Star Health Gain Policy

    Star Health And Allied Insurance

    Star Health Gain Insurance is an excellent health insurance policy for the entire family covering medical expenses due to any sickness or injury. There is a flat premium amount irrespective of the sum insured or age of the persons or the total number persons covered in the policy. Hence, the more you include the members in the plan, the more advantageous the plan would be.

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    Highlights of Star Health Gain Policy

    • Covers both Individual and Family
    • Cover for both in-patient and out-patient treatments
    • The unutilized Outpatient benefit can be carried forward to next year against renewal
    • No claim discount up to 10% applicable at renewal
    • Flat premium across all Sum Insured ranges and age groups
    • Tax Benefit as per the prevailing Income Tax Laws

    Scope of cover

    Indivdual Plan

    Entry Age

    For children : 05 months

    Adults :

    Minimum : 18 years

    Maximum : 65 years

    Number of Members Covered

    Maximum Members : NA

    Maximum Adults : NA

    Maximum Children : NA

    Sum Insured

    1/2/3/4/5 lakhs


    discount

    NA


    Policy Periods Available

    Annual


    Pre-Policy Medical Check-up

    Above 50 years of age


    Family Floater Plan

    Entry Age

    For children : 05 months

    Adults :

    Minimum : 18 years

    Maximum : 65 years

    Number of Members Covered

    Maximum Members : 05

    Maximum Adults : 02

    Maximum Children : 03

    Sum Insured

    1/2/3/4/5 lakhs


    discount

    NA


    Policy Periods Available

    Annual


    Pre-Policy Medical Check-up

    Above 50 years of age


    Important Features

    Day Care Treatments

    Covers certain day care procedures like Dialysis, Chemotherapy, Radiotherapy, Cataract Surgery, etc.

      No-Claim Benefits

      For every claim free year, you will be entitled to a bonus of up to 10% of your sum insured.

        Pre Hospitalization

        Compensates for the Pre-Hospitalisation expenses for consultations, investigations and medicines incurred up to 30 days before Hospitalisation

          Post Hospitalization

          Compensates for a lump sum amount equal to 7% of hospitalization expense (excluding room charges) up to a maximum of Rs.5,000 per occurrence of post-hospitalization expense. Note: In the case of packaged treatments, the post-hospitalization expense is covered within the specified limit after calculating the room rent and boarding charges.

            Good to Have Benefits

            OPD Expense Cover

            This plan covers outpatient benefits up to specified limit depending on the sum insured opted and age of the members covered. Please refer the brochure for the details of these limits. The outpatient treatment also includes the cost for pre-existing conditions, dental expenses, pre and post natal care.

              PORTABILITY

              If you want to transfer the policy to another insurer, the plan allows you to do so without losing your accrued benefits after the waiting periods.

                TAX BENEFITS

                You can avail tax benefits for the premium amount paid towards this plan under Section 80D of the Income Tax Act,1961.

                  SUM ASSURED ENHANCEMENT

                  You can apply for the sum increase at the time of renewal. However, there should not be any claim made on the policy for considering the request.

                    Emergency Ambulance

                    Compensates you up to Rs.750 for each hospitalization towards the emergency ambulance services up to a maximum of Rs.1,500 per policy period.

                      Value Adds

                      NEW BORN BABY COVER

                      Not applicable unless added to the policy post the completion of the eligible age.

                        FREE LOOK PERIOD

                        For any reason, should you decide not to proceed with the policy, you can return the same and request for a refund within 15 days from the date of receipt of the policy document.

                          Terms & Conditions

                          Room Rent / Room Category

                          This plan has a room-rent limit in case of normal hospitalization up to 2% of sum insured up to a maximum of Rs.4,000 per day for Class A cities. Similarly, 1% of sum insured up to a maximum of Rs.3,000 per day for Class B cities & 1% of the sum insured up to a maximum of Rs.1,000 per day for other locations.

                            Sub-Limits

                            This plan has sub-limit of 80% for packaged treatments. Sub-limits of Rs.15,000 for the entire policy period is applicable for Cataract treatment.

                              Waiting Period

                              Cooling Off Period

                              A 30 days cooling off period for all claims except any arising out of accidental injuries.

                                Specific Illnesses

                                The policy covers some specific diseases/treatments only after either 12 months or 24 months. These include Cataract, Glaucoma, Gall Bladder & Pancreatic Diseases and treatments, and so forth.

                                  Pre-Existing Illnesses

                                  You can claim for any pre-existing conditions after 48 months from the policy start date.

                                    Permanent Exclusions

                                    The Plan will not cover any liabilities towards the treatments of following conditions-

                                    • Attempted suicide
                                    • Use of alcohol or drug
                                    • AIDS
                                    • Congenital disease
                                    • Naturopathy treatment
                                    • Infertility and in vitro fertilization.
                                    • Hospitalization out of war, riot, strike and nuclear weapons

                                    The detailed list of what the policy does not cover is available in the policy wording.

                                    Review of Star Health Gain Policy

                                    With various benefits like OPD cover, No Claim Bonus, compensation towards the emergency ambulance charges, etc.; Star Health's Gain Policy is designed to provide coverage for individual and floater basis. However, lack of some valuable benefits like maternity cover and strict limits on room rent is a bit restraint.

                                    **Reviews and ratings are based only on Benefits and Conditions. Things like Claim Settlement Ratio, Hospital Network have not been covered under product ratings. These are covered under Company ratings.

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