2

ACKNOWLEDGEMENT

Training report is never the sole product of the person whose name appears on the

cover. Many people have lent technical assistance and service. I am graduated to Mr.

Yashvir Singh whose continuous encouragement and willing cooperation have been a

great help in the preparation of this training report.

I wish to express my gratitude to Mr. Yashvir Singh our project guides that

helped me in providing many books.

I express my deep sense of gratitude to Mr. Nitin Srivastav for her valuable

suggestion and up to date guidance at many stages of report which has

enabled me to complete the project on schedule.

Last but not the least I thank all who are responsible for the success of this

training report

Ankush

3

DECLARATION

I Ankush Bathla student of GURU JAMBHESHWAR UNIVERSITY OF SCIENCE &

TECHNOLOGY, HISAR have undertaken this report in my training under the title

“STAR HEALTH FAMILY OPTIMA PLAN” at STAR HEALTH INSURANCE

COMPANY HISSAR

All the information in this reports is my own and original and not copied from anywhere

else.

I also declare that I have done my work sincerely and accurately even then if any

mistake or error had kept in it, I request the readers to point out these errors and guide

me to remove these errors in future.

4

PREFACE

Summer training is a part of our studies. All students have to go for

summer training in an industrial or commercial organization. Their

main objective is to arrange an exposure to actual functioning of the

real atmosphere surrounding the organization. There are so many

aspects which are more complex in practical and their treatment is

possible only through bookish knowledge. I did my summer training in

STAR HEALTH INSUARNCE

Practical work experience is the integral part of individual learning. An

individual who is learning managerial concepts has to undergo this

practical experience for being a future executive.

STAR HEALTH INSURANCE is the market leader in health insurance

company offer project on Star Health Family Optima Plan to

understand the management work through data provided by them.

The training report is the presentation of our observation at insurance sector

Ankush Bathla

5

CONTENTS

Topic Page no.

1. Introduction to insurance 6-30

2. Company profile 30-32

3. About the product 33

4. SWOT analysis 35-36

5. Introduction to subject 44

6. Objective of study 44

7. Policy documents 47

8. Research methodology 48

9. Questionnaire 49

10. Conclusions 51

11. Bibliography 52

6

INTRODUCTION OF INSURANCE:

What is Insurance?

Insurance is a mechanism that ensures an individual to thrive on adverse

consequences by compensating the individual, his/her loss financially. Every individual

in the world and all activities connected with him/her, be it life, profession, business,

travel or any other pursuits are subject to unforeseen and uncalled for hazards or

dangers. The benefit that an individual enjoys in his life by owning a car or a house or a

factory can be snatched by sudden accident which can render even the individual

immobile, and his family vulnerable. At this critical juncture, only insurance helps him

not only to survive but recover his loss and continue his life in a normal manner, which

would otherwise be unthinkable.

The concept of insurance is quite simple. People, who are in similar trade and are

exposed to the same risks, congregate and some to an agreement that if any individual

member suffers a loss, then the loss will be shared by others and minimized in order to

enable the individual member recover from the loss and cover his ground. Similarly the

different kinds of risks can be identified and separate groups can be formed to counter

such risks and reduce the impact to a manageable proportion, in which the share could

be collected from the members either after the loss or in advance, at the time of

admission to the group. This is an exemplary sign of humanity and insurance therefore

serves the mankind to a great extent; a point most of the individuals tend to overlook,

since monetary aspect is involved. Now such is for tangible assets.

The concept of insurance has been extended beyond the coverage of tangible assets.

Exporters run the risk of importers in other country defaulting as well as losses due to

sudden fluctuations in the currency exchange rates, economic policies turmoil. These

risk are now insured. Doctors run the risk of being charged with negligence and can

subsequently liable for damages. The amount in questions can be fairly large, beyond

the capacity of individuals to bear. These are insured. Thus insurance is extended to

7

intangible assets. In some countries even the voice of a singer, legs of a footballer can

be insured, even though the advantage of spread may not be available in these cases.

Satisfaction of economic needs requires generation of income from some source. If

the property, which is the source of such income, were lost fully or partially,

8

Permanently or temporarily, the income too would stop. The purpose of insurance is a

safeguard against such misfortunes few, through the help of the fortune many, who

were

exposed to the same risk, but saved from the misfortune. Thus the essence of

insurance is to share losses and substitute certainty by uncertainty.

The different types of human activities that come under the umbrella of insurance are

as follows.

• House/Office/factory or any moveable - Fire Insurance

Assets destroyed in life.

• Shipment or transportation of goods - Marine Insurance

by ship, destroyed in catastrophe.

• Jewellery/Cash/Household goods - Burglar Insurance

Stolen or robbed.

