Star Health Assure Insurance Policy

Star Health Assure Insurance Policy
UIN: SHAHLIP23017V012223
About the policy Covers hospitalization expenses incurred as a result of illness and/or accidental injuries
Type of Cover Individual and Floater
Entry Age
Individual : 18 Years to 75 Years, Dependent Children: 91 Days to 18 Years
Floater : 18 Years to 75 Years, Dependent Children: 16 Days to 18 Years
Note: In case of dependent children, when they complete 18 years of age, such children will be considered as
Adult and he/she can continue under floater sum insured till he/she gets married
Maximum Family Size
Maximum family size is 2A+3C+4P. Self, Spouse , Dependent children, Parents and Parents in law.
(or)
6 Adults + 3 Children (6 Adults = Self + Spouse + Parents + Parents-in-law).
If Dependent parents and parents in-laws alone wants to cover under this policy separately, the same is
possible under 2A family scheme.
Midterm Inclusion Available for Newly Wedded spouse, New born baby and Legally adopted child. Intimation should be given
within 45 days from the date of marriage or date of birth
Zone based pricing Zone A: Delhi including Faridabad, Gurgaon, Ghaziabad and Noida, Mumbai including Thane, Ahmedabad,
Surat and Vadodara
Zone B: Pune including Nashik, Trivandrum, Ernakulam, Chennai, Bengaluru, Hyderabad, Secunderabad
and Rest of Gujarat
Zone C: Rest of India
Co-payment 10% of each and every claim amount for fresh as well as renewal policies for insured person whose age at
the time of entry is 61 years an above.
Renewal Lifelong
Policy Term One Year, Two years & Three Years
Long Term Discount Two year policy: 10 % discount on 2 nd year premium
Three year policy: 10% discount is available on 2 nd and 3rd year premium
Floater Discount Under floater policy, premium for child aged up to 17 years will be according to the family size.
Above 17 years, the child can continue under the floater policy by paying the premium applicable for the
child based on his/her appropriate age from the 1A premium table with a floater discount of 40%.
The premium for parents (in-laws) is based on their appropriate age from the 1A table
with a floater discount of 10% for each parent.
Pre Medical Screening For those who declare adverse medical history, company may subject them to undergo pre-policy medical
check-up. 100% cost of such medical examination is borne by the company
Note : For children whose age is less than 12 years, Paediatrician letter, Vaccination report
or Health Report should be submitted and the proposal will be routed to our CMU Team for
medical opinion.
Sum Insured Options (Rs. in Lakhs) 5 10 15 20 25 50 75 100 200
Note: Rs 75 Lakhs, Rs 100 Lakhs and Rs 200 Lakhs sum insured will be available for persons aged up to
65 years only. This is applicable only at the time of inception of this policy
Room Rent Upto 1% of Sum Insured or upto Rs.20,000/- per day whichever is
less
No limit (Any room)
Coverage for Non Medical Items
(Consumables)
If there is an admissible claim under inpatient / day care the policy, then Items as per List I will become
payable
Emergency Road Ambulance Covered upto sum insured
(i) for transportation to hospital (ii) from one hospital to other hospital (iii) from hospital to residence
Pre & Post Hospitalization 60 days & 180 days. Covered upto sum insured
Organ Donor Expenses Covered upto sum insured. Additional SI up to Basic SI for the Complications(if any) that necessitate a Redo
Surgery/ICU admission
Day Care Treatments All day care treatments are covered upto sum insured
Domiciliary hospitalization Covered upto sum insured.Treatment taken at home for the period exceeding three days
Home Care Treatment Payable up to 10% of the sum insured subject to maximum of Rs 5 Lakhs in a policy year
Air Ambulance Covered up to 10% of sum insured per policy year
Star Wellness Program
Available for Insured aged => 18 yrs
Wellness platform is available both in our mobile app “Star Power” & Customer Portal (Retail) The
Insured can earn reward points and avail premium discount up to 20% on the renewal premium by
enrolling and achieving the wellness goals. For details please refer the policy wording / prospectus.
