Star Health Insurance ppt

1. Shubham Chaudhari (14005)

2. Unique Features
It is a fully loaded Top end Floater Policy
for the entire family with
 High sum Insured Options
 Extended Benefits
 No sum Limits
 No Capping on Room Rent
 Restoration of sum Insured
 101 Days care Procedures

3. Sum Insured

4. Age Eligibility
 18 years-65 years.(For entry age 61-65yrs,
sum Insured restricted to a maximum of
Rs. 7.50Lakhs only which cannot be
enhanced at any points of the time
subsequently)
 Children of above 5 months can be
covered if Parent is covered.
 Beyond the age of 65 years only renewals
are accepted.
 Guaranteed renewal for life time.

5. Eligibility
 Cover can be given to HIV+ persons
whose CD 4 count is not less than 350 at
entry points
 No claims payable for Opportunistic
infections
 No claim for treatment of HIV / AIDS

6. Coverage

7. Sec 1-HOSPITALISATION
 Room Rent ,Boarding and Nursing
Expenses-No Cap
 ICU and Operation Theatre Expenses-No
Cap
 Surgeon, Anaesthetist, medical
Practitioner, Consultants, Specialist Fees,
Chemotherapy, Diagnostic -No Cap

8. Ambulance Charges & Pre/Post
Hospitalisation
 Pre Hospitalization Expenses-30 Days
 Post Hospitalization Expenses-60 Days
 For these benefits prescriptions, bills/receipt/copy of reports to be
submitted.

9. Sec 2-Delivery & New Born Baby
Cover
 Waiting period 36 months
 Maximum 2 deliveries. Waiting period
between the first delivery claim and the
second one is 24 months.

10. Sec 2-Delivery & 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

11. Sec 3-OP:Dental & Ophthalmic
Treatment
 Dental & Ophthalmology Treatment is covered after a
waiting period of 36 months
 Payable even if there is claim under Section 1 in the
three year period
 Can be claimed for Root Canal Treatment
 Purchase of Spectacles

12. Sec 3-OP:Dental & Ophthalmic
Treatment
For Examples
A family of three persons 2A + 1C covered
for a sum insured of Rs. 5 lakhs for 2
years:2010-11 & 2011-12.
In 2012-13 another Child is added.
In 2013-14 a claim is made under
Ophthalmic section for the Child added in
2012-13.
Claim Not admissible because the 3 year
waiting period has not been completed by the
child.

13. Section 4-Hospital Cash
 Cash Benefit-maximum of 7 days per
hospitalisation, provided there is an admissible
claim under section1.
 Maximum during one policy period-120 days
 Time excess : One day

14. Sec 4- Cost of Health Check-up
 Cost of Health Check-up up to the limits
specified after a block of 3 claim free years of
continuous coverage
 Benefits payable for insured persons who have
been continuously insured under the 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/diseases unrelated to the
illness/diseases for which claim were
made.
 Restoration will be available for only
section 1 after fully exhausting the
Original Sum Insured.

16. Claims Loading
 Where the claims ratio for the preceding 2
consecutive years exceeds 100%,premium
loading as per the table given below.
 Claims under sec1 alone will be
considered for Claims loading.

17. Co-payment
 10% co-payment for persons entering
between 61yrs & 65yrs and continues
thereafter
 Co-payment applicable only for section 1
claims

18. 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 sec1
benefit and NOT for any other section.

19. Star Comprehensive v/s Apollo’s
Easy Health
Both Price and benefit comparison given separately

20. Star Cardiac Care Insurance
Policy

21. Thank You….