Star Health Family Delite Insurance

  • Available for 5 months to 62 years of age
  • Family health plan
  • Pre-hospitalization and Post-hospitalization Expenses
  • Pre-existing diseases are covered after 48 months of continuous insurance
  • Lifelong renewability
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Eligibility

  • Entry age is 5 months to 65 years for the proposer.
  • Non-allopathic treatments are not covered
  • Payment by any mode other than cash for insurance is eligible for relief under section 80D of the Income Tax Act.
  • Benefits
  • Eligibility
  • Exclusions
  • Renewal

  • Room, Boarding and Nursing Expenses @ 1% of sum insured.
  • Intensive Care Unit expenses are provided up to 1.5% of the Sum Insured.
  • 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.
  • Emergency ambulance charges for transporting the insured patient to the hospital up to a sum of Rs.750/- per hospitalization and overall limit of Rs.1500/- per policy period.

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 - a lumpsum calculated at 7% of the hospitalization expenses (excluding room charges) subject to a maximum of Rs.5,000/- is payable.

Benefits table

*Limit of Company's Liability in one policy period.
Disease/Conditions Sum Insured Rs.2,00,000 Sum Insured Rs.3,00,000
All Cardiac diseases/ailments
For Coronary Artery By-Pass Grafting (CABG)
1,00,000 75,000
All Cardiac diseases/ailment
PTCA (All inclusive irrespective of the number of stunts used) (The limits mentioned are inclusive of cost of Angiogram)
2,00,000 1,50,000
Minor surgeries warranting hospitalization Rs. 12,000 Rs. 15,000
Admissions for medical disease related to Cardio-Vascular System/Central Nervous system Rs. 35,000 Rs. 45,000
Major surgeries (other than what is provided) Rs. 35,000 Rs. 45,000
Oncology (all modes of therapy) Rs. 70,000 Rs. 1,00,000
Accidental grievous injuries Rs. 70,000 Rs. 1,00,000
Joint Replacement Rs. 70,000 Rs. 1,00,000
Renal Transplant Surgery Dialysis
(Per sitting cost limited to Rs. 1,000)
Rs. 70,000
Rs.15,000
Rs. 1,00,000
Rs.20,000
Cataract Rs.15,000 Rs.20,000
Treatment for infectious diseases Up to Rs.3,000 per day subject to a maximum of RRs.9,000 per hospitalization Up to Rs.4,500 per day subject to a maximum of RRs.12,000 per hospitalization

  • Anyone who is between the age of 5months and 62 years of age who is residing in India are eligible for this plan.
  • Children of 5 months to 25years can be Covered as dependent.
  • Beyond 65 years only renewals are accepted.

  1. No One Year Exclusions.
  2. Only First 2 year Exclusions.
  3. Pre-existing Diseases – waiting period 48months.
  4. Non-allopathic treatments not covered.
  5. Enhanced External Counter Pulsation therapy and related therapies and Rotational Field Quantum Magnetic Resonance Therapy excluded.

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%.

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.

 
 

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