The concerns over health are on the rise. On one side, there are life-threatening ailments, on the other side, there are ever increasing medical expenses. But when it comes to life and health, your most valuable asset, you should never settle for anything less than complete protection. This is why Star Health and allied Insurance Co.Ltd., and Shriram Life Insurance Co.Ltd., bring to you Star Shri Individual Care Insurance-a policy which offers both Life and Health covers.
Star Shri Individual Care Insurance is a product that provides for regular hospitalization benefits like any other medical insurance policy under section 1. Moreover, this product also provides for payment of lump-sum in the event of death, under section 2.
Coverage under Section 1 is provided by Star Health and Allied Insurance Co. Ltd., and coverage under Section 2 is provided by Shriram Life Insurance Co.Ltd.
POLICY BENEFITS Section 1
Hospitalization Cover: In-patient hospitalization expenses for a minimum of 24 hours. Includes room rent and boarding at 2% of sum insured subject to a maximum of Rs.4000/- per day. Nursing Expenses
Surgeon’s fees, Consultant’s fees, Anesthetist’s and specialist’s fees. Cost of medicines and drugs.
Emergency ambulance charges for transporting the insured patient to the hospital up to a sum of Rs.750/- per hospitalization and overall limit of Rs.1500/- per policy period.
Section 2
Pure Term Life Insurance Cover: Lump-sum in the event of death.
It pays the nominee the stated sum assured in case of death of the policyholder during the policy term of the contract.
Waiting Period: A waiting period of 90 days from the date of acceptance of the policy. Only accidental death benefits are covered during this period. In this period, no death benefit is payable in case of death due to other causes. After the expiry of this period, death due to any causes (subject to mandatory exclusions) are payable.
Policy term: 60 yrs less age at entry (fixed). Note:
This policy does not acquire any surrender value.
The policy holder is not entitled to any loan under this policy. PRE-EXISTING DISEASES/CONDITIONS
Pre-existing diseases are covered after 48 months of continuous insurance with the company under health section.
PRE & POST – HOSPITALIZATION (APPLICABLE FOR SECTION 1)
Pre-hospitalization medical expenses up to 30 days prior to the date of admission.
Post-hospitalization: a lump sum calculated at 7% of the hospitalization expenses (exclusive room charges) subject to a maximum of Rs.5000/-.
NON – ALLOPATHIC TREATMENT (APPLICABLE FOR SECTION 1)
Up to 25% of sum insured subject to a maximum of Rs.25000/- per occurrence, per policy period. NON CLAIM DISCOUNT (APPLICABLE FOR SECTION 1)
Discount at 5% for every claim free year subject to a maximum of 25%. ELIGIBILITY
Proposals from persons between 18 years last birthday and 50 years last birthday are eligible( Under section 1 dependent children from 5 months can be covered only if one of their parent is covered). Renewals however are accepted up to 60 years. Beyond 60 years, health insurance can be renewed under any of the similar health insurance schemes offered by the company. Life cover would, however, not be available beyond 60 years.
POLICY PREMIUM
Health Insurance Section SUM
INSURED(Rs)
AGE 5months-35
years
36-45 years 46-55 years 56-60 years
100000 1200 1350 2447 3000 150000 1800 2000 3400 4200 200000 2350 2600 4583 5300 250000 2800 3150 5548 7200 300000 3300 3650 6170 8200 350000 3750 4150 7408 10196 400000 4200 4500 8700 11451 500000 4900 5400 10700 13958
NOTE: Premium Figures are excluding service tax. Pure Life Term Insurance Cover
With Standard age proof SUM ASSURED(Rs) AGE
18-35 years 36-45 years 45-50 years
100000 900 1100 1400
200000 1300 1900 2400
300000 1800 2700 3500
Without Standard Age proof SUM ASSURED(Rs) AGE
18-35 years 36-45 years 46-50 years
100000 10000 1400 1700
200000 1600 2400 3100
300000 2300 3500 4400
500000 3500 5600 7200
NOTE: Premium figures are excluding service tax. Premium Rate Guarantee
Premium is reviewable on the 5th policy anniversary and every anniversary thereafter. However, premium rates can be changed only after approval of IRDA.
Standard Age Proof
School Certificate
College Certificate
Employer Certificate
Passport (issued after 01/04/1986)
Driving License (issued after 18/04/1993)
PAN Card
Birth Certificate/ Municipal birth certificate/certificate extract from municipal or other records made at the time of birth.
Baptism Certificate Non-Standard Age Proof
Ration Card
Voter ID Card
ESIC Card
Domicile Certificate in which the date of birth is mentioned
Certificate extract from the birth register maintained by the village panchayat stating the date of birth. This extract to be on letter head of the village panchayat with signature of the sarpanch along with the seal.
Marriage certificate of Christians issued by a Roman Catholic Church.
Life Insurance policy from any insurer. Grace Period
A grace period of 15 days from the date of first unpaid premium is available for payment of renewal premium. After expiry of grace period, the policy can’t be revived.
If death occurs within this period but before the payment of the premium then due, the policy shall be valid and the claim if admitted will be paid after deducting the said premium as also the unpaid premiums falling due before the next policy anniversary.
Free Look Period
If the policy holder is not satisfied with the ‘Term and Conditions’ of the policy, the policy can be returned to the Company within 15 days from the date of receipt of the policy. However, the company reserves the right to deduct medical examination fees, stamp duty charges for issue of the policy and proportionate risk premium for the period concerned.
