new insurance ppt

8/7/2019 new insurance ppt

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Submitted By:

Astha KukretiZainab Begum


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Why Star

Because STAR HEALTH AND ALLIED INSURANCE, is a specialist inHealth Insurance and provides quality service at the best rates. As thecountry's first stand alone health insurance company in India, it iscommitted to the service of the insured. There is no Third PartyAdministrator involved in claims settlement, which means better service, inshorter time and no hassles... at all!

No.1 private sector Health Insurance Company in India. Source IRDAUnaudited results

India's first Exclusive Standalone Health Insurance Company

Pan India Presence

No-Claim discount

24 X 7 FREE Expert Doctor consultation

Large Hospital Network of more than 4600 Hospitals Cashless Hospitalization Facility

Faster settlement of Claims, no TPA involved

Wide range of Products


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Star Advantages

No Third Party Administrator; direct in-house claims settlement

Faster & hassle-free claim settlement

Cashless hospitalization

Network of more than 4600 hospitals across India

24 x7 Toll- free Helpline

Free General Physician Consultation over phone. Doctors on duty24x7. By quoting the policy number, any person can contact ourDoctor on the toll free number 1800 425 2255 for medical advices.

Free Health magazines are issued to policy holders at regularintervals

Tax Benefits Amount paid by any mode other than by cash for this insurance is

eligible for relief under Section 80D of the Income Tax Act.


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Claims Procedure

Call the 24 hour help-line for assistance - 1800 425 2255

Inform the ID number for easy reference

In case of planned hospitalization inform 24 hours prior to admission in

the hospital

In case of emergency hospitalization information to be given within 24hours after hospitalization

Cashless facility can be availed in all net-work hospitals

In non-network hospitals payment must be made up-front and then

reimbursement will be effected on submission of documents.


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Types of Health Insurance Products

1. Star Unique Health

2. Medi Classic

3. Family Health Optima

4. Super Surplus

5. Star health Gain

6. Star Wedding Gift

7. Diabetes Safe

8. Senior Citizen Red Carpet

9. Star Netplus10. Star Criticare Plus


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Health

Insurance

Product

Pre-medical Screening Pre-existing Disease/

Illness

Eligibility

1. Star Unique

Health

No pre-acceptance medical screening Pre-Existing Disease/ Condition

(other than those diseases /conditions for which specific

periods have been mentioned under

exclusions) will be covered after 11

months of continuous coverage

have elapsed, since inception of

this policy with the Company

Any person aged between

18 years and 65 yearsresiding in India.

Renewals would be

accepted up to 70 years.

2. Medi Classic Compulsory medical check up done for

personsabove 50rs at cost of the company

Are covered after 48 months of

continuous insurance with the

company

3. Family

Health Optima

No pre-acceptance medical screening Are covered after 48 months of


company

Any person aged between 5

months and 60 years residing

in India can take this

insurance. Dependent

children up to 25 yrs can be

covered

Family Includes

Proposer, spouse,

dependent children upto 25years, who are economically

dependent on their parents

4. Super

Surplus

No pre-acceptance medical screening Are covered after 36 months of


company

Any person aged between 5

months and 60 years can take

this insurance up to a

maximum sum insured of

Rs10,00,000/-

Renewals granted up to 75years

-


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Policy Benefits Common to All

Hospitalization Cover :

In-patient hospitalisation for a minimum of 24 hours.

Expenses covered are: Room rent, Boarding and Nursing

Expenses @ 1%-2% of sum insured subject to a maximum of

Rs.3000-4000/- per day.

Surgeon, Anaesthetist, Medical Practitioner, Consultants,

Specialist Fees.

Anaesthesia, Blood, Oxygen, Operation Theatre charges,

Surgical Appliances, Medicines and Drugs, DiagnosticMaterials and X-ray, Dialysis, Chemotherapy, Radiotherapy,

cost of Pacemaker and similar expenses.


