Policy Features

STAR HEALTH ASSURE INSURANCE POLICY

ABOUT THE POLICY
• Covers Hospitalization expenses incurred as a result of illness and / or accidental injuries

TYPES OF COVER
• Individual
• Floater

ENTRY AGE
• Individual:- Min 18 Years to Max 75 Years, Dependent Children :- Min 91 Days to Max 17 Years.
• Floater :- Min 18 Years to Max 75 Years, Dependent Children :- Min 91 Days to Max 17 Years.
• Note :- In case of Dependent children, at the time of renewal when they become 18 Years of age , such children will be considered as Adult and He/ She can continue under floater sum insured till He/ She gets married.

MAXIMUM FAMILY SIZE
• Maximum Family Size is 2A+3C+4P, Self, Spouse, Dependent Children, Parents and parents in law.
• 6 Adults + 3 children (6 adults = Self, Spouse, Parents, parents in law).
• If dependent parents and parents in law alone wants to cover under this policy separately, the same is possible under 2A family scheme.

MIDTERM INCLUSION
• Available for Newly wedded Spouse.
• New born baby and Legally adopted child. Intimation should be given within 45 days from date of marriage of date of birth.

ZONE BASED PRICING
• Zone A :- Delhi including Faridabad, Gurgaon, Ghaziabad and Noida , Mumbai including Thane, Ahmedabad, Surat and Vadodara.
• Zone B :- Pune Including Nashik, Trivandrum, Emakulam, Chennai, Bengaluru, Hyderabad, secunderabad and Rest of Gujarat.
• Zone c :- Rest of India

CO – PAYMENT
• 10% of each and every claim amount for fresh as well as renewal policies for insured person whose age at the time of entry is 61 years an above…

RENEWAL
• Lifelong

POLICY TERM
• one Year, Two Year, & Three year

LONG TERM DISCOUNT
• Two Year policy :- 10% discount on 2nd Year premium
• Three Year Policy :- 10% discount is available on 2nd and 3rd Year premium.

FLOTER DISCOUNT
• For Child:- 40% discount is available from 1A premium when She/ He becomes 18 years at the time of renewal in floater policy.
• For parent/ parent in law 10% discount is available from 1 premium for each parent when they come under floater policy.

PRE MEDICAL SCREENING
• For those who declare adverse medical history, company may subject them to undergo pre- policy medical check – up 100% cost of such medical examination is borne by the company.

Note :- For children whose age is less than 12 years, pediatrician letter , Vaccination report or health Report should be submitted and the proposal will be routed to our CMU Team for medical opinion.

SUM INSURED OPTIONS (RS. IN LAKHS)

5/10/15/20/25/50/75/100/200.

Note :- Rs. 75 Lakhs , Rs. 100 lakhs and Rs. 200 lakhs sum insured will be available for persons aged up to 65 Years only. This is applicable only at the time of inception of his policy.

ROOM RENT
• 1% OF SI Any room (except suite or above category) ANY ROOM

COVERAGE FOR NON MEDICAL ITEMS (CONSUMABLES)
• If there is an admissible claim under inpatient/ day care the policy, then items as per List will become payable.

EMERGENCY ROAD AMBULANCE
Covered up to sum insured
1. For Transportation to hospital
2. From one hospital to other hospital
3. From hospital to residence

PRE & POST HOSPITALIZATION
• 60 DAYS & 180 days. Covered upto sum insured.

ORGAN DONOR EXPENSES
• Covered upto sun insured. Additional SI up to SI for the complications (if any) that necessitate a redo.

DAY CARE TREATMENTS
• All day care treatments are covered up to sum insured.

DOMICILLARY HOSPITALIZATION
• Covered up to sum insured. Treatment taken at home for the period exceeding three days.

HOME CARE TREATMENT
• 5/10/15/20/25/50/75/100/200
• Payable up to 10% of the sum insured subject to
maximum of Rs.5 Lakhs in a policy year.

