Total Health SecurityFor You & Your Family

FAMILYHEALTH PROTECTOR

Pre and PostHospitalisation

Expenses

CoverageStarts fromDay One

HospitalCash Benefit

TaxBenefit

AffordablePremium

ConvalescenceBenefit

Health Check upReimbursement

CumulativeBonus

Covers DayCare Expenses

AmbulanceCharge

Reimbursement

Cashless Hassle Free Hospital

Treatment

Option to cover maximum familymembers in a single policy. ( Up to 4 adults + 4 children in one policy)

High Sum Insured options available (Rs.5 lakhs, Rs.7.5 lakhs & Rs.10 lakhs per policy)

ROYAL SUNDARAM ALLIANCE INSURANCE CO.LTDSundaram Towers, 45&46, Whites Road,Royapettah,Chennai - 600 014.Telephone: 044-2851 7387, Fax: 044-2846 2345E-mail: customer.services@royalsundaram.inCall: 1860 425 0000 l Visit: www.royalsundaram.in

AMSURE INSURANCE AGENCYRegistered Office:Plot No. 5, DDA Local Shopping Centre,Okhla Commercial Complex, Phase-II,New Delhi - 110 020Visit us at www.amsure.in

Requirement of Medical Documents

Sum Insured limit

Upto Rs.5 lakhsSum Insured

Rs.7.5 lakhs &Rs.10 lakhsSum Insured

Age band

Age 56-65

Age 51-65

Tests

Blood Sugar Test (fasting & PP), ECG print out with report, Routine Urine Analysis

HBA1C (Blood Sugar report), Urine Analyis report , ECG printout with report, Lipid Profile, Hemoglobin, Serum Creatinine and Liver Function Test. Medical Examination Report by doctor ( in prescribed format)

Insurance is the subject matter of solicitation

PT1

228/

FEB

12/V

ER02

The premium is inclusive of 12.36% Service Tax. Service Tax charges subject to change with notification of Government and will have an impending effect on premium.*Available only upto 65 years for New business. Age bracket between 66 to 70 years is available only for renewals

Sum Insured-2,00,000

Upto 35 yrs 2943 3618 4223 4827 5430 3893 4450 4951 5450 5951 5476 6032 6533 7033 7532 6815 7372 7872 8372 8872

Upto 45 Yrs 3515 4204 4854 5504 6154 4651 5221 5757 6294 6832 6538 7108 7644 8182 8719 8137 8707 9244 9781 10318

Upto 55 Yrs N.A 6363 7583 8803 10024 6770 7798 8807 9815 10825 9522 10550 11558 12567 13577 11848 12876 13885 14895 15903

Upto 60 Yrs N.A 8150 9682 11212 12744 8752 10018 11284 12550 13817 12310 13577 14843 16109 17376 15319 16585 17852 19118 20384

Upto 70 Yrs N.A 10182 11713 13243 14775 11441 12707 13973 15240 16506 16089 17356 18622 19888 21154 20021 21288 22554 23820 25086

Sum Insured-3,00,000

Upto 35 yrs 4024 4840 5575 6311 7047 5321 5995 6604 7213 7822 7482 8156 8765 9374 9983 9310 9984 10593 11202 11811

Upto 45 Yrs 4534 6467 8285 10101 11918 5998 7595 9097 10598 12099 8433 10030 11532 13033 14534 10495 12092 13594 15094 16595

Upto 55 Yrs N.A 8826 10720 12615 14511 9119 10715 12282 13848 15414 12825 14421 15987 17554 19120 15959 17556 19122 20689 22255

Upto 60 Yrs N.A 10884 12817 14749 16682 11841 13438 15036 16633 18231 16648 18246 19844 21442 23040 20720 22319 23916 25514 27111

Upto 70 Yrs N.A 15497 17688 19878 22068 17597 19408 21218 23028 24839 24749 26560 28370 30180 31991 30799 32609 34419 36229 38040

Sum Insured 4,00,000

Upto 35 yrs 4694 5575 6370 7166 7962 6209 6937 7594 8251 8909 8732 9459 10116 10775 11432 10865 11593 12250 12908 13565

Upto 45 Yrs 5678 6585 7437 8289 9140 7511 8260 9457 9670 10374 10563 11312 12016 12722 13426 13145 13895 14599 15303 16008

Upto 55 Yrs N.A 10026 11355 12685 14014 11468 12587 13687 14785 15884 16126 17246 18345 19444 20542 20067 21188 22286 23386 24484

