Health Insurance 233 views June 8, 2021

Royal Sundaram Lifeline Supreme Plan

Royal Sundaram Lifeline Supreme Plan provides coverage against medical expenses during the policy period with sum insured options of INR 5 Lakh, INR 10 Lakh, INR 15 Lakh, INR 20 Lakh, INR 50 Lakh. The sum insured means the extent up to which the health expenses can be covered under the plan, which comes with several other attractive features that you should know. Read this page further and know more about the Royal Sundaram Lifeline Supreme Plan.

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Royal Sundaram Lifeline Supreme Base Cover

The insurer shall cover the following expenses during the policy term:

  1. Inpatient Care: This includes medical practitioner’s fees, diagnostic tests, medicines, drugs and other consumables, nursing charges, operation theatre charges, ICU charges, cost of intravenous fluids, blood transfusion, injection administration charges, cost of prosthetics and other devices or equipment implanted internally during a surgical procedure.
  2. Pre-hospitalization: Medical expenses incurred due to illness shall be covered up to 60 days before admission to the hospital.
  3. Post-hospitalization: Medical expenses incurred due to illness shall be covered up to 90 days post-discharge from the hospital.
  4. Day-Care Treatment: Medical expenses for daycare treatments such as Chemotherapy, Radiotherapy, Hemodialysis, or any procedure which needs a period of specialized observation shall be covered under this policy.
  5. Ambulance Cover: The insurer will cover the ambulance expenses incurred to transfer the insured person to the nearest hospital up to INR. 5,000 per hospitalization.
  6. Organ Donor Expenses: Medical expenses incurred for harvesting of the organ shall be covered under this policy
  7. Domiciliary Hospitalization: If the medical treatment is taken at home continuously for 3 days due to any reason, the insurer shall cover such expenses.
  8. No Claim Bonus (NCB): The base sum insured shall be increased by 20% after every claim-free year, subject to a maximum of 100%.
  9. Reload of Sum Insured: The insurer will reload up to 100% of the base sum insured if it along with NCB is partially or completely exhausted during the policy period. You can utilize the reload of the sum insured for different illnesses only.

Note: Reload of Sum Insured is not available for Worldwide Emergency Hospitalization, International Treatment for 11 specified critical illnesses and optional benefits.

  1. Ayush Treatment: The insurer will cover alternative treatments taken in government hospitals or any institute recognized by the government and accredited by the Quality Council of India, up to INR 30,000.
  2. Vaccination for Animal Bite Treatment: OPD treatment expenses for vaccination or immunization shall be covered up to INR 5,000.
  3. Health Check-up – The insurer shall cover the cost of a health check-up annually on policy renewal.
  4. Preventive Healthcare & Wellness: You’ll get access to various preventive healthcare & wellness-related activities like health-related articles, various preferred health maintenance networks.
  5. Second Opinion for Critical Illness: The insurer will provide you a second medical opinion for 11 critical illnesses only once during the policy year. The second Opinion shall be provided for the following critical illnesses: 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 & Multiple Sclerosis
  6. Emergency Domestic Evacuation: In case of a medical emergency, the cost of evacuation shall be covered up to INR 1 Lakh under this policy. This benefit shall be available to you only once in a policy year.

Additional Optional Benefits

The following are the optional covers that you can add to this policy and enhance your coverage:

  1. Top-up plan on Aggregate Basis: Under this cover, the following deductible options are available to you – INR 1 Lakh, INR 2 Lakh, INR 3 Lakh, INR 4 Lakh, INR 5 Lakh and INR 10 Lakh – along with a premium discount.
  2. Hospital Cash: If you are hospitalized during the policy period due to an illness/injury, the insurer will pay a hospital cash amount as specified in the policy schedule for each continuous and completed period of 24 hours of hospitalization. This benefit is payable if you are hospitalized for at least 48 hours continuously. The maximum liability under this benefit is limited to 30 days.

Waiting Period

Check out the waiting period applicable to this plan –

  1. 30 days for all illnesses, except any accidents
  2. A 90-day initial waiting period for critical illnesses
  3. A 36-month waiting period for pre-existing diseases
  4. A 2-year waiting period applies for the following conditions: Stones in biliary and urinary systems, Lumps, cysts, nodules, polyps, internal tumors, Gastric and Duodenal Ulcers, Surgery on tonsils/adenoids, Osteoarthrosis, Arthritis, Gout, Rheumatism, Spondylosis, Spondylitis, Intervertebral Disc Prolapse, Cataract, Fissure, Fistula, Hemorrhoids, Hernia, Hydrocele, Chronic Renal Failure or end-stage Renal Failure, Sinusitis, Deviated Nasal Septum, Tympanoplasty, Chronic Suppurative Otitis Media, Benign Prostatic Hypertrophy, Knee/Hip Joint replacement, Dilatation and Curettage, Varicose veins, Dysfunctional Uterine Bleeding, Fibroids, Prolapse Uterus, Endometriosis, Diabetes and related complications, Hysterectomy for any benign disorder

Exclusions from Royal Sundaram Lifeline Supreme

The insurer shall not pay for the medical expenses arising out of the following:

  1. Treatment-related to addictive conditions and disorders
  2. Active participation in adventure or hazardous sports
  3. Treatment to relieve symptoms caused by aging, puberty, or other natural physiological cause
  4. Alternative Treatment except for AYUSH Treatments
  5. Charges for admission, discharge, administration, RMO charges, night charges, registration, documentation and filing, surcharges, service charges levied by the Hospital
  6. Artificial life maintenance
  7. Any charges incurred to procure any medical certificate, medical records for the treatment of Illness/Injury
  8. Circumcision unless necessary for the treatment of an illness or necessitated by an accident.
  9. Illness or injury resulting from nuclear or chemical contamination, war, riot, revolution, acts of terrorism or any similar event
  10. Any External Congenital Anomaly
  11. Convalescence and Rehabilitation
  12. Cosmetic surgery unless medically required as a part of treatment for cancer, accidents and burns to restore functionality
  13. Dental/oral treatment
  14. Drugs and dressings for OPD Treatment or take-home use
  15. Treatment to correct eyesight, unless necessitated due to an accident
  16. Cost of routine eye examinations, contact lenses, spectacles or laser eyesight correction.
  17. Health hydros, nature cure, wellness clinics, etc.
  18. HIV and AIDS
  19. Hereditary conditions (as specified in the policy document)
  20. Hospitalization for observation or investigations only
  21.  Items of personal comfort and convenience
  22. Psychiatric and Psychosomatic Conditions
  23. Obesity
  24. OPD Treatment
  25. Preventive care
  26. Reproductive Medicine
  27. Self-inflicted injuries
  28. Sexual problems and gender issues
  29. Sexually transmitted diseases
  30. Sleep disorders
  31. Speech disorders
  32. Stem Cell Implantation
  33. Treatment for Alopecia
  34. Treatment for developmental problems
  35. Treatment received outside India
  36. Unproven/Experimental Treatment
  37. Treatment by an unrecognized physician
  38. Unrelated diagnostic tests, X-ray or laboratory examinations
  39. Breach of law with criminal intent

Free Look Period

You’ll have a free look period of 15 days from the date of receipt of the policy document to review the terms and conditions of this policy. And if you have any objections to any of the terms and conditions, return the policy stating the reasons for cancellation. If no claim has been made under this policy, you’ll receive a refund of the paid premium after a deduction of medical checkup, stamp duty charges and proportionate risk premium for the period on the cover.

Note: The free look period is not available at the time of policy renewal.

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