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As per amendment in the Income Tax Rules, PAN or Aadhaar are to be mandatorily quoted for cash deposit or withdrawal aggregating to Rupees twenty lakhs or more in a FY. Please update your PAN or Aadhaar. Kindly reach out to the Bank’s contact center on 1800 10 888 or visit the nearest IDFC FIRST Bank branch for further queries.
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Coverage up to 2cr
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Automatic restoration for unlimited no. of times in a policy year
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Up to 9 family members can be covered
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Up to 20% wellness discount on renewal premium
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Coverage up to 2cr
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Automatic restoration for unlimited no. of times in a policy year
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Up to 9 family members can be covered
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Up to 20% wellness discount on renewal premium
Star Health Insurance
Star Health Assure is a health insurance policy offered by Star Health and Allied Insurance Company Limited. Policy covers hospitalization expenses incurred for any illness, accident, or injury. It acts as a protective shield for savings and healthcare, so you and your family can live a happy, fulfilling life. By paying a premium to the insurer, you can save yourself and your family from dire financial stress.
What's Included?
Star Health Assure Insurance Policy is a unique indemnity health insurance product which covers expenses incurred on hospitalization due to Illness or Accident. Some of the innovative benefits offered are: -
Home care treatment for the specified conditions
Ayush Treatment covered upto the sum insured
Non-Medical items (Consumables) like gloves, food charges etc are covered upto the sum insured
Modern Treatments are covered upto the sum insured
Delivery Expenses, Assisted Reproduction Treatment (For Sub-fertility)
Treatment of New Born Baby are covered with sublimits
In Utero Fetal Surgery / Intervention is covered upto the Sum Insured
Rehabilitation and Pain management is covered.
Option is available to choose Deductible
Plan Benefit
Star Health Assure Insurance Policy is a unique indemnity health insurance product which covers expenses incurred on hospitalization due to Illness or Accident. Some of the innovative benefits offered are: -
· Policy Type - This policy can be availed either on an Individual or Floater basis.
· Medical Examination - No pre-medical check-up is required to avail this policy. However, those who declare adverse medical history may be subjected to pre-medical check-up at Company's cost
· Room Rent - Room, boarding and nursing expenses incurred during in-patient hospitalisation are covered up to 1% of the Sum Insured per day for Rs. 5 lakh Sum Insured; any room (except suite or above category) for Rs. 10/15/20/25 lakh Sum Insured options; and any room for Rs. 50/75/100/200 lakh Sum Insured options
· Domiciliary Hospitalization - Expenses incurred for domiciliary hospitalisation, including AYUSH on the advice of a medical practitioner for a period exceeding three days are covered.
· Day Care Procedures- Medical treatments and surgical procedures that require less than 24 hours of hospitalisation due to technological advancements are covered.
· Coverage for Non-medical Items - If there is an admissible claim under the policy, then non-medical items specified in this policy will become payable.
· Automatic Restoration of Sum Insured for an unlimited no. of times in a policy year
· Home care treatment for the specified conditions
· Ayush Treatment covered upto the sum insured
· Modern Treatments are covered - Expenses incurred for modern treatments such as Oral Chemotherapy, Intra Vitreal injections, Robotic Surgeries, etc. are covered up to the Sum Insured.
· Delivery Expenses, Assisted Reproduction Treatment (For Sub-fertility)
· Treatment of New Born Baby are covered with sublimits
· In Utero Fetal Surgery / Intervention is covered upto the Sum Insured
· Organ Donor Expenses - In-patient hospitalisation expenses incurred for organ transplantation from the Donor to the recipient insured person are payable provided the claim for transplantation is payable. In addition, the expenses incurred by the Donor, (if any) for the complications that necessitate a Redo Surgery / ICU admission will be covered.
· Wellness discount is available up to 20% on the renewal premium
· Assured health checkup benefit is available every year (Irrespective of claim)
· Rehabilitation and Pain management is covered.
· Option is available to choose Deductible
· Road Ambulance - This policy covers ambulance charges for admission in hospital, for shifting from one hospitals to another for better medical treatment and from hospital to residence (if it is in the same city).
