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Presentation On Star Super Surplus

Presentation On Star Super Surplus. Major Product Features. Wider coverage option of Rs. 7 Lacs and Rs. 10 Lacs Low Premium. Age Limits. 5 Months – 60 Years (entry age) Renewals can be effected up to 75 years. Pre - Insurance Medical Test. No Pre – Insurance Medical Test is required.

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Presentation On Star Super Surplus

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  1. Presentation On Star Super Surplus

  2. Major Product Features • Wider coverage option of Rs. 7 Lacs and Rs. 10 Lacs • Low Premium

  3. Age Limits • 5 Months – 60 Years (entry age) • Renewals can be effected up to 75 years

  4. Pre - Insurance Medical Test • No Pre – Insurance Medical Test is required

  5. Coverages Hospitalization Expenses incurred as aninpatient for • Sickness/Illness/Diseases • Accidental injuries

  6. What is a Hospital? • Hospital, Nursing Home means any institution in India established for indoor care and treatment of sickness and injuries and which Either • It has been registered with the local authorities and is under the supervision of a registered and qualified Medical Practitioner or • Should comply with minimum criteria as under • It should have at least 15 inpatient beds (10 in Class ‘C’ Towns). • Fully equipped operation theatre of its own wherever surgical operation is carried out. • Fully qualified nursing staff under its employment round the clock • Fully qualified Doctor(s) should be in charge round the clock.

  7. Sum Insured • The following Sum Insured options are available • Rs. 7,00,000/- (Rs. 4,00,000/- in excess of Rs. 3,00,000/-) • Rs. 10,00,000/- (Rs. 7,00,000/- in excess of Rs. 3,00,000/-) • Compulsory Deductible – Rs. 3,00,000/- per claim

  8. Deductible • This insurance will pay for the hospitalisation expenses, as per detailed policy terms, in excess of Rs. 3,00,000/-. This limit of Rs. 3,00,000/- is for each hospitalisation. • For arriving at the cost per hospitalisation the expenses incurred on pre hospitalisation are to be excluded

  9. Allowable Expenses • Room rent & boarding charges subject to a maximum of Rs.4,000/- per day • ICU expenses • Nursing charges • Surgeons, Anesthetist, Medical Practitioner, Consultants, Specialists fees

  10. Allowable Expenses (Contd.) • Anaesthesia, Blood, Oxygen, Operation Theatre charges, Surgical Appliances, Medicines and Drugs, Diagnostic Materials and X-ray Dialysis, Chemotheraphy, Radiotherapy, Cost of Pacemaker and similar expenses • Post hospitalization expenses on a lump-sum basis @ 7% of the actual hospitalization expenses (excluding room rent and hospital registration charges), subject to a maximum of Rs. 30,000/-. Note: The policy does not cover Pre Hospitalisation expenses

  11. Premium Rating

  12. Exclusions • Pre Existing Diseases • Any Disease contracted during first 30 days • First Two Years Exclusions • Knee Replacement Surgery • Joint Replacement Surgery • Congenetial Disease whether internal or external • Injury / Disease arising due to War, Invasion, Act of Foreign Enemy, Warlike operations

  13. Exclusions (Contd.) • Circumcision unless necessary for treatment of a disease • Cost of spectacles and contact lens, hearing aids, walkers, crutches wheel chairs and such other aids • Dental treatment or surgery • Convalescence, general debility, Run-down condition, rest cure, sterility, venereal disease, intentional self injury and use of intoxicating drugs/alcohol

  14. Exclusions (Contd.) • Naturopathy Treatment • Expenses incurred on Lasik Laser or Refractive Error Correction treatment • Hospital registration charges, record charges, telephone charges and such other similar charges. • Expenses for Non Allopathic treatment.

  15. Premium Ratingincl. of Service Tax Sum Insured = 10 Lacs ( 3 + 7 )

  16. Other Benefits • Benefits under Section 80-D of the IT Act • Cashless Service without intervention of TPA • Direct Tie up with hospitals on an All India Basis • 24 X 7 In-House Call center (044-2826 3300) • Toll Free Telephone line assistance (1800 425 2255) • Full knowledge based website to offer medical information, including Health Tips. • Frequent health meets to disseminate information on health related topics • Doctor on Call (Free Consultation with Doctor on phone)

  17. Claim Procedure In case of Network Hospitals • Immediate intimation to the Call Centre (1800 425 2255/044-28263300) • The insured has to send a request for ‘Pre Authorization Form’ signed by the Doctor in the Network Hospital • Based on the intimation a field visit will be done by the Star Doctor • Pre Authorization will be issued to the Hospital • Based on the Pre Authorization and the Report by the Star Doctor, Cash Less Treatment will be given by the Network Hospital

  18. Claim Procedure (Contd.) In case of Non Network Hospitals • Immediate intimation to the Call Centre (1800 425 2255 /044-28263300) • Claim form will be sent to the Insured. • Based on the intimation a field visit will be done by the Star Doctor • Bills has to be settled by the Insured and will be reimbursed by Star on submitting the following documents • Original Discharge Summary • Main Hospital Bill with Break Up • Investigation Reports with X-Ray Film • Medical Bills with Prescriptions

  19. Thank You

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