Royal Sundaram Lifeline Plan

Let’s Get To Know The Plan Better!

The Royal Sundaram Lifeline is a health insurance policy provided by Royal Sundaram General Insurance Company Limited. With this plan, you can be confident that you and your family will receive necessary medical care without undergoing the stress of unexpected medical bills. It comes with various features, benefits, add-ons, etc., to cater to different customer needs. The plan offers three options: Classic, Supreme, and Elite. You can choose the one that suits you best for your healthcare needs.

Age Criteria For Royal Sundaram Lifeline Plan

• Minimum Age of Entry:

  • Adults - 18 years
  • Dependent children - 91 days or
• Maximum Age of Entry:
  • Adults - 99 years
  • Dependent children - 25 years
     

An Overview of The Plan’s Benefits & Limits

In-patient hospitalisation costs are the expenses incurred when you are admitted to the hospital for over 24 hours, including room board charges, nursing expenses, doctor fees, prescribed medicines, drugs, ICU charges, and other related expenses. The Royal Sundaram Lifeline plan not only covers such expenses but also offers various other l benefits. Here's a glimpse of some expenses covered –

• Pre- & Post-Hospitalisation Expenses
  If the doctor needs to conduct diagnostic tests before or after your hospital stay, you don’t have to worry, as the Royal Sundaram Lifeline plan has got you covered. It takes care of both pre-hospitalisation and post-hospitalisation expenses up to the sum insured. The duration of coverage depends on the plan variant you choose –

Note: The insurer will cover these expenses only if they are related to your medical condition and are approved under the inpatient hospitalisation coverage.

• Daycare Treatment Coverage
  Medical procedures or surgeries that used to need a long hospital stay can now be done in just 24 hours due to advancements in medical technology. These are called daycare treatments. The Royal Sundaram Lifeline plan covers all daycare procedures with no limit, ensuring expenses are covered up to the sum insured.
   
• Domiciliary Treatment Coverage
  Domiciliary treatments are treatments or procedures administered for illnesses or injuries that need urgent hospital attention, but they are given at home because the patient is too sick to travel safely to a hospital or there are no nearby hospital beds. The Royal Sundaram Lifeline plan covers domiciliary treatment costs up to the sum insured.
   
• Organ Donor Coverage
  Royal Sundaram Lifeline plan covers the inpatient costs of the organ donor when an organ transplantation is performed, and you are the recipient. Such costs are covered up to the sum insured you choose under the policy.
   
• Modern Treatment Coverage
  Healthcare is evolving fast with new technologies and advancements, making treatments accessible that were once thought impossible. The Royal Sundaram Lifeline plan is designed to stay up-to-date with these changes. It covers expenses associated with modern treatments up to 50% of the sum insured.
   
• No Claim Bonus
  If you stay healthy and don't make any claims in a policy year, you earn an annual bonus – more like a reward. With each claim-free year, it increases your sum insured, up to a certain limit based on your chosen variant. Even if you need to make a claim later on, your accumulated bonus stays intact.
  Here’s how the No Claim Bonus is offered under the three variants -

• Restoration Benefit
  The restoration benefit is designed to automatically restore your sum insured when it is used up in a given policy year. This feature kicks in when your base sum insured, and any cumulative bonus (if applicable) is entirely or partially exhausted. It applies to subsequent claims in a policy year. You can make use of this benefit once per policy year throughout your lifetime as long as you keep renewing your policy.
  This benefit can only be used for unrelated illnesses. However, if you choose the 'Supreme' or 'Elite' version of this plan, you have the option to apply it even for related illnesses by paying an additional premium.
   
• Room Rent Limit
  This is the maximum value your insurance company will pay for the room during your hospital stay, which is called the room rent limit. If you choose a room within this limit, you will not have to pay anything extra. However, if you stay in a room with a higher rent, a proportionate deduction will apply. This means that you will be responsible for a proportionate share of the entire cost, not just the difference in room rent.
  With the Royal Sundaram Lifeline plan, you have the flexibility to select any room you prefer – whether it is a shared room, a single room, a deluxe room, or any available option. The policy does not levy any restrictions on room rent, so you can make the choice that suits you without worrying about extra expenses.
   