Upto 60 Yrs N.A 13721 16165 18609 21052 14915 16935 18955 20975 22997 20974 22995 25015 27035 29055 26102 28121 30142 32162 34183

Upto 70 Yrs N.A 19554 22323 25091 27859 22198 24486 26776 29064 31352 31216 33504 35794 38081 40371 38847 41136 43425 45713 48003

Sum Insured 5,00,000

Upto 35 yrs 7492 8594 9588 10582 11576 9909 10819 11640 12462 13284 13935 14845 15666 16488 17309 17342 18251 19073 19895 20715

Upto 45 Yrs 10515 11648 12715 13780 14845 13907 14844 15723 16603 17483 19558 20495 21374 22254 23134 24337 25274 26153 27034 27913

Upto 55 Yrs N.A 17729 19390 21050 22710 21208 22609 23983 25355 26729 29824 31225 32597 33971 35344 37113 38513 39886 41260 42633

Upto 60 Yrs N.A 23903 26956 30010 33064 27574 30099 32624 35149 37673 38775 41300 43824 46350 48875 48256 50780 53305 55830 58354

Upto 70 Yrs N.A 30833 34294 37755 41217 36199 39060 41920 44781 47642 50905 53765 56626 59487 62348 63349 66209 69070 71930 74792

Sum Insured 7,50,000

Upto 35 yrs N.A 10336 11827 13318 14809 13895 15546 17038 18528 20019 19538 21189 22680 24170 25662 24313 25964 27455 28946 30438

Upto 45 Yrs N.A 13921 15518 17117 18715 19552 21252 22850 24449 26048 27493 29194 30793 32391 33990 34215 35915 37513 39112 40711

Upto 55 Yrs N.A 21216 23709 26201 28695 29881 32422 34914 37406 39898 42021 44561 47053 49545 52038 52293 54833 57325 59817 62310

Upto 60 Yrs N.A 28887 33467 38049 42630 38889 43468 48049 52629 57208 54688 59268 63848 68427 73007 68055 72635 77215 81795 86375

Upto 70 Yrs N.A 37126 42319 47510 52703 51094 56285 61478 66670 71862 71851 77043 82235 87427 92620 89414 94607 99800 104991 110184

Sum Insured 10,00,000

Upto 35 yrs N.A 11122 13110 15099 17088 14272 16474 18464 20454 22444 20069 22272 24262 26252 28241 24976 27179 29168 31159 33148

Upto 45 Yrs N.A 14825 16957 19088 21220 20094 22362 24493 26625 28756 28258 30524 32657 34787 36919 35166 37434 39564 41696 43827

Upto 55 Yrs N.A 22588 25912 29235 32557 30721 34110 37434 40758 44081 43203 46591 49915 53239 56562 53764 57152 60476 63798 67123

Upto 60 Yrs N.A 31104 37212 43322 49430 39990 46099 52208 58317 64426 56235 62344 68453 74562 80671 69983 76093 82201 88311 94420

Upto 70 Yrs N.A 39764 46688 53612 60536 52545 59470 66395 73319 80244 73892 80816 87741 94665 101591 91956 98880 105805 112729 119654

Premium Table (Rs.)

A - Adult, C - Children,

Key Features & Benefits

One Policy - One Premium for the entire family: The floater health plan covers your family under one policy with one sum insured and one premium. This takes care of hospitalisation expenses in case of a sudden illness and accident for the entire family. You can choose a cover of Rs.2 Lakhs, Rs.3 Lakhs, Rs.4 Lakhs, Rs.5 lakhs, Rs.7.5 lakhs or Rs.10 lakhs. Family Includes - Self, Spouse, Dependent Parent and Dependent children upto the age of 21 years of age. Minimum and Maximum age of Entry:Adults - 18 years to 65 years. For Dependent children 91 days to 21 years.Cashless Hassle Free Facilities:These facilities are available at over 3000 network hospitals across India, Ensuring complete peace of mind.Hospital Cash Benefit: For all admissible claims, apart from the medical expenses, a daily cash benefit of Rs.500 for each 24 hours of hospitalisa-tion will be paid. This cash benefit is aimed towards out of pocket expenses over and above hospitalisation expenses.Convalescence Benefit:For all admissible claims, if the hospitalisation exceeds 21 consecutive days a lump sum of Rs.10,000 will paid as convalescence benefit.Pre and Post-Hospitalisation Expenses:Covers all relevant medical expenses incurred 30 days prior to and 60 days after hospitalisation.Income Tax Benefit:Income tax exemption under Section 80D of Income tax Act.Tenure - One yearCover from day 1 - Waiver of 30 days waiting period.No Health check up requirement for persons up to 50 years of age for Sum Insured Rs.7.5 & Rs,10 lakhs and upto 55 years of age for Sum Insured upto Rs.5 lakhs.