· Air Ambulance - Air ambulance expenses are covered up to 10% of the Sum Insured per policy year, provided the situation requires an immediate hospitalisation of the insured person and ground transportation cannot be provided.
· Compassionate Travel - The air transportation expenses incurred up to Rs. 10,000/- are payable for an immediate family member to travel to the hospital in case of hospitalisation of the insured person for life-threatening emergency times, at the place away from insured’s usual place of residence.
· Repatriation of Mortal Remains - The expenses incurred for the repatriation of mortal remains of the insured person are covered up to Rs. 15,000/- in a policy year.
· Treatment in Valuable Service Providers Network - In the event of hospitalisation in Valuable Service Provider, then a lump-sum of 1% of the Sum Insured subject to a maximum of Rs. 5,000/- per policy period is provided.
· Cumulative Bonus - Cumulative bonus is provided at 25% of the Sum Insured for each claim-free year subject to a maximum of 100% of the Sum Insured.
Eligibility
Eligibility
- Floater Sum Insured · For Adults – Minimum - 18 years & Maximum - Up to 75 years
- For Dependent Children - Minimum - 16 days & Maximum - Up to 17 years
- In case of dependent children, at the time of renewal when they become 18 yrs of age, such children will be considered as Adult and he/she can continue under floater sum insured till he/she gets married.
- Individual Sum Insured · Minimum - 91 days and Maximum upto 75 years, provided Good Health declaration, Pediatrician Opinion and the proposal should routed through our Central Medical Underwriting Team
- Renewability: Lifetime
Documentation
Health Insurance Proposal form
KYC Documents: CKYC Detail/ID Proof & address proof (PAN & Aadhar)
For Net banking – Not Applicable
For Mobile banking – Not Applicable
Claims
Condition Precedent to Admission of Liability: The terms and conditions of the policy must be fulfilled by the insured person for the Company to make any payment for claim(s) arising under the policy
Documents for Cashless Treatment
- Call the 24 hour help-line for assistance - 1800 425 2255/1800 102 4477, Senior Citizens may call at 044 40020888
- Inform the ID number for easy reference
- On admission in the hospital, produce the ID Card issued by the Company at the Hospital Helpdesk
- Obtain the Pre-authorisation Form from the Hospital Help Desk, complete the Patient Information and resubmit to the Hospital Help Desk
- The Treating Doctor will complete the hospitalization/ treatment information and the hospital will fill up expected cost of treatment. This form is submitted to the Company
- The Company will process the request and call for additional documents / clarifications if the information furnished is inadequate
- Once all the details are furnished, the Company will process the request as per the terms and conditions as well as the exclusions therein and either approve or reject the request based on the merits
- In case of emergency hospitalization information to be given within 24 hours after hospitalization
- Cashless facility can be availed only in networked Hospitals. For details of Networked Hospitals, the insured may visit www.starhealth.in or contact the nearest branch In non-network hospitals payment must be made up-front and then reimbursement will be effected on submission of documents.
- Note: The Company reserves the right to call for additional documents wherever required. Denial of a Pre-authorization request is in no way to be construed as denial of treatment or denial of coverage. The Insured Person can go ahead with the treatment, settle the hospital bills and submit the claim for a possible reimbursement.
For Reimbursement claims: Time limit for submission of:
Sr. No Type of Claim Prescribed Time Limit 1 Reimbursement of hospitalization, day care and pre hospitalization expenses Claim must be filed within 15 days from the date of discharge from the hospital 2 Reimbursement of Post Hospitalization Within 15 days from completion of 90 days from the date of discharge from hospital
Notification of Claim: Upon the happening of the event, notice with full particulars shall be sent to the Company within 24 hours from the date of occurrence of the event irrespective of whether the event is likely to give rise to a claim under the policy or not.
- Note:Above conditions are precedent to admission of liability under the policy. However the Company will examine and relax the time limit mentioned in these conditions depending upon the merits of the case.
