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Accident Care Individual Insurance Policy
IRDAI UIN: IRDAI/HLT/SHAI/P-P/V.III/134/2017-18
HIGHLIGHTS
Plan Essentials
Entry Age
Any individuals aged between 18 and 70 years can avail this policy. Dependent children of the insured person are cover from 5 months to 25 years.
Policy Type
This policy can be availed either on an Individual or Floater basis. Under the family plan insured’s spouse and dependent children are covered.
Premium Discount
10% discount on the premium is available, if the policy is opted as family basis.
Online Discount
A 5% discount on premium is available is the policy is purchased online.
Detailed List
Understand what’s included
IMPORTANT HIGHLIGHTS
Sum Insured
The minimum Sum Insured of this policy is Rs. 1,00,000/- and it can be enhanced in the multiples of Rs. 10,000/-. The maximum Sum Insured will vary depending upon the earning capacity of the insured person.
Policy Benefit
Table A - Provides cover for Accidental Death.
Table B - Provides cover for Accidental Death and Permanent Disablement.
Table C - Provides cover for Accidental Death, Permanent Disablement and Temporary Total Disablement.
Accidental Death
This policy provides 100% of the Sum Insured along with cumulative bonus in the event of accidental death of the insured person.
Permanent Total Disablement
This policy provides 150% of the Sum Insured along with the cumulative bonus (calculated only on 100% of the Sum Insured) in the event of Permanent Total Disablement of the insured person due to accident.
Permanent Partial Disablement
This policy provides specific percentage of the Sum Insured as mentioned in the policy clause in the event of Permanent Partial Disablement following accidental injuries.
Temporary Total Disablement
This policy provides 1% of the Sum Insured under Table C per completed week not exceeding Rs. 15,000/- (per week) up to 100 weeks, in the event of grievous injury of the insured person solely due to accidents and leads to temporary total disablement.
ADDITIONAL BENEFITS FOR TABLE A,B & C
Educational Grant
In the event of accidental death or permanent total disability of the insured person, an educational grant for a maximum of two dependent children of the insured is provided.
I) A maximum of Rs. 10,000/- is provided per child, up to two dependent children
II) In case of more than one dependent child below 18 years, Rs. 10,000/- per child is payable not exceeding more than Rs. 20,000/-.
Ambulance Charges / Transportation of the Mortal Remains
For an admissible claim due to accidents outside the place of the insured’s residence, the policy provides lump sum either for ambulance charges to go to the hospital or transportation of the mortal remains of the insured person to his/her residence, up to a maximum of Rs. 5,000/-.
Travel Expenses for One Relative
The company will provide 1% of the Sum Insured up to Rs. 50,000/- (subject to the actual) for transportation of one relative to the insured’s residence in case of accidental death of the insured person.
Vehicle / Residence Modification
The expenses incurred to modify the insured person’s residential accommodation or vehicle as long as the modification is been carried out in India and certified by the Doctor which is required as the result of accident are covered up to 10% of the Sum Insured (of Table B and C) subject to the maximum of Rs. 50,000/-.
Purchase of Blood
This policy provides 5% of the Sum Insured subject to the maximum of Rs. 10,000/- (whichever is less) in addition to the Sum Insured, towards the expenses incurred for purchasing the blood for the insured person’s medical or surgical treatment.
Transportation of Imported Medicines
The policy provides 5% of the Sum Insured subject to the maximum of Rs. 20,000/- towards the expenses incurred on freight charges for importing medicines to India.
Cumulative Bonus
Cumulative bonus is provided at 5% of the Sum Insured for each claim-free year subject to a maximum of 50% of the Sum Insured.
OPTIONAL BENEFIT
Medical Expenses Extension
The medical expenses incurred towards in-patient and as out patient are covered up to 25% of the valid claim or 10% of the total Sum Insured or actuals (whichever is less), subject to an overall limit of Rs. 5,00,000/- per policy period.
Coverage for Winter Sports
This extension can be granted for the period the Insured person proposes to participate in such sports.
Hospital Cash
A cash benefit of Rs.1000/- is provided for each completed day in the hospital when such hospitalisation happens within 30 days from the date of accident. This benefit is provided for a maximum of 15 days per occurrence and 60 days per policy period.
Home Convalescence
The expenses incurred for one attendant at the residence of the insured after discharge from the hospital with the advice of the attending physician are covered up to Rs. 500/- for each completed day subjected to the maximum of 15 days per occurrence and 60 days per policy period.
