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It is a fully loaded Top end Floater Policy for the entire family with
High Sum InsuredExtended BenefitsNo Sub LimitsNo Capping on Room RentRestoration of Sum Insured
Unique Features
Star Comprehensive Insurance Policy
Star Comprehensive Insurance Policy
Sum Insured Options
Sum Insured
5 Lakhs
7.5 Lakhs
10 Lakhs
15 Lakhs
20 Lakhs
25 Lakhs
18 years – 65 Years.
Children of 5 months can be Covered if Parent is
Covered.
Beyond the age of 65 years only renewals are accepted. But
sum insured options will be limited to a max of Rs7.5 lacs.
Guaranteed renewal.
Star Comprehensive Insurance Policy
Age Eligibility
Cover can be given to HIV + persons whose CD 4 count is not less than 350 at entry point
No claim payable for Opportunistic infections
No claim on treatment for HIV / AIDS
Star Comprehensive Insurance Policy
Eligibility
Section CoverageSection - I
In-patient Hospitalization
Section - II
Delivery Charges, New Born Baby coverage and Vaccination benefits
Section - III
Out-Patient Dental / Ophthalmic coverage
Section - IV
Hospital Cash
Section - V
Cost of Health Check-upStar Comprehensive Insurance Policy
Coverage
Section I - HOSPITALISATION
Room Rent ,Boarding and Nursing Expenses - No Cap
ICU and Operation Theatre Expenses - No Cap
Surgeon, Anaesthetist, Medical Practitioner, Consultants,
Specialist Fees - No Cap
Anaesthesia, Blood, Oxygen, Operation Theatre charges,
Surgical Appliances, Medicines and Drugs, Diagnostic
Materials and X-ray, Dialysis, Chemotherapy,
Radiotherapy, cost of Pacemaker and similar expenses -
No Cap
Star Comprehensive Insurance Policy
Star Comprehensive Insurance Policy
Sum Insured (Rs.) Ambulance Charges Per Policy Period (Rs.)
5 Lakhs 2000
7.5 Lakhs 3000
10 Lakhs 3500
15 Lakhs 4000
20 Lakhs 4500
25 Lakhs 5000
Pre Hospitalization Expenses - 30 Days
Post Hospitalization Expenses - 60 days
For both these benefits prescriptions, bills / receipts /
copy of reports to be submitted.
Section II
Delivery and New Born Baby CoverWaiting period 36monthsMaximum 2 deliveries. Waiting period between
the first delivery claim and the second one is 24 months.
Delivery Benefit Limits
No Pre and Post Hospitalisation benefits for this Section Both Insured and Spouse should be covered in the same
policy for identical sum insured throughout.
Star Comprehensive Insurance Policy
Sum Insured(Rs.)
Normal Delivery(Rs.)
Caesarean Section Delivery
(Rs.)
5 Lakhs 10,000 15,000
7.5 Lakhs 20,000 40,000
10 Lakhs -25 Lakhs
25,000 40,000
New Born Baby Coverage for the remaining policy period
Vaccination expenses up to Rs 1000/- incurred on the new born baby
Subject to Valid claim for DeliveryCovers congenital defects alsoClaim Made under this Section will not reduce
the policy Sum Insured, adversely affect Health Check-up benefit or add on for Claims loading
Star Comprehensive Insurance Policy
Section IIDelivery and New Born Baby Cover
For Sum Insured (Rs.) Limit of Coverage (Rs.)
5,00,000/- 50,000/-
7,50,000/- & above 1,00,000/-
Section - III
OP Dental and Ophthalmic Treatment • Dental & Ophthalmology Treatment is covered after a waiting
period 36 Months• Can be taken as an Out-patient• Payable even if there is claim in the three year period• Can be claimed for Root Canal Treatment also• Purchase of spectacles
Limits
• The claimant must have been insured continuously.
Claim Made under this Section will not reduce the policy Sum Insured, adversely affect Health Check-up benefit or add on for Claims loading
Star Comprehensive Insurance Policy
Sum Insured (Rs)Amount payable subject to production of
Prescription and supporting Bills (Rs.)
5,00,000/- & 7,50,000/- Upto 5000
10,00,000/- & above Upto 10000
Section - III
OP Dental and Ophthalmic Treatment
For example : A family of three persons 2A + 1C covered
for a Sum Insured of Rs. 5 lakhs for 2 years - 2010-11 and 2011-12.
In 2012-13 another Child is added. In 2013-14 a claim is made for Ophthalmic
Section for the Child added in 2011-12. Not admissible because the waiting period
has not been completed by the child.
Star Comprehensive Insurance Policy
Section – IV Hospital CashCash Benefit -maximum of 7 days per
hospitalisation, provided there is an admissible claim under Section I.
Maximum during one policy period – 120 daysFirst one day will not be paid
Claim for Hospital cash will not affect the policy sum insured
Star Comprehensive Insurance Policy
Sum Insured (Rs.) Limits per day (Rs.)
