Lifeline Health Insurance Plan Summary

TABLE OF CONTENTS
Introducing Lifeline………………………………………………………………………… 2
Policy Design………………………………………………………………………..………… 2
Policy Coverage………………………………………………………………………………… 7
Terms and Conditions………………………………………………………………………… 17
Exclusions……………………………………………………………………………………… 23
Let’s check your insight………………………………………………………………………… 25
Premium Calculation………………………………………………………………………… 26
Underwriting Process………………………………………………………………………… 30
Proposal Form………………………………………………………………………………… 32
Activity: Filing the Proposal form…………………………………………………………… 33
Claims Process………………………………………………………………………………… 38
Annexure I: Pre-authorisation Form………………………………………………………… 42
Annexure II: Claim Form……………………………………………………………………… 44
Frequently Asked Questions…………………………………………………………………… 49
Appendix I: Premium Tables…………………………………………………………………… 58
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UIN: IRDAI/NL-HLT/RSAI/P-H/V.I/32/14-15
INTRODUCING LIFELINE
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 the 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 plan which ‘Works for You’ as you want.
POLICY DESIGN
Lifeline is a unique health insurance plan, providing most comprehensive health coverage at an affordable price.
Lifeline is an individual and family oriented health insurance cover which is simple to buy and easy to under-
stand. Some of the key features of Life line are as under:
1. Age Eligibility
Children: The minimum entry age under this policy is 91 days and maximum is 25 years.
Adult: Minimum entry age is 18 years. There is no limit on maximum entry age in this policy.
2. Individual & Family Combination
The policy can be purchased on an Individual basis or on a Family Floater basis. In case of a family floater
policy, one family will share a single sum insured as opted. A floater plan can cover self, spouse and depen
dent children upto age of 25 years. A floater cover can cover a maximum of 2 adults and 4 dependent children
under a single policy.
3. Policy Period Option
Customer can buy the policy for one, two or three continuous years at the option of the Insured. ‘One Policy
Year’ shall mean a period of one year from the date of issuance of the policy.
4. Plan & Sum Insured Options
Customer has the option to choose from a wide range of Sum Insured’s available under 3 plans:
Plan Sum Insured

Classic Rs.2lacs, Rs.3lacs, Rs.4lacs
Supreme Rs.5lacs, Rs.10lacs, Rs.15lacs, Rs.20lacs, Rs. 50lacs
Elite Rs.25lacs, Rs.30lacs, Rs.50lacs, Rs.100lacs, Rs.150lacs
Sum Insured is on Annual basis.
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5. 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.
A discount of 15% for members in Zone 2 will be applicable. Grid as below:
ZONE Discount
Zone 1 0%
Zone 2 15%
e.g, 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) (All premiums are exclusive of service tax)
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PRODUCT BENEFITS TABLE - LIFELINE
Sum Insured (SI) Rupees Classic

2 lacs 3 lacs 4 lacs
Baseline cover benefits (1), (2)
Inpatient Care Covered up to Sum Insured
Pre and post hospitalization expenses 30/60 days, Covered upto Sum Insured
All Day care procedures Covered upto Sum Insured
Ambulance Cover Up to Rs.3,000
Organ Donor Expenses Covered upto Sum Insured
Other Benefits
Domiciliary Hospitalization Covered upto Sum Insured
No Claim 10% of Base Sum Insured upto a max of 50%
Re-load of Sum Insured (3) Upto Base Sum Insured
Government Hospitals - Covered upto Sum Insured;

Ayush Treatment (4)
Other Hospitals - Covered upto Rs.20,000
Vaccination in case of Animal Bite (5) Upto Rs.2,500
Emergency Domestic Evacuation (Bed to Bed on advise of treating

Not Covered
doctor)
Worldwide Emergency Hospitalization (excluding US and

Not Covered
Canada)$
International Treatment abroad for specified 11 critical illnesses along

with one time return airfare for insured person(6) Not Covered
(excluding US and Canada)$
Health & Wellness Benefits
Health Check-up Once in 2 years
Preventive Healthcare & Wellness (7) Available
Second Opinion for 11 specified Critical Illness (8) Not Covered
OPD Treatment (9) Not Covered
Maternity Benefits (10)
- Maternity cover for up to 2 deliveries Not Covered
- New Born Baby Cover Not Covered
- Vaccinations for new born baby in the first year (#) Not Covered
CUSTOMER LEVEL OPTIONS:
1. Top-up plan on annual aggregate basis Deductible of Rs.1,2,3,4,5 and 10 lacs
2. Hosptial Cash (for 30 days in case of hospitalization

Rs.1,000/day
beyond 2 days)
3. Option to inlcude US and Canada for Worldwide Emergency
Hospitalization and International Treatment for 11 specified Not Available
Critical Illness$
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Sum Insured (SI) in Rs.
Supreme Elite
5 lacs 10lacs 15lacs 20lacs 50lacs 25lacs 30 lacs 50 lacs 100 lacs 150 lacs
Covered up to Sum Insured Covered up to Sum Insured
60/90 days, Covered upto Sum Insured 60/180 days, Covered upto Sum Insured
Covered upto Sum Insured Covered upto Sum Insured
Up to Rs.5,000 Up to Rs.10,000
Covered upto Sum Insured Covered upto Sum Insured
Covered up to Sum Insured Covered up to Sum Insured
20% of Base Sum Insured upto a max of 100% 20% of Base Sum Insured upto a max of 100%
Upto Base Sum Insured Upto Base Sum Insured
Government Hospitals - Covered upto Sum Insured; Government Hospitals - Covered upto Sum Insured;
Other Hospitals - Covered upto Rs.30,000 Other Hospitals - Covered upto Rs.50,000
Upto Rs.5,000 Upto Rs.7,500
Covered upto Rs.100,000 Covered upto Rs.300,000
50% of Base Sum Insured upto max of Rs.20lacs; Deductible of $1,000

Not Covered
per hospitalization
Covered upto Sum Insured

Not Covered
Airfare covered upto Rs.3 lac
Annual Annual
Available Available
Available once during the policy year Available once during the policy year
Not Covered Upto Rs.10,000
Not Covered Rs.200000 Rs.200000 Rs.200000 Rs.250000 Rs.250000
Not Covered Rs.625,000 Rs750,000 Rs.1,250,000 Rs.2,500,000 Rs.3,750,000
Not Covered Covered upto 10,000
Deductible of Rs.1,2,3,4,5 and 10lacs Not Available
Rs.2,000/day Rs.5,000/day
Not Available Available
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Notes:
(1) Baseline cover includes a

- 48 month waiting period for Classic, 36 months waiting period for Supreme & 24 months waiting period
for Elite for pre-existing conditions
- 2 year waiting period for specific 17 diseases/conditions
- 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 specific 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 Benefit upto defined 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 Benefit 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 Benefit - 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 (only in Elite variant). 36 month
waiting period applies to maternity benefit.
# 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 specified 11 critical illness
cover is excluding US and Canada. However, Customer has option to include US and Canada by paying an
additional premium. This benefit can be availed only at the inception of first policy with us.
Note: Policy offers both individual and family floater cover options with defined relationships allowed of
Husband, Wife & Dependent Children
Maximum Family Combination Allowed: 2 Adults + 4 Children
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POLICY COVERAGE
The policy covers reasonable and customary expenses incurred towards medical treatment taken during the Poli-
cy Period for an Illness or an Accident. The benefits are subject to the Sum Insured, any sub-limit specified in the
Product Benefit Table, the terms, conditions, limitations and exclusions mentioned in the Policy and eligibility
as per the plan opted. The Policy covers the following expenses:
Basic Covers
1. Inpatient Care: Inpatient Care means treatment for which the Insured Person has to stay in a hospital for
more than 24 hours for a covered event. The Policy covers Medical Expenses up to Sum Insured for:
(a) Medical Practitioners’ fees;
(b) Room Rent, boarding expenses;
(c) Intensive Care Unit charges;
(d) Diagnostics Procedures charges;
(e) Medicines, drugs and consumables;
(f) Nursing Charges;
(g) Intravenous fluids, blood transfusion, injection administration charges;
(h) Anesthesia, Blood, Oxygen, Operation theatre charges, surgical appliances;
(i) The cost of prosthetics and other devices or equipment if implanted internally during a Surgical
Procedure.
2. Pre & Post hospitalization Medical Expenses: The Policy covers expenses for consultations, investigations
and medicines incurred of an Insured person due to an accident or injury or illness incurred immediately
prior to hospitalisation or incurred post hospitalisation up to the limits specified under the plan opted by
the Insured subject. These are payable for the same illness or treatment as long as we have accepted an
inpatient hospitalization claim for that treatment or illness. These can be claimed only as reimbursements.

Sum Insured (SI) Classic Supreme Elite
Rupees
2/3/4 lacs 5/10/15/20/50 lacs 25//30/50/100/150 lacs
Pre and post 30/60 days,
60/90 days, Covered upto 60/180 days, Covered upto
hospitalization Covered upto
Sum Insured Sum Insured
expenses Sum Insured
3. Day Care Treatment: Day Care Treatment means Medically Necessary Day Care Treatment or Surgery that
require less than 24 hours Hospitalization due to advancement in technology and which is undertaken in
a Hospital/Day Care Center on the recommendation of a Medical Practitioner. Policy Covers Medical
expenses up to Sum Insured for Day-Care Procedures. Any OPD Treatment undertaken in a hospital will
not be covered. Pre & Post hospitalization Medical Expenses are not payable for this benefit.
4. Ambulance Cover: Reasonable charges for ambulance expenses (by surface transport only) incurred to
transfer the insured person following an Emergency to the nearest Hospital, if we accept the in-patient
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claim. Our maximum liability for ambulance expenses is limited up to limit specified in Product Benefits
Table per event of hospitalization is as per the limit specified below:

Rupees
2/3/4 lacs 5/10/15/20/50 lacs 25//30/50/100/150 lacs
Ambulance Cover Up to Rs.3,000 Up to Rs.5,000 Up to Rs.10,000
5. Domiciliary Hospitalization: Domiciliary Hospitalization means medical treatment for an Illness/disease/

injury which in the normal course would require care and treatment at a Hospital but is actually taken
while confined at home under any of the following circumstances:
• the condition of the patient is such that he/she is not in a condition to be removed to a hospital or;
• the patient takes treatment at home on account of non availability of room in a hospital.
Policy Covers Medical expenses up to Sum Insured for treatment taken at home if the treatment continues
for an uninterrupted period of 3 days and the condition for which treatment is taken would otherwise have
necessitated hospitalization as long as either.
(i) the attending medical practitioner confirms that the insured person could not be transferred to a
hospital or
(ii) you satisfy us that a hospital bed was unavailable. Claims for pre-hospitalization expenses up to 30
days shall be payable, however, post-hospitalisation medical expenses shall not be payable.
6. Organ Donor Expenses: Policy Covers Medical expenses up to Sum Insured for an organ donor’s treat
ment for harvesting of the organ provided that:
a. The insured person has been medically advised to undergo an organ transplant
b. The donation conforms to The Transplantation of Human Organs Act 1994 and the organ is for the use
of the insured person;
Policy will not cover:
(a) Pre-hospitalisation or post-hospitalization medical expenses or screening expenses of the donor or

any other medical expenses as a result of the harvesting from the donor;
(b) Costs directly or indirectly associated with the acquisition of the donor’s organ.
7. No Claim Bonus: If no claim has been made by any insured person, we will increase the base sum insured
as per the plan opted (Classic – 10% of Base Sum Insured, Supreme & Elite – 20% of Base Sum Insured)
on each policy year up to a maximum of 50% of base Sum Insured of that policy year for Classic plan and
100% of base Sum Insured of that policy year for Supreme & Elite plan, provided the Policy is renewed
continuously.
If two or more individual Policies of Lifeline are renewed as Family Floater Policy, then the No Claim Bonus
carried to the floater Sum Insured will be the lowest No Claim Bonus available amongst the Insured Persons
in that Family unit. For e.g. if Husband and Wife have individual cover of Rs.5 lacs each and NCB of 40%
and 20% respectively and they decide to renew the policy as Family Floater at the time of renewal, then
NCB carried forward to renewed policy will be 20% (lower NCB) for both the insured.
If the Base Sum Insured is increased/decreased, No Claim Bonus will be calculated on the basis of Base Sum
Insured of the last completed Policy Year and will be capped to max No Claim Bonus allowed for renewed
plan Base Sum Insured.
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If customer has opted for 2 years or 3 years policy, then No Claim Bonus will be added at the end of each
policy year subject to no claim being made in policy year.
Illustration:
Customer has opted for 3 years policy period and sum insured of Rs. 5 Lakhs (Supreme Plan) No claim
is being made in the first year, hence, No Claim Bonus is added at the end of first year i.e. 1 Lakh (20% of
Sum Insured). Second year, no claim being made, hence, No Claim Bonus is added at the end of second year.
Sum Insured after a period of two years will be Rs. 7 Lakhs.
8. Re-load of Sum Insured: Policy will provide Re-load of Sum Insured upto 100% of Base Sum Insured only
once in the policy year, if the Base Sum Insured and No Claim Bonus is used partially or completely due to
claims made and paid or claims made and accepted as payable for one particular Illness during the Policy
Year as per Policy terms and conditions provided that:
(a) It will be applicable only to subsequent claims made by the Insured Person and not against any Illness
(including its complications or follow up) for which a claim has been paid or accepted as payable in the
current Policy Year.
(b) Any unutilized reload sum insured cannot be carried forward to next year.
(c) In case of floater policy, reload will be available on floater basis.
Illustration of Re-load of Sum Insured for 2A+2C Family Floater Policy
Claim 2
Claim 1
Scenerio I Scenerio II Scenerio III
Details
Claim for Claim for Claim for Claim for
Husband Husband Husband Wife
Total Sum Insured 5 lacs
Ilness Heart Heart Liver Kidney
Claim Amount 4 lacs 2 lacs 2 lacs 2 lacs
Balance Sum Insured 1 lac
Claim Paid from SI 4 lacs 1 lac 1 lac 2 lacs
Reload of Not Applicable
Applicable Applicable
Sum Insured as same illness
Reload SI 5 lacs 5 lacs
Claim Paid from
0 1 lac 1 lac
Reload
Reload Balance SI 5 lacs 4 lacs 4 lacs
Claim Paid by
1 lac 0 0
Customer
9. Vaccination in case of Animal Bite (in case of Post Bite Treatment): Policy will cover reimbursement
of medical expenses incurred for vaccination including inoculation and immunizations in case of post-
bite treatment up to actuals subject to the limit mentioned below. This will be part of overall sum insured.
Coverage limit will be as per level:
(I) Classic – Upto Rs.2,500/-

(II) Supreme – Upto Rs.5,000/-
(III) Elite – Upto Rs.7,500/-
Animal bite would include Dog bite, Monkey bite, Honey Bee bite, Snake bite etc.
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10. Ayush Treatment: Policy will cover medical expenses for in-patient treatment taken under Ayurveda,
Unani, Sidha and Homeopathy provided the treatment has been undergone in a government hospital or
in any institute recognized by government and/or accredited by Quality Council of India/National Ac
creditation Board on Health. Our maximum liability will be as per below table:

Rupees
2/3/4 lacs 5/10/15/20/50 lacs 25//30/50/100/150 lacs
Government Hospitals - Government Hospitals - Government Hospitals -
Covered upto Covered upto Covered upto
Ayush Treatment Sum Insured; Sum Insured; Sum Insured;
Other Hospitals - Covered Other Hospitals - Covered Other Hospitals - Covered
upto Rs.20,000 upto Rs.30,000 upto Rs.50,000
11. Emergency Domestic Evacuation (Available for Supreme & Elite plan only): Policy will cover expenses
of domestic evacuation in case of life threatening emergency condition for treatment of an illness or injury
on the advice of treating doctor subject to:
(a) Treating doctor confirms that insured need to be transferred to another hospital having suitable medical
technology & equipment for treatment.
(b) Evacuation will be from one medical center to another medical center.
(c) Our maximum liability will be as mentioned below:
(I) Classic – Not Available

(II) Supreme – Upto Rs.100,000/-
(III) Elite – Upto Rs.300,000/-
(d) Any expenses over and above the limit specified above, customer will have to make the payment to
the service provider.
(e) This benefit can be availed once by an Insured Person during a Policy Year.
(f) This benefit is on per Insured Person basis.
12. Worldwide Emergency Hospitalization (excluding US and Canada) (available for Elite Plan only):
Policy will cover medical expenses of the insured person upto 50% of Base Sum Insured upto max of Rs.20
lacs incurred outside India as per the limit specified, provided:
(a) The treatment is medically necessary and has been certified as an Emergency by a Medical Practitio
ner and such treatment cannot be postponed until the insured person has returned to India.
(b) The medical expenses payable shall be limited to Inpatient Hospitalization only.
(c) Each admissible claim will be subject to a deductible of USD 1000.
(d) Claim will be settled on cashless as well as reimbursement basis. Any hospitalization should be
intimated to us within 24 hours of hospitalization.
(e) The payment of any claim under this Benefit will be based on the rate of exchange as on the date of
payment to the Hospital published by Reserve Bank of India (RBI) and shall be used for conversion
of foreign currency into Indian rupees for payment of claim. If on the date of discharge, RBI rates
are not published, the exchange rate next published by RBI shall be considered for conversion.
(f) This benefit is available Worldwide excluding US and Canada. However, customer has an option to
include treatment in US and Canada by paying additional premium.
(g) Re-load benefit will not be triggered for this benefit.
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13. International Treatment abroad for specified 11 critical illnesses (excluding US and Canada)
(available for Elite Plan only):
We will cover medical expenses of the insured person incurred outside India for below mentioned 11
specified critical illnesses:
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
We will Cover Medical Expenses subject to :

a. Such claim in India should have been admissible under the Inpatient Care.
b. The medical expenses payable shall be limited to Inpatient Hospitalization & Day Care
Hospitalization only.
c. The symptoms of the Critical Illness first occur or manifest itself during the Policy Period and after
completion of the 90 days initial waiting period.
d. The Critical Illness is diagnosed by a Medical Practitioner within India during the Policy Period and
after completion of the 90 day initial waiting period.
e. Customer should get the pre-authorization from us before going for treatment.
f. Our maximum liability will be limited as mentioned below:
Year 1 – 50% of Sum Insured and Year 2 onwards – 100% of Sum Insured
g. All claims will be subject to 20% co-payment.
h. This benefit is available worldwide except US and Canada. However, customer has an option to
include treatment in US and Canada by paying additional premium.
i. The payment of any claim under this Benefit will be based on the rate of exchange as on the date
of payment to the Hospital published by Reserve Bank of India (RBI) and shall be used for
conversion of foreign currency into Indian rupees for payment of claim. If on the date of discharge,
RBI rates are not published, the exchange rate next published by RBI shall be considered for
conversion.
j. We will also provide one time return air fare upto a maximum of Rs.3 lacs, for insured person for
whom claim has been accepted. This will be settled on reimbursement basis. This is a part of overall
sum insured.
k. Re-load benefit will not be triggered for this benefit.
14. Maternity Benefits (Available only for Elite Plan)

Maternity Expenses: This benefit is available only to you or your spouse under family floater policy, only
when you and your spouse, are both covered under the same policy. We pay Medical Expenses for the de
livery of a child, only after 36 months of continuous coverage since the inception of the first Policy with
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Us. There is a sub-limit on maternity expenses as shown under below table. Maternity benefits are paid
only twice during the lifetime of the Policy including any of its renewals. However, expenses in respect of
harvesting and storage of stem cells are not covered. In case, customer is porting from any other policy pro
viding maternity benefit, the respective waiting period served in that policy will be considered as waiting
period waiver in Lifeline policy as per portability guideline.
New Born Baby: The new born baby will be covered as an insured person from birth. We will cover
medical expenses towards the medical treatment of the Insured Person’s new born baby while the Insured
Person is Hospitalized as an Inpatient for delivery and we have accepted the maternity claim as payable.
There is a sub-limit on maternity expenses as shown under below table.
Vaccination for New Born Baby: We will cover Reasonable & Customary Charges for vaccination of the
new born baby, if we have accepted the maternity claim as payable, until the new born baby completes
one year. If the policy ends before the baby completes one year, then we will cover the vaccinations only if
the baby has been added as an insured person at the time of renewal. There is a sub-limit on maternity
expenses as shown under below table.
Maternity Benefits
Maternity cover for

Rs.200000 Rs.200000 Rs.200000 Rs.250000 Rs.250000
up to 2 deliveries
New Born Baby

Rs.625,000 Rs750,000 Rs.1,250,000 Rs.2,500,000 Rs.3,750,000
Cover
Vaccinations for
new born baby in Covered upto 10,000
the first year
List of Vaccinations
Time interval Vaccination to be done (age) # Frequency
Vaccination for first year
BCG (From birth to 2 weeks) 1
OPV (0‚6‚10 weeks) OR OPV + IPV1 (6,10 weeks) 3 OR 4
0-3 months DPT (6 & 10 week) 2
Hepatitis-B (0 & 6 week) 2
Hib (6 & 10 week) 2
OPV (14 week) OR OPV + IPV2 1 OR 2
DPT (14 week) 1

3-6 months
Hepatitis-B (14 week) 1
Hib (14 week) 1
9 months Measles (+9 months) 1
12 months Chicken Pox(12 months) 1
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15. OPD Treatment (Available only for Elite Plan): We will cover reasonable & customary charges upto the
maximum of Rs. 10,000 for Insured Person’s medically necessary consultation with a Medical Practitioner,
as an OPD Treatment to assess the Insured Person’s health condition for any illness. We will also pay for
any diagnostic tests prescribed by the medical practitioner and medicines purchased under and supported
with a Medical Practitioner’s prescription.
We will also cover the Reasonable & Customary Charges for Dental OPD Treatment, Cost of Spectacles,
Contact Lenses and Hearing Aids once in 2 years with a sublimit of 30% of OPD Treatment.
Value Added Covers

16. Health Checkup: The Policy covers the cost of a Health Check-up once in two years for Classic Plan and
Annually for Supreme and Elite. The Policy covers health checkups arranged by the Company through the
empanelled Service Providers as per the plan opted.
Plan List of Medical Tests

Classic Complete Blood Count, Urine Routine, ESR, Fasting Blood Sugar, ECG, S Cholesterol, SGPT,
Creatinine
Supreme Complete Blood Count, Urine Routine, ESR, Fasting Blood Sugar, Lipid Profile, Kidney
Function Test, ECG, Complete physical examination be Physician
Elite Complete Blood Count, Urine Routine, ESR, Fasting Blood Sugar, Lipid Profile, Stress Test
(TMT) or 2D Echo, Kidney Function Test, Complete physical examination be Physician
Abbreviation of test is provided here:
ESR – Erythrocyte Sedimentation Rate, ECG – Electrocardiogram, S Cholesterol – Serum Cholesterol,

SGPT – Serum Glutamic Pyruvate Transaminase, TMT – Tread Mill Test
This benefit is available to those insured person who have attained the age of 18 years or above on the
Policy Period Start Date.
This benefit is provided irrespective of any claim being made in the Policy Year.
17. Second Opinion for critical illnesses (Available for Supreme & Elite Plan only): Policy will cover ex
penses of second opinion to the insured person if he is diagnosed with any of the below mentioned 11
critical illnesses:
1. Cancer
2. First Heart Attack
3. Open Chest CABG
4. Open Heart Replacement or Repair of Heart Valves
5. Coma
6. Kidney Failure
7. Stroke
8. Major Organ/Bone Marrow Transplant
9. Permanent paralysis of Limbs
10. Motor Neurone Disease
11. Multiple Sclerosis
This benefit is available only once during the policy year. Benefit is available only for adults.
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18. Preventive Healthcare & Wellness
We will provide various Preventive Healthcare & Wellness related services that will help the insured person
to assess their health status and aid in improving their overall well being. Various Preventive Healthcare &
Wellness services include Health related articles, access to various preferred health maintenance network
etc.
Health and Wellness Services shall broadly include following set of Services.
A. Health Articles on Royal Sundaram Website:
• There shall be a microsite on Royal Sundaram website which shall be updated every fortnight
• This microsite shall provide a list of new health articles (articles based on 100 differential health
topics.
• There shall be atleast 30 such publications in a year and each publication will consist of 6 health
related articles on differential topics.
B. Doctor on Chat via e-mail communication:
i. There shall be a link on Royal Sundaram website in the form of a micro website in connection with
providing Doctor on chat facility on Royal Sundaram website.
ii. All the queries posted under this section shall be responded to the customer by e-mail within 24
hours from query raised.
C. Discount Services:
1. Policyholders will be issued e-cards which will be downloaded from the Royal Sundaram’s website
by filling up few prescribed details i.e. login ID, password etc.
2. Policyholder can avail a minimum discount in the range of 10-25% by displaying co-branded health
e-card to various health and wellness centres having tie-ups Royal Sundaram’s designated Service
Providers. However, policyholder shall directly pay the balance amount to the merchant from where
the service is availed.
Design of e-card shall be as under:
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Optional Benefits
1. Top-up Plan (on Annual Aggregate Deductibles) –Available only for Classic and Supreme
Top-up plan is a modification of existing cover to annual aggregate deductible by which discount premium
will be available .You can choose from one of six optional deductibles of Rs 1 lac, Rs 2 Lacs, Rs 3 lacs, Rs.
4 Lacs, Rs 5 Lacs and Rs.10Lacs. You can choose to the take the top up cover under Classic & Supreme plan.
If a top-up plan (on annual aggregate deductible) is chosen then the insured person shall bear all assessed
claim amounts payable under the policy up to the deductible amount, under his policy for any Policy Year.
Our liability to make payment under the Policy in respect of any claim made in that Policy Year will only
commence once the Deductible has been exhausted.
Any claim amount that is assessed to be payable by Royal Sundaram under this policy and is borne by the
insured person (even if paid for through another Health Insurance Policy) will be accepted as reason of
deductible exhaustion.
Insured Person should submit all the claim documents to us to calculate the exhaustion of deductible on
aggregate basis. We will inform the insured person once the deductible amount is exhausted and any claim
(assessed to be payable) exceeding the deductible will be paid by us.
Top-up Illustration
Customer has an existing policy with SI of Rs.2lacs from another company. Customer opts for a Top-up
Plan with a deductible of Rs.2lacs and Sum Insured of Rs.3lacs
C Claim
Available Sum Claim amount Claim
Amount Deductible Balance
A Insured in paid by the other Amount paid
Assessed by Exhaustion Deductible
L Lifeline Policy insurance policy by Us
Us
C
U At
- - Rs 200,000 Rs 300,000 - -
L Inception
A Claim 1 Rs 20,000 Rs 20,000 Rs ,80,000 Rs 300,000 Rs 20,000 0
T
I Claim 2 Rs 1,90,000 Rs 1,80,000 0 Rs 300,000 Rs 1,80,000 Rs 10,000
O
N Claim 3 Rs 3,60,000 0 0 Rs 290,000 0 Rs. 2,90,0000
15
2. Hospital Cash
If the insured person is hospitalized and if We have accepted an inpatient care hospitalization claim under
the base plan, We will pay the hospital cash amount as opted by you for each continuous and completed
period of 24 hours of hospitalization provided that:
(a) You should have been hospitalized for a minimum period of 48 hours continuously;
(b) We will not make any payment under this optional benefit in respect of an Insured Person for more
than 30 days of hospitalization in total under any policy year;
(c) We will not make any payment under this optional benefit for any diagnosis or treatment arising
from or related to pregnancy (whether uterine or extra uterine), childbirth including caesarean
section, medical termination of pregnancy and/or any treatment related to pre and post natal care
of the mother or the new born baby.

