Family Health Insurance

ROYAL SUNDARAM ALLIANCE INSURANCE COMPANY LIMITED

Royal Sundaram Alliance Insurance Company Limited was the first private insurer in India to be licensed post privatization in 2001.

They are a result of a joint venture of Sundaram Finance, which is one of the most respected non-banking financial institution in India and RSA,

one of the oldest and second largest general insurer in the UK.

One of their health insurance plans is for families called the Family Health Insurance.

The SALIENT FEATURES of this policy are:

· This covers self, spouse, dependent children as well as dependent parents all under one policy

· The insurance is applicable for one and two years

· It is a family floater policy

· It covers expenses incurred towards inpatient hospitalization for a period more than 24 hours for the illness/disease contracted of injury sustained by the insured

· Pre-hospitalization expenses are covered for 30 days

· Post-hospitalization expenses are covered for 60 days

· Ambulance charges subject to a limit of Rs.1000 per claim

· Reimbursement of expenses incurred on room, boarding as provided by the hospital/nursing home subject to a maximum of 2% of the sum insured and for ICU to a maximum of 4% of the sum insured

· Reimbursement of expenses incurred on Surgeon’s fees (including Assistant surgeon’s fee) but limited to 40% of sum insured

· It also covers expenses incurred on:

· Anesthesia

· Blood

· Oxygen

· Operation theatre charges

· Medicines and drugs

· Diagnostic materials and X-ray

· Dialysis

· Chemotherapy

· Radiotherapy

· Donors medical expenses towards organ transplant

· Cost of pace maker

· Artificial limbs

· Cost of organs

· Pre-existing diseases will be covered after a waiting period of 4 continuous years

AGE LIMIT:

· Apart from self and spouse, dependent children, i.e. unmarried between the age of 91 days and 21 years can be covered under this policy

· Dependent parents up to the age of 50 years are also covered within the same policy

· Renewals will be accepted up to the age of 70 years for adults and up to the age of 21 years for dependent children

MAXIMUM AMOUNT PAYABLE TOWARDS VARIOUS TREATMENTS:

DISEASE/TREATMENT	LIMIT PER PERSON PER POLICY PERIOD
Cataract	8% of sum insured
Piles, Fistula, Tonsilitis, Sinusitis	10% of sum insured
Benign prostatic, Hypertrophy, Hernia	20% of sum insured
Joint Replacement	50% of sum insured
Appendicitis and gall bladder stones and gynaec disorders including hysterectomy	20% of sum insured
Dialysis, Chemotherapy and Radiotherapy	10% of sum insured per month

PREMIUM TABLE:

FOR 1 YEAR:

SUM INSURED	AGE	2A	2A+1C	2A+2C	2A+3C
Rs.1 lac	Up to 35 years	2255/-	3070/-	3886/-	4702/-
	Up to 45 years	3127/-	3942/-	4758/-	5573/-
	Up to 50 years	4012/-	4827/-	5642/-	7081/-
Rs.2 lacs	Up to 35 years	3592/-	4904/-	6217/-	7517/-
	Up to 45 years	5177/-	6490/-	7803/-	10083/-
	Up to 50 years	7115/-	8428/-	9741/-	12020/-
Rs.3 lacs	Up to 35 years	5387/-	7356/-	9325/-	11293/-
	Up to 45 years	7764/-	9733/-	11701/-	15120/-
	Up to 50 years	10908/-	12875/-	14844/-	18262/-
Rs.4 lacs	Up to 35 years	6875/-	9420/-	11966/-	14511/-
	Up to 45 years	9837/-	12381/-	14926/-	19256/-
	Up to 50 years	13817/-	16362/-	18908/-	23237/-
Rs.5 lacs	Up to 35 years	7735/-	10598/-	13462/-	16327/-
	Up to 45 years	11064/-	13928/-	16791/-	21663/-
	Up to 50 years	15545/-	18407/-	21270/-	26142/-

· A Service Tax of 10.3% will be levied on all the premium amounts given above

· The premium paid towards the health insurance is exempt from Income Tax

EXCLUSIONS:

· All diseases/injuries existing at the time of proposing the insurance.

· Any disease contracted by the insured during the first 30 days from the commencement of the cover

· First year exclusions are for treatment of (except if caused due to an accident):

· Congenital internal diseases

· Any type of migraine/vascular headache

· Stones in the urinary and biliary systems

· Surgery on tonsils/adenoids

· Gastric and duodenal ulcer

· Any type of cyst/nodule/polyps

· Any type of breast lump

· Two year exclusions are for treatment of (except if caused due to an accident):

· Spondylosis

· Any type of inter vertebral disc prolapse and such other degenerative disorders

· Cataract

· Benign prostatic hypertrophy

· Hysterectomy

· Fistula

· Fissure in anus

· Piles

· Hernia

· Hydrocele

· Sinusitis

· Knee/hip joint replacement

· Chronic renal failure

· Heart disease

· Any type of carcinoma/sarcoma/blood cancer

· Osteoarthritis of any joint

· Injury or disease caused due to war invasion

· Circumcision unless necessary for treatment of a disease

· Cost of spectacles, contact lenses and hearing aids

· Any dental treatment or surgery which is a corrective, cosmetic or aesthetic procedure, including wear and tear, unless arising from accidental injury and which requires hospitalization for treatment

· Convalescence general debility “run down” condition or rest cure, congenital external disease or defects or anomalies, sterility, venereal disease, intentional self injury and use of intoxicating drugs/alcohol

· All expenses arising out of any condition due to AIDS and HIV

· Charges incurred at a hospital/nursing home for diagnostic, X-ray or laboratory examinations not consistent with any ailment, sickness or injury

· Expenses on vitamins and tonics unless forming part of treatment for injury or disease

· Injury or disease caused by nuclear weapons or materials

· Treatment arising from pregnancy, childbirth, miscarriage, abortion or complications of caesarean section

· Any treatment other than allopathic system of medicine

· Any routine or preventative examinations, vaccinations, inoculation or screening

· Outpatient treatment charges

· Sex change or treatment that results from or to sex change

· Hormone replacement therapy, cytotron therapy

· Cost of allopathic treatment if administered by non-allopathic practitioner

· Treatment of obesity and any weight control programs

· Treatment of psychiatric, mental, nervous or condition of insanity

· Any cosmetic, plastic surgery, aesthetic or related treatment of any description

· Use of intoxicating drugs or alcohol

· Any stay in hospital for any domestic reason

· Any treatment received outside India

· Any ayurvedic, homeopathic or naturopathic treatment

· Any fertility, sub-fertility or assisted conception treatment

· Any person engaged in hazardous activities like bungee jumping, parasailing, parachuting, etc

The Royal Sundaram health insurances can either be bought online from www.royalsundaram.in or from their toll free number 1800-345-8899

ADDITIONAL BENEFITS of buying a health insurance policy from Royal Sundaram are:

· Reimbursement of master health check up subject to a maximum of Rs.1500 per insured person after each 4 consecutive claim free years

· The sum insured under this policy shall be progressively increased by 5% for every claim free year subject to a maximum of 50%. But the Cumulative Bonus will be reversed to 2 slabs in case of a claim

· Cashless facility towards claim reimbursements