Accident Care Policy (2009-10)

Accident Care Benefits

Accidental death
Permanent disability – total or partial – following an accident
Temporary total disablement – the Insured Person is eligible for a weekly benefit at 1% of Capital Sum Insured (following an accident) subject to maximum of Rs.5000/- per week for a for 100 weeks
Educational grant to children (1 Child – Rs.5000/-, 2 Children– Rs.10,000/-)
Transportation expenses of mortal remains (Rs.3000/-)
Travel expenses of one relative (Rs.1000/-)
Cumulative Bonus of 5% accrues to the Insured Person for every claim free year, subject to a maximum of 50%

Optional Benefits

Policy can be extended to cover Medical Expenses on payment of Additional Premium

Risk Features

For purpose of rating, persons proposed for insurance are classified under three risk groups
Risk Group I – Persons engaged primarily in administrative functions
Risk Group II – Persons engaged in manual work other than what is specifically provided for under Group III
Risk Group III – Persons working in explosives industry, mines workers, high tension electric supply, horse racing including jockeys, athletes and occupations of similar hazards

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 hospitalization, please register 24 hours prior to admission to the hospital
In case of emergency hospitalization, please register within 24 hours of hospitalization
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 on events occurring before the commencement of the cover or otherwise outside the Period of Insurance
Any claim in respect of Pre-existing condition
Any claim if the insured acts against the advice of a physician
Any claim arising out of Accidents that the Insured Person has caused intentionally or by committing a crime or as a result of drunkenness or addiction (drugs, alcohol, etc)
Any claim arising out of mental disorder, suicide or attempted suicide self inflicted injuries, or sexually transmitted conditions, anxiety, etc
Participation in Hazardous Sport/Hazardous activities
Persons who are physically and mentally challenged unless specifically agreed and endorsed in the policy.

How much to pay (for individuals)?

Coverage / Risk Group	Group I	Group II	Group III
Table I	0.45 per mile	0.60 per mile	0.80 per mile
Table II	0.80 per mile	1.30 per mile	1.75 per mile
Table III	1.25 per mile	1.75 per mile	2.00 per mile

For groups

Group Size	% of discount on Premium (Excluding add-on Covers & Service Tax)
2 - 100 Persons	5%
101 - 1000	10%

Can this policy be taken by a group?

Group Policies are allowed without additional benefits. But Group Policies are eligible for a discount on the basic premium when the size of the group increases substantially.

Renewal

The Insurance may be renewed under mutual consent.