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Star Health Gain Insurance Policy

26.04.20 03:59 PM Comment(s) By Gaurav

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POLICY BENEFITS
ELIGIBILITY
GENERAL TERMS
POLICY BENEFITS
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Section I: - Hospitalization Cover: Room, Boarding, Nursing Expenses upto 1% of sum insured per day. A proportionate deduction shall happen in hospitalization expenses if room rent limit is exceeded.

  • Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees, Cost of Medicines and Drugs.
  • Ambulance charges up to Rs.750/- per hospitalization and Rs.1500/- per policy period.
  • Pre-Hospitalization expenses up to 30 days prior to admission in the hospital.
  • Post-hospitalization expenses up to 60 days from the date of discharge.
  • Expenses incurred for all day-care procedures.
  • Treatment for Cataract is subject to limits mentioned in the policy
  • Co-Payment: Co-payment of 20% of each and every claim amount for fresh as well as renewal policies for insured persons whose age at the time of entry is above 60 years.

Waiting periods:

  • 30 days (Not applicable for Accidents)
  • 24 months for specified illness/ diseases.
  • 48 months for treatment of Pre existing diseases

Section II: Out Patient Benefits:

  • Premium option and Sum Insured Option shall be deciding outpatient benefit level.
  • Medical expenses incurred in networked facility shall be reimbursed. There is no waiting period or co-pay applicable
  • Un utilized benefit in a policy year can be carried forward to immediately succeeding renewal year. No further carry over is permitted.

Exclusions:

Please refer to policy terms and conditions for complete information about exclusions that are applicable to Section I – In patient hospitalization and Section II – Out patient benefits.

Premium (Excluding Tax)Sum Insured Options
Options
Premium Rs.
Option 115,000/-
Option 220,000/-
Option 325,000/-
Option 430,000/-

Sum Insured Options
1 Lakh2 Lakhs3 Lakhs4 Lakhs5 Lakhs
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ELIGIBILITY
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  • Age at entry 91 days to 65 years
  • Family means Self, Spouse, Dependent children up to 25 years of age
GENERAL TERMS
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Tax Benefits:

Amount paid by any mode other than by cash for this insurance is eligible for relief under Section 80D of the Income Tax Act.

Free Look Period:

A free look period of 15 days from the date of receipt of the policy by the insured is available to the insured to review the terms and conditions of the policy. In case the insured is not satisfied with the terms and conditions, the insured may seek cancellation of the policy and in such an event the Company may allow refund of premium paid after adjusting the cost of pre-medical screening, stamp duty charges and proportionate risk premium for the period concerned provided no claim has been made until such cancellation.

Free look Period is not applicable at the time of renewal of the policy

Renewal: Lifelong renewal
Grace Period for renewal: 30 days from date of expiry of policy.
NOTE: Renewal premium, terms and conditions are subject to change with prior approval from IRDAI.

Revision of Sum Insured: Option to Reduce or enhance sum insured is permissible at the time of renewal subject to approval of the Company
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