Diabetes Safe Insurance Policy

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED
Regd. & Corporate Office: 1, New Tank Street, Valluvar Kottam High Road, Nungambakkam,
Chennai - 600 034. « Phone : 044 - 28288800 « Email : [email protected]
Website : www.starhealth.in « CIN : L66010TN2005PLC056649 « IRDAI Regn. No. : 129
DIABETES SAFE INSURANCE POLICY

Unique Identification No.: SHAHLIP23081V082223
PREAMBLE Hospitalization: Hospitalization means admission in a Hospital for a minimum period of 24

The proposal, declaration and other documents if any given by the proposer shall be the consecutive 'In-patient Care' hours except for specified procedures/ treatments, where
basis of this Contract and is deemed to be incorporated herein. such admission could be for a period of less than 24 consecutive hours.
Illness: Illness means a sickness or a disease or pathological condition leading to the
I. DEFINITIONS (APPLICABLE FOR PLAN A AND PLAN B)
impairment of normal physiological function and requires medical treatment;
STANDARD DEFINITIONS (a) Acute condition - Acute condition is a disease, illness or injury that is likely to
respond quickly to treatment which aims to return the person to his or her state of
Accident: An accident means sudden, unforeseen and involuntary event caused by
health immediately before suffering the disease/ illness/ injury which leads to full
external, visible and violent means.
recovery
Any one illness: Any one illness means continuous period of illness and includes relapse (b) Chronic condition - A chronic condition is defined as a disease, illness, or injury that
within 45 days from the date of last consultation with the Hospital/Nursing Home where has one or more of the following characteristics;
treatment was taken. 1. It needs ongoing or long-term monitoring through consultations, examinations,
Cashless facility: Cashless facility means a facility extended by the insurer to the insured check-ups, and /or tests
where the payments, of the costs of treatment undergone by the insured in accordance with 2. it needs ongoing or long-term control or relief of symptoms
the policy terms and conditions, are directly made to the network provider by the insurer to 3. it requires rehabilitation for the patient or for the patient to be specially trained to
the extent pre-authorization is approved. cope with it
Condition Precedent: Condition Precedent means a policy term or condition upon which 4. it continues indefinitely
the Insurer's liability under the policy is conditional upon. 5. it recurs or is likely to recur
Congenital Anomaly: Congenital Anomaly means a condition which is present since birth, Injury: Injury means accidental physical bodily harm excluding illness or disease solely
and which is abnormal with reference to form, structure or position. and directly caused by external, violent, visible and evident means which is verified and
a) Internal Congenital Anomaly: Congenital anomaly which is not in the visible and certified by a Medical Practitioner.
accessible parts of the body
Inpatient Care: Inpatient care means treatment for which the insured person has to stay in
b) External Congenital Anomaly: Congenital anomaly which is in the visible and a hospital for more than 24 hours for a covered event.
accessible parts of the body
Intensive Care Unit: Intensive care unit means an identified section, ward or wing of a
Day Care Centre: A day care centre means any institution established for day care hospital which is under the constant supervision of a dedicated medical practitioner(s), and
treatment of illness and/or injuries or a medical setup with a hospital and which has been which is specially equipped for the continuous monitoring and treatment of patients who
registered with the local authorities, wherever applicable, and is under supervision of a are in a critical condition, or require life support facilities and where the level of care and
registered and qualified medical practitioner AND must comply with all minimum criterion supervision is considerably more sophisticated and intensive than in the ordinary and other
as under – wards.
i) has qualified nursing staff under its employment;
ii) has qualified medical practitioner/s in charge; ICU Charges: ICU (Intensive Care Unit) Charges means the amount charged by a
Hospital towards ICU expenses which shall include the expenses for ICU bed, general
iii) has fully equipped operation theatre of its own where surgical procedures are carried
medical support services provided to any ICU patient including monitoring devices, critical
out;
care nursing and intensivist charges.
iv) maintains daily records of patients and will make these accessible to the insurance
company's authorized personnel. Kidney Failure Requiring Regular Dialysis: End stage renal disease presenting as
chronic irreversible failure of both kidneys to function, as a result of which either regular
Day Care Treatment: Day care treatment means medical treatment, and/or surgical
renal dialysis (haemodialysis or peritoneal dialysis) is instituted or renal transplantation is
procedure which is:
carried out. Diagnosis has to be confirmed by a specialist medical practitioner.
i. Undertaken under General or Local Anesthesia in a hospital/day care centre in less
than 24 hrs because of technological advancement, and Medical Advice: Medical Advice means any consultation or advice from a Medical
ii. which would have otherwise required hospitalization of more than 24 hours Practitioner including the issuance of any prescription or follow-up prescription.
Treatment normally taken on an out-patient basis is not included in the scope of this Medical Expenses: Medical Expenses means those expenses that an Insured Person
definition has necessarily and actually incurred for medical treatment on account of Illness or
Disclosure to information norm: The policy shall be void and all premium paid thereon Accident on the advice of a Medical Practitioner, as long as these are no more than would
shall be forfeited to the Company in the event of misrepresentation, mis-description or have been payable if the Insured Person had not been insured and no more than other
non-disclosure of any material fact. hospitals or doctors in the same locality would have charged for the same medical
treatment.
Grace Period: Grace period means the specified period of time immediately following the
premium due date during which a payment can be made to renew or continue a policy in Medical Practitioner: Medical Practitioner means a person who holds a valid registration
force without loss of continuity benefits such as waiting periods and coverage of from the Medical Council of any State or Medical Council of India or Council for Indian
pre-existing diseases. Coverage is not available for the period for which no premium is Medicine or for Homeopathy set up by the Government of India or a State Government and
received. is thereby entitled to practice medicine within its jurisdiction; and is acting within its scope
and jurisdiction of license.
Hospital: A hospital means any institution established for in-patient care and day care
treatment of illness and/or injuries and which has been registered as a hospital with the Medically Necessary Treatment: Medically necessary treatment means any treatment,
local authorities under Clinical Establishments (Registration and Regulation) Act 2010 or tests, medication, or stay in hospital or part of a stay in hospital which:
under enactments specified under the Schedule of Section 56(1) of the said act Or i) is required for the medical management of the illness or injury suffered by the insured;
complies with all minimum criteria as under: ii) must not exceed the level of care necessary to provide safe, adequate and
i) has qualified nursing staff under its employment round the clock; appropriate medical care in scope, duration, or intensity;
ii) has at least 10 in-patient beds in towns having a population of less than 10,00,000 and iii) must have been prescribed by a medical practitioner;
at least 15 in-patient beds in all other places; iv) must conform to the professional standards widely accepted in international medical
iii) has qualified medical practitioner(s) in charge round the clock; practice or by the medical community In India.
iv) has a fully equipped operation theatre of its own where surgical procedures are Migration: “Migration” means, the right accorded to health insurance policyholders
carried out; (including all members under family cover and members of group health insurance policy),
v) maintains daily records of patients and makes these accessible to the insurance to transfer the credit gained for pre-existing conditions and time bound exclusions, with the
company's authorized personnel; same insurer.
Diabetes Safe Insurance Policy Unique Identification No.: SHAHLIP23081V082223 POL / DIA / V.18 / 2023 1 of 10
Network Provider: Network Provider means hospitals or health care providers enlisted by Insured Person: Insured Person means the persons named in the schedule of the Policy.
an insurer, TPA or jointly by an Insurer and TPA to provide medical services to an insured by
Instalment: Instalment means Premium amount paid through Half-yearly mode by the
a cashless facility.
Policy Holder / Insured.
Non-Network Provider: Non-Network means any hospital, day care centre or other
In-Patient: In-Patient means an Insured Person who is admitted to Hospital and stays
provider that is not part of the network.
there for a minimum period of 24 hours for the sole purpose of receiving treatment.
Notification of Claim: Notification of claim means the process of intimating a claim to the
Material fact: Material fact is one which would affect the judgment of a prudent insurer in
insurer or TPA through any of the recognized modes of communication.
deciding whether to accept the risk and if so, at what rate or premium and subject to what
OPD treatment: OPD treatment means the one in which the Insured visits a clinic / hospital terms and conditions.
or associated facility like a consultation room for diagnosis and treatment based on the
advice of a Medical Practitioner. The Insured is not admitted as a day care or in-patient. Networked Facility: Networked Facility means hospitals, day care centers, clinics,
diagnostic centers that the Company has mutually agreed with to provide medical services.
Pre-Existing Disease: Pre-existing Disease means any condition, ailment, injury or
disease: Nuclear, Chemical and Biological Terrorism: Nuclear, Chemical and Biological
a) That is/are diagnosed by a physician within 48 months prior to the effective date of the Terrorism shall mean the use of any nuclear weapon or device or the emission, discharge,
policy issued by the insurer or its reinstatement dispersal, release or escape of any solid, liquid or gaseous Chemical agent and/or
Biological agent during the period of this insurance by any person or group(s) of persons,
or
whether acting alone or on behalf of or in connection with any organisation(s) or
b) For which medical advice or treatment was recommended by, or received from, a government(s), committed for political, religious or ideological purposes or reasons
physician within 48 months prior to the effective date of the policy issued by the insurer including the intention to influence any government and/or to put the public, or any section of
or its reinstatement the public, in fear. “Chemical” agent shall mean any compound which, when suitably
Pre-hospitalization Medical Expenses: Pre-hospitalization Medical Expenses means disseminated, produces incapacitating, damaging or lethal effects on people, animals,
medical expenses incurred during pre-defined number of days preceding the plants or material property. “Biological” agent shall mean any pathogenic (disease
hospitalization of the Insured Person, provided that: producing) micro-organism(s) and/or biologically produced toxin(s) (including genetically
i. Such Medical Expenses are incurred for the same condition for which the Insured modified organisms and chemically synthesized toxins) which cause illness and/or death in
Person's Hospitalization was required, and humans, animals or plants.
ii. The In-patient Hospitalization claim for such Hospitalization is admissible by the Single Standard A/c room: Single Standard A/c room means a single occupancy air-
Insurance Company conditioned room with attached wash room and a couch for the attendant. The room may
Portability: “Portability” means, the right accorded to individual health insurance have a television and /or a telephone. Such room must be the most economical of all
policyholders (including all members under family cover), to transfer the credit gained for accommodations available in that hospital as single occupancy. This does not include a
pre- existing conditions and time bound exclusions, from one insurer to another insurer. deluxe room or a suite.
Post-hospitalization Medical Expenses: Post-hospitalization Medical Expenses means II. COVERAGE
medical expenses incurred during pre-defined number of days immediately after the
In consideration of the premium paid and subject to the terms and conditions as set out in the
insured person is discharged from the hospital provided that:
Schedule with all its Parts the Company by this Policy agrees as under:
i. Such Medical Expenses are for the same condition for which the insured person's
hospitalization was required, and a. Section 1 (Applicable for Plan A and Plan B)
ii. The inpatient hospitalization claim for such hospitalization is admissible by the If during the policy period stated in the schedule, the Insured Person shall develop