Noteworthy Features You Should Be Aware of!

Some of the highlighting features of the Royal Sundaram Lifeline plan include –

• Additional Facility Of App-Based Cabs As A Part Of Ambulance Cover (Ola/Uber)
  In the age of technological progress, transportation has evolved significantly, and app-based cab services like Ola and Uber have become integral to modern urban life. Recognising the importance of these services, the Royal Sundaram Lifeline plan (except Classic) provides reimbursement for cab ride expenses incurred during hospital admissions or discharges up to a specified limit, depending on the plan variant. To avail of this convenient feature, all you need to do is submit the app-generated invoice containing the necessary details to the insurer.

• Mobility Devices
  Getting recovered after an accident involves more than just medical care. It includes necessary mobility devices like walkers, manual wheelchairs, crutches, etc. Royal Sundaram Lifeline plan assists in covering the expenses related to such devices when prescribed as part of treating a disability resulting from an accident. The coverage extends up to a specific limit, depending on the plan type. It is, however, important to mention that this benefit is available as an add-on only in the Supreme and Elite variants.
  Here are the coverage limits of the Supreme and Elite variants under this benefit -

• Bariatric Surgery Coverage
  The Royal Sundaram Lifeline plan includes coverage for expenses connected to bariatric surgery – a procedure for weight loss. Individuals aged 18 years or older are eligible for this coverage, but it comes with a waiting period. The waiting period varies based on the plan you select, and there might be other conditions related to the coverage as well. It is important to highlight that this benefit is an add-on and is accessible only in the Supreme and Elite variants.
  Here are the coverage limits of the Supreme and Elite variants under this benefit -

Understanding Waiting Periods

Once you've purchased a health insurance policy, you need to wait a certain period of time before you can claim for certain illnesses and diseases. Once this waiting period is over, you can start claiming for those conditions. Let's take a look at some of the different types of waiting periods -

• Initial Waiting Period
  There is a 30-day initial waiting period for all medical conditions except for accidents. This means you cannot make a claim for hospitalisation during the first 30 days unless it is due to an accident.

• Waiting Period For Pre-existing Diseases
  A pre-existing disease is any medical condition, injury or illness that you had in the 48 months before getting a health insurance policy. During this period, the policy will not cover any expenses related to your pre-existing conditions. The waiting periods for pre-existing conditions under the Royal Sundaram Lifeline plan are as follows –

• Waiting Period For Specific Diseases
  Insurers impose waiting periods for specific medical conditions or illnesses, apart from your pre-existing conditions, regardless of whether you have previously experienced them or not.  These waiting periods are set by the insurer and do not depend on your current health status. For the Royal Sundaram Lifeline plan, there is a waiting period of 24 months (applicable to all variants) for specific diseases.
   

What is not Covered Under The Plan?

Exclusions are situations or conditions your health insurance policy will not cover, and these include –

• Standard Permanent Exclusions: The IRDAI has set 'standard permanent exclusions' that all insurance companies must follow. Some of these include –

  • Investigation and Evaluation: Hospital admission that is solely for observation or monitoring purposes.
  • Rest Cure, Rehabilitation, and Respite Care: Getting admission to a facility for bed rest and no active treatment is provided.
  • Obesity/Weight Control: Treatment or surgery for obesity or weight control.
  • Change of Gender Treatment: Treatment aimed at altering the body's characteristics to that of the opposite sex.
  • Plastic/Cosmetic Surgery: Treatment or surgery intended to modify body characteristics or appearance.
  • Profession in Hazardous or Adventure Sports: Expenses incurred for treatment while participating as a professional in adventure activities like river rafting, mountaineering, scuba diving, horse racing, etc.
  • Breach of Law: Expenses related to the treatment of a person who has committed or attempted to commit a breach of law with criminal intent.
  • Excluded Providers: Treatment from a medical practitioner or hospital is excluded by the insurance company.
  • Narcotics: Treatment for addictive conditions like alcohol addiction, drug usage, etc.
  • Treatments in Establishments Arranged for Domestic Purposes: Treatment that is taken in health spas, nursing homes, or similar establishments arranged entirely or partially for domestic reasons.
  • Dietary Supplements, Substances Purchased Without Prescription: Vitamins, minerals, etc., not prescribed by a medical practitioner.
  • Refractive Error: Expenses associated with correcting refractive errors of up to 7.5 diopters for improved eyesight.
  • Unproven Treatments: Medical procedures, surgeries, or treatments that are not proven to be effective.
  • Expenses Related to Birth Control, Sterility Infertility: Contraception, artificial insemination, sterilisation, advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI, gestational surrogacy, etc.
  • Maternity Expenses: Pre/post-natal costs, childbirth-related hospitalisation expenses, etc.
     
