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Presentation on Star Wedding Gift. Major Features / Coverages. Child Delivery Expenses Pre and Post Natal expenses New Born Baby cover Post delivery complications Expenses for detecting abnormality in Foetus and Hospitalisation expenses cover on floater basis. Child Delivery Expenses.

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Presentation on star wedding gift

Presentation on

Star Wedding Gift


Major features coverages
Major Features / Coverages

  • Child Delivery Expenses

  • Pre and Post Natal expenses

  • New Born Baby cover

  • Post delivery complications

  • Expenses for detecting abnormality in Foetus

    and

  • Hospitalisation expenses cover on floater basis


Child delivery expenses
Child Delivery Expenses

  • Child delivery expenses (Normal and Caesarean)


Pre and post natal expenses
Pre and Post Natal expenses

  • Covered as part of Child Delivery expenses

  • Pre-Natal Expenses mean expenses incurred 12 weeks before child delivery and during pregnancy

  • Post-Natal Expenses mean expenses incurred 12 weeks post delivery


New born baby cover
New Born Baby cover

  • Expenses on treatment of the New-born for any disease, illness (including any congenital internal or external disorders) or accidental injuries.

  • Where the New-Born is diagnosed with Down’s syndrome or Cerebral Palsy the Company will pay a lump-sum.


Post delivery complications
Post delivery complications

  • Expenses incurred on treatment for complications to the insured mother post delivery.

  • However, Claim for Post Partum Haemorrhage admissible only where it is severe & requiring hysterectomy and is payable only if there is an admissible claim


Abnormality in foetus
Abnormality in Foetus

  • Test for detecting congenital abnormalities in the foetus Rs. 1,000/-.

  • Payable only once after 27 months of continuous coverage under this policy with the Company.


Hospitalisation expenses
Hospitalisation expenses

Hospitalization Expenses incurred as an inpatient for

  • Sickness/Illness/Diseases

  • Accident

    For the entire family on floater basis


Medical examination
Medical Examination

No pre acceptance medical examination


Coverage period
Coverage Period

  • There is a provision to purchase a long term policy.

  • Policy is offered for the following terms

  • 1 year

  • 2 years or

  • 4 years


Free look in period
Free Look In Period

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

  • During this free look period if the insured person 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.


Age limits
Age Limits

  • Entry Age : 18 years to 40 years

  • Renewals allowed upto 45 Years


Allowable expenses
Allowable Expenses

  • Room Rent, Boarding, Nursing Expenses up-to a maximum of Rs. 4,000/- per day

  • Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist Fees.

  • Anaesthesia, Blood, Oxygen, Operation Theatre charges, Surgical Appliances, Medicines and Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, cost of Pacemaker and similar expenses.

  • Expenses for delivery of a baby either normal or by Caesarean up-to the limits mentioned below (including pre-natal and post natal).


Allowable expenses contd
Allowable Expenses (Contd.)

  • Expenses incurred on treatment for complications to the insured mother post delivery.

  • Expenses up-to the limits mentioned in the Schedule, incurred in a hospital/ nursing home on treatment of the New-born for any disease, illness (including any congenital disorders) or accidental injuries.

  • Emergency Ambulance charges to go to Hospital for treatment @ Rs 1,000/- per hospitalisation upto a maximum of Rs 1,500/- per policy period


Allowable expenses contd1
Allowable Expenses (Contd.)

  • Pre-hospitalization expenses incurred for a period of 30 days prior to the date of hospitalization

  • Post hospitalization expenses on a lump-sum basis @ 7% of the actual hospitalization expenses (excluding room rent and hospital registration charges), subject to a maximum of Rs. 5,000/-


What is a hospital
What is a Hospital?

  • Hospital, Nursing Home means any institution in India established for indoor care and treatment of sickness and injuries and which

    Either

  • It has been registered with the local authorities and is under the supervision of a registered and qualified Medical Practitioner

    or

  • Should comply with minimum criteria as under

  • It should have at least 15 inpatient beds (10 in Class ‘C’ Towns).

  • Fully equipped operation theatre of its own wherever surgical operation is carried out.

  • Fully qualified nursing staff under its employment round the clock

  • Fully qualified Doctor(s) should be in charge round the clock.


Day care treatment
Day Care Treatment

Minimum of 24 hours Hospitalization is not necessary for the following

  • Dialysis

  • Chemotherapy

  • Radiotherapy

  • Cataract surgery

  • Dental Surgery following accident

  • Lithotripsy

  • Tonsillectomy

  • Treatment of Fracture/Dislocation

  • Incision and Draining of Abscess

  • Liver Aspiration

  • Pleural Effusion Aspiration

  • Sclerotheraphy

    The above treatment shall be taken in the Hospital / Nursing Home and the Insured is discharged on the same day.





