Senior Citizens Red Carpet Ppt

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Senior Citizens Red Carpet Ppt

  1. 1. Presentation on Senior Citizens Red Carpet Health Insurance
  2. 2. <ul><li>For People aged Between 60 and 69 Years </li></ul><ul><li>Guaranteed renewals beyond 69 years </li></ul><ul><li>No Pre Insurance Medical Test required </li></ul><ul><li>Covers Pre Existing Diseases </li></ul>Star Health and Allied Insurance Co. Ltd. Major Product Features Presentation on Senior Citizens Red Carpet Health Insurance
  3. 3. <ul><li>60 Years – 69 Years </li></ul><ul><li>Proposals from persons 60 and above, age proof in the form of DL, Pass Port, Ration Card or School Certificate is required. </li></ul><ul><li>Guaranteed Renewals beyond 69 years </li></ul>Star Health and Allied Insurance Co. Ltd. Presentation on Senior Citizens Red Carpet Health Insurance Age Limits
  4. 4. <ul><li>No Pre – Insurance Medical Test is required </li></ul><ul><li>However 10% discount on premium will be allowed if the following reports are produced to the satisfaction of the Insurer </li></ul><ul><li>Stress Thallium Report </li></ul><ul><li>BP report </li></ul><ul><li>Sugar (Blood & Urine)‏ </li></ul><ul><li>Blood urea & creatinine </li></ul><ul><li>Self-declaration or certification that surgeries related to Heart / Brain / Cancer has / have not been done in the past. </li></ul><ul><li>The tests should have been taken not before 45 days from the date of proposal </li></ul>Star Health and Allied Insurance Co. Ltd. Pre - Insurance Medical Test Presentation on Senior Citizens Red Carpet Health Insurance
  5. 5. <ul><li>Hospitalization Expenses incurred as an inpatient for </li></ul><ul><li>Sickness/Illness/Diseases </li></ul><ul><li>Accidental injuries </li></ul>Star Health and Allied Insurance Co. Ltd. Presentation on Senior Citizens Red Carpet Health Insurance Coverages
  6. 6. <ul><li>Pre – Existing Diseases are covered except those </li></ul><ul><li>for which treatment was recommended or received during 12 Months preceding the date of proposal </li></ul><ul><li>Diseases mentioned under First year exclusions and first two year exclusions </li></ul><ul><li>The cover is subject to 50% Co-payment </li></ul>Star Health and Allied Insurance Co. Ltd. Pre Existing Diseases Cover Presentation on Senior Citizens Red Carpet Health Insurance
  7. 7. <ul><li>Hospital, Nursing Home means any institution in India established for indoor care and treatment of sickness and injuries and which </li></ul><ul><li>Either </li></ul><ul><li>It has been registered with the local authorities and is under the supervision of a registered and qualified Medical Practitioner </li></ul><ul><li>or </li></ul><ul><li>Should comply with minimum criteria as under </li></ul><ul><li>It should have at least 15 inpatient beds (10 in Class ‘C’ Towns). </li></ul><ul><li>Fully equipped operation theatre of its own wherever surgical operation is carried out. </li></ul><ul><li>Fully qualified nursing staff under its employment round the clock </li></ul><ul><li>Fully qualified Doctor(s) should be in charge round the clock. </li></ul>Star Health and Allied Insurance Co. Ltd. What is a Hospital? Presentation on Senior Citizens Red Carpet Health Insurance
  8. 8. <ul><li>The following Sum Insured options are available </li></ul><ul><li>Rs. 1,00,000/- </li></ul><ul><li>Rs. 2,00,000/- </li></ul>Star Health and Allied Insurance Co. Ltd. Sum Insured Presentation on Senior Citizens Red Carpet Health Insurance
  9. 9. <ul><li>Room rent & boarding charges @ 1% of the sum insured per day </li></ul><ul><li>ICU expenses Per Day @ 2% of the Sum Insured </li></ul><ul><li>Nursing charges </li></ul><ul><li>Surgeons, Anesthetist, Medical Practitioner, Consultants, Specialists fees subject to a maximum of 25% of the Sum Insured per hospitalisation </li></ul>Star Health and Allied Insurance Co. Ltd. Allowable Expenses Presentation on Senior Citizens Red Carpet Health Insurance