insurance company. any complications of Diabetes Mellitus and if such complications shall require the
Insured Person, upon the advice of the duly Qualified Medical Practitioner, to incur
Qualified Nurse: Qualified nurse means a person who holds a valid registration from the hospitalization expenses for medical/surgical treatment at Nursing Home / Hospital
Nursing Council of India or the Nursing Council of any state In India. in India as an inpatient, the Company will pay the amount of such expenses as are
Reasonable and Customary Charges: Reasonable and Customary charges means the reasonably and necessarily incurred as would fall under different heads as stated
charges for services or supplies, which are the standard charges for the specific provider hereto up-to the limits mentioned but not exceeding the sum insured in aggregate as
and consistent with the prevailing charges in the geographical area for identical or similar stated in the schedule hereto;
services, taking into account the nature of the illness / injury involved. A. Room (Single Standard A/C room), Boarding and Nursing Expenses
B. Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist Fees
Room Rent: Room Rent means the amount charged by a Hospital towards Room and
C. Anaesthesia, Blood, Oxygen and Operation Theatre charges, ICU Charges,
Boarding expenses and shall include the associated medical expenses.
Surgical Appliances, Medicines and Drugs, Diagnostic Materials and diagnostic
Surgery or Surgical Procedure: Surgery or Surgical Procedure means manual and / or imaging modalities, X-ray and stent. With regard to coronary stenting, medicines,
operative procedure(s) required for treatment of an illness or injury, correction of Implants and such other similar items the Company will pay cost of stent as per
deformities and defects, diagnosis and cure of diseases, relief from suffering and the Drug Price Control Order (DPCO) / National Pharmaceuticals Pricing
prolongation of life, performed in a hospital or day care centre by a medical practitioner. Authority (NPPA) Capping
Unproven/Experimental treatment: Unproven/Experimental treatment means the D. Emergency ambulance charges up-to a sum of Rs. 2000/- per policy period for
treatment including drug experimental therapy which is not based on established medical transportation of the insured person by private ambulance service when this is
practice in India, is treatment experimental or unproven. needed for medical reasons to go to hospital for treatment, provided however
there is an admissible claim under this section
SPECIFIC DEFINITIONS E. Relevant Pre Hospitalization medical expenses incurred for a period not
Associated medical expenses: Associated medical expenses means medical expenses exceeding 30 days prior to the date of Hospitalisation, on the disease/illness
such as Professional fees, OT charges, Procedure charges, etc., which vary based on the contracted following an admissible claim under the policy
room category occupied by the insured person whilst undergoing treatment in some of the
F. Post Hospitalization expenses incurred up to 60 days after discharge from the
hospitals. If Policy Holder chooses a higher room category above the eligibility defined in
hospital. The amount payable shall not exceed the sum equivalent to 7% of the
policy, then proportionate deduction will apply on the Associated Medical Expenses in
hospitalization expenses subject to a maximum of Rs.5,000/- per hospitalization
addition to the difference in room rent. Such associated medical expenses do not include
provided such expenses so incurred are in respect of ailment for which the
Cost of pharmacy and consumables, Cost of implants and medical devices and Cost of
insured person was hospitalized. For the purpose of calculation of the 7%, only
diagnostics.
nursing expenses, surgeon's / consultants fees, diagnostic charges and cost of
Basic Sum Insured: Basic Sum Insured means the Sum Insured Opted for and for which drugs and medicines will be taken
the premium is paid.
b. Special conditions applicable for Section 1
Company: Company means Star Health and Allied Insurance Company Limited.
Plan A Plan B
Diagnosis: Diagnosis means Diagnosis by a registered medical practitioner, supported by
clinical, radiological and histological, histo-pathological and laboratory evidence and also
surgical evidence wherever applicable, acceptable to the Company.
1. Donor expenses for kidney 1. Donor expenses for kidney
Hazardous Sports/ Hazardous Activities: Hazardous Sports/ Hazardous Activities transplantation where the insured transplantation where the insured
means engaging whether professionally or otherwise in any sport or activity, which is person is the recipient are payable person is the recipient are payable
potentially dangerous to the Insured Person (whether trained, or not). Such Sport/Activity
provided the claim for provided the claim for
including but not limited to Winter sports, Ice hockey, Skiing, Skydiving, Parachuting,
transplantation is payable and transplantation is payable and
Ballooning, Scuba Diving, Bungee Jumping, Mountain Climbing, Riding or Driving in
Races or Rallies, caving or pot holing, hunting or equestrian activities, diving or under- subject to the availability of the sum subject to the availability of the sum
water activity, rafting or canoeing involving rapid waters, yachting or boating outside insured. Donor screening expenses insured. Donor screening expenses
coastal waters, jockeys, horseback, Polo, Circus personnel, army/navy/air force personnel and post-donation complications of and post-donation complications of
and policemen whilst on duty, persons working in underground mines, explosives, the donor are not payable the donor are not payable
magazines, workers whilst involved in electrical installation with high-tension supply,
nuclear installations, handling hazardous chemicals.
Plan A Plan B c. Section 2 (Applicable for Plan A and Plan B)
If during the period stated in the Schedule the insured person, upon the advice of a duly
Qualified Physician / Medical Specialist / Medical Practitioner or of duly Qualified
2. Expenses incurred on dialysis 2. Expenses incurred on dialysis Surgeon to incur Hospitalization expenses for medical/surgical treatment for any
(inclusive of AV fistula /graft (inclusive of AV fistula /graft disease/illness/sickness (Other than those falling under Section 1 above), accidental
creation charges) are payable up- creation charges) are payable up-to injuries at any Nursing Home / Hospital in India as an in-patient, the Company will
to Rs.1,000/- per sitting commencing Rs.1,000/- per sitting commencing pay to the Insured Person/s the amount of such expenses as are reasonably and
from the policy year in which Chronic from the policy year in which Chronic necessarily incurred up-to the limits indicated but not exceeding sum insured in
Kidney disease occurs and payable Kidney disease occurs and payable aggregate as stated in the schedule hereto;
for up to 24 consecutive months for up to 24 consecutive months A. Room (Single Standard A/C room), Boarding and Nursing Expenses
provided the policy is in force provided the policy is in force B. Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist Fees
C. Anaesthesia, Blood, Oxygen and Operation Theatre charges, ICU charges,
Surgical Appliances, Medicines and Drugs, Diagnostic Materials and diagnostic
3. Cost of artificial limbs following 3. Cost of artificial limbs following imaging modalities and X-ray. With regard to coronary stenting, medicines,
amputation is payable up-to 10% of amputation is payable up-to 10% of Implants and such other similar items the Company will pay cost of stent as per
Sum Insured provided the claim for Sum Insured provided the claim for the Drug Price Control Order (DPCO) / National Pharmaceuticals Pricing
such amputation is admissible under such amputation is admissible under Authority (NPPA) Capping
the policy the policy D. Relevant Pre Hospitalization medical expenses incurred for a period not
exceeding 30 days prior to the date of Hospitalisation, on the disease/illness
contracted following an admissible claim under the policy
4. Claims directly or indirectly relating 4. Claims directly or indirectly relating
E. Emergency ambulance charges up-to a sum of Rs. 2000/- per policy period for
to Cardio Vascular System, Renal to any Cardio Vascular System,
transportation of the insured person by private ambulance service when this is
System, Diseases of eye, Foot Renal System, Diseases of eye,
needed for medical reasons to go to hospital for treatment, provided however
Ulcer, Diabetic Peripheral Vascular Foot Ulcer and other complications there is an admissible claim under this section
Diseases and other complications of of diabetes are eligible to be
diabetes are eligible to be payable payable under Section 1 only, except F. Post Hospitalization expenses incurred up to 60 days after discharge from the
under Section 1 only, except where where specifically provided for hospital. The amount payable shall not exceed the sum equivalent to 7% of the
hospitalization expenses subject to a maximum of Rs.5,000/- per hospitalization
specifically provided for The expenses payable in respect of provided such expenses so incurred are in respect of ailment for which the
diseases relating to Cardio Vascular insured person was hospitalized. For the purpose of calculation of the 7%, only
System is limited to the amount nursing expenses, surgeon's / consultants fees, diagnostic charges and cost of
mentioned there against drugs and medicines will be taken
Limit of the d. Special conditions applicable for Section 2 (Applicable for Plan A and Plan B);
Company’s 1. Expenses on Hospitalization for a minimum period of 24 hours only are
SI. Sum Insured admissible. However this time limit will not apply for the day care treatments /
Liability per
No. (Rs.) procedures, where treatment is taken in the Hospital / Nursing Home and the
policy period
(Rs.) Insured is discharged on the same day
2. The expenses incurred on treatment of cataract are limited to;
1 3,00,000/- 2,00,000/-
Sum Insured Rs. Limit Rs.
2 4,00,000/- 2,50,000/- 3,00,000/- 4,00,000/- 20,000/- per eye per hospitalisation and
and 5,00,000/- 30,000/- for the entire policy period.
3 5,00,000/- 3,00,000/-
30,000/- per eye per hospitalisation and
10,00,000/-
4 10,00,000/- 4,00,000/- 40,000/- for the entire policy period
3. Expenses relating to Associated Medical Expenses will be considered in
5. Claim for cataract surgery is payable 5. Claim for cataract surgery is payable proportion to the eligible room rent/room category stated in the policy
under Section 2 only under Section 2 only schedule or actuals whichever is less. Proportionate deductions are not
applied in respect of the hospitals which do not follow differential billing or
for those expenses in respect of which differential billing is not adopted
based on the room rent.
6. The expenses as above are payable 6. The expenses as above are payable e. Section 3 - Outpatient Expenses;
only where the in-patient only where the in-patient The Company will pay the amount of such expenses as are reasonably and
hospitalization is for a minimum hospitalization is for a minimum necessarily incurred at any Networked Facility in India herein defined as an
period of 24 hours. However this period of 24 hours. However this Out-patient Treatment, provided policy is in force;
time limit will not apply to the day- time limit will not apply to the day- a. The Cost of Fasting and Post Prandial and HbA1C tests - once every six months –
care treatments / procedures, where care treatments / procedures, where upto Rs.750/- per event upto Rs.1500/- per policy period
treatment is taken in the Hospital / treatment is taken in the Hospital / b. Other expenses like medical consultation, other diagnostics, medicines and
Nursing Home and the Insured is Nursing Home and the Insured is drugs upto the limits given below per policy period
discharged on the same day discharged on the same day Note: Payment of any claim under this section shall not be construed as a waiver of
Company's right to repudiate any claim on grounds of non disclosure of material fact or
pre-existing disease, for hospitalization expenses under hospitalization provisions of
the policy contract.
7. Important Note: Expenses relating 7. Important Note: Expenses relating Applicable for Plan A
to Associated Medical Expenses to Associated Medical Expenses
Individual
will be considered in proportion will be considered in proportion to
to the eligible room rent/room the eligible room rent/room Sum Insured Rs. 3,00,000 4,00,000 5,00,000 10,00,000
category stated in the policy category stated in the policy Limit of OP Benefit Rs. 1,000/- 2,500/- 3,500/- 5,500/-
schedule or actuals whichever is schedule or actuals whichever is Floater
less. Proportionate deductions less. Proportionate deductions
are not applied in respect of the are not applied in respect of the Sum Insured Rs. 3,00,000 4,00,000 5,00,000 10,00,000
hospitals which do not follow hospitals which do not follow Limit of OP Benefit Rs. 2,000/- 3,500/- 5,500/- 7,500/-
differential billing or for those differential billing or for those Applicable for Plan B
expenses in respect of which expenses in respect of which
differential billing is not adopted differential billing is not adopted Individual
based on the room rent. based on the room rent. Sum Insured Rs. 3,00,000 4,00,000 5,00,000 10,00,000
Limit of OP Benefit Rs. 500/- 2,000/- 3,000/- 5,000/-
Floater