Premium rating for one year cover
Premium Rating for One Year cover

Note : Premium figures are excluding Service Tax.


Premium rating for two years cover
Premium Rating for Two Years cover

Note : Premium figures are excluding Service Tax.


Premium rating for four years cover
Premium Rating for Four Years cover

Note : Premium figures are excluding Service Tax.



Exclusions
Exclusions

  • Pre Existing Diseases

  • Any Disease contracted during first 30 days

  • 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


Exclusions contd
Exclusions (Contd.)

  • 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)

  • Inter-vertebral Disc Prolapse (other than caused by accident)

  • Degenerative Vertebral and Disc diseases

  • Varicose veins and Varicose ulcers


Exclusions contd1
Exclusions (Contd.)

  • Expenses for delivery of a child within 36 months in case of premium paid for 1 or 2 year and 24 months in case of premium paid for 4 years of continuous renewal from the date of commencement of this policy with the company.

  • The amount of claim indicated in the schedule to be borne by the Insured Person.

  • 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)

  • Circumcision unless necessary for treatment of a disease not excluded hereunder or as may be necessitated due to an accident, vaccination or inoculation or change of life or cosmetic or aesthetic treatment of any description, plastic surgery other than as may be necessitated due to an accident or as a part of any illness. 


Exclusions contd2
Exclusions (Contd.)

  • Cost of spectacles and contact lens, hearing aids, walkers, crutches wheel chairs and such other aids.

  • Dental treatment or surgery of any kind unless necessitated due to accidental injuries and requiring hospitalization.

  • Convalescence, general debility, Run-down condition or rest cure, Psychosomatic disorders, Congenital external disease or defects or anomalies, infertility, venereal disease, intentional self injury and use of intoxicating drugs/alcohol.

  • All expenses arising out of any condition directly or indirectly caused due to or associated with human T-cell Lymph tropic Virus type III (HTLV-III) or Lymphadinopathy 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.


Exclusions contd3
Exclusions (contd.)

  • 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.

  • Expenses on vitamins and tonics unless forming part of treatment for injury or disease as certified by the attending Physician.

  • Injury or Disease directly or indirectly caused by or contributed to by nuclear weapons / materials.

  • Treatment arising from or traceable to pregnancy, miscarriage, abortion or complications of any of these other than what is stated to be covered under this policy.


Exclusions contd4
Exclusions (Contd.)

  • Naturopathy Treatment.

  • Hospital registration charges, record charges, telephone charges and such other similar charges.

  • Expenses incurred on Lasik Laser or Refractive Error Correction treatment

  • Expenses incurred on weight control services including surgical procedures for treatment of obesity, medical treatment for weight control/loss programs

  • Non Allopathic shall be restricted to 25% of the sum insured subject to a maximum of Rs. 25,000/- per occurrence for the entire policy period.


Claim procedure contd
Claim Procedure (Contd.)

In case of Non Network Hospitals

  • Immediate intimation to the Call Centre

    (1800 425 2255 /044-28263300)

  • 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

  • Original Discharge Summary

  • Main Hospital Bill with Break Up

  • Investigation Reports with X-Ray Film

  • Medical Bills with Prescriptions


Other benefits
Other Benefits

  • Benefits under Section 80-D of the IT Act

  • Cashless Service without involvement of TPA

  • Direct Tie up with hospitals on an All India Basis

  • 24 X 7 In-House Call center (044-2826 3300)

  • Toll Free Telephone line assistance

    (1800 425 2255)

  • Full knowledge based website to offer medical information, including Health Tips.

  • Information on health through free health magazine


Target group
Target Group

  • Newly married couples

  • Couples with one child


Transfer from any other policy of star to wedding gift
Transfer from any other policy of Star to Wedding Gift

  • Continuity benefits with regard to the following will be provided

  • 30 days waiting period

  • First year exclusions

  • First two years exclusions

  • Pre Existing Diseases

  • However, child delivery expenses will be covered only after 36 months of continuous coverage under this policy.


Transfer from other insurers to wedding gift
Transfer from other Insurers to Wedding gift

  • Continuity benefits with regard to the following will be provided

  • 30 days waiting period

  • However, for other exclusions are concerned, it will treated as a fresh policy only.


How it is wider than fho
How it is wider than FHO ?

  • Increased Day Care limits

    Eg : Cataract 20,000/- & 30,000/- as against 12,000/- under FHO

  • Coverage for New Born against any congenital disease (both Internal & External)



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