Star Health & Allied - Star Comprehensive Insurance Policy

The Policy offers exclusive benefits for the entire family designed to elimate your health worries

1- No Third Party Administrator - direct in - house claims settlement.
2- Faster and hassle-free claim settlement.
3- Cashless hospitalization.
4- Network of more than 5400 hospitals across India.
5- Free expert medical consultation over phone 24 x 7 Toll Free Helpline.
6-Free storage facility for storing medical records in electronic form. For details contact toll free no 1800 425 2255 / 1800 102 4477.

Section 1: In-patient hospitalization expenses
1-Hospitalisation Cover Protects the insured for in patient hospitalisation expenses for a minimum of 24 hrs.These expenses include room rent,nursing and boarding charges, Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist Fees,Cost of Medicines and Drugs.
2-Ambulance charges for emergency transportation to hospital as per specified limits
3-Pre-Hospitalization expenses up to 30 days prior to admission in the hospital
4-Post Hospitalization expenses up to 60 days after discharge from the hospital
5-101 Day-care treatments covered
Pre-Existing Diseases / Illness :
1-Are covered after 48 months of continuous Insurance without break with any Indian Insurance Company.
Section 2 : Delivery and New - Born Cover :
1- Expenses for Delivery - normal delivery or by caesarean section, including Pre-natal and Post natal expenses up-to the limits specified.
2- Automatic coverage for the New Born (including internal and external congenital problems) up to the expiry of the current policy (On renewal this new born baby should be covered specifically)
3- Vaccination expenses for the New Born
4- This benefit is available after 36 months of continuous coverage under this policy with Star.
Section 3: Out-Patient Dental, Opthalmic treatment:
1- Elective Dental / Ophthalmic treatments as an out-patient - once in a block of every three years irrespective of whether a claim is made or not.
Section 4: Hospital Cash:
Hospital cash benefit for each completed day of hospitalization.
Section 5: Health Check-up:
1-Cost of Health Check-up once after a block of every three claim-free years

Any person between 5 months and 65 years age

A free look period of 15 days from the date of receipt of the policy is available for reviewing the policy terms and conditions. In case insured is not satisfied he can seek cancellation of the policy and in such event the Company will allow refund of premium after adjusting the cost of pre-acceptance of medical screening , stamp duty charges and proportionate risk premium for the period concerned provided no claim has been made until such cancellation.Free look cancellation is not applicable at the time of renewal.

A grace period of 30 days from the date of expiry of the policy is available for renewal. If renewal is made within this 30 days period the continuity of benefits will be allowed. However the actual period of cover will start only from the date of payment of premium. In other words no protection is available between the policy expiry date and the date of payment of premium for renewal.

