Star Health and Allied Insurance Co. Ltd. Presentation on Star Wedding Gift Presentation on Star Wedding Gift.
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Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Presentation on
Star Wedding Gift
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Major Features / Coverages
• Child Delivery Expenses• Pre and Post Natal expenses• New Born Baby cover• Post delivery complications• Expenses for detecting abnormality in Foetus
and• Hospitalisation expenses cover on floater basis
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Child Delivery Expenses
• Child delivery expenses (Normal and Caesarean)
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Pre and Post Natal expenses
• Covered as part of Child Delivery expenses
• Pre-Natal Expenses mean expenses incurred 12 weeks before child delivery and during pregnancy
• Post-Natal Expenses mean expenses incurred 12 weeks post delivery
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
New Born Baby cover
• Expenses on treatment of the New-born for any disease, illness (including any congenital internal or external disorders) or accidental injuries.
• Where the New-Born is diagnosed with Down’s syndrome or Cerebral Palsy the Company will pay a lump-sum.
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Post delivery complications
• Expenses incurred on treatment for complications to the insured mother post delivery.
• However, Claim for Post Partum Haemorrhage admissible only where it is severe & requiring hysterectomy and is payable only if there is an admissible claim
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Abnormality in Foetus
• Test for detecting congenital abnormalities in the foetus Rs. 1,000/-.
• Payable only once after 27 months of continuous coverage under this policy with the Company.
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Hospitalisation expenses
Hospitalization Expenses incurred as an inpatient for
Sickness/Illness/Diseases
Accident
For the entire family on floater basis
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Medical Examination
No pre acceptance medical examination
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Coverage Period
• There is a provision to purchase a long term policy.
• Policy is offered for the following terms1 year2 years or4 years
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Free Look In Period
• Free look period of 15 days from the date of receipt of policy is available (under 4 year period policy only)
• During this free look period if the insured person is not satisfied , he / she has option to cancel the policy . On doing so the premium paid will be refunded after deduction of 5% subject to there being no claim.
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Age Limits
Entry Age : 18 years to 40 years
Renewals allowed upto 45 Years
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Allowable Expenses
Room Rent, Boarding, Nursing Expenses up-to a maximum of Rs. 4,000/- per day
Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist Fees.
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.
Expenses for delivery of a baby either normal or by Caesarean up-to the limits mentioned below (including pre-natal and post natal).
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Allowable Expenses (Contd.)
Expenses incurred on treatment for complications to the insured mother post delivery.
Expenses up-to the limits mentioned in the Schedule, incurred in a hospital/ nursing home on treatment of the New-born for any disease, illness (including any congenital disorders) or accidental injuries.
Emergency Ambulance charges to go to Hospital for treatment @ Rs 1,000/- per hospitalisation upto a maximum of Rs 1,500/- per policy period
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Allowable Expenses (Contd.)
Pre-hospitalization expenses incurred for a period of 30 days prior to the date of hospitalization
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. 5,000/-
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
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
orShould 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.
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Day Care TreatmentMinimum of 24 hours Hospitalization is not necessary for the following • Dialysis• Chemotherapy• Radiotherapy• Cataract surgery• Dental Surgery following accident• Lithotripsy• Tonsillectomy• Treatment of Fracture/Dislocation• Incision and Draining of Abscess• Liver Aspiration• Pleural Effusion Aspiration• Sclerotheraphy The above treatment shall be taken in the Hospital / Nursing Home
and the Insured is discharged on the same day.
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Sub Limits
Name of the Ailment / Surgery / Procedure
Sub Limit
Cataract surgery Rs. 20,000/- in respect of one eye and
Rs. 30,000/- in the entire policy period
Lithotripsy (Kidney stone removal) Rs. 20,000/-
Tonsillectomy Rs.15,000/-
Incision and Draining of Superficial Abscess
Rs. 1,500/-
Incision and Draining of Deep seated Abscess
Rs. 4,000/-
Liver Aspiration Rs. 2,000/-
Pleural Effusion Aspiration Rs. 2,000/-
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Sub Limits (Contd.)
Name of the Ailment / Surgery / Procedure
Sub Limit
Sclerotheraphy Rs. 5,000/-
Treatment of Fracture/Dislocation Rs. 2,000/-
Chalazion Rs. 3,000/-
Tympnoplasty Rs. 20,000/-
Dialysis Rs. 1,200/-
Test for detecting congenital abnormalities in the foetus Rs. 1,000/- (payable only once after 27 months of continuous coverage with the Company)
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Sum InsuredOptions Option 1 Option 2
(a) Hospitalisation Expenses Rs. 3,00,000/- Rs. 5,00,000/-
(b) Child Delivery Expenses Rs. 15,000/- for normal and Rs. 20,000/- for ceasarean
Rs. 20,000/- for normal and Rs. 25,000/- for ceasarean
(c) Pre and Post Natal Expenses (as part of Child Delivery Expenses)
Pre Natal : Rs. 1,500/-
Post Natal : Rs. 2,000/-
Pre Natal : Rs. 2,000/-
Post Natal : Rs. 4,000/-
(d) New Born Baby Cover : Hospitalisation expenses for treatment including congenital diseases
Rs. 30,000/- Rs. 50,000/-
(e) New Born Baby Cover :
Lump sum payment for Down’s Syndrome and Cerebral Palsy
Rs. 60,000/- Rs. 1,00,000/-
(f) Post Delivery Complications Actuals within Hospitalisation Limits
Actuals within Hospitalisation Limits
(g) Test for detecting congenital abnormality in foetus
Rs. 1,000/- Rs. 1,000/-
Note : The coverage limits mentioned in (b) to (f) above, are part of the overall Sum Insured mentioned under (a) above.