Please refer to the Policy Documents to know the policy details and Terms & Conditions.
For the purpose of rating, persons proposed for insurance are classified under three risk groups
Risk Group I - Persons engaged primarily in administrative functions
Risk Group II - Persons engaged in manual work other than what is specifically provided for under Risk Group III
Risk Group III - Persons working in explosives industry, mine and /or Magazine workers, high tension electric supply, horse racing including jockeys, athletes and occupations of similar hazard.
Premium Excluding Tax
1 Year Policy
Coverage/ Risk group | Premium (in Rs.) per mille sum insured | ||
Group I | Group II | Group III | |
Table A | 0.43 | 0.60 | 0.80 |
Table B | 0.70 | 1.30 | 1.75 |
Table C | 1.25 | 1.75 | 2.00 |
2 Year Policy
Coverage/ Risk group | Premium (in Rs.) per mille sum insured | ||
Group I | Group II | Group III | |
Table A | 0.83 | 1.16 | 1.54 |
Table B | 1.35 | 2.51 | 3.38 |
Table C | 2.41 | 3.38 | 3.86 |
3 Year Policy
Coverage/ Risk group | Premium (in Rs.) per mille sum insured | ||
Group I | Group II | Group III | |
Table A | 1.20 | 1.68 | 2.24 |
Table B | 1.96 | 3.63 | 4.89 |
Table C | 3.49 | 4.89 | 5.59 |
* per mille means per thousand sum insured
Premium for Optional Benefits | |
| Medical Expenses Extension | 10% of the final premium per year per person |
| Winter Sports & Rallies | 100% of the policy premium per person |
| Hospital Cash | Rs.40/- per year per person |
| Home Convalescence | Rs.15/- per year per person |
Final Premium means: Basic premium + premium for other extensions, if any
Policy Premium means: Basic premium + premium of opted optional benefits
Free look period:
The Free Look Period shall be applicable on new individual health insurance policies and not on renewals or at the time of porting/migrating the policy.
The insured person shall be allowed free look period of thirty days from date of receipt of the policy document whether electronically or otherwise to review the terms and conditions of the policy, and to return the same if not acceptable.
i. If the insured has not incurred any claim during the Free Look Period, the insured shall be entitled to a refund of the premium paid less any expenses incurred by the Company on medical examination of the insured person and the stamp duty charges or
ii. where the risk has already commenced and the option of return of the policy is exercised by the insured person, a deduction towards the proportionate risk premium for period of cover or
iii. where only a part of the insurance coverage has commenced, such proportionate premium commensurate with the insurance coverage during such period
Note: Wherever the word “Death / Disability” occurs it means “Death/Disability” arising out of Accidents.
STAR HEALTH
Why Choose Star Health Insurance?
As a Health Insurance specialist, we extend our services from offering tailor-made products to fast in-house claim settlements. With our growing network of hospitals, we ensure easy access to fulfill your medical needs.
Diagnostic Centres
Get access to 1,635 diagnostic centres across India with home pickup of lab samples and health checkups at your doorstep.
E-Pharmacy
Order medicines online at a discounted price. Home delivery and store pick-ups are available across 2780 cities.
24*7 Customer Service
Call us at 1800-425-2255 for claim intimation, telehealth services, and to clear your queries.
In-house Claim Settlement
We’re the first Standalone Health Insurance company to settle the claims without any TPA but with a qualified in-house team.
Claim Settlement
90% of our claims are settled under cashless within 2 hours and 92% of claims are settled under reimbursement within 7days.
Hospitals
We got you covered under our valuable service providers, an agreed network and network hospitals for quality treatment.
Awards
We’ve been awarded for innovative product, best claim settlement and service provider from reputed survey organisations.
Network Hospitals
Hospitals in agreement with Star Health provide seamless cashless facilities. The approval process is quick and comfortable.
Agreed Network Hospitals
Hospitals that have agreed with Star Health to provide cost-effective package rates for surgical and medical procedures.
Valuable Service Providers
These hospitals are identified by Star Health and have been specially recognised for their efforts, services and quality.
Non-Network Hospitals
For getting treatments in non-network hospitals(not in agreement with Star Health), you can avail reimbursement claims.
Excluded Providers
Hospitals, where claims are not admissible. But life-threatening situations/accidents expenses are payable up to stabilisation.
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