• Goods in transit by roads or railways - Carrier Insurance

Destroyed.

• Theft or accident of vehicles - Vehicle Insurance

• Financial cover in ailment/surgery etc. – Health Insurance

9

All these are non-life insurance. In conclusion one can safely say that the purpose of

insurance be it life or non-life is to transfer the financial loss to the insurance company

who spreads in over to the policyholders.

10

Characteristics of Insurance

It is a contract for compensating losses.

Premium is charged for Insurance Contract.

The payment of Insured as per terms of agreement in the event of loss.

It is a contract of good faith.

It is a contract for mutual benefit.

It is a future contract for compensating losses.

It is an instrument of distributing the loss of few among many.

The occurrence of the loss must be accidental.

Insurance must be consistent with public policy.

Nature of Insurance

Sharing of Risks

C0-operative Device

Valuation of Risk

Payment made on contingency

Amount of Payment

Large Number of Insured Persons

Insurance is not gambling

Insurance is not charity

11

SCOPE OR KINDS OF INSURANCE

Broadly, insurance may be classified into the following categories:

i. Classification on the basis of nature of insurance.

ii. Classification from business point of view.

iii. Classification from risk point of view.

I. ON THE BASIS OF NATURE OF BUSINESS

On the basis of nature of business, insurance may be the following types:

1. Life insurance

2. Fire insurance

3. Marine insurance

4. Social insurance,

5. Miscellaneous insurance.

LIFE INSURANCE

Life insurance may be defined as a contract in which the insurer, in

consideration of a certain premium, either in a lump sum or by other

periodical payments, agrees to pay to the assured, or to the person for

12

whosen benefit the policy is taken , the assured sum of money, on the

happening of a specified event contingent on the human life.

A contract of life insurance, as in other forms of insurance, requires

that the assured must have at the time of the contract an insurable

interest in his life

Upon which the insurance is affected. In a contract of life insurance, unlike

other Insurance, interest has only to be proved at the date of the

contract, and not Necessarily present at the time when the policy falls

due.

A person can assure in his own life and every part of it, and can

insure for any sum whatsoever, as he likes. Similarly, a wife has an

insurable interest in her husband and vice-versa. However, mere natural

love and affection is not sufficient to constitute an insurable interest. It

must be shown that the person Affectining an assurance on the life of

another is so related to that other person as to have a claim

for support. For example, a sister has an insurable interest in the life of a

brother who supports her.

A person not related to the other can have insurable

interest on that other person. For example creditor has insurable

interest in the life of his debtor to the extent of the debt. A creditor

can insure the life of his debtor up to the amount of the debt, at the

time of issue of the policy. An employee has an insurable interest in

the life of the employer arising out of contractual obligation to

employ him for a Stipulated period at fixed salary. Similarly, from an

employer to the employee who is bound by the contract to serve for a

certain period of time.

13

FIRE INSURANCE

Fire insurance is a contract under which the insurer in return for a consideration (premium) agrees to indemnify the insured for the financial loss which the latter may

suffer due to destruction of or damage to property or goods, caused by fire, during a specified period. The contract specifies the maximum amount , agreed to by the parties

at the time of the contract, which the insured can claim in case of loss. This amount is not , however , the measure of the loss. The loss can be ascertained only after the fire has occurred. The insurer is liable to make good the actual amount of loss not

exceeding the maximum amount fixed under the policy. A fire insurance policy cannot be assigned without the permission of the insurer because the insured must have insurable interest in the property at the time of contract as well as at the time of loss. The insurable interest in goods may arise out on account of

(i) ownership, (ii) possession, or (iii) contract.

A person with a limited interest in a property or goods may insure them to cover not only his own interest but also the interest of others in them.

Under fire insurance, the following persons have insurable interest in the subject matter:-

Owner Mortgagee Pawnee

Pawn broker Official receiver or assignee in insolvency proceedings

14

MARINE INSURANCE

A contract of marine insurance is an agreement whereby the insurer undertakes to

indemnity the assured in a manner and to the extent thereby agreed, against marine

Losses incidental to marine adventure perils of the seas, such as fire, war perils,

pirates, rovers, thieves, captures, Jettisons, barratry and any other perils which are

either of the like, kind or may be designed by the policy.

SOCIAL INSURANCE

Social insurance has been developed to provide economic security to weaker sections of the society who are unable to pay the premium for adequate insurance.

Pension plans, disability benefits, unemployment benefits, sickness insurance, etc.are the various forms of social insurance.

