Health Insurance 126 views September 10, 2021

Royal Sundaram Family Plus Plan provides coverage against medical expenses incurred towards your family members. It’s a health insurance plan that secures you financially against a sudden illness, accident or surgery to any of your family members. Under this, you can cover self, spouse, son, daughter and other dependents of your family. You can purchase the Royal Sundaram Family Plus on an individual or family floater basis. Know more about the Royal Sundaram Family Plus Plan on this page below.

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Royal Sundaram Family Plus Plan Base Cover

Royal Sundaram Health Insurance shall cover the following expenses during the policy period –

In-Patient Care

If you or any of the members are admitted to the hospital, the insurer shall cover the following expenses during your stay –

  • Medical practitioner’s fees
  • Diagnostics tests, medicines, drugs and consumables
  • Nursing charges
  • Treatment Charges
  • Operation theatre charges
  • Room rent, Intensive Care Unit (ICU), Intravenous fluids, blood transfusion, injection administration charges
  • Cost of prosthetics and other devices or equipment (if implanted internally during a surgical procedure)

Modern Treatmentsprovides coverage against medical expenses incurred towards your family members.

The following procedures shall be covered up to 50% of the sum insured if the insured is admitted as an in-patient or seek treatment as a part of daycare in a hospital –

  • Uterine Artery Embolization and HIFU
  • Balloon Sinuplasty
  • Deep Brain Stimulation
  • Oral Chemotherapy
  • Immunotherapy- Monoclonal Antibody to be given as an injection
  • Intra vitreal injections
  • Robotic surgeries
  • Stereotactic radio surgeries
  • Bronchial Thermoplasty
  • Vaporization of the prostate (Green laser treatment or holmium laser treatment)
  • IONM – (Intra Operative Neuro Monitoring)
  • Stem cell therapy for bone marrow transplant for hematological conditions

Pre & Post-Hospitalization Expenses

Pre and post-hospitalization expenses are covered up to 60 and 90 days, respectively.

Day Care Treatment

Medical expenses for day care treatments including Chemotherapy, Radiotherapy, Hemodialysis, etc. as mentioned in the policy schedule.

Ambulance Cover

The insurer shall cover the ambulance expenses up to INR 4,000 per hospitalization.

Domiciliary Hospitalization

If the medical treatment is taken at home for a continuous period of 3 days as per the attending medical practitioner’s advice, the insurer shall cover the expenses on such treatment. This is called domiciliary hospitalization.

Organ Donor Expenses

The insurer pays for an organ transplant, provided the insured person has been medically advised to undergo an organ transplant and the donation conforms to the Transplantation of Human Organs Act 1994.

Vaccination for Post Animal Bite Treatment

The insurer shall reimburse the expenses for vaccination including inoculation and immunizations, subject to a maximum of INR 5,000.

Ayush Treatment

In-patient treatment taken under Ayurveda, Unani, Sidha and Homeopathy in a government hospital or any institute recognized by the government shall be covered up to INR 30,000.

Emergency Domestic Evacuation

In case of a life-threatening condition for treatment of an illness/injury, the insurer shall cover the evacuation of the insured from one medical center to another. It is subject to the treating doctor confirming the need for the insured to be transferred to another hospital with suitable medical technology and equipment for treatment. This benefit is available per insured and can be availed once during a policy year, subject to a maximum of INR 1 Lakh.

Royal Sundaram Family Plus No Claim Bonus (NCB)

You will receive 20% NCB after every claim-free year, subject to 100% of the individual base sum insured. The NCB is calculated based on the individual base sum insured of the last completed policy year and capped to the maximum NCB allowed for renewed base sum insured. If you have opted for a 2 or 3-year policy term, the NCB will be added at the end of each policy year if no claim is made in that year.

Royal Sundaram Family Plus Reload of Sum Insured

The sum insured shall be reinstated to 100% if the base sum insured, NCB and floater sum insured are insufficient to file a claim. The reload of the sum insured is subject to the following conditions –

  • This benefit can be available for different insured members in the same policy year.
  • After the reload of the sum insured, you can use it jointly or severally.
    Utilize the reload sum insured other than the illness/injury for which the claim has already been paid in that year.
  • If the reload happens for any one of the insured members, this will not be available again for another insured in the same policy year.
  • The unutilized reload sum insured won’t be carried forward to the subsequent policy year.

Royal Sundaram Family Plus Plan Value Added Covers

You’ll get the following benefits as well other than the base cover under Royal Sundaram Family Plus Plan –

Annual Health Check-up

Royal Sundaram will arrange the same at the empanelled service providers. Tests will include – Complete Blood Count, Urine Routine, ESR, Fasting Blood Sugar, Lipid Profile, Kidney Function Test, ECG, Complete physical examination. This benefit can be availed at policy renewal.

Second Opinion for Critical Illnesses

he insured can get a second opinion for the following – Cancer, First Heart Attack, Open Chest CABG, Open Heart Replacement or Repair of Heart Valves, Coma, Kidney Failure, Stroke, Major Organ/Bone Marrow Transplant, Permanent paralysis of Limbs, Motor Neurone Disease and Multiple Sclerosis. This benefit is available once during the policy year and lifetime of the insured (adult).

Preventive Healthcare & Wellness

The insurer provides various preventive healthcare and wellness services including health-related articles, access to various preferred health maintenance networks, etc.

Maternity Benefits

Medical expenses related to childbirth shall be covered up to INR 50,000. The benefit is available after 24 months of continuous coverage. Up to two deliveries for each female member are covered during the lifetime of the policy. If the insurer accepts the maternity claim, you’ll also get newborn baby cover, vaccination for newborn baby and nutrition allowance for mother post-discharge.

Optional Benefits Under Royal Sundaram Family Plus Plan

You can add the ‘Hospital Cash’ cover by paying an extra premium for it. If you opt for this, the insurer will pay a hospital cash amount as opted by you for each completed period of hospitalization, up to 30 days.

Royal Sundaram Family Plus Plan Sum Insured & Premium Amount

You’ll get the following sum insured options –

Type of Sum InsuredSum Insured (In INR)
Base Sum Insured2, 3, 5, 10, 15 Lakhs
Floater Sum Insured3, 4, 5, 10, 15, 20, 25, 50 Lakhs

The premium will depend on the sum insured, policy tenure, entry age, the number of insured members, zone of cover and optional cover if opted.

Eligibility Criteria for Royal Sundaram Family Plus Plan

The minimum entry age is 18 years for an adult and 91 days for children. There is no maximum entry age.

Free Look Period

A free look period of 15 days starts from the date you receive the policy document. It is 30 days if you purchase the policy through telesales, online and web aggregators. You can review the terms and conditions of the policy and return the same if not acceptable. On such cancellation, the insurer will refund the paid premium after deducting the medical checkup expenses, stamp duty charges and proportionate risk premium for the period on the cover.

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