STAR COMPREHENSIVE INSURANCE POLICY

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITEDPERSONAL & CARING

STAR COMPREHENSIVE INSURANCE POLICY


• Family Floater• Family Size : 2A + 3C• Age At Entry : 5months to 65 years

RENEWALS GUARANEED TILL LIFELONG .

No Cap on Room Rent. No Sub limits on any Hospitalization Expenses including Day Care

Procedures. Pre hospitalization up to 30 days & Post hospitalization expenses can be

claimed up to 60 days on actual basis. ( All bills, receipts, reports, Prescription to be submitted).

Allowable Expenses…

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITEDPERSONAL & CARINGStar Comprehensive Insurance Policy

Sum Insured (Rs.) Ambulance Charges Per Policy Period (Rs.)

5 Lakhs 2000

7.5 Lakhs 3000

10 Lakhs 3500

15 Lakhs 4000

20 Lakhs 4500

25 Lakhs 5000

Ambulance Charges


What is Hospital Cash?Can be termed as incidental Expenses (say Auto Expenses, food, lodging boarding etc for the attendee)

Do I need to submit any bills ?

No…..

How do I claim Hospital Cash?

Will be paid as a reimbursement

Hospital Cash…


• Per hospitalization : 7 days• Per policy Period : 120 days• To be paid only in case of Inpatient Treatment.

Time Excess : One day

Sum Insured (Rs.) Limits per day (Rs.)

5 Lakhs 500

7.5 Lakhs – 10 Lakhs 750

15 Lakhs – 20 Lakhs 1000

25 Lakhs 1500

Hospital Cash…


Sum Insured Options…

Age @ Entry (61 – 65)

SI restricted to 5 lacs/7.50 lacs Maximum during lifetime.

Sum Insured (Rs.)

5 Lakhs 7.50Lakhs 10 Lakhs

15 Lakhs 20 Lakhs 25 Lakhs


Delivery Benefit Limits

Sum Insured(Rs.)

Normal Delivery(Rs.)

Caesarean Section Delivery (Rs.)

5 Lakhs 10,000 15,000

7.5 Lakhs 20,000 40,000

10 Lakhs -25 Lakhs 25,000 40,000

Waiting period 36 monthsDelivery and New Born Baby Cover..

Maximum 2 deliveries. Waiting period between the first delivery claim and the second one is 24 months.


Can I claim for room rent, doctor fees over above the delivery charges?No…It’s a package and nothing extra is payable is over and above what is shown as Delivery Charges. This package also includes pre and post Natal Check Up.

No loading is applicable for Delivery & New Born

Baby cover.

Delivery charges..


For Sum Insured (Rs.) Limit of Coverage (Rs.)

5,00,000/- 50,000/-

7,50,000/- & above 1,00,000/-

Delivery and New Born Baby Cover..

New Born Baby Coverage for the remaining policy period

Vaccination expenses up to Rs 1000/- incurred on the new born baby.

Subject to Valid claim for Delivery. Covers congenital defects both internal and external.

Both these claims are over and above the Sum Insured.


Baby is born when there are two months left for

renewal.

For two months the baby is covered for 50K for any

impatient treatment.

On renewal, the policy is renewed for 5 lacs and the

child, although less than 5 months, which is the

entry age, assumes the main SI and is covered for all

congenital internal as well as external disease also.

Benefit illustration : SI : 5 lacs : Family size 2A

New Born Baby Cover..


Outpatient Claim Dental/Ophthalmic

Sum Insured (Rs.) Amount payable subject to production of Prescription & Supporting Bills

5,00,000/- & 7,50,000/- Up to Rs.5,000/-

10,00,000/- & above Upto Rs.10,000/-

Waiting period 36 months

Payable after every block of 36 months


Outpatient Claim - Dental/Ophthalmic

• For What all Treatments ?.......

• Dental : Gingivectomy, Root Canal, Braces, Teeth whitening, Cavity etc.

• Ophthalmic : Eye check up, Contact Lens and Spectacles etc…

..

No loading for this claim.Is over and above the Sum Insured.


Cost of Health Check-up to the limits specified after a block of 3 Claim free years of continuous coverage

Benefit payable for insured persons who have been continuously insured under the policy .

Sum Insured (Rs.) Limits (Rs.) on submission of bills / receipts / report copies

5 Lakhs 5,000/-

7.5 Lakhs – 10 Lakhs 7,500/-

15 Lakhs – 25 Lakhs 12,000/-

Cost of Health Check-up..


