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%.
Dear Sir, I am Kiran Kothari , 57 years old. sufferinf from controlled diabities and hypothyroid from nearly 10years without any hospitalization. I am fit and having regular walk and exercise session.My medical insurance was covered by corporate policy of my executive son. Now I would like to have medical [health insurance]. policy. Please guide me accordingly. Kiran Kothari
The worst insurance firm ever.. My Father took Senior Citizen Red Carpet Policy [Coverage: 1 Lac; POLICY NO. 006908] from Star Health. On August 29, 2013 when he took policy, he declared that he has Asthma. In October 2013, due to the high blood pressure he was admitted at Sanjeevani Criticare Hospital, Kopar Khairane, Navi Mumbai from 03.10.2013 to 05.10.2013. He spent around Rs. 20,000/- in this process. I had submitted all the papers to Star Health Vashi Office. After which I had no clue on the status of my claim. Every time I called up the helpline, I was flooded with multiple numbers where I need to call and follow-up with each one you in order to have a clear visibility of my claim status. Every time there was a new story that I was hearing from customer support "that the claim in process", but today, I came to know that my Father???s claim has been rejected (claim # 0130102) and it was stated to me that it won???t cover under policy due to norms mentioned as "patient was symptomatic prior to inception of star policy". I do not understand the diagnosis/Analysis been done on this from which you had conclude to reject this normal claim?? I had copied this email to Dr. Sachin Gangavane Sir (Sanjeevani Criticare Hospital) under whose treatment my father???s health was stabilized. As I came to know from your representative that the claim has been rejected on the basis of description written on the indoor paper submitted by hospital, I am sure this is human error and as Health Insurance Company I feel you guys should verify all the medical bills and supporting documents submitted by client before taking such nasty decision. Irrespective of the Policy coverage and terms specified in it you should have thoroughly studied the case history of the client and follow the norms under the same prior you conclude on anything. This is really causing a pain for me to accept your decision under abnormal circumstances. Please let me know, did you find any medical history of my father related to high blood pressure?? On the basis of one note written on some paper how you guys deal with client???s problems before investigating further??? My father felt cheated now as his claim got rejected when he really need it. What is the legal way to handle this issue? Can anybody guide me further on this?
does it covers liposuction treatment
It may be the best .If so answre A senior citizen is issued policy five year back.she paye premium regularly and made bo claim.Can premium jump 100%.She has to pay rs 15000 instead of rs 7000 for sum assured of rs 300000.Is this not misselling.Can you punish Andheri mumbai advisor
This is really sad. We should certainly take some action as permitted by law. Maybe we can go to consumer court and file a petition. Freedom of common man cannot be curbed. Strict action against these demons is the need of the hour....
The worst insurance firm star health allied insurance Andheri Mumbai.The agent cheated us. We have paid regular premium for five years and no claim made but this year the premium is increased 100%. I had complained to all officers and IRDA but they are not afraid. They refuse to give formula of 100% increase There should be action against agent for mis selling. The firm is also refusing to give physical copies of policy if renewed online
These insurance companies know how to dupe people - even educated people. Friends, don't fall into this vicious trap. Also go for renowned companies and consult someone before even talking to these sidey agents.