Rupees
2/3/4 lacs 5/10/15/20 lacs 25//30/50/100/150 lacs
Hospital Cash Rs.1,000/day Rs.2,000/day Rs.5,000/day
3. Include US and Canada for Worldwide Emergency Hospitalization and International Treatment for
11 specified Critical Illnesses.
Customer 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.
16
TERMS AND CONDITIONS
Standard Terms and Conditions
A. Disclosure to Information Norm
The policy shall be null and void and no benefit shall be payable in the event of untrue or incorrect
statements, misrepresentation, mis-description or non-disclosure of any material particulars in the
proposal form, personal statement, declaration, claim form declaration, medical history on the claim form
and connected documents, or any material information having been withheld by Insured or any one
acting on Insured Person behalf, under this Policy. Insured further understand and agree that We may at
Our sole discretion cancel the Policy and the premium paid shall be forfeited to Us.
B. Observance of terms and conditions

The due adherence/observance and fulfillment of the terms, conditions and endorsement of this Policy in
so far as they relate to anything to be done or complied with by the Insured Person, shall be a Condition
Precedent to any liability to make payment under this Policy .
C. Reasonable Care
The Insured Person shall take all reasonable steps to safeguard against any Accident or Illnesses that may
give rise to any claim under this Policy.
D. Material Change
It is a Condition Precedent to the Our’s liability under the Policy that the Policyholder shall immediately
notify Us in writing of any material change in the risk on account of change in nature of occupation or
business at his own expense (refer Annexure III). We may, in its discretion, adjust the scope of cover and/
or the premium paid or payable, accordingly. Insured must exercise the same duty to disclose those matters
to Us before the Renewal, extension, variation, endorsement or reinstatement of the contract.
E. Subrogation
The Insured Person shall do and concur in doing and permit to be done all such acts and things as may be
necessary or required by Us, before or after indemnification, in enforcing or endorsing any rights or
remedies, or of obtaining relief or indemnity, to which We are or would become entitled or subrogated.
Neither You nor any Insured Person shall do any acts or things that prejudice these subrogation rights
in any manner. Any recovery made by Us pursuant to this clause shall first be applied to the amounts paid
or payable by Us under this Policy and the costs and expenses incurred by Us in effecting the recovery,
whereafter We shall pay the balance amount to Insured Person. This clause shall not apply to any Benefit
offered on a fixed benefit basis (like Hospital Cash benefit).
F. Contribution
If two or more policies are taken by Insured Person during the same period from one or more Insurers to
indemnify treatment costs and the amount of claim is within the Sum Insured limit of any of the policies,
Insured Person will have the right to opt for a full settlement of Insured Person’s claim in terms of any of
Insured Person’s policies.
Where the amount to be claimed exceeds the Sum Insured under a single policy after considering
Deductible, Co-payments (if applicable), Insured Person can choose the insurer with which Insured
Person would like to settle the claim. Wherever We receive such claims We have the right to apply the
Contribution clause while settling the claim.
G. Alteration to the Policy

This Policy constitutes the complete contract of insurance. No change or alteration will be effective or valid
unless approved in writing which will be evidenced by a written endorsement signed and stamped by Us.
No one except Us can change or vary this Policy.
17
H. Change of Policyholder
The policyholder may be changed only at the time of Renewal of the Policy. The new Policyholder must be
a member of the Insured Person’s immediate family. Such change would be solely subject to Our
discretion and payment of premium by Insured Person. The renewed Policy shall be treated as having been
renewed without break.
The Policyholder may be changed upon request in case of his demise.
I. No Constructive Notice
Any knowledge or information of any circumstances or condition in relation to the Policyholder/Insured
Person which is in Our possession and not specifically informed by the Policyholder/Insured Person shall
not be held to bind or prejudicially affect Us notwithstanding subsequent acceptance of any premium.
J. Free Look Provision

Insured Person have a period of 15 days from the date of receipt of the Policy document to review the
terms and conditions of this Policy. If Insured Person have any objections to any of the terms and
conditions, Insured Person may cancel the Policy stating the reasons for cancellation and provided that no
claims have been made under the Policy, We will refund the premium paid by Insured Person after
deducting the amounts spent on any medical checkup, stamp duty charges and proportionate risk
premium for the period on cover. All rights and benefits under this Policy shall immediately stand
extinguished on the free look cancellation of the Policy. The free look provision is not applicable and
available at the time of Renewal of the Policy.
K. Cancellation/ Termination (other than Free Look cancellation)
1. Cancellation by Insured Person:
Insured Person may terminate this Policy during the Policy Period by giving Us at least 30 days prior
written notice. We shall cancel the Policy and refund the premium for the balance of the Policy Period
in accordance with the table below provided that no claim has been made under the Policy by or on
behalf of any Insured Person.
Refund of Premium (basis

Cancellation date upto (x months)
Policy Period)
from the Policy Period Start Date
1 Year 2 Year 3 Year
Upto 1 month 75% 87% 91%
Upto 3 months 50% 74% 82%
Upto 6 months 25% 61.5% 73.5%
Upto 12 months 0% 48.5% 64.5%
Upto 15 months NA 24.5% 47%
Upto 18 months NA 12% 38.5%
Upto 24 months NA 0% 30%
Upto 30 months NA NA 8%
Beyond 30 months NA NA 0%
2. Automatic Cancellation:

a. Individual Policy:
The Policy shall automatically terminate on death of the Insured Person.

b. Family Floater Policies:
The Policy shall automatically terminate in the event of the death of all the Insured Persons.
18

c. Refund:
A refund in accordance with the table in Section 5(k)(1) above shall be payable if there is an
automatic cancellation of the Policy provided that no claim has been filed under the Policy by or on
behalf of any Insured Person.
3. Cancellation by Us:
Without prejudice to the above, We may terminate this Policy during the Policy Period by sending 30
days prior written notice to Insured Person’s address shown in the Schedule of Insurance Certificate
without refund of premium if:
I. You or any Insured Person or any person acting on behalf of either has acted in a dishonest or
fraudulent manner under or in relation to this Policy;
II. You or any Insured Person has not disclosed any true , complete and all correct facts in relation to
the Policy and/or;
III. Continuance of the Policy poses a moral hazard.
For avoidance of doubt, it is clarified that no claims shall be admitted and/or paid during the notice period
by Us in relation to the Policy.
L. Fraudulent claims
If a claim is in any way found to be fraudulent, or if any false statement, or declaration is made or used in
support of such a claim, or if any fraudulent means or devices are used by the Insured Person or any false
or incorrect Disclosure to Information Norms or anyone acting on behalf of the Insured Person to obtain
any benefit under this Policy, then this Policy shall be void and all claims being processed shall be forfeited
for all Insured Persons and all sums paid under this Policy shall be repaid to Us by all Insured Persons who
shall be jointly liable for such repayment.
M. Limitation of Liability
If a claim is rejected or partially settled and is not the subject of any pending suit or other proceeding or
arbitration, as the case may be, within twelve months from the date of such rejection or settlement the
claim shall be deemed to have been abandoned and Our liability shall be extinguished and shall not be
recoverable thereafter.
N. Records to be maintained
You or the Insured Person, as the case may be shall keep an accurate record containing all relevant medical
records and shall allow Us or our representative(s) to inspect such records. You or the Insured Person as
the case may be, shall furnish such information as may be required by Us under this Policy at any time
during the Policy Period or until final adjustment (if any) and resolution of all Claims under this Policy.
O. Territorial Jurisdiction
The geographical scope of this Policy applies to events within India other than for Worldwide Emergency
Hospitalization and International Treatment for 11 specified Critical Illness. However, all admitted or
payable claims shall be settled in India in Indian rupees other than for Worldwide Emergency
Hospitalization and International Treatment for 11 specified Critical Illness.
P. Policy Disputes
Any and all disputes or differences under or in relation to this Policy herein shall be determined by Indian
law and shall be subject to the jurisdiction of the Indian Courts.
19
Q. Loading/Co-payment
We shall apply a risk loading on the premium payable or Co-payment for certain specific conditions as per
Our board approved underwriting policy (based upon the declarations made in the proposal form and
the health status of the persons proposed for insurance), which shall be mentioned specifically in the
Schedule of Insurance Certificate. The maximum risk loading applicable shall not exceed 150% per
diagnosis / medical condition and an overall risk loading of 200% per person. These loadings are applied
from the inception of the initial Policy including subsequent Renewal(s) with Us or on the receipt of
a request for increase in Sum Insured (for which the loading shall be applied on the increased Sum
Insured). The maximum risk Co-payment shall not exceed 20% per diagnosis/medical condition and an
overall risk co-payment of 20% per person.
We will inform You about the applicable risk loading or Co-payment through post/courier/email/phone.
You shall revert to Us with your written consent and additional premium (if any), within 15 days of the
issuance of such counter offer. In case, You neither accept the counter offer nor revert to Us within 15 days,
We shall cancel Your application and refund the premium paid within the next 15 days.
R. Portability Benefit
You can port Your existing health insurance policy from another company or from existing product of
Royal Sundaram to Lifeline, provided that:
i. You have been covered under an Indian retail health insurance policy from a Non-life/Stand Alone Health
insurance company registered with IRDA without any break.
ii. We should have received Your application for Portability with complete documentation at least 45 days
before the expiry of Your present period of insurance.
iii. If the Sum Insured under the previous Policy is higher than the Sum Insured chosen under this
Policy, the applicable waiting periods under Section 4(a), 4(b), 4(c), 4(d) and 4(e) as mentioned in
policy document shall be reduced by the number of months of continuous coverage under such health
insurance policy with the previous insurer to the extent of the Sum Insured and the eligible
Cumulative Bonus under the expiring health insurance policy.
iv. In case the proposed Sum Insured opted for under Our Policy is more than the insurance cover under
the previous policy, then all applicable waiting periods under Section 4(a), 4(b), 4(c), 4(d) and 4(e)
as mentioned in policy document and shall be applicable afresh to the amount by which the Sum
Insured under this Policy exceed the total of Sum Insured and eligible Cumulative Bonus under the
expiring health insurance policy.
v. All waiting periods under Section 4(a), 4(b), 4(c), 4(d) and 4(e) as mentioned in policy document
shall be applicable individually for each Insured Person and claims shall be assessed accordingly.
vi. If You were covered on a floater basis under the expiring Policy and apply for a floater cover under this
Policy, then the eligible Cumulative Bonus to be carried forward on this Policy shall also be available
on a floater basis.
vii. If You were covered on an individual basis in the expiring Policy then the eligible Cumulative Bonus to
be carried forward on this Policy shall be available on an individual basis.
For the purpose of this provision, eligible Cumulative Bonus shall mean the Cumulative Bonus which You
or the Insured Person would have been eligible for had the same policy been Renewed with the existing
insurance company.
It is further agreed and understood that:
a. Portability benefit will be offered to the extent of sum of previous Sum Insured and accrued
Cumulative Bonus (if opted for), and Portability shall not apply to any other additional increased Sum
Insured.
20
b. We may subject Your proposal to Our medical underwriting, restrict the terms upon which We may of
fer cover, the decision as to which shall be in Our sole and absolute discretion.
c. There is no obligation on Us to insure all Insured Persons on the proposed terms, even if You have
given Us all documentation.
d. We should have received the database and claim history from the previous insurance company for Your
previous policy.
The Portability provisions will apply to You, if You wish to migrate from this Policy to any other health
insurance policy on Renewals.
In case You have opted to switch to any other insurer under portability provisions and the outcome of
acceptance of the portability request is awaited from the new insurer on the date of renewal:
i. We may upon Your request extend this Policy for a period of not less than one month at an additional
premium to be paid on a pro-rata basis.
ii. If during this extension period a claim has been reported, You shall be required to first pay the full
premium so as to make the Policy Period of full 12 calendar months. Our liability for the payment of
such claim shall commence only once such premium is received. Alternatively, We may deduct the
premium for the balance period and pay the balance claim amount if any and issue the Policy for the
remaining period.
S. Renewal of Policy
i. This Policy will automatically terminate at the end of the Policy Period. This Policy is ordinarily
renewable on mutual consent for life, subject to application of Renewal and realization of Renewal
premium. All Renewal application should reach Us on or before the Policy Period End Date.
ii. We may in Our sole discretion, revise the Renewal premium payable under the Policy provided that
revision to the Renewal premium are in accordance with the IRDA rules and regulations as applicable
from time to time. Renewal premiums will not alter based on individual claims experience. We will
intimate Insured Person of any such changes at least 3 months prior to date of such revision or
modification.
iii. The premium payable on renewal shall be paid to Us on or before the Policy Period End Date and in
any event before the expiry of the Grace Period. For the purpose of this provision, Grace Period means
a period of 30 days immediately following the Policy Period End Date during which a payment can be
made to renew this Policy without loss of continuity benefits such as Waiting Periods and coverage of
Pre Existing Diseases. Coverage is not available for the period for which premium is not received by Us
and We shall not be liable for any Claims incurred during such period. The provision of Section 64VB
of the Insurance Act shall be applicable.
iv. Renewal of the Policy will not ordinarily be denied other than on grounds of moral hazard, misrepre
sentation or fraud or non-cooperation by Insured Person.
v. We reserve the right to carry out underwriting in relation to any alterations like increase/decrease in
Sum Insured, change in plan/coverage, addition/deletion of members, addition/deletion of Medical
Conditions, request at the time of Renewal of the Policy. We reserve Our right in relation to acceptance
of the request for changes on Renewal. The terms and conditions of the existing Policy will not be
altered.
vi. This product may be withdrawn by Us after due approval from the IRDA. In case this product is
withdrawn by Us, this Policy can be renewed under the then prevailing Health Insurance Product or its
21
nearest substitute approved by IRDA. We shall duly intimate Insured Person regarding the withdrawal
of this product and the options available to You at the time of Renewal of this Policy.
vii. In case of floater policies, children attaining 25 years at the time of renewal will be moved out of the
floater into an individual cover however all continuity benefits on the policy will remain intact.
Cumulative Bonus earned on the Policy will stay with the floater policy.
T. Communications & Notices
Any communication or notice or instruction under this Policy shall be in writing and will be sent to:
i. To Us, at the address as specified in Schedule of Insurance Certificate
ii. The Policyholder’s, at the address as specified in Schedule of Insurance Certificate
iii. No insurance agents, brokers, other person or entity is authorized to received any motice on behalf of
Us unless explicitly stated in writing by Us
iv. Notice and instructions will be deemed served 10 days after posting or immediately upon receipt in the
case of hand delivery, facsimile or e-mail.
U. Nominee
You are mandatorily required at the inception of the Policy to make a nomination for the purpose of
payment of claims, under the Policy in the event of death.
Any change of nomination shall be communicated to Us in writing and such change shall be effective only
when an endorsement on the Policy is made by Us.
In case of any Insured Person other than You under the Policy, for the purpose of payment of claims in the
event of death, the default nominee would be You.
V. Overriding Effect of Policy Schedule

In case of any inconsistency in terms and conditions in this Policy vis-a-vis the information contained in
the Policy Schedule, the information contained in the Policy Schedule shall prevail.
W. Complete Discharge
We will not be bound to take notice or be affected by any Notice of any trust, charge, lien, assignment or
other dealing with or relating to this Policy. The payment made by Us to You/Insured Person or to Your
Nominee/Legal Representative or to the Hospital, as the case may be, of any Medical Expenses or
compensation or benefit under the Policy shall in all cases be complete, valid and construe as an effectual
discharge in favour of Us.
22
EXCLUSIONS
We shall not be liable under this Policy for any claim in connection with or in respect of the following:
A. Initial Waiting Period
i. 30 days Initial Waiting Period
We will not cover any treatment taken during the first 30 days since the date of commencement of the
Policy, unless the treatment needed is the result of an Accident/Injury. This exclusion shall not apply for
any subsequent and continuous Renewals of Your Policy provided that there is no break in the insur
ance cover or Policy is enforced with any other Insurance Company (Non-Life/Health Insurance
Company).
ii. 90 days Initial Waiting Period for Critical Illness

We will not cover any treatment for critical illness symptoms of which first occur or manifest itself
during the first 90 days since the date of commencement of the policy.
B. Pre-Existing Diseases
Claim will not be admissible for any Medical Expenses incurred as Hospitalization Expenses for diagnosis/
treatment of any Pre-existing Diseases;
(i) for Classic plan, until 48 months of continuous coverage have elapsed since the inception of the
first Policy with Us;
(ii) for Supreme plan, until 36 months of continuous coverage have elapsed since the inception of the
first Policy with Us;
(iii) for Elite plan, until 24 months of continuous coverage have elapsed since the inception of the first
Policy with Us.
Where the Policy is renewed for enhanced Sum Insured, waiting periods would start and apply afresh for
the amount of increase in Sum Insured
C. Specific Waiting Period
A waiting period of 24 months shall apply and will be covered from the commencement of the 3rd Policy Year
as long as the Insured Person has been insured continuously under the Policy without any break, to the
treatment of the following, whether medical or surgical for all Medical Expenses along with their
complications on treatment towards;
1. Cataract
2. Stones in biliary and urinary systems
3. Hernia / Hydrocele
4. Hysterectomy for any benign disorder
5. Lumps / cysts / nodules / polyps / internal tumours
6. Gastric and Duodenal Ulcers
7. Surgery on tonsils / adenoids
8. Osteoarthrosis / Arthritis / Gout / Rheumatism / Spondylosis / Spondylitis / Intervertebral Disc

Prolapse
9. Fissure / Fistula / Haemorrhoid
23
10. Sinusitis / Deviated Nasal Septum / Tympanoplasty / Chronic Suppurative Otitis Media
11. Benign Prostatic Hypertrophy
12. Knee/Hip Joint replacement
13. Dilatation and Curettage
14. Varicose veins
15. Dysfunctional Uterine Bleeding / Fibroids / Prolapse Uterus / Endometriosis
16. Diabetes and related complications
17. Chronic Renal Failure or end stage Renal Failure
If these diseases are pre-existing at the time of proposal or subsequently found to be pre-existing the
pre-existing waiting periods shall apply.
D. Personal Waiting Periods
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 specifically stated in the Schedule of Insurance Certificate and will be applied only after receiving
Your specific consent.
E. Permanent Exclusions
We will not be liable under any circumstances, for any claim in connection with or with regard to any of
the permanent exclusions and any such other exclusions as may be specified in the Schedule of Insurance
Certificate.-. The detailed list of Permanent Exclusions has been mentioned under Policy Wording
Document. Please refer Policy Wording for the aforesaid list.
24
LET’S CHECK YOUR INSIGHT
Last few pages have assisted to understand the product Lifeline in a best possible manner. Hence, this section has
been designed to check and verify your understanding of the Product. Answer the following questions with a ‘Yes’
or ‘No’. Royal Sundaram will pay the claim if:
1. Raman was hit by a car and had to undergo surgery?
2. Surekha had a heart attack and went through a bypass?
3. Sunita had an emergency appendicitis operation in the first month of her policy?
4. Ramaya had a cavity in her tooth for which she had root canal therapy?
5. Rekha has been taking treatment for T.B. for past one year and this is her first policy here?
6. Rakhi has been hospitalized due to liver problem from excessive drinking?
7. Manish has to undergo multiple surgeries for his deformed leg which is present since birth?
8. Sheenam has dental surgery because an accident resulted in her teeth falling out?
9. Shyna is taking treatment at an Ayurvedic Hospital?
10. Ruchi goes for a weight loss treatment?
11. Vishwa has taken a policy and opted for a sum Insured of Rs. 4 Lakhs. He has claimed an amount of
Rs. 2.5 Lakhs when he was hospitalized for some Kidney ailment. He has been again hospitalized for some
liver ailment in the same policy year and claimed an amount of Rs. 2.5 Lakhs? Whether his entire claim will
be accepted or not?
12. Sunil has bought Supreme plan of the Lifeline and has made a claim of Rs. 5,900 against the animal bite
treatment. Whether his entire claim is acceptable?
13. Vishal has bought Elite Plan of Lifeline and has flown to Canada for Treatment of one of the specified Critical
Illness. He has spent an amount of Rs. 4.2 Lakhs on the return Airfare. Whether entire amount of Rs. 4.2 Lakhs
can be re-imbursed ?
14. Annual Health Check-up is available for all the three plans of Lifeline?
15. There is an option to remove initial waiting period in case of Elite plan of the Policy?
25
PREMIUM CALCULATION
Example 1:
(For Zone 1)
We have the following inputs from proposer:
SI 5 lac
Age 40
Family combination 2A+2C
Location Chennai
Policy period 2 Year
Hospital cash benefit, opted Yes
Top up plan (Deductible, opted) 2 lac
Premium Calculation
First of all, we will look for the premium amount for SI 5 Lacs at age 40 from the table of family combination
2A+2C.
As the policy period is opted as 2 years, will look at the age of 41 in the same table for SI 5 Lacs.
Step 1 Table Rate at age 40 for Zone 1 12,221 Table rates

By adding the above two premiums, we get premium for 2 years policy period.
Step 3 Total Table Premium 24886 =12,221+12,665
Now, as the location comes under Zone 1, this proposal is not applicable for zonal discount.
But, it is applicable for multiyear policy discount, which is 7.5%.
Step 4 Zonal discount 0% (Chennai -> Zone 1)

Step 5 Discount for 2 year policy period 7.5%
By applying above discounts on the premium calculated at step 3, we get below premium:
Total Premium with Zonal and multi-year

Step 6 23,019 =24,886*(1-0%)*(1-7.5%)
policy-period discount
Now, the proposer opted for Top-up plan of 2 lac, for which the factor is 75%. So, the premium after applying
this factor to the premium calculated at step 6:
Step 7 (Top up) Deductible - Multiplicative factor 75.0%

Step 8 Total Premium with Deductible and Zonal and =23,019*75%
multi-year policy-period discount 17,264
In this example, proposer has taken hospital cash option and this is a multiyear policy period.
26
Hence we will apply loading for hospital cash loading and apply a discount for multiyear policy period to the
premium calculated at step 3 as shown below:
Step 9 Hospital Cash loading 16.0%

Step 10 Hospital Cash Premium =24,886*16%
3,982
Step 11 Hospital Cash Premium with multi-year policy =24,886*16%*(1-7.5%)
period discount 3,683
Now we add amounts calculated at step 8 and step 11 to get the pre-service-tax premium as shown in step 12
Step 12 Premium rate (without service tax) 20,947 =17,264+3,683
After applying service tax of 14%, we get the final premium as shown in step 14:
Step 13 Service Tax 14%

Step 14 Final premium (with service tax) 23,880 =20,947*(1+14%)
Example 2:
(For Zone 2)
We have the following inputs from proposer:
SI 5 lac
Age 40
Location Madurai
Top up plan (Deductible, opted) 2 lac
Premium Calculation
First of all, we will look for the premium amount for SI 5 Lacs at age 40 from the table of family combination
2A+2C.
As the policy period is opted as 2 years, will look at the age of 41 in the same table for SI 5 Lacs.