Sum Insured Options (Rs. in Lakhs) 5 10 15 20 25 50 75 100 200
Health Check up
Assure
Each policy year
(Irrespective of
claim)
Individual (Rs) 1500 2000 4000 5000 5000 5000 8000 8000 8000
Floater (Rs) 2500 5000 8000 10000 10000 10000 15000 15000 15000
Cumulative Bonus
25% of sum insured for each claim free and maximum up to 100% of the sum insured
Ayush Treatment
(For Ayurveda, Unani, Sidha &
Homepathy)
Covered up to sum insured
Assisted Reproduction Treatment
(Limit of Liability in a policy year)
1 Lakh 2 Lakhs 2 Lakhs 2 Lakhs 2 Lakhs 4 Lakhs 4 Lakhs 4 Lakhs 4 Lakhs
Delivery Expenses (Per Policy Year) Covered up-to 10% of the Sum Insured.
Both self and spouse are covered under this policy for a continuous period of 2 years under Individual or
floater sum insured
In Utero Fetal
surgery/Intervention
Covered up to sum insured, Waiting period: 2 years from the date of inception of this policy
Sum Insured Options
(Rs. in Lakhs)
5 10 15 20 25 50 75 100 200
Hospitalization Expenses for
Treatment of New Born Cover
2 Lakhs 2 Lakhs 2 Lakhs 2 Lakhs 2 Lakhs 4 Lakhs 4 Lakhs 4 Lakhs 4 Lakhs
Treatment for Chronic Severe
Refractory Asthma
Payable up to 10% of sum insured not exceeding Rs.5 Lakhs per policy period
Compassionate Travel Company will reimburse the transportation expenses by air incurred up to Rs.10,000/- for one immediate
family member (other than the travel companion)
Repatriation of mortal remains Company shall reimburse up to Rs.15,000/- in a policy year
Payable towards the cost of repatriation of mortal remains of the insured person (including the cost of
embalming and coffin charges) to the residence of the Insured as recorded in the policy
Treatment in Valuable
Service Providers Network 1% of Sum Insured subject to a maximum of Rs.5,000/- per policy period is payable as lump sum
Shared Accommodation Payable for in-patient hospitalization, then amount of Rs.1,000/- per day will be payable for each
continuous and completed period of 24 hours of stay in such shared accommodation
Second Medical Opinion Can obtain a Second Medical Opinion from a Doctor in the Company’s network of Medical Practitioners.
All medical records should be forwarded to the mail-id e_medicalopinion@starhealth.in.or through
Post/Courier.
Automatic Restoration
Sum Insured will be restored unlimited number of times and maximum up to 100% each time, which
can be utilized for a subsequent hospitalization.
Restoration will trigger immediately upon partial/ full utilization of the sum insured, which can be utilized
for a subsequent hospitalization.
On partial utilization of the Sum Insured, it will be restored up to extent of utilization.
On full utilization of the Sum Insured, it will be restored to 100%
Used for all claims including for modern treatment, but for a subsequent hospitalization
Maximum payable amount for a single claim under restoration benefit shall not more than the sum insured
Modern treatments Covered up to sum insured
Rehabilitation and Pain
Management
Covered up to the sub-limit (or) maximum up to 20% of the sum insured whichever is less, per policy year
Optional Cover
Optional Cover to choose
deductible
This deductible is applicable for
every policy year (on Aggregate
basis)
Sum Insured Aggregate Deductible
Option
Discount Offered
Upto Rs 20 Lakhs Rs 50,000 45%
Rs 1 Lakh 55%
Above Rs 20 Lakhs Rs 50,000 35%
Rs 1,00,000 50%
Waiting Period
Initial waiting period 30 days for all illnesses (except accident)
For Specific diseases 2 years
For Pre-existing diseases Applicable for 3 year policy term: 2.5 years.
Applicable for 1 year and 2 year policy term :3 years
Delivery Expenses Cover 2 years
In Utero Fetal Surgery /
Intervention
2 years
Assisted Reproduction Treatment 2 years
New Born Baby Cover 1 year
* The information provided in this document is only indicative. For more details on the terms and conditions, please read the policy wordings before concluding a sale.

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Category: Health Insurance