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Frequently Asked Questions

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General Questions

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Why I Need Health Insurance?

Health insurance will protect you and your family against any financial risks arising due to a medical emergency. Buying a proper health plan would help you in saving your hard-earned savings and other assets

What is the maximum number of claims allowed over a year?

Any number of claims is allowed during the policy period. However, the sum insured is the maximum limit under the policy.

What is the Family Floater Plan?

One single policy takes care of the hospitalization expenses of your entire family. Family Floater Health Plan takes care of all the medical expenses during sudden illness, surgeries and accidents.

My wife and childrens are residing in another city, I am in another city. Can I cover all of us in one policy?

Yes, you can cover the entire family under one policy. Your health insurance policy is in force across India.

Does Health insurance cover diagnostic charges like X-Rays, MRI or ultrasound?

Health Insurance covers all diagnostic test like X- ray, MRI, blood tests etc as long they are associated with the patients stay in the hospital for at least 24 hours. Any diagnostic tests which does not lead to treatment or which have been prescribed as Outpatient are generally not covered.

Does any health policy cover the treatment for existing disease also?

Normally health plans exclude treatment of any pre-existing disease/condition. The treatment of any such pre-existing disease/ condition is covered after 48 months of continuous renewals.

What do you mean by Network /Non-network Hospitalization?

A Hospital, which has an agreement with us for providing Cashless treatment, is referred to as a ‘Network Hospital’. Cashless facility is provided ONLY at the network hospitals. Non-network hospitals are those with whom we do not have any agreement and any policyholder seeking treatment in these hospitals will have to pay for the treatment and later claim as per reimbursement procedure.

How does one get Reimbursements in case of treatment in non- network hospitals?

Cashless Hospitalization is available only in Network Hospitals. While it’s recommended that you choose a network hospital you are at liberty to choose a non-network hospital also. In case you avail of treatment in a Non-Network hospital, The health insurance company will reimburse you the amount of bills subject to the policy taken by the policyholder. The Policy Holders attention is drawn to the definition of Hospital in the Mediclaim policy. JMJ Insurance Service Center be contacted within 24 hours from the time of admission with details of Star Health ID card number, nature of illness, name & address of the Hospital/ Nursing Home/ Clinic, Room Number etc. The claim will be registered by Customer Care and a claim number will be provided to the Policy holder. Claim form will be sent to the Policy holder address. This claim form must be filled fully and sent to Star Health office along with the following documents in original. Main Hospital Bill with Receipt for payment along with the breakup. Doctor’s prescription and medicine bills. Discharge summary sheet from the hospital. Investigation reports along with the X-ray film other relevant details and documents connected to hospitalization.

Note: Only expenses relating to hospitalization will be reimbursed as per the policy taken. All non-medical expenses will not be reimbursed.

What do you mean by Cashless Hospitalization?

In the event of hospitalization, the patient or their family will have a bill to pay the hospital. Under Cashless Hospitalization the patient does not settle the hospitalization expenses at the time of discharge from hospital. The settlement is done directly by  Health Insurance Company. This is to reduce the financial burden on insured individual at the time of hospitalization

Is there an Income Tax exemption under Health policy?

Premium paid under the Health insurance Policy is exempted from Income Tax under section 80D of the Income Tax Act up to Rs.25,000 for individual covering his family and dependent Children. In case the proposer intends to cover his parents below 60 years under medical insurance, he is eligible for a deduction of another Rs.25000 under section 80D. In case the age of parent to be covered is above 60 years, the deduction available is Rs.50000 under section 80D.

Is a medical checkup necessary before buying a Health policy?

At the time of issuance of medical policy. We would conduct pre medical tests for individuals above age of 50 years, when customer prefers Medi classic individual, Family Health Optima for Sum Insurance 3 Lakhs, and Diabetic safe plan A.

Pre medical tests are not done when customer prefers Family health optima above 4 Lakh SI, Comprehensive Health Insurance, Senior Citizens Red Carpet Health Insurance, Cardiac Care and Diabetic safe plan B.

Sl No. Product AGE SI/Plan
1 Medi-classic-Individual Above 50 Years All SI
2 Family Health Optima Above 50 Years 3 L
3 Star Comprehensive Insurance Policy NO MEDICAL TEST
4 Senior Citizens Red Carpet Health Insurance NO MEDICAL TEST
5 Star Cardiac Care NO MEDICAL TEST
6 Diabetes Safe Insurance Policy Plan A ALL AGE PLAN A
7 Diabetes Safe Insurance Policy Plan B NO MEDICAL TEST

I am a known diabetic for the past years. Can I take a mediclaim policy with you?

Yes. You can take any individual policy with us in which the existing condition of diabetes would be excluded. At the same time, you can cover yourself with a Diabetes Safe policy which covers the complications arising due to Diabetic Retinopathy, Diabetic Nephropathy and Diabetic Foot Ulcer. However, this policy requires a pre-medical screening even if the proposer is less than 50 yrs. of age.

