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Presentation on Senior Citizens Red Carpet Health Insurance. Presentation on Senior Citizens Red Carpet Health Insurance. Major Product Features. For People aged Between 60 and 74 Years Guaranteed renewals beyond 74 years No Pre Insurance Medical Test required
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Presentation on Senior Citizens Red Carpet Health Insurance
Presentation on Senior Citizens Red Carpet Health Insurance Major Product Features • For People aged Between 60 and 74 Years • Guaranteed renewals beyond 74 years • No Pre Insurance Medical Test required • Covers Pre Existing Diseases Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance Pre - Insurance Medical Test • No Pre – Insurance Medical Test is required • However 10% discount on premium will be allowed if the following reports are produced to the satisfaction of the Insurer • Stress Thallium Report • BP report • Sugar (Blood & Urine) • Blood urea & creatinine • Self-declaration or certification that surgeries related to Heart / Brain / Cancer has / have not been done in the past. The tests should have been taken not before 45 days from the date of proposal Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance Coverages Hospitalization Expenses incurred as aninpatient for • Sickness/Illness/Diseases • Accidental injuries Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance What is a Hospital? • Hospital, Nursing Home means any institution in India established for indoor care and treatment of sickness and injuries and which Either • It has been registered with the local authorities and is under the supervision of a registered and qualified Medical Practitioner or • Should comply with minimum criteria as under • It should have at least 15 inpatient beds (10 in Class ‘C’ Towns). • Fully equipped operation theatre of its own wherever surgical operation is carried out. • Fully qualified nursing staff under its employment round the clock • Fully qualified Doctor(s) should be in charge round the clock. Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance Pre Existing Diseases Cover • Pre – Existing Diseases are covered except those • for which treatment was recommended or received during 12 Months preceding the date of proposal • Diseases mentioned under First year exclusions and first two year exclusions • The cover is subject to 50% Co-payment Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance Co-payment • 50% co-payment applicable for Pre-Existing Diseases / Conditions • 30% co-payment applicable for all other claims Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance Sum Insured • The following Sum Insured options are available • 1Lac, 2Lac, 3Lac, 4Lac & 5Lac Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance Allowable Expenses • Room rent & boarding charges @ 1% of the sum insured per day • ICU expenses Per Day @ 2% of the Sum Insured • Nursing charges • Surgeons, Anesthetist, Medical Practitioner, Consultants, Specialists fees subject to a maximum of 25% of the Sum Insured per hospitalisation Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance Allowable Expenses (Contd.) • Anaesthesia, Blood, Oxygen, Operation Theatre charges, Surgical Appliances, Medicines and Drugs, Diagnostic Materials and X-ray Dialysis, Chemotheraphy, Radiotherapy, Cost of Pacemaker and similar expenses subject to a maximum of 50% of the Sum Insured per hospitalisation. • Emergency Ambulance charges to go to Hospital for treatment @ Rs 750/- per hospitalisation upto a maximum of Rs 1,500/- per policy period Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance Allowable Expenses (Contd.) • Post hospitalization expenses on a lump-sum basis @ 7% of the actual hospitalization expenses (excluding room rent and hospital registration charges), subject to a maximum of Rs. 5,000/-. Note: The policy does not cover Pre- Hospitalisation expenses Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance Day Care Treatment Minimum of 24 hours Hospitalization is not necessary for the following • Dialysis, • Chemotherapy, • Radiotherapy, • Cataract surgery, • Dental Surgery, • Lithotripsy (Kidney stone removal), • Tonsillectomy, • Cutting and Draining of Abscess, • Liver Aspiration, • Pleural Effusion Aspiration, • Colonoscopy, • Sclerotheraphy, The above treatment shall be taken in the Hospital / Nursing Home and the Insured is discharged on the same day. Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance Sub Limits Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance Major Surgeries Includes but not limited to • Intestinal obstruction – both acute and sub-acute, colon surgeries, bladder surgeries including Urethra, nephrectomy, pancreatic surgery, GJ Vagotomy, Knee/hip surgery Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance Premium Rating Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance Renewal Loading Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance Exclusions • Treatment taken in Non Network Hospitals • Pre Existing Diseases for which treatment was recommended or received during 12 months preceding the date of proposal • Any Disease contracted during first 30 days • First Year Exclusions • Benign prostate hypertrophy • Hernia, Hydrocele, Fistula in Anus, Piles • Congenital Internal Disease/defect • Sinusitis • Renal stone and Gall stone removal • First Two Years Exclusions • Cataract • hysterectomy following menorrhia or fibromyoma • Knee Replacement Surgery • Joint Replacement Surgery • Prolapse of intervertibral • Vericose veins/ulcers Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance Exclusions (Contd.) • Pre Hospitalisation Expenses • Injury / Disease arising due to War, Invasion, Act of Foreign Enemy, Warlike operations • Circumcision unless necessary for treatment of a disease • Cost of spectacles and contact lens, hearing aids, walkers, crutches wheel chairs and such other aids • Dental treatment or surgery • Convalescence, general debility, Run-down condition or rest cure, congenital external disease or defects or anomalies, sterility, venereal disease, intentional self injury and use of intoxicating drugs/alcohol • Naturopathy Treatment • Expenses incurred on Lasik Laser or Refractive Error Correction treatment Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance Exclusions (Contd.) • Hospital registration charges, record charges, telephone charges and such other similar charges. • Expenses for Non Allopathic treatment. Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance Other Benefits • Benefits under Section 80-D of the IT Act • Cashless Service without intervention of TPA • Direct Tie up with hospitals on an All India Basis • 24 X 7 In-House Call center (044-2826 3300) • Toll Free Telephone line assistance (1800 425 2255) – only from BSNL and MTNL • Full knowledge based website to offer medical information, including Health Tips. • Frequent health meets to disseminate information on health related topics Star Health and Allied Insurance Co. Ltd.
Presentation on Senior Citizens Red Carpet Health Insurance Claim Procedure • Immediate intimation to the Call Centre (1800 425 2255/044-28263300) • The insured has to send a request for ‘Pre Authorization Form’ signed by the Doctor in the Network Hospital • Based on the intimation a field visit will be done by the Star Doctor • Pre Authorization will be issued to the Hospital • Based on the Pre Authorization and the Report by the Star Doctor, Cash Less Treatment will be given by the Network Hospital Star Health and Allied Insurance Co. Ltd.
Thank You Star Health and Allied Insurance Co. Ltd.