Step 3 Total Table Premium 24,886 =12,221+12,665

Now, as the location comes under Zone 2, this proposal is applicable for zonal discount of 15%.
Also, we will apply multiyear policy discount as well, which is 7.5%.
Step 4 Zonal discount 15% (Madurai -> Zone 1)

27
Total Premium with Zonal and multi-year

Step 6 19,566 =24,886*(1-15%)*(1-7.5%)
policy-period discount
Now, the proposer opted for Top-up plan of 2 lac, for which the factor is 75%. So, the premium after applying
this factor to the premium calculated at step 6:
Step 7 (Top up) Deductible - Multiplicative factor 75.0%

Step 8 Total Premium with Deductible and Zonal and 14,675 =19,566*75%
multi-year policy-period discount

Step 10 Hospital Cash Premium =24,886*16%
3,982
Step 11 Hospital Cash Premium with multi-year policy =24,886*16%*(1-7.5%)
period discount 3,683
Now we add amounts calculated at step 8 and step 11 to get the pre-service-tax premium as shown in step 12:
Step 12 Premium rate (without service tax) 18,358 =14,675+3,683

Step 14 Final premium (with service tax) 20,928 =18,358(1+14%)
Example 3:
(For Elite)
Plan Elite
SI 50 Lacs
Age 40
Location Delhi
Top-up Plan Not Applicable
Opted for hospitalization in US/Canada Yes
Premium Calculation
First of all, we will look for the premium amount for Elite SI 50 Lacs at age 40 from the table of family
combination 2A+2C.
28
As the policy period is opted as 2 years, will look at the age of 41 in the same table for Elite SI 50 Lacs.

Step 3 Total Table Premium 1,92,923 =95,982+96,942
As the insured opted for international hospitalization in US/Canada, we need to apply 8% loading to table pre-
mium, as shown below:
Step 4 US/Canada Option Loading 8%

Step 5 Premium after loading for US/Canada 2,08,357 =1,92,923*(1+8%)
Now, as the location comes under Zone 1, this proposal is not applicable for zonal discount.
But, it is applicable for multiyear policy discount, which is 7.5%.
Step 6 Zonal discount 0%

Step 7 Discount for 2 year policy period 7.5% Multiyear policy discount
Step 8 Total Premium with Zonal and multi year 1,92,731 =2,08,357*(1-0%) *(1-
policy-period discount 7.5%)

Step 10 Hospital Cash Premium 9,646 =1,92,923*5%
Hospital Cash Premium with multi-year policy
Step 11
period discount 8,923 =1,92,923*5%*(1-7.5%)
Now we add amounts calculated at step 8 and step 11 to get the pre-service-tax premium as shown in step 12:
Step 12 Premium rate (without service tax) 2,01,654 =1,92,731+8,923

Step 14 Final premium (with service tax) 2,29,886 =2,01,654*(1+14%)
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UNDERWRITING PROCESS
Introduction to underwriting
The term refers to the process by which an insurance company decides whether it can accept the risk offered to it
and if it accepts the risk then at what rate and at what terms and conditions.
Underwriters will evaluate the risk and exposures of potential clients. They decide whether to insure the clients,
based on the amount of coverage the client seeks and any loading or co-payment to be applied. The function of
the underwriter is to underwrite business that will make the insurance company profitable and to protect the
company from risks that they feel will be loss making.
The information used to evaluate the risk of an applicant for insurance will depend on the type of coverage
involved. For example, in underwriting for Health Insurance, medical underwriting may be used to examine
the applicant’s present and previous health status and other factors such as age and occupation. The factors
that insurers use to classify risks should be objective, clearly related to the likely cost of providing the coverage,
practical to administer, consistent with applicable law and designed to protect the long-term viability of the
insurance programme.
Royal Sundaram’s underwriting philosophy aims to be objective risk assessment based on medical facts deter-
mined by information presented in the proposal form, medical tests and any other information that may have
been shared by the customer for the purpose of taking a Royal Sundaram health insurance policy.
The primary information required for underwriting is sourced from the proposal form and includes:
1. Applicant’s name, date of birth, and address, as well as proof of ID and age, if necessary.
2. Above mentioned details of all dependants to be covered by the policy.
3. Any existing health insurance policy details and claims history, if applicable.
4. Disclosure of any pre-existing medical conditions, habits with details.
5. Medical history report for applicant and dependants, if necessary.
6. Height and Weight.
FROM PROPOSAL TO POLICY

The customer is sold a Royal Sundaram Policy through an agent. The underwriting process has the following key
steps:
Step 1
The screening is done in two parts. The first part is at the branch where the application is logged in and the second
part can be managed by the Underwriting department.
Step 2
The branch operations team will also check and ensure screening of the answers to all the six questions medical
question and 3 lifestyle related question in the proposal form.tedicines or drugs on a regular basis?
1. 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)
2. 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)
3. Within the last 5 years have you been to a hospital for an operation/medical treatment?
4. Do you take tablets, medicines or drugs on a regular basis?
30
5. Within the last 3 months have you experienced any health problems or medical conditions which you have
not seen a doctor for?
6. 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
Lifestyle and Habit questions
Insured Insured Insured Insured Insured Insured

Substance
#1 #2 #3 #4 #5 #6
Alcohol Yes/No
Quantity$
No of Years
Smoking Yes/No
Quantity (no/day)
No of Years
Any other substance Yes/No
like Tobacco/Guthka/ Quantity (pouch/day)
Pan/Pan Masala, etc
No of Years
Narcotics Yes/No
Quantity
No of Years
($: 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 & the reason for doing the
same
_____________________________________________________________________________________________
_____________________________________________________________________________________________
If all questions are answered with “NO” and BMI is less than 33 the application is processed accordingly with
acceptance and issuance of policy certificate. The risk is hedged against the declaration of the pre-existing
condition rule and the list of permanent exclusions, sum assured and specific waiting periods.
Step 3
If answer to any of these 6 medical questions is ‘Yes’ or any other 4 conditions (Age, Sum Insured, BMI or Porta-
bility) is triggered, the case will be sent for medical underwriting. Underwriter will call the customer and depend-
ing upon the response to medical question in Proposal Form and ask another 15 to 20 questions.
Step 4
Depending upon the response to these further questions, underwriter will take further action:
1. Accept at standard risk

2. Reject
3. Subject to Medical Test
31
Step 5
Underwriting Decisions
Upon full assessment of facts, the underwriter, with possibly additional opinion, has discretion to decide wheth-
er the applicants declared condition presents a future risk.
Three potential options will be determined by the Underwriter.

A. Low to Medium Risk – accept application with no condition(s) / exclusion(s)
B. Medium to High Risk – accept application, with special conditions; waiting period (s); loading or
co-payment; and (or) exclusion (s)
C. Very High Risk – decline policy cover
PROPOSAL FORM
A proposal form is the most important document in insurance. It captures essential information necessary for
the company to issue a policy. Information in the proposal form is necessary to ensure that the company is aware
of the risk profile of people it is taking in the insurance pool. Based on the principle of utmost good faith, the
statements made by the proposer in the proposal form are assumed to be true and correct. This data is used to
ascertain broadly the physical and occupational hazard. The moral hazard, on the other hand, is broadly judged
by the proposal form as well as the Medical Examiner’s Report and the Advisor’s confidential Report. Correct
evaluation can be made if the relevant information is carefully and truthfully recorded.
If it is found that an insured person has not disclosed, suppressed, intentionally misrepresented or attempted
to conceal any material aspects of the risk, the insurer will be entitled to avoid any payment of claims under the
policy. The non-disclosure or distortion of information may happen due to ignorance or due to treating it as of
no consequence. In their enthusiasm for procuring business or in any other circumstance, the agent or the sales
staff should not become a party to such wrong statements.
32
ACTIVITY: FILLING THE PROPOSAL FORM
Fill a proposal form provided in Annexure for the person sitting next to you. You will be assessed for complete-
ness, accuracy and speed.
33
34
35
36
Collection of Address Proof of Customers:
Zone 1 : Address Proof not required.
Zone 2 : All customers are required to submit the address Proof. Address Proof should be in the name of the
Proposer.
Following documents can be accepted as a valid address Proof:
1. Passport
2. Voter ID card
3. Driving License
4. Aadhar card
5. Landline/Mobile bill
6. Mahanagar gas bill
7. Electricity bill etc.
Collection of Age Proof of Customers:
Since the amount of premium is determined on the basis of age of eldest member, all applications wherein age
of the eldest member among the applicants is more than 45 years, Age proof of the eldest member needs to be
collected for both Zone-1 and Zone-2.
Following documents can be accepted as a valid age Proof:
1. Passport
2. Driving License
3. PAN Card
4. SSC or HSC marksheet
4. Voter ID
37
CLAIMS PROCESS
Under an Insurance contract, the insurer makes a promise to pay for the loss on happening of the insured event.
On happening of the insured event, the insured or his beneficiary asks the insurer to perform his promise and
thus a claim arises. A claim has to be handled delicately as the policyholders tend to look at any delay as a breach
of contract. The insurer, however, has to ensure that only genuine claims get cleared so that fraudulent tendencies
of policyholders are arrested. This is very essential for the success of any insurance company.
Royal Sundaram’s claims services are designed to ensure that the claim process is simple and convenient to the
customer. It is our constant endeavour to provide quality service to our customers by fair, prompt and efficient
claim settlement.
Our claim department has a firm commitment to leading the industry by providing the highest quality service to
our customers.
Our continuing dedication to improving every aspect of our claims operation is guided by the belief that cus-
tomer satisfaction is the ultimate measure of our performance.
CLAIMS PROCEDURE
1.1 Claim Intimation
Claim Intimations may be received through –

a.
Telephone
b.
Email
c. In Person
Types of Health Claims
I. Cashless claims
II. Reimbursement claims including Pre & Post hospitalization claims
1.2 Cashless Claims
1.2.1 Procedure for Domestic Claims Only
a. Claim Intimation to TPA 3 days in advance for planned admission and within 48 hours of
hospitalization in case of emergency admission, shall be given by the insured.
Documentation for Pre-authorization for availing Cashless Facility
1. First prescription indicating detection and diagnosis of ailment / disease.

a. All reports as prescribed by the Doctor -for example USG, Blood Test, X-rays etc.
b. The advice for admission.
c. Cashless request form of the TPA signed by the attending physician.
d. Any other Papers /reports required by the Panel Doctor for sanction of cashless facility.
Post evaluation of the case by TPA, there shall be following scenerios:
a. Claim is accepted
b. Claim is rejected with an option to apply for reimbursement claims
c. Claim is rejected per se giving reasons of rejection.
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1.2.2 Procedure for Worldwide Emergency Hospitalization
In the event of an Emergency, the Insured Person or Network Hospital shall call Our Service Provider
immediately, on the helpline number specified in the Insured Person’s Schedule of Insurance Certificate,
requesting for a pre-authorization for the medical treatment required;
Our Service Provider will evaluate the request and the eligibility of the Insured Person under the Policy and
call for more information or details, if required;
Our Service Provider will communicate directly to the Hospital whether the request for pre-authorization
has been approved or denied;
If the pre-authorization request is approved, Our Service Provider will directly settle the claim with the
Hospital. Any additional costs or expenses incurred by or on behalf of the Insured Person beyond the
limits pre-authorized by the Service Provider shall be borne by the Insured Person;
It is agreed and understood that We shall not cover any costs or expenses incurred in relation any persons
accompanying the Insured Person during the period of Hospitalization, even if such persons are also In
sured Persons.
1.2.3 Procedure for International Treatment for 11 specified Critical Illness
a. In the event of the diagnosis of a Specified Critical Illness, the Insured Person should call Our Service
Provider immediately and in any event before the commencement of the travel for treatment overseas,
on the helpline number specified in the Schedule of Insurance Certificate requesting for a
pre-authorization for the treatment;
b. Our Service Provider will evaluate the request and the eligibility of the Insured Person the Policy and
call for more information or details, if required.
c. Our Service Provider will communicate directly to the Hospital and the Insured Person whether the
request for pre-authorization has been approved or denied.
f. If the pre-authorization request is approved, Our Service Provider will directly settle the claim with the
Hospital. Any additional costs or expenses incurred by or on behalf of the Insured Person beyond the
limits pre-authorized by the Service Provider or at any Non-Network Hospital shall be borne by the
Insured Person.
3 Claim Processing & settlement – reimbursement claims (for Domestic and Worldwide Emergency
Hospitalization claims) and pre-post hospitalization claims
• Notice of claim: Preliminary notice of claim with particulars relating to Policy number, Name of the
Insured Person in respect of whom claim is made, nature of illness/injury and name and address
of the attending hospital, should be given to the Insurer within 72 hours before admission incase
of planned hospitalization, and not later than 48 hours or before discharge, in case of emergency
hospitalization.
• Submission of claim: The insured shall submit the claim form along with attending physician’s
certificate duly filled and signed in all respects with the following claim documents not later than 30
days from the date of discharge.
Documents Required in case of Re-imbursement Cliams
1. Details of Claim Intimation.
2. Test reports and prescriptions relating to First / Previous consultations for the same or related illness.
39
3. Case history / Admission-discharge summary describing the nature of the complaints and its
duration, treatment given, advice on discharge etc issued by the Hospital.
4. Death summary in case of death of the insured person at the hospital.
5. Hospital Receipts / bills / cash memos in Original (including advance and final hospital settlement
receipts).
6. 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).
7. Doctor’s prescriptions with cash bills for medicines purchased from outside the hospital.
8. F.I.R/MLC. in the case of accidental injury and English translation of the same, if in any other
language.
9. Detailed self-description stating the date, time, circumstances and nature of injury/accident in case of
claims arising out of injury.
10. 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.
11. For a) maternity claims, Discharge Summary mentioning LMP, EDD & Gravida b) Cataract claims -
IOL sticker c) PTCA claims - Stent sticker.
12. Copies of health insurance policies held with any other insurer covering the insured persons
13. If a claim is partially settled by any other insurer, a certificate from the other insurer confirming the
final claim amount settled by them and that Original claim documents are retained at their end.
14. For domiciliary hospitalization claims, a certificate from the attending doctor confirming that the
condition of the patient is such that he/she is not in a condition to be removed to a hospital.
15. For Emergency Domestic Evacuation
a. Certification by the treating Medical Practitioner of such life threatening emergency condition and
confirming that current Hospital does not have suitable medical equipment & technology for the life
threatening condition
b. Bills/Receipts of transportation agency/ambulance company/air ambulance receipts
16. For Worldwide Emergency Hospitalization and International Treatment for 11 specified Critical
Illness – Insured Person/Attendants -passport, Visa, Tickets and Boarding Passes
Documents to be submitted if specifically sought
1. Copy of indoor case records (including nurse’s notes, OT notes and anesthetists’ notes, vitals chart).
2. Copy of extract of Inpatient Register.
3. Attendance records of employer/educational institution.
4. Complete medical records (including indoor case records and OP records) of past hospitalization/
treatment, if any.
5. Attending Physician’s certificate clarifying

a. reason for hospitalization and duration of hospitalization
b. history of any self-inflicted injury
40
c. history of alcoholism, smoking
d. history of associated medical conditions, if any
6. Previous master health check-up records/pre-employment medical records, if any.
7. Any other document necessary in support of the claim on case to case basis.
Acceptance of photocopies: If the insured submits proof that he has a claim with his employer or another
insurer we may accept photocopies of the claim documents duly attested by the employer or the other insurer
with a certificate for the amount of bills paid by them. If they pay only part of the bills, then the original bills,
which are not honoured by them, must be submitted to us.
All claims are to be notified to Us within a timeline as mentioned above. In case where the delay in
intimation is proved to be genuine and for reasons beyond the control of the Insured Person or Nominee
specified in the Schedule of Insurance Certificate, We may condone such delay and process the claim, We
reserve a right to decline such requests for claim process where there is no merit for a delayed claim. Please
note that the waiver of the time limit for notice of claim and submission of claim is at Our evaluation.
Claims Falling in 2 policy Periods
If the claim event falls within two Policy Periods, the claims shall be paid taking into consideration the
available Sum Insured in the two Policy Periods, including the deductibles for each Policy Period. The
admissible claim amount shall be reduced to the extent of premium to be received for the Renewal/due date
of premium of health insurance policy, if not received earlier.
41
ANNEXURE I : PREAUTHORISATION FORM
42
2
43
ANNEXURE II: CLAIM FORM
44
45
46
47
48
FREQUENTLY ASKED QUESTIONS
1. What are the Key Features of Lifeline Product?
Key design and service features of Lifeline are as mentioned below:
1. Wide range of Sum Insured – from Rs.2lacs to Rs.1.5cr
2. No upper age limit for enrolment in policy
3. Provides coverage for International Treatment(excluding US and Canada in the Base cover) for 11
specified illnesses upto Sum Insured along with return airfare upto Rs.3lacs
4. No worries in case of any Emergency Hospitalization while you are abroad during business/leisure
trip. (excluding US and Canada in the Base cover)
5. Access best class healthcare facilities with no capping in terms of Room Rent, disease specific
sublimits, etc
6. Reload of Sum Insured – In case customer has utilized the entire sum insured, then sum insured will
be automatically reloaded at no extra cost which can be used for different illness
7. Maternity Benefit including cover for New Born Baby and vaccination for new born baby
8. OPD Treatment covering the expenses incurred on doctor’s consultation, medicines, diagnostic tests,
etc
9. Accelerated No Claim Bonus which helps in doubling your Sum Insured in 5 claim free year period
(Supreme & Elite). In Classic, your sum insured will increase by 50%
10. Coverage not limited only to Allopathic treatment. You can also take treatment under Ayurveda, Ho-
meopathy in case of hospitalization
11. Health check-up for insured members – irrespective of claims history
12. Health & Wellness benefits to proactively manage your health. Avail exciting offers across various ser-
vices at our preferred network along with communication on latest health topics
13. Covers all day care procedures so that customer need not to worry if something is covered or not
14. Domestic Evacuation in case of emergency
15. Second Opinion for 11 specified Critical Illness
16. Cashless hospitalization across 3500+ network hospitals across India
17. Easy documentation and hassle free claim settlement
18. One sum insured covering all family members
19. Zonal Pricing depending upon the location of your stay. Pay less if you do not stay in Metro Cities and
Gujarat State
20. Hospital Cash Benefit to take care of miscellaneous expenses incurred during hospitalization
21. Top-up Plan to enhance your coverage. Choose the deductible on annual aggregate basis rather than
per claim basis
49
2. Which all Plans are available under Lifeline?
Lifeline offers 3 different plans – Classic, Supreme and Elite. Sum Insured offered under these plans is as
mentioned below:
Plans Sum Insured

Classic Rs.2lacs, Rs.3lacs, Rs.4lacs
Supreme Rs.5lacs, Rs.10lacs, Rs.15lacs, Rs.20lacs, Rs. 50lacs
Elite Rs.25lacs, Rs.30lacs, Rs.50lacs, Rs.100lacs, Rs.150lacs
While Classic Plan offers similar benefits like other health insurance plans available in market, Supreme
and Elite offer much more comprehensive coverages like Second Opinion for Critical Illness, International
Treatment for 11 Critical Illness, Worldwide Emergency Hospitalization, etc to provide a very comprehen
sive coverage to customer
3. Is Maternity benefit covered under Lifeline?

Maternity Benefit is covered in Lifeline in Elite Plan. It covers the expenses related to Maternity and also
covers the New Born Baby till the next renewal. It also covers the vaccination for the new born baby in the
first year. Maternity benefit is payable only when Husband and Wife both are covered under the policy
after a continuous coverage of 3 years. Maternity Benefit can be claimed maximum upto 2 times.
4. Is OPD benefit covered under Lifeline ?

OPD Treatment is covered in Lifeline in Elite Plan. OPD Treatment covers the consultation, diagnostic fees,
medicines,etc. It also cover the expenses incurred on Dental OPD Treatment, Cost of Spectacles, Contact
Lenses and Hearing Aids once in 2 years with a sublimit of 30% of OPD Treatment
5. What is International Treatment for 11 specified CIs in Lifeline?

If the customer is diagnosed with any of the 11 specified critical illnesses, customer can avail the treatment
in any hospital of his choice across the world. The policy will cover the expenses incurred on the
hospitalization for the treatment of the critical illness covered. It will also cover the return airfare upto
Rs.3lacs of the insured person. This benefit is available on cashless basis only. Customer need to obtain a
pre authorization from us by submitting the pre authorisation request along with diagnosis confirmed in
India, before the treatment. The diagnosis of the 11 specified CIs should be as per definitions of these 11
specified 11 CIs given under Policy wording. All claims will be subject to co-payment of 20%.
a. Our maximum liability for this claim will be limited as mentioned below:
i. Year 1 – 50% of Sum Insured
ii. Year 2 onwards – 100% of Sum Insured
6. What is Worldwide Emergency Hospitalization benefit in Lifeline?

Worldwide Emergency hospitalization covers hospitalization expenses abroad ( out of India) subject to:
• The treatment is Medically Necessary and has been certified as an Emergency by a Medical Practitioner, where
such cannot be postponed until the Insured Person has returned to the India
• Indicative conditions – what could be covered as inpatient – heart attack, stroke, major accident, paralysis, high
grade fever, severe stomach ache, bleeding from nose etc
• 2 yrs Pre-existing diseases waiting period and 2 yrs initial waiting period for 17specified diseases, and 30 day
initial waiting period (except accidents) will be applicable in this benefit
50
• Expenses payable shall be limited to Inpatient Hospitalization only – incase of small injuries, fractures, burns,
minor bleeding (cut on a finger not covered but if its bleeding from nose it may be covered), etc it is covered as
OPD and hence not covered under policy
• $1,000 deductible per claim
Overall liability will be limited to 50% of Sum Insured upto a max of Rs.20 lacs
7. As Lifeline covers treatments abroad, will it also substitute for a Overseas travel insurance policy?
Lifeline covers Worldwide Emergency Hospitalization however it does not cover certain other benefits
related to travel inconvenience like Passport Loss, Loss of Baggage, etc. Hence, we suggest that if a customer
is travelling abroad, they should also take an oversea travel insurance policy as per their travel itinerary.
Lifeline Elite plan is a suitable offering for HNI customers who are frequently travelling or want the best of
class treatment across the globe. This plan will help them to get the treatment done across the globe
8. Is Ayush treatment covered in Lifeline ?

