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Unique Identification No. : IRDA/NL-HLT/SHAI/P-H/V.I/167/13-14 Payment of premium by any mode other than cash for this insurance is eligible for relief aware of the existence of the congenital internal disease/defect before inception of the Deficiency Syndrome or any Syndrome or condition of a similar kind commonly
under Section 80D of the Income Tax Act 1961. policy it will be treated as Pre-existing. diseases/defects) are Pre-Existing at the time referred to as AIDS.
With the perfect balance between insurance and tax benefit - Star Health Gain
Outpatient treatment cover of proposal they shall be covered subject to exclusion no1 above. If the insured is
Insurance is the policy just for you. Despite a reassuringly low premium, it offers 13. Charges incurred at Hospital or Nursing Home primarily for Diagnostic, X-ray or
Covers cost of treatment incurred as an outpatient in any hospital or nursing home. aware of the existence of the congenital internal disease/defect before inception of the
both outpatient and inpatient hospitalization expenses cover with maximum tax laboratory Examinations not consistent with or incidental to the diagnosis and
policy it will be treated as Pre existing.
benefits. Sure enough, the best of the both worlds is now yours. Treatment costs covered even for pre-existing conditions/diseases, dental expenses, treatment of the positive existence or presence of any ailment, sickness or injury,
prenatal and post-natal care 4. During the First two Years of continuous operation of Insurance cover, the expenses on
for which confinement is required at hospital / nursing home.
Features treatment of Cataract, Hysterectomy for Menorrhagia or Fibromyoma, Knee
Renewal
Flat amount of Rs. 15,353/- only irrespective of the sum insured or age of the Replacement Surgery (other than caused by an accident), Joint Replacement Surgery 14. Expenses on vitamins and tonics unless forming part of treatment for injury or
Lifelong renewal of the policy is offered, except on grounds such as moral hazard,
persons or number of persons covered. (other than caused by an accident), Prolapse of intervertibral disc(other than caused disease as certified by the attending Physician.
misrepresentation or fraud.
by accident), Varicose veins and Varicose ulcers. Beyond such period also, if these
15. Treatment arising from or traceable to pregnancy, (other than ectopic
Coverage for both inpatient and outpatient treatments under one policy. Enhancement of Sum Insured is permitted only during renewal. diseases are Pre-Existing at the time of proposal they shall be covered subject to
pregnancy) childbirth, miscarriage, abortion or complications of any of these
A grace period of 30 days from the date of expiry of the policy is available for renewal. exclusion no 1 above.
Any unutilized amount under outpatient benefit can be carried forward to the including caesarean section.
next one year. In the event of this policy being withdrawn / modified with revised terms and/or premium with
Note: The above exclusions from 1 to 4 do not apply for benefits under Section-2 16. Naturopathy Treatment.
the prior approval of the Competent Authority, the insured will be intimated three months in
Eligibility advance and accommodated in any other equivalent health insurance policy offered by the 17. Hospital registration charges, record charges telephone charges and such other
5. The exclusions 2, 3 and 4 shall not however apply in case of the Insured Person/s
Any person aged between 5 months and 65 years can be covered under this Company, if requested for by the Insured Person, at the relevant point of time. having been covered under any insurance scheme with any of the Indian Insurance charges
insurance. Beyond 65 years, only renewals can be made. Renewal premium is subject to change with prior approval from IRDAI. companies for a continuous period of preceding 12/23 months respectively without 18. Expenses incurred on Lasik Laser or Refractive Error Correction treatment
Exclusions (for inpatient cover only) any break.
