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Royal Sundaram Medical Insurance |
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Health Shield Standard Quality Health Insurance
Health Shield is a comprehensive Health Insurance package specially designed to offer complete protection to the insured and his family. You can cover your spouse, children (above 90 days) and dependent parents (up to 60 years) from all Health worries. However, renewal is accepted only up to 70 years.
Age of the Primary insured person on first enrolment should be less than 60 years
With Health Shield, you will also have access to value added services like cashless treatment (subject to conditions and authorisations) at a list of hospitals provided by us, a 24 hour helpline and ambulance referral facility at no additional cost. It has been designed to ensure that you and your family get the best medical treatment at any time when you need it.
Royal Sundaram Health Card
This card is specially designed exclusively for all Health Shield customers of Royal Sundaram. It enables you to use the services of our Network Hospitals and provides you with Cashless facility at over 2200 hospitals across 166 cities in India.
Your Health Shield card will be of great significance. You can undergo treatment in any one of the Network Hospitals and walk out without paying any of your medical expenses, which are covered under Health Shield. All you need to do is call TPA on the 24-hour helpline and take an authorisation. All your expenses will be settled directly with the hospital (subject to exclusions and conditions). In case you want to go to any hospital other than the Network Hospitals, you will have to pay the bills and get it reimbursed by us.
Health Shield simplifies health insurance a great deal and makes it more convenient and easy to understand, since one of its unique feature is easy documentation and hassle-free claim settlement.
Features & Benefits
Health Shield Coverage
Hospitalisation cover:
All inpatient hospitalisation expenses in case of any accidents/illnesses covered by the policy for hospitalisation for more than 24 hours.
Pre and post-hospitalisation expenses:
Covers all relevant medical expenses incurred 30 days prior to and 60 days after hospitalisation.Day care treatment expenses are covered in certain areas.
In the event of any claim becoming admissible under the Policy, the Company will pay to the Proposer, the Reasonable and Customary expenses, subject to the various limits mentioned hereunder, but not exceeding the Sum Insured and the Cumulative Bonus, if any, mentioned in the Schedule for all claims admitted during the Period of Insurance.
The Claim amount payable towards the treatment of following disease, illness, medical condition or injury is subject to a limit of :
Pre-existing conditions waiver:
Normally all pre-existing illness at the time of taking the policy are excluded. However, if you continue to be with Health Shield for 5 years consecutively, pre-existing diseases will not be excluded from the sixth year.
Cumulative Bonus:
Sum Insured under this policy increases by 5% for every claim free year, up to a maximum of 50%.
Hospital Cash Allowance:
A lump sum of 2% of the Sum Insured per claim, in case of continuous hospitalization for a period of more than 15 days.
Ambulance charges in an emergency, subject to a limit of Rs.1000/- per claim.
Reimbursement of expenses, subject to a maximum of Rs.750/- per Insured Person, towards Master Health Check up for the Insured Person, after each 5 consecutive claim free for the Insured (excluding Cumulative Bonus) for each of those 5 years is equal to or more than 1,00,000/- per person.
Room, Boarding Expenses as charged by the Hospital/Nursing Home, subject to a limit of 1.5% of the Sum Insured per day and for Intensive Care Unit 3% of the Sum Insured per day.Surgeon, Anesthetist, Medical Practitioner, Consultants and Specialist Fees are subject to a limit of 40% of the Sum Insured.
Family Discount:
A discount of 10% is allowed on the premium payable by you if 3 or more persons opt for Health Shield Standard at the same time.
Exclusion waivers:
If you are holding an existing Health Insurance Policy and are below the age of 40 years, first year exclusions and 30 days waiting period shall be waived. Option for Health Shield Standard should be done before the expiry date of your existing policy.
Key Features of Health Shield
Health Shield comes with certain additional features, which normal health insurances may not include:
• Access to 24-hour helplines
• Cumulative bonus on renewal
• Free ambulance referral facilities
• Income tax benefits on premium paid as per section 80D of Income Tax Act
• Online access to your family´s medical history, information on hospitals, illnesses and Medicines
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