Yes, Lifeline also provide coverage for Ayush Treatment in case of Inpatient Hospitalization. Please note
that OPD treatment undertaken in Ayush is not covered
9. What is Organ Donor expenses? What is the sublimit in Lifeline for organ donor?
Organ Donor Expenses covers the expenses incurred on the hospitalization of the organ donor. All
inpatient care expenses related to organ donor are covered, provided:
• He fulfils the Transplantation of Human Organs Act,1994 and other applicable laws.
• The organ donated is used by the insured person.
• A claim is filed for inpatient care by the insured.
However, any other expenses related to acquisition of donor, related pre- and post-hospitalization
expenses, and treatment of associated medical complications will not be covered
Organ Donor Expenses are covered upto Sum Insured
10. Please explain the Reload benefit ‘in Lifeline? Is it same as Restore benefit of Apollo and Recharge
benefit of Religare ?
If you ever exhaust your health cover due to claims in a given year and there is a further claim either by you
for a different illness or your insured family member, we will reload the entire sum insured of your policy
at no extra cost. Reloaded sum insured will help you to settle those claims
Reload of Sum Insured is similar to Recharge benefit of Religare as it is trigerred when the claim amount
exceeds the available sum insured including the NCB for a different illness or different person. In Optima
Restore, sum insured is restored only when entire sum insured is exhausted (for eg, if the SI is Rs.3lacs,
and initial claim was of Rs.2.5lacs, Restore will not be triggered for second claim (of different illness or
different person) of Rs.1lacs and only Rs.50,000 will be paid. Whereas, Reload will be triggered and entire
Rs,1lac will be paid)
11. What is covered in Pre & Post hospitalization expenses ? What is the limit to which its covered ?
Pre Hospitalization covers the medical expenses incurred before hospitalization for Diagnostic Test,
Medication, etc
Post Hospitalization covers the medical expenses incurred on follow up visit with doctor, medication,
further investigative test, etc
Pre & Post Hospitalization expenses are covered upto Sum Insured
51
12. What is Vaccination for Animal byte in Lifeline ? Will it cover byte by Honey bees ? are medicines &
bandage covered under this for treatment ?
Vaccination in case of Animal Bite covers the expenses incurred by you to take vaccination in OPD. For eg,
in case of Dog Bite, you need to take Rabbies vaccination at regular interval which is an OPD procedure.
Lifeline will cover the expenses incurred on vaccination upto the limit against your plan.
It does not cover the medicines, bandages or other expenses incurred while taking the vaccination
13. Is Annual health check up available in Lifeline ? If Yes – what all test are covered ?
Lifeline offers annual health check-up for Supreme & Elite Plan and once in 2 years for Classic Plan. Health
check-up is offered to all the insured above the age of 18 years irrespective of claims status. Please refer to
grid below for covered medical test
Plan List of Medical Tests

Classic Complete Blood Count, Urine Routine, ESR, Fasting Blood Sugar, ECG,
S Cholesterol, SGPT, Creatinine
Supreme Complete Blood Count, Urine Routine, ESR, Fasting Blood Sugar, Lipid Profile,
Kidney Function Test, ECG, Complete physical examination be Physician
Elite Complete Blood Count, Urine Routine, ESR, Fasting Blood Sugar, Lipid Profile, Stress
Test (TMT) or 2D Echo, Kidney Function Test, Complete physical examination be
Physician
14. What is the coverage of ambulance in Lifeline ? Does it cover the ‘Hearse van’ expenses, if the insured
dies during treatment and hospitalization is otherwise payable ?
We will cover the expense incurred on an ambulance offered by a hospital or ambulance service provider
for transferring you to the nearest hospital provided we accept the inpatient care claim for the given
hospitalization. It is covered upto Rs.3000 in Classic, Rs.5000 in Supreme and Rs.10000 in Elite.
Expenses incurred on Hearse Van is not covered.
15. What are Prosthetic Implants ? Are they covered in Lifeline ?

Prosthetic Implants are artificial substitutes for body parts, and materials inserted into tissue for
functional, cosmetic, or therapeutic purposes. Prostheses can be functional, as in the case of artificial arms
and legs, or cosmetic, as in the case of an artificial eye. Implants, all surgically inserted or grafted into the
body, tend to be used therapeutically.
These are covered in Lifeline.
16. What is 2 yrs waiting period for 17 diseases ? what all diseases are not covered in this period ?
There are certain conditions for which customer can wait for treatment and does not need immediate
medical treatment. Lifeline has 2 years waiting period for 17 conditions as mentioned below:
a. Cataract
b. Stones in biliary and urinary systems
c. Hernia / Hydrocele
d. Hysterectomy for any benign disorder
e. Lumps / cysts / nodules / polyps / internal tumours
f. Gastric and Duodenal Ulcers
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g. Surgery on tonsils / adenoids
h. Osteoarthrosis / Arthritis / Gout / Rheumatism / Spondylosis / Spondylitis / Intervertebral Disc Pro-

lapse
i. Fissure / Fistula / Haemorrhoid
j. Sinusitis / Deviated Nasal Septum / Tympanoplasty / Chronic Suppurative Otitis Media
k. Benign Prostatic Hypertrophy
l. Knee/Hip Joint replacement
m. Dilatation and Curettage
n. Varicose veins
o. Dysfunctional Uterine Bleeding / Fibroids / Prolapse Uterus / Endometriosis
p. Diabetes and related complications
q. Chronic Renal Failure or end stage Renal Failure
17. What is the difference between Pre-existing waiting periods & Initial waiting periods?
Initial Waiting Period is the cooling period applied at the start of new policy. This waiting period is not
applicable for renewal policy or portability policy. Only Accidents are covered in the Intial Waiting period
Pre Existing Disease waiting period is the waiting period applied for any of the existing disease customer is
suffering from. It might vary from 4 years in Classic to 2 years in Elite Plan. With each policy year, the pre
existing disease waiting period reduces by 1 year. Any claim related to pre existing disease hospitalization
will not be covered in the policy during waiting period.
18. Does Lifeline price remain same throughout India?

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.
A discount of 15% for members in Zone 2 will be applicable. Grid as below:
ZONE Discount
Zone 1 0%
Zone 2 15%
Eg, Premium for a 35 year old for a Sum Insured of Rs.5lacs is Rs.5549 in Mumbai (Zone 1) and Rs.4717
in Nasik (Zone 2).
19. What is Hospital cash benefit in Lifeline? Is it optional or compulsory?

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
53
It is a optional cover and customer can opt for the Hospital Cash benefit at the time of new purchase or
renewal.
20. What is the Top Up option in Lifeline? is it Per claim or annual aggregate ? what is the difference
between 2 types ?
You can choose from one of six optional deductibles of Rs 1 lac, Rs 2 Lacs, Rs 3 lacs, Rs. 4 Lacs, Rs 5 Lacs
and Rs.10Lacs. By doing so you will receive a discount in the premium calculation of your Policy. You can
choose to the take the top up cover under Classic & Supreme plan.
If a top-up plan (on annual aggregate deductible) is chosen then the insured person shall bear all assessed
claim amounts payable under the policy up to the deductible amount, under his policy for any Policy Year.
Our liability to make payment under the Policy in respect of any claim made in that Policy Year will only
commence once the Deductible has been exhausted
In case of per claim deductible, top up plan is applicable if the claim amount exceeds the deductible
amount. In Lifeline, deductible is on aggregate basis and not per claims basis.
21. What is 2nd opinion in Critical illness in Lifeline ? Can I consult any doctor of my choice and tell RS
to cover these expenses for second opinion ?
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:
a. Cancer of Specified Severity
b. First Heart Attack of Specified Severity
c. Open Chest CABG
d. Open Heart Replacement or Repair of Heart Valves
e. Coma of Specified Severity
f. Kidney Failure requiring Regular Dialysis
g. Stroke resulting in Permanent Symptoms
h. Major Organ/Bone Marrow Transplant
i. Permanent paralysis of Limbs
j. Motor Neurone Disease with Permanent Symptoms
k. Multiple Sclerosis with Persisting Symptoms
To avail this benefit, you need to contact us and we will arrange for the second opinion. You can choose
from our empanelled doctors/hospitals. Please note that this benefit is not on reimbursement basis
22. What is Domestic Evacuation benefit in Lifeline ? If I am trapped in a tragedy like Kashmir Floods, will
RS cover me?
If you are stuck in an emergency due to accident or illness in India, we will assist to transport you safely
from one hospital to another hospital to provide a suitable medical treatment.
For eg, in case of a natural calamity like Kashmir Flood, you are rescued by Army and admitted in a
hospital in one of the relief camp. Royal Sundaram will arrange for Domestiv Evacuation from this
hospital to another hospital having better medical facilities for treatment.
This benefit is available for Supreme and Elite only. Any expenses beyond the limit (Rs.1lac for Supreme
and Rs.3lacs for Elite) has to be paid by you.
54
23. How much No Claim bonus will I get in Lifeline ?
Lifeline offers 10% of Sum Insured upto a max of 50% of Sum Insured for Classic Plan and 20% of Sum
Insured upto a max of 100% for Supreme and Elite plan.
Unlike NCB offered by other policies, there is no penalty in case of claim. Thus NCB earned by you
remains as is even if you claim.
For eg, if you have a policy with SI of Rs.5lacs (Supreme Plan) and there has been no claim in the first year,
then at the time of renewal you will get a NCB of 20% (Rs.1lac). In second year, if you claimed then on
second renewal your NCB of Rs.1lac will remain intact and it will not be reduced.
24. What are the Medical tests / health criterion in Lifeline ?

Every insured person will have to answer the medical questions as mentioned in proposal form. Basis the
response to those medical questions, underwriters will decide on the medical test to be undertaken.
Apart from that, every insured person will be subject to medical test as per below grid.
Age/Sum Insured Sum Insured upto Sum Insured Rs.10lacs, Sum Insured above
Rs.5lacs 15lacs & Rs.20lacs Rs.20lacs
Upto 5 years No Check-up# No Check-up# No Check-up#
6 years to 18 years No Check-up# No Check-up# MER
19 years to 45 years No Check-up# CBC, ESR, URA, MER, FBS/ CBC, ESR, URA, MER,
HbA1C, S Cholesterol, ECG, HbA1C, Lipid Profile,
SGPT, S Creatinine TMT or 2D Echo, LFT
with GGT, RFT, HBsAg, S
Creatinine
46 years and above CBC, ESR, URA, CBC, ESR, URA, MER, CBC, ESR, URA, MER,
MER, FBS/HbA1C, S HbA1C, Lipid Profile, TMT HbA1C, Lipid Profile,
Cholesterol, ECG, or 2D Echo, LFT with GGT, TMT or 2D Echo, LFT
SGPT, S Creatinine RFT, HBsAg, S Creatinine with GGT, RFT, HBsAg, S
Creatinine
# - Subject to no adverse health condition
25. Can a diabetic or Hypertensive patient be given Lifeline ?

If a customer with diabetes or hypertension can be offered Lifeline subject to underwriting criteria.
Underwriter will evaluate the medical history and accept the case either on standard rates or with loading/
co-payment.
26. Is new born baby covered in Lifeline ?

Medical expenses incurred on the treatment of New Born Baby is covered if claim for maternity benefit
(covered only under Elite Plan) is payable. New Born Baby is covered till the renewal of the policy.
27. Are first year vaccinations covered in Lifeline for children ?

First year vaccinations for New Born Baby is covered if claim for maternity benefit (covered only under
Elite Plan) is payable
28. I have my wife + 2 kids + my parents in laws and an aunt in my house, can you cover all of us in Life
line
Lifeline allows coverage for maximum of 2 Adults and 4 Children and relationship between the insured
has to be Self, Spouse and Dependent Children.
55
However, you can take 2 different policies of Lifeline to cover all of them.
Policy 1 – Self, Wife and 2 Kids
Policy 2 – Parents in Law
Policy 3 - Aunt
29. What is Doctor on Chat in Lifeline ? If I have high fever, can I contact your Doctor on Chat ?
Lifeline not only take care of your medical expenses but also provide benefits which help you in
proactively manage your good health. You can obtain opinion from a doctor using our Health & Wellness
Program. You can email your query on fever and you will get a response within 24 working hours. Please
note that this does not substitute the medical treatment you would have otherwise taken
30. For Doctor on Chat is it necessary to have internet connection? I don’t have internet at home so can I
chat with your doctors on Phone ?
Doctor on Chat facility is through email which can be accessed through Internet either on computer or
mobile phone
31. Can I buy 2 yr or 3 yr policy in Lifeline ? Will I not be a looser for such policies as I will block my
money for 2/3 yrs ?
You can buy 2 years or 3 years policy in Lifeline. You get a discount of 7.5% for 2 year policy tenure and
12% for 3 year policy tenure.
32. If I have a National Insurance policy from a Bank for the last 4 yrs, will you Port me in Lifeline ?
Lifeline will support the external as well as internal portability. You can port your existing policy from
National Insurance subject to underwriting
33. I am already having royal sundaram policy of 2 lakhs sum insured but its a old policy for the last 5
yrs, if I have to buy Lifeline can I buy additionally or can I port from existing RS policy ?
You can either buy a fresh policy of Lifeline or port the existing policy
34. Is Ventillator treatment covered in Lifeline ?

Ventillator treatment is covered if the person is not brain dead
35. Are natural calamities like Hurrican Hudhud covered in Lifeline ?

Any hospitalization due to these natural calamities like Hudhud is covered
36. I am covered in a Family policy taken by my father – 5 lakhs for say 3 yrs, and I meet a girl after 3 yrs
who is also covered in Lifeline alongwith her father in a policy of say 10 lakhs, and if we decide to
marry, how will NCB be transferred to the new Lifeline policy for me and my wife ?
If 2 individual policies of Lifeline are converted into Family Floater, the NCB transferred will be the lower
of the 2 policies
37. I have a Piles problem and I go abroad frequently. If I start facing Piles problem when I am abroad can
I claim under Lifeline ?
Worldwide Emergency Hospitalization covers treatment abroad due to any emergency. Treatment of Piles
is not an emergency hospitalization and customer can wait to return back to India and take treatment.
Generally, Piles is under 2 year waiting period.
56
38. If I get admitted to a Suit in a Hospital will you pay me full ?
Yes. There is no capping on room rent category and customer can choose from any of the room available
in hospital
39. In Lifeline, what all expenses in a hospital not covered in the Policy?
Expenses which are not related to hospitalization are normally not covered. Please refer to policy
document for details of exclusion
57
PREMIUM TABLES
Premium Rate Table for Lifeline (Exclusive of Service Tax)
Premium rate tables - (Zone 1 rates without optional benefits and any Disease specific loading)
Premium rates are based on the age of the insured person.
Individual
Age Classic Supreme Elite
(yrs) 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
91 days 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
1 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
2 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
3 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
4 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
5 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
6 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
7 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
8 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
9 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
10 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
11 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
12 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
13 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
14 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
15 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
16 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
17 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
18 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
19 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
20 3,112 3,473 4,125 4,252 5,883 6,751 7,419 11,099 22,583 24,317 37,723 41,891 46,080
21 3,122 3,486 4,140 4,282 5,941 6,816 7,489 11,198 26,721 28,890 41,383 47,460 51,947
22 3,152 3,520 4,180 4,293 5,998 6,882 7,563 11,310 27,255 29,468 41,704 49,783 52,986
23 3,182 3,554 4,221 4,345 6,059 6,953 7,640 11,428 27,800 30,057 41,998 49,851 54,046
24 3,213 3,589 4,262 4,397 6,116 7,017 7,710 11,528 28,356 30,658 42,245 49,919 55,127
25 3,244 3,624 4,303 4,450 6,179 7,090 7,791 11,655 28,923 31,271 42,480 50,046 56,229
26 3,307 3,693 4,386 4,549 6,294 7,221 7,934 11,860 29,502 31,897 42,705 50,166 57,354
27 3,370 3,764 4,470 4,651 6,418 7,365 8,092 12,103 30,092 32,535 42,984 50,312 58,501
28 3,434 3,836 4,556 4,754 6,541 7,506 8,248 12,337 30,694 33,185 43,281 50,478 59,671
29 3,501 3,909 4,643 4,858 6,668 7,652 8,408 12,578 31,307 33,849 43,602 50,675 60,864
30 3,567 3,984 4,732 4,911 6,726 7,718 8,480 12,682 31,934 34,526 43,959 50,912 62,082
31 3,635 4,047 4,824 5,033 6,900 7,932 8,726 13,113 32,572 35,217 44,372 51,339 63,323
32 3,706 4,109 4,918 5,159 7,079 8,153 8,979 13,558 33,224 35,921 45,119 52,111 64,590
33 3,777 4,173 5,014 5,286 7,261 8,378 9,237 14,016 33,888 36,639 45,644 52,672 65,882
34 3,849 4,238 5,112 5,416 7,445 8,604 9,496 14,467 34,566 37,372 46,701 53,831 67,199
35 3,923 4,303 5,211 5,549 7,638 8,845 9,773 14,961 35,257 38,120 47,789 55,000 68,543
36 4,012 4,402 5,330 5,691 7,812 9,045 9,994 15,299 35,962 38,882 49,690 56,287 69,914
37 4,103 4,503 5,452 5,836 7,991 9,252 10,222 15,646 36,682 39,660 51,591 57,449 71,312
38 4,197 4,605 5,577 5,984 8,174 9,465 10,458 16,008 37,415 40,453 52,084 58,452 72,739
39 4,294 4,710 5,704 6,135 8,363 9,684 10,701 16,383 38,164 41,262 52,577 60,008 74,193
40 4,391 4,818 5,835 6,289 8,551 9,902 10,940 16,745 38,927 42,087 53,622 61,194 75,677
41 4,878 5,364 6,491 6,701 8,841 10,236 11,309 17,309 39,705 42,929 55,172 62,915 77,191
42 5,041 5,545 6,709 6,945 9,138 10,579 11,688 17,888 40,499 43,787 56,564 64,351 78,735
43 5,211 5,731 6,934 7,196 9,445 10,936 12,082 18,492 41,309 44,663 58,019 65,861 80,309
44 5,387 5,924 7,168 7,561 9,763 11,304 12,489 19,116 42,136 45,556 58,600 67,439 81,916
45 5,567 6,122 7,408 7,724 10,092 11,685 12,910 19,757 42,978 46,468 59,772 69,077 83,554
46 6,005 6,624 8,000 8,284 10,586 12,249 13,528 20,671 43,838 47,397 60,967 70,949 85,225
47 6,297 6,971 8,409 8,701 11,105 12,842 14,178 21,630 44,276 47,871 64,914 72,813 86,077
48 6,604 7,337 8,839 9,139 11,649 13,462 14,857 22,629 44,719 48,350 66,769 74,749 86,938
49 6,927 7,723 9,289 9,599 12,219 14,111 15,566 23,670 45,166 48,833 68,700 76,761 87,807
50 7,263 8,129 9,764 10,082 12,816 14,791 16,310 24,758 49,031 53,987 72,226 80,377 88,726
58
Premium rates are based on the age of the insured person.
Individual

