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Star Health Medi Classic Individual Insurance Policy

17.04.20 10:49 AM Comment(s) By Gaurav

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POLICY BENEFITS
ELIGIBILITY
GENERAL TERMS
POLICY BENEFITS
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  • Room, boarding and Nursing expenses - 2% of sum insured subject to maximum of Rs.5000/-
  • Emergency Ambulance charges upto a sum of Rs.750/- per hospitalization and Rs.1500/- per policy period.
  • Pre-Hospitalization expenses up to 30 days prior to admission in the hospital
  • Post-hospitalisation expenses incurred for a period up to 60 days from the date of discharge from the hospital. The amount payable shall not exceed the sum equivalent to 7% of the hospitalization expenses subject to a maximum of Rs.5000/- per hospitalisation
  • Cost of Health Check-up once after a block of every four claim-free years. This benefit is available for sum insured of Rs. 2,00,000/- and above only.
  • Cataract is payable up to the limits

  • Psychiatric and Psychosomatic Disorder: If the insured person is diagnosed with psychiatric or psychosomatic disorder for the first time and hospitalized for minimum period of 5 consecutive days under this policy, then the Company will pay hospitalization expenses up to Basic Sum Insured

  • Cumulative Bonus: 5% of the basic sum insured for every claim free year subject to a maximum of 25%

  • Automatic Restoration: There shall be automatic restoration of the Basic Sum Insured by 200%, once during the policy period

  • Non Allopathic Treatment: Up to 25% of the Basic Sum Insured subject to a maximum of Rs 25000/- during entire policy period.

  • Family Package Plan (Not Available under Gold Plan): - Available for persons from 5 months to 45 years. The sum insured is apportioned equally among insured family members. Health Checkup benefit will be calculated on the policy sum insured and equally divided among all the insured persons.

If the insured person needs wider benefits then they can choose Gold Plan :

BENEFITS UNDER GOLD PLAN:

  • Room, boarding, nursing expenses for sum insured of Rs. 3,00,000/- and Rs. 4,00,000/- is payable up to 5000/- per day and Above Rs.5,00,000/- Private Single A/c Room

  • Emergency Ambulance charges up to Rs.2000/- per hospitalization.

  • Pre-Hospitalization expenses up to 30 days prior to admission in the hospital

  • Post-hospitalisation expenses incurred for a period up to 60 days from the date of discharge from the hospital

  • Cost of Health Check-up is payable up to the limits

  • Cataract is payable up to the limits

  • Psychiatric and Psychosomatic Disorder: If the insured person is diagnosed with psychiatric or psychosomatic disorder for the first time and hospitalized for minimum period of 5 consecutive days under this policy, then the Company will pay hospitalization expenses up to Basic Sum Insured consecutive days

  • Cumulative Bonus: 25% of basic sum insured in the second year and additional 20% of the basic sum insured for each subsequent years subject to a maximum of 100% overall

  • Automatic Restoration: There shall be automatic restoration of the Basic Sum Insured by 200%, once during the policy period

  • Super Restoration of basic Sum Insured by 100% would be provided once for the remaining policy period which can be used for the subsequent hospitalization
  • Domiciliary hospitalization treatments for a period exceeding three days
  • Organ Expenses incurred for organ transplantation from the Donor to the recipient insured person are payable provided the claim for transplantation is payable

  • Shared accommodation If the Insured person occupies shared accommodation during in patient hospitalisation, then a lump sum payment as stated will be payable

  • Additional Basic Sum Insured for Road Traffic Accident (RTA) If the insured person meets with a Road Traffic Accident resulting in patient hospitalization, then the basic sum insured shall be increased by 50%

  • Hospitalization expenses for treatment of New Born Baby: The coverage for new born baby starts from the 16th day after its birth and is subject to a limit of 10% of the Sum Insured or Rupees Fifty thousand, whichever is less

  • Non Allopathic Treatment: Up to 25% of the Basic Sum Insured subject to a maximum of Rs 25000/- during entire policy period.

  • Add-on covers (subject to payment of additional premium): 

  • Patient Care: Available for persons above 60 years. Pays for attendant charges after discharge from hospital for maximum 5 days per hospitalisation and 14 days per policy period.

  • Hospital Cash: Hospital cash benefit for each completed day of hospitalization subject to a maximum of 7 days per hospitalization and 14 days per policy period.

  • Discounts (Available only if Gold Plan is chosen):

  • Family Discount: 5% discount is available if 2 or more family members are covered under this policy

  • Major Organ Donor Discount: If at the time of renewal if the insured person submits proofs that he / she has donated a major organ, a discount of 25% of the premium is available at the time of renewal. This discount is available even for subsequent renewals also.

WAITING PERIODS:

  • The Company shall not be liable under this policy directly or indirectly for;

  • First 30 days for illness/disease (other than accidents)
  • 24 months for specified illness/disease/treatments
  • 48 months for pre-existing disease.

EXCLUSIONS: Please refer to policy terms and conditions for complete information about exclusions.

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ELIGIBILITY
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  • Age at entry 5 months and 65 years
  • Under Gold plan age at entry is 16th day to 65 years.

Sum Insured Options:

  • Rs.1.5 lacs, Rs.2 lacs, Rs.3 lacs, Rs.4 lacs, Rs.5 lacs, Rs.10 lacs and Rs.15 lacs.

  • Under Gold Plan: Rs.3 lacs, Rs.4 lacs, Rs.5 lacs, Rs.10 lacs, Rs.15 lacs, Rs.20 lacs and Rs.25 lacs

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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 is available for reviewing the policy terms and conditions (Not Applicable for Renewals).

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.

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