Note: (Applicable for Plan A and Plan B): Only complications of Diabetes that are Sum Insured Rs. 3,00,000 4,00,000 5,00,000 10,00,000
declared by the insured and accepted by the company shall be considered as
Limit of OP Benefit Rs. 1,500/- 3,000/- 5,000/- 7,000/-
covered under Section 1.
This benefit forms part of Sum Insured.
f. Section 4 - Coverage for Modern Treatments: The expenses payable during the Applicable for Section 2 and Section 4 under Plan A and Plan B
entire policy period for the following treatment / procedure (either as a day care or as A. Expenses related to the treatment of the following listed Conditions,
an in-patient exceeding 24hrs of admission in the hospital) is limited to the amount surgeries/treatments shall be excluded until the expiry of 24 months of
mentioned in table below; continuous coverage after the date of inception of the first policy with us. This
exclusion shall not be applicable for claims arising due to an accident
Sum Insured Rs. 3,00,000/- 4,00,000/- 5,00,000/- 10,00,000/-
B. In case of enhancement of sum insured the exclusion shall apply afresh to the
Sum Insured on Individual Basis: extent of sum insured increase
Limit per person, per policy period for each C. If any of the specified disease/procedure falls under the waiting period specified
treatment / procedure for pre-existing diseases, then the longer of the two waiting periods shall apply
Treatment / Procedure
Sum Insured on Floater Basis:
Limit per policy period for each D. The waiting period for listed conditions shall apply even if contracted after the
treatment / procedure Rs. policy or declared and accepted without a specific exclusion
E. If the Insured Person is continuously covered without any break as defined under
Uterine artery Embolization and HIFU 37,500/- 1,00,000/-- 1,25,000/- 1,50,000/- the applicable norms on portability stipulated by IRDAI, then waiting period for the
Balloon Sinuplasty 15,000/- 40,000/- 50,000/- 1,00,000/- same would be reduced to the extent of prior coverage
F. List of specific diseases/procedures;
Deep Brain Stimulation 75,000/- 2,00,000/- 2,50,000/- 3,00,000/-
a. Cataract and diseases of the Anterior and Posterior Chamber of the Eye,
Oral Chemotherapy* 37,500/- 1,00,000/- 1,25,000/- 2,00,000/- Retinal detachment, Glaucoma, Diseases of ENT, Diseases related to
Immunotherapy-Monoclonal Antibody to Thyroid, Prolapse of intervertebral disc (other than caused by accident),
75,000/- 2,00,000/- 2,50,000/- 4,00,000/- Varicose veins and Varicose ulcers, all Diseases of Prostrate, Stricture
be given as injection
Urethra, all Obstructive Uropathies, benign prostatic hypertrophy,
Intra Vitreal injections 15,000/- 40,000/- 50,000/- 75,000/- stapedectomy, all types of Hernia, Epididymal Cyst, Benign Tumours of
Robotic surgeries 75,000/- 2,00,000/- 2,50,000/- 3,00,000/- Epididymis, Spermatocele, Varicocoel, Hydrocele, Fistula / Fissure in ano,
Hemorrhoids, Pilonidal Sinus and Fistula, Rectal Prolapse, Stress
Stereotactic radio surgeries 75,000/- 1,75,000/- 2,00,000/- 2,25,000/-
Incontinence, and Congenital Internal disease / defect
Bronchical Thermoplasty b. Desmoid Tumour of anterior abdominal wall, Gall Bladder and Pancreatic
Vaporisation of the prostate (Green laser diseases and All treatments (conservative, interventional, laparoscopic and
Up to Sum Insured open) for Hepato pancreato biliary diseases including gall bladder and
treatment or holmium laser treatment)
pancreatic calculi. All types of management for kidney calculi and
IONM-(Intra Operative Neuro Monitoring)
genitourinary tract calculi
Stem cell therapy: Hematopoietic stem c. All treatments (conservative, interventional, laparoscopic and open) related
cells for bone marrow transplant for 75,000/- 2,00,000/- 2,50,000/- 3,00,000/- to all Diseases of Uterus, Fallopian Tubes, Cervix and Ovaries, Uterine
haematological conditions Bleeding, Pelvic Inflammatory Diseases, Benign breast diseases, Umbilical
Sinus, Umbilical Fistula
* Sublimit all inclusive with or without hospitalization where ever hospitalization includes d. Conservative, operative treatment of all types of intervention for diseases
pre and post hospitalization.
related to tendon, ligament, Fascia, bones and joint including Arthroscopy
g. Section 5 - Personal Accident (Applicable for Plan A and Plan B): If at any time and Arthroplasty [other than caused by accident]
during the Period of Insurance, the Insured Person shall sustain any bodily injury e. Degenerative disc and vertebral diseases including Replacement of bones
resulting solely and directly from an Accident caused by external, violent and visible and joints and degenerative diseases of the musculo-skeletal system
means and if such accident causes death of the Insured Person within 12 Calendar f. Subcutaneous benign lumps, sebaceous cyst, dermoid cyst, Mucous Cyst
months from the date of Accident, then the Company will pay an amount as lip/cheek, Carpel Tunnel Syndrome, Trigger Finger, lipoma, neurofibroma,
compensation the Sum Insured mentioned in the Schedule. ganglion and similar pathology
Note g. Any transplant and related surgery
1. Geographical Scope: The insurance cover under this Section applies Worldwide
2. This Section is applicable for the person specifically mentioned in the Schedule 3. 30-day waiting period - Code Excl 03
3. At any point of time only one person will be eligible to be covered under this Applicable for Section 1 under Plan B;
Section 1. Expenses related to the treatment of any illness within 30 days from the first policy
commencement date shall be excluded except claims arising due to an accident,
4. The sum insured for this Section is equal to the sum insured opted for Section 1 / 2
provided the same are covered
5. Any claim under Section 1/2/3/4 will not affect the Sum Insured under this section
2. This exclusion shall not, however, apply if the Insured Person has continuous
III. EXCLUSIONS coverage for more than twelve months
3. The within referred waiting period is made applicable to the enhanced sum
The Company shall not be liable to make any payments under this policy in respect of any
insured in the event of granting higher sum insured subsequently
expenses what so ever incurred by the insured person in connection with or in respect of;
Applicable for Section 2 and Section 4 under Plan A and Plan B;
STANDARD EXCLUSIONS
1. Expenses related to the treatment of any illness within 30 days from the first policy
1. Pre-Existing Diseases Applicable for Section 2 and Section 4 under Plan A and commencement date shall be excluded except claims arising due to an accident,
Plan B - Code Excl 01 provided the same are covered
A. Expenses related to the treatment of a pre-existing Disease (PED) and its direct
2. This exclusion shall not, however, apply if the Insured Person has continuous
complications shall be excluded until the expiry of 48 months of continuous
coverage for more than twelve months
coverage after the date of inception of the first policy with insurer
3. The within referred waiting period is made applicable to the enhanced sum
insured in the event of granting higher sum insured subsequently
extent of sum insured increase
C. If the Insured Person is continuously covered without any break as defined under 4. Investigation & Evaluation - Code Excl 04
the portability norms of the extant IRDAI (Health Insurance) Regulations, then A. Expenses related to any admission primarily for diagnostics and evaluation
waiting period for the same would be reduced to the extent of prior coverage purposes only are excluded
D. Coverage under the policy after the expiry of 48 months for any pre-existing B. Any diagnostic expenses which are not related or not incidental to the current
disease is subject to the same being declared at the time of application and diagnosis and treatment are excluded
accepted by Insurer 5. Rest Cure, rehabilitation and respite care - Code Excl 05: Expenses related to any
2. Specified disease / procedure waiting period - Code Excl 02 admission primarily for enforced bed rest and not for receiving treatment. This also
includes:
Applicable for Section 1 under Plan B
1. Custodial care either at home or in a nursing facility for personal care such as help
A. Expenses related to the treatment of following listed systems shall be excluded
with activities of daily living such as bathing, dressing, moving around either by
until the expiry of 12 months of continuous coverage after the date of inception of
skilled nurses or assistant or non-skilled persons
the first policy with us. This exclusion shall not be applicable for claims arising
due to an accident 2. Any services for people who are terminally ill to address physical, social,
emotional and spiritual needs
extent of sum insured increase 6. Obesity / Weight Control - Code Excl 06: Expenses related to the surgical treatment
C. The waiting period for listed conditions shall apply even if contracted after the of obesity that does not fulfill all the below conditions;
policy or declared and accepted without a specific exclusion A. Surgery to be conducted is upon the advice of the Doctor
D. List of Systems: Cardio Vascular System, Renal System, Diseases of eye, B. The surgery/Procedure conducted should be supported by clinical protocols
Diabetic Peripheral Vascular Diseases and Foot Ulcer C. The member has to be 18 years of age or older and
D. Body Mass Index (BMI); 26. Unconventional, Untested, Experimental therapies - Code Excl 27
1. greater than or equal to 40 or
27. Artificial Pancreas, Chondrocyte Implantation, Procedures using Platelet Rich plasma
2. greater than or equal to 35 in conjunction with any of the following severe co- and Intra articular injection therapy - Code Excl 28
morbidities following failure of less invasive methods of weight loss:
a. Obesity-related cardiomyopathy 28. Biologicals, except when administered as an in-patient, when clinically indicated and
b. Coronary heart disease hospitalization warranted - Code Excl 29
c. Severe Sleep Apnea 29. Inoculation or Vaccination (except for post–bite treatment and for medical treatment
d. Uncontrolled Type2 Diabetes for therapeutic reasons) - Code Excl 31
7. Change-of-Gender treatments - Code Excl 07: Expenses related to any treatment, 30. Hospital registration charges, admission charges, record charges, telephone charges
including surgical management, to change characteristics of the body to those of the and such other charges - Code Excl 34
opposite sex.
31. Cost of spectacles and contact lens, hearing aids, Cochlear implants and procedures,
8. Cosmetic or plastic Surgery - Code Excl 08: Expenses for cosmetic or plastic walkers and crutches, wheel chairs, CPAP, BIPAP, Continuous Ambulatory Peritoneal
surgery or any treatment to change appearance unless for reconstruction following an Dialysis, infusion pump and such other similar aids - Code Excl 35
Accident, Burn(s) or Cancer or as part of medically necessary treatment to remove a 32. Any hospitalization which are not medically necessary / does not warrant
direct and immediate health risk to the insured. For this to be considered a medical hospitalization - Code Excl 36
necessity, it must be certified by the attending Medical Practitioner.
33. Other Excluded Expenses as detailed in the website www.starhealth.in - Code Excl 37
9. Hazardous or Adventure sports - Code Excl 09: Expenses related to any treatment
necessitated due to participation as a professional in hazardous or adventure sports, 34. Existing disease/s, disclosed by the insured and mentioned in the policy schedule
including but not limited to, para-jumping, rock climbing, mountaineering, rafting, (based on insured's consent), for specified ICD codes - Code Excl 38
motor racing, horse racing or scuba diving, hand gliding, sky diving, deep-sea diving. 35. Expenses incurred for treatment of diseases/illness/accidental injuries by systems of
10. Breach of law - Code Excl 10: Expenses for treatment directly arising from or medicine other than allopathy - Code Excl 39
consequent upon any Insured Person committing or attempting to commit a breach of Note: Exclusion nos. 15, 17, 18, 29, 31 and 35 are not applicable for Section 3
law with criminal intent. Exclusions applicable for Section 5
11. Excluded Providers - Code Excl 11: Expenses incurred towards treatment in any 1. Any claim relating to events occurring before the commencement of the cover or
hospital or by any Medical Practitioner or any other provider specifically excluded by otherwise outside the Period of Insurance - Code-Sec 5-Excl 01
the Insurer and disclosed in its website / notified to the policyholders are not 2. Code-Sec 5-Excl 02 Any claim arising out of Accident of the Insured Person from;
admissible. However, in case of life threatening situations or following an accident, a. Intentional self injury / suicide or attempted suicide or
expenses up to the stage of stabilization are payable but not the complete claim. b. Whilst under the influence of intoxicating liquor or drugs or
12. Treatment for Alcoholism, drug or substance abuse or any addictive condition and c. Self endangerment unless in self defense or to save human life
consequences thereof - Code Excl 12
3. Any claim arising out of suicide or attempted suicide self inflicted injuries, or sexually
13. Treatments received in health hydros, nature cure clinics, spas or similar transmitted conditions, anxiety, stress, depression, venereal disease (Other than
establishments or private beds registered as a nursing home attached to such HIV) - Code-Sec 5-Excl 03
establishments or where admission is arranged wholly or partly for domestic reasons - 4. Insured Person engaging in Air Travel unless he/she flies as a fare-paying passenger
