Shubham Chaudhari (14005)

Unique Features
It is a fully loaded Top end Floater Policy
for the entire family with
High sum Insured Options
Extended Benefits
No sum Limits
No Capping on Room Rent
Restoration of sum Insured
101 Days care Procedures
Sum Insured
Age Eligibility
18 years-65 years.(For entry age 61-65yrs,
sum Insured restricted to a maximum of
Rs. 7.50Lakhs only which cannot be
enhanced at any points of the time
subsequently)
Children of above 5 months can be
covered if Parent is covered.
Beyond the age of 65 years only renewals
are accepted.
Guaranteed renewal for life time.
Eligibility
Cover can be given to HIV+ persons
whose CD 4 count is not less than 350 at
entry points
No claims payable for Opportunistic
infections
No claim for treatment of HIV / AIDS
Coverage
Sec 1-HOSPITALISATION
Room Rent ,Boarding and Nursing
Expenses-No Cap
ICU and Operation Theatre Expenses-No
Cap
Surgeon, Anaesthetist, medical
Practitioner, Consultants, Specialist Fees,
Chemotherapy, Diagnostic -No Cap
Ambulance Charges & Pre/Post
Hospitalisation

Pre Hospitalization Expenses-30 Days

Post Hospitalization Expenses-60 Days
For these benefits prescriptions, bills/receipt/copy of reports to be
submitted.
Sec 2-Delivery & New Born Baby
Cover
Waiting period 36 months
Maximum 2 deliveries. Waiting period
between the first delivery claim and the
second one is 24 months.
Sec 2-Delivery & New Born Baby
Cover
New Born Baby Coverage for the
remaining policy period

Vaccination expenses up to Rs 1000 /-

incurred on the new born baby
Subject to valid claim for Delivery
Sec 3-OP:Dental & Ophthalmic
Treatment
Dental & Ophthalmology Treatment is covered after a
waiting period of 36 months
Payable even if there is claim under Section 1 in the
three year period
Can be claimed for Root Canal Treatment
Purchase of Spectacles
Sec 3-OP:Dental & Ophthalmic
Treatment
For Examples
A family of three persons 2A + 1C covered
for a sum insured of Rs. 5 lakhs for 2
years:2010-11 & 2011-12.
In 2012-13 another Child is added.
In 2013-14 a claim is made under
Ophthalmic section for the Child added in
2012-13.
Claim Not admissible because the 3 year
waiting period has not been completed by the
child.
Section 4-Hospital Cash
Cash Benefit-maximum of 7 days per
hospitalisation, provided there is an admissible
claim under section1.
Maximum during one policy period-120 days
Time excess : One day
Sec 4- Cost of Health Check-up
Cost of Health Check-up up to the limits
specified after a block of 3 claim free years of
continuous coverage
Benefits payable for insured persons who have
been continuously insured under the policy.
Automatic Restoration of sum
Insured
Restoration Facility in-built up to 100%
for All sum insured options.
Restored sum insured can be utilized only
for illness/diseases unrelated to the
illness/diseases for which claim were
made.
Restoration will be available for only
section 1 after fully exhausting the
Original Sum Insured.
Claims Loading
Where the claims ratio for the preceding 2
consecutive years exceeds 100%,premium
loading as per the table given below.

Claims under sec1 alone will be

considered for Claims loading.
Co-payment
10% co-payment for persons entering
between 61yrs & 65yrs and continues
thereafter
Co-payment applicable only for section 1
claims
Portability
This policy is portable.
Inward portability can be accepted for
policies of other Insurance Companies
Portability procedure to be followed
Continuity will be given ONLY for sec1
benefit and NOT for any other section.
Star Comprehensive v/s Apollos
Easy Health
Both Price and benefit comparison given separately
Star Cardiac Care Insurance
Policy
Thank You.