Option to take policy on an individual basis or for the entire family (maximum of 19. Expenses incurred on weight control services including surgical procedures for
2 adults plus 3 children). 1. Pre Existing Diseases as defined in the policy until 48 consecutive months of 6. Injury/ Disease directly or indirectly caused by or arising from or attributable to War, treatment of obesity, medical treatment for weight control / loss programs
continuous coverage have elapsed, since inception of the first policy Invasion, Act of Foreign Enemy, Warlike operations (whether war be declared or not)
Benefits 20. Expenses incurred for treatment of diseases/illness/accidental injuries by
with any Indian Insurer. However the limit of the Companys liability in respect of claim
Hospitalization Cover for pre-existing diseases under such portability shall be limited to the sum insured 7. Injury or Disease directly or indirectly caused by or contributed to by nuclear weapons/ systems of medicines other than Allopathic
Expenses in a hospital for inpatient hospitalization (minimum 24-hour stay) under first policy with any Indian Insurance Company. materials 21. Other expenses as detailed elsewhere in the policy.
2. Any disease contracted by the Insured Person during the first 30 days from the
Expenses under the following heads are payable: 8. Circumcision unless necessary for treatment of a disease not excluded hereunder or Cancellation
commencement date of the policy
a) Room rent and boarding up to 2% of the sum insured, subject to a maximum as may be necessitated due to an accident, vaccination (except as part of post bite The company may cancel this policy on grounds of misrepresentation, fraud,
3. During the first year of operation of the Insurance cover the expenses on treatment of
of Rs. 4000/- per day in Class A cities; 1% of the sum insured, subject to a treatment) or inoculation or change of life or cosmetic or aesthetic treatment of any moral hazard and non-disclosure of material fact or non-co-operation by the insured
diseases such as Benign Prostate Hypertrophy, Hernia, Hydrocele, Congenital
maximum of Rs. 3000/- per day is Class B cities; 1% of the sum insured, description, plastic surgery other than as may be necessitated due to an accident or as
person.
subject to a maximum of Rs. 1000/- per day in other locations. a part of any illness.
The insured may at any time cancel this policy and in such event the company shall
b) Nursing charges.
9. Cost of spectacles and contact lens, hearing aids, walkers, crutches, wheel chairs allow refund of premium after retaining premium at company's short period rate (table
c) Surgeons', consultants' and anesthetists' fees. artificial limbs and such other aids. given below )provided no claim has occurred up to the date of cancellation.
d) Blood, oxygen, diagnostic expenses, cost of pacemakers and similar
expenses. 10. Dental treatment or surgery of any kind unless necessitated due to accidental injuries
and requiring hospitalization.
e) Drugs and medicines,
PERIOD ON RISK RATE OF PREMIUM TO BE RETAINED
f) Emergency ambulance charges for transporting the patient to the 11. Convalescence, general debility, mental disorder , Run-down condition or rest cure,
Up to one-month 1/3rd of annual premium
hospital upto a sum of Rs. 750/- per hospitalization and overall policy limit congenital external disease or defects or anomalies, sterility, venereal disease,
Up to three Months of annual premium
of Rs. 1500/-. intentional self injury and use of intoxicating drugs/alcohol.
Up to six months 3/4th of annual premium
Exceeding six months Full annual premium
Free Look Period The Company
A free look period of 15 days from the date of receipt of the policy is available Star Health and Allied Insurance Company Ltd commenced its operations in 2006 with
to the insured to review the terms and conditions of the policy. Incase the insured the business interests in Health Insurance, Travel and Personal Accident. As an
is not satisfied with the terms and conditions, the insured may seek cancellation exclusive Health Insurance Company and the first of its kind in India, the Company is
of the policy and in such an event the Company shall allow refund of premium committed insetting international benchmarks in service and personal caring.
paid after adjusting the cost of pre-acceptance medical screening, stamp duty Prohibition of Rebates
5mths-35yrs
charges and proportionate risk premium for the period concerned provided
Section 41 of Insurance Act 1938 : No person shall allow or offer to allow, either directly
SQPL-06.11.2015-5K
5mths-45yrs 8700 7750 7000 6250 5750
The Health Insurance Specialist
Facility of maintaining personal health record in electronic format Health
46yrs-55yrs 7900 6350 5200 3000 NA Personal & Caring Insurance
above 56yrs 7500 5800 3700 NA NA The Health Insurance Specialist