Arogya Sanjeevani Policy Royal Sundaram

How does Arogya Sanjeevani Policy, Royal Sundaram protect you?
Expenses during hospitalization
We lighten your burden of hospital costs. Room rent, nursing expenses, ICU/ICCU and ambulance charges are covered up to a limit.

AYUSH Treatment
We respect your choice of treatment. Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy treatments at any AYUSH Hospital are covered.

Cataract Treatment
Eye sight is a precious gift and we want you to enjoy it as much as possible. So we cover Cataract treatment.

Expenses before and after hospitalization
We care about you getting better. Medical expenses for 30 days before you are admitted and for 60 days after discharge are covered.

Modern or New-Age Treatments
We cover many advanced treatments not commonly covered by other health insurance policies.

Cumulative Bonus
Your health is important to us, so we reward you by increasing your coverage by 5% after every year without a claim.

Important: We want you to understand this policy fully.
Arogya Sanjeevani Policy, Royal Sundaram offers great coverage.
But it comes with certain limitations set by the regulatory body - IRDAI.
Please make sure you understand these points.

WHAT WE COVER | WHAT WE DON'T COVER

WHAT WE COVER
1.Hospitalization Expenses and other Expenses
2.Ayush Treatment
3.Cataract Treatment
4.Pre-Hospitalization
5.Post Hospitalization
6.Modern Treatments
7.Cumulative Bonus

WHAT'S NOT COVERED
1.Pre-existing Diseases for the first 48 months
2.Cosmetic Surgery
3.Maternity Expenses
4.Diagnostics Expenses
5.Miscellaneous Charges
6.Registration charges
7.Admission fees
8.Service charges
9.Health Supplements
10.ther exclusions

LIMITS IN YOUR COVERAGE
1.Room Rent, Boarding, Nursing Expenses charged by the Hospital/Nursing Home are covered only up to 2% of the sum insured - subject to a maximum of Rs.5000 per day

2.ICU/ ICCU expenses are covered up to 5% of sum insured - subject to a maximum of Rs. 10,000 per day

3.Medical expenses incurred for treatment of Cataract are subject to a limit of 25% of Sum insured or Rs. 40,000, whichever is lower, per each eye in one policy year

4.Each claim under the Policy shall be subject to a co-payment of 5% of claim amount

WAITING PERIODS
In order to prevent misuse, every health insurance policy will

30 Days Initial Waiting Period: We will not cover any treatment taken during the first 30 days from the start of the Policy, unless the treatment is due to an Accident

Pre-Existing Diseases: Treatment expenses for pre-existing diseases are not covered until 48 months of continuous coverage under the policy

Specific Waiting Periods: The 20 conditions listed below will be subject to a waiting period of 24 months and will be covered in the third year of continuous coverage under the policy

1.Benign ENT disorders
2.Tonsillectomy
3.Adenoidectomy
4.Mastoidectomy
5.Tympanoplasty
6.Hysterectomy
7.All internal and external benign tumors, cysts, polyps of any kind, including benign breast lumps
8.Benign prostate hypertrophy
9.Cataract and age-related eye ailments
10.Gastric/Duodenal Ulcer
11.Gout and Rheumatism
12.Hernia of all types
13.Hydrocele
14.Non-infective Arthritis
15.Piles, Fissures and Fistula in anus
16.Pilonidal sinus, Sinusitis and related disorders
17.Prolapse inter Vertebral Disc and Spinal Diseases unless arising from accident
18.Calculi in urinary system, Gall Bladder and Bile duct, excluding malignancy
19.Varicose Veins and Varicose Ulcers
20.Internal Congenital Anomalies

ii. 48 Months waiting period
1.Treatment for joint replacement unless arising from accident
2.Age-related Osteoarthritis & Osteoporosis

EXCLUSIONS
Expenses related to the following will not be covered by Royal Sundaram.
1.Investigation & Evaluation
2.Rest cure, rehabilitation and respite care
3.Obesity/weight Control
4.Change-of-Gender treatments
5.Cosmetic or Plastic Surgery
6.Hazardous or Adventure sports
7.Breach of law
8.Excluded Providers
9.Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof
10.Treatments received in heath hydro's, nature cure clinics, spas or similar establishments or private beds registered at nursing homes attached to such establishments or where admission is arranged wholly or partly for domestic reasons.
11.Dietary supplements and substances that can be purchased without prescription, including but not limited to vitamins, minerals and organic substances unless prescribed by a medical practitioner as part of hospitalization claim or day care procedure
12.Refractive Error
13.Unproven Treatments
14.Sterility and Infertility
15.Maternity Expenses
16.War (whether declared or not) and war-like occurrence or invasion, acts of foreign enemies, hostilities, civil war, rebellion, revolutions, insurrections, mutiny, military or usurped power, seizure, capture, arrest, restraints and detainment of all kinds
17.Nuclear, chemical or biological attack or weapons, contributed to, caused by, resulting from or from any other cause or event contributing concurrently or in any other sequence to the loss, claim or expense
18.Any expenses incurred on Domiciliary Hospitalization and OPD
treatment
19.Treatments taken outside the geographical limits of India
20.In respect to existing diseases disclosed by the insured and mentioned in the policy schedule (based on insured's consent), the policyholder is not entitled to get the coverage for specified ICD codes

CANCELLATION POLICY
Timing of Cancellation Refund %
Up to 30 days 75.00%
31 to 90 days 50.00%
3 to 6 months 25.00%
6 to 12 months 0.00%