Code Excl 13 on an aircraft properly licensed to carry passengers. For the purpose of this exclusion
14. Dietary supplements and substances that can be purchased without prescription, Air Travel means being in or on or boarding an aircraft for the purpose of flying therein
including but not limited to Vitamins, minerals and organic substances unless or alighting there from - Code-Sec 5- Excl 04
prescribed by a medical practitioner as part of hospitalization claim or day care 5. Accidents that are results of war and warlike occurrence or invasion, acts of foreign
procedure - Code Excl 14 enemies, hostilities, civil war, rebellion, insurrection, civil commotion assuming the
15. Refractive Error - Code Excl 15: Expenses related to the treatment for correction of proportions of or amounting to an uprising, military or usurped power, seizure capture
eye sight due to refractive error less than 7. 5 dioptres. arrest restraints detainments of all kings princes and people of whatever nation,
condition or quality whatsoever - Code-Sec 5- Excl 05
16. Unproven Treatments - Code Excl 16: Expenses related to any unproven
treatment, services and supplies for or in connection with any treatment. Unproven 6. Participation in riots, confiscation or nationalization or requisition of or destruction of or
treatments are treatments, procedures or supplies that lack significant medical damage to property by or under the order of any government or local authority - Code-
documentation to support their effectiveness. Sec5- Excl 06
17. Sterility and Infertility - Code Excl 17: Expenses related to sterility and infertility. 7. Any claim resulting or arising from or any consequential loss directly or indirectly
caused by or contributed to or arising from - Code-Sec5- Excl 07
This includes;
a. Ionizing radiation or contamination by radioactivity from any nuclear fuel or from
a. Any type of contraception, sterilization
any nuclear waste from the combustion of nuclear fuel or from any nuclear waste
b. Assisted Reproduction services including artificial insemination and advanced from combustion (including any self sustaining process of nuclear fission) of
reproductive technologies such as IVF, ZIFT, GIFT, ICSI nuclear fuel
c. Gestational Surrogacy b. Nuclear weapons material
d. Reversal of sterilization c. The radioactive, toxic, explosive or other hazardous properties of any explosive
18. Maternity - Code Excl 18 nuclear assembly or nuclear component thereof
a. Medical treatment expenses traceable to childbirth (including complicated d. Nuclear, chemical and biological terrorism
deliveries and caesarean sections incurred during hospitalization) except ectopic 8. Any claim arising out of sporting activities in so far as they involve the training or
pregnancy participation in competitions of professional or semi-professional sports persons -
b. Expenses towards miscarriage (unless due to an accident) and lawful medical Code-Sec5-Excl 08
termination of pregnancy during the policy period
9. Participation in Hazardous Sport / Hazardous Activities - Code-Sec5-Excl 09
SPECIFIC EXCLUSIONS
10. Persons who are physically challenged, unless specifically agreed and endorsed in
19. Circumcision (unless necessary for treatment of a disease not excluded under this the policy - Code-Sec5-Excl 10
policy or necessitated due to an accident), Preputioplasty, Frenuloplasty, Preputial
Dilatation and Removal of SMEGMA - Code Excl 19 11. Any loss arising out of the Insured Person's actual or attempted commission of or
willful, participation in an illegal act or any violation or attempted violation of the law -
20. Congenital External Condition / Defects / Anomalies - Code Excl 20 Code-Sec5- Excl 11
21. Convalescence, general debility, run-down condition, Nutritional deficiency states - 12. Any claim arising out of an accident related to pregnancy or childbirth, infirmity,
Code Excl 21 whether directly or indirectly - Code-Sec5-Excl 12
22. Intentional self -injury - Code Excl 22
IV. CONDITIONS
23. Injury/disease caused by or arising from or attributable to war, invasion, act of foreign
enemy, warlike operations (whether war be declared or not) - Code Excl 24 STANDARD CONDITIONS
1. Disclosure of Information: The policy shall be void and all premium paid thereon
24. Injury or disease caused by or contributed to by nuclear weapons/ materials -
shall be forfeited to the Company in the event of misrepresentation, mis description or
Code Excl 25 non-disclosure of any material fact by the policyholder.
25. Expenses incurred on Enhanced External Counter Pulsation Therapy and related 2. Claim Settlement
therapies, Chelation therapy, Hyperbaric Oxygen Therapy, Rotational Field Quantum A. Condition Precedent to Admission of Liability: The terms and conditions of
Magnetic Resonance Therapy, VAX-D, Low level laser therapy, Photodynamic the policy must be fulfilled by the insured person for the Company to make any
therapy and such other similar therapies - Code Excl 26 payment for claim(s) arising under the policy.
B. For Cashless Treatment (Section 1, Section 2 and Section 4); 3. Provision for Penal Interest
a. For assistance call 24 hours help-line 044-69006900 or Toll Free No. i) The Company shall settle or reject a claim, as the case may be, within 30 days
1800 425 2255, Senior Citizens may call at 044-40020888 from the date of receipt of last necessary document
b. Inform the ID number for easy reference ii) ln the case of delay in the payment of a claim, the Company shall be liable to pay
c. On admission in the hospital, produce the ID Card issued by the Company at interest to the policyholder from the date of receipt of last necessary document to
the Hospital Helpdesk the date of payment of claim at a rate 2% above the bank rate
d. Obtain the Pre-authorization Form from the Hospital Help Desk, complete iii) However, where the circumstances of a claim warrant an investigation in the
the Patient Information and resubmit to the Hospital Help Desk opinion of the Company, it shall initiate and complete such investigation at the
e. The Treating Doctor will complete the hospitalization / treatment information earliest, in any case not later than 30 days from the date of receipt of last
and the hospital will fill up expected cost of treatment necessary document. ln such cases, the Company shall settle or reject the claim
within 45 days from the date of receipt of last necessary document
f. This form should be submitted to the Company
iv) ln case of delay beyond stipulated 45 days, the Company shall be liable to pay
g. The Company will process the request and call for additional documents/
interest to the policyholder at a rate 2% above the bank rate from the date of
clarifications if the information furnished is inadequate receipt of last necessary document to the date of payment of claim
h. Once all the details are furnished, the Company will process the request as
v) "Bank rate" shall mean the rate fixed by the Reserve Bank of lndia (RBI) at the
per the terms and conditions as well as the exclusions therein and either beginning of the financial year in which claim has fallen due.
approve or reject the request based on the merits
i. In case of emergency hospitalization information to be given within 24 hours 4. Complete Discharge: Any payment to the policyholder, insured person or his/ her
after hospitalization nominees or his/ her legal representative or assignee or to the Hospital, as the case
j. Cashless facility can be availed only in networked Hospitals may be, for any benefit under the policy shall be a valid discharge towards payment of
claim by the Company to the extent of that amount for the particular claim
k. KYC (Identity proof with Address) of the proposer, as per AML Guidelines
In non-network hospitals payment must be made up-front by Insured / 5. Multiple Policies (Applicable for Section 1,2, 3 and 4)
Insured Person and then reimbursement will be effected on submission of i. ln case of multiple policies taken by an insured person during a period from one or
documents upon its admissibility more insurers to indemnify treatment costs, the insured person shall have the
Note: The Company reserves the right to call for additional documents wherever right to require a settlement of his/her claim in terms of any of his/her policies. ln all
such cases the insurer chosen by the insured person shall be obliged to settle the
required claim as long as the claim is within the limits of and according to the terms of the
Denial of a Pre-authorization request is in no way to be construed as denial of chosen policy
treatment or denial of coverage. The Insured Person can go ahead with the ii. lnsured person having multiple policies shall also have the right to prefer claims
treatment, settle the hospital bills and submit the claim for a permissible under this policy for the amounts disallowed under any other policy / policies even
reimbursement if the sum insured is not exhausted. Then the insurer shall independently settle
C. For Reimbursement claims: Time limit for submission of; the claim subject to the terms and conditions of this policy
iii. If the amount to be claimed exceeds the sum insured under a single policy, the
Sl.No. Type of Claim Prescribed time limit insured person shall have the right to choose insurer from whom he/she wants to
Reimbursement of hospitalization, Claim must be filed within 15 days claim the balance amount
1. day care and pre hospitalization from the date of discharge from the iv. Where an insured person has policies from more than one insurer to cover the
expenses Hospital. same risk on indemnity basis, the insured person shall only be indemnified the
treatment costs in accordance with the terms and conditions of the chosen policy
within 15 days after completion of Applicable for Section 5: In case of multiple policies which provide fixed benefits, on
Reimbursement of Post
2 60 days from the date of discharge the occurrence of the insured event in accordance with the terms and conditions of the
hospitalization
from hospital. policies, each insurer shall make the claim payments independent of payments
received under other similar polices.
D. Notification of Claim: Upon the happening of any event, which may give rise to
a valid claim under this policy, notice with full particulars shall be sent to the 6. Fraud: lf any claim made by the insured person, is in any respect fraudulent, or if any
Company prior to hospitalisation and in any case not later than 24 hours from the false statement, or declaration is made or used in support thereof, or if any fraudulent
time of Hospitalisation means or devices are used by the insured person or anyone acting on his/her behalf to
obtain any benefit under this policy, all benefits under this policy and the premium paid
Condition C and D are precedent to admission of liability under the policy. However shall be forfeited.
the company may examine and relax the time limits mentioned in condition C and D Any amount already paid against claims made under this policy but which are found
depending upon the merits of the Case fraudulent later shall be repaid by all recipient(s)/policyholder(s), who has made that
E. Documents to be submitted for Reimbursement: The reimbursement claim is particular claim, who shall be jointly and severally liable for such repayment to the insurer.
to be supported with the following documents and submitted within the For the purpose of this clause, the expression "fraud" means any of the following acts
prescribed time limit; committed by the insured person or by his agent or the hospital/doctor/any other party
a. Duly completed claim form, and acting on behalf of the insured person, with intent to deceive the insurer or to induce the
b. Pre Admission investigations and treatment papers insurer to issue an insurance policy:
c. Discharge Summary from the hospital a) the suggestion, as a fact of that which is not true and which the insured person
does not believe to be true;
d. Cash receipts from hospital, chemists
b) the active concealment of a fact by the insured person having knowledge or belief
e. Cash receipts and reports for tests done of the fact;
f. Receipts from doctors, surgeons, anesthetist c) any other act fitted to deceive; and
g. Certificate from the attending doctor regarding the diagnosis. d) any such act or omission as the law specially declares to be fraudulent
h. Copy of PAN card The Company shall not repudiate the claim and / or forfeit the policy benefits on the
i. KYC (Identity proof with Address) of the proposer, as per AML Guidelines ground of Fraud, if the insured person / beneficiary can prove that the misstatement
was true to the best of his knowledge and there was no deliberate intention to suppress
Organ transplant on the Insured Person shall satisfy the requirements of the
the fact or that such misstatement of or suppression of material fact are within the
Transplantation of Human Organs Act of 1994 and any amendments thereto knowledge of the insurer.
F. Claims of Out Patient Consultations / treatments (Section 3) will be settled
on a reimbursement basis on production of cash receipts 7. Cancellation
i. The policyholder may cancel this policy by giving 15 days' written notice and in
G. For Section 5 such an event, the Company shall refund premium for the unexpired policy period
For Accidental Death Claims:- Claim Form as detailed below;
a. Death Certificate
b. Post-mortem Certificate, if conducted Cancellation table applicable for Policy Term 1 Year
c. FIR (wherever required) without installment option
d. Police Investigation report (wherever required)
