Royal Sundaram Family Good Health Insurance Plan
Royal Sundaram Family Good Health Insurance Plan is designed to take care of family against sudden illness, accidents and unexpected hospitalization, provides maximum sum insured cover up to Rs. 4 lacs. Offers, flexibility to get cover for self, spouse, parents and children, life insured and family members can be covered under a single plan. The Sum Insured is floater among family members for Floater plan and individual sum insured for Individual Plan.
Key Features
Covered after 4 policy years
Across 3000 network hospitals
From 5% up to 50 %
Benefits
Expenses like consultation fee, medicines, and diagnostic studies incurred while diagnosing / treating any disease/illness for which further treatment is taken as an inpatient. Pre hospitalization expenses are covered for 30 days prior to date of admission in a hospital.
Expenses like room rent, consultation fee, surgeon's fee, medicines, diagnostic studies , anesthesia, blood, oxygen, operation theatre charges etc., while admitted into a hospital for a minimum period of 24 hours.
Expenses such as consultation fee, physiotherapy charges, medicines incurred related to disease/accident for which hospitalization happened after one gets discharged and incurred within a period of 60 days after date of discharge.
Coverage for medical expenses incurred for any daycare procedures that requires less than 24 hours of hospitalization.
Ambulance charges in an emergency, subject to a limit of Rs.1, 000/- per claim.
Up to Rs.750/- per insured person towards Master Health Checkup after each 4 consecutive claim-free year.
24 hours helpline service, Ambulance Referral Service, track claims online, upload medical documents online.
If the policy holder is not convinced with the terms and conditions of the policy, s/he can cancel the same within 15 days of the receipt of policy document.
Under section 80D of Income Tax Act.
How it works
Under this plan, life insured + spouse + dependent children above the age of 91 days up to 21 years and dependent parents up to the age of 50 years, can be covered without documentation. The plan can be bought for 1 or 2 years and Sum Insured option available between Rs 2 lakhs, Rs 3 lakhs and Rs 4 lakhs.
Exclusions
- Pre-existing diseases will be covered only after 4 years of continuous coverage from the time of inception.
- Ailment within 30 days of policy commencement are excluded from scope of coverage.
- Congenital Internal Disease, Stone in urinary and biliary systems, Migraine/Vascular headaches etc., are not covered during first year of insurance.
- Cataract, Benign Prostatic Hypertrophy, Knee/Hip Replacement, Heart Disease, Chronic Renal Failure/ End Stage Renal Failure etc., are not covered during first two years of insurance.
- Please refer to the policy terms and conditions to get a full list of exclusions under this policy
FAQs
What do you mean by Cashless facility?Cashless facility helps to avail the hospitalization benefits without any advance payments. Insured will be provided with a 'Health Card' along with Policy documents. S/he can use the health card to access Cashless facility in network of hospitals facilitated by TPA (Third Party Administrators).
What is the benefit of carrying a health card?Health card helps to avail the benefits of Cashless facility provided by the policy. It also serves as an identity card in the event of any unforeseen accident to the third party and helps them in arranging necessary emergency treatment.
How can I intimate TPA when there is an emergency hospitalization?Helpline numbers are available on Health Card provided to the life insured. S/he can contact them any time for hospitalization assistance.
I travel abroad frequently; will this policy cover my hospital expenses overseas?No, this policy covers medical expenses incurred for getting treated in India only.
Is maternity covered? What are the coverage limits?No, maternity care expenses are not covered by this policy.
Will my medical expenses be covered from day 1 of the policy?There is a general waiting period of 30 days.
What if my hospitalization period extends beyond 20 days?Convalescence Benefit is another additional benefit that this policy provides. In such cases, a lump sum of Rs. 10,000/- per insured person will be given for hospitalization subject to a maximum of Rs. 20,000/- for all insured persons during the policy period. This benefit is applicable only if there is an admitted liability in expense related to hospitalization
Can I opt for Health Insurance Portability?Yes, the request has to be given at least 45 days prior to the renewal date of earlier policy