Documents to be submitted for Reimbursement: The reimbursement claim is to be supported with the following documents and submitted within the prescribed time limit;
- Duly completed claim form, and
- Pre Admission investigations and treatment papers
- Discharge Summary from the hospital
- Cash receipts from hospital, chemists
- Cash receipts and reports for tests done
- Receipts from doctors, surgeons, anesthetist
- Certificate from the attending doctor regarding the diagnosis
- Copy of PAN card
- Note:Call the 24 hour help-line for assistance - 1800 425 2255 / 1800 102 4477, Senior Citizens may call at 044 40020888
Exclusions
STANDARD EXCLUSIONS
Pre-Existing Diseases –
A. Applicable for 3 year policy term: Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 30 months of continuous coverage after the date of inception of the first policy with insurer. If the insured chooses for 1 year or 2 year policy term Applicable for 1 year and 2 year policy term: Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer
B. In case of enhancement of sum insured the exclusion shall apply afresh to the extent of sum insured increase.
C. If the Insured Person is continuously covered without any break as defined under the portability norms of the extant IRDAI (Health Insurance) Regulations, then waiting period for the same would be reduced to the extent of prior coverage.
D. Applicable for 3 year policy term: Coverage under the policy after the expiry of 30 months for any pre-existing disease is subject to the same being declared at the time of application and accepted by Insurer. Applicable for 1 year and 2 year policy term:Coverage under the policy after the expiry of 36 months for any pre-existing disease is subject to the same being declared at the time of application and accepted by Insurer.
2. Specified disease/procedure waiting period
A. Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of 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.
B. In case of enhancement of sum insured the exclusion shall apply afresh to the extent of sum insured increase.
C. If any of the specified disease/procedure falls under the waiting period specified for pre-existing diseases, then the longer of the two waiting periods shall apply.
D. The waiting period for listed conditions shall apply even if contracted after the policy or declared and accepted without a specific exclusion.
E. If the Insured Person is continuously covered without any break as defined under the applicable norms on portability stipulated by IRDAI, then waiting period for the same would be reduced to the extent of prior coverage.
F. List of specific diseases/procedures
1. Treatment of Cataract and diseases of the anterior and posterior chamber of the Eye, Diseases of ENT, Diseases related to Thyroid, Benign diseases of the breast.
2. Subcutaneous Benign Lumps, Sebaceous cyst, Dermoid cyst, Mucous cyst lip / cheek, Carpal Tunnel Syndrome, Trigger Finger, Lipoma, Neurofibroma, Fibroadenoma, Ganglion and similar pathology
3. All treatments (Conservative, Operative treatment) and all types of intervention for Diseases related to Tendon, Ligament, Fascia, Bones and Joint Including Arthroscopy and Arthroplasty / Joint Replacement [other than caused by accident]
4. All types of treatment for Degenerative disc and Vertebral diseases including Replacement of bones and joints and Degenerative diseases of the Musculo-skeletal system, Prolapse of Intervertebral Disc (other than caused by accident),
5. All treatments (conservative, interventional, laparoscopic and open) related to Hepato-pancreato-biliary diseases including Gall bladder and Pancreatic calculi. All types of management for Kidney calculi and Genitourinary tract calculi.
6. All types of Hernia,
7. DesmoidTumor, Umbilical Granuloma, Umbilical Sinus, Umbilical Fistula,
8. All treatments (conservative, interventional, laparoscopic and open) related to all Diseases of Cervix, Uterus, Fallopian tubes, Ovaries, Uterine Bleeding, Pelvic Inflammatory Diseases
9. All Diseases of Prostate, Stricture Urethra, all Obstructive Uropathies,
10. Benign Tumours of Epididymis, Spermatocele, Varicocele, Hydrocele,
11. Fistula, Fissure in Ano, Hemorrhoids, Pilonidal Sinus and Fistula, Rectal Prolapse, Stress Incontinence
12. Varicose veins and Varicose ulcers
13. All types of transplant and related surgeries.
14. Congenital Internal disease / defect [except for Unborn in Coverage (15) and New Born in Coverage (17)] Note: Waiting period for the following benefits are as follows
a. Delivery Expenses Cover: Benefit under this section is subject to a waiting period of 24 months from the date of first commencement of Star Health Assure Insurance policy and its continuous renewal thereof with the Company
b. In Utero Fetal Surgery / Intervention: The Company will pay the expenses incurred for In Utero Fetal Surgeries and Procedures mentioned below after the waiting period of 24 months from the date of inception of this policy Note: The above mentioned waiting period will not apply for treatment related to congenital Internal disease / defects for the Unborn.
