Royal Sundaram Lifeline Health Plan

Royal Sundaram Lifeline Health Plan

Lifeline Health plan is a comprehensive insurance plan that caters to medical needs of both - you and your family members! With growing uncertainties of health issues in India, having medical insurance has become inevitable. Anyone above 18 years of age can buy this plan. This is an individual plan as well as family floater plan for joint families in India - providing health cover to you, your children and spouse. Because a healthy family is a happy family!

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Royal Sundaram Lifeline Health Plan has three variants:

• Lifeline Classic
• Lifeline Supreme
• Lifeline Elite

These plans offer wide cover ranging from Rs. 2 Lakhs to Rs. 1.5 Crore.

Eligibility Criteria to Buy Royal Sundaram Lifeline Health -

• The proposer needs to be above 18 years to get insured under this plan
• There is no cap on maximum entry age
• The plan will provide coverage to the insured and their spouse as well as their dependent children aged between 91 days and 25 years

Royal Sundaram Lifeline Health Insurance Plans Comparison Table

1.Royal Sundaram Lifeline Classic Plan

The Key Features & Benefits of Royal Sundaram Lifeline Classic Plan are Listed Below:

• Policy tenure of 1,2 & 3 years
• Comprehensive health insurance plan
• Lifelong renewability
• A grace period of 30 days
• Easy cancellation process

Inclusions of Royal Sundaram Lifeline Classic Plan

• Inpatient hospitalization expenses including fees charged by doctors, medical tests, nursing and boarding charges, operation theater and ICU charges, cost of medicines, drugs, and vaccinations. Blood, oxygen and other charges are also included
• 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)
• All day care treatment expenses( required as part of treatment) to be reimbursed up to the sum insured limit ( except OPD charges)
• Ambulance charges to be covered up to Rs.3,000
• Organ Donor treatment expenses to be compensated up to the sum insured limit
• Domiciliary hospitalization charges are also included
• No-claim bonus (NCB) between 10-50% of sum assured. It is not reduced if a claim is filed in a particular year
• 100% reinstatement of sum insured and No-claim bonus, if the sum assured is exhausted during the treatment of different diseases
• AYUSH treatment cover up to sum assured - if hospitalization is done in a government recognized hospital. In other hospitals, compensation is up to Rs.20,000
• Vaccination for an animal bite is covered up to Rs.2,500
• Complete health check-up facility in every 3rd year of the policy
• Preventive healthcare and wellness facility

Sum Assured (Rs.)

• Sum insured is a minimum of Rs 2 lakhs
• Maximum up to Rs 4 lakhs

2. Royal Sundaram Lifeline Supreme Plan

The Key Features & Benefits of Royal Sundaram Lifeline Supreme Plan are Listed Below:

• Policy tenure of 1,2 & 3 years
• Double your coverage amount with No-claim-discount after 5 years of the policy term
• Emergency domestic evacuation cover
• Second opinion for 11 major critical illnesses
• Easy cancellation process

Inclusions of Lifeline Supreme Plan

• Covers all the inpatient hospitalization expenses
• 60 days of pre-hospitalization expenses and 90 days of post-hospitalization expenses are reimbursed
• Medical expenses for day-care procedures like chemotherapy, radiotherapy required as a part of the treatment ( excludes OPD expenses)
• Ambulance cover is extended up to Rs. 5,000.
• Coverage for organ donor expenses up to the sum assured limit
• Domiciliary hospitalization expenses to be recompensed up to the sum insured limit
• 20% to 100% of No-claim bonus (NCB) benefit. The value does not reduce even when a claim is filed during a particular year
• 100% reinstatement of sum insured upon exhaustion of the total sum insured and No-Claim Bonus.
• AYUSH Treatment cover up to the sum assured when hospitalization is done in government hospitals. For other hospitals, the limit is up to Rs. 30,000.
• Vaccination cover up to Rs. 5000 in case of an animal bite
• Annual health check-up facility for each insured member who is above 18 years of age and this is irrespective of the claim
• Domestic evacuation expenses up to Rs. 1 lakhs

Sum Assured (Rs.)
Minimum sum insured is Rs. 5 lakhs
Maximum sum insured is Rs. 50 lakhs

3. Royal Sundaram Lifeline Elite Plan

The Key Features & Benefits of Royal Sundaram Lifeline Elite Plan are Listed Below:

• Worldwide emergency hospitalization cover
• Maternity cover
• Second opinion coverage for 11 major critical illnesses
• Double your sum insured ad no-claim bonus benefit after 5 years
• Easy cancellation process