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Common Policy Benefits

Hospitalisation Cover: Protects the insured person for in-patient

hospitalisation expenses for a minimum of 24 hours. These expenses

include room and boarding charges as per policy conditions

Nursing expenses

Surgeon's fees, Consultant's fees, Anesthetist's and Specialist's fees Cost of medicines and drugs

Emergency ambulance charges for transporting the insured patient to the

hospital up to a sum of Rs.750/- per hospitalization and overall limit of

Rs.1500/- per policy period


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Health

Insurance

Product

Policy Benefits Pre-Hospitalization & Post-

Hospitalization

1. Star Unique

Health

HIV positive persons Covers HIV positive persons except for

opportunistic infections and treatment for HIV / AIDS. The minimum

CD 4 count at the time of entry should be 350.Non Allopathic Treatments Up to 25% of sum insured subject to a

maximum of Rs.25000/- per occurrence, per year of insurance.

Pre-hospitalization medical expenses upto 30

days prior to the date of admission.

Post-hospitalization a lumpsum calculated at7% of the hospitalization expenses (excluding

room charges) subject to a maximum of

Rs.5,000/-.

2. Medi Classic Same as above

3. Family Health

Optima

Same as above

4. Super Surplus

5. Star health Gain -Covered for outpatient limits also.-Hospitalisation expenses under the following heads are payable:

Room rent or boarding up to 2% of the sum insured, subject to a

maximum of Rs 4000 per day in Class A cities; 1% of the sum insured,

subject to a maximum of Rs 3000 per day in Class B cities; 1% of the

sum insured, subject to a maximum of Rs 1000 per day in subject to a

maximum of Rs 1000 per day in other locations.

Same as above

6. Star Wedding

Gift

Expenses for delivery of child (Caesarean/Normal Delivery for one

delivery only) upto the limits Pre natal and Post natal expenses included

Newborn baby cover (including Congenital disorders/defects)

Post delivery Complication cover for mother after delivery

Cost of test incurred for detecting any disorders in the Foetus upto Rs.

1,000/- (after a waiting period of 27 months). The waiting period of 27

months is reduced to 15 months when the policy is taken for a period of

4 years.

Upto 25% of sum insured per occurrence, subject to a maximum of

Rs. 25,000/- per policy period.

Same as above

7. Diabetes Safe Hospitalization Cover :Boarding and room charges at 2% of the suminsured subject to a maximum of Rs.2500 per day in Class A cities and


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What cannot be claimed?

Treatment of disease/sickness/illness contracted

by the Insured Person during the first 30days from

the commencement date of the policy.

Expenses incurred for non-allopathic treatment

Naturopathy treatment

Expenses which are purely diagnostic in nature

with no positive existence of any disease

Expenses which are mainly cosmetic in nature


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Health Insurance

Product

What Cannot BeClaimed?

1. Star Unique Health

2. Medi Classic

Treatment of Congenital external disease/defects/anomalies3. Family Health Optima Treatment of external Congenital disease/defects/anomalies

4. Super Surplus Treatment of congenital diseases/defects/anomalies

5. Star health Gain Treatment of external Congenital disease/defects/anomalies

6. Star Wedding Gift Expenses for treatment of any illness/diseases/condition which are pre-existing.

Not applicable for child delivery claims.

Expenses for delivery of a child within 36 months of continuous coverage fromthe date of commencement of this policy with the company. The waiting period of

36 months is reduced to 24 months when the policy is taken for a period of 4 years.

Treatment of Congenital external defects/anomalies (except for New Born)

7. Diabetes Safe Expenses on treatment of Diabetes Mellitus Type II

Cost of immune-suppressive drugs/ medicines

8. Senior Citizen Red Carpet Treatments currently availed or availed during the previous 12 months from date

of proposal

9. Star Netplus Expenses incurred in treating HIV

All medical conditions that existed prior to the commencement of cover, except

those specifically covered

AIDS confirmation within 90 days of commencement of the policy

10. Star Criticare Plus


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Star Unique Insurance Policy

Star Health brings you this Unique insurance policy with unique benefits

for coverage for both future ailments / diseases and for pre existing

diseases / conditions.

Policy Period

This is a two year policy. The sum insured and sub limits are for each yearof insurance and cannot be cumulated or carried forward.