Restoration of Sum Insured Automatically upto 100% of Sum Insured on exhaustion of Full Sum Insured.

No Extra premium to be charged. Restored amount cannot be used for the same disease for which the

Basic Sum Insured has been used.

Automatic Restoration of Sum Insured..

Benefit illustrations

Family size 2A, Sum Insured 5 lacs. 4th year of the policy period .

1st claim 6 lacs.Claim settled for 5 lacs.

Claim for Delivery & New Born Baby Cover10K + 50 K


1st Inpatient claim settled for 5 lakhs.

Claim for Delivery, New Born Baby cover, Dental/Ophthalmic (Rs.65K) will be still settled even if the main SI is already exhausted in the first inpatient claim.

For the 2nd inpatient claim, Automatic Restoration SI will be utilised.

Benefit illustrations


Waiting period of two years for certain diseases


No claim Bonus ..

The insured would be entitled to benefit of bonus over and above the basic sum insured following a claim free year as per the table given below.

The maximum bonus under the policy will not be more than 100% of the sum insured under any circumstances.


No claim Bonus ..

No Claim Bonus Provision• Where the sum insured under the policy is Rs.5,00,000/- , the insured person would be

entitled to the benefit of bonus calculated at 50% of the basic sum insured under this policy following a claim free year up to a maximum of 100%. In case a claim is made during the policy period, the bonus will be reduced by 50% in the following year. If there is a claim in the succeeding year also the bonus will become zero. The basic sum insured will however not be reduced.

• Where the sum insured under the policy is Rs.7,50,000/-, or Rs.10,00,000/- or Rs. 15,00,000/- or Rs.20,00,000/- or Rs.25,00,000/-, the insured person would be entitled to the benefit of bonus calculated at 100% of the basic sum insured under this policy following a claim free year. In case a claim is made during the policy period, the bonus will become zero in the following year. The maximum allowable bonus is 100%


10% co-payment for persons entering between 61 yrs and 65 yrs and continues thereafter

Co-payment applicable only for Section I claims

All other exclusions remain unchanged.

Co-payment..

Health is Wealth

Enhance your Wealth


Star Comprehensive• Premium less by 1% to 9%• Automatic Restoration of 100%

of Sum Insured

Appollo Easy Health• More expensive than Star• No Restoration facility

Star Comprehensive v/s Apollo’s Easy Health


Claim under Delivery and New Born Baby Cover:Sum Insured for the 1st year - Rs. 5,00,000/-Sum Insured for the 2nd Year - Rs. 7,50,000/-Sum Insured for the 3rd year - Rs. 7,50,000/-Sum Insured for the 4th Year - Rs. 5,00,000/-

A claim is made in the 4th year The eligibility will be as per 5 lakh Sum Insured i.e. Rs 10,000/- for Normal

and Rs 15,000/- for Caesarean delivery. Rs 50,000/- for New Born Baby Rs 1,000/- for Vaccination The limit is inclusive of pre-natal and post-natal expenses

Star Comprehensive Insurance Policy

Benefit Illustration - I


Claim for Health Check Up

Sum Insured for the 1st year - Rs. 5,00,000/-

Sum Insured for the 2nd Year - Rs. 7,50,000/-

Sum Insured for the 3rd year - Rs. 7,50,000/-

Sum Insured for the 4th Year - Rs. 10,00,000/-

Benefits of Health Check Up will be as per Rs 10 lakhs i.e upto Rs 7,500/-


Benefit Illustration - II


Claim for OP treatment for Dental /OpthalSum Insured for the 1st year - Rs. 5 lacsSum Insured for the 2nd Year - Rs. 7.50 lacsSum Insured for the 3rd year - Rs. 7.50 lacsSum Insured for the 4th Year - Rs. 10 lacsBenefit under this section in the fourth year will be as per Rs 10 Lakh SI which

will be Rs 10000/-


Benefit Illustration - III

Admission for Arthroscopic Repair during the 3 year.Sum Insured for 1st Year - Rs. 5 lakhsSum Insured for 2nd Year - Rs. 7.50 Lakhs

Sum Insured Limit for the above treatment will be Rs 5 Lakhs/- (Refer Exclusion 3)

Benefit Illustration - IV


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STAR COMPREHENSIVE INSURANCE POLICY

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