Star Comprehensive Insurance Policy

Star Comprehensive Insurance Policy is, as the name suggests, a comprehensive health insurance plan which can be taken individually or for the entire family. The policy also covers maternity related expenses and is available for individuals aged up to 65 years.

Key features of the plan

• There are no pre-entrance medical check-ups for individuals aged up to 50 years.
• The available Sum Insured under the plan ranges from Rs.5 lakhs to Rs.25 lakhs and the extent of benefits depends on the Sum Insured chosen.
• The plan also covers expenses incurred on Bariatric surgeries.
• There is an inbuilt Accidental Death and Permanent Total Disablement benefit which increases the scope of coverage.

How does the plan work?

Step 1 – the policyholder chooses the Sum Assured and the members covered.

Step 2- If the covered member (s) face any medical contingency and the related expenses are covered by the plan the expenses incurred are paid by the plan.

Step 3 – if the plan matures and no medical contingencies occur, no benefit is paid.

Example

Ravi, a non-smoking male aged 35 years, buys the plan for himself for a Sum Assured of Rs.10 lakhs.

Option 1 – Ravi undergoes a Bariatric surgery after 3 years of buying the plan. The policy pays Rs.2.5 lakhs for the surgery.

Option 2 – if, on the other hand, the plan matures and Ravi doesn’t suffer any medical emergency, no benefit is paid.

Plan benefits

• Medical benefits – the list of medical expenses covered by the plan and their extent is as follows:

Coverages	Sum Insured Rs.5 lakhs	Sum Insured Rs.7.5 lakhs	Sum Insured Rs.10 lakhs	Sum Insured Rs.15 lakhs	Sum Insured Rs.20 lakhs	Sum Insured Rs.25 lakhs
Room rent, Boarding expenses, nursing charges	A single, standard, AC room	A single, standard, AC room	A single, standard, AC room	A single, standard, AC room	A single, standard, AC room	A single, standard, AC room
Day care treatments	405 treatments covered	405 treatments covered	405 treatments covered	405 treatments covered	405 treatments covered	405 treatments covered
Pre-hospitalization	30 days	30 days	30 days	30 days	30 days	30 days
Post hospitalization	60 days	60 days	60 days	60 days	60 days	60 days
Domiciliary hospitalization	Covered	Covered	Covered	Covered	Covered	Covered
Second medical opinion	Covered	Covered	Covered	Covered	Covered	Covered
Ambulance cover	Up to Rs.2000	Up to Rs.3000	Up to Rs.3500	Up to Rs.4000	Up to Rs.4500	Up to Rs.5000
Air Ambulance Cover	Not covered	Up to 10% of Sum Insured	Up to 10% of Sum Insured	Up to 10% of Sum Insured	Up to 10% of Sum Insured	Up to 10% of Sum Insured
Outpatient dental and ophthalmic cover	Up to Rs.5000	Up to Rs.5000	Up to Rs.10,000	Up to Rs.10,000	Up to Rs.10,000	Up to Rs.10,000
Hospital Cash Allowance	Rs.500/day	Rs.750/day	Rs.750/day	Rs.1000/day	Rs.1000/day	Rs.1500/day
Outpatient medical consultation	Up to Rs.1200 per consultation limited to Rs.300	Up to Rs.1200 per consultation limited to Rs.300	Up to Rs.2100 per consultation limited to Rs.300	Up to Rs.2400 per consultation limited to Rs.300	Up to Rs.3000 per consultation limited to Rs.300	Up to Rs.3300 per consultation limited to Rs.300
Maternity expenses	Normal delivery–Rs.10,000 Cesarean delivery –Rs.15,000	Normal delivery–Rs.20,000 Cesarean delivery –Rs.40,000	Normal delivery–Rs.25,000 Cesarean delivery –Rs.40,000	Normal delivery–Rs.25,000 Cesarean delivery –Rs.40,000	Normal delivery–Rs.25,000 Cesarean delivery –Rs.40,000	Normal delivery–Rs.25,000 Cesarean delivery –Rs.40,000
New born baby cover	Up to Rs.50,000	Up to Rs.1 lakh	Up to Rs.1 lakh	Up to Rs.1 lakh	Up to Rs.1 lakh	Up to Rs.1 lakh
First year vaccinations	Up to Rs.1000	Up to Rs.1000	Up to Rs.1000	Up to Rs.1000	Up to Rs.1000	Up to Rs.1000
Restoration of Sum Assured	Up to 100% of Sum Insured	Up to 100% of Sum Insured	Up to 100% of Sum Insured	Up to 100% of Sum Insured	Up to 100% of Sum Insured	Up to 100% of Sum Insured
Health check-ups once in 3 years	Up to Rs.5000	Up to Rs.7500	Up to Rs.7500	Up to Rs.12,000	Up to Rs.12,000	Up to Rs.12,000
Bariatric Surgery	Rs.2.5 lakhs	Rs.2.5 lakhs	Rs.2.5 lakhs	Rs.2.5 lakhs	Rs.2.5 lakhs	Rs.2.5 lakhs
Accidental Death and Disablement	Rs.5 lakhs	Rs.7.5 lakhs	Rs.10 lakhs	Rs.15 lakhs	Rs.20 lakhs	Rs.25 lakhs

• No Claim Bonus – if the policyholder does not make a claim in any policy year he earns a cumulative bonus of 50% increase in the Sun Insured subject to a maximum of 100% if the cover is Rs.5 lakhs and 100% increase in case Sum Insured is above Rs.5 lakhs.

Eligibility Criteria

What is not covered by the plan?

Illnesses suffered during the first 30 days of the plan commencement are not covered.

Critical Illnesses suffered during the first 90 days of the plan commencement are not covered.

Pre-existing illnesses or conditions are not covered by the plan in the first 4 years of the policy

Maternity related expenses and bariatric surgeries are not covered in the first 3 years of the policy.

Specific illnesses are not covered in the first two years of the plan.

Illnesses or accidents caused due to genetic disorder or stem cell surgery, substance abuse, participation in adventure sports or hazardous activities, criminal acts, attempted suicide, war and hazardous substances, etc. are not covered.

Treatments like dental treatments, cosmetic treatments, artificial life support, weight loss treatments, non-allopathic treatments or due to HIV/AIDS, etc. are not covered.

Premium Illustration

Below are the sample rates of premium payable by a non-smoking male for different combinations of age and members covered. The Sum Insured is Rs.5 lakhs and the policy is taken for 1 year.