• Additional Permanent Exclusions
  Beyond the standard permanent exclusions mentioned earlier, insurance companies may also apply additional exclusions for specific situations or medical conditions. If you have severe medical conditions or certain diseases that insurers consider too risky for coverage, they may permanently exclude them from your policy. However, it is essential to note that insurers can only apply permanent exclusions for illnesses listed by the IRDAI (Insurance Regulatory and Development Authority of India).
   
• Non-Standard Exclusions (Specific Exclusions)
  Specific exclusions in health insurance policies, known as non-standard exclusions, go beyond the permanent exclusions set by IRDAI. These exclusions differ among insurance providers and are subject to the specific terms and conditions of the policy. Here are some notable specific exclusions under the Royal Sundaram Lifeline plan –
  • Alternative treatments, except for those falling under Ayush Treatment.
  • Circumcision, unless it is necessary for the treatment of an illness or is required due to an accident.
  • Treatment for external congenital anomalies.
  • Treatments related to intentional self-inflicted harm or attempted suicide by any means.
  • Treatment for sexual problems, such as impotence, erectile dysfunction, etc.
  • Treatment for sexually transmitted diseases, including genital warts, syphilis, gonorrhoea, genital herpes, chlamydia, pubic lice, trichomoniasis, etc.
  • Treatment for sleep apnea, snoring, or any other sleep-related breathing problems.
  • Treatment and associated expenses for alopecia, baldness, wigs, toupees, and medical supplies like elastic stockings, diabetic test strips, etc.
  • Artificial life maintenance if the insured person enters a vegetative state with no chance of recovery.
  • Treatment for critical illness symptoms that manifest within the first 90 days from the policy commencement date.
     

Summary

The OG Reading Material for Your Reference

• Brochure: https://assetmyws.royalsundaram.in/sites/default/files/2022-04/lifeline-brochure.pdf

• Policy Wording: https://assetmyws.royalsundaram.in/sites/default/files/2022-07/Lifeline_terms_conditions.pdf

FAQs

1. What is the maximum coverage available under the Royal Sundaram Lifeline plan?
   The maximum cover you can select under the Royal Sundaram Lifeline plan depends on the plan variant as outlined below -

2. Are there any room rent restrictions under the Royal Sundaram Lifeline plan?
   No, there are no restrictions on room rent. You have the flexibility to choose any available room in the hospital, whether it's a single private room, shared room, deluxe room, etc., across all three plan variants.
    
3. Is coverage for AYUSH treatments included in the Royal Sundaram Lifeline plan?
   Yes, the Royal Sundaram Lifeline plan covers AYUSH or alternative or non-allopathic treatments, if taken from a government hospital, up to the sum insured. For other hospitals, the expenses will be covered up to certain limits, depending on the variant you select.
    
4. Does the Royal Sundaram Lifeline plan include coverage for consumables?
   Regrettably, consumables, such as gloves, masks, syringes, etc., are not covered under any variant of the Royal Sundaram Lifeline plan.
    
5. Does the Royal Sundaram Lifeline plan offer maternity benefits?
   Yes, maternity benefits are included in the Royal Sundaram Lifeline plan. However, it is essential to note that these benefits specifically apply to the Elite variant. The plan covers pregnancy-related expenses up to the limit outlined in the policy.