health insurance plans that work for you - credit card | loan assist to transport you safely from...

Life's uncertainties are inevitable. And that's the case with your health too.

No one can assure that you will be always in the pink of your health. Your life

style choices can make a difference in your health. Each stage of life brings

different health challenges and health care needs. Health emergencies come

unannounced and disturb your financial planning.

Royal Sundaram introduces a comprehensive Health Insurance Plan

'Lifeline' which will take care of your medical expenses at every stage of your

life. We assure that while you are unwell, we will take up all the hassles

related to your treatment expenses. We will provide you access to best

healthcare facilities to put you back on recovery without worrying about

medical and other related expenses.

Lifeline is a health insurance policy which 'Works for You' as you want. It has

different plans like Classic, Supreme and Elite, offering the benefits as per

your requirement.

COVERAGE DETAILS

1. Inpatient Care - Hospitalization for at least 24 hours

We pay for room charges, nursing charges, ICU charges,

doctor's/surgeon fee, anaesthesia, blood, oxygen, operation theatre

charges, etc without any capping on these charges.

2. Pre & Post Hospitalization expense

Sometimes the procedures like Diagnostic Test, Medication, etc that

finally lead you to hospital can have a huge impact on your pocket. We

cover these medical expenses incurred by you before hospitalization.

Medical expenses do not end with the discharge. There are bound to be

expenses like follow up visit with doctor, medication, further

investigative test, etc. We cover these expenses incurred by you after

hospitalization upto sum insured.

3. All Day Care Procedures

We also cover on all day care procedures (like Dialysis, Chemotherapy,

etc) if you undergo a day care treatment at a hospital or day care centre

that requires hospitalization less than 24 hours due to advancement in

medical technology.

4. Organ Donor Expenses

We care about those who help you as much as we care about you. We

will reimburse the medical expenses that are incurred by an organ

donor while undergoing the organ transplant.

5. Reload of 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

Health insurance plans that work for you

policy at no extra cost. Reloaded sum insured will help you to settle

those claims.

6. Domiciliary Hospitalization

If due to your health condition you cannot be moved to a hospital or a

bed is not available in hospital, we will reimburse the medical expenses

incurred for treatment taken at home as long as it involved medical

treatment for a period exceeding 3 days.

7. Ambulance Cover

We will cover the expense incurred on an ambulance for transferring

you to the nearest hospital provided we accept the hospitalization

claim.

8. No Claim Bonus

If you do not claim in a given policy year, we increase the sum insured by

20% (in case of Supreme & Elite) upto a maximum of 100% of sum

insured and 10% (in case of Classic) upto a maximum of 50% of sum

insured. We appreciate your association with us, hence there is no

reduction of No Claim Bonus in case of a claim in any particular year.

9. Health Check-up

While we encourage and support you to stay fit and healthy, we provide

a free regular health check-up which is a report card of your health. You

are eligible for health check-up irrespective of your claim history. For

Supreme & Elite, we provide health check-up every year whereas for

Classic, we offer it once in 2 years.

10. Health & Wellness

We not only take care of your medical expenses but also provide benefits

which help you in proactively manage your good health. You can use

the various services like Diagnostic test, OPD consultation, Pharmacy,

Membership of Gym, etc at a discounted rate across given network. We

also provide latest information on various health topics. You can also

consult a doctor through email for any health related issues.

11. Ayush Treatment

We also cover the medical expenses incurred for an inpatient care claim

for taking treatment under ayurveda/homeopathy.

12. Vaccination in case of Animal Bite

We will reimburse the medical expenses incurred on vaccination in case

of animal bites like dog bite, honey bee bite, monkey bite, etc.

13. Second Opinion for Critical Illness (Only for Supreme & Elite)

We take your illness seriously as you do. 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.

14. Emergency Domestic Evacuation (Only for Supreme & Elite)

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.

15. Worldwide Emergency Hospitalization (Only for Elite)

We will cover medical expenses incurred (deductible of $1000) for any

Emergency Hospitalization while you are abroad during

business/leisure trip so that you need not worry about such expenses

while you are away from your home and family. The base rate is

Worldwide excluding US and Canada. However, you have an option to

include US and Canada by paying additional premium.

16. International Treatment for 11 specified Critical Illness (Only for Elite)

If you want to get the treatment for 11 Critical Illness# in any country of

your choice, we will cover the medical expense (20% co-payment

applicable) provided that such hospitalization has been pre approved

by us. We will also reimburse return airfare upto Rs.3 lacs for insured

person to be treated.

The base rate is Worldwide excluding US and Canada. However, you

have an option to include US and Canada by paying additional

premium.

P.S. - Our liability in first policy year is limited to 50% of Sum Insured

and 100% from subsequent years

# List of critical illnesses covered:

1. Cancer of Specified Severity

2. First Heart Attack of Specified Severity

3. Open Chest CABG

4. Open Heart Replacement or Repair of Heart Valves

5. Coma of Specified Severity

6. Kidney Failure requiring Regular Dialysis

7. Stroke resulting in Permanent Symptoms

8. Major Organ/Bone Marrow Transplant

9. Permanent paralysis of Limbs

10. Motor Neurone Disease with Permanent Symptoms

11. Multiple Sclerosis with Persisting Symptoms

17. Maternity Benefit (Only for Elite)

We will cover the medical expenses incurred for the delivery of baby or

expenses related to medically recommended termination of pregnancy.

Maternity benefits covers up to 2 deliveries if both husband and wife are

covered under the same family floater policy, New born baby cover and

vaccination for new born.

We also cover the new born baby till the next renewal of the policy as

well as expenses incurred in first year on vaccination for new born baby.

36 month waiting period applies to maternity benefit.

18. OPD Treatment (Only for Elite)

We will cover the expenses incurred on Out Patient basis for Doctor

Consultation, Medicines as prescribed by Doctor, Diagnostic Test as

prescribed by Doctor

We will also cover Dental OPD, cost of spectacles, contact lenses,

hearing aid (Once in 2 years with a sublimit of 30% of OPD sum

insured)

Renewal Disclosure

1. Policy offers lifetime renewability

2. Premium payable on renewal is based on the age at the time of renewal.

Premium payable on renewal and on subsequent continuation of cover

are subject to change with prior approval from IRDAI.

3. Any change in terms of cover during renewal shall be subject to IRDAI's

approval & a notice of 90 days before expiry of the policy shall be given.

4. There will be a 30 day grace period available to you from the expiry date

to renew your policy. However there will be no coverage during the

grace period

5. Any alterations like increase/decrease in Sum Insured, change in

variant/coverage, addition/deletion of members can be requested at the

time of renewal. Any request for acceptance of changes on renewal will

be subject to underwriting

6. Children completing 25 years of age at the time of renewal, in a �oater

policy will move out of �oater to an individual policy with continuity

bene�ts.

7. This product can be ported to another company before the renewal date.

8. In case you wish to port, to ensure continuous coverage of the policy

without any break in insurance, please get in touch with the other

insurance company, 45 days before the renewal date to initiate the

necessary porting formalities there.

PREMIUM

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 (inc. Thane and Vashi), Bengaluru, Chennai,

Pune, Hyderabad, Kolkata and Gujarat.

Zone 2: Rest of India.

Premium Tables are for Zone 1. If you are in Zone 2, you will avail a discount

of 15% on the published rate (Address of Proposer is considered for Zone

identi�cation)

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).

IMPORTANT INFORMATION

Tax Bene�t

Health Insurance policy comes with 2 fold bene�t. Not only it ensures that

you and your family can access best in class medical care all times, it also

enables you to avail of tax bene�t on the premium paid by you towards the

health insurance policy under section 80D of Income Tax Act 1961.

Free Look

This policy at inception, has a free look period of 15 days from the date of

receipt of policy. On review of the policy terms and conditions, if you are not

satis�ed with the policy, then you can cancel your policy within this 15 days

free look period. You shall be eligible for a refund of premium, after

deducting applicable risk premium, less the cost of medical examination

incurred by the company and the stamp duty charges, where applicable

provided your intimation of cancellation reach us within the free look

period. Your policy documents will reach you within 15 days from the date

of debit of your card/account.

ELIGIBILITY CRITERIA & POLICY TERMS

Minimum Entry Age 91 days for Dependent children

18 years for Proposer/adults

Maximum Entry Age 25 years for Dependent Children

Lifetime entry age for Adult

Policy Type Individual

Family Floater

Family Coverage

Option of 1 year, 2 years as well as 3 years

Discount of 7.5% if opting for 2 years tenure and 12% if opting for 3 years tenure

Self, Spouse and upto 4 Dependent Children

Separate �oater plan can be taken for ##Parents or other dependents

Sum Insured enhancement

Only at the time of renewals subject to underwriting.

Policy Tenure

## Other dependents can include Grand Father, Grand Mother, Grand Son, Grand Daughter, Brother, Sister, Brother-in law, Sister-in-law, Nephew, Niece, Son-in-law, Daughter-in-law, Father-in-law, Mother-in-law, Uncle, Aunt & Cousin. The relationship between the 2 adults being offered cover in a �oater policy should be husband & wife only.

Proposer should �ll in individual forms for every family members proposed to be covered for individual cover. In case of �oater, will �ll in one form.

OPTIONAL BENEFITS*

1. Hospital Cash

There are many out of pocket expenses like Cab charges, Attendant Food

expenses, etc which are not covered under the normal Hospitalization

policies. Hospital Cash pays a lump sum amount to cater to these

miscellaneous expenses. We will pay for upto 30 days of hospitalization in a

policy year if the stay of hospitalization is more than 2 days.

2. Include US and Canada for Worldwide Emergency Hospitalization and

International Treatment for 11 specified Critical Illnesses.

You can opt to include US and Canada for Worldwide Emergency

Hospitalization and International Treatment for 11 specified Critical

Illness. This benefit can be opted at the inception of first policy with Us.

3. Top Up Plan on Annual Aggregate Basis

Life Line provides a unique facility to be taken as a Top Up policy. If you are

currently covered under another existing health insurance policy or have a

group health cover provided by your employer, then ' Life Line' can be taken

as a Top Up option to help you in the event of a large claim, which exceeds

your existing SI limit.*Additional premium will have to be paid for availing the benefit number 1 & 2 listed above. There will be a

discount on premium available for opting for the 3rd benefit. The percentage of this discount will depend on the

combination of Deductible & Sum Insured chosen.

Application

You need to submit the completely �lled proposal form along with required

documents and premium cheque. Post submission of the form, documents

and cheque, Royal Sundaram will issue the policy (subject to underwriting).

You will receive the Policy Kit along with Cashless Health Cards on the

mailing address mentioned on proposal form.

