Star Health Comprehensive Insurance

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Coverage Type
Coverage Amount
Date of Birth
    or age      years
Policy Duration:
Policy Start Date:
Policy End Date:
  
  
  *Optional
Senior citizens above 60 years need not have to be anxious about health care and financial assistance to pay medical bills. This insurance covers anyone above 60 years and permits entry upto the age of 75 with continuing cover after that.
  • Benefits
  • Eligibility
  • Exclusions
  • Renewal
  • Others

  • Room, Boarding and Nursing Expenses.
  • Insurance covers Surgeon's fees, consultant fees, Anaesthetist's and Specialist's fees, Blood, Oxygen, Operation Theater charges, cost of Pacemaker etc.
  • Cost of medicines and drugs.
  • Up to 10% of the sum insured per policy period. Applicable for sum insured Rs.7.50 Lakhs and above only.
  • Emergency ambulance charges for transporting the insured patient to the hospital up to limits mentioned in the benefit table.

Pre-existing Disease
  • Pre existing diseases are covered after 48 months of continuous insurance with the any Indian Insurance Company.
Pre & Post Hospitalization
  • pre-hospitalization medical expenses up to 30 days prior to the date of admission in the hospital.
  • post-hospitalization medical expenses up to 60 days after discharge from the hospital.
Delivery and New-Born cover
  • Expenses for Delivery: Normal delivery or by Cesarean section.
  • Treatment of the new born baby.
  • Vaccination for Children : Up to Rs.1,000.
Day Care Treatment
  • 405 day care treatments are allowed.
Health Check up
  • The benefit is payable on continuous coverage of a block of every 3 claim free years.
Co Pay
  • 10% of each and every claim made by insured persons who are above 60 years at entry level.
Tax benefits
  • Payment by any mode other than cash for insurance is eligible for relief under section 80D of the Income Tax Act.

Benefits table

Benefits
(Sum Insured in INR)
5 Lakhs 7.50 Lakhs 10 Lakhs 15 Lakhs 20 Lakhs 25 Lakhs
Room Rent (single a/c room) Actual Actual Actual Actual Actual Actual
ICU/Operation Theater Charges Actual Actual Actual Actual Actual Actual
Ambulance Charges - Per Policy Period Up to Rs.2,000 Up to Rs.3,000 Up to Rs.3,500 Up to Rs.4,000 Up to Rs.4,500 Up to Rs.5,000
Pre hospitalization 30 days 30 days 30 days 30 days 30 days 30 days
Post hospitalization 60 days 60 days 60 days 60 days 60 days 60 days
Delivery Coverage - normal Delivery Up to Rs.10,000 Up to Rs.20,000 Up to Rs.25,000 Up to Rs.25,000 Up to Rs.25,000 Up to Rs.25,000
Waiting Period for Delivery 36 months 36 months 36 months 36 months 36 months 36 months
Coverage for New Born Child
(Subject to a terms and conditions)
Up to Rs.50,000 Up to Rs.1,00,000 Up to Rs.1,00,000 Up to Rs.1,00,000 Up to Rs.1,00,000 Up to Rs.1,00,000
Vaccination expenses for New Born
(Subject to a terms and conditions)
Up to Rs.1,000 Up to Rs.1,000 Up to Rs.1,000 Up to Rs.1,000 Up to Rs.1,000 Up to Rs.1,000
OP Dental / Opthal Coverage Up to Rs.5,000 Up to Rs.5,000 Up to Rs.10,000 Up to Rs.10,000 Up to Rs.10,000 Up to Rs.10,000
Cover for Accidental Death and Permanent Total Disablement Rs.5,00,000 Rs.7,50,000 Rs.10,00,000 Rs.15,00,000 Rs.20,00,000 Rs.25,00,000
Hospital cash 7 days per occurrence &
120 days per policy period(1 day time excess)
Rs 500/day Rs 750/day Rs 750/day Rs 1000/day Rs 1000/day Rs 1500/day
Health check up once in a block of every 3 claim free years of continuous renewal Up to Rs.5,000 Up to Rs.7,500 Up to Rs.7,500 Up to Rs.12,000 Up to Rs.12,000 Up to Rs.12,000
Restoration benefit after exhaustion of sum insured 100% 100% 100% 100% 100% 100%

  • 3 months to 65 years are eligible to buy this policy.
  • Guaranteed renewal for life time.
  • No exit age

Eligibility
  • Cover can be given to HIV + persons whose CD 4 count is not less than 350 at entry point.
  • No claim payable for Opportunistic infections.
  • No claim for treatment of HIV / AIDS.

  1. All expenses incurred in connection with treatment of any disease/illness/condition which is pre-existing at the time of commencement of insurance.
  2. Treatment of disease/sickness/illness contacted by the Insured Person during the first 30 days from the commencement date of the policy.
  3. Expense incured in the first two years of continuous operation of insurance cover on treatment of Cataract, Hysterectomy for Menorrhagia or Fibromyoma, Knee replacement surgery (other than caused by an accident) Joint Replacement Surgery (other than caused by accident), Prolapse of intervertebral disc (other than caused by accident), Varicose veins and Varcose ulcers.
  4. Expense incured during the first year of operation of the insurance treatment of diseases such as Bengin Prostate Hypertrophy, Hernia, Hydrocele, Fistula in anus, Piles, Sinusitis and related disorders, gallstones and renal stone removal.
  5. Circumcision unless necessary for treatment of disease not excluded hereunder or as may be necessitated due to an accident, vaccination (except for post bite treatment.), inoculation or change of life or cosmetic or aneshetic treatment, plastic surgery other than as may be necessitated due to an accident or as part of my illness.
  6. Treatment of Congenital external disease/defects/anomalies.
  7. Cost of spectacles, hearing aids, walkers crutches and similar aids.
  8. Dental treatments unless following accidental injuries.

Renewal will not be normally refused except on grounds such as fraud, moral hazard or misrepresentation. Where the claim ratio for the proceding 2 consecutive years exceeds 100%, premium loading as per the table given below would be applicable.

  • Average claims ratio of preceding 2 years (consecutive): >100-125% => Loading on premium: >20%
  • Average claims ratio of preceding 2 years (consecutive): >125-150% => Loading on premium: >30%
  • Average claims ratio of preceding 2 years (consecutive): >150% => Loading on premium: >50%

Claim under Delivery and New Born Section, Dental and Opthalmic treatment will not be taken for loading purpose.
A grace period of 15 days from the date of expiry of the policy is available for renewal. If renewal is made within 15 days period the continuity of benefits will be allowed. However the actual period of cover will start only from the date of payment of premium. In other words no protection is available between the policy expiry date and the date of payment of premium for renewal.

 
 

Star Health Insurance

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