51 7,832 8,886 10,641 11,391 14,125 16,301 17,975 27,285 51,075 56,279 74,151 82,373 90,973
52 8,251 9,494 11,334 12,302 15,255 17,605 19,413 29,468 53,222 58,686 76,201 84,506 93,371
53 8,695 10,143 12,073 13,287 16,475 19,014 20,967 31,826 55,476 61,213 78,413 86,819 95,970
54 9,162 10,836 12,858 14,349 17,793 20,535 22,644 34,372 57,843 63,867 80,843 89,374 98,837
55 9,654 11,577 13,696 15,497 19,217 22,178 24,455 37,122 58,641 64,798 83,557 92,248 1,02,035
56 10,265 12,371 14,636 16,010 20,754 23,952 26,412 40,091 61,286 67,790 86,644 95,541 1,05,721
57 10,815 13,100 15,499 17,290 22,415 25,868 28,525 43,299 64,056 70,922 89,461 99,377 1,10,009
58 11,396 13,872 16,412 18,674 24,208 27,938 30,807 46,762 66,989 74,240 93,796 1,03,903 1,15,063
59 12,008 14,690 17,381 20,168 26,144 30,173 33,271 50,503 70,049 77,701 96,040 1,05,478 1,16,852
60 12,654 15,557 18,406 21,176 27,452 31,681 34,935 54,933 73,269 81,344 98,437 1,07,044 1,18,629
61 13,435 16,570 19,604 22,224 28,251 32,604 35,952 56,533 74,970 83,281 1,03,156 1,08,824 1,20,642
62 14,263 17,650 20,882 23,558 29,946 34,560 38,109 59,925 78,683 87,480 1,07,824 1,16,106 1,28,757
63 15,144 18,801 22,244 24,971 31,743 36,634 40,396 63,521 82,446 91,738 1,14,591 1,23,564 1,37,070
64 16,079 20,026 23,693 26,469 33,648 38,832 42,820 67,332 86,262 96,056 1,18,602 1,27,888 1,45,590
65 17,072 21,331 25,238 27,793 35,330 40,773 44,961 70,699 88,605 98,694 1,22,160 1,31,725 1,46,778
66 17,990 22,478 26,596 29,738 37,803 43,628 48,108 75,647 91,019 1,01,410 1,25,824 1,35,677 1,48,341
67 18,957 23,687 28,027 31,820 40,449 46,682 51,476 80,943 94,334 1,05,140 1,28,341 1,39,747 1,49,905
68 19,976 24,961 29,535 34,047 43,281 49,949 55,079 86,609 97,781 1,09,020 1,34,356 1,45,675 1,61,648
69 21,051 26,305 31,124 36,431 46,310 53,446 58,934 92,671 1,06,129 1,18,498 1,44,679 1,57,722 1,75,016
70 22,182 27,720 32,798 37,159 47,237 54,515 60,113 94,525 1,14,476 1,27,976 1,56,011 1,70,689 1,89,405
71 23,194 28,983 34,292 38,274 48,654 56,150 61,916 97,828 1,20,716 1,35,221 1,68,608 1,84,625 2,05,232
72 24,250 30,303 35,855 40,116 50,270 57,603 63,243 99,925 1,29,417 1,45,059 1,82,131 1,99,414 2,21,719
73 25,354 31,684 37,488 41,941 52,558 60,226 66,125 1,04,477 1,38,799 1,55,668 1,96,715 2,15,367 2,39,505
74 26,510 33,128 39,198 43,851 54,950 62,968 69,135 1,09,233 1,48,704 1,66,870 2,12,404 2,32,218 2,58,295
75 27,718 34,638 40,984 45,846 57,451 65,833 72,280 1,14,203 1,59,029 1,78,547 2,28,900 2,49,793 2,77,895
76 28,746 35,922 42,505 47,543 59,576 68,268 74,953 1,18,425 1,69,938 1,90,887 2,46,938 2,68,372 2,98,617
77 29,811 37,255 44,081 49,303 61,781 70,794 77,727 1,22,808 1,81,541 2,04,014 2,65,905 2,88,141 3,20,668
78 30,917 38,636 45,716 51,129 64,070 73,418 80,608 1,27,360 1,93,941 2,18,042 2,86,144 3,08,310 3,44,241
79 32,063 40,069 47,411 53,022 66,443 76,136 83,592 1,32,075 2,07,211 2,33,057 3,07,681 3,29,892 3,69,479
80 33,252 41,555 49,170 54,987 68,906 78,958 86,692 1,36,973 2,21,436 2,49,152 3,30,526 3,52,985 3,96,543
81 33,586 41,973 49,665 56,098 70,298 80,554 88,444 1,39,741 2,36,709 2,66,434 3,54,660 3,77,693 4,25,608
82 33,927 42,400 50,170 56,665 71,009 81,369 89,338 1,41,155 2,49,631 2,81,063 3,75,299 4,04,132 4,50,249
83 34,275 42,835 50,685 57,245 71,735 82,201 90,252 1,42,598 2,62,911 2,96,100 3,97,226 4,22,421 4,75,585
84 34,631 43,280 51,211 57,836 72,477 83,050 91,184 1,44,071 2,76,592 3,11,591 4,17,466 4,39,318 5,01,696
85+ 34,976 43,711 51,721 58,440 73,234 83,918 92,137 1,45,577 2,90,543 3,27,390 4,38,341 4,65,677 5,28,333
59
Premium rates are based on the age of the eldest member to be insured in the family.
Family Floater: 1 Adult + 1 Childz
18 4,212 4,698 5,579 5,865 8,164 9,364 10,289 15,377 31,021 34,017 51,575 59,369 65,701
19 4,274 4,767 5,662 5,890 8,356 9,579 10,524 15,713 31,334 34,360 52,096 59,969 66,365
20 4,336 4,837 5,744 5,984 8,477 9,717 10,676 15,941 31,651 34,707 52,622 60,574 67,035
21 4,369 4,877 5,792 6,078 8,596 9,853 10,824 16,155 31,970 35,058 53,153 61,186 67,712
22 4,399 4,911 5,832 6,127 8,654 9,920 10,898 16,269 32,505 35,636 53,475 63,509 68,751
23 4,429 4,945 5,873 6,179 8,715 9,991 10,976 16,388 33,050 36,225 53,769 63,577 69,811
24 4,460 4,980 5,914 6,230 8,773 10,056 11,047 16,489 33,606 36,826 54,016 63,645 70,892
25 4,491 5,015 5,956 6,284 8,836 10,130 11,129 16,619 34,173 37,439 54,251 63,772 71,995
26 4,553 5,084 6,038 6,392 8,951 10,261 11,272 16,824 34,751 38,065 54,476 63,891 73,119
27 4,617 5,155 6,122 6,502 9,075 10,405 11,431 17,069 35,341 38,703 54,755 64,038 74,266
28 4,681 5,227 6,207 6,611 9,199 10,547 11,588 17,305 35,943 39,353 55,051 64,204 75,436
29 4,747 5,300 6,294 6,723 9,326 10,694 11,749 17,549 36,557 40,017 55,372 65,400 76,630
30 4,813 5,375 6,383 6,835 9,454 10,840 11,909 17,785 37,183 40,694 55,729 65,637 77,847
31 4,881 5,437 6,475 6,964 9,632 11,060 12,162 18,229 37,822 41,385 56,142 66,065 79,089
32 4,951 5,499 6,569 7,095 9,815 11,286 12,421 18,688 38,473 42,089 56,890 66,837 80,355
33 5,022 5,563 6,665 7,227 10,002 11,518 12,687 19,159 39,138 42,807 57,414 67,898 81,647
34 5,095 5,628 6,763 7,363 10,191 11,751 12,953 19,624 39,816 43,540 58,472 68,557 82,964
35 5,169 5,693 6,862 7,501 10,389 11,997 13,237 20,133 40,507 44,288 59,559 70,226 84,308
36 5,257 5,791 6,981 7,648 10,567 12,203 13,464 20,480 41,212 45,050 61,460 71,512 85,679
37 5,349 5,893 7,103 7,798 10,750 12,415 13,698 20,836 41,931 45,828 63,362 73,075 87,078
38 5,443 5,995 7,227 7,951 10,938 12,633 13,940 21,207 42,665 46,621 63,855 74,677 88,504
39 5,540 6,102 7,358 8,126 11,156 12,885 14,218 21,632 43,282 46,989 64,010 80,066 89,075
40 5,649 6,224 7,504 8,303 11,372 13,135 14,493 22,050 44,007 47,744 64,415 80,867 89,647
41 5,926 6,534 7,876 8,622 11,786 13,613 15,022 22,858 44,278 47,989 65,694 80,969 89,717
42 6,203 6,843 8,247 8,884 12,118 13,997 15,445 23,501 44,558 48,244 66,806 81,058 90,533
43 6,386 7,065 8,519 9,045 12,312 14,232 15,708 23,937 46,165 50,097 67,917 81,147 92,990
44 6,662 7,374 8,890 9,068 12,704 14,683 16,204 24,686 46,992 50,990 68,497 81,525 94,596
45 6,938 7,683 9,261 9,358 13,047 15,079 16,642 25,354 49,212 53,424 70,888 82,558 98,188
46 7,220 7,996 9,636 10,116 13,575 15,682 17,303 26,329 50,250 54,546 72,191 84,863 1,00,205
47 7,513 8,343 10,044 10,547 14,116 16,299 17,979 27,327 51,255 55,637 73,634 86,560 1,02,209
48 7,819 8,709 10,473 11,000 14,682 16,945 18,686 28,367 52,280 56,749 75,107 88,291 1,04,254
49 8,142 9,095 10,923 11,475 15,274 17,620 19,424 29,450 53,326 57,884 76,609 90,057 1,06,339
50 8,478 9,500 11,398 11,647 15,896 18,327 20,198 30,582 54,392 59,042 78,142 91,858 1,08,466
51 8,977 10,204 12,207 12,797 16,920 19,483 21,454 32,376 57,848 63,806 85,083 95,656 1,08,692
52 9,475 10,909 13,016 13,623 17,945 20,639 22,711 34,171 59,995 66,213 87,133 97,788 1,08,918
53 9,974 11,614 13,826 14,451 18,971 21,795 23,969 35,968 61,497 67,904 88,131 98,625 1,09,789
54 10,474 12,319 14,636 15,281 19,996 22,953 25,227 37,765 63,864 70,558 90,560 1,01,180 1,12,657
55 10,973 13,024 15,447 16,114 21,023 24,111 26,486 39,564 64,661 71,489 93,275 1,04,055 1,15,854
56 11,473 13,730 16,258 16,949 22,050 25,269 27,746 41,364 67,307 74,481 96,362 1,07,348 1,19,540
57 12,023 14,458 17,120 17,857 23,200 26,586 29,191 43,513 70,077 77,613 99,179 1,11,183 1,23,828
58 12,603 15,228 18,031 18,819 24,667 28,423 31,367 47,558 73,010 80,931 1,03,514 1,15,709 1,28,883
59 13,214 16,046 18,999 20,314 26,544 30,555 33,689 50,917 76,822 85,229 1,06,973 1,18,761 1,32,398
60 13,859 16,911 20,022 21,812 28,422 32,688 36,011 56,201 79,848 88,656 1,09,057 1,19,188 1,33,731
61 14,639 17,922 21,219 23,314 30,301 34,822 38,334 59,673 81,743 90,809 1,14,088 1,22,106 1,36,188
62 15,466 19,000 22,495 24,819 32,181 36,957 40,658 63,147 85,456 95,008 1,18,756 1,29,388 1,44,304
63 16,345 20,149 23,854 26,327 34,062 39,093 42,983 66,623 89,219 99,265 1,25,523 1,36,846 1,52,617
64 17,278 21,373 25,302 27,838 35,943 41,229 45,308 70,099 93,787 1,04,420 1,30,748 1,42,646 1,62,863
65 18,270 22,676 26,845 29,352 37,825 43,366 47,635 73,577 96,883 1,07,894 1,35,521 1,47,959 1,63,376
66 19,187 23,822 28,202 30,869 39,708 45,504 49,962 79,647 97,792 1,08,937 1,36,757 1,48,959 1,63,888
67 20,154 25,030 29,631 32,455 41,708 47,795 52,477 84,943 1,01,703 1,13,295 1,42,227 1,54,917 1,70,443
68 21,171 26,303 31,138 34,128 44,618 51,212 56,125 90,609 1,05,771 1,17,827 1,47,916 1,58,016 1,77,261
69 22,245 27,646 32,726 36,477 47,135 54,451 59,717 96,671 1,10,002 1,22,540 1,53,833 1,64,336 1,84,352
70 23,376 29,059 34,399 37,749 48,383 55,444 60,876 98,525 1,15,502 1,28,667 1,64,986 1,74,910 1,91,726
60

(yrs.) 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
71 24,387 30,322 35,893 39,413 50,475 57,842 63,509 1,00,344 1,25,320 1,38,894 1,77,592 1,86,885 2,08,572
72 25,442 31,642 37,456 41,153 52,659 60,343 66,254 1,04,682 1,35,679 1,50,205 1,91,566 2,01,383 2,23,527
73 26,546 33,023 39,088 42,972 54,946 62,965 69,134 1,09,231 1,46,876 1,62,428 2,05,963 2,17,038 2,42,348
74 27,702 34,467 40,798 44,876 57,337 65,705 72,142 1,13,984 1,55,477 1,73,561 2,22,107 2,35,170 2,61,750
75 28,909 35,976 42,583 46,865 59,836 68,568 75,286 1,18,951 1,65,802 1,85,238 2,38,603 2,52,745 2,81,350
76 29,938 37,261 44,104 48,563 61,961 71,003 77,958 1,23,173 1,76,711 1,97,578 2,56,941 2,71,323 3,02,072
77 31,003 38,594 45,681 50,325 64,166 73,529 80,731 1,27,556 1,88,314 2,10,705 2,76,908 2,91,092 3,24,123
78 32,109 39,975 47,316 52,152 66,454 76,152 83,612 1,32,106 2,00,714 2,24,733 2,97,147 3,11,262 3,47,695
79 33,256 41,409 49,011 54,046 68,826 78,870 86,595 1,36,821 2,13,984 2,39,748 3,18,684 3,30,223 3,72,934
80 34,445 42,895 50,771 56,012 71,289 81,692 89,694 1,41,717 2,28,210 2,55,843 3,42,029 3,53,315 3,99,998
81 34,782 43,316 51,269 57,140 72,683 83,289 91,449 1,44,489 2,43,482 2,73,125 3,66,663 3,78,024 4,29,063
82 35,126 43,745 51,777 57,732 73,397 84,108 92,347 1,45,908 2,56,404 2,87,754 3,87,302 4,05,463 4,53,704
83 35,477 44,184 52,295 58,336 74,126 84,943 93,264 1,47,357 2,69,684 3,02,791 4,08,729 4,26,752 4,79,040
84 35,835 44,631 52,824 58,951 74,870 85,796 94,200 1,48,837 2,83,365 3,18,282 4,30,469 4,48,649 5,05,151
85+ 36,182 45,065 53,338 59,578 75,630 86,666 95,157 1,50,347 2,97,316 3,34,081 4,51,344 4,74,008 5,31,787
61
Family Floater: 1 Adult + 2 Children

18 4,694 5,236 6,219 6,705 9,200 10,552 11,594 17,327 36,115 40,001 62,995 72,687 80,440
19 4,792 5,346 6,349 6,785 9,473 10,860 11,932 17,817 36,479 40,405 63,632 73,421 81,253
20 4,890 5,455 6,478 6,937 9,677 11,094 12,189 18,200 36,848 40,814 64,274 74,163 82,073
21 4,982 5,555 6,603 7,057 9,834 11,272 12,384 18,486 37,220 41,226 64,924 74,912 82,902
22 5,075 5,655 6,727 7,103 9,888 11,335 12,453 18,592 37,754 41,804 65,245 77,235 83,610
23 5,168 5,755 6,851 7,150 9,945 11,401 12,527 18,704 38,300 42,393 65,539 77,303 84,883
24 5,260 5,855 6,975 7,197 9,999 11,462 12,593 18,798 38,856 42,994 65,786 77,371 86,181
25 5,353 5,955 7,100 7,246 10,058 11,531 12,670 18,919 39,423 43,607 66,021 77,498 87,490
26 5,446 6,055 7,224 7,524 10,400 11,922 13,097 19,552 40,001 44,233 66,246 77,617 88,827
27 5,538 6,155 7,348 7,635 10,517 12,058 13,248 19,784 40,591 44,871 66,525 77,764 90,184
28 5,631 6,255 7,472 7,745 10,634 12,193 13,396 20,008 41,193 45,521 66,822 77,930 91,563
29 5,723 6,355 7,597 7,855 10,755 12,332 13,550 20,240 41,807 46,185 67,142 80,126 93,884
30 5,816 6,455 7,721 7,966 10,876 12,471 13,701 20,465 42,433 46,862 67,499 80,363 95,312
31 5,909 6,555 7,845 8,092 11,046 12,681 13,942 20,887 43,072 47,553 67,912 80,791 96,717
32 6,001 6,655 7,969 8,219 11,220 12,896 14,189 21,325 43,723 48,257 68,660 81,562 98,059
33 6,094 6,755 8,093 8,348 11,398 13,117 14,443 21,774 44,388 48,975 69,184 83,124 99,956
34 6,186 6,855 8,218 8,479 11,578 13,339 14,696 22,217 45,065 49,708 70,242 83,283 1,00,785
35 6,279 6,955 8,342 8,613 11,767 13,574 14,967 22,703 45,757 50,456 71,329 85,452 1,02,588
36 6,372 7,055 8,466 8,754 11,936 13,770 15,184 23,034 46,462 51,218 73,231 86,738 1,03,921
37 6,464 7,155 8,590 8,898 12,112 13,973 15,407 23,373 47,181 51,996 75,132 88,701 1,05,698
38 6,557 7,255 8,715 9,045 12,291 14,181 15,637 23,728 47,915 52,789 75,625 89,588 1,06,175
39 6,650 7,355 8,839 9,227 12,517 14,441 15,925 24,165 48,401 53,217 75,643 90,483 1,07,236
40 6,742 7,455 8,963 9,410 12,741 14,701 16,211 24,599 48,562 53,316 75,751 91,388 1,08,309
41 6,835 7,555 9,087 9,730 13,155 15,180 16,740 25,407 48,851 53,451 76,516 92,302 1,09,392
42 7,013 7,752 9,324 9,995 13,490 15,566 17,166 26,053 49,117 54,033 77,048 93,225 1,10,486
43 7,029 7,797 9,394 10,056 13,553 15,659 17,274 26,284 51,021 55,531 77,815 94,157 1,11,591
44 7,198 7,982 9,618 10,244 13,992 16,160 17,825 27,101 51,848 56,424 78,395 95,099 1,12,706
45 7,371 8,173 9,849 10,432 14,320 16,538 18,243 27,739 55,446 60,380 82,005 97,839 1,16,362
46 7,797 8,658 10,421 10,653 14,831 17,121 18,881 28,680 56,662 61,694 83,414 1,00,577 1,18,760
47 8,076 8,990 10,811 11,064 15,347 17,710 19,527 29,633 58,233 63,402 83,430 1,02,107 1,20,567
48 8,369 9,339 11,221 11,497 15,887 18,326 20,202 30,626 59,841 65,149 83,446 1,03,634 1,22,370
49 8,678 9,708 11,651 11,951 16,453 18,971 20,907 31,660 61,485 66,935 86,519 1,05,153 1,23,594
50 9,000 10,095 12,104 12,428 17,047 19,647 21,646 32,742 63,053 69,135 94,095 1,07,046 1,24,830
51 9,596 10,900 13,045 13,541 18,494 21,292 23,443 35,363 64,621 71,334 96,015 1,08,938 1,26,078
52 10,192 11,706 13,987 14,659 19,942 22,938 25,241 37,987 66,768 73,741 98,065 1,11,070 1,27,339
53 10,789 12,512 14,929 15,225 20,870 23,979 26,315 39,360 67,517 74,595 99,171 1,12,028 1,28,612
54 11,387 13,320 15,872 16,174 21,579 24,670 27,041 40,045 69,884 77,249 1,00,278 1,12,986 1,29,899
55 11,985 14,127 16,816 16,989 22,249 25,368 27,760 40,827 70,682 78,180 1,02,992 1,15,861 1,31,198
56 12,583 14,936 17,760 18,022 22,892 26,092 28,547 41,945 73,327 81,172 1,06,079 1,19,154 1,32,688
57 13,182 15,745 18,705 18,730 23,508 26,948 29,590 44,135 76,097 84,304 1,08,896 1,22,989 1,36,977
58 13,782 16,555 19,572 19,715 24,999 28,814 31,801 48,244 79,030 87,622 1,13,231 1,27,515 1,42,033
59 14,382 17,365 20,597 20,701 26,906 30,980 34,075 51,327 83,595 92,756 1,17,905 1,32,043 1,47,206
60 14,982 18,175 21,544 21,941 28,814 33,148 36,520 57,029 86,428 95,968 1,19,676 1,33,715 1,50,031
61 15,583 18,986 22,491 23,379 30,724 35,317 38,881 60,561 88,516 98,336 1,25,021 1,35,388 1,51,002
62 16,409 20,062 23,765 24,893 32,635 37,488 41,245 64,094 92,229 1,02,535 1,29,688 1,42,671 1,59,117
63 17,287 21,210 25,123 26,411 34,547 39,660 43,609 67,631 95,992 1,06,793 1,36,455 1,50,128 1,67,430
64 18,218 22,431 26,568 27,933 36,461 41,833 45,976 71,169 1,01,313 1,12,784 1,42,895 1,57,904 1,80,284
65 19,209 23,733 28,109 29,458 38,376 44,008 48,343 74,710 1,05,161 1,17,094 1,48,883 1,64,193 1,81,301
66 20,125 24,878 29,465 30,986 41,029 46,744 50,712 83,647 1,07,117 1,19,272 1,52,498 1,67,140 1,83,891
67 21,091 26,085 30,893 32,584 42,328 48,515 53,272 88,943 1,09,073 1,21,449 1,56,113 1,70,088 1,87,134
68 22,107 27,357 32,399 34,476 45,287 51,992 56,983 94,609 1,13,762 1,26,633 1,61,475 1,71,356 1,92,227
69 23,180 28,698 33,985 36,787 47,850 55,287 60,043 1,00,671 1,13,876 1,26,881 1,64,986 1,82,951 2,05,233
70 24,310 30,111 35,657 37,921 49,123 56,304 61,217 1,02,525 1,16,529 1,29,357 1,75,961 1,99,130 2,18,275
62

71 25,321 31,374 37,151 40,065 51,254 58,746 64,505 1,01,919 1,29,924 1,42,566 1,88,576 2,11,145 2,35,647
72 26,376 32,693 38,713 41,703 54,421 62,391 68,515 1,08,254 1,41,941 1,55,350 2,03,001 2,27,353 2,52,352
73 27,480 34,073 40,346 43,512 56,703 65,008 71,390 1,12,796 1,54,953 1,69,188 2,17,211 2,44,709 2,73,246
74 28,635 35,517 42,055 45,404 59,090 67,743 74,392 1,17,540 1,62,250 1,80,252 2,33,810 2,66,121 2,96,199
75 29,842 37,026 43,840 47,383 61,584 70,601 77,530 1,22,498 1,72,575 1,91,929 2,50,305 2,76,766 3,08,090
76 30,871 38,311 45,361 49,082 63,710 73,037 80,204 1,26,722 1,83,484 2,04,270 2,68,943 2,98,907 3,32,781
77 31,937 39,645 46,938 50,843 65,916 75,564 82,979 1,31,107 1,95,087 2,17,396 2,89,911 3,13,853 3,49,466
78 33,043 40,663 48,140 52,191 68,206 78,188 85,860 1,35,659 2,07,487 2,31,424 3,10,150 3,35,822 3,75,131
79 34,190 42,125 49,869 54,121 69,959 80,178 88,037 1,39,098 2,20,757 2,46,439 3,32,687 3,59,330 4,05,806
80 35,380 43,641 51,664 56,123 72,470 83,056 91,197 1,44,091 2,34,983 2,62,534 3,58,532 3,77,296 4,27,147
81 35,582 44,074 52,175 57,286 73,895 84,689 92,990 1,46,925 2,50,255 2,79,816 3,83,666 4,03,707 4,58,214
82 35,796 44,515 52,697 57,913 74,629 85,530 93,913 1,48,383 2,63,177 2,94,445 4,07,305 4,27,930 4,78,844
83 36,088 44,964 53,228 58,550 75,378 86,388 94,855 1,49,871 2,76,457 3,09,482 4,28,231 4,49,326 5,04,381
84 36,456 45,423 53,771 59,199 76,142 87,263 95,816 1,51,389 2,90,138 3,24,973 4,51,472 4,71,792 5,31,209
85+ 36,813 45,868 54,297 59,859 76,922 88,157 96,797 1,52,940 3,04,089 3,40,772 4,72,346 4,95,382 5,55,767
63

18 5,734 6,496 7,759 8,605 11,300 12,852 14,094 21,077 40,929 45,372 69,569 79,778 88,218
19 5,832 6,606 7,889 8,685 11,573 13,160 14,432 21,567 41,294 45,776 70,206 80,512 89,030
20 5,930 6,715 8,018 8,837 11,777 13,394 14,689 21,950 41,663 46,184 70,848 81,254 89,851
21 6,022 6,815 8,143 8,957 11,934 13,572 14,884 22,236 42,035 46,596 71,498 82,003 90,680
22 6,115 6,915 8,267 9,003 11,988 13,635 14,953 22,342 42,569 47,174 71,819 84,326 91,388
23 6,208 7,015 8,391 9,050 12,045 13,701 15,027 22,454 43,114 47,763 72,113 84,393 92,660
24 6,300 7,115 8,515 9,097 12,099 13,762 15,093 22,548 43,670 48,364 72,360 84,461 93,958
25 6,393 7,215 8,640 9,146 12,158 13,831 15,170 22,669 44,237 48,978 72,595 84,588 95,268
26 6,486 7,315 8,764 9,424 12,500 14,222 15,597 23,302 44,816 49,603 72,820 84,708 96,605
27 6,578 7,415 8,888 9,535 12,617 14,358 15,748 23,534 45,406 50,241 73,099 84,855 97,962
28 6,671 7,515 9,012 9,645 12,734 14,493 15,896 23,758 46,008 50,892 73,395 85,020 99,341
29 6,763 7,615 9,137 9,755 12,855 14,632 16,050 23,990 46,622 51,555 73,716 87,217 1,01,662
30 6,856 7,715 9,261 9,866 12,976 14,771 16,201 24,215 47,248 52,232 74,073 87,454 1,03,090
31 6,949 7,815 9,385 9,992 13,146 14,981 16,442 24,637 47,886 52,923 74,486 87,881 1,04,495
32 7,041 7,915 9,509 10,119 13,320 15,196 16,689 25,075 48,538 53,627 75,234 88,653 1,05,837
33 7,134 8,015 9,633 10,248 13,498 15,417 16,943 25,524 49,202 54,346 75,758 90,215 1,07,733
34 7,226 8,115 9,758 10,379 13,678 15,639 17,196 25,967 49,880 55,078 76,816 90,374 1,08,563
35 7,319 8,215 9,882 10,513 13,867 15,874 17,467 26,453 50,571 55,826 77,903 92,542 1,10,365
36 7,412 8,315 10,006 10,654 14,036 16,070 17,684 26,784 51,277 56,588 79,805 93,829 1,11,699
37 7,504 8,415 10,130 10,798 14,212 16,273 17,907 27,123 51,996 57,366 81,706 95,791 1,13,475
38 7,597 8,515 10,255 10,945 14,391 16,481 18,137 27,478 52,729 58,159 82,199 96,678 1,13,952
39 7,690 8,615 10,379 11,127 14,617 16,741 18,425 27,915 53,215 58,587 82,217 97,574 1,15,014
40 7,782 8,715 10,503 11,310 14,841 17,001 18,711 28,349 53,377 58,686 82,325 98,479 1,16,086
41 7,875 8,815 10,627 11,630 15,255 17,480 19,240 29,157 53,665 58,821 83,090 99,393 1,17,169
42 8,053 9,012 10,864 11,895 15,590 17,866 19,666 29,803 53,931 59,403 83,622 1,00,316 1,18,263
43 8,069 9,057 10,934 11,956 15,653 17,959 19,774 30,034 55,836 60,901 84,389 1,01,248 1,19,368
44 8,238 9,242 11,158 12,144 16,092 18,460 20,325 30,851 56,662 61,794 84,969 1,02,190 1,20,484
45 8,411 9,433 11,389 12,332 16,420 18,838 20,743 31,489 60,261 65,750 88,579 1,04,930 1,24,140
46 8,837 9,918 11,961 12,553 16,931 19,421 21,381 32,430 61,476 67,065 89,988 1,07,667 1,26,538
47 9,116 10,250 12,351 12,964 17,447 20,010 22,027 33,383 63,048 68,772 90,004 1,09,198 1,28,345
48 9,409 10,599 12,761 13,397 17,987 20,626 22,702 34,376 64,655 70,519 90,019 1,10,725 1,30,148
49 9,718 10,968 13,191 13,851 18,553 21,271 23,407 35,410 66,299 72,306 93,093 1,12,244 1,31,372
50 10,040 11,355 13,644 14,328 19,147 21,947 24,146 36,492 67,868 74,505 1,00,669 1,14,136 1,32,607
51 10,636 12,160 14,585 15,441 20,594 23,592 25,943 39,113 69,436 76,704 1,02,589 1,16,028 1,33,856
52 11,232 12,966 15,527 16,559 22,042 25,238 27,741 41,737 71,583 79,111 1,04,639 1,18,161 1,35,117
53 11,829 13,772 16,469 17,125 22,970 26,279 28,815 43,110 72,332 79,966 1,05,745 1,19,119 1,36,390
54 12,427 14,580 17,412 18,074 23,679 26,970 29,541 43,795 74,699 82,619 1,06,852 1,20,077 1,37,676
55 13,025 15,387 18,356 18,889 24,349 27,668 30,260 44,577 75,496 83,550 1,09,566 1,22,952 1,38,975
56 13,623 16,196 19,300 19,922 24,992 28,392 31,047 45,695 78,142 86,542 1,12,653 1,26,245 1,40,465
57 14,222 17,005 20,245 20,630 25,608 29,248 32,090 47,885 80,912 89,675 1,15,470 1,30,080 1,44,755
58 14,822 17,815 21,112 21,615 27,099 31,114 34,301 51,994 83,845 92,992 1,19,805 1,34,606 1,49,811
59 15,422 18,625 22,137 22,601 29,006 33,280 36,575 55,077 88,410 98,127 1,24,479 1,39,133 1,54,983
60 16,022 19,435 23,084 23,841 30,914 35,448 39,020 60,779 91,242 1,01,339 1,26,250 1,40,806 1,57,808
61 16,623 20,246 24,031 25,279 32,824 37,617 41,381 64,311 93,331 1,03,706 1,31,594 1,42,478 1,58,780
62 17,449 21,322 25,305 26,793 34,735 39,788 43,745 67,844 97,044 1,07,905 1,36,262 1,49,761 1,66,895
63 18,327 22,470 26,663 28,311 36,647 41,960 46,109 71,381 1,00,806 1,12,163 1,43,029 1,57,219 1,75,207
64 19,258 23,691 28,108 29,833 38,561 44,133 48,476 74,919 1,06,127 1,18,154 1,49,469 1,64,995 1,88,061
65 20,249 24,993 29,649 31,358 40,476 46,308 50,843 78,460 1,09,976 1,22,464 1,55,457 1,71,283 1,89,078
66 21,165 26,138 31,005 32,886 43,129 49,044 53,212 87,397 1,11,932 1,24,642 1,59,072 1,74,231 1,91,669
67 22,131 27,345 32,433 34,484 44,428 50,815 55,772 92,693 1,13,888 1,26,819 1,62,687 1,77,178 1,94,912
68 23,147 28,617 33,939 36,376 47,387 54,292 59,483 98,359 1,18,576 1,32,003 1,68,049 1,78,447 2,00,004
69 24,220 29,958 35,525 38,687 49,950 57,587 62,543 1,04,421 1,18,690 1,32,251 1,71,560 1,90,041 2,13,011
70 25,350 31,371 37,197 39,821 51,223 58,604 63,717 1,06,275 1,21,343 1,34,727 1,82,534 2,06,221 2,26,052
64

