| Section 1 |
Health Insurance Coverage |
| Hospitalization Cover |
Hospitalization cover protects the insured for in patient hospitalization expenses for a minimum period of 24 hrs. These expenses include
- Room rent (Single Standard A/C room), nursing and boarding charges
- Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist fees
- Diagnostics, Anaesthesia, Blood, Oxygen, Operation Theatre Charges, implants, Cost of Medicines and Drugs.
|
| Emergency ambulance charges for transporting the covered patient to the hospital |
| Sum Insured (₹) |
Limit per policy period by road ambulance (Upto ₹) |
| 5,00,000 |
2,000 |
| 7,50,000 |
3,000 |
| 10,00,000 |
3,500 |
| 15,00,000 |
4,000 |
| 20,00,000 |
4,500 |
| 25,00,000 |
5,000 |
|
| Emergency Air Ambulance Charges |
In case of Air Ambulance, the limit per policy period is 10% of the Sum Insured.
However, this is not available for Sum Insured option of Rupees Five Lakhs.
|
| Pre-Hospitalization |
Upto 30 days prior to the date of admission |
| Post-Hospitalization |
Upto 60 days post the discharge from the hospital. |
| Medical Consultations as an Out Patient |
Covered if incurred in a Network Hospital for other than Dental and Ophthalmic, up to the limits mentioned in the table of benefits given below with a limit of Rs.300/- per consultation. This benefit does not form part of the sum insured, and payable while the policy is in force.
| Sum Insured (₹) |
Limit for Out Patient consultation per policy period(Upto ₹) |
| 5,00,000 |
1,200 |
| 7,50,000 |
1,500 |
| 10,00,000 |
2,100 |
| 15,00,000 |
2,400 |
| 20,00,000 |
3,000 |
| 25,00,000 |
3,300 |
|
| Coverage for Domiciliary hospitalization treatments for a period exceeding three days |
Covered under the policy except for Asthma, Bronchitis, Chronic Nephritis and Nephritic Syndrome, Diarrhoea and all types of Dysenteries including Gastro-enteritis, Diabetes Mellitus and Insipidus, Epilepsy, Hypertension, Influenza, Cough and Cold, all Psychiatric or Psychosomatic Disorders, Pyrexia of unknown origin for less than 10 days, Tonsillitis and Upper Respiratory Tract infection including Laryngitis and Pharingitis, Arthritis, Gout and Rheumatism.
Also Pre-hospitalisation, Post-hospitalisation expenses are not applicable for this cover.
|
| Delivery and New Born Baby Cover |
- Expenses for Delivery - including Pre-natal and Post natal expenses up-to the limits specified. A waiting period of 36 months of continuous coverage under this policy will apply.
- Automatic coverage for the New Born (including internal and external congenital problems) up to the expiry of the current policy (On renewal this new born baby should be covered specifically)
| Sum Insured (₹) |
Limit of Delivery |
Limit of Company Liability (₹) |
| Normal (₹) |
C-Section(₹) |
| 5,00,000 |
10,000 |
15,000 |
50,000 |
| 7,50,000 |
20,000 |
40,000 |
1,00,000 |
| 10,00,000 |
25,500 |
40,000 |
1,00,000 |
| 15,00,000 |
25,000 |
40,000 |
1,00,000 |
| 20,00,000 |
25,500 |
40,000 |
1,00,000 |
| 25,00,000 |
25,000 |
40,000 |
1,00,000 |
|
| Vaccination expenses for the New Born |
Upto ₹1,000 |
| Out-patient Dental and Ophthalmic Treatment Coverage |
Expense incurred on acute treatment to a natural tooth or teeth or the services and supplies provided by a licensed dentist, up to limits mentioned in the schedule of Benefits are payable. Expenses incurred for the treatment of the eye or the services or supplies provided by a licensed ophthalmologist, hospital or other provider that are medically necessary to treat eye problem including cost of spectacles / contact lenses, not exceeding the limit for the coverage as mentioned in the Schedule of Benefits are payable.
| Sum Insured (₹) |
Limit for Out Patient Dental & Ophthalmic Treatment (Upto ₹) |
| 5,00,000 |
5,000 |
| 7,50,000 |
5,000 |
| 10,00,000 |
10,000 |
| 15,00,000 |
10,000 |
| 20,00,000 |
10,000 |
| 25,00,000 |
10,000 |
|
| The insured persons become eligible for this benefit after continuous coverage under this policy after every block of 3 years with the company and payable while the policy is in force |
| Hospital Cash |
Cash Benefit up to the limits mentioned in the Table of Benefits given below for each completed day of Hospitalization subject to a maximum of 7 days per occurrence is payable.
This Benefit is available for a maximum of 120 days during the entire policy period. This benefit is subject to an excess of first 24 hours of Hospitalization for each and every claim.
| Sum Insured (₹) |
Hospital Cash Benefit – Limit of Company’s liability per day(Upto ₹) |
| 5,00,000 |
500 |
| 7,50,000 |
500 |
| 10,00,000 |
500 |
| 15,00,000 |
1,000 |
| 20,00,000 |
1,000 |
| 25,00,000 |
1,500 |
|
| Health Check Up |
The insured persons become eligible for these benefits after continuous coverage under this policy after every block of 3 claim-free years with the Company and payable on renewal.
If a claim is made by any of the insured persons the health check up benefits will not be available to other insured persons.
| Sum Insured (₹) |
Limit per policy (Upto ₹) |
| 5,00,000 |
5,000 |
| 7,50,000 |
7,500 |
| 10,00,000 |
7,500 |
| 15,00,000 |
12,000 |
| 20,00,000 |
12,000 |
| 25,00,000 |
12,000 |
|
| Section 2 |
Life Insurance Coverage |
| Life Cover |
This plan provides for lump sum in the event of death of the Primary Life Insured during the term of the plan and ensures that your loved ones are taken care of, even in your absence |
| Sum Assured |
₹3 lacs to ₹15 lacs (@ intervals of ₹1 lac)) |
| Maturity / Survival / Surrender / Loan Benefit |
NIL |
| Medicals Requirement |
No Medicals till insured is 50 years of age |
| Section 3 |
Other Coverages |
| Bariatric Surgery |
- Expenses incurred on hospitalization for bariatric surgical procedure and its complications thereof are payable subject to a maximum of ₹2,50,000/- during the policy period which is inclusive of pre-hospitalization and post hospitalization expenses.
- Claim under this section shall be processed only on cashless basis.
- Coverage under this section is subject to a waiting period of 36 months and payable only while the policy is in force
|
| Accidental Death and Permanent Total Disablement |
- Cover against Accidental Death
- The person chosen by the Proposer at the time of payment of premium as mentioned in the schedule herein is covered for Personal Accident
- The sum insured for this section is equal to the sum insured opted for the Health insurance.
|
| Option for Second Medical Opinion |
- The Insured Person is given the facility of obtaining a Second Medical Opinion in electronic mode from a Doctor in the Company's network of Medical Practitioners
- Medical records can be sent to the mail id e_medicalopinion@starhealth.in
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| Automatic Restoration of Sum Insured (Applicable for Hospitalization Section Only) |
- • Upon exhaustion of Basic sum insured and the Bonus, sum insured will be automatically restored by 100% once policy period. Such restored Sum Insured can be utilized only for illness / diseases unrelated to the illness / diseases for which claim/s was / were made
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