Is there a policy to cover my mother who is 65 years old and is suffering from Diabetic for the past years?

Yes, you can cover your mother under our Star Senior Citizen policy. If she has not undertaken any IP treatment in the last 12 months, she shall be covered for Diabetic also at 50% co-pay

Can I take a health insurance policy for my child who is newborn?

Children are not covered individually in our policies but can be covered with either of the parent.

How does one get Reimbursement for pre and post hospitalization expenses under this scheme?

The Mediclaim Policy allows reimbursement of medical expenses incurred towards the ailment/ disease for which hospitalization was necessitated prior to hospitalization and up to a certain number of days after discharge. This is subject to the limits as described in the policy. The medical expenses incurred prior to Hospitalization are called pre-hospitalization expenses and those incurred subsequent to discharge as post Hospitalization expenses.

Life Insurance

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When can a nomination be done?

In identifying a person to receive the policy amount in the event of death of the policyholder. The nomination can be done at the start of the policy by providing details of the nominee in the proposal form. However, if the nomination is not given at the beginning, it can be done at a later date. This nomination has to be effected by giving notice in a prescribed form to LIC and getting it endorsed on the Policy Bond.

 

The policyholder can change the nomination at any time during the term of the policy and for end number of times. For this, the policyholder has to give a notice in a prescribed form to LIC. Further, nomination can be removed any time by the policyholder without giving prior notice to the nominee.

Under nomination, the nominee gets only the right to receive the policy amount in the event of the death of the policyholder; nomination does not pass on the property in the policy. If nominee dies when the policyholder is still surviving then the nomination would be ineffective. If nominee dies after the death of the policyholder but before receiving policy amount, then again the nomination becomes ineffective and only the legal heirs of the policyholder can claim money.

How do I surrender my policy?

Three consecutive years, the Policy acquires a Surrender Value. The Policy, which has acquired a Surrender Value, can be surrendered for payment in cash. Once the Policy is surrendered the contract is terminated. In the case of ICICI Pru Single Premium Bond the policy can be surrendered after the first year.

How do I revive my policy that has lapsed?

If non-payment of premium within the specified due date, you can re-apply to reinstate it, if:

You apply within 5 years from the date of the first unpaid premium and before the maturity date

You pay all the required premiums and interest

You give us satisfactory evidence of health at your own expense The reinstatement will take effect only if we accept your application. We will notify our acceptance to you.

What is nomination of the policy?

Act 1938 provides for nomination of a person who would receive the benefits of the claim on the death of the life assured. Nomination establishes a clear title to the policy. This prevents dispute and also prevents delay in settlement of a death claim. In the case where nomination has not been given at the time of proposal, the nomination can be made at any time during the term of the policy. Nomination can also be changed, at any time during the tenure of the policy, by intimating the respective insurance company

Can I change my nomination?

At any time till the maturity date. All you need to do is to inform us about the change through a specified form.

Vehicle Insurance

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What are the policies available for covering the vehicles?

There are two policies: Motor Liability Only Policy and Motor Package Policy.

Motor Liability Only Policy

Owners’ liability towards Third Party Personal Injury and Property Damage.

Motor Package Policy/Full Coverage Policy

This type of policy covers all the risks covered under Motor Liability policy plus loss or damage caused to the vehicle due to:

Accident, Fire, Explosion, Self Ignition, Lighting, Burglary, House Breaking, Theft, Riots & Strikes, Earthquakes, Flood, Typhoon, Hurricane, Storm, Cyclones, Malicious Acts, Terrorism, Transit by rail/road, air and waterways and also include towing charges.

Is it mandatory to have insurance for vehicles on the public place?

As per Motor Vehicle Act, it is mandatory to have insurance for vehicles, Atleast you need Third Party insurance to take your vehicle outside your home.

 

What are the exclusions under Package Policy?

Damage caused due to:

Driver being under intoxication, Vehicle being driven by a person not holding an effective valid license, Damage to tyres (unless the vehicle is damaged at the same time),Wear and tear and mechanical breakdown damages.

What are documents required at the time of claim? The amount be paid directly to the repairer? What is the amount I have to bear?

Copy of claim intimation given to insurer with xerox copy of policy and premium receipt, duly filled Claim Form, Driving License, Registration Certificate of Vehicle, Estimate of repairs from repairer and stamped receipt, Bills and Cash Memo of repairs, verification of road tax, Police Panchanama/FIR, Permit and Fitness Certificate and any other documents deem feet for the situation.

The amount be paid directly to the repairer? 

Yes – In case of Approved Garage

No – In case of any other Garage

 

What is the amount I have to bear?

Compulsory excess, Reasonable value of salvage if not surrendered to insurer and depreciation.

What is ``No Claim Bonus``?

It is a special discount given on premium for every claim-free year.

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