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First two Years exclusions : Cataract, Hysterectomy (abdominal and Vaginal),

Dysfunctional Uterine Bleeding (DUB) Fibroid Uterus, Prolapsed Uterus,

Myomectomy, Cystectomy, Treatment of Internal Derangement of Knee (other than

caused by an accident), Treatment for Joints (other than caused by an accident), other

Arthroscopic procedures, Inter-Vertebral Disc Prolapse (other than caused by accident),

Degenerative Vertebral and Disc diseases, Varicose veins and Varicose ulcers,

Thyroiditis, Treatment of Goitre, Tympnoplasty, Mastoidectomy Glaucoma. These are

not payable irrespective of whether they are Pre-Existing or not.

First year exlusions : Deviated Nasal Septum, Benign Prostate Hypertrophy, Hernia,Hydrocele, Congenital Internal diseases/defects, Fistula in anus, Piles, Fissure in anus,

Sinusitis, and related disorders, Nasal Polyps ,Post trauma non union / mal union,

Cholecystectomy, Gall Bladder Calculi and Renal Calculi If any of these are Pre-

Existing they will be covered after 24 months of continous insurance with the

Company.

During the first 48 months of continuous operation of this Insurance cover theexpenses on Stapedectomy, Bone marrow transplant, Cirrhosis of liver with or without

portal Hypertension, Hepatitis, Loss of vision partial / total including Retinopathy,

Retinal Detachment, Macular degeneration and Papill Oedema, all types of Cancer,

Nephropathy and Chronic Kidney diseases and Implant Removal shall not be payable

if these are Pre-Existing at the commencement of this insurance.

30% of each and every admissible claim.


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Medi Classic

The comforts and luxuries of today's life come at a price-the price ofuncertainties. Of the uncertainties, health of oneself and one's family is ofprime concern. Add to this, the fact that medical expenses are gettingdearer. One ailment is all it takes to wipe out years of savings that wasmeant to realize your dreams.

Mediclassic Insurance from Star Health is a policy that aims to providereimbursement of hospitalization expenses incurred as a result of

illness/disease/sickness and/or accidental injuries, so that you can keepyour dreams alive.


First Two Years Exclusions: Cataract, Hysterectomy for Menorrhagia orFibromyoma, Replacement surgery for knee and/or joint(other than caused

by an accident), Prolapse of intervertebral disc (other than caused byaccident), Varicose Veins and Varicose Ulcers

First Year Exclusions: Benign Prostate Hypertrophy, Hernia, Hydrocele,Fistula in anus, Piles, inusitis and related disorders, Congenital internaldisease/defect, removal of gallstones and renal stone


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FamilyHealth Optima While choosing a health insurance plan, make sure you consider Family

Health Optima. This is an exclusive insurance plan for the entire familyunder a single roof- one family one policy one premium and one suminsured that floats among the persons insured net result : considerableflexibility and economy.

A Super Saver Policy among Family Health Insurance Plans

Single Sum Insured

Coverage for entire family

Single Premium

Considerable saving in premium as the family is covered under one policy


First Two Years Exclusions: Cataract, Hysterectomy for Menorrhagia or

Fibromyoma, Replacement surgery for knee and/or joint (other than causedby an accident), Prolapse of intervertebral disc (other than caused byaccident),varicose veins and varicose ulcers

First Year Exclusions: Benign Prostate Hypertrophy, Hernia, Hydrocele,Fistula in anus, Piles, Sinusitis and related disorders, congenital internaldisease/defects, removal of gallstones and renal stone


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Super Surplus When it comes to healthcare needs, you may tend to make a

conservative estimate. However, health problems can far exceedthose estimates which is why there is an advantage in lookingbeyond basic cover plans. Star Health presents Super SurplusInsurance which offers much larger coverage than is offered bybasic plans. So all the focus can be on cures, as it banishes worry.Individual basis or family floater - the choice is yours.

Major Product Features The policy offers the benefits of wider protection at a lesser price.

This policy is available on individual basis and also on floater basis,covering the entire family

Family means two adults and two children (children economicallydependent and upto 25 years)

No ceiling on ICU, medicine, diagnostic charges or consultation fee


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StarHealth Gain Insurance Combine the financial prudence of a significant Tax saving with the necessary

health cover for your family. Avail of the maximum tax benefit with Star Health

Gain Insurance paying a very affordable premium. What's more, it extends bothoutpatient and inpatient hospitalization expenses. Two facets of gain indeed.