71 26,361 32,634 38,691 41,965 53,354 61,046 67,005 1,05,669 1,34,738 1,47,937 1,95,150 2,18,236 2,43,425
72 27,416 33,953 40,253 43,603 56,521 64,691 71,015 1,12,004 1,46,756 1,60,721 2,09,575 2,34,443 2,60,129
73 28,520 35,333 41,886 45,412 58,803 67,308 73,890 1,16,546 1,59,768 1,74,558 2,23,785 2,51,800 2,81,024
74 29,675 36,777 43,595 47,304 61,190 70,043 76,892 1,21,290 1,67,065 1,85,622 2,40,384 2,73,212 3,03,977
75 30,882 38,286 45,380 49,283 63,684 72,901 80,030 1,26,248 1,77,389 1,97,300 2,56,879 2,83,857 3,15,867
76 31,911 39,571 46,901 50,982 65,810 75,337 82,704 1,30,472 1,88,298 2,09,640 2,75,517 3,05,998 3,40,559
77 32,977 40,905 48,478 52,743 68,016 77,864 85,479 1,34,857 1,99,902 2,22,766 2,96,485 3,20,943 3,57,243
78 34,083 41,923 49,680 54,091 70,306 80,488 88,360 1,39,409 2,12,301 2,36,795 3,16,724 3,42,913 3,82,908
79 35,230 43,385 51,409 56,021 72,059 82,478 90,537 1,42,848 2,25,572 2,51,809 3,39,261 3,66,421 4,13,584
80 36,420 44,901 53,204 58,023 74,570 85,356 93,697 1,47,841 2,39,797 2,67,905 3,65,106 3,84,387 4,34,925
81 36,622 45,334 53,715 59,186 75,995 86,989 95,490 1,50,675 2,55,070 2,85,186 3,90,240 4,10,798 4,65,991
82 36,836 45,775 54,237 59,813 76,729 87,830 96,413 1,52,133 2,67,992 2,99,816 4,13,879 4,35,020 4,86,622
83 37,128 46,224 54,768 60,450 77,478 88,688 97,355 1,53,621 2,81,272 3,14,852 4,34,805 4,56,417 5,12,158
84 37,496 46,683 55,311 61,099 78,242 89,563 98,316 1,55,139 2,94,952 3,30,343 4,58,046 4,78,883 5,38,987
85+ 37,853 47,128 55,837 61,759 79,022 90,457 99,297 1,56,690 3,08,903 3,46,142 4,78,920 5,02,473 5,63,545
65

18 6,774 7,756 9,299 10,505 13,400 15,152 16,594 24,827 45,744 50,742 76,143 86,868 95,995
19 6,872 7,866 9,429 10,585 13,673 15,460 16,932 25,317 46,109 51,146 76,779 87,602 96,808
20 6,970 7,975 9,558 10,737 13,877 15,694 17,189 25,700 46,477 51,554 77,422 88,344 97,628
21 7,062 8,075 9,683 10,857 14,034 15,872 17,384 25,986 46,849 51,966 78,071 89,093 98,457
22 7,155 8,175 9,807 10,903 14,088 15,935 17,453 26,092 47,384 52,544 78,393 91,416 99,165
23 7,248 8,275 9,931 10,950 14,145 16,001 17,527 26,204 47,929 53,133 78,687 91,484 1,00,438
24 7,340 8,375 10,055 10,997 14,199 16,062 17,593 26,298 48,485 53,735 78,934 91,552 1,01,736
25 7,433 8,475 10,180 11,046 14,258 16,131 17,670 26,419 49,052 54,348 79,169 91,679 1,03,045
26 7,526 8,575 10,304 11,324 14,600 16,522 18,097 27,052 49,630 54,973 79,394 91,798 1,04,383
27 7,618 8,675 10,428 11,435 14,717 16,658 18,248 27,284 50,221 55,611 79,673 91,945 1,05,739
28 7,711 8,775 10,552 11,545 14,834 16,793 18,396 27,508 50,822 56,262 79,969 92,111 1,07,119
29 7,803 8,875 10,677 11,655 14,955 16,932 18,550 27,740 51,436 56,926 80,290 94,307 1,09,439
30 7,896 8,975 10,801 11,766 15,076 17,071 18,701 27,965 52,062 57,602 80,647 94,544 1,10,867
31 7,989 9,075 10,925 11,892 15,246 17,281 18,942 28,387 52,701 58,293 81,060 94,972 1,12,273
32 8,081 9,175 11,049 12,019 15,420 17,496 19,189 28,825 53,352 58,997 81,808 95,744 1,13,614
33 8,174 9,275 11,173 12,148 15,598 17,717 19,443 29,274 54,017 59,716 82,332 97,305 1,15,511
34 8,266 9,375 11,298 12,279 15,778 17,939 19,696 29,717 54,695 60,449 83,390 97,464 1,16,340
35 8,359 9,475 11,422 12,413 15,967 18,174 19,967 30,203 55,386 61,196 84,477 99,633 1,18,143
36 8,452 9,575 11,546 12,554 16,136 18,370 20,184 30,534 56,091 61,958 86,378 1,00,919 1,19,477
37 8,544 9,675 11,670 12,698 16,312 18,573 20,407 30,873 56,810 62,736 88,280 1,02,882 1,21,253
38 8,637 9,775 11,795 12,845 16,491 18,781 20,637 31,228 57,544 63,529 88,773 1,03,769 1,21,730
39 8,730 9,875 11,919 13,027 16,717 19,041 20,925 31,665 58,030 63,957 88,791 1,04,664 1,22,791
40 8,822 9,975 12,043 13,210 16,941 19,301 21,211 32,099 58,191 64,056 88,899 1,05,569 1,23,864
41 8,915 10,075 12,167 13,530 17,355 19,780 21,740 32,907 58,480 64,191 89,664 1,06,483 1,24,947
42 9,093 10,272 12,404 13,795 17,690 20,166 22,166 33,553 58,746 64,773 90,196 1,07,406 1,26,041
43 9,109 10,317 12,474 13,856 17,753 20,259 22,274 33,784 60,651 66,271 90,963 1,08,338 1,27,146
44 9,278 10,502 12,698 14,044 18,192 20,760 22,825 34,601 61,477 67,164 91,543 1,09,280 1,28,262
45 9,451 10,693 12,929 14,232 18,520 21,138 23,243 35,239 65,076 71,121 95,153 1,12,021 1,31,917
46 9,877 11,178 13,501 14,453 19,031 21,721 23,881 36,180 66,291 72,435 96,562 1,14,758 1,34,315
47 10,156 11,510 13,891 14,864 19,547 22,310 24,527 37,133 67,863 74,143 96,578 1,16,288 1,36,122
48 10,449 11,859 14,301 15,297 20,087 22,926 25,202 38,126 69,470 75,889 96,593 1,17,815 1,37,925
49 10,758 12,228 14,731 15,751 20,653 23,571 25,907 39,160 71,114 77,676 99,667 1,19,334 1,39,149
50 11,080 12,615 15,184 16,228 21,247 24,247 26,646 40,242 72,682 79,875 1,07,242 1,21,227 1,40,385
51 11,676 13,420 16,125 17,341 22,694 25,892 28,443 42,863 74,251 82,074 1,09,163 1,23,119 1,41,633
52 12,272 14,226 17,067 18,459 24,142 27,538 30,241 45,487 76,398 84,481 1,11,213 1,25,251 1,42,894
53 12,869 15,032 18,009 19,025 25,070 28,579 31,315 46,860 77,147 85,336 1,12,319 1,26,209 1,44,168
54 13,467 15,840 18,952 19,974 25,779 29,270 32,041 47,545 79,513 87,989 1,13,426 1,27,167 1,45,454
55 14,065 16,647 19,896 20,789 26,449 29,968 32,760 48,327 80,311 88,920 1,16,140 1,30,042 1,46,753
56 14,663 17,456 20,840 21,822 27,092 30,692 33,547 49,445 82,957 91,912 1,19,227 1,33,335 1,48,243
57 15,262 18,265 21,785 22,530 27,708 31,548 34,590 51,635 85,726 95,045 1,22,044 1,37,170 1,52,532
58 15,862 19,075 22,652 23,515 29,199 33,414 36,801 55,744 88,660 98,363 1,26,379 1,41,696 1,57,588
59 16,462 19,885 23,677 24,501 31,106 35,580 39,075 58,827 93,225 1,03,497 1,31,053 1,46,224 1,62,761
60 17,062 20,695 24,624 25,741 33,014 37,748 41,520 64,529 96,057 1,06,709 1,32,824 1,47,896 1,65,586
61 17,663 21,506 25,571 27,179 34,924 39,917 43,881 68,061 98,146 1,09,076 1,38,168 1,49,569 1,66,557
62 18,489 22,582 26,845 28,693 36,835 42,088 46,245 71,594 1,01,858 1,13,276 1,42,836 1,56,852 1,74,672
63 19,367 23,730 28,203 30,211 38,747 44,260 48,609 75,131 1,05,621 1,17,533 1,49,603 1,64,309 1,82,985
64 20,298 24,951 29,648 31,733 40,661 46,433 50,976 78,669 1,10,942 1,23,525 1,56,043 1,72,085 1,95,839
65 21,289 26,253 31,189 33,258 42,576 48,608 53,343 82,210 1,14,791 1,27,835 1,62,031 1,78,374 1,96,856
66 22,205 27,398 32,545 34,786 45,229 51,344 55,712 91,147 1,16,746 1,30,012 1,65,646 1,81,321 1,99,446
67 23,171 28,605 33,973 36,384 46,528 53,115 58,272 96,443 1,18,702 1,32,190 1,69,261 1,84,269 2,02,689
68 24,187 29,877 35,479 38,276 49,487 56,592 61,983 1,02,109 1,23,391 1,37,373 1,74,623 1,85,537 2,07,782
69 25,260 31,218 37,065 40,587 52,050 59,887 65,043 1,08,171 1,23,505 1,37,621 1,78,134 1,97,132 2,20,788
70 26,390 32,631 38,737 41,721 53,323 60,904 66,217 1,10,025 1,26,158 1,40,097 1,89,108 2,13,311 2,33,830
66

71 27,401 33,894 40,231 43,865 55,454 63,346 69,505 1,09,419 1,39,553 1,53,307 2,01,724 2,25,326 2,51,202
72 28,456 35,213 41,793 45,503 58,621 66,991 73,515 1,15,754 1,51,570 1,66,091 2,16,149 2,41,534 2,67,907
73 29,560 36,593 43,426 47,312 60,903 69,608 76,390 1,20,296 1,64,583 1,79,928 2,30,359 2,58,890 2,88,801
74 30,715 38,037 45,135 49,204 63,290 72,343 79,392 1,25,040 1,71,880 1,90,992 2,46,958 2,80,302 3,11,755
75 31,922 39,546 46,920 51,183 65,784 75,201 82,530 1,29,998 1,82,204 2,02,670 2,63,453 2,90,947 3,23,645
76 32,951 40,831 48,441 52,882 67,910 77,637 85,204 1,34,222 1,93,113 2,15,010 2,82,091 3,13,088 3,48,337
77 34,017 42,165 50,018 54,643 70,116 80,164 87,979 1,38,607 2,04,717 2,28,137 3,03,059 3,28,034 3,65,021
78 35,123 43,183 51,220 55,991 72,406 82,788 90,860 1,43,159 2,17,116 2,42,165 3,23,298 3,50,003 3,90,686
79 36,270 44,645 52,949 57,921 74,159 84,778 93,037 1,46,598 2,30,386 2,57,179 3,45,835 3,73,511 4,21,361
80 37,460 46,161 54,744 59,923 76,670 87,656 96,197 1,51,591 2,44,612 2,73,275 3,71,679 3,91,478 4,42,703
81 37,662 46,594 55,255 61,086 78,095 89,289 97,990 1,54,425 2,59,884 2,90,556 3,96,814 4,17,888 4,73,769
82 37,876 47,035 55,777 61,713 78,829 90,130 98,913 1,55,883 2,72,806 3,05,186 4,20,453 4,42,111 4,94,399
83 38,168 47,484 56,308 62,350 79,578 90,988 99,855 1,57,371 2,86,086 3,20,222 4,41,379 4,63,507 5,19,936
84 38,536 47,943 56,851 62,999 80,342 91,863 1,00,816 1,58,889 2,99,767 3,35,713 4,64,620 4,85,974 5,46,764
85+ 38,893 48,388 57,377 63,659 81,122 92,757 1,01,797 1,60,440 3,13,718 3,51,512 4,85,494 5,09,563 5,71,322
67
Family Floater: 2 Adults

18 4,303 4,867 5,852 6,235 8,617 9,903 10,882 16,317 33,267 36,090 50,334 60,560 65,404
19 4,353 4,885 5,881 6,323 8,820 10,121 11,120 16,629 33,408 36,247 51,891 62,432 66,427
20 4,447 4,998 5,940 6,338 8,890 10,223 11,256 16,946 33,536 36,370 53,447 62,605 66,950
21 4,473 5,032 5,980 6,380 9,561 10,925 11,992 17,785 44,220 48,081 53,545 65,353 70,913
22 4,528 5,065 6,020 6,450 9,637 11,013 12,090 17,937 44,338 48,224 53,643 66,400 72,376
23 4,570 5,112 6,076 6,522 9,716 11,107 12,193 18,097 44,441 48,351 53,716 67,076 72,442
24 4,613 5,160 6,132 6,592 9,789 11,189 12,283 18,226 44,530 48,463 55,339 67,687 73,102
25 4,656 5,208 6,189 6,665 9,869 11,285 12,388 18,396 44,664 48,625 55,857 68,249 73,709
26 4,742 5,304 6,302 6,800 10,033 11,469 12,589 18,685 45,065 49,085 56,334 68,769 75,333
27 4,830 5,402 6,420 6,938 10,207 11,673 12,814 19,031 45,501 49,583 56,889 69,319 75,748
28 4,948 5,466 6,495 7,078 10,378 11,871 13,031 19,361 45,936 50,082 57,449 69,875 76,163
29 5,055 5,491 6,524 7,221 10,554 12,074 13,255 19,699 46,387 50,598 58,027 70,453 77,498
30 5,164 5,591 6,642 7,367 10,728 12,273 13,473 20,022 46,777 51,048 58,643 71,075 77,872
31 5,277 5,674 6,767 7,536 10,979 12,584 13,830 20,656 47,646 52,032 59,309 71,761 78,937
32 5,392 5,756 6,892 7,709 11,234 12,902 14,196 21,311 48,524 53,027 60,339 72,800 80,808
33 5,508 5,841 7,021 7,886 11,493 13,226 14,569 21,980 49,377 53,995 61,156 73,669 80,962
34 5,628 5,927 7,153 8,067 11,753 13,549 14,940 22,636 50,248 54,983 62,070 74,654 81,373
35 5,750 6,014 7,284 8,253 12,026 13,892 15,336 23,355 51,181 56,042 66,475 76,135 82,226
36 5,896 6,146 7,445 8,450 12,267 14,171 15,644 23,827 51,764 56,712 66,537 77,583 85,342
37 6,045 6,346 7,686 8,653 12,515 14,458 15,961 24,311 52,405 57,447 66,599 78,992 85,612
38 6,197 6,486 7,856 8,861 12,768 14,753 16,287 24,815 53,056 58,194 68,103 80,675 88,742
39 6,354 6,629 8,028 9,075 13,030 15,058 16,624 25,338 53,686 58,919 70,649 83,007 92,138
40 6,515 6,777 8,208 9,293 13,289 15,358 16,954 25,840 54,322 59,650 72,326 84,897 92,538
41 6,851 7,617 9,225 9,712 13,839 15,995 17,658 26,916 55,486 60,972 74,565 87,359 95,222
42 7,078 7,869 9,529 10,051 14,269 16,492 18,207 27,756 56,663 62,309 77,207 90,122 98,233
43 7,313 8,129 9,843 10,401 14,714 17,009 18,778 28,632 57,836 63,643 79,631 92,651 1,02,842
44 7,556 8,400 10,172 10,765 15,173 17,543 19,367 29,537 59,077 65,053 80,726 95,695 1,03,351
45 7,886 8,678 10,507 11,092 15,650 18,093 19,976 30,467 60,355 66,507 81,820 98,483 1,07,347
46 8,300 9,367 11,325 12,109 16,134 18,663 20,604 31,452 61,200 67,387 86,292 99,230 1,10,145
47 8,691 9,944 12,006 12,820 17,032 19,691 21,732 33,127 62,076 68,304 89,679 1,02,372 1,13,633
48 9,793 10,854 13,083 14,738 18,673 21,543 23,756 36,043 66,883 73,530 92,792 1,05,631 1,14,081
49 10,345 11,509 13,854 15,551 19,683 22,697 25,019 37,905 69,644 76,646 95,178 1,07,439 1,16,034
50 10,925 12,203 14,667 16,411 20,752 23,916 26,353 39,867 72,594 79,977 1,00,516 1,12,467 1,21,464
51 11,866 13,438 16,103 18,053 22,771 26,211 28,859 43,518 75,965 83,780 1,03,829 1,15,922 1,26,355
52 12,592 14,464 17,280 19,294 24,275 27,906 30,701 46,139 80,209 88,561 1,07,308 1,19,558 1,32,709
53 13,367 15,568 18,543 20,623 25,878 29,708 32,654 48,903 84,694 93,615 1,12,192 1,24,694 1,35,917
54 14,188 16,756 19,896 22,045 27,593 31,635 34,745 51,854 89,480 99,010 1,16,167 1,28,865 1,40,463
55 15,060 18,037 21,352 23,569 29,421 33,683 36,962 54,963 94,535 1,04,710 1,20,510 1,33,438 1,45,448
56 16,132 19,419 22,988 25,101 31,341 35,884 39,378 58,565 1,00,132 1,11,020 1,24,651 1,38,544 1,49,628
57 17,124 20,718 24,526 26,735 33,387 38,228 41,950 62,392 1,06,074 1,17,720 1,30,240 1,44,342 1,55,889
58 18,179 22,105 26,166 28,478 35,576 40,739 44,709 66,518 1,12,442 1,24,902 1,37,108 1,51,036 1,66,140
59 19,298 23,586 27,919 30,338 37,905 43,409 47,639 70,882 1,19,182 1,32,505 1,45,151 1,58,873 1,71,583
60 20,487 25,166 29,789 32,323 40,393 46,259 50,767 78,149 1,26,367 1,40,611 1,51,020 1,66,424 1,81,402
61 21,914 27,008 31,969 35,465 44,330 50,771 55,723 85,796 1,30,951 1,45,803 1,59,859 1,74,237 1,88,176
62 23,440 28,986 34,309 38,012 47,522 54,432 59,741 91,997 1,39,349 1,55,278 1,71,696 1,86,775 2,03,584
63 25,074 31,109 36,822 40,745 50,947 58,356 64,049 98,641 1,48,037 1,65,083 1,82,477 1,94,221 2,11,701
64 26,820 33,386 39,517 43,677 54,623 62,569 68,675 1,05,777 1,57,029 1,75,233 1,96,569 2,10,059 2,28,964
65 28,689 35,829 42,409 46,823 58,565 67,086 73,634 1,13,423 1,59,152 1,77,671 2,04,673 2,19,084 2,38,801
66 30,458 38,040 45,025 50,816 63,568 72,823 79,932 1,23,142 1,60,473 1,79,208 2,09,068 2,27,906 2,50,697
67 32,334 40,386 47,801 53,897 67,430 77,247 84,790 1,30,630 1,62,459 1,81,491 2,16,803 2,36,586 2,57,879
68 34,324 42,876 50,747 57,168 71,530 81,947 89,951 1,38,594 1,74,958 1,95,593 2,24,447 2,45,387 2,65,018
69 36,439 45,520 53,876 60,638 75,880 86,932 95,422 1,47,030 1,90,083 2,12,799 2,32,184 2,54,238 2,77,119
70 38,294 48,324 57,195 64,324 80,504 92,234 1,01,245 1,57,014 1,97,333 2,20,959 2,50,029 2,71,486 2,95,919
68
Family Floater: 2 Adults

71 40,131 50,899 60,242 67,701 84,741 97,090 1,06,579 1,68,394 2,08,253 2,33,637 2,70,945 2,95,292 3,21,869
72 42,050 53,609 63,449 71,255 89,196 1,02,193 1,12,180 1,77,245 2,23,481 2,50,854 2,94,088 3,21,273 3,56,613
73 44,060 56,463 66,825 75,235 94,315 1,08,087 1,18,679 1,87,512 2,39,898 2,69,419 3,19,218 3,49,254 3,80,687
74 46,166 59,467 70,381 78,672 98,621 1,13,022 1,24,097 1,96,073 2,57,233 2,89,022 3,46,338 3,78,919 4,13,021
75 48,368 62,224 73,643 82,264 1,03,122 1,18,179 1,29,758 2,05,018 2,75,300 3,09,458 3,75,040 4,10,004 4,51,005
76 50,260 64,537 76,379 85,321 1,06,949 1,22,564 1,34,572 2,12,624 2,94,391 3,31,053 4,06,431 4,43,310 4,87,641
77 52,224 66,938 79,220 88,490 1,10,921 1,27,114 1,39,568 2,20,517 3,14,697 3,54,024 4,39,794 4,78,635 5,16,926
78 54,261 69,424 82,163 91,779 1,15,043 1,31,839 1,44,756 2,28,714 3,36,396 3,78,574 4,75,490 5,16,092 5,57,379
79 56,374 72,004 85,216 95,188 1,19,316 1,36,733 1,50,129 2,37,205 3,59,619 4,04,849 5,13,581 5,55,815 6,16,955
80 58,566 74,681 88,383 98,726 1,23,751 1,41,816 1,55,711 2,46,024 3,84,514 4,33,017 5,53,802 5,98,249 6,64,056
81 59,253 75,437 89,277 1,00,732 1,26,264 1,44,695 1,58,872 2,51,019 4,11,241 4,63,259 5,96,495 6,43,718 7,14,527
82 59,951 76,209 90,191 1,01,761 1,27,553 1,46,172 1,60,493 2,53,579 4,33,854 4,88,861 6,38,249 6,86,795 7,41,738
83 60,659 76,996 91,122 1,02,811 1,28,868 1,47,678 1,62,147 2,56,193 4,57,094 5,15,174 6,79,736 7,32,042 7,97,925
84 61,378 77,800 92,072 1,03,883 1,30,210 1,49,216 1,63,836 2,58,860 4,81,035 5,42,284 7,23,918 7,79,779 8,49,959
85+ 62,076 78,579 92,995 1,04,978 1,31,581 1,50,786 1,65,560 2,61,584 5,05,450 5,69,932 7,63,734 8,24,034 8,98,197
69
Family Floater: 2 Adults + 1 Child