MISCELLANEOUS INSURANCE

The process of fast development in the society gave rise to a number of risks or

hazards. To provide security against such hazards, many other types of insurance

also have been developed. The important among them are:

15

a. Vehicle insurance on buses, trucks, motorcycles, etc.,

b. Personal accident insurance (by paying an annual premium of Rs. 12/-policy

worth Rs. 12000/- can be insured.)

c. Burglary insurance-(against theft, dacoits etc.)

d. cattle insurance: : Crop insurance may be purchased by farmers to reduce or manage various risks associated with growing crops

e. legality insurance

16

II. Classification from business point of view

From business point insurance can be classified into two broad categories:

1. Life insurance; and

2 General Insurance

GENERAL INSURANCE

General insurance business refers to fire, marine , and miscellaneous insurance

business whether carried on singly or in combination with one or more of them but

does not include capital redemption business and annuity certain business.

III. Classification from risk point of view

From risk point of view, insurance can be classified into four categories:

1. Personal insurance

2. Property insurance

3. Liability insurance

4. Fidelity guarantee insurance

17

FIDELITY GUARANTEE INSURANCE

In this type of the insurer undertakes to indemnify the assured (employer)

in consideration premium, for losses arising out of fraud,or embezzlement

Insurance Sector Reforms:

In 1993, Malhotra Committee headed by former Finance Secretary and RBI

Governor R. N. Malhotra was formed to evaluate the Indian insurance industry and

recommend its future direction.

The Malhotra committee was set up with the objective of completing the reforms

initiated in the financial sector.

The reforms were aimed at “creating a more efficient and competitive financial

system suitable for the requirements of the economy keeping in mind the structural

changes currently underway and recognizing that insurance is an important part of

the overall financial system where it was necessary to address the need for the

similar reforms….”

In 1994, the committee submitted the report and some of the key recommendations

Included:

i) Structure:

• Government stake in the insurance Companies to be brought down to 50%

• Government should take over the holdings of GIC and its subsidiaries so that

these subsidiaries can act as independent corporations.

• All these insurance companies should be given greater freedom to operate.

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ii) Competition

Private Companies with a minimum paid up capital of Rs. 1bn should be allowed to

enter the industry.

• No company should deal in both Life and General Insurance through a single

entity.

• Foreign companies should be allowed to enter the industry with the collaboration

with the domestic companies.

• Postal Life Insurance should be allowed to operate in the rural market.

• Only one State Level Life Insurance Company should be allowed to operate in

each state

iii) Regulatory Body

• The Insurance Act should be changed.

• An Insurance Regulatory body should be set up.

• Controller of Insurance (Currently a part from the Finance Ministry) should be

made independent.

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iv) Investments

• Mandatory Investments of LIC Life Fund in government securities to be reduced

from 75% to 50%.

• GIC and its subsidiaries are not to hold more than 5% in any company.

(There current holdings to be brought down to this level over a period of time)

v) Customer Service

• LIC should pay interest on delays in payments beyond 30 days.

• Insurance companies must be encouraged to set up unit linked pension plans.

• Computerization of operations and updating of technology to be carried out in the

insurance industry.

The committee emphasized that in order to improve the customer services and

increase the coverage of the insurance industry should be opened up to competition.

But at the same time, the committee felt the need to exercise caution as any failure

on the part of new players could ruin the public confidence in the industry.

20

Hence, it was decided to allow competition in a limited way by

stipulating the minimum capital requirement of Rs. 100 crores. The

committee felt the need to provide greater autonomy to insurance

companies in order to improve their performance and enable them act

as independent companies with economic motives. For this purpose, it

had proposed setting up an independent regulatory body.

The Insurance Regulatory and Development Authority:

Reforms in the Insurance sector were initiated with the passage of the

IRDA Bill in Parliament in December 1999. The IRDA since its

incorporation as a statutory body in April 2000 has fastidiously stuck to

its schedule of framing regulations and registering the private sector

insurance companies.

The other decisions taken simultaneously to provide the supporting

systems to the insurance sector and in particular the life insurance

companies were the launch of the IRDA’s online service for issue and

renewal of licenses to agents. The approval of institutions for imparting

training to agents has also ensured that the insurance companies

would have a trained workforce of insurance agents in place to sell

their products, which are expected to be introduced by early next year.

Since being set up as an independent statutory body the IRDA has put

in a framework of globally compatible regulations. In the private sector 12 life Insurance and 6 general insurance companies have been

registered.

21

Restructuring of GIC

The GIC was converted into a national re-insurer and its four

subsidiaries were restructured as independent companies. In

December, 2000 the Parliament passed a bill de-linking the four

subsidiaries from GIC in July, 2002. These are

National insurance co.ltd

the oriental insurance co.ltd

The new India assurance co

United India Insurance Co. Ltd.

