Royal Sundaram Lifeline Elite Plan

Royal Sundaram’s lifeline health insurance plans offer affordable and comprehensive health coverage to support you during any medical emergency. The company offers a complete range of health insurance products. Anyone who is looking for protection against medical expenses can find a plan matching their requirements and budget.

Here is a brief introduction to Royal Sundaram General Insurance Co.

• It is the first private sector company to be registered in October 2000 under IRDAI.

• It offers innovative insurance solutions online as well as offline through 158 branches all across the country and various other channels like agents, brokers, and partners.

• It is the first private insurer in India to introduce hospital cash and cashless settlement for health claims, with a network of 7000+ hospitals.

• The company has paid 81.5% of all the claims and offers individual as well as family health plans that cover maternity expenses up to two deliveries.

• There are three variants of lifeline health insurance plans offered by the company: Royal Sundaram - Lifeline classic, Royal Sundaram - Lifeline supreme and Royal Sundaram - Lifeline Elite.

In this article, we will discuss Royal Sundaram Lifeline Elite Plan in detail.

Royal Sundaram lifeline elite plan is a premium plan with the best health coverage for your whole family. It offers additional benefits like maternity cover and an international treatment facility. This is an ideal health plan for you if you are looking for a large sum insured, critical illness coverage and coverage for treatment abroad.

Royal Sundaram Health Insurance plan - Lifeline Elite offers wide coverage benefits up to ₹ 1.5 crores for medical expenses. The following list shows the various cover benefits included in the plan.

Baseline Cover Benefits

• Inpatient Care expenses are covered up to the sum insured.
• Pre and Post hospitalisation expenses are covered up to the sum insured for 60/180 days.
• Day care procedure coverage up to the sum insured
• There is no room rent capping and no disease-specific sub-limits.
• Ambulance Cover up to ₹ 10,000
• Organ Donor treatment expenses are covered.

Other Benefits

• Domiciliary Hospitalization expenses are covered.
• No Claim Bonus starting from 20% of base coverage up to a maximum of 100%. In case a claim is filed during a policy year, NCB remains the same.
• 100% Re-load of the sum insured in case the sum insured and NCB are completely exhausted during the treatment.
• AYUSH Treatment includes inpatient hospitalisation in authorised Government hospitals up to the sum insured, and in other authorised hospitals up to ₹ 50,000
• Vaccination in case of animal bite is covered up to ₹ 7,500
• OPD Treatment is covered up to ₹ 10,000
• Emergency domestic evacuation is covered up to ₹ 3 lakhs on the advice of the treating doctor.
• Worldwide Emergency Hospitalization (Excluding the US and Canada) covered up to 50% of base sum insured maximum up to ₹ 20 lakhs, - - - Deductible of $ 1000 per hospitalisation
• International Treatment for 11 specified critical illnesses along with one-time return airfare for the insured person (Excluding the US and Canada) covered upto Sum Insured, Airfare covered upto ₹ 3 lakhs.
• Second Opinion for 11 specified critical illnesses available once during the policy year

Maternity Benefits

• Maternity cover is available for 2 deliveries up to ₹ 2.5 lakhs
• Newborn baby cover is up to 25% of the sum insured.
• Vaccinations for a newborn baby are covered in the first year up to ₹ 10,000

Health and Wellness Benefits

• Annual Health Check-up
• Preventive health care & wellness and disease management is also available

Customer Level Options

• Hospital cash benefit for 30 days in case of hospitalisation of more than 2 days are ₹ 5000 per day. This benefit is not available for hospitalisation under optional covers.
• Option to include the US and Canada for Worldwide Emergency Hospitalization and International Treatment for 11 specified critical illnesses along with one-time return airfare for the insured person.
• Monthly, quarterly, half-yearly and annually EMI options.

Elite Plus Option

• This option offers additional benefits that you can add to your existing Elite Plan. It includes
• Additional facility of app-based cabs in ambulance cover
• Refresh of the sum insured available once for the same illness.
• International treatment for 3 additional critical illnesses
• Inpatient for preexisting diseases in case of life-threatening conditions.
• Bariatric Surgery up to ₹ 2 lakhs
• Mobility devices up to ₹ 50,000
• Second opinion for additional 11 critical illnesses.
• IVF treatment up to ₹ 2.5 lakhs

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With all the above-mentioned benefits, there are certain conditions which are not covered under the policy and also there are waiting periods before you can avail of benefits for certain specified conditions.