  10. 10. <ul><li>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 subject to a maximum of 50% of the Sum Insured per hospitalisation . </li></ul><ul><li>Emergency Ambulance charges to go to Hospital for treatment @ Rs 600/- per hospitalisation upto a maximum of Rs 1,200/- per policy period </li></ul>Star Health and Allied Insurance Co. Ltd. Allowable Expenses (Contd.) ‏ Presentation on Senior Citizens Red Carpet Health Insurance
  11. 11. <ul><li>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/-. </li></ul><ul><li>Note: The policy does not cover Pre- </li></ul><ul><li>Hospitalisation expenses </li></ul>Star Health and Allied Insurance Co. Ltd. Allowable Expenses (Contd.) Presentation on Senior Citizens Red Carpet Health Insurance
  12. 12. <ul><li>Minimum of 24 hours Hospitalization is not necessary for the following </li></ul><ul><li>Dialysis, </li></ul><ul><li>Chemotherapy, </li></ul><ul><li>Radiotherapy, </li></ul><ul><li>Cataract surgery, </li></ul><ul><li>Dental Surgery, </li></ul><ul><li>Lithotripsy (Kidney stone removal), </li></ul><ul><li>Tonsillectomy, </li></ul><ul><li>Cutting and Draining of Abscess, </li></ul><ul><li>Liver Aspiration, </li></ul><ul><li>Pleural Effusion Aspiration, </li></ul><ul><li>Colonoscopy, </li></ul><ul><li>Sclerotheraphy, </li></ul><ul><li>The above treatment shall be taken in the Hospital / Nursing Home and the Insured is discharged on the same day. </li></ul>Star Health and Allied Insurance Co. Ltd. Day Care Treatment Presentation on Senior Citizens Red Carpet Health Insurance
  13. 13. Star Health and Allied Insurance Co. Ltd. Sub Limits Presentation on Senior Citizens Red Carpet Health Insurance Rs. 60,000/- - for 1 Lakh Policy Rs. 120,000/- for 2 Lakhs Policy All other Major Sugeries Rs. 75,000/-- for 1 Lakh Policy Rs. 150,000/- for 2 Lakhs Policy Renal Complication Rs. 75,000/- for 1 Lakh Policy Rs. 150,000/- for 2 Lakhs Policy Cardio-Vascular Diseases / Cerebro-Vascular Accident / Cancer and breakage of bones Rs. 5,000/- Sclerotheraphy Rs. 2,000/- Colonoscopy Rs. 2,000/- Pleural Effusion Aspiration Rs. 2,000/- Liver Aspiration Rs. 1,500/- Cutting and Draining of Abscess Rs. 7,500/- Tonsillectomy Rs. 20,000/- Lithotripsy (Kidney stone removal) ‏ Rs. 15,000/- in respect of one eye or both eyes in the entire policy period Cataract surgery Sub Limit Name of the Ailment / Surgery / Procedure
  14. 14. <ul><li>Includes but not limited to </li></ul><ul><li>Intestinal obstruction – both acute and sub-acute, colon surgeries, bladder surgeries including Urethra, nephrectomy, pancreatic surgery, GJ Vagotomy, Knee/hip surgery </li></ul>Star Health and Allied Insurance Co. Ltd. Major Surgeries Presentation on Senior Citizens Red Carpet Health Insurance
  15. 15. Star Health and Allied Insurance Co. Ltd. Premium Rating Presentation on Senior Citizens Red Carpet Health Insurance 9,326/- (8455 + 871) 2,00,000/- 4,908/- (4450 + 458) 1,00,000/- Premium Including S. Tax of 10.30% (Rs.) Sum Insured (Rs.) ‏
  16. 16. <ul><li>50% co-payment applicable for Pre-Existing Diseases / Conditions </li></ul><ul><li>30% co-payment applicable for all other claims </li></ul>Star Health and Allied Insurance Co. Ltd. Co-payment Presentation on Senior Citizens Red Carpet Health Insurance
  17. 17. Star Health and Allied Insurance Co. Ltd. Presentation on Senior Citizens Red Carpet Health Insurance Renewal Loading 50% Above 150% 30% 126% to 150% 20% 100% to 125% Loading Past Two Consecutive Years Claims Experience