22

Life insurance industry today

There are 24 insurance companies registered as “Life Insurance”

companies. The list is given below.

Non-Life insurance industry today

There are 28 insurance companies registered as “General Insurance”

companies.

There are 5 standalone Health Insurance companies.

Rest of the companies handle all types of general insurance business.

List of life insurance companies:

1. AegonReligare Life Insurance 13. IDBI Federal Life Insurance

2. Aviva Life Insurance 14. India First Life Insurance

3. Bajaj Allianz Life Insurance 15. Kotak Mahindra Old Mutual Life

4. Bharti AXA Life Insurance Insurance

5. Birla Sun Life Insurance 16. Life Insurance Corporation

6. Canara HSBC OBC Life Insurance17. Max Life Insurance

7. DHFL Pramerica Life Insurance 18. PNB Metlife

8. Edelweiss Life Insurance 19. Reliance Life Insurance

9. Exide Life Insurance 20. Sahara India Life Insurance

10. Future Generali Life Insurance 21. SBI Life Insurance

11. HDFC Standard Life Insurance 22. Sriram Life Insurance

12. ICICI Prudential Life Insurance 23. Star Union Dai-Ichi Life Insurance

24. Tata AIA Life Insurance

23

List of standalone health insurance companies:

1. Apollo Munich Health Insurance 2. Cigna TTK Health Insurance

3. Max Bupa Health Insurance

4. Religare Health Insurance 5. Star Health Insurance

24

What is Healthcare

You have heard of the saying “Health is Wealth”. The word ‘Health’

was derived from the word ‘hoelth’, which means ‘soundness of the

body’.

Over a period of time, modern medicine has evolved into a complex

science and the goal of modern medicine is no longer mere treatment

of sickness but includes prevention of disease and promotion of quality of life. A widely accepted definition of health is the one given by World

Health Organization in 1948.

Definition

World Health Organization (WHO): Health is a state of complete

physical, mental and social wellbeing and not merely the absence of

disease.

Determinants of health

It is generally believed that the following factors determine the health of

any individual:

a) Lifestyle factors

Lifestyle factors are those which are mostly in the control of the

individual concerned e.g. exercising and eating within limits,

avoiding worry and the like leading to good health; and bad

lifestyles and habits such as smoking, drug abuse, unprotected sex and sedentary life style (with no exercise) etc. leading to diseases

b) Environmental factors

Safe drinking water, sanitation and nutrition are crucial to health,

lack of which leads to serious health issues as seen all over the

world, especially in developing countries.e.g. People working in

certain manufacturing industries are prone to diseases related to

occupational hazards such as Asbestos in workers in asbestos

manufacture and also diseases of the lungs in coal miners.

c) Genetic factors

25

Diseases may be passed on from parents to children through

genes. Such genetic factors result in differing health trends

amongst the population spread across the globe based on race,

geographical location and even communities.

It is quite obvious that a country’s social and economic progress depends on the health of its people. A healthy population not only

provides productive workforce for economic activity but also frees

precious resources which is all the more crucial for a developing

country like India. At an individual level, ill health can cause loss of livelihood, inability to perform daily essential activities and push people

to poverty and even commit suicide.

Thus ‘spend’ on healthcare usually forms a significant part of every

country’s GDP

26

Factors affecting the health systems

in India

The Indian health system has had and continues to face many

problems and challenges. These, in turn, affect the nature and extent

of the healthcare system and the requirement at the individual level

and healthcare organization at the structural level. These are discussed below:

Demographic or Population related trends

India is second largest populated country in the world.

This exposes us to the problems associated with population

growth.

The level of poverty has also had its effect on the people’s

ability to pay for medical care.

Social trends

Increase in urbanization or people moving from rural to urban

areas has posed challenges in providing healthcare.

Health issues in rural areas also remain, mainly due to lack of

availability and accessibility to medical facilities as well as

affordability.

The move to a more sedentary lifestyle with reduced need to

exercise oneself has led to newer types of diseases like

diabetes and high blood pressure.

Life expectancy

Life expectancy refers to the expected number of years that a

child born today will survive.

Life expectancy has increased from 30 years at the time of

independence to over 60 years today but does not address the

issues related to quality of that longer lifespan.

27

Evolution of Health Insurance in India

While the government had been busy with its policy decisions on

healthcare, it also put in place health insurance schemes.

Insurance companies came with their health insurance policies

only later. Here is how health insurance developed in India:

a) Employees’ State Insurance Scheme

Health Insurance in India formally began with the beginning of the Employees’ State Insurance Scheme, introduced vide the ESI Act,

1948, shortly after the country’s independence in 1947. This

scheme was introduced for blue-collar workers employed in the

formal private sector and provides comprehensive health services

through a network of its own dispensaries and hospitals.