Exiting the Policy

You can contact Royal Sundaram General Insurance Co. Limited through

the contact details shared in this brochure. In case you cancel your policy

after the free look period, refund of premium shall be as per the short period

rates mentioned in the Policy

WAITING PERIOD & KEY EXCLUSIONS**1. Initial Waiting period - 30 days

2. Initial waiting period for Critical Illness - 90 days

3. Pre Existing Disease:

a. Classic - 48 months

b. Supreme - 36 months

c. Elite - 24 months

4. Maternity Bene�ts - 36 months

5. Speci�c Waiting Period - 24 months for 17 speci�ed illnesses Stones in billiary and urinary systems Lumps / cysts / nodules / polyps / internal tumours Gastric and Duodenal Ulcers Surgery on tonsils / adenoids Osteoarthrosis / Arthritis / Gout / Rheumatism / Spondylosis / Spondylitis / Intervertebral Disc Prolapse Cataract Fissure / Fistula / Hemorrhoids Hernia / Hydrocele Chronic Renal Failure or end stage Renal Failure Sinusitis / Deviated Nasal Septum / Tympanoplasty / Chronic Suppurative Otitis Media Benign Prostatic Hypertrophy Knee/Hip Joint replacement Dilatation and Curettage

Varicose veins Dysfunctional Uterine Bleeding / Fibroids / Prolapse Uterus / Endometriosis Diabetes and related complications Hysterectomy for any benign disorder

6. Personal Waiting Period

A special waiting period not exceeding 48 months, may be applied to

Individual Insured Persons depending upon declarations on the

proposal form and existing health conditions. Such waiting periods

shall be speci�cally stated in the Schedule of Insurance Certi�cate and

will be applied only after receiving your speci�c consent

7. Permanent Exclusions:

Addictive conditions and disorders; Adventurous or Hazardous Sports; Ageing and puberty; Alternative Treatment; Ancillary Hospital Charges; Arti�cial life maintenance; Charges for Medical Papers; Circumcision; Con�ict and Disaster; Congenital conditions; Convalescence and Rehabilitation; Cosmetic surgery; Dental/oral treatment; Drugs and dressings for OPD Treatment or take-home use; Eyesight; Health hydros, nature cure, wellness clinics etc.; HIV and AIDS; Hereditary conditions (speci�ed); Hospitalization undertaken for observation or for investigations only; Items of personal comfort and convenience; Psychiatric and Psychosomatic Conditions; Obesity; OPD Treatment; Preventive care; Reproductive Medicine; Self-in�icted injuries; Sexual problems and gender issues; Sexually transmitted diseases; Sleep disorders; Speech disorders; Stem Cell Implantation; Treatment for Alopecia; Treatment for developmental problems; Treatment received outside India; Unproven/Experimental Treatment; Unrecognized physician or Hospital; Unrelated diagnostic, X-ray or laboratory examinations; Unlawful Activity; Any costs or expenses speci�ed in the List of Expenses Generally Excluded as Annexure II in Policy Wording; Any other condition as speci�ed on Schedule of Insurance Certi�cate

** The above list of exclusions are illustrative only and is not exhaustive. For

detailed list, refer to the policy terms and conditions, which will be made available

upon request, by our representative

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(1) Baseline cover includes a

- 48 months waiting period for Classic, 36 months waiting period for Supreme and

24 months waiting period for Elite for pre-existing conditions

- a 2 year waiting period for speci�c 17 diseases/conditions

- a 30 day Initial waiting period from inception

- Entry age for Adults is 18 years onwards and from 91 days to 25years for children.

New born children can be added to existing policies at renewal.

- Zone 2 is priced 15% lower than Zone 1 (For eg, if Zone 1 is priced as Rs.100, then Zone 2

will be priced as Rs.85)

(2) Disease speci�c loading for Diabetes, Hypertension & Heart Conditions

(3) Re-load of Sum Insured - Reinstate sum insured upto base sum insured. Applicable for

different illness

(4) AYUSH Treatment - Inpatient Treatment taken up in authorized Government Hospitals

(5) Vaccination for Animal Bite (Post Bite Treatment) - OPD Bene�t upto de�ned limit as

part of overall limit

(6) Critical Illness need to be diagnosed in India and customer need to take Pre-Authorization

before proceeding for treatment. Critical illnesses covered: Cancer, First Heart Attack, Open

Chest CABG, Open Heart Replacement or Repair of Heart Valves, Coma, Kidney Failure, Stroke,

Major Organ/Bone Marrow Transplant, Permanent paralysis of Limbs, Motor Neurone Disease

& Multiple Sclerosis. 20% co-payment applies for treatment

(7) Preventive Healthcare & Wellness Bene�t to offer various health related articles on our website,

access to preferred health maintenance network, etc

(8) 2nd Opinion for following critical illnesses are covered: Cancer, First Heart Attack, Open Chest

CABG, Open Heart Replacement or Repair of Heart Valves, Coma, Kidney Failure, Stroke, Major

Organ/Bone Marrow Transplant, Permanent paralysis of Limbs, Motor Neurone Disease &

Multiple Sclerosis

(9) OPD Treatment covers Medical Practitioner Consultation, Medicine and Diagnostic Tests.

Dental, Contact lenses, Spectacles and Hearing Aids are covered once in 2 years with a sublimit

of 30% of Sum Insured

(10) Maternity Bene�t - Covers up to 2 deliveries if both husband and wife are covered under the

same family �oater policy, New Born Baby Cover and Vaccination for new born (only in Elite

variant). 36 month waiting period applies to maternity bene�t.

# Vaccinations would be covered till the next policy anniversary after which the new born baby has to

be included in the policy for the coverage to continue.

$ Worldwide Emergency Hospitalization and International Treatment abroad for speci�ed 11 critical

illness cover is excluding US and Canada. However, Customer has option to include US and Canada

by paying an additional premium. This bene�t can be availed only at the inception of �rst policy with

us

Note - Policy offers both individual and family �oater cover options with de�ned relationships allowed of

Husband, Wife & Dependent Children Maximum Family Combination Allowed: 2 Adults + 4 Children

CLAIMS

You can claim under your Lifeline policy in 2 ways:

1. If you plan to get admitted to a hospital that is part of our network hospital, please call the

24-Hour Paramount Health Services (TPA) Pvt. Ltd helpline number in your city and take an

authorization at least 72 hours in advance. This way you can avail of Cashless Hospitalization

bene�t. Once your treatment is over, you can simply walk out of the hospital without worrying

about the bills. Royal Sundaram General Insurance Co. Limited will settle the bills directly with

the hospital. In case of an emergency hospitalization, you can call Paramount Health Services

(TPA) Pvt. Ltd upto 48 hours or before discharge, whichever is earlier after being admitted to

take the authorization.

For the following 4 bene�t

International Treatment for 11 speci�ed critical illness

Worldwide Emergency Hospitalization

Second Opinion for 11 Critical Illness

Emergency Domestic Evacuation

Claim will be serviced through Europ Assistance India. You can call on their 24 Hour helpline

number for claim servicing

2. In case you have to be admitted to any other hospital, you need to send all the bills along with

supporting documentation to Royal Sundaram General Insurance Co. Limited who will then

reimburse you.

INDIVIDUAL PLAN PREMIUM CHART - ONE YEARIndicative premium for 1 year cover in Zone 1 (Including Goods and Services Tax)***

***The above premium is inclusive of 18% Goods and Services Tax. The GST rate is subject to change, as and when there is an amendment passed by the Government. The above premium table are on indicative basis, for detailed premium for all ages & sum insured options, please get in touch with Royal Sundaram's representative.

Age (yrs.)

SupremeClassic (`)Elite

25 3,828 4,276 5,077 5,252 7,291 8,366 9,193 13,753 34,129 36,899 50,126 59,054 66,351

30 4,209 4,702 5,584 5,795 7,936 9,108 10,006 14,964 37,682 40,740 51,871 60,076 73,256

35 4,629 5,077 6,149 6,547 9,012 10,437 11,533 17,653 41,603 44,982 56,391 64,900 80,881

40 5,181 5,686 6,885 7,421 10,091 11,684 12,910 19,759 45,933 49,663 63,274 72,208 89,299

45 6,569 7,224 8,742 9,114 11,908 13,789 15,234 23,313 50,714 54,832 70,530 81,511 98,594

50 8,571 9,593 11,522 11,896 15,122 17,453 19,246 29,214 57,857 63,705 85,226 94,845 1,04,696

55 11,392 13,661 16,162 18,287 22,677 26,170 28,857 43,804 69,197 76,462 98,597 1,08,852 1,20,401

60 14,932 18,357 21,720 24,988 32,394 37,383 41,223 64,821 86,457 95,986 1,16,155 1,26,312 1,39,983

65 20,144 25,171 29,780 32,795 41,690 48,113 53,053 83,425 1,04,553 1,16,458 1,44,148 1,55,435 1,73,198

70 26,174 32,710 38,702 43,847 55,739 64,327 70,933 1,11,539 1,35,082 1,51,012 1,84,093 2,01,413 2,23,497

75 32,708 40,872 48,362 54,098 67,793 77,683 85,290 1,34,759 1,87,655 2,10,685 2,70,102 2,94,755 3,27,917

80 39,238 49,035 58,020 64,885 81,310 93,170 1,02,296 1,61,629 2,61,294 2,94,000 3,90,020 4,16,523 4,67,921

85 41,272 51,579 61,031 68,960 86,416 99,024 1,08,721 1,71,781 3,42,841 3,86,320 5,17,243 5,49,499 6,23,433

FLOATER PLAN PREMIUM CHART - ONE YEARIndicative premium for 1 year cover in Zone 1 (Including Goods and Services Tax)***

Age (yrs.)

SupremeClassic1A + 1C (`)Elite

25 5,299 5,917 7,028 7,416 10,426 11,954 13,133 19,611 40,325 44,179 64,017 75,250 84,955

30 5,679 6,343 7,531 8,065 11,156 12,792 14,053 20,987 43,875 48,018 65,761 77,451 91,859

35 6,099 6,717 8,098 8,851 12,259 14,157 15,619 23,757 47,799 52,260 70,279 82,866 99,484

40 6,665 7,344 8,854 9,797 13,418 15,499 17,101 26,020 51,929 56,338 76,009 95,423 1,05,783

45 8,186 9,065 10,927 11,042 15,395 17,793 19,638 29,918 58,070 63,040 83,648 97,418 1,15,862

50 10,004 11,210 13,450 13,743 18,758 21,625 23,834 36,086 64,182 69,670 92,208 1,08,392 1,27,990

55 12,949 15,368 18,227 19,014 24,807 28,451 31,254 46,686 76,299 84,357 1,10,065 1,22,785 1,36,708

60 16,353 19,955 23,626 25,738 33,538 38,572 42,493 66,317 94,220 1,04,614 1,28,687 1,40,642 1,57,803

65 21,558 26,758 31,677 34,636 44,633 51,172 56,209 86,821 1,14,321 1,27,314 1,59,915 1,74,591 1,92,784

70 27,584 34,289 40,591 44,543 57,091 65,424 71,834 1,16,259 1,36,292 1,51,827 1,94,684 2,06,394 2,26,236

75 34,113 42,451 50,247 55,301 70,606 80,910 88,838 1,40,363 1,95,646 2,18,580 2,81,551 2,98,239 3,31,994

80 40,644 50,617 59,909 66,094 84,121 96,396 1,05,838 1,67,227 2,69,288 3,01,895 4,03,595 4,16,911 4,71,998

85 42,694 53,177 62,938 70,302 89,244 1,02,266 1,12,285 1,77,409 3,50,832 3,94,215 5,32,586 5,59,329 6,27,509


2 lac 3 lac 4 lac 5 lac 10 lac 15 lac 20 lac 50 lac 25 lac 30 lac 50 lac 100 lac 150 lac




Age (yrs.)


25 6,317 7,027 8,378 8,550 11,868 13,607 14,950 22,325 46,519 51,457 77,905 91,448 1,03,238

30 6,862 7,617 9,111 9,400 12,834 14,715 16,167 24,149 50,071 55,298 79,649 94,829 1,12,468

35 7,409 8,207 9,844 10,163 13,885 16,018 17,661 26,789 53,993 59,538 84,169 1,00,834 1,21,054

40 7,956 8,797 10,577 11,104 15,035 17,347 19,129 29,027 57,304 62,912 89,387 1,07,838 1,27,805

45 8,697 9,645 11,621 12,310 16,898 19,514 21,527 32,733 65,426 71,248 96,765 1,15,451 1,37,308

50 10,620 11,913 14,282 14,666 20,115 23,183 25,542 38,636 74,403 81,579 1,11,033 1,26,314 1,47,300

55 14,143 16,669 19,842 20,047 26,253 29,934 32,756 48,175 83,404 92,252 1,21,530 1,36,715 1,54,814

60 17,678 21,447 25,422 25,891 34,000 39,114 43,094 67,295 1,01,986 1,13,242 1,41,218 1,57,783 1,77,037

65 22,667 28,005 33,169 34,760 45,284 51,930 57,045 88,158 1,24,089 1,38,170 1,75,681 1,93,747 2,13,935

70 28,686 35,531 42,075 44,747 57,965 66,437 72,237 1,20,979 1,37,505 1,52,641 2,07,633 2,34,974 2,57,565

75 35,214 43,690 51,732 55,911 72,670 83,309 91,486 1,44,548 2,03,640 2,26,477 2,95,359 3,26,584 3,63,546

80 41,748 51,497 60,964 66,225 85,514 98,007 1,07,613 1,70,026 2,77,279 3,09,790 4,23,068 4,45,210 5,04,033

85 43,439 54,124 64,071 70,633 90,768 1,04,025 1,14,221 1,80,470 3,58,825 4,02,110 5,57,368 5,84,550 6,55,805

Age (yrs.)


