Royal Sundaram Lifeline Elite Plan

Royal Sundaram Lifeline Elite Plan

Lifeline Elite is for people who keep traveling to other countries and are looking for a comprehensive Health Insurance Plan that offers coverage in India and overseas.

Read More

Anyone, more than 18 years of age can buy this plan, which is available in an individual as well as family floater option. You can avail the best of medical and healthcare facilities, in India and abroad. The sum assured options range from INR 25 lakh to 1.5 crores.

Lifeline Elite offers various additional benefits including international treatment, critical illnesses, cover, maternity expenses, major health issues, and accidental expenses within India and abroad.

Royal Sundaram Lifeline Elite Plan Key Features

The advantages of Royal Sundaram Lifeline Elite Plan are as follows:

• Maternity expenses are also covered in the Elite plan
• Worldwide emergency hospitalization expenses are also covered
• Second medical opinion cover for 11 life-threatening diseases is provided under this plan
• The easy online purchase process
• Easy cancellation process
• Get double the sum insured and no-claim-discount after five-consecutive years

Royal Sundaram Lifeline Elite Plan Inclusions

• Pre and post-hospitalization expenses for 60 days for the former & 180 days for the latter
• Inpatient Hospitalization charges
• OPD charges up to Rs.10,000
• Emergency Hospitalization expenses to be covered worldwide. The limit is up to 50% of the Sum Insured and to a maximum of Rs.20 lakh. Coverage can be extended to the USA and Canada. Deductibles of $1000 are applicable to each claim
• The plan covers different daycare procedures
• Organ donor costs to be compensated up to the sum assured limit
• Emergency domestic evacuation cover and the limit is up to Rs.3 lakh
• It also covers hospitalization expenses overseas for 11 specified critical illnesses. The limit is up to 3 lakh and it includes the return airfare as well. Coverage can be extended to the USA and Canada.
• Maternity expenses are covered for a maximum of 2 deliveries if both the parents are covered under the same plan. It includes the new-born baby cover and his vaccination expenses
• Emergency ambulance charges up to Rs.10,000
• Domiciliary hospitalization cover ( subjected to the terms and conditions)
• No-claim-discount ranges from 20 to 100% of the sum assured. NCB remains intact, despite a claim during the policy term.
• Annual health check-up facility is offered to the insured members
• Emergency domestic evacuation expenses up to Rs.3 lakh
• Restoration of the sum insured upon exhaustion of the No-claim-discount and sum insured
• AYUSH treatment expenses in a government hospital for a maximum of Rs. 50,000
• Second medical opinion expenses to be covered in case of 11 specified critical illnesses
• Vaccination expenses for an animal bite and the limit is up to Rs.7,500

Sum Assured Options in Royal Sundaram Lifeline Elite Plan

• The minimum sum insured amount is INR 25 lakhs
• The maximum sum insured amount is INR 1.5 crore

Common Exclusions under the Royal Sundaram Lifeline Elite Plan

Following medical expenses are not covered under this policy:

• Pre-existing ailments that were declared at the time of purchasing the policy shall only be covered after waiting of 48-months of the policy term
• Any illness that was diagnosed in the initial 30 days of the policy purchase is not covered
• In case there is any gap in the renewal then your claim will be rejected
• Cataract surgeries and hip/knee replacement surgery will be covered after 2-years of the continuous policy term
• There is a waiting period of 2-years for treatment required for Benign Prostatic Hypertrophy, and End Stage Renal Failure

Royal Sundaram Lifeline Elite Plan Permanent exclusions

The insurer will reject any claim arising due to the following medical reasons:

• Any alternative treatment (other than AYUSH treatment)
• Medical cover availed due to Addictive Conditions and Disorders, Adventure or Hazardous Sports
• Convalescence benefits
• Cosmetic surgeries
• Rehabilitation treatment
• Disaster and conflicts
• Congenital diseases
• Treatment for eyesight
• OPD Expenses
• Wellness Clinics
• AIDS
• Hereditary Conditions
• Sexually Transmitted Diseases
• HIV
• Speech Disorders
• Artificial Life Support/Maintenance
• Obesity
• Circumcision
• Treatment for sleep disorders
• Preventive care
• Oral care
• Treatment that was taken from an unrecognized hospital or physician
• Alopecia treatment
• Stem cell implantation
• Investigative treatments
• Sexual problems
• Psychological disorders
• Self-inflicted Injuries
• Hospitalization required to treat developmental problems
• Any type of experimental treatment
• Loss or damage resulting from an unlawful activity

For details please read your policy wordings before making the payment.

Royal Sundaram Lifeline Elite Plan Claim Procedure

Claim Procedure of Royal Sundaram Lifeline Health Insurance Plans

Claim intimation is the first step in this regard. It is important to notify the insurance company in the stipulated time for both the planned and unplanned hospitalizations.

At the time of claim intimation, you need to furnish the following details:

• Patient’s name/proposer name/policyholder name
• Diagnosis of the treatment with reports
• Date of hospital admission
• Hospital name, address and contact details
• Treating Doctor’s name and contact details
• Expected discharge date

Cashless Pre-Authorization Process for Medical Treatment in India

• If it was a planned hospitalization then make sure that you inform the TPA beforehand. If you want to go for cashless treatment then let your insurer know about the same at least 72 hours in advance.
• If it is an emergency hospitalization, then initiation within 48-hours shall suffice
• Once you have submitted documents as per the requirement then your claim will be processed and you shall get your approval within 3-hours of document submission
• Any extra expense that is not covered under the policy shall be paid by you
• A rejection letter will be issued in case the given treatment is not covered under the policy

 Royal Sundaram Lifeline Elite Reimbursement Claims Procedure

1. All the claims require you to fill, sign and then submit the claim form
2. It is then followed by the submission of all the documents within a month of getting discharged from the hospital. Please note that complete documentation is required for all the claims
3. In case any document is missing or there is any discrepancy, intimation will be given to you within 7 days of submission
4. Upon submission of all the required documents, your claim request will be taken forward and your claim amount will be settled within 30 days
5. All the payments shall be made in the name of the policyholder
6. You can send all the claim documents at the nearest branch

 Cashless Pre-Authorization Claim Procedure (for Overseas Emergency Hospitalization)

• In any case, it is required to inform the insurer within a day of the hospitalization
• Your request will be assessed as per your policy’s eligibility criteria and then it will be taken forward
• The insurer will check with the concerned hospital if your pre-authorization request has been accepted or not
• The insure settles the hospital bills directly once the claim is settled
• Any extra expense that is not covered under the policy shall be borne by you

Claim Procedure for 11 specified Critical Illness

• Once a specified critical illness is diagnosed, then make sure that you immediately inform the insurer before arranging for your treatment overseas
• Register a pre-authorization request before undergoing treatment overseas
• The insurer will ascertain your request and claim eligibility and will ask for details as per your case
• Your claim acceptance or rejection will depend on the approval of your pre-authorization request
• Your claim will be settled once your request is approved, and the same will be conveyed to you
• The expense will be settled directly by the insurer
• Any extra expense that is not covered under the policy shall be paid by you