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One more Delight from the Specialist…. Star Health proudly presents Star Family Delite Insurance Policy 2.

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Presentation on theme: "One more Delight from the Specialist…. Star Health proudly presents Star Family Delite Insurance Policy 2."— Presentation transcript:

1 One more Delight from the Specialist…

2 Star Health proudly presents Star Family Delite Insurance Policy 2

3 Star Family Delite is a simple policy for those with a Budget. It offers two Sum Insured options on Family Floater Basis Rs. 2,00,000/- Rs. 3,00,000/- Star Delite Insurance Policy 3

4 Star Family Delite Insurance Policy Age Eligibility  Entry age 18 years – 65 Years.  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. 4

5 Coverage Room rent including Boarding and Nursing expenses upto 1% of the sum insured opted. ICU charges upto 1.5% of the sum insured opted. Surgeon’s fees Consultant’s fees Anesthetist fees. Cost of blood, oxygen, diagnostic expenses, cost of pace makers, cost of medicines and drugs etc Emergency ambulance charges for transporting the insured patient to the hospital up-to a sum of Rs.750/- per hospitalization and overall limit of Rs.1500/- per policy period Star Family Delite Insurance Policy 5

6 Coverage Pre-Hospitalization upto 30 days prior to the date of admission Post-Hospitalization calculated at 7% of the hospitalization expenses (excluding room rent) subject to a maximum of Rs.5,000/- incurred within 60 days from the date of discharge from the hospital. Star Family Delite Insurance Policy 6

7 Diseases / conditions Sum Insured Rs.2,00,000/- Sum Insured Rs.3,00,000/- Limit of Company’s liability in the policy period All Cardiac diseases /ailments a. CABG b. PTCA (The limits mentioned are inclusive of cost of Angiogram) Rs /- Rs /- Rs /- Rs /- Minor surgeries warranting Hospitalization Rs.12000/-Rs.15000/- Admissions for medical diseases related to Cardio-Vascular System / Central Nervous System Rs /-Rs /- Major surgeries (other than what is specifically provided for) Rs /-Rs /- Oncology (all modes of therapy )Rs /-Rs /- Sub Limits 7

8 Star Family Delite Insurance Policy Diseases / conditions Sum Insured Rs.2,00,000/- Sum Insured Rs.3,00,000/- Limit of Company’s liability in the policy period Accidental grievous injuriesRs70000/-Rs100000/- Joint ReplacementRs70000/-Rs100000/- Renal Transplant Surgery Dialysis - per sitting cost limited to Rs1000/- Rs70000/- Rs15000/- Rs100000/- Rs20000/- CataractRs15000/-Rs 20000/- Treatment for infectious diseases –( amount per day) Subject to a maximum amount per hospitalisation Upto Rs.3000/- Rs.9000/- Upto Rs 4500/- Rs12000/- Sub Limits 8

9 Star Family Delite Insurance Policy Day Care ProcedureLimit (Rs.) Lithotripsy (Kidney stone removal)15000/- Tonsillectomy/ Adenoidectomy12000/- Incision and drainage of abscess 1500/- Liver aspiration / Pleural effusion aspiration 2000/- Sclerotherapy 5000/- Dialysis, Chemotherapy, Radiotherapy, Dental Surgery following accident are also covered under day-care treatment Following day-care treatments are covered upto the limits indicated, Subject to waiting period as mentioned in the exclusions. Day Care Procedures 9

10 Star Family Delite Insurance Policy No First Year Exclusions. Only First 2 years Exclusions. PED – waiting period 48months Circumcision unless necessitated due to an accident Cost of spectacles and contact lens, hearing aids including cochlear implants, walkers, crutches, wheel chairs and such other aids. Dental treatment or surgery unless necessitated due to accident and requiring hospitalization. Charges for Diagnostic, X-ray or laboratory examinations, expenses on vitamins and tonics not consistent with or incidental to the diagnosis and treatment. Exclusions 10

11 Star Family Delite Insurance Policy All expenses arising out of any condition directly or indirectly caused due to AIDS, however, HIV positive persons would be entitled for expenses incurred for treatment other than for opportunistic infections and for treatment of HIV /AIDS, provided at the time of first commencement of Insurance under this policy their CD4 count is not less than 350. Treatment arising from or traceable to pregnancy, miscarriage, abortion or complications of any of these (other than ectopic pregnancy). Naturopathy Treatment and Non Allopathic treatment Vaccination, Inoculation or change of life or cosmetic or aesthetic treatment of any description, Expenses incurred on Lasik Laser or Refractive Error Correction, expenses incurred on weight control services. Expenses incurred on Enhanced External Counter Pulsation therapy and related therapies and Rotational Field Quantum Magnetic Resonance Therapy Exclusions 11

12 Star Family Delite Insurance Policy Underwriting Acceptance limits : Please follow the existing guidelines followed for underwriting of Family Health Optima Policy Medical screening : No Pre acceptance Medical Examination upto the age of 50 years. For Prospects beyond 50 years - Please follow the existing guidelines followed for underwriting of Family Health Optima Policy. This policy is Portable (Inward and Outward) Existing guidelines remain unchanged. 12 Portability :

13 Star Family Delite Insurance Policy Benefit Illustration Claim for Cataract Surgery Sum Insured for 1st Year -Rs. 2,00,000/- Sum Insured for 2 nd Year -Rs. 3,00,000/- Sum Insured for 3 rd Year -Rs. 3,00,000/- During 3 rd year Insured to go in for Cataract Surgery the limit will be as per limit applicable for Rs. 2,00,000/- Sum Insured i.e. Rs 15000/- (Cataract – Excluded in the First two years) 13

14 Star Family Delite Insurance Policy Where the claim ratio for the preceding 2 consecutive years exceeds 100%, premium loading as per the table given below would be applicable. Average claims ratio of preceding two consecutive years Loading on premium > %30% %50% >150%80% Claims Loading 14

15 Sum Insured Rs. 2,00,000/- Star Family Delite Insurance Policy Family Size Premium (Rs) Age (years)For Renewals only 5mths A+1C A+2C A+3C A A+1C A+2C Service Tax Extra Premium Rating 15

16 Star Family Delite Insurance Policy Family Size Premium (Rs) Age (years)For Renewals only 5mths A+1C A+2C A+3C A A+1C A+2C Additional Child for C can be included at an additional premium of Rs. 1000/- for all age bands Service Tax Extra Sum Insured Rs. 3,00,000/- Premium Rating 16

17 Star Family Delite Insurance Policy 17


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