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.
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.
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.
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 |
Minimum | Maximum | |
Age at entry (in completed years) | 3 months | Adults - 65 years Dependent children – 25 years |
Premium paying options | Single pay | |
Sum Assured | Rs.5 lakhs | Rs.25 lakhs |
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.
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.