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Key design and service features of Lifeline are as mentioned below:
Lifeline offers 3 different plans – Classic, Supreme and Elite. Sum Insured offered under these plans is as mentioned below:
Plans Sum Insured
|Classic ₹2 Lakhs, ₹3 Lakhs, ₹4 Lakhs|
|Supreme ₹5 Lakhs, ₹10 Lakhs, ₹15 Lakhs, ₹20 Lakhs, ₹ 50 Lakhs|
|Elite ₹25 Lakhs, ₹30 Lakhs, ₹50 Lakhs, ₹100 Lakhs, ₹150 Lakhs|
While Classic Plan offers similar benefits like other health insurance plans available in market, Supreme and Elite offer much more comprehensive coverages like Second Opinion for Critical Illness, International Treatment for 11 Critical Illness, Worldwide Emergency Hospitalisation, etc. to provide a very comprehensive coverage to customer
Maternity Benefit is covered in Lifeline’s Elite Plan. It covers the expenses related to Maternity and also covers the new born baby till the next renewal. It also covers the vaccination for the new born baby in the first year. Maternity benefit is payable only when Husband and Wife both are covered under the policy after a continuous coverage of 3 years. Maternity Benefit can be claimed maximum up to 2 times.
OPD Treatment is covered in Lifeline’s Elite Plan. OPD Treatment covers the consultation, diagnostic fees, medicines, etc. It also covers the expenses incurred on Dental OPD Treatment, Cost of Spectacles, Contact Lenses and Hearing Aids once in 2 years with a sublimit of 30% of OPD Treatment
If the customer is diagnosed with any of the 11 specified critical illnesses, customer can avail the treatment in any hospital of his choice across the world. The policy will cover the expenses incurred on the hospitalisation for the treatment of the critical illness covered. It will also cover the return airfare up to ₹ 3 lacs of the insured person. This benefit is available on cashless basis only. Customer need to obtain a pre-authorization from us by submitting the pre-authorization request along with diagnosis confirmed in India, before the treatment. The diagnosis of the 11 specified CIs should be as per definitions of these 11 specified 11 CIs given under Policy wording. All claims will be subject to co-payment of 20%.
a.Our maximum liability for this claim will be limited as mentioned below:
Worldwide Emergency hospitalisation covers hospitalisation expenses abroad (out of India) subject to:
Overall liability will be limited to 50% of Sum Insured up to a max of Rs.20 lacs
Lifeline covers Worldwide Emergency Hospitalisation however it does not cover certain other benefitsrelated to travel inconvenience like Passport Loss, Loss of Baggage, etc. Hence, we suggest that if a customer is travelling abroad, they should also take an oversea travel insurance policy as per their travel itinerary.
Lifeline Elite plan is a suitable offering for HNI customers who are frequently travelling or want the best of class treatment across the globe. This plan will help them to get the treatment done across the globe
Yes, Lifeline also provide coverage for Ayush Treatment in case of Inpatient Hospitalisation. Please note that OPD treatment undertaken in Ayush is not covered
Organ Donor Expenses covers the expenses incurred on the hospitalisation of the organ donor. All inpatient care expenses related to organ donor are covered, provided:
However, any other expenses related to acquisition of donor, related pre- and post-hospitalisation expenses, and treatment of associated medical complications will not be covered Organ Donor expenses are covered up to Sum Insured
If you ever exhaust your health cover due to claims in a given year and there is a further claim either by you for a different illness or your insured family member, we will reload the entire sum insured of your policy at no extra cost. Reloaded sum insured will help you to settle those claims Reload of Sum Insured is similar to Recharge benefit of Religare as it is triggered when the claim amount exceeds the available sum insured including the NCB for a different illness or different person. In Optima Restore, sum insured is restored only when entire sum insured is exhausted (for e.g., if the SI is ₹3 Lakhs, and initial claim was of ₹2.5 Lakhs, Restore will not be triggered for second claim (of different illness or different person) of ₹1 Lakh and only ₹50,000 will be paid. Whereas, Reload will be triggered and entire ₹1 Lakh will be paid)
Pre Hospitalisation covers the medical expenses incurred before hospitalisation for Diagnostic Test, Medication, etc.
