Requirement of Medical Documents

Sum Insured limit

Upto Rs.5 lakhs Sum Insured Rs.7.5 lakhs & Rs.10 lakhs Sum Insured

Age band
Age 56-65

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

FAMILY HEALTH PROTECTOR

Age 51-65

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)

Total Health Security For You & Your Family

Option to cover maximum family members 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)

Health Check up Reimbursement

Affordable Premium

Convalescence Benefit

Hospital Cash Benefit

Insurance is the subject matter of solicitation

Tax Benefit

Coverage Starts from Day One

Pre and Post Hospitalisation Expenses

PT1228/FEB12/VER02

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

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

Covers Day Care Expenses

Cumulative Bonus

Cashless Hassle Free Hospital Treatment

Ambulance Charge Reimbursement

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.

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.

Premium Table (Rs.)

Age Band
1A 1A + 1C 1A + 2C 1A + 3C 1A + 4C 2A 2A + 1C 2A + 2C 2A + 3C 2A + 4C 3A 3A + 1C 3A + 2C 3A + 3C 3A + 4C 4A 4A + 1C 4A + 2C 4A + 3C 4A + 4C

Sum Insured-2,00,000
Upto 35 yrs 2943 3618 4204 6363 8150 4223 4854 7583 9682 4827 5504 8803 11212 5430 6154 3893 4651 4450 5221 7798 4951 5757 8807 5450 6294 9815 5951 6832 5476 6538 6032 7108 6533 7644 7033 8182 7532 8719 6815 8137 7372 8707 7872 9244 8372 9781 8872 10318

Upto 45 Yrs 3515

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.

Upto 55 Yrs N.A Upto 60 Yrs N.A Upto 70 Yrs N.A

10024 6770 12744 8752

10825 9522

10550 11558 12567 13577 11848 12876 13885 14895 15903 20384

Minimum and Maximum age of Entry:

Adults - 18 years to 65 years. For Dependent children 91 days to 21 years.

10018 11284 12550 13817 12310 13577 14843 16109 17376 15319 16585 17852 19118 12707 13973 15240 16506 16089 17356 18622 19888 21154

Cashless Hassle Free Facilities:

These facilities are available at over 3000 network hospitals across India, Ensuring complete peace of mind.

10182 11713 13243 14775 11441

20021 21288 22554 23820 25086

Sum Insured-3,00,000
Upto 35 yrs 4024 4840 6467 8826 5575 8285 6311 10101 7047 5321 5995 7595 10715 6604 9097 7213 7822 7482 8156 8765 9374 9983 9310 9984 10593 11202 11811

(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

Hospital Cash Benefit:

For all admissible claims, apart from the medical expenses, a daily cash benefit of Rs.500 for each 24 hours of hospitalisation will be paid. This cash benefit is aimed towards out of pocket expenses over and above hospitalisation expenses.

Upto 45 Yrs 4534 Upto 55 Yrs N.A Upto 60 Yrs N.A Upto 70 Yrs N.A

11918 5998 14511 9119

10598 12099 8433

10030 11532 13033 14534 10495 12092 13594 15094 16595 15959 17556 19122 20689 22255 20720 22319 23916 25514 27111 30799 32609 34419 36229 38040

10720 12615

12282 13848 15414 12825 14421 15987 17554 19120

10884 12817 14749 16682 11841

13438 15036 16633 18231 16648 18246 19844 21442 23040

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.

15497 17688 19878 22068 17597 19408 21218 23028 24839 24749 26560 28370 30180 31991

Sum Insured 4,00,000

Upto 35 yrs 4694 5575 6585 6370 7437 7166 8289 7962 9140 6209 7511 6937 8260 7594 9457 8251 9670 8909 8732 9459 10116 10775 11432 10865 11593 12250 12908 13565

Pre and Post-Hospitalisation Expenses:

Covers all relevant medical expenses incurred 30 days prior to and 60 days after hospitalisation.

Upto 45 Yrs 5678 Upto 55 Yrs N.A Upto 60 Yrs N.A Upto 70 Yrs N.A

10374 10563 11312

12016 12722 13426 13145 13895 14599 15303 16008 20067 21188 22286 23386 24484 26102 28121 30142 32162 34183 38847 41136 43425 45713 48003

Income Tax Benefit:

Income tax exemption under Section 80D of Income tax Act.

(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 Lymphadenopathy Associated Virus (LAV) or the Mutants Derivative 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'.

10026 11355 12685 14014 11468 12587 13687 14785 15884 16126 17246 18345 19444 20542 13721 16165 18609 21052 14915 16935 18955 20975 22997 20974 22995 25015 27035 29055 19554 22323 25091 27859 22198 24486 26776 29064 31352 31216 33504 35794 38081 40371

Tenure - One year Cover 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.

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 24337 25274 26153 27034 27913

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), Tonsillectomy, 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.

Upto 45 Yrs 10515 11648 12715 13780 14845 13907 14844 15723 16603 17483 19558 20495 21374 22254 23134 Upto 55 Yrs N.A Upto 60 Yrs N.A Upto 70 Yrs N.A 17729 19390 21050 23903 26956 30010

22710 21208 22609 23983 25355 26729 29824 31225 32597 33971 35344 37113 38513 39886 41260 42633 33064 27574 30099 32624 35149 37673 38775 41300 43824 46350 48875 48256 50780 53305 55830 58354

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 13921 15518 17117 21216 23709 26201 14809 13895 15546 17038 18528 20019 19538 21189 22680 24170 25662 24313 25964 27455 28946 30438 34215 35915 37513 39112 40711

Upto 45 Yrs N.A Upto 55 Yrs N.A Upto 60 Yrs N.A Upto 70 Yrs N.A

18715 19552 21252 22850 24449 26048 27493 29194 30793 32391 33990 28695 29881 32422 34914 37406 39898 42021 44561 47053 49545 52038

52293 54833 57325 59817 62310 68055 72635 77215 81795 86375 89414 94607 99800 104991 110184

28887 33467 38049 42630 38889 43468 48049 52629 57208 54688 59268 63848 68427 73007 37126 42319 47510 52703 51094 56285 61478 66670 71862 71851 77043 82235 87427 92620

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

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

Upto 45 Yrs N.A Upto 55 Yrs N.A Upto 60 Yrs N.A Upto 70 Yrs N.A

14825 16957 19088 21220 20094 22362 24493 26625 28756 28258 30524 32657 34787 36919 22588 25912 29235 32557 30721 31104 34110

35166 37434 39564 41696 43827

37434 40758 44081 43203 46591 49915 53239 56562 53764 57152 60476 63798 67123 69983 76093 82201 88311 94420

37212 43322 49430 39990 46099 52208 58317 64426 56235 62344 68453 74562 80671

39764 46688 53612

60536 52545 59470 66395 73319 80244 73892 80816 87741 94665 101591 91956 98880 105805 112729 119654

A - Adult, C - Children,
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