Star Accident Care Individual Plan

Accident Care Individual Insurance by Star Health and Allied insurance company is a standalone personal accident disability plan which offers coverage in case of death or disability resulting from an accident. Under this coverage compensation is provided in case of accident related death or injury. This lump sum amount depends on the severity of the injury.

Plan variants –

None

Available options –

Individual, Family Floater, Family package or Group coverage with group coverage having no additional benefits.

Main highlights of the plan –

Along with the basic coverage offered in a personal accident disability plan Accident Care Insurance by Star Health insurance offers benefits like:

1. Coverage for all three occupational risk groups namely group I, group II and group III.

2. Approximately INR 1,55,000 worth coverage without payment of extra premium. Example: coverage for purchase of blood, transportation expense of imported medicine, ambulance expense, travel expense for a relative of the insured and education grant.

3. Worldwide coverage.

4. Family discount of 10% is applicable in this health insurance plan.

5. No-claim bonus equal to 5% of the sum insured up to a maximum of 50% of sum insured on Death and Permanent Total Disability.

6. Option to opt for add-on benefits.

Scope of cover –

This plan is available for employed individuals of between age 18 years to 70 years. The family plan is available for insured, lawful spouse between age 18 years to 70 years and a maximum of 2 dependent children between age 5 months to 25 years.

Note: The policy is lifetime renewable.

Sum insured values –

The Accident Care plan by Star Health and Allied Health Insurance offers coverage from INR 1,00,000 onwards in multiples of 1,00,000 up to the limit specified below:

The sum insured limit for family of insured are as follows:

Non-earning Spouse would be covered up to – 50 % of the Sum Insured of the proposer up to a maximum of INR 5,00,000. Dependent Child would be covered up to – 25% of the Sum Insured of the proposer up to a maximum of INR 5,00,000. Policy Periods available – 1 year, 2 years and 3 years.

Risk Group Classifications –

Risk Group I –

Persons engaged primarily in Administrative functions

Risk Group II –

Persons engaged in manual work

Risk Group III –

Working in explosives industry, mine and / or magazine workers, high tension supply, horse racing including jockeys, athletes and occupations of similar hazard.

Benefits offered in this plan –

Most important –

The Accident Care policy offered by Star Health and Allied Insurance offers benefits like:

ACCIDENTAL DEATH –

Death due to accident within 12 calendar months after accident are covered up to 100% of sum insured.

PERMANENT TOTAL DISABILITY – This benefit is available only for individuals covered under Table B and Table C of this policy. Under this benefit, an injury resulting in permanent disability within 12 months after an accident is covered in the range of 50 to 150% of sum insured, depending on the part of the body affected. Example- Loss of both the eyes, hands, etc. in or after an accident.

PERMANENT PARTIAL DISABILITY – This benefit is available only for individuals covered under Table B and Table C of this policy. Under this benefit, accident resulting in loss of a part, causing partial disability and which occurs within 12 months from the date of accident is covered. Example loss of one hand, one leg, all the toes, etc. is covered. A compensation in the range of 2% to 75 % of sum insured depending on the part of body affected is provided in such cases.

TEMPORARY TOTAL DISABILITY –

This benefit is available only for individuals covered under Table C of this policy. Under this benefit, an injury resulting from accident which has affects the work life and which occurs within 12 months from the date of accident, is covered. In such case, a compensation equal to 1% of sum insured up to maximum of INR 15,000 per week for a maximum of 100 weeks is provided. However, please note that the compensation paid is only on weekly basis.

Value added benefit –

Some of the additional benefits offered in the Accident Care policy by Star Health and Allied Insurance are:

1. Coverage for expenses on purchase of Blood –

This benefit is available for Individuals covered under Table A, Table B and Table C. Under this benefit coverage for expenses on purchase of blood from an approved blood bank or recognized hospital is provided. On submission of the original receipt and other documents required, a benefit equal to 5% of the sum insured up to a maximum of INR 10,000 is provided.

2. Coverage for expense on transportation of Imported Medicines –

This benefit is available for individuals covered under Table A, Table B and Table C. Under this benefit, expenses towards bulk transportation of imported medicine required for surgery or medical treatment are covered. The expenses equal to 5% of sum insured up to a maximum of INR 20,000 are covered.

3. Coverage for expenses on vehicle or Residence modification –

This benefit is applicable for individuals who make valid claim for permanent total disability. Under this benefit, the expenses on modification of vehicle or residence in a way to help disabled insured are covered. Expenses equal to 10% of Sum insured up to a maximum of INR 50,000 are covered. This benefit is available only for individuals covered under Table B and Table C. Note: This benefit is applicable only for claims in India.

4. Coverage for expenses on travel of a relative of deceased insured –

This benefit is applicable for individuals covered under Table A, Table B and Table C of this policy. The benefit can be availed by insured individual’s spouse, children, parents, siblings or in-laws for any accident outside insured individual’s residence. On submission of original proof of expenses, compensation equal to 1% of the sum insured up to a maximum of INR 50,000 id provided. Note: This benefit is applicable only for death claims under this policy.

5. Coverage for expenses on transportation to the hospital or morgue –

This benefit is applicable for individuals covered under Table A, Table B and Table C. Under this benefit cost of transportation to the hospital or morgue is covered up to a maximum of INR 5000.

6. Education Grant –

This benefit is applicable for claims under death or permanent total disability. Under this benefit a maximum of two of the deceased insured’s children under age 18 years would get compensation INR 10,000 per head for coverage of educational expenses.

Add-on covers –

The Accident Care policy by Star Health and Allied insurance gives you an option to opt for some add-on benefits on payment of extra premium. The add-on benefits provided are:

1. Hospital daily cash – This benefit is available in case of hospitalization due to an accident within 30 days after its occurrence. Under this benefit, daily cash up to INR 1000 per day for a maximum of 15 days (except the date of admission and date of discharge) are provided. This benefit can be availed for a maximum of 60 days per policy period.

2. Home convalescence –

With this benefit the insured would get coverage for expenses on engaging an attendant at his/her residence up on advice of physician. Under this benefit, INR 500 per day would be paid for a maximum of 15 days. This benefit could be availed for a maximum of 60 days per policy period. Note: This benefit is valid only after

3. Hospital expense extension –

With this add-on benefit the insured would get coverage for in-patient/ out-patient expenses after valid claim for death/ permanent total disability/ permanent partial disability/ temporary total disability resulting from an accident. Under this benefit medical expenses up to 25% of valid claim or 10% of sum insured under Table A, Table B or Table C or actual expenses or INR 5,00,000 (whichever would be applicable) is provided.

4. Winter Sports Cover –

With this add-on cover the insured can get coverage for death/ permanent total disability/ permanent partial disability or temporary total disability due to an accident while participating in any winter sport. This benefit can be availed anytime during the policy period.

Please refer the policy wordings for the detail list of coverage offered under the section. Note: No two benefits mentioned above are applicable at the same time.

Exclusions –

Some of the major exclusions under a personal accident plan are:

1. War or terrorism related injuries.
2. Self- injury or suicide.
3. Pre-existing injury or disability.

Please refer the policy document for the detailed list of all the exclusions.