e. Viscera Sample Report (wherever required) Period on risk Rate of premium to be retained
f. Forensic Science Laboratory report (wherever required)
g. Legal Heir Certificate Up to 1 mth 25% of the policy premium
h. Succession Certificate (wherever required)
Exceeding 1 mth up to 3 mths 37.5% of the policy premium
i. KYC (Identity proof with Address) of the proposer, as per AML Guidelines
Note Exceeding 3 mths up to 6 mths 57.5% of the policy premium
· The Company reserves the right to call for additional documents wherever
required. Exceeding 6 mths up to 9 mths 80% of the policy premium
· For assistance call 24 hours help-line 044-69006900 or Toll Free No.
Exceeding 9 mths 100% of the policy premium
1800 425 2255, Senior Citizens may call at 044-40020888
Cancellation table applicable for installment option of Half-yearly premium Cancellation table applicable for installment option of Half-yearly premium
payment for Policy Term 1 Year payment for Policy Term 3 Year
Period on risk Rate of premium to be retained Period on risk Rate of premium to be retained
Up to 1 Mth 47.5% of the total premium received Up to 1 Mth 16% of the total premium received
Exceeding 1 mth up to 4 mths 30% of the total premium received
Exceeding 1 mth up to 4 mths 90% of the total premium received
Exceeding 4 mths up to 6 mths 39% of the total premium received
Exceeding 4 mths up to 6 mths 100% of the total premium received Exceeding 6 mths up to 7 mths 22% of the total premium received
Exceeding 6 mths up to 7 mths 65% of the total premium received Exceeding 7 mths up to 10 mths 28.5% of the total premium received
Exceeding 10 mths up to 12 mths 33.5% of the total premium received
Exceeding 10 mths 100% of the total premium received Exceeding 15 mths up to 21 mths 60% of the total premium received
Cancellation table applicable for Policy Term 2 Year Exceeding 21 mths up to 24 mths 66.5% of the total premium received
without installment option Exceeding 24 mths up to 27 mths 79.5% of the total premium received
Period on risk Rate of premium to be retained Exceeding 27 mths up to 33 mths 93% of the total premium received
Exceeding 33 mths 100% of the total premium received
Up to 1 Mth 12.5% of the policy premium
Notwithstanding anything contained herein or otherwise, no refunds of premium shall
Exceeding 1 mth up to 3 mths 20% of the policy premium be made in respect of Cancellation where, any claim has been admitted or has been
lodged or any benefit has been availed by the insured person under the policy.
Exceeding 3 mths up to 6 mths 30% of the policy premium
ii. The Company may cancel the policy at any time on grounds of misrepresentation,
Exceeding 6 mths up to 9 mths 40% of the policy premium non-disclosure of material facts, fraud by the insured person by giving 15 days'
written notice. There would be no refund of premium on cancellation on grounds of
Exceeding 9 mths up to 12 mths 50% of the policy premium misrepresentation,non-disclosure of material facts or fraud
Exceeding 12 mths up to 15 mths 70% of the policy premium 8. Migration (Applicable only for Section 2 and Section 4): The insured person will
have the option to migrate the policy to other health insurance products/plans offered
Exceeding 15 mths up to 18 mths 80% of the policy premium by the company by applying for migration of the Policy atleast 30 days before the
policy renewal date as per IRDAI guidelines on Migration. lf such person is presently
Exceeding 18 mths up to 21 mths 90% of the policy premium covered and has been continuously covered without any lapses under any health
insurance product/plan offered by the company, the insured person will get the
Exceeding 21 mths 100% of the policy premium accrued continuity benefits in waiting periods as per IRDAI guidelines on migration.
Cancellation table applicable for installment option of Half-yearly premium For Detailed Guidelines on migration, kindly refer the link
payment for Policy Term 2 Year https://www.irdai.gov.in/ADMINCMS/cms/frmGuidelines_Layout.aspx?page=PageNo3987
9. Portability (Applicable only for Section 2 and Section 4): The insured person will
Period on risk Rate of premium to be retained have the option to port the policy to other insurers by applying to such insurer to port the
entire policy along with all the members of the family, if any, at least 45 days before, but
Up to 1 Mth 24% of the total premium received
not earlier than 60 days from the policy renewal date as per IRDAI guidelines related to
Exceeding 1 mth up to 4 mths 44.5% of the total premium received portability. lf such person is presently covered and has been continuously covered
without any lapses under any health insurance policy with an lndian General/Health
Exceeding 4 mths up to 6 mths 58.5% of the total premium received insurer, the proposed insured person will get the accrued continuity benefits in waiting
periods as per IRDAI guidelines on portability.
Exceeding 6 mths up to 7 mths 32.5% of the total premium received For Detailed Guidelines on portability, kindly refer the link
https://www.irdai.gov.in/ADMINCMS/cms/frmGuidelines_Layout.aspx?page=PageNo3987
10. Renewal of policy: The policy shall ordinarily be renewable except on grounds of
Exceeding 10 mths up to 12 mths 50% of the total premium received fraud, misrepresentation by the Insured Person;
1. The Company shall endeavor to give notice for renewal. However, the Company
Exceeding 12 mths up to 16 mths 72.5% of the total premium received is not under obligation to give any notice for renewal
2. Renewal shall not be denied on the ground that the insured person had made a
Exceeding 16 mths up to 19 mths 82.5% of the total premium received claim or claims in the preceding policy years
Exceeding 19 mths up to 22 mths 93% of the total premium received 3. Request for renewal along with requisite premium shall be received by the
Company before the end of the policy period
Exceeding 22 mths 100% of the total premium received 4. At the end of the policy period, the policy shall terminate and can be renewed
within the Grace Period of 30 days to maintain continuity of benefits without
Cancellation table applicable for Policy Term 3 Year break in policy
without installment option
5. Coverage is not available during the grace period
Period on risk Rate of premium to be retained 6. No loading shall apply on renewals based on individual claims experience
Up to 1 Mth 7.5% of the policy premium 11. Withdrawal of policy
i. In the likelihood of this product being withdrawn in future, the Company will
Exceeding 1 mth up to 3 mths 12.5% of the policy premium intimate the insured person about the same 90 days prior to expiry of the policy
ii. lnsured Person will have the option to migrate to similar health insurance product
Exceeding 3 mths up to 6 mths 20% of the policy premium available with the Company at the time of renewal with all the accrued continuity
benefits such as cumulative bonus, waiver of waiting period as per IRDAI
Exceeding 6 mths up to 9 mths 27.5% of the policy premium guidelines, provided the policy has been maintained without a break
Exceeding 9 mths up to 12 mths 32.5% of the policy premium 12. Moratorium Period: After completion of eight continuous years under the policy no look
back to be applied. This period of eight years is called as moratorium period. The
Exceeding 12 mths up to 15 mths 45% of the policy premium moratorium would be applicable for the sums insured of the first policy and subsequently
completion of 8 continuous years would be applicable from date of enhancement of sums
Exceeding 15 mths up to 18 mths 52.5% of the policy premium insured only on the enhanced limits. After the expiry of Moratorium Period no health
insurance claim shall be contestable except for proven fraud and permanent exclusions
Exceeding 18 mths up to 21 mths 60% of the policy premium specified in the policy contract. The policies would however be subject to all limits, sub
limits, co-payments, deductibles as per the policy contract.
Exceeding 21 mths up to 24 mths 67.5% of the policy premium
13. Premium Payment in Instalments: lf the insured person has opted for Payment of
Exceeding 24 mths up to 27 mths 80% of the policy premium Premium on an instalment basis i.e. Half Yearly as mentioned in the policy
Schedule/Certificate of Insurance, the following Conditions shall apply
Exceeding 27 mths up to 30 mths 85% of the policy premium (notwithstanding any terms contrary elsewhere in the policy)
i. Grace Period of 7 days would be given to pay the instalment premium due for the
Exceeding 30 mths up to 33 mths 92.5% of the policy premium policy.
Exceeding 33 mths 100% of the policy premium ii. During such grace period, coverage will not be available from the due date of
instalment premium till the date of receipt of premium by Company.
iii. The insured person will get the accrued continuity benefit in respect of the 22. Notices and communication: Any notice, direction or instruction given under this
"Waiting Periods", "Specific Waiting Periods" in the event of payment of premium policy shall be in writing and delivered by hand, post, or facsimile/email to Star Health
within the stipulated grace Period. and Allied Insurance Company Limited, No.1, New Tank Street, Valluvar Kottam High
iv. No interest will be charged lf the instalment premium is not paid on due date. Road, Nungambakkam, Chennai 600034. Customer Care No. 044-69006900 or Toll
Free No. 1800 425 2255, e-mail: [email protected]
v. ln case of instalment premium due not received within the grace period, the policy
will get cancelled. Notice and instructions will be deemed served 7 days after posting or immediately
upon receipt in the case of hand delivery, facsimile or e-mail.
vi. ln the event of a claim, all subsequent premium instalments shall immediately
become due and payable. 23. Territorial Limit: All medical/surgical treatments under this policy shall have to be
vii. The company has the right to recover and deduct all the pending installments taken in India.
from the claim amount due under the policy. 24. Automatic Expiry of the Policy: The insurance under this policy with respect to each
Note relevant Insured Person shall expire immediately on the earlier of the following events;
· In case of policy cancellation, due to non-payment of the instalment within grace ü Upon the death of the Insured Person: This also means that in case of family
period, Company will refund the premium as per the cancellation table. floater policy, the cover for the surviving members of the family will continue,
· If Instalment facility is opted for 2 year and 3 year term policies, the full premium subject to other terms of the policy
applicable for 2 year or 3 year terms should be paid half yearly within the expiry of ü Upon exhaustion of Basic Sum Insured under the policy as a whole
the first year.
25. Policy Disputes: Any dispute concerning the interpretation of the terms, conditions,
14. Possibility of Revision of Terms of the Policy lncluding the Premium Rates: The limitations and/or exclusions contained herein is understood and agreed to by both the
Company, with prior approval of lRDAl, may revise or modify the terms of the policy Insured and the Company to be subject to Indian Law.
including the premium rates. The insured person shall be notified three months before
the changes are effected. 26. Arbitration: If any dispute or difference shall arise as to the quantum to be paid under
this Policy (liability being otherwise admitted) such difference shall independently of all
15. Free Look Period: The Free Look Period shall be applicable on new individual health other questions be referred to the decision of a sole arbitrator to be appointed in writing
insurance policies and not on renewals or at the time of porting/migrating the policy. by the parties to the dispute/difference, or if they cannot agree upon a single arbitrator
The insured person shall be allowed free look period of fifteen days from date of receipt within 30 days of any party invoking arbitration, the same shall be referred to a panel of
of the policy document to review the terms and conditions of the policy, and to return the three arbitrators, comprising of two arbitrators, one to be appointed by each of the
same if not acceptable. parties to the dispute/difference and the third arbitrator to be appointed by such two
lf the insured has not made any claim during the Free Look Period, the insured shall be arbitrators. Arbitration shall be conducted under and in accordance with the provisions
entitled to of the Arbitration and Conciliation Act, 1996.
i. a refund of the premium paid less any expenses incurred by the Company on It is clearly agreed and understood that no difference or dispute shall be referable to
medical examination of the insured person and the stamp duty charges or arbitration, as hereinbefore provided, if the Company has disputed or not accepted
ii. where the risk has already commenced and the option of return of the policy is liability under or in respect of this Policy.
exercised by the insured person, a deduction towards the proportionate risk It is hereby expressly stipulated and declared that it shall be a condition precedent to
premium for period of cover or any right of action or suit upon this Policy that the award by such arbitrator/ arbitrators
iii. where only a part of the insurance coverage has commenced, such proportionate of the amount of the loss or damage shall be first obtained.
premium commensurate with the insurance coverage during such period 27. Revision of Sum Insured: Reduction or enhancement of sum insured is permissible
