Special Care Gold, Star Health And Allied Insurance Company Limited
IRDAI UIN: SHAHLIP23182V012223
Pre-Policy Medical check-up
Understand what’s included
Specially designed policy for the persons with a disabilities as per The Rights of Persons with Disabilities Act, 2016 Or / and for individuals with HIV/AIDS as defined under the Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (Prevention and Control) Act, 2017.
This policy provides benefits only on an individual basis.
The policy can be taken for a term of 1 year.
The Sum Insured options under this policy are Rs.4,00,000/- and Rs. 5,00,000/-.
The coverage under this policy is available for persons with the following disability/disabilities as defined under the Act and any subsequent additions/modifications to the list in the Act. Disability for the purpose of this policy means a person with 40% or more of a specified disability as Certified by the Certifying authority as per the Disability Act 2016. 1. Blindness 2. Muscular Dystrophy 3. Low vision 4. Chronic Neurological conditions 5. Leprosy Cured persons 6. Specific Learning Disabilities 7. Hearing Impairment (deaf and hard of hearing) 8. Multiple Sclerosis 9. Locomotor Disability 10. Speech and Language disability 11. Dwarfism 12. Thalassemia 13. Intellectual Disability 14. Haemophilia 15. Mental Illness 16. Sickle Cell Disease 17. Autism spectrum disorder 18. Multiple Disabilities including deaf/ blindness 19. Cerebral Palsy 20. Acid Attack victim 21. Parkinson's disease
This policy is available for individuals with HIV/AIDS as defined under the Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (Prevention and Control) Act, 2017. Individuals diagnosed as HIV/AIDS by a duly qualified Medical Practitioner with a CD4 count above 350 will only be eligible for cover under this policy.
HOSPITALISATION CARE (INCLUDING DISABILITY AND HIV/AIDS COVER)
Hospitalisation expenses incurred for more than 24 hours of hospitalisation are covered.
Room, boarding and nursing expenses all inclusive as provided by the Hospital/Nursing Home are covered up to 1% of the Sum Insured per day.
Intensive Care Unit (ICU) charges/Intensive Cardiac Care Unit (ICCU) charges all inclusive as provided by the Hospital/Nursing home are covered up to a maximum of 2% of the Sum Insured per day.
In addition to in-patient hospitalisation, the medical expenses incurred up to 30 days before the date of admission to the hospital are also covered.
Post-hospitalisation medical expenses including consultation fees, diagnostic charges, medicines and drugs as recommended by the Hospital / Medical Practitioner are covered up to 60 days from the date of discharge from the hospital.
Emergency Road Ambulance
Ambulance charges are covered up to the maximum of Rs. 2000/- per hospitalisation.
Day Care Procedures
Medical treatments and / or surgical procedures that require less than 24 hours of hospitalisation due to technological advancements are covered.
Expenses incurred for Cataract treatment are covered up to Rs. 40,000/- per eye in one policy year.
Each and every claim under this policy shall be subject to a Co-payment of 20% applicable to the claim amount admissible and payable as per the terms and conditions of the policy.
Waiver of Co-payment
Waiver of co-payment is available on payment of additional premium as per terms & conditions.
LUMPSUM COVERAGE FOR HIV/AIDS
Lumpsum Coverage for HIV/AIDS
In case the CD4 count of the insured is/goes below 150, then the Company will pay 100% of the Sum Insured or the balance Sum Insured available under the policy, whichever is lower, as a lumpsum amount to the insured. This payment will trigger after a waiting period of 90 days from the commencement date of the policy. Note: The claim mentioned above shall be payable once in the lifetime of the insured person and shall not be necessarily linked to an in-patient hospitalisation claim made under the policy.
I) Applicable for Diseases other than Disability/HIV/AIDS: The expenses related to the treatment of pre-existing diseases and their direct complications are covered after a waiting period of 48 months of continuous coverage after the date of inception of the first policy with the insurer. II) Applicable for HIV/AIDS: The expenses related to the treatment of HIV/AIDS and its direct complications are covered after 90 days of continuous coverage from the date of inception of the first policy with the insurer. III) Applicable for Disability: The expenses related to the treatment of pre-existing disability and its direct complications are covered after 24 months of continuous coverage after the date of inception of the first policy with the insurer.
The expenses related to the treatment of listed conditions, surgeries and treatments are covered after a waiting period of 24 months of continuous coverage after the date of inception of the first policy with the insurer.
Initial Waiting Period
The expenses related to the treatment of any illness within 30 days from the first policy commencement date are excluded except for claims arising due to an accident.
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.
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Tiji K Oommen
Tiji K Oommen
My friend told me to buy health insurance from Star Health Insurance. That helped me during my son’s illness. Their cashless treatment facility was very helpful at the time. I truly appreciate their service and support.
I have been with Star Health Insurance for the past 8 years, and have applied for two claims in that time. Both claims got settled, and I received good support from the company during my hospitalisation.
My family has been with Star Health Insurance since 2006. Our claim, which we applied during last month, was handled without any hassle. We are happy that we are part of such service providers.
Star Health Insurance helped me a lot when I was in need. I was covered under Star’s Comprehensive policy, which provided me cashless treatment at their network hospital during my Angioplasty surgery.
I have been using Mediclaim services for the last 7-8 years. I had tried other companies. But, I satisfied with the service Star Health Insurance has provided me, they also have friendly support personnel.
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