Inclusions of Royal Sundaram Lifeline Elite Plan

• Covers inpatient hospitalization expenses
• 60 days pre and 180 days post-hospitalization cover
• Daycare treatment cover up to the sum assured limit
• International treatment cover for 11 specified critical illnesses along with return flight cost to be reimbursed up to Rs.3 lakhs. This excludes cover in the US and Canada. This can be additionally covered at the time of policy purchase.
• Worldwide emergency hospitalization cover up to 50% of insurance amount or up to Rs.20 lakhs. This excludes cover in the US and Canada. This can be additionally covered at the time of policy purchase. Deductibles applicable - equal to $1000 per claim amount
• Maternity cover is provided for 2 deliveries ( both the spouse should be insured)
• Newborn baby cover along with the cost of vaccines for the first year
• Also covers OPD treatment charges up to Rs.10,000
• Extended ambulance reimbursement up to Rs.10,000
• Organ donor treatment expenses are covered up to the sum assured limit
• Reimbursement for domiciliary hospitalization expenses
• 20% to 100% of NCB benefit. The value does not reduce even when a claim is filed during a particular year
• Reinstatement of sum assured on exhaustion of policy amount and NCB
• AYUSH Treatment in government hospitals ( up to the sum insured) and for other hospitals the insurance cap is of 50,000
• Up to Rs.7,500 vaccination cover in case of an animal bite
• Annual health check-up facility
• Second opinion cover - this is valid for 11 specific critical illness ( when diagnosed or undergoing treatment)
• Up to Rs.3 lakhs of domestic evacuation cover in case of an emergency

Sum Assured (Rs.)
Minimum sum insured is Rs. 25 lakhs
Maximum sum insured is Rs. 1.5 crore

Common Exclusions under the Plan

Royal Sundaram Lifeline health insurance plan does not cover the following expenses: 

• Pre-existing illnesses mentioned while purchasing the policy should be covered after completion of 2 continuous policy years. Any break in between will make it inapplicable
• Any claim arising within the first 30 days of the policy inception date ( unless it is an accidental case)
• For the initial 2 years disease like hip replacement surgery, Cataract, benign prostatic Hypertrophy renal failure shall not be covered
• Critical Illness diagnoses or treatment during the initial 90 days from the policy commencement date shall not be recompensed

Permanent Exclusions -

• Alternative treatment other than Ayush treatment
• Congenital diseases
• Self-inflicted injuries or mental disorders like anxiety and depression
• Plastic & cosmetic procedure/surgeries
• Speech related disorders
• Treatment for HIV/AIDS infection
• Stem cell implantation
• Alopecia treatment
• Sleep-related disorders
• Dental treatment
• Observational hospitalization
• Hospitalization required due to involvement in unlawful activities
• Any occupationally related disease
• Treatment received outside India ( it is covered in the supreme plan)

Please refer to the policy wordings for further details, before making the purchase.

Claim Procedure of Royal Sundaram Lifeline Health Insurance Plans

Firstly you need to start with the claim intimation

Notify the insurance company at least 72 hours before hospitalization in the event of planned hospitalization. In the event of emergency hospitalization, you need to inform the insurer within 48 hours.

You need to furnish the following details during claim intimation:

• Name of the insured person/patient
• Details of the Hospital- Name, Contact Number and Address
• Diagnosis
• Hospitalization date
• Details of the Treating Doctor ( his name and contact details)
• Expected discharge date

Procedure for Royal Sundaram Lifeline Health Insurance Pre-Authorization (Cashless Facility)

• If your hospitalization was planned then you need to notify the TPA and try for cashless authorization at least 72 hours before the hospitalization
• And for emergency hospitalization, the TPA needs to be informed within 48 hours of the hospitalization
• Once all the documents are submitted the TPA will approve cashless authorization as per your eligibility criteria and the policy. Approval will be given within 3 hours of document submission. In case the documents are incomplete, then it will also be communicated to the hospital within 3 hours of receipt of documents
• You will need to pay the other expenses that are not covered in your policy
• In case a given treatment is not covered under this plan. then a claim rejection letter would be sent to the hospital within 2 hours of the request

Procedure for Royal Sundaram Lifeline Health Insurance Reimbursement Claims

1. Please send the duly filled and signed claim form and all the information/documents mentioned* therein to Royal Sundaram Insurance within 30 days from the date of discharge. * Please refer to claim form for complete documentation.
2. If there is any discrepancy in the documents/information submitted by you, Royal Sundaram will send the deficiency letter within 7 days of receipt of claim documents.
3. Once all the claim documents are submitted, the insurance company will pay off the admissible amount. You will also get the claim settlement letter within 30 days.
4. The payment will be made in the name of the proposer.
5. Claim documents can be sent on their address

Procedure to avail Pre-Authorization for Cashless facility (for Worldwide Emergency Hospitalization)

• For cashless treatment, you need to inform within 24 hours of the hospitalization
• The insurer’s service provider will assess the request and your eligibility of as per the policy terms. They can seek more information ( as the case may be)
• Royal Sundaram’s service provider will check with the hospital whether your claim request for pre-authorization has been rejected or is approved
• If the claim is approved, your claim will be settled directly with the hospital. Please note that any extra charges, medical costs that are beyond the scope of coverage shall be borne by the policyholder

Procedure for International Treatment for 11 specified Critical Illness

• In case of diagnosis of a specified critical illness, the policyholder should immediately call their service provider before travelling for treatment overseas
• You need to file a request for a pre-authorization for the overseas treatment
• The service provider will assess the request and your eligibility for the claim and seek more information or details depending on your case
• The decision will be communicated directly to you and the hospital regarding the rejection and approval of the pre-authorization
• If the request is approved, your claim cost will be settled directly with the hospital
• Any other expenses incurred during the treatment that is beyond the scope of coverage by or at any non-network hospital should be borne by the policyholder.