25 6,083 6,819 8,120 9,584 14,003 16,037 17,612 26,237 59,587 65,464 81,343 98,530 1,07,646

30 6,901 7,732 9,204 10,475 15,012 17,197 18,884 28,139 62,080 68,323 84,631 1,01,864 1,12,559

35 7,601 8,357 10,140 11,543 16,525 19,080 21,052 32,006 67,276 74,218 93,873 1,07,836 1,17,697

40 8,387 9,221 11,186 12,812 18,056 20,857 23,010 35,006 70,761 77,803 97,530 1,14,681 1,27,509

45 10,420 11,480 13,911 14,326 20,711 23,939 26,418 40,252 79,391 87,598 1,11,122 1,31,526 1,45,857

50 14,183 15,879 19,088 20,439 26,680 30,751 33,881 51,261 94,542 1,04,243 1,32,943 1,50,125 1,63,710

55 19,120 22,943 27,164 28,686 36,802 42,162 46,279 68,923 1,20,430 1,33,427 1,56,534 1,74,872 1,92,012

60 25,543 31,423 37,205 38,870 49,665 56,906 62,466 96,283 1,57,739 1,75,508 1,92,128 2,12,303 2,33,855

65 35,269 44,094 52,207 55,737 70,979 81,339 89,292 1,37,677 1,96,680 2,19,521 2,55,848 2,75,934 3,02,169

70 47,048 58,827 69,649 76,236 96,807 1,10,945 1,21,801 1,89,044 2,42,092 2,70,297 3,05,372 3,34,981 3,69,916

75 58,977 75,275 89,113 97,414 1,23,551 1,41,626 1,55,520 2,45,720 3,33,734 3,75,030 4,56,881 5,01,220 5,52,569

80 71,087 90,072 1,06,620 1,16,988 1,48,043 1,69,688 1,86,332 2,94,405 4,62,607 5,20,828 6,67,818 7,23,349 8,03,970

85 75,347 94,818 1,12,233 1,24,697 1,57,520 1,80,545 1,98,251 3,13,236 6,05,311 6,82,390 9,15,539 9,89,774 10,80,255

Age (yrs.)


25 6,676 7,459 8,898 11,078 16,061 18,432 20,249 30,284 63,027 69,507 95,231 1,15,353 1,24,183

30 7,672 8,824 10,520 12,015 17,069 19,586 21,517 32,174 66,897 73,984 98,519 1,18,581 1,29,094

35 8,379 9,576 11,635 13,106 18,566 21,442 23,651 35,960 72,095 79,877 1,07,761 1,23,791 1,34,232

40 9,050 10,405 12,638 14,421 20,149 23,274 25,671 39,041 75,425 82,995 1,13,258 1,29,115 1,42,415

45 11,488 12,673 15,369 15,301 22,679 26,220 28,931 44,082 85,114 93,982 1,24,241 1,41,635 1,61,206

50 15,361 17,249 20,740 21,301 28,560 32,936 36,290 54,950 1,00,758 1,11,152 1,45,843 1,64,692 1,80,017

55 20,350 24,474 28,987 29,332 38,546 44,199 48,533 72,424 1,26,648 1,40,336 1,69,435 1,89,283 2,08,319

60 26,787 33,011 39,105 39,349 51,303 58,826 64,593 99,728 1,63,779 1,82,219 2,04,659 2,26,150 2,49,697

65 36,549 45,758 54,202 55,943 72,444 83,064 91,211 1,40,825 2,02,895 2,26,430 2,68,748 2,89,846 3,18,474

70 48,760 60,478 71,634 76,518 98,184 1,12,571 1,23,611 1,92,067 2,48,558 2,76,994 3,15,711 3,46,322 3,86,501

75 60,728 76,965 91,146 97,775 1,24,979 1,43,312 1,57,395 2,48,682 3,39,949 3,81,938 4,69,782 5,15,371 5,68,876

80 72,915 91,864 1,08,772 1,17,144 1,49,635 1,71,561 1,88,411 2,97,690 4,68,823 5,27,737 6,80,719 7,37,320 8,20,275

85 77,307 96,771 1,14,574 1,25,211 1,59,404 1,82,747 2,00,691 3,17,092 6,11,527 6,89,298 9,28,439 10,03,720 10,96,562

Age (yrs.)

SupremeClassic2A (`)Elite

25 5,494 6,146 7,303 7,865 11,645 13,317 14,618 21,708 52,704 57,377 65,911 80,533 86,977

30 6,094 6,597 7,838 8,693 12,660 14,483 15,899 23,626 55,197 60,236 69,199 83,869 91,888

35 6,786 7,096 8,596 9,739 14,190 16,392 18,096 27,559 60,393 66,130 78,441 89,839 97,026

0 7,687 7,997 9,686 10,965 15,681 18,122 20,006 30,492 64,100 70,388 85,344 1,00,179 1,09,194

45 9,306 10,240 12,399 13,088 18,468 21,349 23,572 35,951 71,219 78,479 96,548 1,16,209 1,26,669

50 12,891 14,399 17,307 19,365 24,488 28,220 31,097 47,043 85,660 94,373 1,18,608 1,32,711 1,43,328

55 17,770 21,283 25,196 27,811 34,717 39,745 43,616 64,857 1,11,551 1,23,558 1,42,202 1,57,456 1,71,628

60 24,175 29,696 35,151 38,141 47,663 54,585 59,905 92,215 1,49,113 1,65,921 1,78,204 1,96,380 2,14,054

65 33,853 42,279 50,043 55,251 69,107 79,162 86,888 1,33,839 1,87,800 2,09,651 2,41,515 2,58,520 2,81,785

70 45,186 57,022 67,491 75,902 94,994 1,08,836 1,19,469 1,85,276 2,32,853 2,60,731 2,95,035 3,20,354 3,49,185

75 57,074 73,424 86,899 97,072 1,21,684 1,39,451 1,53,114 2,41,922 3,24,854 3,65,160 4,42,548 4,83,804 5,32,185

80 69,108 88,123 1,04,291 1,16,496 1,46,027 1,67,342 1,83,738 2,90,308 4,53,727 5,10,961 6,53,486 7,05,933 7,83,586

85 73,249 92,723 1,09,732 1,23,874 1,55,265 1,77,928 1,95,360 3,08,670 5,96,432 6,72,520 9,01,206 9,72,360 10,59,873






Age (yrs.)


25 7,904 8,945 10,714 13,320 18,539 21,146 23,199 34,708 68,710 75,845 1,02,989 1,23,720 1,33,361

30 8,900 10,310 12,338 14,257 19,547 22,300 24,467 36,598 72,579 80,321 1,06,277 1,26,950 1,38,272

35 9,607 11,064 13,453 15,348 21,044 24,156 26,601 40,384 77,776 86,215 1,15,519 1,32,158 1,43,410

40 10,278 11,891 14,456 16,663 22,627 25,988 28,621 43,465 81,105 89,331 1,21,017 1,37,481 1,51,593

45 12,716 14,159 17,187 17,543 25,158 28,934 31,881 48,508 90,795 1,00,321 1,31,999 1,50,002 1,70,383

50 16,587 18,735 22,556 23,543 31,038 35,650 39,240 59,376 1,06,438 1,17,488 1,53,599 1,73,058 1,89,195

55 21,578 25,960 30,803 31,574 41,024 46,913 51,483 76,848 1,32,330 1,46,672 1,77,193 1,97,650 2,17,496

60 28,015 34,497 40,921 41,591 53,781 61,540 67,543 1,04,154 1,69,460 1,88,556 2,12,415 2,34,517 2,58,875

65 37,775 47,244 56,020 58,185 74,922 85,778 94,161 1,45,249 2,08,576 2,32,766 2,76,504 2,98,213 3,27,652

70 49,985 61,964 73,450 78,760 1,00,662 1,15,285 1,26,561 1,96,493 2,54,239 2,83,329 3,23,467 3,54,690 3,95,678

75 61,954 78,453 92,962 1,00,017 1,27,457 1,46,026 1,60,345 2,53,108 3,45,633 3,88,274 4,77,537 5,23,738 5,78,053

80 74,143 93,350 1,10,590 1,19,386 1,52,113 1,74,275 1,91,361 3,02,116 4,74,504 5,34,073 6,88,477 7,45,686 8,29,453

85 78,534 98,257 1,16,390 1,27,453 1,61,882 1,85,461 2,03,641 3,21,516 6,17,208 6,95,635 9,36,197 10,12,087 11,05,739

Age (yrs.)


25 9,130 10,433 12,532 15,563 21,017 23,860 26,149 39,134 74,391 82,182 1,10,747 1,32,086 1,42,536

30 10,126 11,798 14,156 16,499 22,025 25,014 27,417 41,024 78,260 86,659 1,14,035 1,35,316 1,47,449

35 10,833 12,550 15,271 17,590 23,522 26,870 29,551 44,810 83,456 92,552 1,23,275 1,40,524 1,52,587

40 11,503 13,377 16,273 18,905 25,105 28,702 31,571 47,891 86,786 95,669 1,28,774 1,45,848 1,60,771

45 13,942 15,645 19,003 19,785 27,635 31,648 34,831 52,932 96,475 1,06,657 1,39,754 1,58,368 1,79,561

50 17,815 20,221 24,374 25,785 33,516 38,365 42,190 63,800 1,12,121 1,23,824 1,61,357 1,81,427 1,98,372

55 22,804 27,446 32,621 33,816 43,502 49,627 54,433 81,274 1,38,010 1,53,009 1,84,948 2,06,016 2,26,674

60 29,241 35,985 42,739 43,833 56,259 64,254 70,493 1,08,577 1,75,140 1,94,894 2,20,173 2,42,883 2,68,052

65 39,003 48,732 57,836 60,428 77,400 88,492 97,111 1,49,675 2,14,259 2,39,104 2,84,262 3,06,579 3,36,829

70 51,213 63,450 75,268 81,002 1,03,140 1,17,999 1,29,511 2,00,917 2,59,919 2,89,667 3,31,225 3,63,057 4,04,856

75 63,182 79,939 94,780 1,02,259 1,29,935 1,48,740 1,63,295 2,57,532 3,51,313 3,94,613 4,85,296 5,32,105 5,87,231

80 75,371 94,836 1,12,406 1,21,628 1,54,591 1,76,989 1,94,311 3,06,540 4,80,185 5,40,412 6,96,234 7,54,055 8,38,630

85 79,760 99,745 1,18,208 1,29,695 1,64,360 1,88,175 2,06,591 3,25,942 6,22,888 7,01,971 9,43,953 10,20,453 11,14,917


INDIVIDUAL PLAN PREMIUM CHART - 2 YEARSIndicative premium for 2 year cover in Zone 1 (Including Goods and Services Tax)***

Age (yrs.)


