Royal Sundaram Lifeline Classic Plan
It can be financially and emotionally distressing if any of the family members gets hospitalized. Dealing
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Features of Royal Sundaram Lifeline Classic Plan
The advantages of staying insured under this plan are as follows:
- Policy tenure ranges from 1 to 3 years
- It is an all-inclusive health insurance policy
- The plan offers lifetime renewability option
- There is a grace period of 30 days to renew your policy
- Easy cancellation and purchase process
- Both Individual and family floater option available
- Quick and Hassle-free claim settlement process
Inclusions of Royal Sundaram Lifeline Classic Plan
The plan reimburses the following medical expenses:
- Inpatient hospitalization expenses including doctor fees, medical tests, operation theater charges, nursing and boarding charges, cost of medicines, ICU charges, and vaccinations. Blood oxygen and other charges are also covered
- No-claim bonus
- Pre-hospitalization charges to be covered for 30 days and Post-hospitalization charges to be covered for 60 days ( up to the sum assured limit)
- Daycare treatments are reimbursed up to the sum insured limit ( OPD charges are excluded)
- Ambulance charges to be covered up to Rs.3,000
- Emergency domiciliary hospitalization expenses are also recompensed
- 10-50% of sum assured as No-claim bonus ( if no claim is filed during a policy term)
- Organ donor treatment expenses to be recompensed up to the sum insured limit
- After every 3rd year of the policy, the policy offers complete health check-up facility
- Preventive healthcare and wellness facility
- 100% restoration of the sum insured, upon exhaustion of the sum assured during treatment of different diseases
- AYUSH treatment expenses in a government hospital (up to the sum assured). In other hospitals, the limit is up to Rs.20,000
- Vaccination for the animal bite is covered up to Rs.2,500
Sum Insured Options
- Minimum: Rs. 2 lakhs
- Maximum: Rs. 4 lakhs
- Adults: 18 years & above Children: 91 days to 25 years
Exclusions of Royal Sundaram Lifeline Classic Plan
The insurer is not liable to pay any expenses for the following medical conditions under the Lifeline Classic health insurance plan. Mentioned below are the health conditions that are
- Maternity expenses
- Pre-existing illnesses that are mentioned at the time of policy purchase will be covered after completion of 48 months of the policy period
- Claims are invalidated in case of any gap in the renewal
- Diseases that are diagnosed within the initial 30 days from the policy commencement date are excluded from the policy
- Surgeries such as Benign Prostatic Hypertrophy, Cataract, End Stage Renal Failure, Knee/Hip Replacement surgeries are excluded until completion of 2 years of the policy period.
Permanent exclusions
The plan does not cover the expense incurred on the following medical conditions:
- Medical cover availed due to Addictive Conditions and Disorders, Adventure or Hazardous Sports
- Puberty and Ageing
- Alternative Treatment (except AYUSH)
- Convalescence and Rehabilitation
- Charges for Medical Papers
- Congenital Conditions
- Conflict and Disaster
- Cosmetic Surgery
- Eyesight Treatment
- Drugs and Dressing for OPD Treatment
- Wellness Clinics
- HIV and AIDS
- Hereditary Conditions
- Obesity
- OPD Treatment
- Hospitalization for Investigative or observational purpose only
- Personal comfort and convenience items
- Psychiatric and Psychosomatic Conditions
- Reproductive Medicine
- Circumcision
- Dental/Oral Treatment
- Preventive Care
- Sexually Transmitted Diseases
- Self-inflicted Injuries
- Sexual problems and gender issues
- Sleep Disorders
- Stem Cell Implantation
- Speech Disorders
- Alopecia treatment
- Artificial Life Maintenance
- Treatment for developmental problems
- Treatment received in an International hospital
- Experimental/ Unproven treatment
- Treatment from an Unrecognized Physician or Hospital
- Injury or illness resulting due to involvement in an unlawful activity
Royal Sundaram Lifeline Classic Plan Claim Procedure
There are two types of claim that you can register:
- Health Insurance Reimbursement Claim
- Cashless Health Insurance Claim
You can only avail cashless benefit at a network hospital. The list of network hospitals is available on the insurer’s site.
The process for both cashless and reimbursement claims is different and is explained in detail below:
Royal Sundaram Health Insurance Claim Intimation
For claim intimation you need to furnish the following information:
- Name of the hospital
- Royal Sundaram health policy number
- Nature of illness
- Contact details of the policyholder, residential address, email id, landmark, etc.
- Name of the patient or insured member who is availing the treatment
- Relationship of the insured with the patient
- The date when the illness started to give its initial symptoms
- For claims related to accidental injuries, you would need to provide the time, date, location and details of the incident
Royal Sundaram Health Insurance Cashless Claim Procedure
- For planned hospitalization claims, you need to inform your Third-party administrator about the treatment and seek cashless authorization within 72 hours of hospitalization.
- In case of an unforeseen hospitalization, inform the TPA within 24 hours of getting hospitalized.
- Firstly you will need to fill the cashless authorization form; you can get it from the TPA. All the details and your eligibility criteria will be checked before sanctioning your claim request.
- Attach all the necessary documents along with the duly filled claim form and submit it to the TPA department. In case of any query or discrepancy, the TPA will get in touch with you within few hours of receiving the form.
- Make the payment for the expenses that are not covered in the plan
- If your claim is invalidated, the insurer will issue a rejection letter in your name within 2 hours.
Royal Sundaram Health Insurance Reimbursement Claim Procedure
The claim procedure for medical treatment taken in a non-network hospital is listed below:
- Fill and sign the claim form. You need to submit it within 30 days of getting discharged from the hospital
- If all goes well, then you will get compensation equal to your claim amount within 30 days of registering the claim
- If your claim is rejected, then the insurer will issue a rejection letter in your name within 7 days
- The amount will be settled in the name of the proposer/applicant
- The documents shall be submitted at the nearest branch office