Waiting Period

• Initial Waiting Period - 30 days
• Initial Waiting Period for the specified critical illness - 90 days
• Waiting Period for specified Pre-existing diseases - 24 months
• For maternity benefits - 36 months
• For 16 specified illnesses - 24 months

Exclusions

• Investigation and Evaluation
• Rest Cure
• Rehabilitation and respite cure
• Obesity and weight control treatments
• Gender change treatment
• Cosmetic or plastic surgery
• Adventure sports
• Breach of law
• Any treatment in health hydros, nature cure clinics, spas or similar

Royal Sundaram - Lifeline Elite Health Insurance Plan has several benefits that take care of your family’s medical care needs. Let us explore its benefits.

• Premium Health Coverage with No upper age limit: Royal Sundaram Lifeline Elite Plan provides holistic cover for all your medical expenses, with a sum insured up to ₹ 1.5 cr. The plan has no restriction on the maximum age limit.

• Widest Range of Benefits: It offers a plethora of optional benefits that you can add to enhance your coverage. International treatment, maternity cover, second opinion for 11 critical illnesses and wellness benefits are some of its best-in-class benefits.

• Reload of Sum Insured: Policyholders can reload their sum insured up to 100% if they exhaust the entire sum insured at no extra cost.

• Maternity Benefits: The plan provides maternity cover with newborn cover and vaccination cover for 1 year. This cover is available for 2 deliveries, thus letting you take on the new responsibilities without worrying about the expenses.

• Discounts: The plan offers a discount of 7.5% for the premium paid upfront for a 2-year term and 12% for a 3-year term. There is also a discount of 15% applicable for zone 2 cities.

Speed and efficiency are the most important factors that a policyholder seeks during claim settlement. It is what makes it worth having health insurance coverage. There are two ways in which Royal Sundaram health Insurance Plan claims are processed.

Cashless Claims (Domestic)

• Cashless claims can be availed only if the hospitalisation is done in a network hospital. The process is as follow: The insured should intimate a claim within 24 hrs of emergency hospitalisation and 48 hrs before planned hospitalisation. These details need to be provided at the time of claim intimation:

  • The insured person, i.e. the patient’s Name
  • Details of the diagnosis and the line of treatment
  • The doctor’s advice for hospitalisation
  • The details of the hospital where the treatment will be done
  • Expected Discharge

• Inform the TPA 72 hrs before planned hospitalisation and within 24 hrs of emergency hospitalisation to seek cashless authorisation.

• The TPA, i.e. the third party administrator, would check your documents based on your eligibility and coverage before providing a pre-authorization for the claim.

• On discharge, the hospital bill is directly settled by the company. Please note that in case the cashless facility is rejected, it does not mean your claim is rejected.

Cashless Claim (Worldwide Emergency Hospitalization)

• In case you need emergency hospitalisation, here is how you can file a claim

• Inform the service provider within 24 hours of emergency hospitalisation Service provider will verify your request and the eligibility under the policy and may ask for additional details.

• On verification, the service provider will contact the hospital and inform them whether the claim request has been accepted or rejected.

• On approval claim is directly settled by the service provider.

Reimbursement Claims

If you are availing treatment at a non-network hospital, you can still fill a claim for reimbursement following the process given below.

• Send a claim form which needs to be filled and signed by the policyholder within 30 days of discharge, and send all the medical bills and reports to the insurer. For a list of documents, refer to the claim form.
• The company will verify all the documents sent by you, in case of any discrepancy, the company will inform you within 7 working days of the receipt of documents.
• Once the claim is approved, the company settles the claim within 30 days.

Claim Process for International Treatment of 11 critical illnesses

• If you are diagnosed with a listed critical illness and are seeking treatment abroad, here is how you can file a claim
• Inform the service provider immediately of the confirmed diagnosis of a listed critical illness in case you need treatment outside India. You can email or call on the registered customer care number.
• The service provider will verify your request for your details.
• After verification, your hospital will be informed about the acceptance or rejection of your claim request by the service provider.
• If the claim is authorised, the same would be settled by the insurer.

If you are someone who frequently travels to international locations, and looking for the best coverage in international locations as well as in India, Royal Sundaram - Lifeline Elite plan is the best choice for you. You can take this plan for your entire family. The plan offers an array of benefits with massive coverage for you and your family.