All workers earning wages up to Rs. 15,000 are covered under the

contributory scheme wherein employee and employer contribute

1.75% and 4.75% of pay roll respectively; state governments

contribute 12.5% of the medical expenses.

The benefits covered include:

Free comprehensive healthcare at ESIS facilities

Maternity benefit

Disability benefit

Cash compensation for loss of wages due to sickness and

survivorship and

Funeral expenses in case of death of worker

It is also supplemented by services purchased from authorized medical attendants and private hospitals. The ESIS covers over

65.5 million Beneficiaries as of March 2012.

b) Central Government Health Scheme

28

The ESIS was soon followed by the Central Government Health

Scheme (CGHS), which was introduced in 1954 for the central

government employees including pensioners and their family

members working in civilian jobs. It aims to provide

Comprehensive medical care to employees and their families and is

partly funded by the employees and largely by the employer

(central government).

The contribution from employees is quite nominal though

progressively linked to salary scale – Rs.15 per month to Rs.150

per month.

In 2010, CGHS had a membership base of over 800,000 families

representing over 3 million beneficiaries.

29

c) Commercial health insurance

Commercial health insurance was offered by some of the non-life

insurers before as well as after nationalization of insurance

industry. But, as it was mostly loss making for the insurers, in the

beginning, it was largely available for corporate clients only and that

too for a limited extent.

In 1986, the first standardized health insurance product for

individuals and their families was launched in the Indian market by

all the four nationalized non-life insurance companies

Today, more than 300 health insurance products are available in

the Indian market.

The health insurance market today consists of a number of players

some providing the health care facilities called providers, others the

insurance services and also various intermediaries

30

COMPANY PROFILE

Industry Health Insurance

Founded 2006

Headquarters Chennai, Tamil Nadu, India

Products Health Insurance Accident Care Insurance Travel Insurance

Website www.starhealth.in

https://en.wikipedia.org/wiki/Insurance_in_India

https://en.wikipedia.org/wiki/Tamil_Nadu

https://en.wikipedia.org/wiki/Health_Insurance

https://en.wikipedia.org/w/index.php?title=Accident_Care_Insurance&action=edit&redlink=1

https://en.wikipedia.org/wiki/Travel_Insurance

http://www.starhealth.in/

31

OVERVIEW

Star Health and Allied Insurance Co Ltd commenced its operations in 2006

with the business interests in Health Insurance, Overseas Mediclaim Policy and Personal Accident. With no other insurance category to focus and

divide our attention, we use our resources to focus on service excellence, design products and use core competency of innovation to deliver the best to our customers.

At Star Health Insurance, the company offers a wide range of health

insurance products at affordable prices to make health insurance every human being’s right. As a company, single-mindedly dedicated to health insurance.

CAPITAL

We have built a promising path for our future with a capital base of Rs.733 crores. We have emerged as India’s first stand-alone Health Insurance

Company, dealing in personal accident, medi-claim and overseas travel insurance.

Under a decade, we have progressed by leaps and bounds. With a nation-

wide customer base to boast off, we have raised the benchmark of the health insurance sector.

Tata Capital invested in the company in 2013, thus increasing the

company total capital to Rs5.49 billion

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VISION:

To Become The Largest And Most Preferred Health Insurance

Company In India.

To Provide Financial Security for Health Care Management

MISSION:

To Offer Wide Range of Innovative Products / Services.

To Provide Prompt, Courteous And Quality Service To Customers.

To Leverage State Of Art Technology For Customer Satisfaction.

To Adopt Best Management Practices In Business Operations.

33

PRODUCTS

Health insurance

a. Individual health plan

b. Family health plan

c. Senior citizen plan

Travel insurance

Accidental insurance plan

34

FEATURES

India’s First Stand-Alone Health Insurance Company

Pan India Presence With More Than 290 Branch Offices

Cashless Hospitalization And Reimbursement Facility In With More Than

7000 Hospitals Across India

24*7 hours call centre facility

Hassle-Free And Customer-Friendly Direct Claim Settlement Without

Intervention Of TPA

Health Insurance Company Of The Year 2015 - Indian Insurance Awards

2015

Personalized Doctor Visit For All Customers Getting Hospitalized

35

SWOT ANALYSIS

[1] STRENGTHS: 1.

Earlier entry:

Star health commences it business in 2006 as very much early as earlier as

compared to 4 other health companies.

2. Business Growth:

They growth is very much higher as compared to other co. 3.

Emerging Middle Income Group-

India’s middle income group is rapidly increasing and would be

emerging as a profitable market.

