Family Health Optima Insurance Plan

Highlights

 

Single policy, wider coverage for whole family at an affordable premium.

Get extra sum insured (auto recharge) at no extra cost, up to 30%  of sum insured.

Health Checkup costs up to Rs.5,000/- for every block of 3 years of policy coverage.

Automatic restoration of entire Sum insured by 100%.

New-born baby cover from 16th day.

Donor expenses for organ transplantation.

Domiciliary Hospitalization Expenses for treatment exceeding 3 days.

Cover for over 400 day care procedures.

 

Benefits

 

Recharge Benefit:

This benefit provides additional indemnity upto specified limits, when the sum insured under the policy is exhausted / exceeded. This can be utilized for any claim payable under the policy.

 

More than 400 Day Care procedures

 

Expenses incurred towards cost of Health Check up

 

Coverage for New born Baby

 

Coverage for Domiciliary hospitalization treatments

 

Donor expenses for organ transplantation

 

Bonus:

Bonus in respect of a claim-free year of insurance is allowable upto the limits specified. The bonus so granted will be reduced in the same order in which it was given following a claim. However the Basic sum insured shall not be reduced.

 

 Automatic Restoration of Sum Insured:

 

Immediately upon exhaustion of the limit of coverage during the policy period, there shall be an automatic restoration of the basic sum insured by 100% where the sum insured is Rs.3,00,000/- and above.

 

Policy Benefits:

 

• Hospitalisation Cover Protects the insured for in – patient hospitalisation expenses for a minimum of 24 hrs.These expenses include room rent,nursing and boarding charges.
• Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees, Anesthesia, Blood, Oxygen, Operation Theatre charges, Cost of Pacemaker, Cost of Medicine and drugs etc.
• Ambulance charges for emergency transportation upto a sum of Rs.750/- per hospitalization and overall limit of Rs.1500/- per policy period.
• Pre Hospitalisation expenses upto 60 days prior to admission in the hospital.
• Post Hospitalisation expenses upto 90 days after discharge from the hospital.

 

Eligibility

 

 

• Any person aged between 18 years and 65 years, residing in India, can take this insurance.
• Beyond 65 years, It can be renewed for life time.
• Lifelong renewal. This policy is on floater basis.
• Child from 16th day of age can be covered as part of the family.
• The entire sum insured floats among all covered persons.
• Family : Proposer, spouse, dependent children from 16 days up to 25 years (those who are economically dependent on their parents)

 

General Terms

 

 

A co-payment of 20% of each and every claim applicable for fresh as well as renewal policies for insured persons whose age at the time of entry is above 60 years.

 

 

 

Pre-Existing Diseases/Illness:

Coverage available after 48 months of continuous insurance without break with any Indian insurance company.

 

 

 

Pre- Acceptance medical screening:

Persons above 50 years will be required to undergo pre-acceptance medical screening at the Company nominated centers, cost of which is currently borne by the company.

 

 

 

Tax Benefits:

Amount paid by any mode other than by cash for this insurance is eligible for relief under Section 80D of the Income Tax Act.

 

 

 

Free Look Period:

A free look period of 15 days from the date of receipt of the policy is available for reviewing the policy terms and conditions. In case insured is not satisfied he can seek cancellation of the policy and in such event the Company will allow refund of premium after adjusting the cost of pre-acceptance of medical screening , stamp duty charges and proportionate risk premium for the period concerned provided no claim has been made until such cancellation. Free look cancellation is not applicable at the time of renewal.

 

 

 

NOTE: Renewal premium, terms and conditions are subject to change with prior approval from IRDA.

 

Star Advantages

 

 

• No Third Party Administrator, direct in-house claim settlement.
• Faster and hassle free claim settlement.
• Network of more than 6000 hospitals across India.
• Facility for maintaining personal health records in electronic format.

 

 

 

NOTE: The benefits mentioned herein are only an outline of the policy. For details please contact your nearest Star Health Office or call toll free no 1800 425 2255/1800 102 4477.