18 4,976 5,592 6,761 7,745 10,785 12,393 13,619 20,419 43,818 48,091 58,324 70,562 77,414
19 5,001 5,617 6,765 7,786 10,931 12,550 13,790 20,644 46,124 50,622 61,393 74,276 81,488
20 5,027 5,642 6,770 7,827 11,014 12,636 13,824 20,523 48,551 53,286 64,625 78,185 85,777
21 5,052 5,667 6,774 7,869 11,558 13,231 14,529 21,627 50,053 54,934 66,623 80,604 88,430
22 5,078 5,692 6,778 7,910 11,634 13,320 14,627 21,778 50,171 55,077 66,721 81,651 89,893
23 5,104 5,721 6,814 7,981 11,713 13,413 14,730 21,937 50,274 55,204 66,794 82,327 89,959
24 5,130 5,751 6,848 8,050 11,787 13,496 14,820 22,066 50,363 55,317 68,417 82,938 90,619
25 5,155 5,779 6,882 8,122 11,867 13,591 14,926 22,235 50,497 55,478 68,935 83,500 91,226
26 5,305 5,945 7,079 8,271 12,030 13,775 15,126 22,522 50,898 55,938 69,412 84,020 92,850
27 5,449 6,106 7,269 8,421 12,204 13,977 15,349 22,865 51,334 56,436 69,967 84,570 93,265
28 5,587 6,260 7,452 8,572 12,374 14,174 15,565 23,191 51,769 56,935 70,527 85,125 93,680
29 5,722 6,408 7,628 8,723 12,549 14,375 15,787 23,527 52,220 57,452 71,105 85,704 95,015
30 5,849 6,552 7,800 8,877 12,722 14,573 16,004 23,847 52,610 57,901 71,721 86,326 95,389
31 5,974 6,668 7,966 9,052 12,969 14,880 16,356 24,471 53,479 58,886 72,387 87,012 96,454
32 6,096 6,778 8,130 9,230 13,221 15,194 16,717 25,114 54,357 59,880 73,418 88,051 98,325
33 6,214 6,884 8,288 9,411 13,477 15,513 17,084 25,772 55,210 60,848 74,235 88,920 98,479
34 6,328 6,986 8,443 9,595 13,735 15,832 17,450 26,417 56,081 61,837 75,148 89,905 98,890
35 6,441 7,083 8,594 9,783 14,005 16,170 17,840 27,124 57,014 62,896 79,553 91,386 99,743
36 6,574 7,230 8,772 9,982 14,243 16,447 18,145 27,591 57,597 63,566 79,615 92,834 1,02,859
37 6,707 7,377 8,948 10,186 14,489 16,731 18,459 28,070 58,238 64,300 79,677 94,243 1,03,128
38 6,840 7,521 9,125 10,394 14,740 17,024 18,783 28,569 58,889 65,047 81,181 95,926 1,06,259
39 6,974 7,667 9,302 10,625 15,022 17,351 19,144 29,125 59,374 65,282 82,241 96,225 1,06,990
40 7,107 7,815 9,480 10,858 15,302 17,675 19,500 29,666 59,967 65,935 82,652 97,187 1,08,059
41 7,865 8,667 10,504 11,291 15,867 18,328 20,222 30,770 60,567 66,594 83,479 98,159 1,09,140
42 8,098 8,924 10,814 11,644 16,313 18,843 20,792 31,637 61,173 67,260 84,313 99,141 1,10,231
43 8,331 9,179 11,123 11,757 16,607 19,194 21,182 32,271 63,232 69,681 90,629 1,05,190 1,16,932
44 8,577 9,450 11,452 11,850 17,081 19,744 21,788 33,194 64,472 71,091 91,723 1,08,235 1,17,440
45 8,830 9,728 11,789 12,140 17,551 20,287 22,388 34,112 67,281 74,236 94,172 1,11,462 1,23,607
46 9,405 10,424 12,623 13,108 18,041 20,862 23,023 35,102 68,324 75,330 98,763 1,14,690 1,26,790
47 9,939 11,053 13,366 13,808 18,932 21,882 24,142 36,766 69,402 76,465 1,02,258 1,17,857 1,30,670
48 10,789 11,991 14,455 15,671 20,545 23,704 26,133 39,637 74,415 81,913 1,05,462 1,21,141 1,31,518
49 11,388 12,703 15,290 16,472 21,548 24,850 27,388 41,489 77,386 85,257 1,07,936 1,22,996 1,33,879
50 12,019 13,457 16,176 17,321 22,610 26,061 28,713 43,441 80,120 88,341 1,12,663 1,27,225 1,38,738
51 12,992 14,748 17,675 18,908 24,598 28,321 31,182 47,041 83,490 92,144 1,15,976 1,30,680 1,43,629
52 13,724 15,799 18,876 20,121 26,087 30,000 33,007 49,643 87,734 96,925 1,19,455 1,34,316 1,49,983
53 14,503 16,927 20,164 21,421 27,674 31,787 34,945 52,387 92,219 1,01,979 1,24,339 1,39,452 1,53,191
54 15,329 18,139 21,541 22,815 29,375 33,698 37,018 55,319 97,005 1,07,374 1,28,314 1,43,623 1,57,737
55 16,204 19,443 23,020 24,310 31,188 35,730 39,219 58,409 1,02,060 1,13,073 1,32,656 1,48,196 1,62,722
56 17,289 20,848 24,684 25,818 33,094 37,915 41,618 61,986 1,07,658 1,19,384 1,36,798 1,53,302 1,66,902
57 18,283 22,156 26,235 27,426 35,125 40,243 44,172 65,789 1,13,600 1,26,084 1,42,387 1,59,100 1,73,163
58 19,339 23,552 27,886 29,145 37,300 42,738 46,914 69,890 1,19,967 1,33,266 1,49,255 1,65,794 1,83,414
59 20,458 25,042 29,650 30,980 39,615 45,392 49,827 74,230 1,26,708 1,40,869 1,57,298 1,73,631 1,88,857
60 21,647 26,629 31,529 32,940 42,089 48,226 52,938 81,595 1,33,677 1,48,736 1,62,820 1,79,917 1,98,183
61 23,083 28,486 33,728 36,017 45,990 52,698 57,849 89,176 1,38,476 1,54,167 1,72,006 1,88,995 2,05,450
62 24,617 30,479 36,087 38,529 49,163 56,337 61,844 95,345 1,46,874 1,63,642 1,83,843 2,01,533 2,20,858
63 26,259 32,617 38,618 41,228 52,569 60,241 66,130 1,01,956 1,55,563 1,73,447 1,94,624 2,08,979 2,28,975
64 28,012 34,909 41,331 44,125 56,227 64,434 70,735 1,09,060 1,64,555 1,83,597 2,08,716 2,24,817 2,46,238
65 29,889 37,368 44,243 47,235 60,151 68,931 75,672 1,16,675 1,66,678 1,86,035 2,16,820 2,33,842 2,56,075
66 31,656 39,576 46,859 51,173 65,126 74,635 81,935 1,26,344 1,67,999 1,87,572 2,21,215 2,42,664 2,67,971
67 33,530 41,921 49,633 54,234 68,981 79,051 86,784 1,33,821 1,74,719 1,95,075 2,30,063 2,52,371 2,78,690
68 35,518 44,409 52,580 57,486 73,075 83,745 91,937 1,41,774 1,84,328 2,05,804 2,39,266 2,62,466 2,89,837
69 37,631 47,051 55,706 60,938 77,419 88,723 97,403 1,50,202 1,94,466 2,17,123 2,48,837 2,72,964 3,01,431
70 39,872 49,854 59,025 64,606 82,039 94,021 1,03,221 1,60,206 2,05,162 2,29,065 2,58,790 2,83,883 3,13,488
70
Family Floater: 2 Adults + 1 Child

(yrs.)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
71 41,714 52,435 62,078 67,980 86,281 98,884 1,08,562 1,71,528 2,13,369 2,38,228 2,79,493 3,06,593 3,38,567
72 43,640 55,151 65,293 71,532 90,743 1,03,995 1,14,173 1,80,393 2,30,438 2,57,286 3,01,853 3,31,121 3,65,652
73 45,657 58,012 68,678 75,507 95,868 1,09,896 1,20,679 1,90,672 2,48,873 2,77,869 3,26,001 3,57,611 3,94,904
74 47,770 61,024 72,243 78,953 1,00,189 1,14,847 1,26,115 1,99,261 2,64,758 2,97,386 3,58,485 3,93,677 4,30,295
75 49,981 63,793 75,519 82,555 1,04,705 1,20,022 1,31,796 2,08,238 2,82,826 3,17,822 3,87,187 4,24,762 4,68,279
76 51,885 66,120 78,272 85,635 1,08,555 1,24,433 1,36,638 2,15,887 3,01,917 3,39,417 4,18,578 4,58,068 5,04,915
77 53,860 68,536 81,131 88,828 1,12,550 1,29,010 1,41,663 2,23,827 3,22,223 3,62,388 4,51,941 4,93,393 5,34,199
78 55,910 71,039 84,094 92,141 1,16,697 1,33,763 1,46,882 2,32,074 3,43,922 3,86,938 4,87,637 5,30,850 5,74,653
79 58,037 73,637 87,168 95,577 1,20,997 1,38,688 1,52,290 2,40,619 3,67,145 4,13,213 5,25,728 5,70,573 6,34,229
80 60,243 76,332 90,356 99,142 1,25,461 1,43,804 1,57,908 2,49,495 3,92,039 4,41,380 5,65,948 6,13,007 6,81,330
81 60,950 77,113 91,279 1,01,196 1,28,010 1,46,725 1,61,116 2,54,563 4,18,766 4,71,623 6,08,642 6,58,476 7,31,801
82 61,668 77,909 92,223 1,02,285 1,29,340 1,48,248 1,62,788 2,57,205 4,41,380 4,97,224 6,50,396 7,01,553 7,59,012
83 62,396 78,722 93,183 1,03,394 1,30,697 1,49,802 1,64,493 2,59,899 4,64,620 5,23,538 6,91,882 7,46,800 8,15,199
84 63,135 79,550 94,162 1,04,523 1,32,080 1,51,387 1,66,233 2,62,649 4,88,561 5,50,648 7,36,065 7,94,537 8,67,233
85+ 63,853 80,354 95,113 1,05,675 1,33,492 1,53,005 1,68,009 2,65,454 5,12,975 5,78,296 7,75,881 8,38,792 9,15,471
71
Family Floater: 2 Adults + 2 Children

18 5,427 6,182 7,295 9,047 12,675 14,572 16,016 24,037 51,396 56,627 76,065 92,027 99,401
19 5,484 6,208 7,336 9,061 12,710 14,658 16,053 24,078 51,915 57,199 76,834 92,956 1,00,405
20 5,541 6,234 7,376 9,076 12,861 14,748 16,220 24,266 52,440 57,777 77,610 93,895 1,01,419
21 5,598 6,260 7,417 9,090 13,294 15,252 16,756 25,048 52,969 58,361 78,394 94,844 1,02,443
22 5,602 6,288 7,501 9,174 13,372 15,343 16,856 25,201 53,087 58,504 78,492 96,055 1,03,906
23 5,607 6,299 7,516 9,245 13,453 15,437 16,960 25,361 53,190 58,631 78,826 96,834 1,03,972
24 5,650 6,311 7,528 9,315 13,529 15,522 17,053 25,493 53,280 58,743 80,187 97,207 1,04,632
25 5,658 6,321 7,540 9,388 13,611 15,620 17,161 25,664 53,413 58,905 80,705 97,757 1,05,239
26 5,838 6,555 7,821 9,547 13,774 15,803 17,361 25,950 53,814 59,365 81,182 98,267 1,06,864
27 6,036 6,777 8,082 9,707 13,947 16,004 17,582 26,289 54,250 59,863 81,738 98,797 1,07,279
28 6,195 7,021 8,371 9,865 14,117 16,200 17,797 26,614 54,686 60,362 82,297 99,332 1,07,694
29 6,356 7,291 8,691 10,024 14,291 16,400 18,018 26,946 55,136 60,878 82,875 99,891 1,09,028
30 6,502 7,478 8,916 10,183 14,465 16,598 18,235 27,266 56,693 62,698 83,491 1,00,493 1,09,402
31 6,638 7,627 9,124 10,363 14,709 16,900 18,581 27,876 57,563 63,683 84,157 1,01,160 1,10,467
32 6,768 7,763 9,325 10,545 14,958 17,209 18,936 28,505 58,441 64,678 85,188 1,02,167 1,12,338
33 6,887 7,890 9,512 10,729 15,211 17,524 19,298 29,148 59,294 65,646 86,005 1,03,018 1,12,492
34 6,997 8,008 9,691 10,916 15,467 17,838 19,658 29,781 60,164 66,634 86,919 1,03,986 1,12,903
35 7,101 8,116 9,861 11,106 15,734 18,172 20,043 30,474 61,097 67,693 91,323 1,04,907 1,13,756
36 7,220 8,276 10,055 11,307 15,972 18,448 20,347 30,938 61,680 68,363 92,237 1,07,551 1,16,872
37 7,339 8,371 10,168 11,512 16,217 18,732 20,660 31,414 62,321 69,097 93,159 1,07,751 1,17,142
38 7,452 8,521 10,351 11,722 16,468 19,023 20,983 31,911 62,972 69,844 94,091 1,07,951 1,18,313
39 7,564 8,670 10,533 11,970 16,773 19,374 21,371 32,502 63,355 70,090 95,032 1,08,336 1,19,496
40 7,670 8,817 10,710 12,221 17,075 19,724 21,755 33,085 63,919 70,335 95,982 1,09,419 1,20,691
41 8,843 9,681 11,741 12,665 17,652 20,392 22,493 34,213 64,123 70,530 96,942 1,10,513 1,21,898
42 9,081 9,942 12,056 12,760 18,115 20,925 23,082 35,107 64,329 70,726 97,911 1,11,619 1,23,117
43 9,307 10,189 12,357 12,810 18,260 21,115 23,297 35,506 67,009 73,907 98,890 1,12,735 1,28,204
44 9,557 10,461 12,687 12,875 18,754 21,684 23,924 36,453 68,249 75,317 1,01,621 1,15,848 1,28,712
45 9,736 10,739 13,025 12,967 19,219 22,220 24,517 37,358 72,130 79,646 1,05,289 1,20,029 1,36,616
46 10,442 11,417 13,847 13,931 19,707 22,792 25,148 38,340 73,311 80,890 1,09,986 1,25,385 1,40,106
47 11,113 12,096 14,651 14,623 20,589 23,802 26,257 39,990 74,530 82,178 1,13,580 1,29,481 1,44,300
48 11,692 13,035 15,722 16,422 22,156 25,573 28,193 42,787 79,687 87,782 1,16,866 1,33,227 1,45,468
49 12,337 13,803 16,620 17,213 23,151 26,710 29,438 44,627 82,805 91,284 1,19,418 1,36,080 1,48,155
50 13,017 14,617 17,576 18,051 24,204 27,912 30,754 46,568 85,388 94,196 1,23,595 1,39,570 1,52,557
51 14,019 15,958 19,133 19,579 26,151 30,127 33,174 50,103 88,758 97,998 1,26,908 1,42,999 1,57,448
52 14,756 17,032 20,355 20,762 27,621 31,786 34,979 52,681 93,002 1,02,780 1,30,387 1,46,608 1,63,802
53 15,540 18,182 21,667 22,033 29,190 33,553 36,896 55,401 97,487 1,07,834 1,35,271 1,51,713 1,67,010
54 16,368 19,415 23,066 23,395 30,872 35,444 38,949 58,310 1,02,273 1,13,229 1,39,246 1,55,859 1,71,556
55 17,246 20,740 24,565 24,858 32,666 37,457 41,129 61,376 1,07,328 1,18,928 1,43,589 1,60,409 1,76,541
56 18,342 22,166 26,256 26,338 34,554 39,622 43,506 64,922 1,12,926 1,25,238 1,47,730 1,65,553 1,80,721
57 19,337 23,482 27,817 27,919 36,567 41,929 46,038 68,695 1,18,868 1,31,939 1,53,319 1,71,315 1,86,982
58 20,393 24,885 29,478 29,610 38,724 44,404 48,759 72,765 1,25,235 1,39,120 1,60,187 1,77,938 1,97,233
59 21,513 26,382 31,251 31,416 41,021 47,038 51,649 77,074 1,31,976 1,46,724 1,68,230 1,85,699 2,02,676
60 22,701 27,975 33,139 33,347 43,477 49,852 54,739 84,516 1,38,795 1,54,423 1,73,439 1,91,652 2,11,607
61 24,143 29,846 35,354 36,353 47,330 54,270 59,592 92,012 1,43,744 1,60,022 1,82,938 2,01,007 2,19,269
62 25,684 31,852 37,729 38,826 50,479 57,882 63,557 98,139 1,52,142 1,69,496 1,94,775 2,13,517 2,34,677
63 27,331 34,003 40,277 41,484 53,861 61,759 67,814 1,04,707 1,60,831 1,79,302 2,01,467 2,16,327 2,42,794
64 29,091 36,307 43,006 44,340 57,494 65,924 72,389 1,11,769 1,69,823 1,89,452 2,19,648 2,36,592 2,60,057
65 30,973 38,778 45,934 47,409 61,394 70,394 77,297 1,19,343 1,71,945 1,91,890 2,27,752 2,45,632 2,69,894
66 32,737 40,984 48,548 51,285 66,331 76,056 83,513 1,28,945 1,73,267 1,93,427 2,32,147 2,54,656 2,81,790
67 34,609 43,326 51,320 54,544 70,174 80,460 88,349 1,36,403 1,83,301 2,04,584 2,37,009 2,59,990 2,95,338
68 36,594 45,811 54,265 57,741 74,258 85,142 93,491 1,44,340 1,90,887 2,12,952 2,52,603 2,77,096 3,09,693
69 38,705 48,451 57,390 61,185 78,594 90,111 98,946 1,52,754 1,97,535 2,20,150 2,63,823 2,89,404 3,20,880
70 41,321 51,252 60,706 64,846 83,206 95,399 1,04,755 1,62,769 2,10,642 2,34,740 2,67,551 2,93,494 3,27,543
72

71 43,169 53,837 63,765 68,227 87,452 1,00,267 1,10,101 1,73,960 2,16,949 2,41,441 2,88,041 3,15,970 3,51,925
72 45,101 56,558 66,986 71,632 91,919 1,05,385 1,15,719 1,82,836 2,35,308 2,61,788 3,13,057 3,43,411 3,72,884
73 47,125 59,426 70,379 75,940 97,047 1,11,290 1,22,229 1,93,121 2,55,155 2,83,784 3,38,211 3,71,004 4,06,278
74 49,245 62,446 73,953 79,237 1,01,383 1,16,257 1,27,683 2,01,739 2,70,026 3,03,240 3,70,632 4,07,016 4,44,114
75 51,464 65,225 77,242 82,861 1,05,915 1,21,450 1,33,385 2,10,748 2,88,094 3,23,676 3,98,120 4,36,755 4,82,098
76 53,380 67,568 80,013 85,972 1,09,789 1,25,889 1,38,257 2,18,447 3,07,185 3,45,271 4,29,510 4,70,031 5,18,734
77 55,368 70,000 82,891 89,199 1,13,811 1,30,496 1,43,316 2,26,439 3,27,491 3,68,243 4,62,873 5,05,328 5,48,019
78 57,431 72,520 85,874 92,547 1,17,986 1,35,281 1,48,570 2,34,740 3,49,190 3,92,792 4,98,569 5,42,750 5,88,472
79 59,572 75,136 88,969 96,019 1,22,315 1,40,240 1,54,014 2,43,343 3,72,413 4,19,067 5,36,660 5,82,438 6,48,048
80 61,793 77,850 92,180 99,274 1,26,809 1,45,391 1,59,671 2,52,280 3,97,307 4,47,235 5,76,881 6,24,848 6,95,149
81 62,522 78,658 93,135 1,01,379 1,29,403 1,48,362 1,62,933 2,57,434 4,24,034 4,77,477 6,19,574 6,70,303 7,45,620
82 63,262 79,482 94,110 1,02,533 1,30,784 1,49,943 1,64,669 2,60,177 4,46,648 5,03,079 6,61,328 7,13,345 7,72,831
83 64,013 80,322 95,102 1,03,706 1,32,191 1,51,554 1,66,437 2,62,971 4,69,888 5,29,393 7,02,815 7,58,599 8,29,018
84 64,774 81,177 96,113 1,04,898 1,33,626 1,53,197 1,68,240 2,65,819 4,93,829 5,56,502 7,46,998 8,06,338 8,81,052
85+ 65,514 82,009 97,096 1,06,111 1,35,088 1,54,871 1,70,077 2,68,722 5,18,243 5,84,150 7,86,813 8,50,610 9,29,290
73