4.Huge population [2]

WEAKNESS: 1. Low

investment-

Its capital investment capital base of Rs.733 crores.Which is low?

2. Lack of awareness:

There is a lack of awareness about health insurance among people

.3. Increasing competition:

There is rising competition in health insurance market from other co. such as

Hdfchealth, maxbupa etc.

[3] OPPORTUNITIES:

1. Creation of stronger demand-

India’s improving economic fundamentals will support faster growth

in per capita income in the coming years, which will translate into stronger demand for

insurance products.

36

2. Strong future growth:

Strong growth can be sustained for 10-20 years,. There is plenty of room for growth in

personal accident, health and other liability classes.

3. Rise in Income and Awareness:

Rising household income and risk awareness will be the rise in more demand for these

lines of health business in the future.

[4]THREATS:

1. New Arrival:

There is danger of coming new arrival into market in health sector

2. Govt. policies:

There is chance of opposing rules and regulations by govt.

37

HEALTH INSURANCE PLAN

Family Health Optima Insurance Plan

Features:

1. Over 400 Day Care procedures

2. Expenses incurred towards cost of Health Check up after 3 years worth Rs-5,000/-

3. Coverage for New born Baby after 16 days

4. Coverage for Domiciliary hospitalization treatments

5. Get auto recharge at no extra cost,upto 30% of sum insured.

6. Donor expenses for organ transplantation

38

A policy to cover the entire family

Entry Age 16 days to 65 years; only renewals allowed after 65 years.

Sum assured Rs.1 lakh to Rs.15 lakhs

Premiums charged Rs.3,890 to Rs.34,700;Depends on sum assured, age, family size and zone; based on age of oldest insured member

Bonus 15% to 35% depending on the sum assured

Reinstatement of sum assured

100% for coverage of Rs.3 lakhs and above

Co-payment 20% of all claims for insured members of ages 61 to 65 years

Covers Cataract surgery, Ambulance charges, Pre-Existing diseases,

Pre and Post-hospitalization expenses, Day-care expenses

39

Senior Citizens Red Carpet Health Insurance Policy:

Parents have spent their life trying to make our life secure. It’s time you do the same

for them in their old age. Senior Citizen Red Carpet Policy will help parents live worry

free and experience absolute security. Features:

For Senior citizens aged between 60 to 75 years.

No pre-insurance medical test required. Covers pre-existing diseases from the second year onwards

Medical Consultations as an Out Patient in a Network Hospital Higher Sum Insured coverage upto Rs.10Lakhs

Guaranteed lifetime renewals

Co-Payment:

50% of each and every claim relating to pre-existing diseases and 30% of each and

every claim for all other claims

Pre-Existing Diseases/Illness:

Covered after 12 months of continuous coverage

Pre-Acceptance medical screening:

There is no pre-acceptance medical screening.

Tax Benefits:

Amount paid by any mode other than by cash for this insurance is eligible for relief

under Section 80D of the Income Tax Act.

FreeLook Period:

A free look period of 15 days from the date of receipt of the policy is available for

reviewing the policy terms and conditions.

40

Star Health Travel Insurance

Travelling is no more a rare, complicated .this is due to huge leaps in technology,

transportation and communication. Everyday there are people travelling across

borders and seas with the risks associated with travelling. Insurance companies

provide travelers with travel insurance that protect them from unanticipated events

like accidents, medical emergencies and even contingencies such as flight delays,

baggage delay and lost passport..

Types of Star Health Travel Insurance Policy :

Star Health Insurance recognizes the fact that their customers are looking for

different requirements .They offer different plans, each specially to suit these

requirements.

1. Star Travel Protect Insurance

2. Star Student Travel Protect Insurance 3. star health corporate travel health policy

1. Star Travel Protect Insurance Policy:

Health related emergencies while travelling will be covered by this policy. Everything from flight delays, missed flights, emergency expenses, repatriation,

compensation for accidental injuries etc. will be covered with this policy

Eligibility:

This policy can be purchased for anyone above the age of 6

months. Only Indian citizens can get this cover.

Benefits:

Policyholders who are travelling outside India on vacation or business can make

use of this policy. General cover also includes possibilities like hijack distress,

medical emergencies, flight delay, repatriation etc.

41

It even covers third party bodily injury and property loss. Monetary loss because

of trip cancellation due to the death/injury of a family member will be reimbursed

by the company.

2. Star Student Travel Protect Insurance Policy: If you are planning for education abroad, there are certain risks that you may face such as medical emergencies, bereavement, litigation related risks and others.

Star Student Travel Protect Insurance Policy offers coverage for all these and much more.

