Royal Sundaram Health Insurance Claim Settlement Ratio

Health claim settlement ratio refers to the number of claims that the insurance company settles in relation to the total number of claims filed during the policy term. A higher claim ratio indicates positively of the insurance companies’ ability to settle the claim requests received.

Read More

Royal Sundaram Health Insurance Claim Settlement Ratio

*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply
*Tax benefit is subject to changes in tax laws. Standard T&C Apply

Get insured from the comfort of your home No medicals required
I am a

My name is

My number is

By clicking on ‘View Plans’ you, agreed to our Privacy Policy and Terms of use
Close
Back
I am a

My name is

My number is

Select Age

City Living in

    Popular Cities

    Do you have an existing illness or medical history?

    This helps us find plans that cover your condition and avoid claim rejection

    Get updates on WhatsApp

    What is your existing illness?

    Select all that apply

    When did you recover from Covid-19?

    Some plans are available only after a certain time

    Royal Sundaram General Insurance has a claim settlement ratio of 85% (2018-2019), which makes it a suitable option. Any claim ratio between 85% and 95% is considered good.

    Royal Sundaram Health Insurance at a Glance:

    Key Features

    Highlights

    Network Hospitals

    3000+

    Incurred Claim Ratio (2018-19)

    61%

    Renewability

    Lifelong

    Waiting Period

    3 years

    Policy Tenure Options

    1,2,3 years

    Restoration of Sum Insured

    Up to the base sum insured

    Grace Period

    30 days

    No-claim-Bonus

    In some plans the No-claim-bonus is 10% to 50% and in some plans, it ranges from 10% to 100%

    Daycare procedures

    Up to 200

    Vaccination Charges

    In case of animal bite

    Royal Sundaram Health Insurance Claim Process

    There is no restriction on the number of claims that can be filed in a year up to the sum insured limit. There are two ways a policyholder can claim for health policies:

    • Cashless Claims
    • Reimbursement Claims

    To avail cashless claims the treatment must be availed in a network hospital. The list of network hospitals is available online. To claim the benefits submit the authorization form to the TPA/ Insurance Company.

    To file for reimbursement of expenses, a claim form needs to be provided along with the bills. More details are given below:

    Claim for Cashless Treatment

    • If it is a planned hospitalization you can intimate the TPA and apply for cashless authorization before 72 hours of getting admitted to the hospital.
    • For emergency cases requiring hospitalization, the TPA needs to be intimated in 24 hours of getting admitted
    • After that fill and submit the cashless authorization form within 3 hours.
    • Furnish all the medical documents and duly filled form and submit it to the Insurer/TPA. In case more documents or information is required, the TPA department will get in touch with you.
    • Pay for anything that your insurance policy does not cover and make payment for the necessary expenses, which are excluded under the policy.
    • In case the treatment is excluded, a letter of rejection will be issued. And you can file for reimbursement. If the claim is approved then the insurer will settle the claim directly.

    Claim for Reimbursement Treatment

    For treatments availed in non-network hospitals, you can file reimbursement claims. And the steps to file a reimbursement claim are given below:

    • You need to submit a duly filled and signed claim form
    • The claim will be rejected only if there is a discrepancy and the insurer will issue a rejection letter within 7 days
    • On approval, your claim request will be processed within 30 days of submitting the claim. 
    • The insurer will then reimburse the expenses

    Documents Required for Royal Sundaram Health Insurance Claims

    Here are some of the crucial documents that you need at the time of claim. For complete list you can refer to the policy wordings or speak to Policybazaar’s health claim team. Some of the documents are given below:

    • Doctor’s prescriptions and test reports of medical consultations related to the undergoing treatment.
    • Medical history, admission-discharge summary describing the nature and duration of the treatment, discharge summary, etc.
    • All the medical reports like ECG, X-rays, MRI, CT Scans, Pathology reports etc., should be submitted
    • It includes doctor’s prescription advising medical tests/ investigations. In case of death a death summary of the insured person from the hospital needs to be submitted as well
    • Original copies of hospital bills/receipts/cash memos in Original (including hospital receipts final and advance both).

    For more details you can speak to our customer care team at 1800-208-8787 or write to us at care@policybazaar.com.

    Health insurance articles

    Recent Articles
    Popular Articles
    List of Diseases Covered by Bajaj Allianz Health Insurance Plans

    05 Jul 2022

    Barely any person has remained unaffected due to rising health...
    Read more
    Annual Medical Check-ups in Health Insurance

    05 Jul 2022

    Regular health check-ups are important to keep a track of your...
    Read more
    Advantages and Disadvantages of Buying a Health Insurance Policy

    04 Jul 2022

    In India, healthcare is getting expensive with each passing day...
    Read more
    Does Health Insurance Cover Sports & Gym Injuries?

    27 Jun 2022

    Gone are the days when only athletes and professional sports...
    Read more
    Health Insurance for Rural India

    24 Jun 2022

    Healthcare is expensive in India and is increasing with each...
    Read more
    PMJAY Scheme: Ayushman Bharat Yojana Eligibility & Registration Online
    Prime Minister Shri Narendra Modi announced the launch of (PMJAY) Ayushman Bharat Yojana in his Independence...
    Read more
    Best Health Insurance Plans in India 2022
    Finding the best health insurance plan from so many different health insurance companies can get confusing for many...
    Read more
    Best Maternity Insurance Plans
    Maternity insurance offers comprehensive coverage for medical expenses incurred during pregnancy, including the cost...
    Read more
    How to apply for Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)
    Ayushman Bharat health insurance is a flagship scheme launched by the Government of India, as per the...
    Read more
    Best Health Insurance Plans for Senior Citizens in 2022
    Considering the increase in medical inflation in India, buying adequate health insurance for your loved ones has...
    Read more
     
    top
    Close
    Download the Policybazaar app
    to manage all your insurance needs.
    INSTALL