  18. 18. <ul><li>Treatment taken in Non Network Hospitals </li></ul><ul><li>Pre Existing Diseases for which treatment was recommended or received during 12 months preceding the date of proposal </li></ul><ul><li>Any Disease contracted during first 30 days </li></ul><ul><li>First Year Exclusions </li></ul><ul><li>Benign prostate hypertrophy </li></ul><ul><li>Hernia, Hydrocele, Fistula in Anus, Piles </li></ul><ul><li>Congenital Internal Disease/defect </li></ul><ul><li>Sinusitis </li></ul><ul><li>Renal stone and Gall stone removal </li></ul><ul><li>First Two Years Exclusions </li></ul><ul><li>Cataract </li></ul><ul><li>hysterectomy following menorrhia or fibromyoma </li></ul><ul><li>Knee Replacement Surgery </li></ul><ul><li>Joint Replacement Surgery </li></ul><ul><li>Prolapse of intervertibral </li></ul><ul><li>Vericose veins/ulcers </li></ul>Star Health and Allied Insurance Co. Ltd. Exclusions Presentation on Senior Citizens Red Carpet Health Insurance
  19. 19. <ul><li>Pre Hospitalisation Expenses </li></ul><ul><li>Injury / Disease arising due to War, Invasion, Act of Foreign Enemy, Warlike operations </li></ul><ul><li>Circumcision unless necessary for treatment of a disease </li></ul><ul><li>Cost of spectacles and contact lens, hearing aids, walkers, crutches wheel chairs and such other aids </li></ul><ul><li>Dental treatment or surgery </li></ul><ul><li>Convalescence, general debility, Run-down condition or rest cure, congenital external disease or defects or anomalies, sterility, venereal disease, intentional self injury and use of intoxicating drugs/alcohol </li></ul><ul><li>Naturopathy Treatment </li></ul><ul><li>Expenses incurred on Lasik Laser or Refractive Error Correction treatment </li></ul>Star Health and Allied Insurance Co. Ltd. Exclusions (Contd.) ‏ Presentation on Senior Citizens Red Carpet Health Insurance
  20. 20. <ul><li>Hospital registration charges, record charges, telephone charges and such other similar charges. </li></ul><ul><li>Expenses for Non Allopathic treatment </li></ul><ul><li>Policy cannot be issued to persons suffering from following diseases </li></ul><ul><li>1. Cancer </li></ul><ul><li>2. Chronic Kidney Disease </li></ul><ul><li>3. CVA / Brain Stroke </li></ul><ul><li>4. Alzheimer Disease </li></ul><ul><li>5. Parkinson’s Disease </li></ul>Star Health and Allied Insurance Co. Ltd. Exclusions (Contd.) ‏ Presentation on Senior Citizens Red Carpet Health Insurance
  21. 21. <ul><li>Benefits under Section 80-D of the IT Act </li></ul><ul><li>Cashless Service without intervention of TPA </li></ul><ul><li>Direct Tie up with hospitals on an All India Basis </li></ul><ul><li>24 X 7 In-House Call center (044-2826 3300)‏ </li></ul><ul><li>Toll Free Telephone line assistance </li></ul><ul><li>(1800 425 2255) – only from BSNL and MTNL </li></ul><ul><li>Full knowledge based website to offer medical information, including Health Tips. </li></ul><ul><li>Frequent health meets to disseminate information on health related topics </li></ul>Star Health and Allied Insurance Co. Ltd. Other Benefits Presentation on Senior Citizens Red Carpet Health Insurance
  22. 22. <ul><li>Immediate intimation to the Call Centre </li></ul><ul><li>(1800 425 2255/044-28263300)‏ </li></ul><ul><li>The insured has to send a request for ‘Pre Authorization Form’ signed by the Doctor in the Network Hospital </li></ul><ul><li>Based on the intimation a field visit will be done by the Star Doctor </li></ul><ul><li>Pre Authorization will be issued to the Hospital </li></ul><ul><li>Based on the Pre Authorization and the Report by the Star Doctor, Cash Less Treatment will be given by the Network Hospital </li></ul>Star Health and Allied Insurance Co. Ltd. Claim Procedure Presentation on Senior Citizens Red Carpet Health Insurance
  23. 23. Star Health and Allied Insurance Co. Ltd. Thank You

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