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Star Health Assure Insurance Policy

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IRDAI UIN : SHAHLIP23131V022223

HIGHLIGHTS

Plan Essentials

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Wide Cover

This policy provides wide coverage including self, spouse, dependent children (maximum 3), parents and parents-in-law.
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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.
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Delivery Expenses

Delivery expenses including the Caesarean section (both pre-natal and post-natal) are covered up to 10% of the Sum Insured.
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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.
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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.
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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.
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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.
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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 Type

This policy can be availed either on an Individual or Floater basis.

Individual Entry Age

Any person aged between 91 days and 75 years can avail this policy on an Individual basis.

Floater Entry Age

Any 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 Examination

No 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 Hospitalisation

Hospitalisation expenses incurred for a period of more than 24 hours on account of  illness, injury or accidents are covered.

Pre-Hospitalisation

In 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-Hospitalisation

Post-hospitalisation medical expenses incurred up to 180 days from the date of discharge from the hospital are covered.

Room Rent

Room, 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 Accommodation

Expenses 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 Items

If there is an admissible claim under the policy, then non-medical items specified in this policy will become payable.

Road Ambulance

This 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 Ambulance

Air 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 Hospitalisation

Expenses incurred for domiciliary hospitalisation, including AYUSH on the advice of a medical practitioner for a period exceeding three days are covered.

Day Care Procedures

Medical treatments and surgical procedures that require less than 24 hours of hospitalisation due to technological advancements are covered.

Modern Treatment

Expenses incurred for modern treatments such as Oral Chemotherapy, Intra Vitreal injections, Robotic Surgeries, etc. are covered up to the Sum Insured.

Organ Donor Expenses

In-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 Management

Expenses 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 Treatment

Expenses incurred for the treatment under Ayurveda, Unani, Sidha and Homeopathy systems of medicines in AYUSH hospitals are covered up to the Sum Insured.

Compassionate Travel

The 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 Remains

The 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 / Intervention

Expenses 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 Network

In 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 Bonus

Cumulative 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 Cover

Insured person can avail premium discount if he/she choose any of the deductibles as mentioned in this policy.

Co-Payment

If 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 Assure

Health check-up expenses are covered up to the specified limits for each policy year irrespective of the claim.

Second Medical Opinion

The Insured person can avail a Second Medical Opinion from a Doctor in the Company's network of medical practitioners.

Star Wellness Program

Wellness 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 Period

1. 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 Options

The 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.
STAR HEALTH

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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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