Royal Sundaram Family Plus Plan
Royal Sundaram Family Plus policy is a unique product offered by the insurer. The most alluring feature of the plan is that it covers the extended family of the policyholder under a particular plan. The plan can include up to 19 relationships of the person insured. Another important feature in this plan is that the policyholder can insure the sum for family members on a floater basis or an individual basis. Thus, every member of the family can get individual coverage and join coverage.
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What is the Royal Sundaram Family Plus Plan?
Royal Sundaram Family Plus policy is a family plan. The sum insured varies for individual health insurance and family health insurance. For individual health insurance policies, the sum assured lies between Rs 2 lakh and Rs 15 lakh. For floater plans, the sum insured varies from Rs 3 lakh to Rs 50 lakh. It also has cumulative bonuses where the sum insured is increased by 20% for every no-claim year and 5 consecutive no-claim years, the sum insured doubles. In this plan, there is no maximum entry age of the policy, thus enabling all members of the family to get an insurance cover.
Features of Royal Sundaram Family Plus Plan
The features of the Royal Sundaram Family Plus Plan are:
- Members Covered: The policyholder can cover all family members which can include from one's parents, spouse, children to in-laws and extended family members. The plan can include up to 19 family members.
- Rebates on the Higher Sum Insured: There are rebates available in health insurance plans for choosing a higher sum insured by the policyholder.
- Culminating Bonu: The family floater health insurance plan has bonuses available for every claim-free year, and it doubles for 5 continuous claim-free years. So this feature is very useful for increasing the sum insured.
- Smooth Claim Settlement: There are two options available for claim settlement. They are cashless claim option and reimbursement option.
- Policy Term: The plan has 1 year, 2 years, and 3 years of policy tenure available.
Benefits of Royal Sundaram Family Plus Plan
Some of the benefits of Royal Sundaram Family Plus Plan are:
- Save Money: This plan covers the whole family under a single health insurance plan. The plan for the whole family will be more economical as compared to a single insurance plan for every member.
- Tax Benefit: The premiums paid for the health insurance plan have tax benefits as per Section 80D of the Income Tax Act (1961).
- Restore Exhausted Coverage: The family floater plan has special benefits known as restore benefit. This benefit helps in reinstating the full insurance coverage for unrelated medical expenditures, when the sum insured of the health plans gets over during the policy tenure.
- Addition of New Members: The policyholder can easily add any family member in the existing family floater plan.
- In-patient Cover: This plan provides coverage for inpatient hospitalization. It also covers expenses incurred during Ayush treatment and domiciliary hospitalisation under which the policyholder is allowed to be treated at home.
- Pre and Post-hospitalization: The plan provides coverage for pre-hospitalisation up to 60 days before getting admitted to a hospital and post-hospitalisation for up to 90 days after the policyholder is discharged from hospital.
- Daycare Procedures: The plan covers all daycare procedures for up to the sum insured in comparison to other policies with limited coverage on daycare procedures.
- Health and Wellness: It offers protective healthcare services and wellness services, which helps the person insured in improving their health status and maintain overall wellbeing. In this service, the person insured gets a subscription to various health-related blogs which are shared on their email id. It also offers 24x7 chat service and regular health check-ups for every policyholder above 18 years of age.
- Maternity Benefit: This plan provides coverage for maternity expenditures. The plan includes 2 deliveries for 2 females covered under the health insurance policy. It also includes 'New Born Baby Cover' and 'Vaccination for New Born' for their first year.
Inclusions of the Royal Sundaram Family Plus Plan
The inclusions of Royal Sundaram Family Plus Plan are:
- The plan covers organ transplant and treatment of organ donors for up to a maximum of the sum insured.
- It provides ambulance cover of up to a maximum of Rs 4000 for every hospitalization for every family member.
- It offers 100% reload of the sum insured in case the total sum insured is completely exhausted.
- Vaccination for an animal bite for up to Rs 5000 is covered.
- AYUSH Treatment up to a maximum Rs 30,000 in other hospitals
- Covers for the second opinion for treatment and diagnosis of 11 critical illnesses
- Emergency domestic evacuation cover for up to a maximum of up to Rs 1 lakh.
Exclusions of the Royal Sundaram Family Plus Plan
The exclusions of Royal Sundaram Family Plus Plan are:
- Addictive conditions and disorders
- Ageing and puberty
- Adventure/Hazardous Sports
- Alternative treatment
- Conflict and disaster
- Ancillary Hospital Charges
- Congenital conditions
- Dental or oral treatment
- Cosmetic surgery
- HIV and AIDS
- Psychiatric and Psychosomatic Conditions
- Hereditary condition
- Sleep disorders
- Self-inflicted injuries
- Unproven or Experimental treatment
*This list is only indicative and not exhaustive. one can consider the policy document for the complete list of exclusions.
Eligibility of the Royal Sundaram Family Plus Plans
The eligibility of Royal Sundaram Family Plus Plans is as follows:
- Minimum entry age of the adult - 18 years
- Maximum entry age of the adult - No limit
- Minimum entry age of the child - 91 days
- Maximum entry age of the child - 21 years
- Policy tenure - 1 year, 2 years and 3 years
- Sum insured for
- Individuals - Rs 2 lakh to 15 lakh
- Family - 3 lakh to 50 lakh
Claim Process for the Royal Sundaram Family Plus Policy
The policy can be claimed by following the below steps:
Cashless Claim Process
- Ensure to notify the policy provider company 7 days before undergoing hospitalisation for a particular treatment if it is pre-planned. For emergency, hospitalisation notifies the insurer within 24 hours of admission to the hospital.
