Star Health Personal Accident Insurance Policy: Star Health & Allied Insurance Company Limited is an Indian health insurance company based in Chennai. The company provides services through various channels such as health, personal accident, and overseas travel insurance as well as agents, brokers, and online. Star Health is also majorly involved in Bancassurance having a long association with various banks.
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Star Health Personal Accident Insurance Policy | Full Information
Star Health has written off a gross written premium of Rs 5401 crore during the financial year 2018-19 and a net worth of Rs 1480 crore as of 31 March 2019. At present Star, Health has 10600+ employees and 550+ branch offices across India. On 21 July 2021, Star Health Insurance filed it is Draft Red Herring Prospectus (DRHP) with the Securities and Exchange Board of India (SEBI) for its Initial Public Offering (IPO).
Star Health Personal Accident Insurance | Eligibility
- Both individuals and groups can take advantage of this scheme.
- The family package under the scheme covers children of 3 years along with parents.
There are certain exclusions under the scheme under which the claim will not be admissible. The following are exclusions:
- If any expenditure is incurred before the inception of the policy or otherwise outside the term of the insurance plan.
- Claims arising due to non-compliance with the doctor’s advice.
- Pre-existing conditions under the schemes.
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Star Health Insurance Accident Care Plans.
- Accidental Trauma Care Plan: It covers accidental death, permanent total disability, hospitalization benefits.
- Pravasi Bhim Yojana Scheme: Under this scheme, the benefits of accidental death, permanent total disability, hospitalization are covered for the family members of the deceased insured. Repatriation expenses are also covered under this scheme when there is an employment contingency. Maternity coverage and one-way pecuniary rent are also covered for the life insured under this plan. It is basically issued to employees who are working abroad on contract.
Accident claim intimation for the above schemes is to be done through call center/mail/letters/documents. The following details are required:
- Name of the insured.
- Date of the accident.
- Nature of the accident.
- Entry date.
- Name of the hospital
Documents required for death claim
- Duly filled claim form.
- Death certificate from government officials.
- Post mortem report.
- Police investigation report.
- Original policy copy.
- Legal heir certificate.
- Succession Certificate.
- Death Summary.
- Viscera Report
Documents required for disability:-
- Duly filled claim form and disability certificate.
- Photo of the cut area.
- Field visit report.
- Certificate from the orthopedic surgeon on the percentage of disability based on the location of the cut portion and from the treating doctor for the time period.
- Employee certificate or leave certificate for the period of disability.
There can be two types of claims which are cashless claims and reimbursement claims.
For cashless claims through any network hospital, the insured needs to submit the following documents for the claim:
- Health letter.
- Doctor’s consultation letter.
- Duly filled claim form
- Investigation report.
- Pharmacy-related invoice.
- Medico Legal Certificate (MLC) and FIR.
- Discharge summary.
Star Care will verify the soundness and coverage of the plan post, who will be deputed to a filed doctor to facilitate reauthorization document request and to confirm warrant treatment. Thereafter the claim is approved and the process proceeds.
For reimbursement claims, the insurance company must be reported within 24 hours of hospitalization. All bills have to be settled with the hospitals and then claimed or filed with the insurance company. Within 30 days from the date of discharge, claim documents have to be submitted. The documents required for submission of reimbursement claim are as under:-
- Claim form duly filled. It is important to note here that the toll-free number information is mandatory before filling the form.
- Original bill from the pharmacy with a proper prescription.
- Original Discharge Certificate/Card from hospitals along with original bills and receipts.
- Nature of operation performed and surgeon’s bill and receipt.
- The test report and its receipts from a pathologist are supported by a message from the physician/surgeon attending for the test.
- Hospital registration certificate if the number of beds is less than 15.
- Treating doctor’s certificate.
- Self-declaration/MLC/FIR for accident cases.
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Why One Should Choose Star Health Insurance Plan?
- Cashless hospitalization scheme and reimbursement facility in over 7000 network hospitals in India.
- 90% of all cashless claims under almost all the schemes get approved within just an hour.
- All India presence with over 290 branch offices.
- Hassle-free and user-friendly direct claim settlement process without any TPA.
- The company has been honored with many prestigious awards in the past. And in recent times, the company has been awarded as “Health Insurance Company of the Year 2015” by Insurance Awards of India, 2015.
- The company is rated as the best claim settlement insurer.
- Personalized doctor visits for all hospitalized clients.
- Wide range of insurance plans that cater to the insurance needs of all individuals.
- Accident Care is one of the insurance plans provided by Star Health that provides coverage against Accidental Death, Permanent Disability, and Temporary Total Disability.
Star Health Insurance Accident Care Plans | Features And Benefits.
Benefits covered under the plan include:
- Accidental Death Plan:- In case of death within 12 months from the occurrence of Accidental bodily injury, which is wholly and directly caused by the accident due to external, violent, and visible means, the Sum Assured is paid as per the Schedule of Insurance specified in. certificate.
- Permanent or Partial Disability Plan due to an accident:- If the accident occurs as a result of the unfortunate death and disability of the life insured, the company will provide insurance coverage under this plan.
- Death of the Life Assured:- If the death occurs within 12 months from the date of the accident, the company will pay the maximum sum assured.
- Permanent Disability:- If due to any accident the physical and mental ability of the insured person is permanently damaged or injury is caused, the Company shall indemnify any of the above as mentioned above.
- The disability occurs within 12 calendar months from the date of the accident.
- Before the expiry of the period of 60 days from the date of occurrence of the disability, the disability is confirmed and claimed.
- Temporary Total Disability Scheme:- During the plan period, if the Life Assured suffers any bodily injury wholly and directly as a result of an accident, the Life Assured is eligible for a weekly benefit of up to Rs.5000 at 1% of the Capital Sum Assured Is. /- per week for 100 weeks. This benefit is payable only once during the entire plan period. The compensation never increases the sum assured under the plan. Also, the payment is made only after the termination of such disability.
- Free benefits under the plan:- This include the following coverages:-
- Educational funding:- Under this scheme, if the life insured suffers a permanent total disability or unfortunate death, children below the age of 18 years Rs.5000/- for one dependent child and Rs.10,000/- for two dependents educational funds are provided. Children under 18 years old (maximum 2 children).
- Traveling Expenses of a Relative:- Under this scheme, if the insured person dies outside his/her place of residence, the company will pay transport expenses up to a maximum of Rs.1000/- to the place of accident. The transportation cost of the mortal remains up to a maximum of Rs.3000/-.
- Cumulative Bonus:- A cumulative bonus of 5% of Sum Assured is allowed subject to a maximum of 50% for each claim-free year. On payment of additional premium, the plan can be extended to cover medical expenses as well.
Read More: Star Special Care Insurance Policy
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