8- Star Health And Allied Insurance Company Limited - Critical Illness Insurance
Star Criticare Plus
Star Criticare Plus Insurance from Star Health is a policy that aims to provide reimbursement of hospitalization expenses incurred as a result of illness/disease/sickness and/or accidental injuries and also provides for a lumpsum in case the insured person is diagnosed with a major illness as listed in the policy for the first time during the policy period. Because illnesses don’t come with a warning.
Star Criticare Benefits
This policy offers cover to the Insured Person under two sections. Both regular hospitalization benefits and Major Diseases benefits are available under one policy
Section I
 
  • Provides for in-patient hospitalization expenses for a minimum stay of 24 hours in the hospital
  • These expenses include room rent up-to a maximum of 2% of the sum insured subject to a maximum of Rs4000 per day
  • Boarding and Nursing expenses,
  • Surgeon fees Consultant fees Anesthetist fees,
  • Cost of medicines and drugs
  • Cost of blood, oxygen, diagnostic expenses, cost of pace maker and similar expenses
  • Emergency ambulance charges for transporting the covered patient to the hospital up-to sum of Rs.750/- per hospitalization and overall limit of Rs.1500/- per policy period
Section II (Major Diseases cover)
 
  • Provides for payment of lump-sum amount equal to the sum insured opted if the insured person contracts any one of the Major diseases for the first time.
  • Provides for payment of lump-sum amount equal to the sum insured opted if the insured person contracts any one of the Major diseases for the first time.
Major Diseases covered under the policy
 
  • First Diagnosis of Cancer, Chronic Kidney Disease, Hepatoma, Brain Tumour,
  • Undergoing first time - Major Organ Transplant,
  • Occurrence for the first time of the following medical events: Cerebro-Vascular Stroke causing Hemiplegia, Acute Myocardial Infarction resulting in Left Ventricular Ejection Fraction of < 25%
  • Established irreversible Coma,
  • Established irreversible Paraplegia,
  • Established irreversible Quadriplegia
IT Benefit
Premium paid by any mode other than cash for this insurance is eligible for relief under section 80D of the IT Act.
Claims Procedure
 
  • Call the 24 hour help-line for assistance
  • Inform the ID number for easy reference For claims under Section I**
  • 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 in all net-work hospitals
  • In non-network hospitals payment must be made up-front and then reimbursement will be effected on submission of documents For claims under Section II
  • Intimate the Company on diagnosis of any of the Major Diseases covered. Further procedures would be intimated
Exclusions
For Section I
 
  • All expenses incurred in connection with treatment of any Pre-Existing disease/illness/condition.
  • Treatment of disease/sickness/illness contracted by the Insured Person during the first 30days from the commencement date of the policy.
  • Expense incurred in the first two Years of continuous operation of Insurance cover on treatment for Cataract, Hysterectomy for Menorrhagia or Fibromyoma, Treatment for Knee or Joint Surgery (other than caused by an accident), Prolapse of intervertebral disc (other than caused by accident), Varicose veins and Varicose ulcers.
  • Expense incurred during the first year of operation of the Insurance on treatment of Benign Prostate Hypertrophy, Hernia, Hydrocele, Fistula in anus, Piles, Sinusitis and related disorders, gallstones and renal stones
  • Naturopathy treatment
  • Expenses which are purely diagnostic in nature with no positive existence of any disease
For Section II
 
  • Expenses incurred for treatment of congenital diseases/ defects/anomalies.
  • Manifestation of any of the covered Major Diseases within first 90days from the date of commencement of the policy. This will not apply when the policy is renewed without any break (any break up-to 15days from the date of expiry will be condoned for the purpose of continuity of benefits relating to 30 days waiting period , first year, first two years and Pre-Existing Diseases exclusion and 90 days waiting period for Section II)
  • For a detailed list of exclusions please refer policy conditions
Eligibility
Any person aged between 18years and 65 years can take this insurance. The insurance is renewable up-to 70 years.