The Company shall not be liable to make any payments under this policy in respect of any expenses what so ever incurred by the insured person in
connection with or in respect of:
1. Pre Existing Diseases as defined in the policy until 48 consecutive months of continuous coverage has elapsed, since inception of the first policy with any Indian Insurer. However the limit of the Company's liability in respect of claim for Pre-existing Diseases under such Portability shall be limited to the Sum Insured under first policy with any Indian Insurance Company.
2. Any disease contracted by the insured person during the first 30 days from the commencement date of the policy. This exclusion shall not apply in case of the insured person having been covered under any health insurance policy (Individual or Group Insurance policy) with any of the Indian Insurance companies for a continuous period of preceding 12 months without a break.
3. During the First two Years of continuous operation of insurance cover,
a) The expenses for treatment of cataract, degenerative disc of vertebral diseases and prolapse of intervertebral disc (other than caused by accident), Varicose Veins and Varicose Ulcers, Benign Prostatic Hypertrophy, Deviated Nasal Septum, Sinusitis, Tonsillitis, Nasal Polyps,Chronic Supparative Otitis Media and related disorders, Hernia, Hydrocele, Fistula / Fissure in Ano and Haemorrhoids, Congenital internal disease/defect (except to the extent provided under Section 2 for New Born)
b) All treatments (conservative, interventional, open laparoscopic) for Hepatobilary Gall Bladder and Pancreatic stones and Genito-urinary calculi.
c) All treatments (conservative, interventional, open and laparoscopic) for Uterine prolapse, Dysfunctional Uterine Bleeding, Fibroids, Pelvic Inflammatory Diseases, all diseases of fallopian tubes and ovaries.
d) Arthroscopic repair and removal [other than caused by an accident]
If these are Pre-Existing at the time of proposal they will be covered subject to the waiting period mentioned in Exclusion 1 above The exclusion 3 shall not however apply in the case of the Insured person/s having been covered under any Individual health insurance scheme with
any of the Indian Insurer for a continuous period of preceding 24 months without any break. The Claim for such illnesses/diseases/disabilities contracted / suffered if admitted will be processed as per the Sum Insured of immediately preceding 24 months policy only. Where there is a change in the sum insured in the following continuous policy year the lower of the sum insured will apply.
4- Injury/Disease directly or indirectly caused by or arising from or attributable to War, Invasion, Act of Foreign Enemy, Warlike operations (whether war be declared or not)
5- Injury or Disease directly or indirectly caused by or contributed to by nuclear weapons /materials.
6. a) Circumcision unless necessary for treatment of a disease not excluded under this policy or necessitated due to an accident,
b) Vaccination. However this exclusion will not apply where such expenses are for post bite treatment, for medical treatment other than preventive treatments and to the extent provided for under Section 2 for new born Child
c) Inoculation or change of life or cosmetic or aesthetic treatment of any description, plastic surgery (other than as necessitated due to an accident or as a part of any illness).
7. Cost of spectacles and contact lens (in excess of what is specifically provided), hearing aids including cochlear implants, walkers, crutches wheel
chairs and such other aids.
8. Dental treatment or surgery (in excess of what is specifically provided) unless necessitated due to accidental injuries and requiring hospitalization.
9. Convalescence, general debility, Run-down condition or rest cure, nutritional deficiency states, psychiatric, Psychosomatic disorders, Congenital external disease or defects or anomalies ( except to the extent provided under Section 2 for New Born ) sterility, venereal disease, intentional self injury and use of intoxicating drugs/alcohol.
10. All expenses arising out of any condition directly or indirectly caused due to or associated with Human T-cell Lympho Trophic Virus type III (HTLV-III) or Lymphadenopathy Associated Virus (LAV) or the Mutants Derivative or Variations Deficiency Syndrome or any Syndrome or condition of a similar kind commonly referred to as AIDS. It is however made clear that such of those who are positive for HIV (Human Immuno Deficiency Virus) would be entitled for expenses incurred for treatment other than for opportunistic infections and for treatment of HIV /AIDS provided at the time of first commencement of Insurance under this policy their CD4 count is not less than 350.
11. Charges incurred at Hospital or Nursing Home primarily for Diagnostic, X-ray or laboratory examinations not consistent with or incidental to the diagnosis and treatment of the positive existence or presence of any ailment, sickness or injury, for which confinement is required at hospital/nursing home.
12. Expenses on vitamins and tonics unless forming part of treatment for injury or disease as certified by the attending Physician.
13. Treatment arising from or traceable to pregnancy, miscarriage, abortion or complications of any of these. (other than ectopic pregnancy and to the
extent covered under Section 2 )
14. Naturopathy Treatment.
15. Hospital registration charges, admission charges, record charges, telephone charges and such other charges.
16. Expenses incurred on Lasik Laser or Refractive Error Correction, treatment of Eye disorders requiring intra-vitreal injections.
17. Expenses incurred on weight control services including surgical procedures for treatment of obesity, medical treatment for weight control/loss
programs
18. Expenses incurred on Non Allopathic treatment.
19. Expenses incurred on Enhanced External Counter Pulsation therapy and related therapies and Rotational Field Quantum Magnetic Resonance Therapy
20. 10% of each and every claim made by insured persons who are above 60 years at entry level and their renewals thereafter.
21. Other expenses as detailed elsewhere in the policy.