Post Hospitalisation covers the medical expenses incurred on follow up visit with doctor, medication, further investigative test, etc
Pre & Post Hospitalisation expenses are covered up to Sum Insured
Vaccination in case of Animal Bite covers the expenses incurred by you to take vaccination in OPD. For e.g., in case of Dog Bite, you need to take Rabies vaccination at regular interval which is an OPD procedure. Lifeline will cover the expenses incurred on vaccination up to the limit against your plan. It does not cover the medicines, bandages or other expenses incurred while taking the vaccination
Lifeline offers annual health check-up for Supreme & Elite Plan and once in 2 years for Classic Plan. Health check-up is offered to all the insured above the age of 18 years irrespective of claims status. Please refer to grid below for covered medical test
Plan List of Medical Tests
Classic: Complete Blood Count, Urine Routine, ESR, Fasting Blood Sugar, ECG, S Cholesterol, SGPT, Creatinine
Supreme: Complete Blood Count, Urine Routine, ESR, Fasting Blood Sugar, Lipid Profile, Kidney Function Test, ECG, Complete physical examination be Physician
Elite: Complete Blood Count, Urine Routine, ESR, Fasting Blood Sugar, Lipid Profile, Stress Test (TMT) or 2D Echo, Kidney Function Test, Complete physical examination be Physician
We will cover the expense incurred on an ambulance offered by a hospital or ambulance service provider for transferring you to the nearest hospital provided we accept the inpatient care claim for the given hospitalisation. It is covered up to R₹3000 in Classic, ₹.5000 in Supreme and ₹10000 in Elite.
Expenses incurred on Hearse Van is not covered.
Prosthetic Implants are artificial substitutes for body parts, and materials inserted into tissue for functional, cosmetic, or therapeutic purposes. Prostheses can be functional, as in the case of artificial arms and legs, or cosmetic, as in the case of an artificial eye. Implants, all surgically inserted or grafted into the body, tend to be used therapeutically. These are covered in Lifeline.
There are certain conditions for which customer can wait for treatment and does not need immediate medical treatment. Lifeline has 2 years waiting period for 17 conditions as mentioned below:
Initial Waiting Period is the cooling period applied at the start of new policy. This waiting period is not applicable for renewal policy or portability policy. Only Accidents are covered in the Initial Waiting period Pre-Existing Disease waiting period is the waiting period applied for any of the existing disease customer is suffering from. It might vary from 4 years in Classic to 2 years in Elite Plan. With each policy year, the pre-existing disease waiting period reduces by 1 year. Any claim related to pre-existing disease hospitalisation will not be covered in the policy during waiting period.
The Premium charged on the Policy will depend on the Sum Insured, Policy Tenure, Age, Policy Type, Zone of Cover and Optional Covers opted. Additionally, the health status of the individual will also be considered and premium might be loaded depending on the health condition.
For the purpose of calculating premium, the country has been divided into 2 Zones.
Zone 1: Delhi/NCR, Mumbai (incl. Thane and Vashi), Bengaluru, Chennai, Pune, Hyderabad, Kolkata and
Zone 2: Rest of India.
A discount of 15% for members in Zone 2 will be applicable. Grid as below:
Zone 1 0%
Zone 2 15%
Eg, Premium for a 35 year old for a Sum Insured of Rs.5lacs is Rs.5549 in Mumbai (Zone 1) and Rs.4717 in Nasik (Zone 2).
There are many out of pocket expenses like Cab charges, Attendant Food expenses, etc. which are not covered under the normal Hospitalisation policies. Hospital Cash pays a lump sum amount to cater to these miscellaneous expenses. We will pay for up to 30 days of hospitalisation in a policy year if the stay of hospitalisation is more than 2 days It is an optional cover and customer can opt for the Hospital Cash benefit at the time of new purchase or renewal.