Major Product Features

Flat amount of Rs 14,725 only irrespective of the sum insured or age of the

persons or number of persons covered

Coverage for both inpatient and outpatient treatments under one healthinsurance policy

Any unutilized amount under outpatient benefit can be carried forward to the

next one year.


First Two Years Exclusions: Cataract, Hysterectomy for Menorrhagia or

Fibromyoma, Replacement surgery for knee and/or joint (other than caused by anaccident), Prolapse of intervertebral disc(other than caused by accident),varicose

veins and varicose ulcers

First Year Exclusions: Benign Prostate Hypertrophy, Hernia, Hydrocele, Fistula

in anus, Piles, Sinusitis and related disorders, congenital internal disease/defects,

removal of gallstones and renal stone


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Star Wedding Gift Insurance Policy The comforts and luxuries of todays life come at a price the price of uncertainties. Of

the uncertainties, health of oneself and ones family is of prime concern. Add to this, the fact

that medical expenses are getting dearer. One ailment is all it takes to wipe out years ofsavings that was meant to realize your dreams. Can there be a better gift for wedding than

Star Wedding Gift policy.

Policy Period

Policy is offered for the following periods :1 year, 2 years ,4 years

Free Look In Period

Free look period of 15 days from the date of receipt of policy is available (under 4 yearperiod policy only).

During the free look period if the insured persons is not satisfied, he/she has option to

cancel the policy. On doing so the premium paid will be refunded after deduction of 5%

subject to there being no claim


First Two Years Exclusions: Cataract, Hysterectomy, Dysfunctional Uterine Bleeding(DUB), Fibroid Uterus, Prolapsed Uterus, Treatment of Internal Derangement of Knee (other

than caused by an accident), Treatment for Joints (other than caused by an accident),

Intervertebral Disc Prolapse (other than caused by accident), degenerative Vertebral and Disc

diseases, Varicose veins and Varicose.

First year Exclusions : Deviated Nasal Septum, Benign Prostate Hypertrophy, Hernia,

Hydrocele, Congenital Internal disease/defect, Fistula in anus, Piles, Fissure in anus, Sinusitis,

and related disorders, Nasal Polyps, gall bladder calculi and renal calculi


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Diabetes Safe Over one-fifth of those suffering from Diabetes the world over are in India

and the number is swelling year by year. If left unattended it can severely

affect vital organs like eyes and the kidneys, and therefore it needs urgentattention. Treatment for such complications can often burn a hole in yourpocket.Protection against such an eventuality is offered by Star Health'sdiabetes care plan for those affected by Diabetes Mellitus Type II.

Coverage Offered for Specific Conditions

Eyes: Diabetic Retinopathy requiring laser treatment.

Kidneys: Diabetic Nephropathy leading to chronic renal failure Feet: Diabetic foot ulcer requiring micro-vascular surgical correction

Please note that persons who have already developed complications ofDiabetic Retinopathy and/or Diabetic Nephropathy leading to ChronicRenal failure and/or Diabetic foot ulcer are not eligible to take the policy

Benefits for Type II Diabetics

The plan is a trailblazer among health insurance policies in India andDiabetes Care policies in general.

Hospitalization expenses on donor of kidney for renal transplant surgeryare payable subject to availability of sum insured

Post-renal transplant complications on the insured person covered

Second transplant following failure of the first transplant covered


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Senior Citizen Red Carpet Turning sixty is a major milestone. On the one hand, people tend to find

more time for matters they couldn't adequately attend to during their yearsof career preoccupation. On the other, there is mounting anxiety about

health. Yet, health insurance policies have hardly been available to address

their needs. Star Health is proud to introduce India's first health insurance

policy as a salute to our senior citizens. It provides cover for anyone over

the age of 60 and permits entry right up to the age of 69 with continuingcover after that. It is our way of caring for a generation that has done so

much to build the country.

Major Product Features

This Health Insurance Plan from Star Health is unique among Senior

Health Insurance Policies and extends benefits of Hospitalisation Cover aswell as Post Hospitalisation Cover.