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Premium Rating for One Year cover
Option Family Size
Premium Rs.
5mths-35 yrs 36yrs-45yrs
Option 1 – Rs. 3,00,000/-2A 10305 10740
2A+1C 10535 11305
Option 2 – Rs. 5,00,000/-2A 13960 14680
2A+1C 14470 15310
Note : Premium figures are excluding Service Tax.
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Premium Rating for Two Years cover
Option Family Size
Premium Rs.
5mths-35 yrs 36yrs-45yrs
Option 1 – Rs. 3,00,000/-2A 18550 19335
2A+1C 18965 20350
Option 2 – Rs. 5,00,000/-2A 25130 26425
2A+1C 26050 27560
Note : Premium figures are excluding Service Tax.
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Premium Rating for Four Years cover
Option Family Size
Premium Rs.
5mths-35 yrs 36yrs-45yrs
Option 1 – Rs. 3,00,000/-2A 43285 45110
2A+1C 44250 47485
Option 2 – Rs. 5,00,000/-2A 58635 61660
2A+1C 60775 65145
Note : Premium figures are excluding Service Tax.
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
No Claim Discounts
Nil
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding GiftExclusions
Pre Existing DiseasesAny Disease contracted during first 30 days
First Year Exclusions• Deviated Nasal Septum• Benign Prostate Hypertrophy• Hernia • Hydrocele• Congenital Internal disease/defect• Fistula in anus, Piles, Fissure in anus, Sinusitis, and related
disorders• Nasal Polyps• Gall Bladder Calculi And Renal Calculi
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Exclusions (Contd.)First Two Years Exclusions
• Cataract, • Hysterectomy• Dysfunctional Uterine Bleeding (DUB)• Fibroid Uterus• Prolapsed Uterus• Treatment of Internal Derangement of Knee (other than caused by
an accident)• Treatment for Joints (other than caused by an accident)• Inter-vertebral Disc Prolapse (other than caused by accident)• Degenerative Vertebral and Disc diseases• Varicose veins and Varicose ulcers
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Exclusions (Contd.)Expenses for delivery of a child within 36 months in case of premium paid for 1 or 2 year and 24 months in case of premium paid for 4 years of continuous renewal from the date of commencement of this policy with the company.
The amount of claim indicated in the schedule to be borne by the Insured Person.
Injury/ Disease directly or indirectly caused by or arising from or attributable to War, Invasion, Act of Foreign Enemy, Warlike operations (whether war be declared or not)
Circumcision unless necessary for treatment of a disease not excluded hereunder or as may be necessitated due to an accident, vaccination or inoculation or change of life or cosmetic or aesthetic treatment of any description, plastic surgery other than as may be necessitated due to an accident or as a part of any illness.
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Exclusions (Contd.)Cost of spectacles and contact lens, hearing aids, walkers, crutches wheel chairs and such other aids.
Dental treatment or surgery of any kind unless necessitated due to accidental injuries and requiring hospitalization.
Convalescence, general debility, Run-down condition or rest cure, Psychosomatic disorders, Congenital external disease or defects or anomalies, infertility, venereal disease, intentional self injury and use of intoxicating drugs/alcohol.
All expenses arising out of any condition directly or indirectly caused due to or associated with human T-cell Lymph tropic Virus type III (HTLV-III) or Lymphadinopathy Associated Virus (LAV) or the Mutants Derivative or Variations Deficiency Syndrome or any Syndrome or condition of a similar kind commonly referred to as AIDS.
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Exclusions (contd.)
Charges incurred at Hospital or Nursing Home primarily for Diagnostic, X-ray or laboratory examinations not consistent with or incidental to the diagnosis and treatment of the positive existence or presence of any ailment, sickness or injury, for which confinement is required at hospital / nursing home.
Expenses on vitamins and tonics unless forming part of treatment for injury or disease as certified by the attending Physician.
Injury or Disease directly or indirectly caused by or contributed to by nuclear weapons / materials.
Treatment arising from or traceable to pregnancy, miscarriage, abortion or complications of any of these other than what is stated to be covered under this policy.
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Exclusions (Contd.)
Naturopathy Treatment.
Hospital registration charges, record charges, telephone charges and such other similar charges.
Expenses incurred on Lasik Laser or Refractive Error Correction treatment
Expenses incurred on weight control services including surgical procedures for treatment of obesity, medical treatment for weight control/loss programs
Non Allopathic shall be restricted to 25% of the sum insured subject to a maximum of Rs. 25,000/- per occurrence for the entire policy period.
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
In case of Non Network HospitalsImmediate 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 DoctorBills 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
Claim Procedure (Contd.)
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Other BenefitsBenefits under Section 80-D of the IT Act
Cashless Service without involvement 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.
Information on health through free health magazine
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Target Group
Newly married couples
Couples with one child
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Transfer from any other policy of Star to Wedding Gift
Continuity benefits with regard to the following will be provided
• 30 days waiting period• First year exclusions• First two years exclusions• Pre Existing Diseases
However, child delivery expenses will be covered only after 36 months of continuous coverage under this policy.
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Transfer from other Insurers to Wedding gift
Continuity benefits with regard to the following will be provided
• 30 days waiting period
However, for other exclusions are concerned, it will treated as a fresh policy only.
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
How it is wider than FHO ?
Increased Day Care limits
Eg : Cataract 20,000/- & 30,000/- as against 12,000/- under FHO
Coverage for New Born against any congenital disease (both Internal & External)
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Wedding Gift
Thank You
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