Star Health and Allied Insurance - Senior Citizens Red Carpet

About

The Star Health's 'Red Carpet Health Insurance Policy' aims particularly at senior citizens. It provides coverage to anyone over the age of 60 and permits entry right up to the age of 75 with continuing cover thereafter till lifetime.

The coverage ranges from Rs 1 lakh to Rs 10 lakhs for cerebrovascular accident, cardiovascular disease, cancer, bone fractures, kidney diseases and all other major surgeries. Premium charges vary from Rs.4,450 to Rs.22,500 depending on sum assured chosen.

Major Product Features:

• Entry age between 60 and 75 years
• Guaranteed renewals beyond 75 years
• No pre-insurance medical test required
• Treatment at network hospitals only
• All preexisting diseases are covered from first year, except those for which treatment or device was recommended by or received during the immediately preceding 12 months from the data of proposal.
• Disease for which treatment or advice was recommended by or received during the immediately preceding 12 months form the date of proposal will be covered from second years onwards

Note: Please refer to the policy documents for the complete Insurance Policy subject to the insurance Company. This information is valid for 2015 – 2016.

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Policy Benefits

• The policy protects the insured for in patient hospitalization expenses for a minimum of 24 hrs. These expenses include room rent, specialist fees, cost of medicines and boarding up to 1% of the sum insured subject a maximum of Rs 4000/-per day.
• ICU expenses per day up to 2% of the sum insured
• Nursing Expenses
• Surgeon's fees, consultant's fee, Anesthetist's and Specialist's fees up to 25% of sum insured per hospitalization.
• Cost of blood, oxygen, pacemaker, drugs and diagnostic tests up to 50% of the sum insured per hospitalization

• Emergency ambulance charges for transporting the insured patient to the hospital up to a sum of Rs 600 per hospitalization and overall limit of Rs 1,200 per policy period
• Out-patient consultation in network hospitals across India
• Copayment benefits of 50% for each claim related to pre-existing diseases and 30% for all other claims
• Pre-existing diseases will be covered after one year of continuous coverage
• Treatment for cardiovascular disease, cerebrovasculasr accident, cancer and bone fracture are covered subject to the following limits:

Tax Benefit

Amount paid by any mode other than by cash for this insurance is eligible for relief under Section 80D of the Income Tax Act.

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Free Look Period

A free look period of 15 days from the date of receipt of the policy is available for reviewing the policy terms and conditions. In case insured is not satisfied he can seek cancellation of the policy and in such event the company will allow a refund of the premium after adjusting the cost of pre-acceptance of medical screening, stamp duty charges and proportionate risk premium for the period concerned provided no claim has been made until such cancellation. However, free look cancellation is not applicable at the time of renewal.

Note: Please refer to the policy documents for the complete Insurance Policy subject to the insurance Company. This information is valid for 2015 – 2016.

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Premium Rates (Service Tax Extra)

The premium to be paid on Star Health and Allied Insurance’s Senior Citizen Red Carpet policy is listed below:

Sum Insured (Rs.)	Premium
1,00,000	4,450
2,00,000	8,456
3,00,000	12,990
4,00,000	15,501
5,00,000	18,000
7,500,00	21,000
1,000,000	22,500

A discount of 10% of the above premium will be allowed if the proposer produces the following documents to the satisfaction of the company:

a) Stress Thallium Report*

b) BP Report*

c) Sugar (blood & urine)*

d) Blood Urea & Creatinine*

e) Self-declaration or Certification that surgeries related to Heart/Brain/Cancer has/have not been done in the past.

* The tests should have been taken not before 45 days from the date of the proposal.

Note: Please refer to the policy documents for the complete Insurance Policy subject to the insurance Company. This information is valid for 2015 – 2016.

Terms & Conditions for Claims

Remember to pay premiums always on time, the terms of the policy are quite stringent. If you miss a premium, no reminders may be sent.

1. Every notice or communication to be given or made under this policy shall be delivered in writing to the address as shown on the schedule.

2. The premium payable under this policy shall be payable in advance. No receipt of premium shall be valid except on the official form of the company signed by a duly authorized official of the company. The due payment of premium and the observance of fulfillment of the terms, provision, conditions and endorsements of this policy by the Insured Person, in so far as they relate to anything to be done or complied with by the Insured Person, shall be a condition precedent to any liability of the Company to make any payment under this policy. No waiver of any terms, provisions, conditions, and endorsements of this policy shall be valid unless made in writing and signed by an authorized official of the Company.

3. Upon the happening of any event, which may give rise to a claim under this policy, notice with full particulars shall be sent to the Company within 24 hours from the date of Death, Injury, Hospitalization.

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4. The claim must be filed with 15 days from the date of discharge from the Hospital. Note: This is a condition precedent to the admission of liability under the policy.

5. The Insured Person shall obtain and furnish the Company with all original bills, receipts and other documents upon which a claim is based and shall also give the Company such additional information and assistance as the Company may require in dealing with the claim.

6. All claims under this policy shall be payable in Indian currency. All medical/surgical treatments under this policy shall have to be taken in India.

Note: Please refer to the policy documents for the complete Insurance Policy subject to the insurance Company. This information is valid for 2015 – 2016.

Renewal and Claim Procedure

• Lifelong renewal of the policy offered, except on grounds such as moral hazard, misrepresentation or fraud committed
• A grace period of 30 days from the date of expiry of the policy is available for renewal
• Enhancement of sum insured is permitted only during renewal
• In respect of diseases/sickness for which claims have been made, the sum insured will be restricted to that policy sum insured where the claims were made
• In the event of this policy being withdrawn or modified with revised terms and premium with the prior approval of the competent authority, the insured will be intimated three months in advance and accommodated in any other equivalent health insurance policy offered by the company, if requested for by the insured person at the relevant point of time
• Renewal premium is subject to change with prior approval from IRDI

Procedure

• Call the 24 - hour help-line for assistance - 1800 425 2255. Inform the ID/ Policy number for easy reference
• In case if planned hospitalization, inform 24 - hours prior to admission in the hospital
• In case of emergency hospitalization information to be given within 24 - hours after hospitalization
• Cashless facility whenever possible in more than 6000 network hospitals
• In non-network hospitals payment must be made up-front and then reimbursement will be effected on submission of documents