Star Health Star Gain Health Insurance Policy

Introduction:

This policy has a very low premium cost, but still it covers all in-patient and out-patient hospitalisation expenses. Also it has huge tax benefits attached to it.

Eligibility:

• Minimum age – 5 months maximum – 65 years up to a maximum assured sum of 1000000 INR ,

• Applicable for individuals as well as for family. If taken for individuals the sum insured is applicable for each person separately. If taken on floater basis it is for entire family (self, spouse and dependent children), (max 2 adults + 3 children).

Policy benefits:

• Flat amount of 15000 INR irrespective of sum insured or age of person or the number of persons insured.
• One policy underlines both in-patient and out-patient treatments.
• Carry forward option of amount corresponding to out-patient unutilized amount.

Policy details:

• Hospitalisation expenses (minimum period 24 hours) are covered up to a max of 2% and subject to a limit of 4000 INR per day in class A cities, 1% of sum: max-3000 INR In class B cities, 1% of sum: max-1000 per day in other locations.
• No ceiling on ICU, medicine or diagnostic tests, boarding and nursing expenses are covered, surgeons /consultants fees are covered.
• Medical equipment and devices.
• Emergency ambulance charge: up to a sum of 750 INR and overall policy limit of 1500 INR.

Out-Patient cover:

• Expenses borne for any hospital and nursing home.
• Treatment also covered for pre-existing diseases, dental expenses and prenatal/postnatal care.

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

 

Premium details:

Limit of out-patient Benefits for individuals:

Sum Insured	100000	200000	300000	400000	500000
5M-45Yrs	8700	7750	7000	6250	5750
46-55Yrs	7900	6350	5200	3000	NA
Above 56	7500	5800	3700	NA	NA

 

 

Family size	Limit of out-patient benefits for family
	Sum Insured	100000	200000	300000	400000	500000
2A	5M-35Yrs	8400	7400	6750	5900	5250
	36-45Yrs	8400	7400	6500	5500	4900
	46-55Yrs	NA	5650	4000	2000	NA
	Above 56	NA	5000	2250	NA	NA
1A + 1C	5M-35Yrs	8500	7700	6950	5750	5500
	36-45Yrs	8500	7500	6750	5750	5250
	46-55Yrs	NA	5850	4500	2400	NA
	Above 56	NA	5200	2250	NA	NA
1A + 2C	5M-35Yrs	8450	7500	6900	6000	5500
	36-45Yrs	8450	7250	6650	5750	5000
	46-55Yrs	NA	5750	4450	2250	NA
	Above 56	NA	5150	2250	NA	NA
1A + 3C	5M-35Yrs	8350	7400	6650	5750	5250
	36-45Yrs	8350	7200	6450	5500	4750
	46-55Yrs	NA	5500	4000	NA	NA
	Above 56	NA	4750	2250	NA	NA
2A + 1C	5M-35Yrs	8250	7250	6600	5750	5000
	36-45Yrs	8250	7000	6150	5450	4500
	46-55Yrs	NA	5000	3500	NA	NA
	Above 56	NA	4250	1500	NA	NA
2A + 2C	5M-35Yrs	8250	7000	6500	5500	4650
	36-45Yrs	8250	7000	5950	5000	3750
	46-55Yrs	NA	5000	3500	NA	NA
	Above 56	NA	4250	1500	NA	NA
2A + 3C	5M-35Yrs	8250	7000	6250	5250	4250
	36-45Yrs	825O	6700	5750	4900	3700
	46-55Yrs	NA	4750	3250	NA	NA
	Above 56	NA	4000	1150	NA	NA

 

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

Free Look Period: A period of 15 days after date of receipt of policy document to review terms and conditions during which insured can cancel it and gets due refunds.

Portability:

If the insured wishes to migrate to another Insurer towards renewal, he can draft an application at least 45 days before the date of renewal.

Renewal Policy:

• Allows a grace period of 30 days from the date of expiry.
•  Permitting an enhancement after renewal during this process.

Tax Benefit: Payment of premium by any mode other than cash is subject to rebate under section 80D.

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.