Star Family Delite Insurance Policy

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• Star Family Delite Insurance Policy
• Star Health and Allied Insurance Co Ltd

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Why Star Family Delite?

• Policy intent is to target customers who cannot
  leapfrog to New FHO with Restore.
• This is a defined benefit policy for a reasonable
  premium

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Star Family Delite Insurance Policy

• This policy is on floater basis for entire family
• Family means
• Self
• Spouse
• Dependent children not over 25 years
• (maximum 3 children can be covered)
• Other relationships cannot be covered.

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Sum Insured

• Only two options
• Rs 200000/
• Rs300000/

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Eligibility

• 18 years to 65 years of age are eligible.
• Children 5 months and above can be covered if
  parents are covered.
• Beyond 65 years only renewals are accepted.

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Coverages

• Room, boarding nursing charges _at_1 of Sum
  Insured per day.
• ICU Charges up to 1.5 of The Sum Insured

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Coverages

• Surgeon, Anesthetist, Medical Practitioner,
  Consultants, Specialist Fees,

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Coverages

• Anesthesia, Blood, Oxygen, Operation Theatre
  charges, Surgical Appliances, Medicines and
  Drugs, Diagnostic Materials and X-ray, diagnostic
  imaging modalities Dialysis, Chemotherapy,
  Radiotherapy

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Coverages

• Ambulance
• Rs 750/ Per Occurrence for all Sum Insured
• Rs 1500/Per Policy Period for all Sum Insured.

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Coverages

• Cover can be given to HIV persons whose CD 4
  count is not less than 350 at entry point
• No claim payable for Opportunistic infections
• No claim on treatment for HIV / AIDS

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Day CareCoverages

• Lithotripsy (Kidney Stone Removal) Rs 15000
• Tonsillectomy Rs
  12000
• Incision and Drainage of Abcess Rs 1500
• Liver aspiration /Pleural effusion
• Aspiration
  Rs 2000
• Sclerotherapy
  Rs 5000

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Day Care Coverages(Contd)
Cataract Package Rs 15000/for one Eye and
Rs20000/Per Policy Period.
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Coverages
Sum Insured (Rs) Sum insured (Rs)/ Limit per policy period 200000 300000
Cardiac- CABG 110000 125000
PTCA- including cost of stents (any number) 70000 80000
Includes cost of Angiogram
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Coverages
Sum insured (Rs)/ Limit per policy period 200000 300000
Other Major Surgeries Not Specifically provided for 35000 45000
Minor Surgeries warranting Hospitalisation 12000 15000

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Coverages
Sum insured (Rs)/ Limit per policy periodSum insured (Rs) 200000 300000
Treatment for infectious diseases Rs 3000/ Per Day Maximum Rs 9000/ per hospitalization 4500/Per Day Maximum Rs 12000/ per hospitalization
Cardio Vascular /Central Nervous System Rs35000/- Rs45000/-
Renal Transplant Rs70000/- Rs100000/-
Dialysis Per sitting limited to Rs1000/- and subject to a maximum of per policy period Rs15000/- Rs20000/-
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Coverages contd..
Sum insured (Rs)/ Limit per policy period (Rs) 200000 300000
Oncology (all modes of therapy) Rs70000/- Rs100000/-
Joint Replacement Rs70000/- Rs100000/-
Accidental Grievous Injury Rs70000/- Rs100000/-
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Exclusions

• No One Year Exclusions.
• Only First 2 year Exclusions.
• PED waiting period 48months
• Non-allopathic treatments not covered
• Enhanced External Counter Pulsation therapy and
  related therapies and Rotational Field Quantum
  Magnetic Resonance Therapy excluded

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Underwriting

• Acceptance limits
• Can be accepted by all Offices
• Medical screening

Medical examination Above 50 years for all sum
insured through Lab Portal
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Benefit Illustration

• Cataract Surgery
• Sum Insured for 1st Year Rs 200000/
• Sum Insured for 2nd Year Rs 300000/
• Sum Insured for 3 rd Year Rs 300000/
• During 3 rd year Insured to go in for Cataract
  Surgery the limit will be as per Rs 200000/Sum
  Insured i.e Rs 15000/(Exclusion no 3)

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Claims Loading
Where the claim ratio for the preceding 2
consecutive years exceeds 100, premium loading
as per the table given below would be applicable.
Average claims ratio of preceding two consecutive years Loading on premium
gt100-125 30
126-150 50
gt150 80
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