Treatment at network hospitals only

Disease for which treatment or advice was recommended by or received

during the immediately preceding 12 months from the date of proposal will

be covered from second year onwards


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First year exclusions: Hernia, Piles, Hydrocele, Congenital Internal

disease/defect, Sinusitis, Gall Stone/Renal Stone removal and BenignProstrate Hypertrophy

First Two-Year Exclusions: Hysterectomy, Cataract, Joint/Knee Replacement

surgery(other than caused by an accident), Prolapsed Intervertebral Discs,

Varicose Veins, Ulcers

50% co-payment applicable for pre-existing diseases/conditions 30% co-payment applicable for all other claims


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Star Netplus It's a special policy from Star Health to extend a protective arm to socially isolated persons

often disowned by their family members - the Star NetPlus insurance - reaching insurance

where it is most needed. This HIV Insurance policy fills the gap where all other policies and

insurers treat HIV as exclusion.

For the first time in India, governmental agencies, NGOs and registered societies serving

persons diagnosed as HIV positive can propose their members/beneficiaries for an insurance

policy specifically designed as a health insurance for HIV to facilitate better care at the critical

stage for the respective covered persons. With several unique benefits, this HIV Care policy

ensures care, anonymity and privacy to the policy holders.

Unique Benefits

This policy fills the gap where all other policies and insurers treat HIV as exclusion

Complete confidentiality of the covered persons ensured

Facilitates better health care at the critical stage (AIDS) with financial support. Lump sum is

paid at one go once the insured reaches the AIDS stage and no bills/receipts required

Extension of medical cover for hospitalization as an optionThe Application Procedure

Pre-insurance medical test at Star Health cost. After satisfying the eligibility criterion

enrollment done

Tests include CD4 or any other test as required

Cost of Pre-insurance Medical Tests will be borne by Star Health


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Star Criticare Plus Work pressures and higher levels of stress have led to higher incidence of major

illnesses like kidney disease, tumors and heart attack particularly among urban Indians.

Star Health has a critical illness insurance policy that offers regular hospitalisationbenefits along with Major Disease benefits in one policy.

Star Criticare Plus Insurance provides for reimbursement of hospitalization

expenses incurred as a result of illness/disease/sickness and/or accidental injuries and

also provides for a lump-sum benefit in case the insured person is diagnosed with any

Major Illness as listed in the policy for the first time during the policy period.

Star Criticare Benefits

This policy offers critical illness insurance cover to the Insured Person under two

sections. Both regular hospitalization benefits and major diseases benefits are available

under one policy

Section I

Provides for in-patient hospitalization expenses for a minimum stay of 24 hours in

the hospital. Room rent up-to a maximum of 2% of the sum insured subject to a

maximum of Rs4000 per day

Boarding and Nursing expenses ,Surgeon's fees, Consultant's fees, Anesthetist fees

Cost of blood, oxygen, diagnostic expenses, cost of medicines and drugs,

cost of pace maker and similar expenses

Emergency ambulance charges for transporting the covered patient to the hospital


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Section II (Major Diseases cover)

Provides for payment of lump-sum amount equal to the sum insured opted if the insured person

contracts any one of the Major diseases for the first time

Major Diseases Covered Under The Policy

First Diagnosis of Cancer, Chronic Kidney Disease, Hepatoma, Brain Tumour Undergoing first time - Major Organ Transplant

Occurrence for the first time of the following medical events:

Cerebro-Vascular Stroke causing Hemiplegia, Acute Myocardial Infarction resulting in Left Ventricular

Ejection Fraction of < 25%

Established irreversible Coma, irreversible Paraplegia, irreversible Quadriplegia

What Cannot Be Claimed For Section I

Expense incurred in the first two Years of continuous operation of Insurance cover on treatment for

Cataract, Hysterectomy for Menorrhagia or Fibromyoma, Treatment for Knee or Joint Surgery (other than

caused by an accident), Prolapse of intervertebral disc (other than caused by accident), Varicose veins and

Varicose ulcers.

Expense incurred during the first year of operation of the Insurance on treatment of Benign Prostate

Hypertrophy, Hernia, Hydrocele, Fistula in anus, Piles, Sinusitis and related disorders, gallstones and renal

stones

For Section II

Expenses incurred for treatment of congenital diseases/ defects/anomalies.

Manifestation of any of the covered Major Diseases within first 90 days from the date of

commencement of the policy. This will not apply when the policy is renewed without any break.


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THANK YOU

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