25 7,149 7,986 9,483 9,822 13,614 15,619 17,164 25,668 63,771 68,948 92,981 1,09,383 1,23,976

30 7,859 8,767 10,431 10,855 14,872 17,082 18,779 28,154 70,409 76,125 96,414 1,11,607 1,36,879

35 8,662 9,502 11,507 12,269 16,862 19,526 21,577 33,028 77,735 84,047 1,06,398 1,21,471 1,51,124

40 10,118 11,114 13,453 14,178 18,984 21,982 24,284 37,170 85,827 92,795 1,18,749 1,35,465 1,66,855

45 12,631 13,912 16,818 17,473 22,569 26,122 28,857 44,128 94,759 1,02,454 1,31,785 1,52,838 1,84,223

50 16,477 18,573 22,273 23,438 29,406 33,936 37,422 56,805 1,09,266 1,20,356 1,59,770 1,77,642 1,96,142

55 21,741 26,140 30,925 34,390 43,629 50,350 55,522 84,278 1,30,900 1,44,720 1,85,774 2,04,970 2,26,766

60 28,476 35,067 41,487 47,372 60,799 70,167 77,372 1,21,663 1,61,803 1,79,688 2,20,039 2,35,619 2,61,164

65 38,270 47,817 56,576 62,794 79,825 92,123 1,01,585 1,59,736 1,96,061 2,18,414 2,70,675 2,91,869 3,22,123

70 49,526 61,893 73,229 82,335 1,04,665 1,20,791 1,33,195 2,09,952 2,56,712 2,87,280 3,54,323 3,87,825 4,30,748

75 61,631 77,016 91,127 1,01,935 1,27,736 1,46,372 1,60,705 2,53,913 3,59,069 4,03,237 5,19,378 5,65,576 6,29,263

80 72,954 91,172 1,07,879 1,21,250 1,51,942 1,74,106 1,91,160 3,02,032 5,00,066 5,62,763 7,47,882 7,97,535 8,97,378

85 76,354 95,422 1,12,908 1,27,574 1,59,872 1,83,192 2,01,135 3,17,796 6,34,255 7,14,691 9,56,899 10,16,573 11,53,353

FLOATER PLAN PREMIUM CHART - 2 YEARSIndicative premium for 2 year cover in Zone 1 (Including Goods and Services Tax)***

Age (yrs.)


25 9,872 11,024 13,090 13,835 19,415 22,258 24,451 36,503 75,231 82,413 1,18,674 1,39,344 1,58,393

30 10,581 11,800 14,034 15,062 20,832 23,903 26,274 39,309 81,868 89,588 1,22,106 1,43,752 1,71,296

35 11,380 12,534 15,108 16,534 22,874 26,415 29,144 44,329 89,196 97,512 1,32,093 1,54,707 1,85,540

40 12,635 13,925 16,786 18,474 25,277 29,196 32,216 49,018 96,363 1,04,492 1,42,016 1,76,644 1,95,776

45 15,454 17,113 20,625 21,256 29,057 33,576 37,051 56,413 1,08,563 1,17,851 1,56,171 1,82,741 2,16,545

50 19,051 21,506 25,764 26,681 35,819 41,270 45,464 68,717 1,22,510 1,34,089 1,78,159 2,04,672 2,37,027

55 24,501 29,201 34,608 36,090 47,015 53,898 59,195 88,332 1,44,043 1,59,326 2,06,989 2,30,746 2,56,933

60 31,104 38,021 45,014 49,255 64,096 73,686 81,147 1,26,478 1,76,376 1,95,885 2,43,563 2,63,373 2,94,618

65 40,884 50,753 60,085 65,730 84,629 97,001 1,06,527 1,67,245 2,12,488 2,36,671 2,97,192 3,24,085 3,57,209

70 52,132 64,816 76,724 84,222 1,07,904 1,23,651 1,35,767 2,17,066 2,62,856 2,92,042 3,73,925 3,94,899 4,36,926

75 64,231 79,938 94,620 1,04,159 1,32,942 1,52,341 1,67,267 2,64,278 3,73,852 4,17,843 5,40,886 5,72,021 6,36,806

80 75,562 94,100 1,11,377 1,23,506 1,57,145 1,80,077 1,97,718 3,12,395 5,14,852 5,77,370 7,73,538 7,98,257 9,04,919

85 78,985 98,377 1,16,437 1,30,059 1,65,100 1,89,192 2,07,729 3,28,208 6,49,041 7,29,300 9,85,284 10,34,759 11,60,889





Age (yrs.)


25 11,787 13,109 15,636 16,119 22,330 25,597 28,124 41,992 86,691 95,878 1,44,369 1,69,307 1,92,449

30 12,798 14,201 16,991 17,528 23,927 27,454 30,172 45,136 93,329 1,03,054 1,47,801 1,75,900 2,09,599

35 13,808 15,291 18,346 18,956 25,872 29,845 32,910 49,923 1,00,656 1,10,976 1,57,788 1,87,946 2,25,404

40 14,818 16,384 19,702 20,890 28,265 32,615 35,965 54,581 1,06,326 1,16,536 1,66,199 2,00,497 2,37,621

45 16,557 18,370 22,123 23,014 31,818 36,739 40,522 61,581 1,22,366 1,33,244 1,80,555 2,16,571 2,56,636

50 20,297 22,916 27,451 28,345 38,794 44,685 49,215 74,337 1,39,357 1,53,322 2,07,506 2,35,748 2,73,866

55 26,816 31,721 37,738 38,215 49,271 56,169 61,457 90,346 1,57,187 1,73,932 2,28,200 2,56,519 2,88,030

60 33,363 40,562 48,064 49,466 64,987 74,730 82,300 1,28,348 1,90,951 2,12,084 2,67,087 2,93,726 3,28,577

65 42,934 53,059 62,842 65,975 86,672 99,056 1,08,118 1,72,846 2,31,701 2,57,995 3,28,957 3,61,649 3,98,606

70 54,172 67,111 79,470 85,121 1,09,561 1,25,578 1,37,225 2,23,151 2,69,004 2,96,804 3,97,893 4,47,814 4,95,456

75 66,268 82,231 97,363 1,05,291 1,36,758 1,56,781 1,72,166 2,72,024 3,88,639 4,32,452 5,66,758 6,28,348 6,99,512

80 77,455 95,740 1,13,340 1,23,785 1,59,758 1,83,094 2,01,041 3,17,643 5,29,637 5,91,976 8,10,109 8,52,466 9,66,372

85 80,362 1,00,130 1,18,532 1,30,674 1,67,919 1,92,447 2,11,308 3,33,869 6,63,826 7,43,906 10,31,131 10,81,420 12,13,239

Age (yrs.)


25 10,257 11,473 13,634 14,696 21,724 24,835 27,262 40,474 97,939 1,06,650 1,22,457 1,49,555 1,62,679

30 11,396 12,296 14,635 16,267 23,693 27,131 29,801 44,399 1,03,063 1,12,511 1,28,743 1,55,906 1,71,157

35 12,710 13,271 16,076 18,232 26,515 30,630 33,815 51,499 1,12,364 1,23,071 1,45,183 1,67,784 1,82,900

40 14,590 15,709 19,028 20,743 29,609 34,222 37,781 57,583 1,19,857 1,31,660 1,60,332 1,88,017 2,04,939

45 17,666 19,696 23,831 25,323 34,693 40,119 44,293 67,585 1,32,676 1,46,146 1,83,493 2,15,804 2,37,392

50 24,876 27,988 33,586 37,617 47,505 54,714 60,263 91,014 1,62,153 1,78,742 2,23,044 2,49,286 2,70,494

55 34,047 40,884 48,396 53,124 66,321 75,931 83,325 1,23,915 2,12,479 2,35,470 2,67,594 2,96,870 3,22,075

60 46,281 56,947 67,408 73,990 92,475 1,05,909 1,16,233 1,78,945 2,80,863 3,12,621 3,39,325 3,71,831 4,03,394

65 64,559 80,630 95,435 1,06,572 1,33,309 1,52,710 1,67,616 2,58,211 3,48,871 3,89,534 4,51,599 4,87,890 5,34,288

70 85,601 1,08,301 1,28,183 1,44,105 1,80,366 2,06,646 2,26,839 3,55,183 4,42,697 4,96,191 5,68,643 6,18,637 6,74,315

75 1,07,653 1,38,360 1,63,749 1,82,918 2,29,291 2,62,771 2,88,515 4,55,856 6,21,819 6,99,119 8,52,974 9,31,392 10,24,532

80 1,28,599 1,63,853 1,93,915 2,17,709 2,72,892 3,12,727 3,43,367 5,42,523 8,68,567 9,78,286 12,55,549 13,55,607 15,04,723

85 1,35,513 1,71,538 2,03,009 2,29,168 2,87,241 3,29,165 3,61,418 5,71,039 11,03,397 12,44,163 16,67,232 17,98,866 19,60,764

Age (yrs.)


25 11,418 12,797 15,239 17,893 26,083 29,870 32,803 48,853 1,10,672 1,21,610 1,51,004 1,82,848 2,00,918

30 12,905 14,430 17,210 19,571 28,042 32,148 35,322 52,741 1,15,796 1,27,474 1,57,295 1,89,198 2,09,397

35 14,207 15,624 18,955 21,572 30,833 35,600 39,278 59,722 1,25,097 1,38,033 1,73,733 2,01,076 2,21,140

40 16,341 17,989 21,814 24,175 34,021 39,296 43,357 65,966 1,31,562 1,44,655 1,81,331 2,13,221 2,37,072

45 19,903 21,997 26,645 27,559 38,849 44,915 49,568 75,547 1,48,013 1,63,251 2,10,588 2,46,844 2,73,309

50 27,299 30,786 36,948 39,543 51,527 59,357 65,375 98,762 1,78,581 1,96,998 2,49,559 2,81,504 3,08,203

55 36,556 43,978 52,068 54,715 70,163 80,384 88,234 1,31,412 2,28,907 2,53,726 2,94,108 3,29,086 3,59,784

60 48,824 60,157 71,229 75,267 96,136 1,10,159 1,20,924 1,86,397 2,97,056 3,30,619 3,65,462 4,02,667 4,40,565

65 67,177 83,985 99,438 1,07,411 1,36,739 1,56,703 1,72,028 2,65,255 3,65,299 4,07,792 4,78,114 5,20,106 5,71,997

70 89,051 1,11,649 1,32,184 1,44,718 1,83,722 2,10,555 2,31,161 3,62,088 4,56,827 5,10,050 5,87,535 6,44,505 7,11,719

75 1,11,186 1,41,799 1,67,862 1,83,579 2,32,773 2,66,822 2,92,996 4,62,931 6,38,247 7,17,375 8,79,493 9,63,609 10,62,241

80 1,32,282 1,67,485 1,98,255 2,18,668 2,76,662 3,17,113 3,48,216 5,50,180 8,84,995 9,96,541 12,82,066 13,87,824 15,42,432

85 1,39,392 1,75,412 2,07,631 2,30,688 2,91,412 3,34,010 3,66,765 5,79,486 11,19,824 12,62,420 16,93,748 18,31,083 19,98,474



Age (yrs.)


