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Star Health and Allied Insurance Co. Ltd.
Presentation on Star Super Surplus
Presentation On
Star Super Surplus
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Super Surplus
Major Product Features
Wider coverage option of Rs. 7 Lacs and Rs. 10 Lacs
Low Premium
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Super Surplus
Age Limits
5 Months – 60 Years (entry age)
Renewals can be effected up to 75 years
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Super Surplus
Pre - Insurance Medical Test
No Pre – Insurance Medical Test is required
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Super Surplus
Coverages
Hospitalization Expenses incurred as an inpatient for
Sickness/Illness/Diseases
Accidental injuries
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Super Surplus
What is a Hospital?Hospital, Nursing Home means any institution in India established for indoor care and treatment of sickness and injuries and which
Either
It has been registered with the local authorities and is under the supervision of a registered and qualified Medical Practitioner
orShould comply with minimum criteria as under
• It should have at least 15 inpatient beds (10 in Class ‘C’ Towns).• Fully equipped operation theatre of its own wherever surgical
operation is carried out.• Fully qualified nursing staff under its employment round the
clock• Fully qualified Doctor(s) should be in charge round the clock.
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Super Surplus
Sum Insured
The following Sum Insured options are available
• Rs. 7,00,000/-
(Rs. 4,00,000/- in excess of Rs. 3,00,000/-)
• Rs. 10,00,000/-
(Rs. 7,00,000/- in excess of Rs. 3,00,000/-)
• Compulsory Deductible – Rs. 3,00,000/- per claim
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Super Surplus
Deductible
• This insurance will pay for the hospitalisation expenses, as per detailed policy terms, in excess of Rs. 3,00,000/-. This limit of Rs. 3,00,000/- is for each hospitalisation.
• For arriving at the cost per hospitalisation the expenses incurred on pre hospitalisation are to be excluded
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Super Surplus
Allowable Expenses
Room rent & boarding charges subject to a maximum of Rs.4,000/- per day
ICU expenses
Nursing charges
Surgeons, Anesthetist, Medical Practitioner, Consultants, Specialists fees
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Super Surplus
Allowable Expenses (Contd.)Anaesthesia, Blood, Oxygen, Operation Theatre charges, Surgical Appliances, Medicines and Drugs, Diagnostic Materials and X-ray Dialysis, Chemotheraphy, Radiotherapy, Cost of Pacemaker and similar expenses
Post hospitalization expenses on a lump-sum basis @ 7% of the actual hospitalization expenses (excluding room rent and hospital registration charges), subject to a maximum of Rs. 30,000/-.
Note: The policy does not cover Pre Hospitalisation expenses
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Super Surplus
Premium Rating
Sum Insured (Rs.) Premium including S. Tax (Rs.)
7,00,000/- 3,309/-
10,00,000/- 4,412/-
10,00,000/-
family floater
6,287
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Super Surplus
Exclusions
Pre Existing Diseases
Any Disease contracted during first 30 days
First Two Years Exclusions• Knee Replacement Surgery• Joint Replacement Surgery
Congenetial Disease whether internal or external
Injury / Disease arising due to War, Invasion, Act of Foreign Enemy, Warlike operations
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Super Surplus
Exclusions (Contd.)
Circumcision unless necessary for treatment of a disease
Cost of spectacles and contact lens, hearing aids, walkers, crutches wheel chairs and such other aids
Dental treatment or surgery
Convalescence, general debility, Run-down condition, rest cure, sterility, venereal disease, intentional self injury and use of intoxicating drugs/alcohol
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Super Surplus
Exclusions (Contd.)
Naturopathy Treatment
Expenses incurred on Lasik Laser or Refractive Error Correction treatment
Hospital registration charges, record charges, telephone charges and such other similar charges.
Expenses for Non Allopathic treatment.
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Super Surplus
Premium Ratingincl. of Service Tax
Medi Classic + Super SurplusAGE 3 Lacs 10 Lacs 10 Lacs
5 Months to 35 Years
3640 4412 8052
36 Years to 45 Years
4026 4412 8438
46 Years to 55 Years
6805 4412 11217
56 Years to 65 Years
9045 4412 13457
Sum Insured = 10 Lacs ( 3 + 7 )
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Super Surplus
Other BenefitsBenefits under Section 80-D of the IT Act
Cashless Service without intervention of TPA
Direct Tie up with hospitals on an All India Basis
24 X 7 In-House Call center (044-2826 3300)
Toll Free Telephone line assistance
(1800 425 2255)
Full knowledge based website to offer medical information, including Health Tips.
Frequent health meets to disseminate information on health related topics
Doctor on Call (Free Consultation with Doctor on phone)
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Super Surplus
Claim Procedure
In case of Network HospitalsImmediate intimation to the Call Centre
(1800 425 2255/044-28263300)The insured has to send a request for ‘Pre Authorization Form’ signed by the Doctor in the Network HospitalBased on the intimation a field visit will be done by the Star DoctorPre Authorization will be issued to the HospitalBased on the Pre Authorization and the Report by the Star Doctor, Cash Less Treatment will be given by the Network Hospital
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Super Surplus
18
In case of Non Network HospitalsImmediate intimation to the Call Centre
(1800 425 2255 /044-28263300)Claim form will be sent to the Insured.Based on the intimation a field visit will be done by the Star DoctorBills has to be settled by the Insured and will be reimbursed by Star on submitting the following documents
• Original Discharge Summary• Main Hospital Bill with Break Up• Investigation Reports with X-Ray Film• Medical Bills with Prescriptions
Claim Procedure (Contd.)
Star Health and Allied Insurance Co. Ltd.
Presentation on Star Super Surplus
Thank You