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Royal Sundaram Claim Settlement Ratio

95.95%

Royal Sundaram

94.21%

Industry Average

Health claim settlement ratio is the percentage of claims settled against the total claims received by the insurance company in a given fiscal year. Royal Sundaram has a claim settlement ratio of 95.95%, as compared to the industry average of 94.21%.

Royal Sundaram Claim Process

Royal Sundaram supports both cashless claims and reimbursement claims. This section covers the information on how to check Royal Sundaram health insurance claim status, fill Royal Sundaram health insurance claim form, and the claim settlement process.

Step 1: File the claim
If you are insured with Royal Sundaram Health Insurance, you must file a claim within 24 hours of hospitalisation in case of emergencies. In case of planned hospitalisation, you must do so 48 hours before being admitted.

Step 2: Processing of cashless claims
After you are admitted to one of our network hospitals, we will receive intimation from the hospital and initiate claim processing at our end after verification of all submitted documents.

Step 3: Bill settlement on discharge
In the case of cashless hospitalisation, you can relax and focus on your treatment at the hospital and on getting better while Royal Sundaram takes care of the rest.At the time of your discharge from the hospital,we will directly settle the bill with the hospital management without having you pay anything from your pocket.

Step 1: Inform the insurer
If you choose to be treated at a non-network hospital, you are still entitled to receive a reimbursement for your expenses incurred during hospitalisation. Your health insurance with Royal Sundaram allows you to claim reimbursement with the insurer later. In this case, we expect you to inform us of your planned hospitalisation treatment at least 48 hours in advance. In case of medical emergencies, make sure to inform us of your urgent hospitalisation within 24 hours.

Step 2: Submission of form and documents to TPA
After completion of treatment and at the time of discharge from the hospital, you would need to submit all medical records to the Third Party Administrator (TPA) at the hospital desk. Duly fill out the Royal Sundaram Health Insurance claim form received from the hospital and submit it along with the other required documents to the TPA. The documents include diagnostic test reports, pharmacy bills, doctor prescriptions, original hospital bills, and other medical reports.

Step 3: Claim reimbursement
Upon receipt of the claim form and documents by Royal Sundaram,we will thoroughly check and verify the claim made. Upon approval,we will reimburse the insured the amount they incurred on medical expenses.

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FAQs

If the hospitalisation occurs within the pre-existing waiting period, coverage would not be available.However, after the waiting period is over,coverage would be allowed for pre-existing illnesses

Renewals of Royal Sundaram health insurance plans are allowed lifelong. There is no cover ceasing age

Yes, at the time of renewal, the sum insured can be increased if the company allows it. However, for the increased part of the sum insured, the pre-existing waiting period would apply from start

Porting means changing one health insurance policy to another. When you port, you can retain the renewal benefits of your existing health insurance policy. Thus, the waiting period in the new policy would be reduced by the term of the existing policy and you can enjoy better coverage.
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