25 12,548 14,055 16,767 20,667 29,891 34,298 37,680 56,336 1,17,038 1,29,091 1,76,699 2,13,960 2,31,511

30 14,342 16,486 19,691 22,424 31,844 36,564 40,185 60,188 1,24,710 1,37,944 1,82,988 2,20,106 2,39,987

35 15,631 17,893 21,738 24,464 34,609 39,972 44,085 67,033 1,34,011 1,48,506 2,00,356 2,31,898 2,51,730

40 18,025 20,191 24,504 27,163 37,904 43,788 48,298 73,456 1,39,756 1,53,754 2,10,577 2,40,055 2,64,787

45 22,025 24,185 29,330 29,358 42,489 49,130 54,211 82,625 1,58,750 1,75,226 2,34,974 2,67,869 3,02,042

50 29,510 33,372 40,068 41,074 54,963 63,350 69,777 1,05,517 1,90,081 2,09,780 2,73,423 3,08,425 3,38,370

55 38,845 46,831 55,471 55,880 73,371 84,132 92,379 1,37,853 2,40,407 2,66,507 3,17,974 3,55,787 3,89,951

60 51,131 63,112 74,761 76,079 99,117 1,13,649 1,24,792 1,92,680 3,08,391 3,43,218 3,88,985 4,28,588 4,70,300

65 69,539 87,060 1,03,127 1,07,724 1,39,412 1,59,850 1,75,523 2,71,006 3,76,800 4,20,575 5,01,981 5,46,065 6,02,163

70 92,221 1,14,705 1,35,860 1,45,249 1,86,273 2,13,569 2,34,516 3,67,541 4,66,716 5,19,751 6,06,429 6,65,231 7,41,640

75 1,14,436 1,44,943 1,71,643 1,84,281 2,35,440 2,69,970 2,96,497 4,68,465 6,49,747 7,30,156 9,03,358 9,89,757 10,92,408

80 1,35,689 1,70,829 2,02,270 2,19,013 2,79,656 3,20,631 3,52,122 5,56,354 8,96,495 10,09,323 13,05,931 14,13,657 15,72,600

85 1,43,016 1,79,024 2,11,962 2,31,642 2,94,896 3,38,083 3,71,278 5,86,620 11,31,326 12,75,199 17,17,613 18,56,883 20,28,640






INDIVIDUAL PLAN PREMIUM CHART - 3 YEARSIndicative premium for 3 year cover in Zone 1 (Including Goods and Services Tax)***

Age (yrs.)


25 10,303 11,507 13,664 14,174 19,615 22,509 24,731 36,986 91,917 99,379 1,33,091 1,56,303 1,78,692

30 11,326 12,605 15,029 15,683 21,500 24,717 27,191 40,865 1,01,483 1,09,723 1,38,574 1,60,291 1,97,291

35 12,499 13,715 16,608 17,731 24,342 28,185 31,141 47,670 1,12,046 1,21,142 1,54,793 1,75,216 2,17,825

40 14,859 16,331 19,767 20,701 27,548 31,897 35,241 53,936 1,23,705 1,33,748 1,71,707 1,95,697 2,40,496

45 18,555 20,474 24,731 25,657 33,003 38,190 42,176 64,441 1,36,125 1,47,177 1,92,782 2,21,012 2,64,643

50 24,243 27,529 32,958 35,072 43,817 50,568 55,760 84,641 1,59,216 1,75,440 2,31,125 2,56,752 2,83,555

55 31,914 38,470 45,513 50,672 64,782 74,763 82,442 1,25,141 1,91,047 2,11,325 2,69,632 2,98,191 3,29,967

60 41,902 51,688 61,153 69,529 88,937 1,02,639 1,13,183 1,77,973 2,35,635 2,61,787 3,21,299 3,44,721 3,82,160

65 56,093 70,089 82,928 92,783 1,17,944 1,36,117 1,50,095 2,36,016 2,84,477 3,16,964 3,90,776 4,22,784 4,62,113

70 72,299 90,347 1,06,898 1,19,988 1,51,774 1,74,729 1,92,388 3,03,501 3,78,610 4,23,932 5,26,210 5,76,028 6,40,022

75 89,588 1,11,956 1,32,470 1,48,170 1,85,675 2,12,764 2,33,598 3,69,083 5,30,111 5,95,468 7,70,226 8,37,270 9,31,632

80 1,04,635 1,30,765 1,54,727 1,74,192 2,18,286 2,50,131 2,74,630 4,33,914 7,34,955 8,27,240 11,01,210 11,78,387 13,21,259

85 1,08,956 1,36,169 1,61,121 1,82,052 2,28,138 2,61,422 2,87,025 4,53,502 9,05,100 10,19,886 13,65,520 14,50,677 16,45,864

Age (yrs.)


25 14,817 16,805 20,128 24,816 34,474 39,320 43,138 64,523 1,27,549 1,40,814 1,91,050 2,29,441 2,48,490

30 16,613 19,238 23,051 26,574 36,427 41,584 45,642 68,374 1,35,219 1,49,668 1,97,339 2,35,583 2,56,966

35 17,900 20,641 25,100 28,611 39,190 44,993 49,543 75,218 1,44,522 1,60,229 2,14,707 2,47,377 2,68,710

40 20,294 22,942 27,866 31,310 42,490 48,808 53,755 81,643 1,50,267 1,65,478 2,24,926 2,55,535 2,81,767

45 24,294 26,934 32,694 33,507 47,072 54,151 59,667 90,811 1,69,261 1,86,950 2,49,323 2,83,347 3,19,020

50 31,780 36,123 43,432 45,221 59,547 68,371 75,234 1,13,701 2,00,590 2,21,502 2,87,775 3,23,902 3,55,351

55 41,114 49,583 58,833 60,028 77,955 89,152 97,836 1,46,042 2,50,918 2,78,231 3,32,326 3,71,267 4,06,929

60 53,401 65,862 78,121 80,225 1,03,699 1,18,670 1,30,249 2,00,866 3,18,902 3,54,942 4,03,337 4,44,068 4,87,282

65 71,810 89,811 1,06,489 1,11,873 1,43,996 1,64,871 1,80,982 2,79,192 3,87,310 4,32,297 5,16,331 5,61,544 6,19,142

70 94,491 1,17,454 1,39,223 1,49,398 1,90,858 2,18,590 2,39,973 3,75,727 4,77,227 5,31,474 6,20,781 6,80,707 7,58,618

75 1,16,706 1,47,694 1,75,006 1,88,429 2,40,025 2,74,991 3,01,954 4,76,653 6,60,259 7,41,880 9,17,708 10,05,238 11,09,385

80 1,37,960 1,73,578 2,05,633 2,23,161 2,84,239 3,25,653 3,57,580 5,64,539 9,07,004 10,21,049 13,20,281 14,29,136 15,89,578

85 1,45,287 1,81,775 2,15,322 2,35,788 2,99,482 3,43,105 3,76,736 5,94,808 11,41,836 12,86,923 17,31,964 18,72,360 20,45,619

Age (yrs.)


25 17,088 19,554 23,490 28,963 39,059 44,340 48,595 72,710 1,38,060 1,52,537 2,05,402 2,44,917 2,65,466

30 18,883 21,987 26,415 30,720 41,012 46,606 51,102 76,559 1,45,730 1,61,390 2,11,690 2,51,062 2,73,944

35 20,173 23,393 28,462 32,760 43,776 50,011 55,000 83,402 1,55,031 1,71,953 2,29,056 2,62,855 2,85,688

40 22,564 25,693 31,230 35,460 47,073 53,830 59,211 89,828 1,60,780 1,77,200 2,39,278 2,71,015 2,98,742

45 26,564 29,684 36,054 37,655 51,656 59,172 65,124 98,998 1,79,769 1,98,673 2,63,674 2,98,827 3,35,999

50 34,051 38,874 46,792 49,368 64,131 73,392 80,691 1,21,889 2,11,103 2,33,228 3,02,127 3,39,381 3,72,329

55 43,385 52,334 62,196 64,176 82,538 94,174 1,03,293 1,54,227 2,61,427 2,89,954 3,46,675 3,86,746 4,23,909

60 55,671 68,612 81,484 84,372 1,08,285 1,23,691 1,35,709 2,09,053 3,29,412 3,66,664 4,17,689 4,59,545 5,04,258

65 74,081 92,562 1,09,850 1,16,021 1,48,579 1,69,892 1,86,440 2,87,379 3,97,820 4,44,020 5,30,682 5,77,021 6,36,121

70 96,761 1,20,205 1,42,584 1,53,545 1,95,443 2,23,611 2,45,430 3,83,911 4,87,737 5,43,198 6,35,130 6,96,187 7,75,596

75 1,18,979 1,50,445 1,78,367 1,92,577 2,44,610 2,80,012 3,07,413 4,84,838 6,70,767 7,53,603 9,32,059 10,20,715 11,26,364

80 1,40,231 1,76,330 2,08,994 2,27,308 2,88,824 3,30,673 3,63,037 5,72,725 9,17,516 10,32,772 13,34,632 14,44,616 16,06,556

85 1,47,557 1,84,527 2,18,684 2,39,935 3,04,065 3,48,126 3,82,193 6,02,993 11,52,344 12,98,646 17,46,316 18,87,839 20,62,598



Age (yrs.)


25 14,186 15,839 18,812 19,914 27,895 31,979 35,130 52,452 1,08,269 1,18,592 1,69,760 1,99,063 2,27,805

30 15,208 16,938 20,174 21,697 30,010 34,460 37,893 56,801 1,17,834 1,28,936 1,75,242 2,06,163 2,46,405

35 16,379 18,044 21,750 23,828 32,924 38,021 41,951 63,809 1,28,398 1,40,356 1,91,461 2,23,061 2,66,937

40 18,461 20,353 24,535 26,800 36,631 42,309 46,688 71,036 1,37,944 1,49,506 2,04,478 2,52,221 2,80,262

45 22,502 24,945 30,052 31,175 42,301 48,867 53,917 82,045 1,56,505 1,69,890 2,25,036 2,63,734 3,12,146

50 27,964 31,789 38,027 39,529 52,709 60,694 66,835 1,00,860 1,78,848 1,96,322 2,59,971 2,96,258 3,38,597

55 35,793 42,795 50,700 52,875 68,818 78,884 86,626 1,29,219 2,09,804 2,32,169 2,99,906 3,34,973 3,73,015

60 45,653 55,901 66,183 72,632 94,396 1,08,479 1,19,419 1,85,894 2,56,534 2,85,012 3,55,031 3,84,917 4,30,131

65 59,823 74,275 87,931 96,235 1,23,820 1,41,913 1,55,837 2,47,313 3,07,758 3,42,803 4,30,422 4,69,184 5,16,818

70 76,016 94,518 1,11,886 1,22,860 1,57,335 1,80,296 1,97,961 3,15,207 3,90,959 4,33,809 5,54,655 5,84,805 6,47,780

75 93,301 1,16,125 1,37,452 1,51,351 1,93,104 2,21,284 2,42,960 3,83,877 5,51,209 6,16,312 8,02,114 8,46,463 9,42,396

80 1,08,361 1,34,948 1,59,723 1,77,446 2,25,717 2,58,654 2,83,991 4,48,706 7,56,055 8,48,084 11,38,081 11,80,456 13,32,023

85 1,12,714 1,40,386 1,66,158 1,85,598 2,35,603 2,69,982 2,96,432 4,68,363 9,26,198 10,40,729 14,06,027 14,76,629 16,56,624






Age (yrs.)