TAX BENEFITS
Payment of premium by any mode other than cash for insurance under Section 1 is eligible for relief under Section 80D of the Income Tax Act.
Payment of premium for insurance under Section 2 is eligible for relief under Section 80C of the Income Tax Act.
EXCLUSIONS Section 1
Expenses for the treatment of any illness/diseases/condition which is pre-existing.
Treatment of illness/diseases/sickness contracted by the insured person during the first 30 days from the commencement date of this policy.
First two year’s exclusions: Cataract, Hysterectomy for Menorrhagia or Fibromyoma, Replacement surgery for knee and/or joint (other than caused by an accident). Prolapsed of intervertebral disc (other than caused by accident), various veins and varicose ulcers.
First year exclusions: Benign Prostate Hypertrophy, Hernia, Hydrocele, Fistula in anus, Piles, Sinusitis and related disorders, Congenital internal diseases/defects, removal of gallstones and renal stone.
Naturopathy treatment.
Expenses which are purely diagnostic in nature with no positive existence of any disease.
Expenses incurred for non-allopathic treatment.
Expenses which are mainly cosmetic in nature. Section 2
The life assured will not be entitled to any benefits for death directly or indirectly due to or caused, occasioned, accelerated or aggravated by any of the following:
If the life assured commits suicide, whether sane or insane, within one year from the date of acceptance of risk, the policy shall be void and no claim will be payable.
War , terrorism, invasion, act of foreign enemy, hostilities, civil war, martial law, rebellion revolution, insurrection, military or usurper declared or not.
Taking part in any act of a criminal nature, an assault, an illegal activity or any breach of law.
Treatment for injury or illness caused by avocations/activities such as hunting, mountaineering, steeple-chasing, professional sports, racing of any kind, scuba diving, aerial sports, activities such as hand-gliding, ballooning, deliberate exposure to exceptional danger.
Radioactivity contamination due to nuclear accidents.
Participation in aviation other than as a fare-paying passenger in an aircraft that is authorized by the relevant regulations to carry such passengers between established aerodromes.
CLAIMS PROCEDURE Section 1
Call the 24 hour helpline 1800 425 2255 and 1800 425 6116 for assistance.
Inform the ID number for easy reference.
In case of planned hospitalization, inform 24 hours prior to admission in the hospital.
In case of emergency hospitalization, information to be given within 24 hours after hospitalization.
Cashless facility can be availed at all our network hospitals.
In non-network hospitals payment must be made upfront and then reimbursement will be effected on submission of documents.
Section 2
Inform about the occurrence within 24 hours to Shriram Life at Toll Free No 1800 425 6116 or Star Health at Toll Free No 1800 425 2255.
Submit claim form along with required document.
The claims under this section will be serviced and settled by Shriram Life Insurance Company Limited. THE COMPANY
About Star
Star Health & Allied Insurance Co.Ltd., is a joint venture between Oman Insurance Company, UAE and leading NRIs and Indian business houses. It has a capital base of INR 303 crores that far exceeds the requirement to form a full-fledged general insurance company. As an exclusive Health Insurance Company is committed to setting international benchmarks in service and personal caring.
About Shriram
Shriram Life Insurance Company is the joint venture between the Shriram Group and the Sanlam Group. The Shriram Group is one of the largest and well-respected financial services conglomerates in India. The Group’s main line of activities in financial services includes chit fund, truck financing, consumer durable financing, stock broking and life insurance. Sanlam Life Insurance Limited, a part of Sanlam Group, is one of the largest providers of life Insurance in South Africa with 3.2 million individual policies under administration.
Prohibition of Rebates
Section 41 of Insurance Act
No person shall allow or offer to allow either directly or indirectly as inducement to take out renew or continue an insurance in respect of any kind of risk relating to lives or property in India any rebates of the whole or part of the commission payable on the premium show on the policy nor shall any person taking out renewing or continuing a policy accept any rebate except such rebates as may be allowed in accordance with the published prospectus or tables of the Insurer. Any person making default in complying with the provision of this section shall be punishable with fine, which may extend to five hundred rupees.
Section 45 of the Insurance Act 1938
No policy of life insurance effected before the commencement of this Act shall, after the expiry of two years from the date of commencement of this Act, and no policy of this Act shall, after the expiry of two years from the date on which it was effected, be called in question by an insurer on the ground that a statement made officer, or referee, or friend of the insured, or in any other document leading to the issue of policy, was in accurate or false, unless the insurer shows that such statement was on a material matter or suppressed fact which it was materials to disclose and that it was suppressed facts which it was materials to disclose.
STAR – SHRIRAM ADVANTAGES
No third Party Administrator; direct in-house claims settlement. Faster & hassle-free-claims settlement.
Cashless hospitalization.
Network of more than 4600 hospitals across India. Free expert medical consultation over phone. 24*7 toll-free helpline.
The global expertise of one of the biggest Life Insurance IMPORTANT NOTE
This product is jointly offered by Star Health & Allied Insurance Co.Ltd., and Shriram Life Insurance Co.Ltd.
Coverage under Section 1 is offered by Star Health & Allied Insurance Co.Ltd. Coverage under Section 2 is offered by Shriram Life Insurance Co. Ltd.
Each section of the policy is serviced by two different insurers namely Star Health & Allied Insurance Co Ltd, and Shriram Life Insurance Co. Ltd.
The customer, if he so desires, at the time of renewal can continue with either section, discontinuing the other section.
TO BUY THIS INSURANCE