You can choose from one of six optional deductibles of ₹ 1 Lakh, ₹ 2 Lakhs, ₹ 3 Lakhs, ₹ 4 Lakhs, ₹ 5 Lakhs and ₹10 Lakhs. By doing so you will receive a discount in the premium calculation of your Policy. You can choose to the take the top up cover under Classic & Supreme plan. If a top-up plan (on annual aggregate deductible) is chosen, then the insured person shall bear all assessed claim amounts payable under the policy up to the deductible amount, under his policy for any Policy Year. Our liability to make payment under the Policy in respect of any claim made in that Policy Year will only commence once the Deductible has been exhausted In case of per claim deductible, top up plan is applicable if the claim amount exceeds the deductible amount. In Lifeline, deductible is on aggregate basis and not per claims basis.
If you are suffering from 11 critical illnesses as mentioned below and feel uncertain about your diagnosis
or wish to get a second opinion of an expert/doctor, we arrange one for free of cost for you:
To avail this benefit, you need to contact us and we will arrange for the second opinion. You can choose
from our empaneled doctors/hospitals. Please note that this benefit is not on reimbursement basis
If you are stuck in an emergency due to accident or illness in India, we will assist to transport you safely from one hospital to another hospital to provide a suitable medical treatment.
For e.g., in case of a natural calamity like Kashmir Flood, you are rescued by Army and admitted in a hospital in one of the relief camp. Royal Sundaram will arrange for Domestic Evacuation from this hospital to another hospital having better medical facilities for treatment.
This benefit is available for Supreme and Elite only. Any expenses beyond the limit (₹1Lakh for Supreme and ₹3 Lakh for Elite) has to be paid by you.
If a customer with diabetes or hypertension can be offered Lifeline subject to underwriting criteria.
Underwriter will evaluate the medical history and accept the case either on standard rates or with loading/ co-payment.
Medical expenses incurred on the treatment of new born baby is covered if claim for maternity benefit (covered only under Elite Plan) is payable. New born baby is covered till the renewal of the policy.
First year vaccinations for new born baby is covered if claim for maternity benefit (covered only under Elite Plan) is payable
Lifeline allows coverage for maximum of 2 Adults and 4 Children and relationship between the insured has to be Self, Spouse and Dependent Children.
56 UIN: IRDAI/NL-HLT/RSAI/P-H/V.I/32/14-15
However, you can take 2 different policies of Lifeline to cover all of them.
Policy 1 – Self, Wife and 2 Kids
Policy 2 – Parents in Law
Policy 3 – Aunt
Lifeline not only take care of your medical expenses but also provide benefits which help you in proactively manage your good health. You can obtain opinion from a doctor using our Health & Wellness Program. You can email your query on fever and you will get a response within 24 working hours. Please note that this does not substitute the medical treatment you would have otherwise taken
Doctor on Chat facility is through email which can be accessed through Internet either on computer or mobile phone
You can buy 2 years or 3 years policy in Lifeline. You get a discount of 7.5% for 2 year policy tenure and 12% for 3 year policy tenure.
Lifeline will support the external as well as internal portability. You can port your existing policy from National Insurance subject to underwriting
You can either buy a fresh policy of Lifeline or port the existing policy
Ventilator treatment is covered if the person is not brain dead
Any hospitalization due to these natural calamities like Hudhud is covered
If 2 individual policies of Lifeline are converted into Family Floater, the NCB transferred will be the lower of the 2 policies
Worldwide Emergency Hospitalisation covers treatment abroad due to any emergency. Treatment of Piles is not an emergency hospitalisation and customer can wait to return back to India and take treatment. Generally, Piles is under 2 year waiting period.
Yes. There is no capping on room rent category and customer can choose from any of the room available in hospital
Expenses which are not related to hospitalisation are normally not covered. Please refer to policy document for details of exclusion