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Royal Sundaram Health Shield Online

Product Description:

Health Shield Online is an individual health insurance plan from Royal Sundaram but it also allows the option of extending the cover to the dependent family members (spouse, dependent children upto 18 yrs and dependent parents upto 50 yrs) of the Primary Insured. Apart from providing the Inpatient benefits (upto Sum Insured), the policy also covers all related expenses for 30 days prior to and 60 days post hospitalization period. The Insured members can also avail of room-rent, doctor’s fees, etc subject to various sub-limits as per policy terms and conditions (refer www.royalsundaram.in). The policy can be renewed until the Insured attains the max age of 70 yrs, as on last birthday.

Know more about your Insurance

Key features: Availability, Benefits and Exclusions

Minimum Age at Entry : 3 months
Maximum Age at Entry : 50 years
Maximum Age at Renewal : 70 years
Minimum Sum Assured : Rs 1 lacs
Maximum Sum Assured : Rs 5 lacs
No claim Bonus – Annual : 5%
No claim Bonus – cumulative : upto 50%
Maternity Benefits : N/A
Pre-Existing Disease cover : after 4 years
Waiting Period : 30 Days

Product pricing (Incl. S/Tax)   (Rs)
Age SA 1 lacs SA 1.5 lacs SA 2 lacs SA 2.5 lacs SA 3 lacs SA 4 lacs SA 5 lacs
91 days – 25 yrs 1151 1581 1850 2271 2776 3589 4038
26 – 40 yrs 1861 2791 2947 3944 4420 5598 6871
41 – 45 yrs 2182 3272 3746 5016 5681 7116 8734
46 – 50 yrs 2731 3752 4956 6218 7710 9768 11026

Claim procedure
  1. Intimation & Assistance - In case of planned hospitalization, select and approach the service desk of the chosen network hospital, preferably at least 3 days in advance. Use your Royal Sundaram Health card for identification purpose. You can also share your policy no and passport no with the healthcare provider or use your PAN card or voter ID card for the same.

  2. Pre-authorization: Get the pre-authorization form (available at the hospital help desk and/or TPA website), filled and signed from the treating doctor and submit the same with the hospital along with other necessary documents. The network hospital checks the identity of the Insured for validation and submits the pre-authorization form (through fax) to the TPA. After cross verifying the identity of the Insured and the policy coverage, the TPA will provide confirmation to the provider by e-mail/fax with in 24 hrs. If cashless treatment is not approved by the TPA, please get admitted, undergo treatment and settle all bills directly with the hospital. Later, file for a re-imbursement of your expenses with the Insurer/TPA by intimating them (toll free at 1800 345 8899 or mobile no 9444448899) not later than 7 days of discharge. You can follow your intimation up with all claim documents (ORIGINALS) anytime within 30 days of discharge.

  3. Cashless settlement: Get admitted for treatment at the network hospital and sign all forms, invoices and documents on discharge. Royal Sundaram will directly make the payment to the hospital for pre-approved treatment and as per policy terms & conditions. Any non-medical expense and/or expenses towards conditions not authorized under hospitalization need to be paid directly by the beneficiary of treatment. Also, remember signing the Royal Sundaram claims form and hand it over to the hospital along with all the relevant supporting documents.

*Please note in case of emergency, authorization should be taken not later than 24 hrs of admission.

Some key statistics for Max Bupa

Claims Pending Ratio : To be Announced soon
Complaints Resolved Ratio : To be Announced soon
Provider Network (cashless) : To be Announced soon

General Health Insurance Tips

Understand the cost of healthcare in your city/area before deciding the total cover (Sum Assured)

If your family includes a young bride, it is important to ensure the coverage of maternity benefits

Ask about the coverage of pre-existing diseases

Look at the waiting period

Satisfy yourself about the specific disease’s coverage under the Critical Illness cover

Inquire about the availability of cashless facility at the Network hospitals

Always compare before buying

Disclaimer: This is only an illustrative document to serve as a quick guide for aide in decision making.

Information Source: Royal Sundaram website www.royalsundaram.in as on 11th Oct’2011
IRDAI annual report’2010