AIR AMBULANCE
• Covered up to 10% of sum insured per policy year
STAR WELLNESS PROGRAM: - (available for insured aged => 18 yrs).
• Insured can earn reward points and avail premium discount up to 20% on the renewal premium by enrolling and achieving the wellness goals. For details please refer the policy wording/prospectus.
Sum Insured Options (Rs. in Lakhs)
• 5/10/15/20/25/50/75/100/200

HEALTH CHECK –UP ASSURE (each policy year irrespective of claim)
Individual (RS): - 1500/2000/4000/5000/5000/8000/8000/8000
Floater (RS): - 2500/5000/8000/10000/10000/10000/15000/15000

CUMULATIVE BONUS
• 25% of sum insured for each claim free and maximum up to 100% of the sum insured.
Ayush Treatment (For Ayurveda, Unani, Sidha & Homeopathy)
• Covered up to sum insured
Assisted Reproduction Treatment (Limit of Liability in a policy year)
1lakhs/ 2lakhs/2lakhs/2lakhs/2lakhs/4lakhs/4lakhs/4lakhs/4lakhs

Delivery Expenses (Per Policy Year)
• Covered up-to 10% of the Sum Insured.
• Both self and spouse are covered under this policy for a continuous period of 2 years under Individual or floater sum insured.

In Utero Fetal surgery/Intervention
• Covered up to sum insured, Waiting period: 2 years from the date of inception of this policy.

Sum Insured Options (Rs. in Lakhs)
• 5/10/15/20/25/50/75/100cr/200cr
Hospitalization Expenses for Treatment of Now Born Cover.
2lakhs/2lakhs/2lakhs/2lakhs/2lakhs/4lakhs/4lakhs/4lakhs/4lakhs

Treatment for Chronic Severe Refractory Asthma.
• Payable up to 10% of sum insured not exceeding Rs. 5 Lakhs per policy period
Compassionate Travel
• Company will reimburse the transportation expenses by air incurred up to Rs. 10,000/- for one immediate family member (other than the travel companion)
Repatriation of mortal remains
• Company shall reimburse up to Rs. 15,000/- in a policy year
• Payable towards the cost of repatriation of mortal remains of the insured person (including the cost of embalming and coffin charges) to the residence of the Insured as recorded in the policy.

Treatment in Valuable Service Providers Network.
• 1% of Sum insured subject to a maximum of Rs. 5,000/- per policy period is payable as lump sum.

Shared Accommodation
• Payable for in-patient hospitalization, then amount of Rs. 1,000/- per day will be payable for each continuous and completed period of 24 hours of stay in such shared accommodation

Second Medical Opinion
• Can obtain a Second Medical Opinion from a Doctor in the Company's network of Medical Practitioners. All medical records should be forwarded to the mail-ide medicalopinion@starhealth.in.or through Post/Courier.

Automatic Restoration
• Sum insured will be restored unlimited number of times and maximum up to 100% each time, which can be utilized for a subsequent hospitalization.

• Restoration will trigger immediately upon partial/ full utilization of the sum insured, which can be utilized for a subsequent hospitalization.

• On partial utilization of the Sum insured, it will be restored up to extent of utilization. On full utilization of the Sum Insured, it will be restored to 100% Used for all claims including for modern treatment, but for a subsequent hospitalization.

• Maximum payable amount for a single claim under restoration benefit shall not more than the sum insured Covered up to sum insured.

Modern treatments
• Covered up to sum insured

Rehabilitation and Pain Management
• Covered up to the sub-limit (or) maximum up to 20% of the sum insured whichever is less, per policy year.

Optional Cover to choose deductible: - This deductible is applicable for every policy year (on Aggregate basis)

OPTIONAL COVER

Sum insured Aggregate Deductible option Discount offered

Up to Rs. 20 lakhs Rs. 50,000 45%,
Rs. 100,000 55%

Above Rs. 20 lakhs Rs. 50,000 35%,
Rs. 100,000 50%

WAITING PERIOD
• Initial waiting period:- 30 days for all illnesses (except accident)
• For Specific diseases for Pre-existing diseases: - 2 year
• For pre - For Pre-existing diseases: - Applicable for 3-year policy term: 2.5 years.
• Applicable for 1 year and 2-year policy term 3 year
• Delivery Expenses cover: - 2 years
• In Utero Fetal Surgery/ intervention: - 2 years
• Assisted Reproduction treatment: - 2 years
• New born baby cover: - 1 year