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Star Health and Allied Insurance Co. Ltd. Presentation on Star Wedding Gift Presentation on Star Wedding Gift.

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Presentation on theme: "Star Health and Allied Insurance Co. Ltd. Presentation on Star Wedding Gift Presentation on Star Wedding Gift."— Presentation transcript:

1 Star Health and Allied Insurance Co. Ltd. Presentation on Star Wedding Gift Presentation on Star Wedding Gift

2 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

3 Star Health and Allied Insurance Co. Ltd. Presentation on Star Wedding Gift Child Delivery Expenses Child delivery expenses (Normal and Caesarean)

4 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

5 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 Downs syndrome or Cerebral Palsy the Company will pay a lump-sum.

6 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

7 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.

8 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

9 Star Health and Allied Insurance Co. Ltd. Presentation on Star Wedding Gift Medical Examination No pre acceptance medical examination

10 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 terms 1 year 2 years or 4 years

11 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.

12 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

13 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).

14 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 Rs 1,000/- per hospitalisation upto a maximum of Rs 1,500/- per policy period

15 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 7% of the actual hospitalization expenses (excluding room rent and hospital registration charges), subject to a maximum of Rs. 5,000/-

16 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 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.

17 Star Health and Allied Insurance Co. Ltd. Presentation on Star Wedding Gift Day Care Treatment Minimum 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.

18 Star Health and Allied Insurance Co. Ltd. Presentation on Star Wedding Gift Sub Limits Name of the Ailment / Surgery / Procedure Sub Limit Cataract surgeryRs. 20,000/- in respect of one eye and Rs. 30,000/- in the entire policy period Lithotripsy (Kidney stone removal)Rs. 20,000/- TonsillectomyRs.15,000/- Incision and Draining of Superficial Abscess Rs. 1,500/- Incision and Draining of Deep seated Abscess Rs. 4,000/- Liver AspirationRs. 2,000/- Pleural Effusion AspirationRs. 2,000/-

19 Star Health and Allied Insurance Co. Ltd. Presentation on Star Wedding Gift Sub Limits (Contd.) Name of the Ailment / Surgery / Procedure Sub Limit SclerotheraphyRs. 5,000/- Treatment of Fracture/DislocationRs. 2,000/- ChalazionRs. 3,000/- TympnoplastyRs. 20,000/- DialysisRs. 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)

20 Star Health and Allied Insurance Co. Ltd. Presentation on Star Wedding Gift Sum Insured Options Option 1Option 2 (a) Hospitalisation ExpensesRs. 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 Downs Syndrome and Cerebral Palsy Rs. 60,000/- Rs. 1,00,000/- (f) Post Delivery Complications Actuals within Hospitalisation Limits (g) Test for detecting congenital abnormality in foetus Rs. 1,000/- Note : The coverage limits mentioned in (b) to (f) above, are part of the overall Sum Insured mentioned under (a) above.

21 Star Health and Allied Insurance Co. Ltd. Presentation on Star Wedding Gift Premium Rating for One Year cover OptionFamily Size Premium Rs. 5mths-35 yrs36yrs-45yrs Option 1 – Rs. 3,00,000/- 2A A+1C Option 2 – Rs. 5,00,000/- 2A A+1C Note : Premium figures are excluding Service Tax.

22 Star Health and Allied Insurance Co. Ltd. Presentation on Star Wedding Gift Premium Rating for Two Years cover OptionFamily Size Premium Rs. 5mths-35 yrs36yrs-45yrs Option 1 – Rs. 3,00,000/- 2A A+1C Option 2 – Rs. 5,00,000/- 2A A+1C Note : Premium figures are excluding Service Tax.

23 Star Health and Allied Insurance Co. Ltd. Presentation on Star Wedding Gift Premium Rating for Four Years cover OptionFamily Size Premium Rs. 5mths-35 yrs36yrs-45yrs Option 1 – Rs. 3,00,000/- 2A A+1C Option 2 – Rs. 5,00,000/- 2A A+1C Note : Premium figures are excluding Service Tax.

24 Star Health and Allied Insurance Co. Ltd. Presentation on Star Wedding Gift No Claim Discounts Nil

25 Star Health and Allied Insurance Co. Ltd. Presentation on Star Wedding Gift Exclusions Pre Existing Diseases Any 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

26 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

27 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.

28 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.

29 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.

30 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.

31 Star Health and Allied Insurance Co. Ltd. Presentation on Star Wedding Gift In case of Non Network Hospitals Immediate intimation to the Call Centre ( / ) 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 Claim Procedure (Contd.)

32 Star Health and Allied Insurance Co. Ltd. Presentation on Star Wedding Gift Other Benefits Benefits 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 ( ) Toll Free Telephone line assistance ( ) Full knowledge based website to offer medical information, including Health Tips. Information on health through free health magazine

33 Star Health and Allied Insurance Co. Ltd. Presentation on Star Wedding Gift Target Group Newly married couples Couples with one child

34 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.

35 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.

36 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)

37 Star Health and Allied Insurance Co. Ltd. Presentation on Star Wedding Gift Thank You


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