Medi Premier Policy (2009-10)
The STAR Medi Premier Insurance is a
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
- Hospitalization cover – in-patient hospitalization 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 hospitalization and Rs.1500/- per policy period.
- Pre-hospitalization expenses up to 30 days prior to date of admission into the hospital.
- A lump sum calculated at 7% of the specified hospitalization expenses payable towards Post-hospitalization, 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 hospitalization under Section I.
- Such hospitalization 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 Illnesses
- Stroke.
- Renal Failure.
- Cancer.
How much to pay?
| Sum Insured (In Rs.) | 26 - 35 Yrs | 36 - 45 Yrs | 46 - 55 Yrs | 56 - 65 Yrs | 66 - 70 Yrs | 71 - 75 Yrs |
| 100000/- | 1488/- | 1700/- | 3107/- | 4104/- | 5723/- | 6133/- |
| 150000/- | 2231/- | 2525/- | 4390/- | 5856/- | 8481/- | 9125/- |
| 200000/- | 2950/- | 3275/- | 5807/- | 6800/- | 11041/- | 12010/- |
| 250000/- | 3544/- | 4000/- | 7102/- | 9252/- | 13557/- | 14811/- |
| 300000/- | 4200/- | 4650/- | 7870/- | 10300/- | 15983/- | 17556/- |
| 350000/- | 5325/- | 9438/- | 12848/- | 12848/- | 18380/- | 20236/- |
| 400000/- | 5375/- | 5800/- | 10992/- | 14101/- | 20626/- | 22802/- |
Service tax extra
Can this policy be taken by a Group?
Yes. All Group Policies are eligible for a discount on the basic premium as per the following scale (based on the group size)
| Group Size | % of Discount on Premium (Excluding add-on Covers & Service Tax) |
| Upto 500 Persons | NIL |
| 501 - 1000 | 2.5% |
| 1001 - 3000 | 5% |
| 3001 - 7000 | 7.5% |
| 7001 - 10000 | 10% |
| > 10000 | 0 |
Service tax extra
IT Benefit
Premium paid by cheque /credit card for this
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 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 Inter-vertebral Disc, Varicose veins / ulcers.
- Naturopathy treatment.
- Expenses, which are purely diagnostic in nature with no positive existence of any disease.
- Expenses which 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%.
