STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

PERSONAL & CARING

Benefits of your
Group Tailor Made
Policy

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

PERSONAL & CARING

COVERAGE SCOPE
EXPENSES COVERED

Inpatient
Hospitalization

Room rent , Boarding and nursing exp.,

ICU Charges,
Doctors fees
Diagnostic charges
Nursing charges Surgeon
Anesthetist
Consultant and Specialist fees
Blood
Oxygen
OT charges
Surgical Appliances
Medicines and Drugs
Diagnostic Materials X ray etc

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

PERSONAL & CARING

MINIMUM DURATION REQUIRED DURING

HOSPITALISATION

IN PATIENT

DAY CARE
PROCEDURES

Means medical treatment

which is undertaken in a
Hospital/day care
An Insured Person who is
centre in less than 24 hours
admitted to Hospital and
because
stays there for a minimum of technological advancement,
period of 24 hours for the
and
sole purpose of receiving
which would have otherwise
treatment.
required a Hospitalization of
more than 24 hours

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

PERSONAL & CARING

BENEFITS COVERED : (Example)

Period of Insurance
Grade Sum Insured
Family Floater
Hospitalization in a
Non-Network Hospital
Hospitalization in a
Network Hospital
Pre-Existing Diseases
1 yr & 2 yr Exclusions
Maternity cover
New Born Baby cover
Day Care Procedures
Pre & Post Hospitalization
30 Days 60 Days

08/11/2013 to 13/09/2015
Rs.5,00,000/Yes
(Employee, Spouse,
Children)
Yes
( Only Incase of Accident or
Emergency)

Yes
Covered from Day 1
Waived of
Covered from Day 1
Covered from Day 1
Yes
Yes

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

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PERSONAL & CARING

ROOM RENT,BOARDING AND NURSING

Exp.,
Ambulance Not exceeding Rs.5,000/- if incurred

Room rent
For 5,00,000/- Sum Insured 2% of Sum Insured
subject to Maximum of Rs.5000/- per day
Stay in room other than eligibility Expenses relating to the hospitalisation will be
considered in proportion to the room rent stated in
the policy.

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

*
PERSONAL & CARING

PRE & POST HOSPITALISATION

EXPENSES

Pre - Hospitalization expenses - 30 days

Post Hospitalization Expenses - 60
days

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

*
PERSONAL & CARING

DAY CARE
PROCEDURES :

Policy specifies sub-limits to following

procedures:
Cataract, Lithotripsy, Tonsillectomy, Cutting
and Draining of Abscess, Liver Aspiration,
Pleural Efusion Aspiration, Colonoscopy,
Sclerotheraphy.

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

*
PERSONAL & CARING

CORPORATE BUFFER
Sum Insured available Rs.10,00,000/Corporate Bufer limit restricted to Individual/Individual
Family Sum Insured
Further corporate bufer can be utilized only when there
is a left over balance under the basic Sum Insured
available only.
Corporate bufer benefit can be utilized only for
treatment of major Diseases.
Major Diseases means - Cancer, Chronic Kidney Disease,
Brain Tumour, Major Organ Transplant, Cerebro-Vascular
Stroke causing Hemiplegia, Acute Myocardial Infarction,
Established Irreversible Coma, Established Irreversible
Paraplegia & Established Irreversible Quadriplegia.
STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED
*
PERSONAL & CARING

MATERNITY & N EW BORN BABY COVER

For Caesarean

For Normal

New Born baby cover

Rs.50,000/-

Rs.35,000/-

From Day One

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

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PERSONAL & CARING

MIDTERM INCLUSION

In Case of Existing
Employee
In Case of Newly joined
Employee

Only Newly Married Spouse

and Newborn Child can be
added.
Employee and Dependents
can be added.

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

*
PERSONAL & CARING

IN THE EVENT OF ANY CLAIM

Note:
Treatment in our network hospitals only,
Incase of Medical Emergencies & Accidents
treatment can
be taken in other Hospitals.
In all cases immediate intimation shall be given
to our
call center

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

*
PERSONAL & CARING

IN THE EVENT OF ANY CLAIM (contd)

CONTACT DETAILS
Please inform
24X7 call centre

Toll free : 1800 425 2255 / 1800 102

4477
(or)
044-28263300

1800 425 55 22
Fax
(or)
044-28306700
Local Assistance
Dr. Chandra Mohan - 9700000544
Dr. Nagesh - 9849709522
Cashless Hospitalization
Land line no: 040-44344801/802
(Between 10.00 am to 8.30 pm)
Pavan 040-44344806
Re-imbursement
(Between 10.00 am to 5.30 pm)

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

*
PERSONAL & CARING

CLAIM PROCEDURE
In case of Network Hospitals
Intimate the hospitalization details immediately to the
Call Centre
on Toll Free No: 1800 424 2255 / 044 2826 3300.
The insured has to send a request for Pre Authorization
Form signed by the Doctor in the Network Hospital.
Based on the intimation a field visit will be done by the
Star
Health Doctor.
Pre Authorization will be issued to the Hospital.
Based on the Pre Authorization and the Report by the
Star
Doctor, Cash Less Treatment will be given by the
Network
Hospital.

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

*
PERSONAL & CARING

CASH LESS CLAIM PROCESS

Claim Registration 1800 425 2255

Field visit report

Initial Sanction

Rejection

Final Enhancement
given
Final Bill submission

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

*
PERSONAL & CARING

CLAIM PROCEDURE (CONTD)

In case of Non-Network Hospitals
Intimate the hospitalization details immediately to the
Call Centre
on Toll Free No: 1800 424 2255 / 044 2826 3300.
Claim form will be sent to the Insured.
Based on the intimation a field visit will be done by the
Star
Doctor
Bills has to be settled by the Insured and will be
reimbursed by
Star on submitting the following documents to concern
person
at your office, (Please remember to collect following
documents from hospital without fail).
Original Discharge Summary
STAR HEALTH
AND
ALLIED Bill
INSURANCE
COMPANY
LIMITED
Main
Hospital
with
Break
Up
*
PERSONAL & CARING
Investigation Reports with X-Ray Film

REIMBURSEMENT CLAIM PROCESS

Claim Registration -1800 425 2255

Field visit report

Submission of Claim
Form
Claim settlement

Rejection

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

*
PERSONAL & CARING

REIMBURSEMENT CLAIM PROCESS

(CONTD)
Claim form must be filled fully and sent to Star Health
office along with the following documents in original
where ever applicable..
All columns of Claim form should be filled in properly
and signed by the Customer.
In the Claim form Medical Certificate to be filled in by
Treating doctor with Signature and Stamp.
Discharge summary.
Lab Investigation reports and Bills.
Medical bills with doctors prescriptions.
First consultation report.
Case sheet
Policy Bond/Id card.
Any Accident case: Self declaration ; FIR / MLC is
mandatory for Motor & Other Accidents.
X-rays, MRI, CT-Scan, USG Scan films and reports.
Any Fracture Case: Pre and Post Operative X- ray films.
Final break up bills with receipt Nos.

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

*
PERSONAL & CARING

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

PERSONAL & CARING

ACCIDENT COVER

Sum Insured per employee Rs.10,00,000/Coverage Accidental Death ,

Permanent Total Disability,
Permanent Partial Disability,
Temporary Total Disability (Weekly
Compensation)
STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED
*
PERSONAL & CARING

Thank You

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

PERSONAL & CARING