Health Shield 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.

Another one of their health insurance plans is for individuals called the Health Shield Insurance.

The SALIENT FEATURES of this policy are:

· There are no medical tests up to the age of 50 years

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

· Lump sum payment of 2% of sum insured if hospitalization exceeds 15 consecutive days and where liability is admitted for hospitalization

· 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 limit of 1.5% of the sum insured and for ICU to a maximum of 3% 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 18 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

MAXIMUM AMOUNT PAYABLE TOWARDS VARIOUS TREATMENTS:

DISEASE/TREATMENT	LIMIT PER PERSON PER POLICY PERIOD
Cataract	7.5% of sum insured subject to a maximum of Rs.20000
Piles, Fistula, Tonsilitis, Sinusitis	10% of sum insured subject to a maximum of Rs.30000
Benign prostatic, Hypertrophy, Hernia	20% of sum insured subject to a maximum of Rs.50000
Joint Replacement	50% of sum insured subject to a maximum of Rs.1.5 lacs
Appendicitis and gall bladder stones and gynaec disorders including hysterectomy	25% of sum insured subject to a maximum of Rs.40000
Dialysis, Chemotherapy and Radiotherapy	10% of sum insured per month

PREMIUM TABLE:

FOR 1 YEAR:

AGE	Rs.1 lac	Rs.1.5 lacs	Rs.2 lacs	Rs.2.5 lacs	Rs.3 lacs	Rs.4 lacs	Rs.5 lacs
91 days – 25 years	1151/-	1581/-	1850/-	2271/-	2776/-	3589/-	4038/-
26-40 years	1861/-	2791/-	2947/-	3944/-	4420/-	5598/-	6871/-
41-45 years	2182/-	3272/-	3746/-	5016/-	5681/-	7116/-	8734/-
46-50 years	2731/-	3752/-	4956/-	6218/-	7710/-	9768/-	11026/-

FOR 2 YEARS:

AGE	Rs.1 lac	Rs.1.5 lacs	Rs.2 lacs	Rs.2.5 lacs	Rs.3 lacs	Rs.4 lacs	Rs.5 lacs
91 days – 25 years	2187/-	3002/-	3515/-	4316/-	5275/-	6819/-	7672/-
26-40 years	3536/-	5302/-	5601/-	7493/-	8397/-	10637/-	13056/-
41-45 years	4146/-	6217/-	7117/-	9527/-	10674/-	13521/-	16595/-
46-50 years	5189/-	7129/-	9419/-	11816/-	14649/-	18559/-	20949/-

· The premium amounts given above are inclusive of Service Tax of 10.3%

· The premium paid towards the health insurance is exempt from Income Tax under section 80D

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:

· There is a family discount of 10% if the policy is taken for 3 or more members from the same family under a single policy

· Reimbursement of health check up costs up to Rs.750per insured person after 5 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

· 24-hour helpline number

· Ambulance referral facilities

· Online access to medical and claim information

· Online storage of medical records

· Tie up with over 3000 hospitals across the country