c. Assisted Reproduction Treatment:Awaiting period of 24 months from the date of first inception of this policy with the Company for the insured person
d. New Born Baby Cover: This cover is available only If Delivery Expenses Claim is paid under this policy or if Mother is covered under this policy for a continuous period of 12 months without break 3. 30-day waiting period
A. 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, provided the same are covered B. This exclusion shall not, however, apply if the Insured Person has Continuous Coverage for more than twelve months C. The within referred waiting period is made applicable to the enhanced sum insured in the event of granting higher sum insured subsequently 4. Investigation & Evaluation
A. Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded
B. Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment are excluded
5. Rest Cure, rehabilitation(except to the extent covered under Coverage 28) and respite care - Code Excl 05: Expenses related to any admission primarily for enforced bed rest and not for receiving treatment. This also includes: i. Custodial care either at home or in a nursing facility for personal care such as help with activities of daily living such as bathing, dressing, moving around either by skilled nurses or assistant or non-skilled persons ii. Any services for people who are terminally ill to address physical, social, emotional and spiritual needs
6. Obesity/ Weight Control - Code Excl 06: Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions;
A. Surgery to be conducted is upon the advice of the Doctor
B. The surgery/Procedure conducted should be supported by clinical protocols
C. The member has to be 18 years of age or older and D. Body Mass Index(BMI); 1. greater than or equal to 40 or 2. greater than or equal to 35 in conjunction with any of the following severe co-morbidities following failure of less invasive methods of weight loss: a. Obesity-related cardiomyopathy b. Coronary heart disease c. Severe Sleep Apnea d. Uncontrolled Type2 Diabetes
7. Change-of-Gender treatments: Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex.
8. Cosmetic or plastic Surgery - Code Excl 08: Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an Accident, Burn(s) or Cancer or as part of medically necessary treatment to remove a direct and immediate health risk to the insured. For this to be considered a medical necessity, it must be certified by the attending Medical Practitioner.
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, including but not limited to, para-jumping, rock climbing, mountaineering, rafting, motor racing, horse racing or scuba diving, hand gliding, sky diving, deep-sea diving.
10. Breach of law - Code Excl 10: Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent.
11. Excluded Providers - Code Excl 11: Expenses incurred towards treatment in any hospital or by any Medical Practitioner or any other provider specifically excluded by the Insurer and disclosed in its website / notified to the policyholders are not admissible. However, in case of life threatening situations or following an accident, expenses up to the stage of stabilization are payable but not the complete claim.
12. Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof - Code Excl 12
13. Treatments received in health hydros, nature cure clinics, spas or similar establishments or private beds registered as a nursing home attached to such establishments or where admission is arranged wholly or partly for domestic reasons - Code Excl 13
14. Dietary supplements and substances that can be purchased without prescription, including but not limited to Vitamins, minerals and organic substances unless prescribed by a medical practitioner as part of hospitalization claim or day care procedure - Code Excl 14
15. Refractive Error - Code Excl 15:Expenses related to the treatment for correction of eyesight due to refractive error less than 7.5 dioptres.
16. Unproven Treatments - Code Excl 16: Expenses related to any unproven treatment, services and supplies for or in connection with any treatment. Unproven treatments are treatments, procedures or supplies that lack significant medical documentation to support their effectiveness.