- After reaching the hospital, one must show the following documents at the helpdesk - health card provided by the insurer, ID proof of the policyholder, and other important documents for availing cashless treatment.
- One can fill up the claim form or the pre-authorisation letter. After filling the claim form and attaching the documents, wait for the insurer to intimate the decision.
- The insurance company will notify the customer about the claim within a few hours. If it is approved, cashless facilities can be taken.
- After the policyholder is discharged from the hospital, one must keep the original documents like bills and receipts at the hospital. Ensure to make the necessary payment which isn't covered by the insurer or co-payment, if any, before leaving.
After completion of procedures, the insurer will pay the remaining bill.
Reimbursement Claim Process
If the treatment of the person insured is not at the network hospital, then they choose for the reimbursement process. Visit any hospital for a particular surgery and notify the policy provider company in advance.
- For emergency or accidental hospitalisation, one must intimate the policy provider company within 24 hours of admission to the hospital.
- After the treatment is over, the policyholder is ready for discharge. One must collect all the original receipts, medical bills, discharge sheets, prescriptions and other necessary bills & pay the amount incurred due to hospitalisation and treatment undergone by the patient.
- Then one must fill the claim from the and notify the insurance provider about the claim. One must include all the necessary documents as asked by the policy provider company for the claim process. The person insured must submit only original bills, prescriptions, invoices & medical receipts for the claim.
- After sending the documents, Royal Sundaram Health Insurance company will check & verify all necessary documents received and will approve or reject the claim accordingly. The insurance provider company, if necessary, can ask for more documents for accepting the claim.
- After a few days, the insurer will inform the policyholder about rejection or approval by registered SMS or email.
After accepting the claim, the company will process it by bank account transfer which is done through NEFT.
Documents required for Claim Process
The policyholder is required to submit various documents for emergency or planned hospitalisation to claim for the medical charges. The various documents required to submit are:
- Duly filled claim form
- A medical report that states the policyholder has no pre-existing illness
- First consultation letter' second copy and prescription of the doctor
- For accidental hospitalisation, one must submit FIR of the accident.
- Signed up the claim form
- Various medical certificates & related treatments bill
- Additional documents as asked by the insurer
After submission of necessary documents by the policyholder, Royal Sundaram will inform about the claim approval.
How to Buy the Royal Sundaram Family Plus Plan Policy?
The Royal Sundaram Family Plus Plan can be bought offline as well as online. Here is the stepwise process to buy the plan.
- Visit com to know about all the plan details.
- Then, choose Royal Sundaram Family Plus Plan to buy. Click on the 'Buy Now' tab.
- A page opens asking one to fill up personal details and for creating a new account. Click on the 'continue' tab.
- The website will ask one to confirm the phone number & email provided by the customer by generating an OTP.
- After confirming contact information, the customer has a choice to compare online with other health insurance plans and click on the 'continue' tab.
- In this step, enter all policy details like age & name of the person insured, number of policyholders, etc. Enter the policy tenure, the sum insured, etc. from the drop-down menu. For easy calculation of premiums, use the paisawiki premium calculator. After knowing the premium amount proceed to the next page.
- The policyholder can choose to add riders for higher coverage. Choose the 'proceed' option.
- Enter any other relevant details.
- Upload the KYC documents.
- Check the box to agree to the terms & conditions of the policy.
- Enter the financial details to pay for the premium amount & pay it.
After payment, the applicant will receive the policy documents through email.
Documents Required to Buy the Royal Sundaram Family Plus plan
The documents required to buy the Royal Sundaram Family Plus Plan are:
- Passport size coloured photograph
- For Age Proof: Birth Certificate, School or College Leaving Certificate, Permanent Account Number, i.e. PAN Card, Voter Card, Driving License, Adhaar Card and Passport.
- For Address Proof: Electricity Bill, Ration Card, Bank A/C statement, Utility Bill, Passport, Postpaid Bill, Telephone Bill.
- Photo ID Proof: Passport, Voter ID, Aadhar Card, Driving License or PAN card.
Renewal Process of the Royal Sundaram Family Plus Plan
The renewal process of the policy is as follows:
- Go to the website of paisawiki.com
- Log in by providing the user ID & password
- Click on the policy renewal tab. Enter the policy number details & click to continue
- In this page, enter the plan details like policy number and other details.
- Click on the renew plan tab.
- In this step, a policyholder can add or remove family members.
- If family members are added to the policy, add their details. Upload documents if required.
- For new members or riders, calculate the new premium using the health premium calculator.
- Choose the next option.
- After adding details, the policyholder must agree to the new policy conditions & terms. Pay the renewal premium.
After payment, the new policy documents will be mailed to the customer.
Ans: Yes, the policyholder can add a member at any time.
Ans: The limit on maternity coverage per delivery is Rs 50,000.
Ans: Yes, the policyholder can switch hospitals.
Ans: Yes, it is advised to have a check if the policyholder is above 50 years of age.
Ans: 98The premium rates depend on the number of members included, the sum insured and age of the oldest family member.
Written By: Paisawiki - Updated: 09 April 2021