Star Health Assure Insurance Policy
IRDAI UIN : SHAHLIP23131V022223
HIGHLIGHTS
Plan Essentials
Wide Cover
This policy provides wide coverage including self, spouse, dependent children (maximum 3), parents and parents-in-law.
Mid-Term Inclusion
Newly married / wedded spouse, New Born Baby and legally adopted child can be covered under the policy on payment of an additional premium.
Delivery Expenses
Delivery expenses including the Caesarean section (both pre-natal and post-natal) are covered up to 10% of the Sum Insured.
New Born Cover
Hospitalisation expenses for the treatment of newborn are covered from day one of birth till the expiry date of the policy subject to limits. However, the sublimit will not apply for treatment related to congenital disease/defects for the new born.
Automatic Restoration of Sum Insured
On partial or full utilisation of the Sum Insured during the policy period, 100% of the Sum Insured will be restored unlimited number of times in the policy year that can be utilised for all the claims.
Home Care Treatment
Expenses incurred for home care treatment for specified conditions are covered up to 10% of the Sum Insured subject to the maximum of Rs. 5 Lakh in a policy year. The insured person can avail this service either on a cashless or reimbursement basis.
Chronic Severe Refractory Asthma
In-patient hospitalisation, Day Care, Home Care and Outpatient expenses incurred for the treatment of Chronic Severe Refractory Asthma are covered up to 10% of the Sum Insured subject to the maximum of Rs. 5,00,000/- per policy period.
Assisted Reproduction Treatment
Expenses incurred for proven Assisted Reproduction Treatments are covered up to the specified limits.
DETAILED LIST
Understand what’s included
IMPORTANT HIGHLIGHTS
Policy TypeThis policy can be availed either on an Individual or Floater basis. |
Individual Entry AgeAny person aged between 91 days and 75 years can avail this policy on an Individual basis. |
Floater Entry AgeAny person aged between 18 and 75 years can avail this policy. Under the Floater basis, a maximum of up to three dependent children aged between 16 days and 17 years are covered. |
Medical ExaminationNo pre-medical check-up is required to avail this policy. However, those who declare adverse medical history may be subjected to pre-medical check-up at Company's cost. |
In-Patient HospitalisationHospitalisation expenses incurred for a period of more than 24 hours on account of illness, injury or accidents are covered. |
Pre-HospitalisationIn addition to in-patient hospitalisation, the medical expenses incurred up to 60 days before the date of admission to the hospital are also covered. |
Post-HospitalisationPost-hospitalisation medical expenses incurred up to 180 days from the date of discharge from the hospital are covered. |
Room RentRoom, boarding and nursing expenses incurred during in-patient hospitalisation are covered up to 1% of the Sum Insured per day for Rs. 5 lakh Sum Insured; any room (except suite or above category) for Rs. 10/15/20/25 lakh Sum Insured options; and any room for Rs. 50/75/100/200 lakh Sum Insured options. |
Shared AccommodationExpenses incurred on occupying a shared accommodation by the insured person are covered up to the limits mentioned in the policy clause. |
Coverage for Non-medical ItemsIf there is an admissible claim under the policy, then non-medical items specified in this policy will become payable. |
Road AmbulanceThis policy covers ambulance charges for admission in hospital, for shifting from one hospitals to another for better medical treatment and from hospital to residence (if it is in the same city). |
Air AmbulanceAir ambulance expenses are covered up to 10% of the Sum Insured per policy year, provided the situation requires an immediate hospitalisation of the insured person and ground transportation cannot be provided. |
Domiciliary HospitalisationExpenses incurred for domiciliary hospitalisation, including AYUSH on the advice of a medical practitioner for a period exceeding three days are covered. |
Day Care ProceduresMedical treatments and surgical procedures that require less than 24 hours of hospitalisation due to technological advancements are covered. |
Modern TreatmentExpenses incurred for modern treatments such as Oral Chemotherapy, Intra Vitreal injections, Robotic Surgeries, etc. are covered up to the Sum Insured. |
Organ Donor ExpensesIn-patient hospitalisation expenses incurred for organ transplantation from the Donor to the recipient insured person are payable provided the claim for transplantation is payable. In addition, the expenses incurred by the Donor, (if any) for the complications that necessitate a Redo Surgery / ICU admission will be covered. |
Rehabilitation & Pain ManagementExpenses incurred for Rehabilitation and Pain Management are covered up to the specified sub-limit or maximum up to 20% of the Sum Insured whichever is less, per policy year. |
AYUSH TreatmentExpenses incurred for the treatment under Ayurveda, Unani, Sidha and Homeopathy systems of medicines in AYUSH hospitals are covered up to the Sum Insured. |
Compassionate TravelThe air transportation expenses incurred up to Rs. 10,000/- are payable for an immediate family member to travel to the hospital in case of hospitalisation of the insured person for life-threatening emergency times, at the place away from insured’s usual place of residence. |
Repatriation of Mortal RemainsThe expenses incurred for the repatriation of mortal remains of the insured person are covered up to Rs. 15,000/- in a policy year. |
In Utero Fetal Surgery / InterventionExpenses incurred for In Utero Fetal surgeries and procedures mentioned in this policy are covered with a waiting period. Note: The above-mentioned waiting periods will not apply for the treatment related to congenital Internal disease/defects for the Unborn. |
Treatment in Valuable Service Providers NetworkIn the event of hospitalisation in Valuable Service Provider, then a lump-sum of 1% of the Sum Insured subject to a maximum of Rs. 5,000/- per policy period is provided. |
Cumulative BonusCumulative bonus is provided at 25% of the Sum Insured for each claim-free year subject to a maximum of 100% of the Sum Insured. |
Deductible - Optional CoverInsured person can avail premium discount if he/she choose any of the deductibles as mentioned in this policy. |
Co-PaymentIf the insured person purchases or renews the policy at 61 years of age or above, then he/she is subjected to the co-payment of 10% for each and every claim amount. |
Health Check-Up AssureHealth check-up expenses are covered up to the specified limits for each policy year irrespective of the claim. |
Second Medical OpinionThe Insured person can avail a Second Medical Opinion from a Doctor in the Company's network of medical practitioners. |
Star Wellness ProgramWellness program designed to motivate and encourage the healthy lifestyle of the insured person through various wellness activities. In addition, the earned wellness points can be utilised for availing renewal discounts up to a maximum of 20%. |
Waiting Period1. For Pre-Existing Diseases (3 year term) - 30 months
2. For Pre-Existing Diseases (1 and 2 year term) - 36 months
3. For Specific Diseases/Procedures - 24 months
Initial Waiting Period - 30 days |
Instalment OptionsThe policy premium can be paid on a quarterly or half-yearly basis. It can also be paid on an annual, biennial (once in 2 years) and triennial (once in 3 years) basis. This facility is not available for long-term (2 & 3 year term) options. |
Please refer to the Policy Documents to know the policy details and Terms & Conditions.
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PREMIUM CHART
WELLNESS BENEFITS
GENERAL TERMS
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Take part in our wellness programs and earn rewards for staying healthy. Redeem those rewards to avail renewal discounts.
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