25 16,965 18,863 22,503 23,267 32,164 36,873 40,513 60,493 1,24,623 1,37,807 2,06,425 2,41,822 2,76,735

30 18,408 20,419 24,438 25,210 34,414 39,508 43,438 65,084 1,34,191 1,48,152 2,11,907 2,52,037 3,01,228

35 19,849 21,977 26,375 27,273 37,191 42,903 47,308 71,762 1,44,752 1,59,571 2,28,128 2,70,910 3,24,196

40 21,382 23,636 28,425 30,255 40,898 47,192 52,041 78,980 1,52,156 1,66,974 2,38,122 2,87,549 3,40,789

45 24,137 26,812 32,276 33,383 46,206 53,340 58,827 89,355 1,76,883 1,92,599 2,58,405 3,12,062 3,69,348

50 29,893 33,957 40,640 42,189 57,612 66,330 73,031 1,10,165 2,01,909 2,22,435 2,99,240 3,39,613 3,92,771

55 39,200 46,529 55,327 55,804 71,285 81,419 89,195 1,31,780 2,28,558 2,53,013 3,30,176 3,71,751 4,16,255

60 48,777 59,421 70,403 72,909 95,712 1,10,020 1,21,124 1,88,661 2,77,432 3,08,239 3,88,761 4,27,585 4,77,820

65 62,746 77,565 91,865 96,600 1,26,407 1,44,615 1,58,175 2,56,796 3,33,690 3,71,555 4,75,063 5,20,676 5,73,535

70 78,926 97,794 1,15,802 1,24,285 1,60,742 1,84,254 2,01,696 3,24,706 4,03,309 4,43,680 5,89,332 6,62,112 7,33,395

75 96,208 1,19,398 1,41,366 1,52,964 1,98,553 2,27,620 2,49,955 3,94,931 5,72,311 6,37,158 8,40,230 9,23,683 10,28,367

80 1,10,857 1,37,309 1,62,548 1,77,901 2,29,480 2,63,000 2,88,781 4,56,271 7,77,153 8,68,928 11,93,644 12,55,355 14,16,590

85 1,14,679 1,42,887 1,69,146 1,86,474 2,39,628 2,74,627 3,01,543 4,76,437 9,47,296 10,61,571 14,71,451 15,43,214 17,31,325

Age (yrs.)


25 14,775 16,524 19,637 21,186 31,266 35,749 39,242 58,267 1,40,423 1,52,950 1,75,573 2,14,260 2,33,421

30 16,441 17,675 21,081 23,481 34,206 39,210 43,093 64,371 1,48,435 1,62,103 1,85,139 2,23,916 2,46,741

35 18,370 19,218 23,275 26,329 38,221 44,155 48,744 74,238 1,61,316 1,76,737 2,07,275 2,41,647 2,62,903

40 21,229 23,118 27,996 30,171 42,987 49,682 54,846 83,605 1,72,862 1,89,955 2,32,705 2,72,452 2,96,975

45 25,832 29,064 35,138 37,405 50,690 58,615 64,705 98,697 1,90,683 2,09,962 2,67,690 3,11,609 3,43,840

50 36,741 41,644 49,896 55,823 70,399 81,029 89,212 1,34,497 2,37,552 2,62,007 3,23,621 3,61,308 3,95,140

55 50,172 60,407 71,510 78,300 97,765 1,11,934 1,22,834 1,82,676 3,12,290 3,46,253 3,89,817 4,32,311 4,68,281

60 68,370 84,277 99,757 1,09,862 1,37,324 1,57,279 1,72,613 2,65,772 4,11,899 4,58,653 5,01,105 5,47,690 5,95,171

65 94,994 1,18,642 1,40,428 1,57,356 1,96,842 2,25,496 2,47,509 3,81,296 5,00,596 5,59,044 6,54,757 7,09,824 7,76,076

70 1,25,102 1,58,700 1,87,832 2,11,086 2,64,212 3,02,711 3,32,292 5,21,954 6,53,223 7,32,539 8,46,361 9,22,152 10,11,819

75 1,56,646 2,01,137 2,38,045 2,65,907 3,33,320 3,81,982 4,19,409 6,62,664 9,18,347 10,32,724 12,68,161 13,83,096 15,11,465

80 1,84,599 2,35,018 2,78,137 3,12,787 3,92,065 4,49,297 4,93,318 7,79,445 12,76,826 14,38,327 18,57,227 20,02,827 22,01,741

85 1,93,378 2,44,789 2,89,699 3,27,028 4,09,902 4,69,729 5,15,752 8,14,885 15,74,579 17,75,453 23,79,184 25,67,032 27,98,063

Age (yrs.)


25 16,520 18,515 22,044 25,766 37,487 42,930 47,145 70,220 1,58,593 1,74,298 2,16,311 2,61,772 2,87,990

30 18,606 20,766 24,815 28,202 40,406 46,362 50,961 76,252 1,66,607 1,83,451 2,25,878 2,71,427 3,01,310

35 20,480 22,524 27,324 31,101 44,379 51,242 56,535 85,965 1,79,488 1,98,087 2,48,018 2,89,155 3,17,470

40 23,956 26,382 31,980 35,089 49,306 56,953 62,839 95,609 1,88,685 2,07,461 2,60,061 3,05,795 3,40,002

45 29,255 32,403 39,229 40,556 56,617 65,451 72,225 1,10,050 2,12,880 2,34,711 3,06,528 3,57,220 3,95,701

50 40,223 45,694 54,752 58,514 76,109 87,623 96,470 1,45,506 2,60,995 2,88,062 3,61,461 4,07,282 4,48,951

55 53,765 64,846 76,779 80,531 1,03,224 1,18,261 1,29,810 1,93,333 3,35,734 3,72,308 4,27,656 4,78,285 5,22,095

60 72,010 88,880 1,05,235 1,11,614 1,42,510 1,63,300 1,79,259 2,76,334 4,35,117 4,84,459 5,38,587 5,92,350 6,48,472

65 98,727 1,23,430 1,46,139 1,58,503 2,01,718 2,31,165 2,53,777 3,91,311 5,28,956 5,90,520 6,93,753 7,56,866 8,33,562

70 1,30,035 1,63,486 1,93,555 2,11,956 2,69,011 3,08,303 3,38,474 5,31,792 6,73,889 7,52,403 8,72,398 9,56,988 10,56,786

75 1,61,704 2,06,070 2,43,944 2,66,888 3,38,321 3,87,805 4,25,845 6,72,833 9,41,795 10,58,780 13,06,001 14,29,071 15,65,278

80 1,89,884 2,40,237 2,84,375 3,14,244 3,97,511 4,55,626 5,00,315 7,90,496 13,00,269 14,64,380 18,95,066 20,48,800 22,55,554

85 1,98,914 2,50,319 2,96,296 3,29,198 4,15,855 4,76,641 5,23,382 8,26,942 15,98,020 18,01,508 24,17,024 26,13,005 28,51,875


Age (yrs.)


25 18,206 20,409 24,344 29,741 42,918 49,248 54,106 80,895 1,67,678 1,84,973 2,52,980 3,06,142 3,31,646

30 20,673 23,746 28,416 32,284 45,825 52,655 57,891 86,859 1,79,330 1,98,395 2,62,546 3,15,485 3,44,965

35 22,490 25,713 31,240 35,228 49,761 57,477 63,394 96,391 1,92,206 2,13,031 2,87,345 3,32,506 3,61,123

40 26,576 29,531 35,832 39,092 54,871 63,384 69,916 1,06,339 1,99,758 2,19,716 3,02,002 3,44,283 3,79,749

45 32,492 35,568 43,118 43,117 61,802 71,456 78,837 1,20,132 2,28,418 2,52,035 3,41,482 3,89,292 4,37,189

50 43,397 49,434 59,254 60,634 80,971 93,274 1,02,704 1,55,088 2,77,407 3,06,301 3,95,515 4,45,658 4,92,003

55 57,034 68,938 81,657 82,153 1,07,772 1,23,577 1,35,690 2,02,479 3,52,143 3,90,549 4,61,711 5,16,372 5,65,143

60 75,312 93,116 1,10,301 1,12,693 1,46,711 1,68,226 1,84,720 2,85,215 4,51,374 5,02,524 5,72,316 6,29,452 6,91,110

65 1,02,095 1,27,815 1,51,402 1,59,121 2,05,498 2,35,623 2,58,726 3,99,464 5,48,808 6,12,553 7,23,669 7,89,473 8,79,547

70 1,34,568 1,67,853 1,98,808 2,12,566 2,72,659 3,12,610 3,43,271 5,39,517 6,88,355 7,66,307 9,02,005 9,89,465 10,92,763

75 1,66,365 2,10,580 2,49,369 2,67,940 3,42,169 3,92,345 4,30,892 6,80,810 9,58,204 10,77,020 13,40,058 14,66,337 16,08,327

80 1,94,780 2,45,052 2,90,154 3,14,827 4,01,857 4,60,734 5,05,984 7,99,454 13,16,680 14,82,618 19,29,121 20,85,623 22,98,601

85 2,04,090 2,55,474 3,02,473 3,30,557 4,20,827 4,82,454 5,29,823 8,37,122 16,14,432 18,19,743 24,51,080 26,49,820 28,94,923






Disclaimer

Lifeline Insurance product is underwritten and issued by Royal Sundaram General Insurance Co. Limited. Claims will be settled by Royal Sundaram General Insurance Co. Limited as per the terms and conditions of the policy. This brochure is not a contract of Insurance. Please refer policy document for exact terms and conditions and specific details applicable to this Insurance. Your participation in this insurance product is purely on a voluntary basis. We advise you to take your own professional advice before you participate. Lifeline Insurance product of Royal Sundaram is approved by IRDAI.

This policy is underwritten by Royal Sundaram General Insurance Co. Limited with its registered office at No.21 Patullos Road, Chennai 600 002. For more details on risk factors, terms and conditions, please read the policy terms and conditions carefully before concluding the sale.

All insurance applications are subject to the Insurance Company�s underwriting and acceptance.

Section 41 of the Insurance Act, 1938 - Prohibition of rebates

1) No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take out or renew or continue an Insurance in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy nor shall any person taking out or renewing or continuing a Policy accept any rebate, except such rebate as may be allowed in accordance with the published prospectus or tables of the Insurer.

2) Any person making default in complying with the provisions of this section shall be liable for penalty which may extend to ten lakh rupees.

Summary

This brochure is only a brief summary of Lifeline. This is not an insurance contract or an offer of insurance. The coverage will be subject to the terms and conditions of the Lifeline issued by Royal Sundaram General Insurance Co. Limited.

The Company may terminate the policy on grounds like misrepresentation, false representation of a matter of fact or non-disclosure of material fact by the applicant/insured and in such cases the policy shall be terminated immediately, from inception, and applicant/insured shall not be eligible for any refund.

LIFELINE | UIN-IRDAI/HLT/RSAI/P-H/V.II/32/15-16

Age (yrs.)


25 21,446 24,333 29,142 35,661 49,460 56,414 61,894 92,577 1,82,678 2,01,702 2,73,459 3,28,233 3,55,874

30 23,912 27,672 33,214 38,204 52,367 59,821 65,682 98,542 1,94,324 2,15,125 2,83,025 3,37,575 3,69,194

35 25,733 29,640 36,037 41,145 56,304 64,641 71,183 1,08,073 2,07,205 2,29,760 3,07,825 3,54,594 3,85,353

40 29,817 33,458 40,630 45,011 61,413 70,550 77,704 1,18,018 2,14,757 2,36,446 3,22,482 3,66,372 4,03,979

45 35,732 39,493 47,916 49,034 68,344 78,622 86,625 1,31,811 2,43,418 2,68,765 3,61,962 4,11,377 4,61,416

50 46,636 53,360 64,052 66,552 87,513 1,00,440 1,10,492 1,66,771 2,92,405 3,23,029 4,15,994 4,67,743 5,16,229

55 60,273 72,861 86,454 88,071 1,14,314 1,30,743 1,43,478 2,14,162 3,67,142 4,07,278 4,82,191 5,38,462 5,89,371

60 78,553 97,043 1,15,099 1,18,613 1,53,253 1,75,390 1,92,508 2,96,897 4,66,373 5,19,254 5,92,796 6,51,541 7,15,341

65 1,05,334 1,31,740 1,56,198 1,65,041 2,12,041 2,42,790 2,66,514 4,11,146 5,63,805 6,29,282 7,44,148 8,11,562 9,03,777

70 1,37,807 1,71,780 2,03,605 2,18,484 2,79,201 3,19,776 3,51,059 5,51,199 7,03,355 7,83,036 9,22,485 10,11,553 11,16,990

75 1,69,604 2,14,506 2,54,164 2,73,860 3,48,711 3,99,509 4,38,681 6,92,492 9,73,201 10,93,747 13,60,537 14,88,427 16,32,554

80 1,98,019 2,48,977 2,94,952 3,20,748 4,08,399 4,67,898 5,13,772 8,11,136 13,31,679 14,99,348 19,49,600 21,07,708 23,22,831

85 2,07,328 2,59,400 3,07,271 3,36,474 4,27,368 4,89,620 5,37,611 8,48,805 16,29,431 18,36,475 24,71,560 26,71,910 29,19,151

Age (yrs.)


