Star Comprehensive Insurance Policy
About STAR Health Insurance
- Star Health and Allied Insurance Co Ltd commenced its operations in 2006 with the business interests in Health Insurance, Overseas Mediclaim Policy and Personal Accident. Star built a promising path for our future with a capital base of Rs.985 crores. Star have emerged as India’s first stand-alone Health Insurance Company, dealing in personal accident, medi-claim and overseas travel insurance.
- At Star Health Insurance, the company offers a wide range of health insurance products at affordable prices to make health insurance every human being’s right. And as a company, single-mindedly dedicated to health insurance.
Sum Insured Option
In- Patient Treatment
Star Comprehensive will cover all medical expenses in case of medically necessary hospitalization of an Insured person incurred due to Disease, Illness or injury when the Insured person is admitted as an in-patient for more than 24 consecutive hours.
- Nursing expenses.
- Medical Practitioner
- Specialist Fees
- Operation Theatre charges
- Surgical Appliances
- Medicines and Drugs
- Diagnostic Materials and X-ray
Pre And Post Hospitalization
- Pre Hospitalization: Star will cover medical expenses of an Insured person due to a disease or injury or illness incurred immediately prior to hospitalization, up to 30 days under the plan opted by the Insured subject to a claim being admissible under In-patient Hospitalization and expenses are related to the same illness/condition.
- Post Hospitalization: Star will cover medical expenses of an Insured person incurred post hospitalization due to a disease or injury or illness up to 60 days under the plan opted by the Insured subject to a claim being admissible under In-patient Hospitalization and expenses are related to the same illness/condition.
Room Rent Or Hospital Accommodation
Star will cover the room charges of up to Single A/C Room or to (Actual s).
Day Care Procedures/ Treatments
- All those medical expenses of an Insured Person in case of medically necessary day care treatment or surgery that requires less than 24 hours hospitalization due to advancement in technology and which is undertaken in a hospital / nursing home on the recommendation of a medical practitioner.
- Star Comprehensive will cover all 405 day care procedures.
- Some of the day care procedures are :- Cataract, Chemotherapy, Dialysis, Hemodialysis.
Emergency Ambulance Cover
Air Ambulance is payable for only from the place of first occurrence of the illness/ accident to the nearest appropriate hospital. And such Ambulance should have been duly licensed to operate as such by competent authorities of the government.
New Born Baby
Cover the new born baby as an Insured Person until the expiry of the Policy Year in which the baby is born without the payment of any additional premium.
Star will cover all those vaccination expenses incurred by the insured up to Rs 1000 under new born baby cover.
No Claim Bonus
Automatic Restoration Benefit
- The Recharge shall be utilized only after the Sum Insured, No Claims Bonus have been completely exhausted in the Policy Year.
- The Recharge shall be available only for all future Claims and not in relation to any Illness or Injury for which a Claim has already been admitted for that Insured Person during the Policy Year.
O. P. Dental & Ophthalmic
For every block of 3 years, the insured can avail Out Patient Dental & Ophthalmic benefit depending upon the Basic Sum Insured, Provided the insured has to continuously renew the policy.
This benefit is available for each complete day of hospitalization based on the basic sum insured, subjected to maximum of 7 days per hospitalization and up to maximum of 120 days per policy period. This benefit subjected to an excess of first 24 hrs hospitalization for each and every claim.
- Waiting Period of 3 years from the inception of the policy and with the opinion of two qualified surgeons and with a prior approval from the company under cashless benefit only.
- The minimum age of the insured at the time of surgery should be above 18 years.
- BMI should be more than 40 or above 35 with co-morbidity (like Diabetes and Hypertension) and insured is unable to lode weight through traditional methods like Diet and Exercises.
- The maximum limit for the surgery is Rs.250000 inclusive of Pre and Post Hospitalization.
- The limit of coverage is subjected to part of the sum insured under sec 1.
Accident Death and Permanent Total Disablement
- Cover is available for the proposer or one insured opted by the proposer, other than dependents children and person more than 70 years.
- 100% Death and permanent Total Disability.
Domiciliary Hospitalization Treatment
Domiciliary Hospitalization means medical treatment for a period of exceeding 3 days, for an Illness/Injury which in the normal course would require care and treatment at a Hospital but is actually taken while confined at home under any of the following circumstances:
- The attending Doctor confirms that the Insured Person could not be transferred to a Hospital or
- The customer satisfies the company that a Hospital bed was unavailable.
- 30 Days Initial waiting period except Accidents
- 48 Months waiting period if any Pre-Existing diseases.
- 24 Months waiting period for specific diseases.
List Of Specific Diseases
- The expenses for treatment of Cataract, Glaucoma, Retinal detachment, Macular degeneration, prolapse of intervertebral disc, Varicose Veins and Varicose ulcers, benign Prostatic hypertrophy, Deviated Nasal Septum.
- All treatments (conservative, interventional, laparoscopic and open) for Hepatobiliary gall bladder and Pancreatic calculi and Genitourinary calculi.
- All treatments (conservative, interventional, laparoscopic and open) for Uterine Prolapse, Dysfunctional Uterine Bleeding, Fibroids, Pelvic Inflammatory Diseases, all diseases of Fallopian tubes and Ovaries.
- Conservative and operative treatment of joint diseases (other than caused by accident).
- All types of joint replacement (other than caused by accident).
- Any transplant and related surgery.
- Degenerative disc and vertebral diseases and degenerative diseases of the Musculo-Skeletal system
- Addictive conditions and disorders; Ageing and puberty, Artificial life maintenance; Circumcision, Dental /oral treatment, Conflict and disaster, Congenital conditions, Convalescence and Rehabilitation,
- Cosmetic surgery, Drugs and dressings for OPD Treatment or take-home use; Eyesight, Unproven/ Experimental treatment, Health hydros, nature cure, wellness clinics etc.
- HIV and AIDS, Obesity, Hereditary conditions (specified), Items of personal comfort and convenience, Alternative treatment, Psychiatric and Psychosomatic Conditions, OPD Treatment, Stem cell implantation, Ancillary Hospital Charges,
- Preventive care, Treatment for Alopecia, Unrelated diagnostic, x-ray or laboratory examinations, Charges for medical papers, Reproductive medicine, Self-inflicted injuries, Sexual problems and gender issues, Sexually transmitted diseases, Unrecognized physician or Hospital,
- Active participation in adventure or hazardous sports including but not limited to para-jumping, rock climbing, mountaineering, motor racing, horse racing or deep-sea diving, Unlawful Activity, Any costs or expenses specified in the List of Expenses Generally Excluded at Annexure I .