Additional features:

Cumulative Bonus: Sum Insured increases by 5% for every claim free policy year subject to maximum of 50%

Day Care expenses also covered for treatments like Dialysis, Chemotherapy, Radiotherapy, Eye surgery, Cataract, Lithotripsy (Kidney stone removal), Tonsillec-tomy, D & C , Cardiac Catheterization, Hydrocele surgery, Hernia Repair surgery and such other surgeries that require hospitalization less than 24 hours.

Ambulance charges reimbursement subject to Rs.1000/- per person per claim

Health Check up reimbursement subject to a maximum of Rs.750/- per person, after each 4 consecutive claim free years.

Coverage for pre-existing diseases after 4 consecutive years of Insurance with Royal Sundaram.

Hospitalization Expenses:

Room, Boarding Expenses as charged by the Hospital /Nursing Home, subject to a limit of 2% of the Sum Insured per day and for Intensive care unit 4% of the Sum Insured per day.

Nursing Expenses Surgeon, Anesthetist, Medical Practitioner, Consultants

and Specialist Fee

Anaesthesia, Blood, Oxygen, Operation Theatre charges, Medicines and Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs, Cost of Organs

The Claim amount payable towards treatment of Cataract is limited to 10% of Sum Insured per person during the period of Insurance.

Exclusions

Any pre existing condition(s) as defined in the policy, until 48 months of continuous coverage have elapsed, since inception of the first Family Health Protector Insurance with us.

(a)First Year Exclusions:

Treatment of Congenital Internal Diseases, any type of Migraine /Vascular head ache, Stones in the Urinary and Biliary systems, Surgery on Tonsils / Adenoids, Gastric and Duodenal Ulcer, any type of Cyst/ Nodules / Polyps, any type of Breast Lumps for all Insured Persons for one year from the Commencement Date of the cover with Us under this Family Health Protector policy. These exclusions will not be applicable if caused directly due to an accident during period of insurance However if these diseases are Pre Existing as defined, at the time of proposal then they will be considered as falling under Exclusion 1

(b) Two Year Exclusions: Treatment of Spondylosis / Spondilitis - any type, Inter

vertebral Disc Prolapse and such other Degenerative Disorders. Cataract, Benign Prostatic Hypertrophy, Hysterectomy, Fistula, Fissure in Anus, Piles, Hernia, Hydrocele, Sinusitis, Knee / Hip Joint replacement, Chronic Renal Failure or end stage Renal Failure, Heart diseases, any type of Carcinoma / Sarcoma / Blood Cancer, Osteoarthritis of any joint for all Insured Persons for two years from the Commencement Date of the cover with Us under this Family Health Protector policy. These exclusions will not be applicable if caused directly due to an accident during period of insurance.

Treatment arising from or traceable to pregnancy/ childbirth

Circumcision unless necessary for t reatment of a disease, not excluded hereunder or necessitated due to an accident.

The cost of spectacles, contact lenses and hearing aids. Dental treatment or surgery of any kind unless requiring

Hospitalisation. Convalescence, general debility, 'Run-down' condition or

rest cure, Congenital External Disease or defects or anomalies, Tubectomy, Vasectomy, Venereal disease, intentional self injury or attempted suicide.

All expenses arising out of any condition directly or indirectly caused by or associated with Human T-Cell Lymphotropic Virus Type III (HTLB III) or Lymphad-enopathy Associated Virus (LAV) or the Mutants Deriva-tive or variations Deficiency Syndrome or any Syndrome or condition of a similar kind commonly referred to as AIDS.

The list of exclusions is not exhaustive and for complete details, please refer to the policy terms and conditions'.

Age Band1A+

1C

1A+

2C

1A+

3C

1A+

4C2A

2A+

1C

2A+

2C

2A+

3C

2A+

4C

3A+

1C

3A+

2C

3A+

3C

3A+

4C

4A+

1C

4A+

2C

4A+

3C

4A+

4C4A3A1A