17. Sterility and Infertility (except to the extent covered under Coverage 16) - Code Excl 17: Expenses related to sterility and infertility. This includes; a. Any type of contraception, sterilization b. Assisted Reproduction services including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT,ICSI c. Gestational Surrogacy d. Reversal of sterilization
18. Maternity - Code Excl 18 (except to the extent covered under Coverage 14) i. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; ii. Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period
19. Circumcision (unless necessary for treatment of a disease not excluded under this policy or necessitated due to an accident), Preputioplasty, Frenuloplasty, Preputial Dilatation and Removal of SMEGMA-Code Excl 19
20. Congenital External Condition / Defects / Anomalies(except to the extent covered under Coverage17) - Code Excl 20
21. Convalescence, general debility, run-down condition, Nutritional deficiency states - Code Excl 21 Star Health Assure Insurance Policy Unique Identification No.: SHAHLIP23131V022223 PROS / SHA / V.2 / 2022 10 of 32
22. Intentional self -injury - Code Excl 22
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
24. Injury or disease caused by or contributed to by nuclear weapons/ materials - Code Excl 25
25. Expenses incurred on Enhanced External Counter Pulsation Therapy and related therapies, Chelation therapy, Hyperbaric Oxygen Therapy, Rotational Field Quantum Magnetic Resonance Therapy, VAX-D, Low level laser therapy, Photodynamic therapy and such other therapies similar to those mentioned herein under this exclusion - Code Excl 26
26. Unconventional, Untested, Experimental therapies - Code Excl 27
27. Autologous derived Stromal vascular fraction, Chondrocyte Implantation, Procedures using Platelet Rich plasma and Intra articular injection therapy - Code Excl 28
28. Biologicals, except when administered as an in-patient, when clinically indicated and hospitalization warranted - Code Excl 29
29. Inoculation or Vaccination (except for post–bite treatment and for medical treatment for therapeutic reasons) - Code Excl 31
30. Cost of spectacles and contact lens, hearing aids, Cochlear implants and procedures, walkers and crutches, wheel chairs, CPAP, BIPAP, Continuous Ambulatory Peritoneal Dialysis, infusion pump and such other similar aids - Code Excl 35
31. Any hospitalization which are not medically necessary / does not warrant hospitalization - Code Excl 36
32. Existing disease/s, disclosed by the insured and mentioned in the policy schedule (based on insured's consent), for specified ICD codes - Code Excl 38
Special Exclusions
The Company shall not be liable to make any payments under this policy in respect of any expenses what so ever incurred by the insured person in connection with or in respect of:
1. Pre and Post treatment expenses
2. Sub-fertility services that are deemed to be unproven, experimental or investigational
3. Services not in accordance with standards of good medical practice and not uniformly recognized and professionally endorsed by the general medical community at the time it is to be provided.
4. Reversal of voluntary sterilization
5. Treatment undergone for second or subsequent pregnancies except where the child from the first delivery/ previous deliveries is/are not alive at the time of treatment
6. Payment for services rendered to a surrogate
7. Costs associated with cryopreservation and storage of sperm, eggs and embryos
8. Selective termination of an embryo.
9. Services done at unrecognized centre
10. Surgery / procedures that enhances fertility like Tubal Occlusion, Bariatric Surgery, Diagnostic Laparoscopy with Ovarian Drilling and such other similar surgery / procedures
Disclaimer
This website is a user interface platform owned and maintained by IDFC FIRST Bank to provide information and to communicate better with the user who may be interested in knowing about the products and services offered by the company & buying them.
Star Health product details are mentioned solely for information and educational purposes. Neither this website nor the contents available can be construed as a professional advice and before making any decision based on the information the user shall consult a professional advisor.
Star Health has taken all necessary precautions to ensure that the information contained in this website is current, accurate and complete as on the date of Publication. No representations or warranties are made (express or implied) as to the reliability, accuracy or completeness of such information. Star Health cannot be held liable for any loss arising directly or indirectly from the use of, or any action taken in on any information appearing on this website.
Insurance is the subject matter of solicitation. "IDFC FIRST Bank having its registered office at KRM Tower, 7th Floor, No. 1, Harrington Road, Chetpet, Chennai – 600031, is authorized by the Insurance Regulatory and Development Authority of India to act as a Corporate Agent of Star Health & Allied Insurance Co. Ltd. for procuring or soliciting health insurance business under license number CA0106”. The purchase of Insurance products by IDFC FIRST Bank customers is purely on voluntary and not linked to availing of any other services from the bank.
