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Star Comprehensive Insurance Policy

Star Comprehensive Insurance Policy . Unique Features. It is a fully loaded Top end Policy with High Sum Insured Extended Benefits No Sub Limits No Capping on Room Rent Restoration of Sum Insured. Star Comprehensive Insurance Policy . Sum Insured Options.

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Star Comprehensive Insurance Policy

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  1. Star Comprehensive Insurance Policy

  2. Unique Features It is a fully loaded Top end Policy with • High Sum Insured • Extended Benefits • No Sub Limits • No Capping on Room Rent • Restoration of Sum Insured Star Comprehensive Insurance Policy

  3. Sum Insured Options Star Comprehensive Insurance Policy

  4. Age Eligibility • 18 years – 65 Years. • Children of 5 months can be Covered if Parent is Covered. • Beyond the age of 65 years only renewals are accepted. But sum insured options will be limited to a max of Rs7.5 lacs. • Guaranteed renewal. Star Comprehensive Insurance Policy

  5. 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 on treatment for HIV / AIDS Star Comprehensive Insurance Policy

  6. Coverage Star Comprehensive Insurance Policy

  7. Section I - HOSPITALISATION • Room Rent ,Boarding and Nursing Expenses - No Cap • ICU and Operation Theatre Expenses - No Cap • Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist Fees - No Cap • Anaesthesia, Blood, Oxygen, Operation Theatre charges, Surgical Appliances, Medicines and Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, cost of Pacemaker and similar expenses - No Cap Star Comprehensive Insurance Policy

  8. Pre Hospitalization Expenses - 30 Days • Post Hospitalization Expenses - 60 days • For both these benefits prescriptions, bills / receipts / copy of reports to be submitted. Star Comprehensive Insurance Policy

  9. Section IIDelivery and New Born Baby Cover • Waiting period 36months • Maximum 2 deliveries. Waiting period between the first delivery claim and the second one is 24 months. Delivery Benefit Limits • No Pre and Post Hospitalisation benefits for this Section • Both Insured and Spouse should be covered in the same policy for identical sum insured throughout. Star Comprehensive Insurance Policy

  10. Section IIDelivery 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 also • Claim Made under this Section will not reduce the policy Sum Insured, adversely affect Health Check-up benefit or add on for Claims loading Star Comprehensive Insurance Policy

  11. Section - III OP Dental and Ophthalmic Treatment • Dental & OphthalmologyTreatment is covered after a waiting period 36 Months • Can be taken as an Out-patient • Payable even if there is claim in the three year period • Can be claimed for Root Canal Treatment • Purchase of spectacles • Limits • The claimant must have been insured continuously. • Claim Made under this Section will notreduce the policy Sum Insured, adversely affect Health Check-up benefit or add on for Claims loading • Non Allopathic Treatment • Rs 20000/Per Policy Period upto Sum Insured of Rs 750000/ • Rs 25000/Per policy Period for Sum Insured of Rs 1000000/and above • Dental Treatment • Rs 5000/Per Policy Period for Sum Insured of Rs 500000/&Rs 750000/ • Rs 10000/Per Policy Period for Sum Insured of Rs 1000000/and Above • Day Care Procedure • 101 Procedures Star Comprehensive Insurance Policy

  12. Section - III OP Dental and Ophthalmic Treatment For example : • A family of three persons 2A + 1C covered for a Sum Insured of Rs. 5 lakhs for 2 years - 2010-11 and 2011-12. • In 2012-13 another Child is added. • In 2013-14 a claim is made for Ophthalmic Section for the Child added in 2011-12. • Not admissible because the waiting period has not been completed by the child. Star Comprehensive Insurance Policy

  13. Section – IVHospital Cash • Cash Benefit -maximum of 7 days per hospitalisation, provided there is an admissible claim under Section I. • Maximum during one policy period – 120 days • First one day will not be paid • Claim for Hospital cash will not affect the policy sum insured Star Comprehensive Insurance Policy

  14. Section – IVCost of Health Check-up • Cost of Health Check-up Once in a block of every 3 claim- free Continuous renewals • Benefit payable for insured persons who have been continuously insured under the policy . Star Comprehensive Insurance Policy