16. Redressal of Grievance: Incase of any grievance the insured person may contact the only at the time of renewal.
Company through Enhancement of sum insured is subject to no claim being lodged or paid under this
Website : www.starhealth.in policy, Both the acceptance for enhancement and the amount of enhancement will be
E-mail : [email protected], [email protected] at the discretion of the Company. Where the sum insured is enhanced, the amount of
such additional sum insured including the respective sublimits shall be subject to the
Ph. No. : 044-69006900 | Toll Free No. 1800 425 2255 following terms
Senior Citizens may call at 044-69007500
Exclusion given below shall apply afresh from the date of such enhancement for the
Courier : 4th Floor, Balaji Complex, No.15, Whites Lane, Whites Road, increase in the sum insured, that is, the difference between the expiring policy sum
Royapettah, Chennai-600014 insured and the increased current sum insured;
lnsured person may also approach the grievance cell at any of the company's i. First 30 days exclusion as under - Code Excl 03
branches with the details of grievance. ii. 24 months with continuous coverage without break (with grace period) in respect
lf lnsured person is not satisfied with the redressal of grievance through one of the of diseases / treatments falling under exclusion - Code Excl 02
above methods, insured person may contact the grievance officer at 044-43664600. iii. 48 months of continuous coverage without break (with grace period) in respect of
For updated details of grievance officer, kindly refer the link Pre-Existing diseases as under exclusion - Code Excl 01
https://www.starhealth.in/grievance-redressal iv. 48 months of continuous coverage without break (with grace period) for diseases
lf lnsured person is not satisfied with the redressal of grievance through above / conditions diagnosed / treated irrespective of whether any claim is made or not in
methods, the insured person may also approach the office of lnsurance Ombudsman the immediately preceding three policy periods
of the respective area/region for redressal of grievance as per lnsurance Ombudsman The above applies to each relevant insured person
Rules 2017.
28. Relief under Section 80-D: Insured Person is eligible for relief under Section 80-D of
Grievance may also be lodged at IRDAI lntegrated Grievance Management System - the IT Act in respect of the premium paid by any mode other than cash.
https://bimabharosa.irdai.gov.in/
29. Important Note
17. Nomination: The policyholder is required at the inception of the policy to make a
nomination for the purpose of payment of claims under the policy in the event of death of a) Where the policy is issued for more than 1 year, the Basic Sum Insured including
the policyholder. Any change of nomination shall be communicated to the company in sublimits, cumulative bonus (if applicable), automatic restoration benefit (if applicable is
writing and such change shall be effective only when an endorsement on the policy is for each of the year), without any carry over benefit thereof. The said benefits / covers
made. ln the event of death of the policyholder, the Company will pay the nominee {as available for the 2nd year or 3rd year cannot be utilized in the 1st year itself. The terms,
named in the Policy Schedule/Policy Certificate/Endorsement (if any)} and in case there conditions and exceptions that appear in the Policy or in any Endorsement are part of
is no subsisting nominee, to the legal heirs or legal representatives of the policyholder the contract, must be complied with and applies to each policy year
whose discharge shall be treated as full and final discharge of its liability under the policy. b) Where the insured person has opted for floater policy, the sum insured floats
amongst the insured members
SPECIFIC CONDITIONS
c) The Policy Schedule and any Endorsement are to be read together and any word
18. The Insured Person/s shall obtain and furnish the Company with all original bills, or such meaning wherever it appears shall have the meaning as stated in the Act /
receipts and other documents upon which a claim is based and shall also give the Indian Laws
Company such additional information and assistance as the Company may require in
dealing with the claim. d) The terms, conditions and exceptions that appear in the Policy or in any
Endorsement are part of the contract and must be complied with. Failure to
19. All claims under this policy shall be payable in Indian currency. comply may result in the claim being denied
20. The premium payable under this policy shall be payable in advance. No receipt of e) The attention of the policy holder is drawn to our website www.starhealth.in for
premium shall be valid except on the official form of the company signed by a duly anti fraud policy of the company for necessary compliance by all stake holders
authorized official of the company. The due payment of premium and the observance 30. Automatic Restoration of Sum Insured (Applicable only for Section 2 under
and fulfillment of the terms, provision, conditions and endorsements of this policy by Plan A and Plan B)
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 There shall be automatic restoration of the Basic Sum Insured by 100% immediately
make any payment under this policy. No waiver of any terms, provisions, conditions, upon exhaustion of the basic sum insured, once during the policy period.
and endorsements of this policy shall be valid unless made in writing and signed by an It is made clear that such restored Sum Insured can be utilized only for illness
authorized official of the Company. /disease/treatment unrelated to the illness /diseases/treatment for which claim/s was
/were made.
21. Any medical practitioner authorized by the Company shall be allowed to examine the
Insured Person in case of any alleged injury or diseases requiring Hospitalization 31. Customer Service: If at any time the Insured Person requires any clarification or
when and as often as the same may reasonably be required on behalf of the Company assistance, the insured may contact No.1, New Tank Street, Valluvar Kottam High
at Company's cost. Road, Nungambakkam, Chennai 600034, during normal business hours.
List of Insurance Ombudsman
AHMEDABAD BENGALURU BHOPAL
Office of the Insurance Ombudsman, Office of the Insurance Ombudsman, Office of the Insurance Ombudsman, BHUBANESWAR
Jeevan Prakash Building, 6th floor, Jeevan Soudha Building, PID No. 57-27-N-19 1st floor, "Jeevan Shikha", Office of the Insurance Ombudsman,
Tilak Marg, Relief Road, Ahmedabad - 380 001. Ground Floor, 19/19, 24th Main Road, 60-B, Hoshangabad Road, 62, Forest park, Bhubaneswar – 751 009.
Tel.: 079 - 25501201/02/05/06 JP Nagar, Ist Phase, Bengaluru – 560 078. Opp. Gayatri Mandir, Bhopal – 462 011. Tel.: 0674 - 2596461 /2596455
Email: [email protected] Tel.: 080 - 26652048 / 26652049 Tel.: 0755 - 2769201 / 2769202 Email: [email protected]
JURISDICTION: Gujarat, Dadra & Nagar Email: [email protected] Email: [email protected] JURISDICTION: Odisha.
Haveli, Daman and Diu. JURISDICTION: Karnataka. JURISDICTION: Madhya Pradesh Chattisgarh.
CHANDIGARH
Office of the Insurance Ombudsman, CHENNAI DELHI ERNAKULAM
S.C.O. No. 101, 102 & 103, 2nd Floor, Batra Office of the Insurance Ombudsman, Office of the Insurance Ombudsman, Office of the Insurance Ombudsman,
Building, Sector 17 – D, Chandigarh – 160 017. Fatima Akhtar Court, 4th Floor, 453, 2/2 A, Universal Insurance Building, 2nd Floor, Pulinat Bldg.,
Tel.: 0172 - 2706196 / 2706468 Anna Salai, Teynampet, Chennai - 600 018. Asaf Ali Road, New Delhi – 110 002. Opp. Cochin Shipyard, M. G. Road,
Email: [email protected] Tel.: 044 - 24333668 / 24335284 Tel.: 011 - 23232481/23213504 Ernakulam - 682 015.
JURISDICTION: Punjab, Haryana Email: [email protected] Email: [email protected] Tel.: 0484 - 2358759 / 2359338
(excluding Gurugram, Faridabad, Sonepat JURISDICTION: Tamil Nadu, Puducherry JURISDICTION: Delhi & following Districts Email: [email protected]
and Bahadurgarh), Himachal Pradesh, Town and Karaikal (which are part of of Haryana - Gurugram, Faridabad, JURISDICTION: Kerala, Lakshadweep,
Union Territories of Jammu & Kashmir, Puducherry). Sonepat & Bahadurgarh. Mahe-a part of Union Territory of Puducherry.
Ladakh & Chandigarh.
GUWAHATI HYDERABAD JAIPUR KOLKATA
Office of the Insurance Ombudsman, Office of the Insurance Ombudsman, Office of the Insurance Ombudsman, Office of the Insurance Ombudsman,
Jeevan Nivesh, 5th Floor, Nr. Panbazar over 6-2-46, 1st floor, "Moin Court", Lane Opp. Saleem Jeevan Nidhi – II Bldg., Gr. Floor, Hindustan Bldg. Annexe, 7th Floor,
bridge, S.S. Road, Guwahati – 781001(ASSAM). Function Palace, A. C. Guards, Lakdi-Ka-Pool, 4, C.R. Avenue, Kolkata - 700 072.
Bhawani Singh Marg, Jaipur - 302 005.
Tel.: 0361 - 2632204 / 2602205 Hyderabad - 500 004. Tel.: 040 - 23312122 Tel.: 033 - 22124339 / 22124340
Tel.: 0141 - 2740363 Email: [email protected]
Email: [email protected] Email: [email protected]
Email: [email protected] JURISDICTION: West Bengal, Sikkim,
JURISDICTION: Assam, Meghalaya, Manipur, JURISDICTION: Andhra Pradesh, Telangana,
Mizoram, Arunachal Pradesh, Nagaland and Tripura. Yanam and part of Union Territory of Puducherry. JURISDICTION: Rajasthan. Andaman & Nicobar Islands.
LUCKNOW NOIDA
PATNA
Office of the Insurance Ombudsman, Office of the Insurance Ombudsman,
Office of the Insurance Ombudsman,
6th Floor, Jeevan Bhawan, Phase-II, Bhagwan Sahai Palace
2nd Floor, Lalit Bhawan,
Nawal Kishore Road, Hazratganj, 4th Floor, Main Road, Naya Bans, Sector 15,
Bailey Road, Patna 800 001.
Lucknow - 226 001. MUMBAI Distt: Gautam Buddh Nagar, U.P-201301.
Tel.: 0612-2547068
Tel.: 0522 - 2231330 / 2231331 Office of the Insurance Ombudsman, Tel.: 0120-2514252 / 2514253
Email: [email protected]
Email: [email protected] 3rd Floor, Jeevan Seva Annexe, Email: [email protected]
JURISDICTION: Bihar, Jharkhand.
JURISDICTION: Districts of Uttar Pradesh: S. V. Road, Santacruz (W), JURISDICTION: State of Uttarakhand and
Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Mumbai - 400 054. the following Districts of Uttar Pradesh:
PUNE
Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Tel.: 69038821/23/24/25/26/27/28/29/30/31 Agra, Aligarh, Bagpat, Bareilly, Bijnor,
Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Budaun, Bulandshehar, Etah, Kannauj, Office of the Insurance Ombudsman,
Email: [email protected] Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s.
Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Mainpuri, Mathura, Meerut, Moradabad,
JURISDICTION: Goa, Mumbai Metropolitan 195 to 198, N.C. Kelkar Road, Narayan Peth,
Lakhimpur, Bahraich, Barabanki, Raebareli, Muzaffarnagar, Oraiyya, Pilibhit, Etawah,
Region (excluding Navi Mumbai & Thane). Pune – 411 030. Tel.: 020-41312555
Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Farrukhabad, Firozbad, Gautam Buddh
Balrampur, Basti, Ambedkarnagar, Sultanpur, nagar, Ghaziabad, Hardoi, Shahjahanpur, Email: [email protected]
Maharajgang, Santkabirnagar, Azamgarh, Hapur, Shamli, Rampur, Kashganj, JURISDICTION: Maharashtra, Areas of Navi
Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Sambhal, Amroha, Hathras, Mumbai and Thane (excluding Mumbai
Chandauli, Ballia, Sidharathnagar. Kanshiramnagar, Saharanpur. Metropolitan Region).
Kindly refer our website, for future updates in Ombudsman address
Benefit Illustration in respect of Policies offered on Individual and Family Floater Basis - Plan A
Coverage opted on individual basis Coverage opted on individual basis covering Coverage opted on family floater basis with
covering each member of the family multiple members of the family under a single policy overall Sum insured
separately (at a single point of time) (Sum insured is available for each member of the family) (Only one sum insured is available for the entire family)
Age
of the
Members Premium or
insured Premium consolidated Premium
Floater
(in yrs) Premium Sum Insured Premium Discount, After Sum Insured premium for After Sum Insured
Discount,
(Rs.) (Rs.) (Rs.) (if any) Discount (Rs.) all members Discount (Rs.)
(if any)
(Rs.) of family (Rs.)
(Rs.)
Illustration - 1
64 37,205 5,00,000 37,205 37,205 5,00,000
Nil 67,618 15,798 51,820 5,00,000
58 30,413 5,00,000 30,413 30,413 5,00,000
Total Premium for all members of the family is Total Premium for all members of the family is Total Premium when policy is opted on floater basis is
Rs.67,618/-, when each member is covered separately. Rs.67,618/-, when they are covered under a single policy. Rs.51,820/-,
Sum insured available for each individual is Sum insured available for each family member is Sum insured of Rs.5,00,000/- is available for the entire family
Rs.5,00,000/- Rs.5,00,000/- (2A)
Illustration - 2
47 22,983 5,00,000 22,983 22,983 5,00,000
Nil 43,216 11,039 32,177 5,00,000
44 20,233 5,00,000 20,233 20,233 5,00,000
Total Premium for all members of the family is Total Premium for all members of the family is Total Premium when policy is opted on floater basis is
Rs.43,216/-, when each member is covered separately. Rs.43,216/-, when they are covered under a single policy. Rs.32,177/-
Sum insured available for each individual is Sum insured available for each family member is Sum insured of 5,00,000/- is available for the entire family
Rs.5,00,000/- Rs.5,00,000/- (2A)
Note: Premium rates specified in the above illustration are standard premium rates without considering any loading. Also, the premium rates are exclusive of taxes applicable.
A - Adult
ITEMS THAT ARE TO BE SUBSUMED INTO ROOM CHARGES
SI.NO. ITEM SI.NO. ITEM
1 BABY CHARGES (UNLESS SPECIFIED/INDICATED) 20 LUXURY TAX