Benefits:

Reimbursed for tickets to fly home in the event of an emergency

As compassionate benefits, visit of an immediate family member and

reimbursement of academic tuition fee in case of sponsor’s death is offered with this student travel insurance scheme.

The costs related to legal claims including that for bail bond (for false arrest or detention) will be covered.

If the insured has caused bodily injury to third party or damage to third party

property, the costs will be covered.

3. Star Corporate Travel Protect Insurance Policy :

Travelling across the globe for business is the norm now days, and there are many risks associated with it. Everything from delayed baggage, accidental injuries, missed flights travel-related risks are covered in this policy.

Available for a sum insured limit of USD 1,00,000, USD 2,50,000 and USD

5,00,000, this corporate insurance plan is available for travel to countries across

the world including Canada and USA.

Eligibility:

An insured person, his/her spouse and up to two dependent children below

18 years can be covered. They must all be Indian citizens.

The following exigency will be covered in this policy:

Emergency medical expenses

Hijack distress

Compensation following accidental injuries

Repatriation of mortal remains

Repatriation in case of medical emergency Missed departure/connection

Loss of your checked in baggage(up to the limits)

Reasonable expenses incurred for obtaining new passport

Flight delay

paid for the amount you lost due to cancellation of your trip because of death of a family member.

Legal Liability charges; bodily injury or property damage to third party.

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Star Health Travel Insurance Claim Process:

o call the toll-free number to contact Star Health Insurance claims

assistance and register your claim.

o You will be asked to fill out a claims form and send it either by fax or

mail,

o must keep the following ready before making a claim: copy of passport

with immigration stamp, policy copy, original bills/invoices/receipts,

copy of police complaint

o Approval and reference number of assistance company, proof of expenses and a copy of your e-ticket.

o Once the surveyor has assessed your case and documents, your claim

will be processed.

Star health Accidental Care Insurance:

Features:

o Cover for Accident death, Permanent Disability and temporary

Disablement. Compensation for Permanent Total Disablement is 150%

of the sum insured. Enhanced weekly compensation up to Rs.15000/-

per week (maximum 100

o weeks).

o Educational Grant for dependent children

o Cumulative bonus 5% per annum maximum 50%

Benefits:

Additional free benefits

Medical Expenses Extension

Coverage for Winter Sports

Policy Benefits:

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Table A – covers Accidental Death

Table B – covers Accidental Death and Permanent Disablement

Table C – covers Accidental Death, Permanent Disablement and Temporary Total

Disablement (Weekly Compensation)

Additional Free Benefits:

o Educational Grant: Maximum of Rs.10,000/- per child upto 2 children in

case of Death/Permanent Total Disability of the insured person

o Ambulance Charges / Transportation Expenses of Mortal Remains:

The limit of Company’s liability is Rs.5,000/- only during the policy

period.

o Travel Expenses for One Relative (Applicable for Death claims only):

1% of

o Total Sum Insured upto Rs.50,000/- subject to actual for the transport

expenses to one relative of the insured person.

o .

o Purchase of Blood: Upto 5% of the Total sum insured subject to a

maximum of Rs.10,000/- towards the expenses incurred in purchasing

blood through a Hospital or Government approved blood bank.

o Transportation of Imported Medicines: Upto 5% of Total sum insured

subject to a maximum of Rs.20,000/- towards the expenses incurred on

freight charges for importing medicines.

o The above mentioned amounts are payable in addition to the sum

insured.

Eligibility:

o Any person between 18 and 70 years of age at the time of entry can

take this insurance. Lifelong renewal.

o Dependent children covered from 5 months

o Policy benefits are applicable individually for each person covered

under family.

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INTRODUCTION TO TOPIC

STAR Health Family Optima plan:

STAR health insurance given you an option to choose your family health

plan. Premium and policy according to your budget and requirements

OBJECTIVE OF THE STUDY

To know about market share of star health in Indian health insurance sector?

To understand about the company policy

How to calculate premium?

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STAR FAMILY HEALTH OPTIMA INSURANCE PLAN

Features:

Over 400 Day Care procedures

Expenses incurred towards cost of Health Check up after 3 years worth Rs-

5,000/-

Coverage for New born Baby after 16 days

Coverage for Domiciliary hospitalization treatments

Get auto recharge at no extra cost, up to 30% of sum insured.

Donor expenses for organ transplantation

Bonus:

Bonus in respect of a claim-free year of insurance is allowable upto the limits

specified. The bonus so granted will be reduced in the same order in which it was

given following a claim. However the Basic sum insured shall not be reduced.

Automatic Restoration of Sum Insured:

Immediately upon exhaustion of the limit of coverage during the policy period, there

shall be an automatic restoration of the basic sum insured by 100% where the sum

insured is Rs.3,00,000/- and above.