  15. Automatic Restoration of Sum Insured • Restoration facility in-built up to 100% for ALL sum insured options. • Restored Sum Insured can be utilized only for illness /disease unrelated to the illness /diseases for which claim/s was /was made. • Restoration will be available for section 1 only. Star Comprehensive Insurance Policy

  16. Exclusions Some important exclusions: • First 30-days exclusion (other than for accidents) • No First year exclusions- Only two year Exclusion. • PED – waiting period 48months • Non-allopathic treatments not covered • Enhanced External Counter Pulsation therapy and related therapies and Rotational Field Quantum Magnetic Resonance Therapy excluded. Star Comprehensive Insurance Policy

  17. Claims Loading • Where the claim ratio for the preceding 2 consecutive years exceeds 100%, premium loading as per the table given below would be applicable. Star Comprehensive Insurance Policy

  18. Co-payment • 10% co-payment for persons entering between 61 yrs and 65 yrs and continues thereafter • Co-payment applicable only for Section I claims Star Comprehensive Insurance Policy

  19. Portability • This policy is portable. • Inward portability can be accepted for policies of other Insurance Companies • Portability procedure to be followed • Continuity will be given ONLY for Section I benefit and NOT for any other Section Star Comprehensive Insurance Policy

  20. Migration from Star Policies Migration allowed from any other health policy of Star except • Senior Citizens Red Carpet • Unique policy • Diabetes Safe and • Super Surplus - Individual & Floater • Continuity of benefits will be given for Section I only • Persons insured under this policy can migrate to any other policy of Star with continuity of benefits again for in-patient hospitalization only. • Migration permitted upto the age of 60 yrs only. • Migration permissible only on Renewal for Policies with 2 continuous Claims free years. Where claims have been made in the past case to be referred to Corporate office Star Comprehensive Insurance Policy

  21. Migration guidelines…. Migration not permitted for persons suffering from the following declined risks : * Cancer * Stroke * Heart Diseases * Chronic Renal Diseases Star Comprehensive Insurance Policy

  22. Underwriting • Acceptance limits (FRESH PROPOSALS ) • Branch < 50years and Sum Insured of Rs 15Lakhs. • Branch > 50 Years Sum Insured upto 5 Lakhs. • Beyond 5 lacs and > 50 yrs refer to Corporate office Star Comprehensive Insurance Policy

  23. Star Comprehensive v/s Apollo’s Easy Health Both Price and benefit comparison given separately Star Comprehensive Apollo’s Easy Health • Automatic Restoration of 100% of Sum Insured • Premium less by 1% to 9% • No Restoration facility • More expensive than Star • Star and Apollo comparison Star Comprehensive Insurance Policy

  24. Benefit Illustration 1 Claim under Delivery and New Born Baby Cover: Sum Insured for 1st Year 5 Lakhs Sum Insured for 2nd Year 7.50 Lakhs Sum Insured For 3rd Year 7.50 Lakhs Sum Insured For 4th Year 5 Lakhs • 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 1000/- for Vaccination • The limit is inclusive of pre-natal and post-natal expenses Star Comprehensive Insurance Policy

  25. Benefit Illustration 2 • Claim for Health Check Up Sum Insured for the 1st year Rs 500000/- Sum Insured for the 2nd Year Rs 750000/- Sum Insured for the 3rd year Rs 750000/- Sum Insured for the 4th Year Rs 1000000/- Benefits of Health Check Up will be as per Rs 10lakhs i.e upto Rs 7500/- Star Comprehensive Insurance Policy

  26. Benefit Illustration 3 Claim for OP treatment for Dental /Opthal Sum Insured for 1st Year 5 Lakhs Sum Insured for 2nd Year 7.50 Lakhs Sum Insured For 3rd Year 7.50 Lakhs Sum Insured For 4th Year 10 Lakhs Benefit under this section in the fourth year will be as per Rs 10 Lakh Sum Insured which will be Rs 10000/- Star Comprehensive Insurance Policy

  27. Benefit Illustration 4 Admission for Arthroscopic Repair during the 3 year. Sum Insured for 1st Year 5 Lakhs Sum Insured for 2nd Year 7.50 Lakhs Sum Insured Limit for the above treatment will be Rs 5 Lakhs/- (Refer Exclusion 3) Star Comprehensive Insurance Policy

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