Royal Sundaram General Insurance Company

No matter what plan you are looking to buy from the Royal Sundaram General insurance plan, the claim process for each is different. Let’s take a look at them one by one:

1. Motor (Cashless & Reimbursement)

When it comes down to the claim process of a motor insurance plan, you can choose either of the two forms.

Cashless Claim Process: Once you’ve informed the company about the claim and provided them with the details of your policy as well as the events that led to the loss or damage, they’ll help you find a suitable workshop to repair your vehicle as soon as possible and to the highest quality standards, so you can get back on the road. All you need to do is fill out and sign a claim form. If the vehicle in question is a company vehicle, a company seal and signature from an authorized signatory are necessary. Also, self-attested photocopies of the vehicle’s registration certificate and the driver’s license at the time of the accident. An FIR must be filed at the police station if the accident results in death, injury, or property damage to third parties.

Reimbursement Claim Process: The original invoice will be requested for reimbursement claims. In this situation, you will be responsible for paying for the car repair out of pocket, after which the company will repay you the amount based on the original invoices, after deducting any deductible.

2. Health (Cashless & Reimbursement) Claim Process

If you are looking to claim your health insurance, you can choose either of the two ways.

Cashless Claim Process: In the case of scheduled hospitalization, you should notify Royal Sundaram at least 48 hours ahead of time, and in the case of emergency hospitalization, you should notify Royal Sundaram within 24 hours. Please notify TPA of any scheduled hospitalization and request cashless authorization at least 72 hours before the commencement of the hospitalization. TPA must be notified of any emergency hospitalization within 24 hours of the admission. TPA will verify your coverage and issue a cashless authorization letter to the hospital within three hours of receiving all of your papers. If there is a discrepancy in the documents supplied, the hospital will be notified within 4 hours of receiving the documents.

The list of the document include the Final hospital discharge summary, Pharmacy bills along with the prescription Original bills, Original hospital bills, Canceled cheque or NEFT details for payment, Treating doctor’s report, and original consultation notes, FIR or post-mortem report if happened, Nature of operation performed and surgeon’s bill and receipt, Test reports along with attending doctor’s or surgeon’s report, etc. Before discharge, please pay all non-covered non-medical expenses and levies to the hospital. The hospital will receive a denial notification within two hours if the disease or treatment is not covered by the policy.

Cashless Facility (Worldwide Emergency Hospitalization): You must notify the Service Provider within 24 hours after being admitted to the hospital. Their Service Provider will evaluate the request and the Insured Person’s eligibility under the Policy and will contact them if more information or details are needed. They will instantly notify the hospital whether the pre-authorization request was approved or denied. If the pre-authorization request is approved, the Service Provider will pay the claim with the hospital right away. The Insured Person is responsible for any expenditures or expenses incurred by or on behalf of the Insured Person that exceeds the Service Provider’s pre-authorized limits.

Reimbursement Claim Process: Please send Royal Sundaram the fully completed and signed claim form, as well as all information/documents, within 30 days after release. If there is a discrepancy in the papers/information you gave, Royal Sundaram will send a deficiency letter within 7 days of receiving your claim documents. Within 30 days of obtaining the whole set of claim documents, Royal Sundaram will make payment for the admissible amount (as per Policy Terms & Conditions) along with a settlement letter.

3. Travel Insurance Claim Process

If you are looking to claim your travel insurance, you can choose either of the two ways.

For Cashless Claims: In the event of emergency hospitalization, the insured person must notify the Service Provider within one day of being admitted to the hospital, but in any case, before being discharged. If the above-mentioned deadlines are not met, the company is not obligated to provide a cashless facility.

Reimbursement Claim: All claims will be reimbursed in Indian Rupees at the exchange rate in effect on the date the amount is billed. If, on the other hand, it can be demonstrated that the necessary foreign currency to pay the bill was obtained at a less favorable rate, the appropriate exchange rate will be used. Within 30 days after receiving the last relevant document, all acceptable claims under this policy must be submitted for settlement. Where a settlement offer has been made and accepted by the insured person, nominee, or legal heir, the company must pay the offered claim amount within 7 days of such acceptance, failing which the company will be liable to pay interest at 2% above the bank rate in effect at the beginning of the financial year in which the claim is reviewed. At the time of claim settlement, the Company may require the Proposer’s KYC documentation following current AML requirements.

4. Other (Home, Personal Accident Insurance, and Business Insurance)

If an incident occurs that may give rise to a claim under this policy, you must notify the company immediately by phone or email at customer.services@ royalsundaram .in, or by providing written notice, and you must provide detailed particulars of the amount of the loss or damage, as well as such explanation and evidence to substantiate the claim as the Company may reasonably require, within 14 days.

You must also produce, procure, and give to the company all further particulars, plans, specification books, vouchers, invoices, duplicates or copies thereof, documents, proofs, and information relating to the claim, the origin and cause of the loss, and the circumstances under which the loss or damage occurred at all times at your own expense. Any matter relating to the Company’s liability or the amount of the company’s liability that may be reasonably requested by or on behalf of the company, as well as a declaration on oath or in another legal form of the claim’s truth and any items related thereto. Please make sure that the documents are in English or that you can give an English translation of them. The company may provide a Service Provider to check the papers, if necessary, to speed up the claim procedure.