2 HAND WASH 21 HVAC
3 SHOE COVER 22 HOUSE KEEPING CHARGES
4 CAPS 23 AIR CONDITIONER CHARGES
5 CRADLE CHARGES 24 IM IV INJECTION CHARGES
6 COMB 25 CLEAN SHEET
7 EAU-DE-COLOGNE / ROOM FRESHNERS 26 BLANKET / WARMER BLANKET
8 FOOT COVER 27 ADMISSION KIT
9 GOWN 28 DIABETIC CHART CHARGES
10 SLIPPERS 29 DOCUMENTATION CHARGES / ADMINISTRATIVE EXPENSES
11 TISSUE PAPER 30 DISCHARGE PROCEDURE CHARGES
12 TOOTH PASTE 31 DAILY CHART CHARGES
13 TOOTH BRUSH 32 ENTRANCE PASS / VISITORS PASS CHARGES
14 BED PAN 33 EXPENSES RELATED TO PRESCRIPTION ON DISCHARGE
15 FACE MASK 34 FILE OPENING CHARGES
16 FLEXI MASK 35 INCIDENTAL EXPENSES / MISC. CHARGES (NOT EXPLAINED)
17 HAND HOLDER 36 PATIENT IDENTIFICATION BAND / NAME TAG
18 SPUTUM CUP
37 PULSEOXYMETER CHARGES
19 DISINFECTANT LOTIONS
ITEMS THAT ARE TO BE SUBSUMED INTO PROCEDURE CHARGES
1 HAIR REMOVAL CREAM 13 SURGICAL DRILL