25 24,686 28,258 33,937 41,578 56,002 63,578 69,681 1,04,259 1,97,676 2,18,431 2,93,938 3,50,318 3,80,103

30 27,152 31,597 38,010 44,122 58,909 66,985 73,470 1,10,223 2,09,327 2,31,854 3,03,505 3,59,664 3,93,422

35 28,971 33,564 40,833 47,066 62,846 71,808 78,971 1,19,755 2,22,203 2,46,491 3,28,302 3,76,684 4,09,581

40 33,056 37,382 45,428 50,929 67,955 77,714 85,492 1,29,703 2,29,757 2,53,175 3,42,961 3,88,460 4,28,207

45 38,974 43,416 52,711 54,953 74,883 85,786 94,413 1,43,496 2,58,417 2,85,494 3,82,439 4,33,467 4,85,646

50 49,876 57,285 68,850 72,473 94,055 1,07,604 1,18,280 1,78,452 3,07,404 3,39,759 4,36,474 4,89,834 5,40,458

55 63,514 76,788 91,252 93,991 1,20,856 1,37,907 1,51,266 2,25,844 3,82,140 4,24,008 5,02,669 5,60,550 6,13,599

60 81,792 1,00,967 1,19,897 1,24,530 1,59,796 1,82,556 2,00,296 3,08,579 4,81,369 5,35,983 6,13,274 6,73,631 7,39,568

65 1,08,574 1,35,664 1,60,995 1,70,960 2,18,583 2,49,953 2,74,302 4,22,828 5,78,805 6,46,011 7,64,628 8,33,648 9,28,005

70 1,41,048 1,75,704 2,08,403 2,24,405 2,85,744 3,26,940 3,58,846 5,62,881 7,18,353 7,99,767 9,42,964 10,33,642 11,41,219

75 1,72,844 2,18,430 2,58,962 2,79,778 3,55,251 4,06,675 4,46,469 7,04,174 9,88,201 11,10,480 13,81,016 15,10,517 16,56,783

80 2,01,259 2,52,902 2,99,749 3,26,666 4,14,941 4,75,064 5,21,560 8,22,818 13,46,679 15,16,078 19,70,079 21,29,798 23,47,060

85 2,10,569 2,63,324 3,12,069 3,42,395 4,33,910 4,96,783 5,45,399 8,60,486 16,44,426 18,53,204 24,92,038 26,93,996 29,43,380


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REACH US

ABOUT ROYAL SUNDARAM

Royal Sundaram General Insurance Co. Limited is the first private non-life Insurance Company licensed to operate in India. Started in the year 2000, Royal Sundaram offers a range of innovative general Insurance

products which includes Health, Personal Accident, Home and Travel Insurance for individual customers. The company's Accident and Health claims process received ISO 9001-2008 certification for its effective

customer service delivery. For commercial clients, Royal Sundaram offers a wide range of specialised insurance covers in Fire, Marine, Engineering, Liability and Business Interruption risks.

The company also offers specially designed products to the Small and Medium Enterprises and rural customers. Royal Sundaram currently has over five million customers, 1700 employees and has its presence in over

180 cities across India.

PR17093/JUL17/VER.2

Royal Sundaram General Insurance Co. Limited(Formerly known as Royal Sundaram Alliance Insurance Company Limited)

Vishranthi Melaram Towers, No. 2 / 319, Rajiv Gandhi Salai (OMR), Karapakkam, Chennai - 600097. Registered Office: 21, Patullos Road, Chennai - 600 002.Royal Sundaram IRDAI Registration No.102 | CIN-U67200TN2000PLC045611



Proposal No.

FOR INTERNAL USE

Proposal Received On:_____________________________________________________________________________________________________________________

Processed By:____________________

Customer ID:____________________________________________________________________________________________________________________________

D D M M YY YYDate Approved By:____________________ D D M M YY YYDate

Mr. Mrs. Miss Others _______________________ #PAN Number

Married# M

and

ato

ry if

pre

miu

m u

nd

er t

his

pro

po

sal i

s `1

lac

or

mo

re

Name of theProposer First Name Middle Name Last Name

Mobile* /

E-mail*

Marital Status Single

Pincode Telephone -

Landmark

City State

Address forCorrespondence

< 50,000 Annual Income (`) 50,000 - 150,000 150,001 - 300,000 300,001 - 500,000 > 500,000

PROPOSER DETAILS

Education Qualification

Occupation

If salaried, specify designation_________________________________________________________________________________________________________

If self employed, specify business/occupation____________________________________________________________________________________________

Lesser than matriculation Matriculation Graduate Post Graduate Professional Course

Salaried Self employed Student House wife Others

Proposed Policy Tenure: 1 Year 2 Years 3 YearsPolicy Type: Individual Family Floater

If Family Floater*, number of persons to be covered: Adults : Children:____________________________ ____________________________________________(* - Max 2 Adults and 4 children)

Please fill up this form in CAPITAL LETTERS for yourself and each proposed insured person

D D M M YY YYDate of BirthNationality____________________________________

* Mobile number and Email is mandatory

GUIDELINES FOR COMPLETION OF THE FORM (TO BE FILLED BY PROPOSER)

Please answer all the questions fully and correctly. This proposal will be the basis of any insurance policy that We may issue. You must disclose all facts relevant to

all persons proposed to be insured that may affect our decision to issue a policy or its price, terms, conditions and exclusions. The policy shall become void at our

sole discretion, in the event of any untrue or incorrect statement, misrepresentation, non-description or non-disclosure in any material particular in the proposal

form/personal statement, declaration and connected documents or any material information having been withheld by the Proposer or any one acting on his

behalf.

If there is insufficient space for you to provide information whether as requested or otherwise, please attach a separate sheet. If you are in any doubt, please seek the

help of our company representative or your insurance advisor. If We accept a proposal for insurance, it shall be subject to the Policy terms and conditions and We

shall have no liability to make any payment under the Policy if premium is not received by Us in full and in time, or is not realized or non-fulfillment of pre-policy

medical check-up.


AG Code________________________ RM Name_______________________________________________ RM Employee ID________________________________

RM Branch________________________________________ RM/SP Code__________________________ RM Signature ___________________________________

Sum Insured

2 Lacs 3 Lacs 4 Lacs 5 Lacs 10 Lacs 15 Lacs 20 Lacs 50 Lacs 25 Lacs 30 Lacs 50 Lacs 1 Cr 1.5 Cr

Classic Supreme Elite

Customer Segment Citigold Private Client Citigold Citibanking Suvidha Citi Priority

PROPOSAL FORM

DETAILS OF PERSONS TO BE COVERED

ADDITIONAL BENEFIT

Nomination

In the event of the death of the proposer any payment due under the policy shall become payable to the nominee proposed in the form. The receipt of the proceeds by such nominee would be sufficient discharge to the company. Nominee for all other persons proposed to be insured shall be the proposer himself/herself. Following section to be filled by the proposer:

Nominee Name(First, Middle, Last)

Relationship with the proposer Address and contact details of Nominee

Address

Phone Number

4. Medical & Lifestyle Information

Please answer the below mentioned questions accurately to the best of your knowledge in respect of each person proposed to be insured. If the answer to any of these questions is YES, please provide the complete details in the table for additional medical information

Important: You must answer these questions truthfully.

Please ensure that you are fully informed about the standard waiting periods and permanent exclusions that apply to the Lifeline

Insured Name (First, Middle, Last) Date of birth Gender

Relationship with proposer

Sl.No

2.

3.

4.

5.

6.

1.

Profession/trade/occupation

Weight(kg)

Height(cm)

D D M M Y Y M F

D D M M Y Y M F

D D M M Y Y M F

D D M M Y Y M F

D D M M Y Y M F

D D M M Y Y M F

YES 1. Hospital Cash Benefit: Do you want to apply for a Hospital Cash benefit?

2. Include US and Canada for Worldwide Emergency Hospitalization and International Treatment for 11 specified Critical Illness:

Do you want to avail this benefit?* YES *This benefit can be availed only at the inception of first policy with us.

3. Top-up Option: You can choose a deductible (on annual aggregate basis) as per your choice

Deductible Amount: 1Lacs 2Lacs 3 Lacs 4 Lacs 5 Lacs 10 Lacs

Note: In addition to the above, we may have additional questions for you or may ask you to undergo medical tests to complete your full medical assessment

DetailsSl. No

YES NO YES NO YES NO YES NO YES NO YES NO

Within the last 2 years have you consulted a doctor or healthcare professional? (other than Preventive Health Check-up or Pre Employment Health Check-up)

Within the last 2 years have you underwent for any detailed investigation (e.g. X-ray, CT Scan, biopsy, MRI, Sonography, etc) (other than Preventive Health Check-up or Pre Employment Health Check-up)

YES

YES

NO

NO

YES

YES

NO

NO

YES

YES

NO

NO

YES

YES

NO

NO

YES

YES

NO

NO

YES

YES

NO

NOWithin the last 5 years have you been to a hospital for an operation/medical treatment?

Do you take tablets, medicines or drugs on a regular basis?

Have any of the person proposed to be insured ever suffered from or taken treatment, or hospitalized for or have been recommended to take investigations/ medication/surgery or undergone a surgery for any of the following � Diabetes; Hypertension; Ulcer/Cyst/Cancer; Cardiac Disorder; Kidney or Urinary Tract Disorder; Disorder of muscle/bone/joint; Respiratory disorder; Digestive tract or gastrointestinal disorder; Nervous System disorder; Mental Illness or disorder, HIV or AIDS

Within the last 3 months have you experienced any health problems or medical conditions which you/proposed insured person have/has not seen a doctor for

YES

YES

YES

NO

NO

NO

YES

YES

YES

NO

NO

NO

YES

YES

YES

NO

NO

NO

YES

YES

YES

NO

NO

NO

YES

YES

YES

NO

NO

NO

YES

YES

YES

NO

NO

NO

1

2

3

4

5

6


Insured 1 Insured 2 Insured 3 Insured 4 Insured 5 Insured 6

2

Does any person proposed to be insured consume any of the following:

Substance Insured 1 Insured 2 Insured 3 Insured 4 Insured 5 Insured 6




Alcohol Quantity**

Narcotics Quantity

Quantity(No./Day)

Quantity(Pouch/Day)

No. of Years

No. of Years

No. of Years

No. of Years

Smoking

Any other substance like Tobacco/Guthka/Pan/Pan Masala, etc

(**Beer � No. of Pints per week, Wine & Spirit � ml/week)

If any of these habits has been in the past please mention the year of stopping it and the reason for doing the same habit _________________________________

________________________________________________________________________________________________________________________________________

5. Additional Medical Information:

If you have answered YES to any of the questions in section 4, please give full details here. If you need more space please use extra sheets. If you are unsure whether any details are relevant, please include them.

Substance Insured 1 Insured 2 Insured 3 Insured 4 Insured 5 Insured 6

Name of illness/injury suffering from or suffered in the past

Date of first diagnosis (Month & Year)

Treatment/medication received/receiving

Treatment outcome (fully cured/partially cured/ ongoing, etc)

Note:

Company may apply an exclusion/risk loading on the premium payable (based upon the declarations made in the proposal form and the health status of the members proposed to be insured). These loadings would be applied from the policy period start date including all subsequent renewals with the company.

