Group Health Insurance Policy
Frequently Asked Questions
The following are the Sum Insured amounts available
- Rs 2 Lac
- Rs 3 Lac
- Rs 5 Lac
- Rs 7 Lac
- Rs 10 Lac
This cover is available for self, spouse and up to 2 dependent children.
No need to undergo any medical examination if the insured are in good health and upto the age of 55. You can get the cover by just confirming your good health status in the online form and paying applicable premium amount
The cover is available for those who are up to the age of 55 years.
- Cashless hospitalisation in around 4000 hospitals across India.
- Cover from the date and time of premium payment.
- Cover for accidents without any waiting period.
- 100% cover for Surgeon / Doctor Fees
- Cover for Day care procedures which do not require 24 hours hospitalisation.
- 30 days Pre hospitalisation expenses.
- 60 days Post hospitalisation expenses.
- 30 days waiting period – for diseases contracted during first 30 days of cover.
- One year waiting period – for treatment of Cataract, Benign Prostatic Hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Fistula in anus, Piles, Sinusitis and related disorders.
- 3 year waiting period – for treatment of pre-existing diseases & complications.
While majority of your health conditions shall be under purview of the cover, Policy still has some permanent exclusions which shall be applicable forever. Some are listed below:
- Pregnancy and its complications for individual policy
- Outpatient treatment charges
- Dental treatments unless requiring hospitalisation
- Cosmetic / weight management treatments/surgeries
- Nuclear, Biological, Chemical Terrorism
- Hormone replacement therapy
- Treatments other than allopathic
- Any hospitalization arising out of hazardous occupation/ activities
- Treatment received outside India
- Alcoholism, Drug addiction
- Along with your Certificate of Insurance a plastic TPA card will be given to you
- The unique identification number of the policy along with T.P.A.'s (Third Party Administrator) contact phone number will be available on the card
- In the event of hospitalisation, please give a call to the T.P.A and enquire nearby network hospital which shall provide cashless treatment
- In case of a planned treatment, approach the hospital at least 72 hours before admission and show the TPA card, identification details & doctor's advice. In the unfortunate event of an emergency admission ensure you approach the hospital with TPA card within 48 hours of admission.
- If the medical condition for which treatment is proposed does not fall under any waiting period or permanent exclusion then T.P.A will send a pre-authorization to the hospital.
- The cashless treatment can then be availed from the hospital.
- If the chosen hospital is not under network of T.P.A., all the bills with the hospital have to be settled by the insured and presented to Royal Sundaram at the below address along with claim form and other relevant documents.
- Accident & Health Claims Department
Royal Sundaram General Insurance Co.Limited
6th Floor, Vishranthi Melaram Towers, 2/319,
Rajiv Gandhi Salai (OMR), Karapakkam,
Chennai – 600 097.
- In this scenario, please intimate Royal Sundaram within 7 days from date of discharge
- Accident & Health Claims Department
- If the medical condition for which treatment is proposed does not fall under any waiting period or permanent exclusion then Royal Sundaram will process the claim and send cheque in settlement.
- The claim documents for reimbursement should be submitted within 30 days from date of discharge from hospital.
This is a health policy and can be renewed for life long, provided your account continues to be with DBS and DBS renews its policy with Royal Sundaram