2 DISPOSABLES RAZORS CHARGES (for site preparations) 14 EYE KIT
3 EYE PAD 15 EYE DRAPE
4 EYE SHEILD 16 X-RAY FILM
5 CAMERA COVER 17 BOYLES APPARATUS CHARGES
6 DVD, CD CHARGES 18 COTTON
7 GAUSE SOFT 19 COTTON BANDAGE
8 GAUZE 20 SURGICAL TAPE
9 WARD AND THEATRE BOOKING CHARGES 21 APRON
10 ARTHROSCOPY AND ENDOSCOPY INSTRUMENTS 22 TORNIQUET
11 MICROSCOPE COVER
23 ORTHOBUNDLE, GYNAEC BUNDLE
12 SURGICAL BLADES, HARMONICSCALPEL,SHAVER
ITEMS THAT ARE TO BE SUBSUMED INTO COSTS OF TREATMENT
1 ADMISSION / REGISTRATION CHARGES 10 HIV KIT

2 HOSPITALISATION FOR EVALUATION / DIAGNOSTIC PURPOSE 11 ANTISEPTIC MOUTHWASH
3 URINE CONTAINER 12 LOZENGES
4 BLOOD RESERVATION CHARGES AND ANTE NATAL BOOKING CHARGES 13 MOUTH PAINT
5 BIPAP MACHINE 14 VACCINATION CHARGES
6 CPAP / CAPD EQUIPMENTS 15 ALCOHOL SWABS
7 INFUSION PUMP — COST 16 SCRUB SOLUTION / STERILLIUM
8 HYDROGEN PEROXIDE / SPIRIT / DISINFECTANTS ETC 17 GLUCOMETER & STRIPS
9 NUTRITION PLANNING CHARGES - DIETICIAN CHARGES - DIET CHARGES 18 URINE BAG

Diabetes Safe Insurance Policy

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STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

DIABETES SAFE INSURANCE POLICY

PREAMBLE Hospitalization: Hospitalization means admission in a Hospital for a minimum period of 24

SI.NO. ITEM SI.NO. ITEM

1 BABY CHARGES (UNLESS SPECIFIED/INDICATED) 20 LUXURY TAX

ITEMS THAT ARE TO BE SUBSUMED INTO PROCEDURE CHARGES

SI.NO. ITEM SI.NO. ITEM

1 HAIR REMOVAL CREAM 13 SURGICAL DRILL

ITEMS THAT ARE TO BE SUBSUMED INTO COSTS OF TREATMENT

SI.NO. ITEM SI.NO. ITEM

1 ADMISSION / REGISTRATION CHARGES 10 HIV KIT

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