Basic Sum Insured (Rs) % of Restoration on the Basic Sum Insured

Up to 200,000 Nil

300,000 and above 100%

This benefit provides additional indemnity upto specified limits, when the sum

insured under the policy is exhausted / exceeded. This can be utilized for any claim

payable under the policy.

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Policy Benefits:

Hospitalization Cover Protects the insured for in - patient hospitalization expenses for a minimum of 24 hrs.These expenses include room rent,

nursing and boarding charges.

Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees, Anesthesia, Blood, Oxygen, and Operation Theatre charges, Cost of

Pacemaker, Cost of Medicine and drugs etc.

Ambulance charges for emergency transportation upto a sum of Rs.750/-

per hospitalization and overall limit of Rs.1500/- per policy period.

Pre Hospitalization expenses up to 60 days prior to admission in the

hospital. Post Hospitalization expenses upto 90 days after discharge

from the hospital.

Eligibility:

Any person aged between 18 years and 65 years

Beyond 65 years. It can be renewed for life time.

Lifelong renewal. This policy is on floater basis.

Family: Proposer, spouse, dependent children from 16 days up to 25 years

Child from 16th day of age can be covered as part of family

Co-Payment: A co-payment of 20% of each and every claim applicable for fresh as well as renewal

policies for insured persons whose age at the time of entry is above 60 years.

Pre-Existing Diseases/Illness:

Coverage available after 48 months of continuous insurance without break with any

Indian insurance company.

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Pre-Acceptance medical screening:

Persons above 50 years will be required to undergo pre-acceptance medical

screening at the Company nominated centers, cost of which is currently borne by the

company.

Tax Benefits:

Amount paid by any mode other than by cash for this insurance is eligible for relief

under Section 80D of the Income Tax Act.

Free Look Period:

A free look period of 15 days from the date of receipt of the policy is available for reviewing the policy terms and conditions. In case insured is not satisfied he can

seek cancellation of the policy and in such event the Company will allow refund of

premium after adjusting the cost of pre-acceptance of medical screening , stamp

duty charges and proportionate risk premium for the period concerned provided no

claim has been made until such cancellation

ADVANTAGE: No Third Party Administrator, direct in-house claim settlement.

Faster claim settlement. Network of more than 7000 hospitals across India.

Facility for maintaining personal health records in electronic format.

DOCUMENTATION REQUIRED FOR POLICY:

One id proof of head of family

DOB of all members covered

One photo of all members covered

Height and weight of all members being covered under policy

PREMIUM CALCULATION

Premium is calculated by agent on the basis of premium chart depending upon on

the age of person of elder member of family & no of person assured.

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RESEARCH METHODOLOGY

DATA COLLECTION:

Primary: Through structured Questionnaire

Secondary: Through Internet, Journals, Newspapers, Company website, brochure &

Misc. sources.

Procedure: Survey method

RESEARCH INSTRUMENT: Structured Questionnaire.

SAMPLING PLAN

Sample Design: Convenience

sampling Sample size: 100

Sample Area: Study was conducted at Anaj Mandi Bhuna

Sample unit: Data was gathered from student, government job & private person

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QUESTIONAIRE DESIGN

QUESTIONNAIRE ANALYSIS

Respondents =100

Respondents Responded =100

Response Rate =100%

Respondents are taken from student, private, government and business sectors.

(1)Have you got a health insurance plan for you and your family?

(A) yes (b) no

Yes No Total

4 96 100

(2)If yes, whether your co. provides cashless treatment?

(A) yes (b) no

Yes No Total

2 98 100

(3)Do you think health insurance is important in today world?

(a) yes (b) no

Yes No Total

50 50 100

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(4)If yes, what according to you should be minimum sum insured?

(A)3 lacs (b) 5lacs (c) 10lacs (d) 15 lacs

3lacs 5lacs 10lacs 15lacs Total

20 60 5 5 100

Name……………………………Age..............................................

Family members................................Occupation.........................................

Mobile no.......................................................

Address..........................................................................

FINDINGS

1. People are unaware about health insurance product 2. Most of people know about only life insurance companies .e.g. LIC 3. They consider the fact health insurance is important in today world

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CONCLUSION

There are 5health insurance companies in India and the market share of the STAR HEALTH INSUARANCE is 1.89% in insurance sector & growth rate is 33.6% in July 2016 as compared to July 2015.

The policy of the company is designed according to the budget and requirements of the customer.

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BIBLIOGRAPHY

WEBSITES:

www.google.com

www.starhealth.in

www.wikipedia.org

NEWSPAPERS:

Times of india

star health insurance summer report

Education

Transcript of star health insurance summer report