5 Lakhs 500
7.5 Lakhs – 10 Lakhs
750
15 Lakhs – 20 Lakhs
1000
25 Lakhs 1500
Section – IV Cost of Health Check-up
Cost of Health Check-up Once in a block of every 3 claim- free Continuous renewals
Benefit payable for insured persons who have been
continuously insured under the policy .
Star Comprehensive Insurance Policy
Sum Insured (Rs.) Limits per day (Rs.) on submission of prescriptions bills / receipts / report copies
5 Lakhs 5000
7.5 Lakhs – 10 Lakhs
7500
15 Lakhs – 25 Lakhs
12000
Automatic Restoration of Sum Insured
Restoration facility in-built up to 100% for ALL sum insured options.
Restored Sum Insured can be utilized only for illness /disease unrelated to the illness /diseases for which claim/s was /was made.
Restoration will be available for section 1 only.
Star Comprehensive Insurance Policy
Exclusions Some important exclusions:First 30-days exclusion (other than for
accidents)No First year exclusions- Only two year
Exclusion.PED – waiting period 48monthsNon-allopathic treatments not coveredEnhanced External Counter Pulsation
therapy and related therapies and Rotational Field Quantum Magnetic Resonance Therapy excluded.
Star Comprehensive Insurance Policy
Claims Loading
Where the claim ratio for the preceding 2 consecutive years exceeds 100%, premium loading as per the table given below would be applicable.Average claims ratio of
preceding 2 consecutive years (%)
Loading on Premium
>100 - 125 20%
126-150 30%
> 150 50%
Star Comprehensive Insurance Policy
Co-payment
10% co-payment for persons entering between 61 yrs and 65 yrs and continues thereafter
Co-payment applicable only for Section I claims
Star Comprehensive Insurance Policy
PortabilityThis policy is portable.Inward portability can be accepted for
policies of other Insurance CompaniesPortability procedure to be followedContinuity will be given ONLY for Section
I benefit and NOT for any other Section
Star Comprehensive Insurance Policy
Migration allowed from any other health policy of Star except
Senior Citizens Red Carpet Unique policy Diabetes Safe and Super Surplus - Individual & Floater
Continuity of benefits will be given for Section I only
Persons insured under this policy can migrate to any other policy of Star with continuity of benefits again for in-patient hospitalization only.
Migration permitted upto the age of 60 yrs only.Migration permissible only on Renewal for
Policies with 2 continuous Claims free years. Where claims have been made in the past case to be referred to Corporate office
Star Comprehensive Insurance Policy
Migration from Star Policies
Migration guidelines….
AGE NO CLAIMWITH
CLAIM REMARKS
≤ 50yrsPre acceptance
Medical Examination NOT required
Refer to Head Office
51 yrs – 60 yrs
Pre acceptance Medical Examination as per Package 1.4
Refer to Head Office
No migration if MER reveals
declined risks*
> 60 yrs No MigrationNo
migration
Star Comprehensive Insurance Policy
Migration not permitted for persons suffering from the following declined risks : * Cancer
* Stroke* Heart Diseases* Chronic Renal Diseases
Declined Risks*
Underwriting
Acceptance limits (FRESH PROPOSALS )
Branch < 50years and Sum Insured of Rs 15Lakhs.
Branch > 50 Years Sum Insured upto 5 Lakhs.
Beyond 5 lacs and > 50 yrs refer to Corporate office
Star Comprehensive Insurance Policy
Star Comprehensive Apollo’s Easy Health
Automatic Restoration of 100% of Sum Insured
Premium less by 1% to 9%
No Restoration facility
More expensive than Star
Star and Apollo comparison
Star Comprehensive Insurance Policy
Star Comprehensive v/s Apollo’s Easy Health
Both Price and benefit comparison given separately
Benefit Illustration 1 Claim under Delivery and New Born Baby Cover:Sum Insured for 1st Year 5 LakhsSum Insured for 2nd Year 7.50 LakhsSum Insured For 3rd Year 7.50 LakhsSum Insured For 4th Year 5 Lakhs
A claim is made in the 4th year The eligibility will be as per 5 lakh Sum Insured i.e Rs 10,000/- for Normal and Rs 15,000/- for Caesarean delivery.
Rs 50,000/- for New Born BabyRs 1000/- for VaccinationThe limit is inclusive of pre-natal and post-natal expenses
Star Comprehensive Insurance Policy
Benefit Illustration 2Claim for Health Check UpSum Insured for the 1st year Rs 500000/-Sum Insured for the 2nd Year Rs 750000/-Sum Insured for the 3rd year Rs 750000/-Sum Insured for the 4th Year Rs 1000000/-
Benefits of Health Check Up will be as per Rs 10lakhs
i.e upto Rs 7500/-
Star Comprehensive Insurance Policy
Benefit Illustration 3Claim for OP treatment for Dental /OpthalSum Insured for 1st Year 5 LakhsSum Insured for 2nd Year 7.50 LakhsSum Insured For 3rd Year 7.50 LakhsSum Insured For 4th Year 10 Lakhs
Benefit under this section in the fourth year will be as per Rs 10 Lakh Sum Insured which will be Rs 10000/-
Star Comprehensive Insurance Policy