

      *No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.

      *The values taken for effective cost calculation are indicative values and may change as per the selected plan.

      *Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.

      *Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.

      *The scope of coverage may vary from plan to plan.

      ~Source: Google Review Rating available on:- http://bit.ly/3J20bXZ

      ##On ground claim assistance is available in 114 cities

      Tax Benefits are subject to changes in tax laws. GST Exemption depends on fulfilment of qualification criteria and submission of relevant documents as required by the insurers. For more details on risk factors, terms and conditions, please read the sales brochure and applicable rules and regulation carefully before concluding a sale.

      STANDARD TERMS AND CONDITIONS APPLY. For more details on risk factors, terms and conditions, please read the sales brochure carefully before concluding a sale.

      Policybazaar is a registered Composite Broker |Registration No. 742, Valid till 09/06/2024, License category- Composite Broker| Visitors are hereby informed that their information submitted on the website may be shared with insurers.

      Policybazaar Insurance Brokers Private Limited | CIN: U74999HR2014PTC053454 | Registered Office - Plot No.119, Sector - 44, Gurgaon, Haryana - 122001 Contact Us | Legal and Admin Policies

      © Copyright 2008-2024 policybazaar.com. All Rights Reserved.

      top
      Close
      Download the Policybazaar app
      to manage all your insurance needs.
      INSTALL