Star Health Mediclassic Individual Insurance Policy

Introduction

It covers hospitalization expenses incurred in daily life due to diseases and illness or accidental injuries thus taking care of uncertainties.

Eligibility:

• Minimum age: 5 months and maximum: 65 years at the time of entry. Children can be covered only along with parents.
• The sum insured under this insurance is per individual member covered.

Who Can Take This Insurance?      

Policy Benefits:

• Hospitalisation Cover: Hospitalisation expenses are covered for a minimum of 24 hours (room rent, nursing and boarding charges, Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist Fees, Cost of Medicines and Drugs).
• Ambulance charges for emergency transportation to hospital as per specified limits.
• Pre-Hospitalization expenses up to 30 days prior to admission in the hospital.
• Post-hospitalisation paid as lump-sum up to 60 days from the date of discharge; payment not exceeding 7% of hospitalization expenses; maximum of 5000 INR.
• 101 Day-care treatments covered.
• Non-Allopathic Treatments: Covered up-to specified limits.
• Pre-Existing Diseases / Illness:   Are covered after 48 months of continuous Insurance without break with any Indian Insurance Company.

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

• Patient Care: Available for above 60 years (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.

Policy details:

Term of one year but if a premium of two years is paid in advance then a discount of 5% is allowed on total premium.

Automatic Restoration of Sum Insured( not applicable for Family Package ): In the event of a claim, during the currency of the policy, if the entire sum insured is exhausted and the policy has not expired then the automatic restoration of Sum Insured will operate and the sum insured will be restored to the original amount i.e. 200% only once. This restored sum insured can be utilized, during the remaining policy period, for any other illness / diseases unrelated to the ones for which claim/s has /have been made.

Bonus:

For every claim year bonus is equal to 5% of the basic sum subject to a maximum of 25% (only for family package plan).

Pre- Acceptance medical screening: Persons above 50 years will be required to undergo pre-acceptance medical screening at the Company nominated centres. Cost of screening is currently borne by the company.

 

Family Package:

• Available for persons between 5 months to 45 years. The sum insured is distributed equally among insured family members and calculated on the policy sum insured.

Optional Benefit of New Born Baby cover available under this Plan: Sum Insured : 10% of the mother's sum insured. Premium: 10% of the policy premium.

Health Check-up benefits: 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 for a maximum of 5000 INR and payable on renewal.

 

HIV Persons Coverage:  This policy can be taken by HIV positive persons. But the CD 4 count at the time of entry should be above 350 (proof to be produced). However, hospitalization for any opportunistic infections is not covered.

Premium Chart:

Zone 1
Delhi, Noida, Gurgaon, Ghaziabad, Faridabad, Mumbai, Thane, Pune and entire State of Gujarat
Sum Insured	Annual Premium (service tax extra)
	Age in years						Renewal only
	5m-35	36-45	46-50	51-55	56-60	61-65	66-70	71-75	76-80	Above 80
150000	2510	2510	3770	4495	6200	7900	11800	13300	16800	21840
200000	3030	3260	5120	6110	7750	9850	14005	17330	22300	28990
300000	4400	4650	7665	11365	13750	14350	20000	24350	32270	41950
400000	4915	5550	8950	12690	15535	20000	26800	31525	42420	55140
500000	5450	6145	10700	14000	16775	24430	34680	38700	52540	68300
1000000	7800	8200	13600	18384	22910	28900	34755	41615	58250	75725
1500000	9545	9910	15310	22510	29160	39555	47125	52525	67825	88170
Optional Benefits
Hospital cash					Patient care
1000 per day(max- 7 days and 14 days per policy period)					400 per day for max 5 days per hospitalisation and 14 days per policy period

 

 

Zone 1
Rest of India (excluding Delhi, Noida, Gurgaon, Ghaziabad, Faridabad, Mumbai, Thane, Pune and entire State of Gujarat
Sum Insured	Annual Premium (service tax extra)
	Age in years						Renewal only
	5m-35	36-45	46-50	51-55	56-60	61-65	66-70	71-75	76-80	Above 80
150000	2510	2510	3770	4495	6200	7900	11800	13300	16800	21840
200000	2880	3175	4775	5900	7350	9550	13500	16950	22000	28600
300000	4000	4535	7200	11115	13200	14000	19600	23800	31900	41470
400000	4515	5210	8700	12335	15000	19600	26200	31000	41900	54470
500000	5080	5870	10700	13555	15875	24000	33840	38100	51900	67470
1000000	7465	7965	13265	17875	21440	28200	34200	40800	57600	74880
1500000	9165	9595	14710	21710	28810	38365	46395	50675	66700	86710
Optional Benefits
Hospital cash					Patient care
1000 per day(max- 7 days and 14 days per policy period)					400 per day for max 5 days per hospitalisation and 14 days per policy period

 

*The above rates may vary. Please check the policy wordings for more details.

Free look period: To review terms and conditions by the insurer and making way for a judicious decision a period of 15 days after policy comes into effect is allowed. Within this period the insurer may also ask for cancellation.

Exclusions:

• Pre Existing diseases as mentioned.
• Disease that creeps into the insured during the first 30 days of the policy period. Also expenses of defined and related diseases as mentioned would not be borne during the first two years of continuous operation of insurance.
• Dental treatment or surgery (excluding accidental damages).
• Injury due to nuclear weapons and war or breach of law on an intentional basis.
• Expenses on Vitamins and tonics not part of the treatment schedule.
• Hospital registration and admission charges, record and telephone charges.

Cancellation Policy:

Misrepresentation, fraud, moral hazard or non-cooperation on behalf of the insured might lead to cancellation of policy making way for appropriate refund.

Period on risk	Rate of Premium to be retained by the insurer
Up to 1 month	1/3rd of annual premium
Up to 3 month	1/2 of annual premium
Up to 6 month	3/4th of annual premium
Exceeding 6 months	Full annual premium