18 6,467 7,442 8,835 10,947 14,775 16,872 18,516 27,787 56,211 61,997 82,639 99,117 1,07,178
19 6,524 7,468 8,876 10,961 14,810 16,958 18,553 27,828 56,730 62,569 83,408 1,00,047 1,08,182
20 6,581 7,494 8,916 10,976 14,961 17,048 18,720 28,016 57,254 63,147 84,184 1,00,986 1,09,196
21 6,638 7,520 8,957 10,990 15,394 17,552 19,256 28,798 57,784 63,731 84,968 1,01,934 1,10,221
22 6,642 7,548 9,041 11,074 15,472 17,643 19,356 28,951 57,902 63,874 85,066 1,03,145 1,11,684
23 6,647 7,559 9,056 11,145 15,553 17,737 19,460 29,111 58,005 64,001 85,400 1,03,925 1,11,750
24 6,690 7,571 9,068 11,215 15,629 17,822 19,553 29,243 58,094 64,114 86,761 1,04,297 1,12,410
25 6,698 7,581 9,080 11,288 15,711 17,920 19,661 29,414 58,228 64,275 87,279 1,04,848 1,13,017
26 6,878 7,815 9,361 11,447 15,874 18,103 19,861 29,700 58,629 64,735 87,756 1,05,358 1,14,641
27 7,076 8,037 9,622 11,607 16,047 18,304 20,082 30,039 59,065 65,233 88,311 1,05,888 1,15,056
28 7,235 8,281 9,911 11,765 16,217 18,500 20,297 30,364 59,500 65,732 88,871 1,06,423 1,15,471
29 7,396 8,551 10,231 11,924 16,391 18,700 20,518 30,696 59,951 66,249 89,449 1,06,981 1,16,806
30 7,542 8,738 10,456 12,083 16,565 18,898 20,735 31,016 61,507 68,069 90,065 1,07,584 1,17,180
31 7,678 8,887 10,664 12,263 16,809 19,200 21,081 31,626 62,377 69,053 90,731 1,08,251 1,18,245
32 7,808 9,023 10,865 12,445 17,058 19,509 21,436 32,255 63,255 70,048 91,762 1,09,258 1,20,116
33 7,927 9,150 11,052 12,629 17,311 19,824 21,798 32,898 64,108 71,016 92,579 1,10,109 1,20,270
34 8,037 9,268 11,231 12,816 17,567 20,138 22,158 33,531 64,979 72,004 93,493 1,11,077 1,20,681
35 8,141 9,376 11,401 13,006 17,834 20,472 22,543 34,224 65,912 73,063 97,897 1,11,998 1,21,534
36 8,260 9,536 11,595 13,207 18,072 20,748 22,847 34,688 66,495 73,733 98,811 1,14,642 1,24,650
37 8,379 9,631 11,708 13,412 18,317 21,032 23,160 35,164 67,135 74,468 99,733 1,14,842 1,24,919
38 8,492 9,781 11,891 13,622 18,568 21,323 23,483 35,661 67,787 75,215 1,00,665 1,15,042 1,26,091
39 8,604 9,930 12,073 13,870 18,873 21,674 23,871 36,252 68,169 75,460 1,01,605 1,15,426 1,27,274
40 8,710 10,077 12,250 14,121 19,175 22,024 24,255 36,835 68,733 75,705 1,02,556 1,16,510 1,28,469
41 9,883 10,941 13,281 14,565 19,752 22,692 24,993 37,963 68,938 75,901 1,03,516 1,17,604 1,29,676
42 10,121 11,202 13,596 14,660 20,215 23,225 25,582 38,857 69,144 76,097 1,04,485 1,18,709 1,30,895
43 10,347 11,449 13,897 14,710 20,360 23,415 25,797 39,256 71,823 79,277 1,05,464 1,19,825 1,35,981
44 10,597 11,721 14,227 14,775 20,854 23,984 26,424 40,203 73,064 80,687 1,08,195 1,22,939 1,36,490
45 10,776 11,999 14,565 14,867 21,319 24,520 27,017 41,108 76,945 85,017 1,11,863 1,27,120 1,44,393
46 11,482 12,677 15,387 15,831 21,807 25,092 27,648 42,090 78,126 86,261 1,16,560 1,32,475 1,47,883
47 12,153 13,356 16,191 16,523 22,689 26,102 28,757 43,740 79,345 87,548 1,20,154 1,36,571 1,52,077
48 12,732 14,295 17,262 18,322 24,256 27,873 30,693 46,537 84,502 93,152 1,23,440 1,40,318 1,53,245
49 13,377 15,063 18,160 19,113 25,251 29,010 31,938 48,377 87,619 96,654 1,25,992 1,43,171 1,55,932
50 14,057 15,877 19,116 19,951 26,304 30,212 33,254 50,318 90,202 99,566 1,30,169 1,46,660 1,60,335
51 15,059 17,218 20,673 21,479 28,251 32,427 35,674 53,853 93,573 1,03,368 1,33,482 1,50,089 1,65,226
52 15,796 18,292 21,895 22,662 29,721 34,086 37,479 56,431 97,817 1,08,150 1,36,961 1,53,698 1,71,579
53 16,580 19,442 23,207 23,933 31,290 35,853 39,396 59,151 1,02,302 1,13,204 1,41,845 1,58,804 1,74,787
54 17,408 20,675 24,606 25,295 32,972 37,744 41,449 62,060 1,07,088 1,18,599 1,45,820 1,62,950 1,79,333
55 18,286 22,000 26,105 26,758 34,766 39,757 43,629 65,126 1,12,143 1,24,298 1,50,163 1,67,500 1,84,318
56 19,382 23,426 27,796 28,238 36,654 41,922 46,006 68,672 1,17,740 1,30,609 1,54,304 1,72,644 1,88,498
57 20,377 24,742 29,357 29,819 38,667 44,229 48,538 72,445 1,23,682 1,37,309 1,59,893 1,78,406 1,94,760
58 21,433 26,145 31,018 31,510 40,824 46,704 51,259 76,515 1,30,050 1,44,490 1,66,761 1,85,028 2,05,010
59 22,553 27,642 32,791 33,316 43,121 49,338 54,149 80,824 1,36,790 1,52,094 1,74,804 1,92,789 2,10,454
60 23,741 29,235 34,679 35,247 45,577 52,152 57,239 88,266 1,43,610 1,59,794 1,80,013 1,98,743 2,19,385
61 25,183 31,106 36,894 38,253 49,430 56,570 62,092 95,762 1,48,559 1,65,392 1,89,512 2,08,098 2,27,047
62 26,724 33,112 39,269 40,726 52,579 60,182 66,057 1,01,889 1,56,957 1,74,866 2,01,349 2,20,607 2,42,455
63 28,371 35,263 41,817 43,384 55,961 64,059 70,314 1,08,457 1,65,645 1,84,672 2,08,041 2,23,418 2,50,572
64 30,131 37,567 44,546 46,240 59,594 68,224 74,889 1,15,519 1,74,637 1,94,822 2,26,222 2,43,683 2,67,834
65 32,013 40,038 47,474 49,309 63,494 72,694 79,797 1,23,093 1,76,760 1,97,260 2,34,326 2,52,723 2,77,672
66 33,777 42,244 50,088 53,185 68,431 78,356 86,013 1,32,695 1,78,081 1,98,797 2,38,721 2,61,747 2,89,567
67 35,649 44,586 52,860 56,444 72,274 82,760 90,849 1,40,153 1,88,115 2,09,954 2,43,583 2,67,080 3,03,116
68 37,634 47,071 55,805 59,641 76,358 87,442 95,991 1,48,090 1,95,702 2,18,322 2,59,177 2,84,186 3,17,470
69 39,745 49,711 58,930 63,085 80,694 92,411 1,01,446 1,56,504 2,02,350 2,25,520 2,70,397 2,96,495 3,28,657
70 42,361 52,512 62,246 66,746 85,306 97,699 1,07,255 1,66,519 2,15,457 2,40,110 2,74,125 3,00,584 3,35,320
74

71 44,209 55,097 65,305 70,127 89,552 1,02,567 1,12,601 1,77,710 2,21,764 2,46,811 2,94,615 3,23,061 3,59,703
72 46,141 57,818 68,526 73,532 94,019 1,07,685 1,18,219 1,86,586 2,40,123 2,67,158 3,19,631 3,50,502 3,80,661
73 48,165 60,686 71,919 77,840 99,147 1,13,590 1,24,729 1,96,871 2,59,970 2,89,154 3,44,785 3,78,095 4,14,056
74 50,285 63,706 75,493 81,137 1,03,483 1,18,557 1,30,183 2,05,489 2,74,841 3,08,611 3,77,206 4,14,107 4,51,892
75 52,504 66,485 78,782 84,761 1,08,015 1,23,750 1,35,885 2,14,498 2,92,909 3,29,046 4,04,693 4,43,846 4,89,875
76 54,420 68,828 81,553 87,872 1,11,889 1,28,189 1,40,757 2,22,197 3,11,999 3,50,642 4,36,084 4,77,122 5,26,511
77 56,408 71,260 84,431 91,099 1,15,911 1,32,796 1,45,816 2,30,189 3,32,305 3,73,613 4,69,447 5,12,418 5,55,796
78 58,471 73,780 87,414 94,447 1,20,086 1,37,581 1,51,070 2,38,490 3,54,004 3,98,163 5,05,143 5,49,841 5,96,249
79 60,612 76,396 90,509 97,919 1,24,415 1,42,540 1,56,514 2,47,093 3,77,227 4,24,438 5,43,234 5,89,529 6,55,826
80 62,833 79,110 93,720 1,01,174 1,28,909 1,47,691 1,62,171 2,56,030 4,02,122 4,52,605 5,83,455 6,31,938 7,02,927
81 63,562 79,918 94,675 1,03,279 1,31,503 1,50,662 1,65,433 2,61,184 4,28,849 4,82,848 6,26,148 6,77,394 7,53,397
82 64,302 80,742 95,650 1,04,433 1,32,884 1,52,243 1,67,169 2,63,927 4,51,462 5,08,449 6,67,902 7,20,435 7,80,609
83 65,053 81,582 96,642 1,05,606 1,34,291 1,53,854 1,68,937 2,66,721 4,74,702 5,34,763 7,09,389 7,65,690 8,36,796
84 65,814 82,437 97,653 1,06,798 1,35,726 1,55,497 1,70,740 2,69,569 4,98,644 5,61,873 7,53,571 8,13,428 8,88,830
85+ 66,554 83,269 98,636 1,08,011 1,37,188 1,57,171 1,72,577 2,72,472 5,23,058 5,89,521 7,93,387 8,57,701 9,37,067
75

18 7,507 8,702 10,375 12,847 16,875 19,172 21,016 31,537 61,026 67,368 89,213 1,06,208 1,14,956
19 7,564 8,728 10,416 12,861 16,910 19,258 21,053 31,578 61,545 67,940 89,981 1,07,137 1,15,960
20 7,621 8,754 10,456 12,876 17,061 19,348 21,220 31,766 62,069 68,517 90,758 1,08,076 1,16,974
21 7,678 8,780 10,497 12,890 17,494 19,852 21,756 32,548 62,599 69,101 91,542 1,09,025 1,17,998
22 7,682 8,808 10,581 12,974 17,572 19,943 21,856 32,701 62,717 69,244 91,640 1,10,236 1,19,461
23 7,687 8,819 10,596 13,045 17,653 20,037 21,960 32,861 62,820 69,371 91,973 1,11,015 1,19,527
24 7,730 8,831 10,608 13,115 17,729 20,122 22,053 32,993 62,909 69,484 93,335 1,11,388 1,20,188
25 7,738 8,841 10,620 13,188 17,811 20,220 22,161 33,164 63,043 69,646 93,853 1,11,938 1,20,794
26 7,918 9,075 10,901 13,347 17,974 20,403 22,361 33,450 63,444 70,105 94,330 1,12,448 1,22,419
27 8,116 9,297 11,162 13,507 18,147 20,604 22,582 33,789 63,879 70,603 94,885 1,12,978 1,22,834
28 8,275 9,541 11,451 13,665 18,317 20,800 22,797 34,114 64,315 71,102 95,445 1,13,513 1,23,249
29 8,436 9,811 11,771 13,824 18,491 21,000 23,018 34,446 64,766 71,619 96,023 1,14,072 1,24,583
30 8,582 9,998 11,996 13,983 18,665 21,198 23,235 34,766 66,322 73,439 96,639 1,14,674 1,24,957
31 8,718 10,147 12,204 14,163 18,909 21,500 23,581 35,376 67,192 74,423 97,305 1,15,341 1,26,022
32 8,848 10,283 12,405 14,345 19,158 21,809 23,936 36,005 68,070 75,418 98,336 1,16,348 1,27,894
33 8,967 10,410 12,592 14,529 19,411 22,124 24,298 36,648 68,923 76,386 99,153 1,17,199 1,28,048
34 9,077 10,528 12,771 14,716 19,667 22,438 24,658 37,281 69,793 77,374 1,00,067 1,18,167 1,28,458
35 9,181 10,636 12,941 14,906 19,934 22,772 25,043 37,974 70,726 78,434 1,04,471 1,19,088 1,29,311
36 9,300 10,796 13,135 15,107 20,172 23,048 25,347 38,438 71,310 79,104 1,05,384 1,21,733 1,32,427
37 9,419 10,891 13,248 15,312 20,417 23,332 25,660 38,914 71,950 79,838 1,06,307 1,21,933 1,32,697
38 9,532 11,041 13,431 15,522 20,668 23,623 25,983 39,411 72,601 80,585 1,07,238 1,22,133 1,33,868
39 9,644 11,190 13,613 15,770 20,973 23,974 26,371 40,002 72,984 80,830 1,08,179 1,22,517 1,35,052
40 9,750 11,337 13,790 16,021 21,275 24,324 26,755 40,585 73,548 81,075 1,09,130 1,23,600 1,36,247
41 10,923 12,201 14,821 16,465 21,852 24,992 27,493 41,713 73,753 81,271 1,10,089 1,24,695 1,37,453
42 11,161 12,462 15,136 16,560 22,315 25,525 28,082 42,607 73,959 81,467 1,11,059 1,25,800 1,38,672
43 11,387 12,709 15,437 16,610 22,460 25,715 28,297 43,006 76,638 84,648 1,12,038 1,26,916 1,43,759
44 11,637 12,981 15,767 16,675 22,954 26,284 28,924 43,953 77,878 86,058 1,14,769 1,30,029 1,44,267
45 11,816 13,259 16,105 16,767 23,419 26,820 29,517 44,858 81,759 90,387 1,18,436 1,34,210 1,52,171
46 12,522 13,937 16,927 17,731 23,907 27,392 30,148 45,840 82,941 91,631 1,23,134 1,39,566 1,55,661
47 13,193 14,616 17,731 18,423 24,789 28,402 31,257 47,490 84,160 92,918 1,26,727 1,43,662 1,59,855
48 13,772 15,555 18,802 20,222 26,356 30,173 33,193 50,287 89,316 98,522 1,30,014 1,47,408 1,61,023
49 14,417 16,323 19,700 21,013 27,351 31,310 34,438 52,127 92,434 1,02,025 1,32,566 1,50,261 1,63,710
50 15,097 17,137 20,656 21,851 28,404 32,512 35,754 54,068 95,017 1,04,936 1,36,743 1,53,751 1,68,112
51 16,099 18,478 22,213 23,379 30,351 34,727 38,174 57,603 98,388 1,08,739 1,40,056 1,57,180 1,73,004
52 16,836 19,552 23,435 24,562 31,821 36,386 39,979 60,181 1,02,632 1,13,520 1,43,535 1,60,789 1,79,357
53 17,620 20,702 24,747 25,833 33,390 38,153 41,896 62,901 1,07,116 1,18,574 1,48,419 1,65,894 1,82,565
54 18,448 21,935 26,146 27,195 35,072 40,044 43,949 65,810 1,11,903 1,23,969 1,52,394 1,70,041 1,87,111
55 19,326 23,260 27,645 28,658 36,866 42,057 46,129 68,876 1,16,958 1,29,669 1,56,736 1,74,590 1,92,096
56 20,422 24,686 29,336 30,138 38,754 44,222 48,506 72,422 1,22,555 1,35,979 1,60,878 1,79,734 1,96,276
57 21,417 26,002 30,897 31,719 40,767 46,529 51,038 76,195 1,28,497 1,42,679 1,66,467 1,85,496 2,02,537
58 22,473 27,405 32,558 33,410 42,924 49,004 53,759 80,265 1,34,865 1,49,861 1,73,335 1,92,119 2,12,788
59 23,593 28,902 34,331 35,216 45,221 51,638 56,649 84,574 1,41,605 1,57,464 1,81,378 1,99,880 2,18,231
60 24,781 30,495 36,219 37,147 47,677 54,452 59,739 92,016 1,48,424 1,65,164 1,86,587 2,05,833 2,27,162
61 26,223 32,366 38,434 40,153 51,530 58,870 64,592 99,512 1,53,373 1,70,762 1,96,086 2,15,188 2,34,824
62 27,764 34,372 40,809 42,626 54,679 62,482 68,557 1,05,639 1,61,771 1,80,237 2,07,923 2,27,698 2,50,232
63 29,411 36,523 43,357 45,284 58,061 66,359 72,814 1,12,207 1,70,460 1,90,042 2,14,615 2,30,508 2,58,349
64 31,171 38,827 46,086 48,140 61,694 70,524 77,389 1,19,269 1,79,452 2,00,192 2,32,796 2,50,773 2,75,612
65 33,053 41,298 49,014 51,209 65,594 74,994 82,297 1,26,843 1,81,575 2,02,630 2,40,900 2,59,813 2,85,449
66 34,817 43,504 51,628 55,085 70,531 80,656 88,513 1,36,445 1,82,896 2,04,167 2,45,295 2,68,837 2,97,345
67 36,689 45,846 54,400 58,344 74,374 85,060 93,349 1,43,903 1,92,930 2,15,324 2,50,157 2,74,171 3,10,893
68 38,674 48,331 57,345 61,541 78,458 89,742 98,491 1,51,840 2,00,517 2,23,692 2,65,751 2,91,277 3,25,248
69 40,785 50,971 60,470 64,985 82,794 94,711 1,03,946 1,60,254 2,07,164 2,30,891 2,76,971 3,03,585 3,36,435
70 43,401 53,772 63,786 68,646 87,406 99,999 1,09,755 1,70,269 2,20,271 2,45,480 2,80,699 3,07,675 3,43,098
76

71 45,249 56,357 66,845 72,027 91,652 1,04,867 1,15,101 1,81,460 2,26,579 2,52,182 3,01,189 3,30,151 3,67,480
72 47,181 59,078 70,066 75,432 96,119 1,09,985 1,20,719 1,90,336 2,44,938 2,72,529 3,26,205 3,57,593 3,88,439
73 49,205 61,946 73,459 79,740 1,01,247 1,15,890 1,27,229 2,00,621 2,64,785 2,94,524 3,51,359 3,85,185 4,21,833
74 51,325 64,966 77,033 83,037 1,05,583 1,20,857 1,32,683 2,09,239 2,79,655 3,13,981 3,83,780 4,21,197 4,59,670
75 53,544 67,745 80,322 86,661 1,10,115 1,26,050 1,38,385 2,18,248 2,97,723 3,34,417 4,11,267 4,50,937 4,97,653
76 55,460 70,088 83,093 89,772 1,13,989 1,30,489 1,43,257 2,25,947 3,16,814 3,56,012 4,42,658 4,84,212 5,34,289
77 57,448 72,520 85,971 92,999 1,18,011 1,35,096 1,48,316 2,33,939 3,37,120 3,78,984 4,76,021 5,19,509 5,63,574
78 59,511 75,040 88,954 96,347 1,22,186 1,39,881 1,53,570 2,42,240 3,58,819 4,03,533 5,11,717 5,56,932 6,04,027
79 61,652 77,656 92,049 99,819 1,26,515 1,44,840 1,59,014 2,50,843 3,82,042 4,29,808 5,49,808 5,96,619 6,63,603
80 63,873 80,370 95,260 1,03,074 1,31,009 1,49,991 1,64,671 2,59,780 4,06,937 4,57,976 5,90,028 6,39,029 7,10,704
81 64,602 81,178 96,215 1,05,179 1,33,603 1,52,962 1,67,933 2,64,934 4,33,664 4,88,218 6,32,722 6,84,484 7,61,175
82 65,342 82,002 97,190 1,06,333 1,34,984 1,54,543 1,69,669 2,67,677 4,56,277 5,13,820 6,74,476 7,27,526 7,88,386
83 66,093 82,842 98,182 1,07,506 1,36,391 1,56,154 1,71,437 2,70,471 4,79,517 5,40,133 7,15,962 7,72,781 8,44,573
84 66,854 83,697 99,193 1,08,698 1,37,826 1,57,797 1,73,240 2,73,319 5,03,458 5,67,243 7,60,145 8,20,519 8,96,607
85+ 67,594 84,529 1,00,176 1,09,911 1,39,288 1,59,471 1,75,077 2,76,222 5,27,872 5,94,891 7,99,961 8,64,791 9,44,845
Zonal Discount
Zonal Discount (not applicable on Hospital Cash Benefit)
Zone
Cities Discount
Categorization
For Zone 1
(Discount on Delhi (NCR), Mumbai including Suburbs, Chennai, Bengaluru, Hyderabad, Kolkata, Pune, Gujarat 0%
premium rate)
For Zone 2
(Discount on Rest of India 15%
premium rate)
Multi-year Policy Discount

Discount for multi-year policy period
Policy Period Discount

1 Year 0.0%
2 Year 7.5%
3 Year 12.0%
77
Customer Level Options
Option for Hospital Cash Benefit (For Individual and Family Floater)
% of Table premium in
Sum Insured Limit/Day
Zone 1
2 lac 1,000 14.0%
3 lac 1,000 12.0%
4 lac 1,000 10.0%
5 lac 2,000 16.0%
10 lac 2,000 14.0%
15 lac 2,000 12.0%
20 lac 2,000 10.0%
50 lac 2,000 7.0%
25 lac 5,000 6.0%

30 lac 5,000 5.5%
50 lac 5,000 5.0%
100 lac 5,000 4.5%
150 lac 5,000 4.0%
Option for Top-up plan on annual aggregate basis

Multiplicative Factor Applied on Table Premium rate for Individual and Family Floater
Sum Insured Top-up Plan on annual aggregate basis

1 lac 2 lac 3 lac 4 lac 5 lac 10 lac
2 lac 75.0% 68.0% 55.0% 50.0% 40.0% 30.0%
3 lac 75.0% 72.0% 58.0% 54.0% 44.0% 35.0%
4 lac 75.0% 72.0% 60.0% 56.0% 50.0% 40.0%
5 lac 80.0% 75.0% 64.0% 58.0% 53.0% 40.0%
10 lac 80.0% 75.0% 68.0% 61.0% 56.0% 45.0%
15 lac 80.0% 75.0% 70.0% 63.0% 58.0% 50.0%
20 lac 80.0% 75.0% 72.0% 65.0% 60.0% 55.0%
50 lac 90.0% 85.0% 81.0% 73.0% 65.0% 59.0%
Option to include US and Canada for Worldwide Emergency loading on

Hospitalization & International Treatment for 11 specified Critical Illness 8% premium
(For Elite Variant Only) rate table
78
Annexure 2: Premium Rate Table
Premium Calculation-Illustration
Example 1
SI 5 lac
Age 40
Location Delhi Zone 1
Top-up Plan, opted 2 lac
Premium Calculation
Step 3 Total Table Premium 24,886 =12,221+12,665
Step 4 Zonal discount 0%
Step 6 Total Premium with Zonal and multi year policy-period discount 23,019 = 24,886*(1-0%)*(1-7.5%)
Step 7 Top-up Plan - Multiplicative factor 75.0%

Total Premium with Top-up Plan, Zonal and multi-year policy-
Step 8 17,264 = 23,019*75%
period discount
Step 10 Hospital Cash Premium 3,982 = 24,886*16%
Step 11 Hospital Cash Premium with multi-year policy period discount 3,683 = 24,886*16%*(1-7.5%)
Step 12 Premium rate (without service tax) 20,947 = 17,264+3,683
Step 13 Final Premium (without service tax) 20,947 =20,947
Step 15 Final premium (with service tax) 23,880 = 20,947*(1+14%)
79
NOTE
80

Lifeline Health Insurance Plan Summary

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Lifeline Health Insurance Plan Summary

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TABLE OF CONTENTS

Terms and Conditions………………………………………………………………………… 17

Let’s check your insight………………………………………………………………………… 25

Activity: Filing the Proposal form…………………………………………………………… 33

Annexure I: Pre-authorisation Form………………………………………………………… 42

Annexure II: Claim Form……………………………………………………………………… 44

Frequently Asked Questions…………………………………………………………………… 49

Appendix I: Premium Tables…………………………………………………………………… 58

2. Individual & Family Combination

3. Policy Period Option

4. Plan & Sum Insured Options

Plan Sum Insured

Sum Insured is on Annual basis.

Zone 2: Rest of India.

A discount of 15% for members in Zone 2 will be applicable. Grid as below:

Sum Insured (SI) Rupees Classic

Baseline cover benefits (1), (2)

Inpatient Care Covered up to Sum Insured

All Day care procedures Covered upto Sum Insured

Ambulance Cover Up to Rs.3,000

Organ Donor Expenses Covered upto Sum Insured

Domiciliary Hospitalization Covered upto Sum Insured

No Claim 10% of Base Sum Insured upto a max of 50%

Re-load of Sum Insured (3) Upto Base Sum Insured

Government Hospitals - Covered upto Sum Insured;

Vaccination in case of Animal Bite (5) Upto Rs.2,500

Emergency Domestic Evacuation (Bed to Bed on advise of treating

Worldwide Emergency Hospitalization (excluding US and

International Treatment abroad for specified 11 critical illnesses along

Health & Wellness Benefits

Health Check-up Once in 2 years

Preventive Healthcare & Wellness (7) Available

Second Opinion for 11 specified Critical Illness (8) Not Covered

OPD Treatment (9) Not Covered

Maternity Benefits (10)

- Maternity cover for up to 2 deliveries Not Covered

- New Born Baby Cover Not Covered

CUSTOMER LEVEL OPTIONS:

1. Top-up plan on annual aggregate basis Deductible of Rs.1,2,3,4,5 and 10 lacs

2. Hosptial Cash (for 30 days in case of hospitalization

Covered up to Sum Insured Covered up to Sum Insured

Covered upto Sum Insured Covered upto Sum Insured

Covered upto Sum Insured Covered upto Sum Insured

Covered up to Sum Insured Covered up to Sum Insured

Upto Base Sum Insured Upto Base Sum Insured

Upto Rs.5,000 Upto Rs.7,500

Covered upto Rs.100,000 Covered upto Rs.300,000

50% of Base Sum Insured upto max of Rs.20lacs; Deductible of $1,000

Covered upto Sum Insured

Not Covered Upto Rs.10,000

Not Covered Rs.200000 Rs.200000 Rs.200000 Rs.250000 Rs.250000

Not Covered Rs.625,000 Rs750,000 Rs.1,250,000 Rs.2,500,000 Rs.3,750,000

Not Covered Covered upto 10,000

Deductible of Rs.1,2,3,4,5 and 10lacs Not Available

Not Available Available

(1) Baseline cover includes a

(a) Medical Practitioners’ fees;

(b) Room Rent, boarding expenses;

(c) Intensive Care Unit charges;

(d) Diagnostics Procedures charges;

(e) Medicines, drugs and consumables;

(f) Nursing Charges;

(g) Intravenous fluids, blood transfusion, injection administration charges;