Claim Process - Royal Sundaram General Insurance

  1. Intimation
  2. Availing Treatment
  3. Compilation / Submission of Claim File

How to intimate health claim with Royal Sundaram General Insurance

Planned Treatment - At least 72 Hrs prior to hospitalization
Emergency Treatment - Within 48 Hrs of hospitalization
Register Claim Online
Claim Helpline
1860-425-0000
Nearest Branch

Details required for Registration/ Intimation of Claim

To Register claim by calling/FAX on above contact point, you will need to provide the following information to the customer support executive:-
  • Health card Membership number.
  • Policy number
  • Name of the Patient.
Once the claim is registered, the customer support executive will provide you with a Claim Reference/Intimation Number.

Points to Remember

  • Every claim should be intimated & file should be submitted within time, as non adherence can lead to delay in claim settlement.
  • The claim is decisioned only when all required & necessary documents are submitted.
  •  NEFT & KYC details should be updated with the Insurer for easier & faster claim settlement.
  • Pre hospitalization expenses may be claimed along with main hospitalization expenses.
  • Unreasonable & Non medical expenses are not payable.
  • Every claim should be intimated & file should be submitted within time, as non adherence can lead to delay in claim settlement.
  • The claim is decisioned only when all required & necessary documents are submitted.
  •  NEFT & KYC details should be updated with the Insurer for easier & faster claim settlement.
  • Pre hospitalization expenses may be claimed along with main hospitalization expenses.
  • Unreasonable & Non medical expenses are not payable.

 

The claim file has to be submitted at the below mentioned addresses within 30 days of discharge.

 

The claim file has to be submitted at the below mentioned addresses within 30 days of discharge.
Courier Address
M/s.Royal Sundaram Alliance Insurance Co.Ltd., Corporate office - Vishranthi Melaram Towers, No. 2 / 319, Rajiv Gandhi Salai (OMR), Karapakkam, Chennai - 600097.




List of Documents

List of claim submission documents are as below

  • Claim form consist of two parts (Part A to be filled by Insured and Part B to be filled by Hospital).
  • Test reports and prescriptions relating to First / Previous consultations for the same or related illness
  • Case history Admission discharge summary describing the nature of the complaints and its duration, treatment given, advice on discharge etc issued by the Hospital
  • Death summary in case of death of the insured person at the hospital
  • Hospital Receipts / bills / cash memos in Original (including advance and final hospital settlement receipts)
  • All test reports for X rays, ECG, Scan, MRI, Pathology etc. including doctor’s prescription advising such tests/investigations (CDs of angiogram, surgery etc. need not be sent unless specifically sought)
  • Doctor’s prescriptions with cash bills for medicines purchased from outside the hospital
  • F.I.R/MLC. in the case of accidental injury and English translation of the same, if in any other language
  • Detailed self description stating the date, time, circumstances and nature of injury/accident in case of claims arising out of injury
  • Legal heir certificate in the absence of nomination under the policy, in case of death of the proposer. In the absence of legal heir certificate, evidence establishing legal heirship may be provided as required by Us
  • Maternity claims, Discharge Summary mentioning LMP, EDD & Gravida 
  • Cataract claims IOL sticker 
  • PTCA claims Stent sticker
  • Copies of health insurance policies held with any other insurer covering the insured persons
  • KYC
  • Cancelled cheque

Process of Claim

01
The treatment is to be intimated within prescribed timelines.
02
Post completion of treatment, documents are to be collected from hospital during discharge.
03
The claim file is to be prepared with reference to check list. (The claim form part B is to be filled by hospital)
06
Post receiving of all required info, the claim will be processed within 30 days.
05
Royal Sundaram will inform about any deficiency within 7 days.
04
Duly filled claim forms along with all necessary documents are to be submitted within prescribed timelines.
07
If the claim is approved, amount will be transferred within 30 days.
08
If the claim is rejected, letter with details are to be shared with Insured.
  • Save ₹3,900/month & get
    up to ₹50 Lakhs on Retirement
    or ₹30,000 Pension/month
    CHECK NOW
  • By clicking on the "GET A CALL" button, I accept the terms and conditions & authorize OneInsure representatives to contact me (via Call/SMS/Email).

THANK YOU!