Any exclusion/loadings, if applicable, shall be suitably intimated to the proposer based on the assessment of the proposal form and medical tests. Proposer shall be required to pay the additional premium within stipulated time of such intimation. Company shall not be at any risk during this period. In the event of the decline of proposal due to non-receipt of this additional premium within the stipulated time or due to any reason, Company shall cancel your proposal and refund the premium amount after deducting charges as per policy terms and conditions.

1. Family Physician details:

Family Physicians name___________________________________________________________________________________________________________________

Contact Number__________________________________________________

2. Existing Insurance Details

Is the proposer or any of the persons proposed to be insured already insured under or proposed for a health insurance policy with Royal Sundaram General

Insurance Co. Limited or any other insurance company

GENERAL INFORMATION:

If YES, please indicate below the Policy/Application number(s). (Please mention application number in case of pending proposal)Since when have you been continuously insured.

If you want to avail the portability benefit from your existing insurance policy, please also submit to us (as an annexure to this proposal form) all the policy documents relating to the existing policy in addition to the information given above

YES NO

3. Caution

You are obliged to make a full and frank disclosure of all facts material to the assumption of risk in relation to you and every person proposed to be insured that would influence our decision to issue policy or the terms on which it is issued and you must not misrepresent any information to us. The obligation continues until the policy is issued and does not end with the submission of this proposal form. If therefore, there is any change in the information given herein or new information comes to light before the policy is issued, then you must inform us of the same in writing without delay. If there is insufficient space to provide additional information, whether as requested or otherwise, then please attach an extra sheet duly signed. If the disclosure obligations are breached then may render any policy issued void.


Insured Name (First, Middle, Last)

Claims details if anyFrom

D D M M Y Y

D D M M Y Y

D D M M Y Y

D D M M Y Y

Sum Insured (`)Policy No./

Application No.Insurer Name

Period of Insurance

To

3



MD MD Y YY YDate :

Place : ____________________________________________

Signature of the Proposer : ____________________________________________________________________

Name of Proposer : __________________________________________________________________________

4. Authorization for electronic policy fulfillment and service communications (Please read carefully and put a check mark against each before signing)

I hereby consent that the policy documents may be sent to me by email at (Please provide us your e-mail id) ______________________________________________________________

I hereby consent to and authorize Royal Sundaram General Insurance Co. Limited (� Company�) to make welcome calls, service calls or any other communication (electronic or otherwise) with respect to the proposed or existing policy of Company from time to time.

5. Declaration

I/We hereby declare, on my behalf and on behalf of all persons proposed to be insured, that the above statements, answers and/or particulars given by me are true and complete in all respects to the best of my knowledge and that I/We am/are authorized to propose on behalf of these other persons. I/We undertake that the loadings applicable have been informed and understood by me.

I understand that the information provided by me will form the basis of the insurance policy, is subject to the Board approved underwriting policy of the insurance company and that the policy will come into force only after full receipt of the premium chargeable.

I/We further declare that I/We will notify in writing any change occurring in the occupation or general health of the life to be insured/proposer after the proposal has been submitted b u t before communication of the risk acceptance by the company

I/We declare and consent to the company seeking medical information from any doctor or from a hospital who at anytime has attended on the life to be insured/proposer or from any past or present employer concerning anything which affects the physical or mental health of the life to be assured/proposer and seeking information from any insurance

company to which an application for insurance on the life to be assured/proposer has been made for the purpose of underwriting the proposal and/or claim settlement.

I/We authorize the company to share information pertaining to my proposal including the medical records for the sole purpose of proposal underwriting and/or claims settlement and with any Government and/or Regulatory authority.

I understand that corporate agent will earn 15% as commission on this policy in their capacity as the registered Corporate Agent of Royal Sundaram General Insurance Co. Limited.

Additional Information

I declare that persons proposed include my family members and they are not engaged in high - risk occupation. I also declare that I have explicitly given information of any pre - existing disease that they have and understand that such Pre - Existing medical conditions, Personal waiting period, Permanent exclusions, First 30 Days exclusion, Two years exclusion will not be covered under the policy (as per policy conditions).

This proposal shall form the basis of contract of Insurance. If any statements, answers, particulars are untrue or incorrect, the insurer shall incur no liability under this insurance. I hereby agree to apply myself and / or my family members to the Lifeline Plan offered by Royal Sundaram General Insurance Co. Limited., I understand that to apply myself and / my family members I must currently be a customer of corporate agent. I am also aware that the entire amount of the initial premium needs to be paid for the insurance policy to come into force and the renewal premia is subject to change as per the relevant age band and service tax rates, amended by Ministry of Finance, Govt. of India.

I confirm that I have understood the premium amount payable by me for this policy to be issued by the insurance company and I agree to pay this amount.

This policy is underwritten by Royal Sundaram General Insurance Co. Limited with its registered office at No. 21, Patullos Road, Chennai 600 002. For more details on risk factors, please read the policy terms and conditions, which can be made available on request, before concluding the sale.

I understand that the company may terminate the policy immediately, from inception, on grounds of misrepresentation, false representation of a matter of fact or non-disclosure of material fact by the applicant / insured and in such case the Company shall not refund any portion of the premium to the applicant.

I / We understand that acceptance of proposal shall be based purely on the underwriting guidelines of the company.

6. Vernacular Declaration

I hereby declare that I have fully explained the contents of the proposal form and all other documents incidental to availing the health insurance from Royal Sundaram General Insurance Co. Limited to the proposer in the language understood by him/her. The same have been fully understood by him/her and the replies have been recorded as per the information provided by the proposer and the replies have been read out to fully understood and confirmed by the proposer.

Signature of declarant : _______________________________________ Signature of applicant in vernacular : _______________________________________

Declarants Name

Relationship with proposer

7. Premium Amount (`)

PR17093/JUL17/VER.2

Sign Here

X Place :___________________________________________ ___________________________________ Signature of Applicant

8. For payment of claims/refund through direct bank transfer, please provide the following details: (please enclose a cancelled cheque along with the proposal form)

Name of Bank Branch City ____________________________________________________________________ ____________________________ ___________________________

IFSC Code Account Number

Intermediary Declaration

I, (Full Name) in my capacity as an Insurance Advisor/Specified Person of the Corporate Agent/Authorized employee of the _______________________________________________________________________ Broker/Relationship Officer, do hereby declare that I have explained all the contents of this Proposal Form, including the nature of the questions contained in this Proposal Form to the Proposer including statement (s), information and responses(s) submitted by him/her in this Proposal Form to questions contained herein or any details sought herein will form the basis of the Contract of Insurance between the Company and the Proposer, if this Proposal is accepted by the Company for issuance of the Policy. I have further explained that if any untrue statement(s)/information/response(s) is/are contained in this Proposal Form / including addendum(s), affidavits, statements, submissions, furnished/ to be furnished, the Company shall have the right to vary the benefits which may be payable and furthermore, if there has been a non-disclosure of any material fact, the Policy issued to his/her favour pursuant to this Proposal may be treated by the Company as null and void and all premium paid under the Policy may be forfeited to the Company.

License No./ID (Advisor/Corporate Agent/Broker/Relationship Officer)

MD MD Y YY YDate : Signature : ________________________________________________

SECTION 41 OF THE INSURANCE ACT, 1938 - PROHIBITION OF REBATES

1. No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take out or renew or continue an Insurance in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy nor shall any person taking out or renewing or continuing a Policy accept any rebate, except such rebate as may be allowed in accordance with the published prospectus or tables of the Insurer.

2. Any person making default in complying with the provisions of this section shall be liable for penalty which may extend to ten lakh rupees.

MD MD Y YY YDate :

Place : ____________________________________________

Signature of the Proposer : ___________________________________________________________________

Name of Proposer : _________________________________________________________________________

4

Cheque/NEFT/DD Payment Option: Cheque/NEFT/DD Number

Cheque/NEFT/DD Date

Cash

D D M M YY Bank


Proposal No.

We acknowledge with thanks the receipt of your proposal and amount by Cash/Cheque/NEFT/DD/Others _ of_________________________________________

amount of `. dated ________________________________________________________________________________ ______________________________________

drawn on ______________________________________________________________________________________________________________________________

D D M M YY YYDate

Neither the submission to us of a completed proposal for Insurance nor any payment for any policy sought obliges us to agree to issue a policy, which decision is

and always shall be in our sole and absolute discretion. If we accept a proposal for Insurance, it shall be subject to the policy terms and conditions and we shall have

no liability whatsoever if premium is not received by us in full and in time or is not realized. If we do not accept the proposal, we will inform you and refund the

payment, if any, received from you without interest.

Signature of the receiver and office seal

ACKNOWLEDGEMENT

S.No Intermediary Con�rmation

Ops Con�rmation RemarksDocument/Check point

This is a must

This is a must

No overwriting

In case of Zone 2 address, address proof to be submitted

Please tick the applicable policy tenure

Please tick the applicable plan

Please tick the applicable sum insured

Please tick the applicable policy type

Clearly mention the no of adult and children

If premium is more than Rs.50K

Name of all insrured person to be mentioned. No Overwriting

DOB of all insrured person to be mentioned. No Overwriting

Height of all insured person either in cm or feet and inches to be mentioned

Weight of all insured to be mentioned

1 Email id

2 Mobile number

3 Proposer Name & DOB

4 Address of proposer including pincode

5 Policy tenure (1/2/3 year)

6 Plan (Classic/Supreme/Elite)

7 Sum Insured

8 Policy (Individual/Family Floater)

9 No. of adult & child if Family Floater (eg.2A+2C)

10 PAN No. (As per AML guideline)

11 Insured Name (all insured)

12 Insured Date of Birth (all insured)

13 Insured height (all insured)

14 Insured weight in KG (all insured)

CHECKLIST FOR LIFELINE

MANDATORY FIELDS

MANDATORY DOCUMENTS REQUIRED

Mention the relationship

If the customer is opting for any optional bene�t, it should be ticked as Yes

Proposer cannot be the nominee. It has to be different from Proposer

Should be answered for all insured members and not to be blank

Sign at these places

Provide details like cheque details/cc details, etc

Mandatory if customer is opting for Portability



Voter ID is not a valid age proof. Aadhar Card can be accepted if complete DOB is mentioned on the card.

Required where address is of Zone 2

All previous year policy documents for which continuity is asked for.

1 Age Proof of eldest insured Member (if insured age is > 45 years

2 Proposer/Insured address proof (for Zone 2 cases)

3 For Portability cases, Portability Form and previous year policy copies

MANDATORY FIELDS



15 Insured Relationship

16 Optional bene�ts - Hospital Cash, Top-up and Include US/Canada (Elite Plan)

17 Nominee details - Name. Relationship, address & phone number

18 6 Health questions - to be answered for all insured members

19 Proposer declaration (point 4, 5 and 8) - signature

20 Payment details (point 7)

21 Existing insurance details (mandatory if opting portability)

Proposal Form No Date Signature


6


Vishranthi Melaram Towers, No. 2 / 319, Rajiv Gandhi Salai (OMR), Karapakkam, Chennai - 600097. Registered Office: 21, Patullos Road, Chennai - 600 002.

CIN:U67200TN2000PLC045611 Royal Sundaram IRDAI Registration No.102 |

1860 425 0000 [email protected] www.royalsundaram.inInsurance is the subject matter of solicitation PR17093/JUL17/VER.2


PR17093/JUL17/VER.2


Vishranthi Melaram Towers, No. 2 / 319, Rajiv Gandhi Salai (OMR), Karapakkam, Chennai - 600097. Registered Office: 21, Patullos Road, Chennai - 600 002.Royal Sundaram IRDAI Registration No.102 | CIN-U67200TN2000PLC045611

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