STAR Health Medi Premier

The STAR Medi Premier Insurance is a policy that provides additional lump sum payment in case of diagnosis of certain illnesses during the policy term. The diagnosis may require a large sum of money to be paid at very short notice and that is where this policy is specifically helpful, apart from providing cover for hospitalization due to illnesses and accidents.

  Medi Premier benefits

The policy has two sections. While Section I offers protection against unexpected health care requirements, the second section ensures a lump sum payment of 50% of the sum insured when certain health disorders are diagnosed.

Section I

• Hospitalisation cover – in-patient hospitalisation expenses are covered which includes room rent at 2% of Sum Insured subject to a maximum of Rs.4,000/-
• Boarding and nursing expenses.
• Surgeon’s fees, Consultant’s fees, Anesthetist’s fees.
• Cost of blood, oxygen, diagnostic expenses, cost of pace-makers, artificial limbs, etc
• Cost of medicines and drugs.
• Emergency ambulance charges for transporting the insured patient at Rs.750/- per hospitalisation and Rs.1500/-per policy period.
• Pre-hospitalisation expenses upto 30 days prior to date of admission into the hospital.
• A lump sum calculated at 7% of the specified hospitalisation expenses payable towards Post-hospitalisation, subject to a maximum of Rs.5000/-

Section II

• 50% Lump-Sum Compensation of the sum assured is provided under Section II in addition to payment of hospitalisation under Section I.
• Such hospitalisation expenses would be paid only till the date of diagnosis of the Major Illness.
• On entitlement for payment of lump-sum under this section, all further benefits under the policy of insurance shall cease and the policy automatically terminates.
• Only one lump sum payment will be made during the Insured Person’s lifetime regardless of the number of the Major illness incapacities or treatments suffered by the Insured Person.
• Survival Period - To become eligible for lump sum compensation, the diagnosis should be 90 days from the commencement date of the policy. In case of detection of major illness, the insured person must survive beyond 30 successive days from such date of detection to be eligible for a claim under this policy.

Specified Major Illnessess

• Stroke.
• Renal Failure.
• Cancer.

IT Benefit

• Premium paid by cheque /credit card for this insurance is eligible for relief under section 80D of the IT Act.

Claim Procedure

• Call the Star Health 24 hour help-line to register the details of hospitalization.
• Kindly mention your Star Health ID number for easy access to your policy details.
• In case of a planned hospitalisation, please register 24 hours prior to admission to the hospital
• In case of emergency hospitalisation, please regiser within 24 hours of hospitalisation
• In all network hospitals, the cashless facility on payments can be availed
• For treatment in non-network hospitals, payments must be made up-front to the hospital. Reimbursement of the expenses will be effected by Star Health, on submission of the necessary documents.

Exclusions

• Expenses incurred for treatment of any illness/ disease/ condition, which is pre-existing at the time of commencement of insurance.
• Any expenses incurred for treatment of illness/ disease/ sickness contracted by the Insured Person during the first 30 days from the commencement of the policy.
• First Year Exclusions – Hernia, Piles, Hydrocele, Congenital Internal disease/ defect, Sinusitis, Gall Stone / Renal Stone removal / treatment.
• Two Years Exclusions – Hysterectomy, Cataract, Joint Replacement Surgery, Prolapsed Intervertebral Disc, Varicose veins / ulcers.
• Naturopathy treatment.
• Expenses, which are purely diagnostic in nature with no positive existence of any disease.
• Expenses that are cosmetic in nature.
• Expenses incurred for treatment by systems of medicines other than Allopathic shall be limited to 25% of Sum Insured, subject to a maximum of Rs.25000/-in the entire policy period.

Eligibility

• Any person aged between 26 years and 75 years can take this insurance.

Renewal Features

• Renewal of policy under mutual consent.
• Where Claims ratio is 100% for immediately preceding two consecutive years, a loading on the premium may be imposed ranging from 20% to 50%