Star Cardiac Care Health Insurance Policy Details

Wednesday, May 17, 2017

LIC Of INDIA

Star Cardiac Care Health Insurance Policy Details | Features, Benefits Reviews, Premium, Maturity and Risk Cover

  • This policy is for persons who have undergone for the first time the named surgery / intervention / correction for the existing Cardiac diseases.
  • This policy has two Plan options – Gold Plan and Silver Plan
  • Silver Plan pays for expenses incurred as an inpatient for treatment in respect of all cardiac related complications that necessitate surgery/intervention
  • Gold Plan pays for expenses incurred as an inpatient for treatment in respect of all cardiac related complications that necessitate medical management, surgery/intervention.
  • Under both the Plans regular hospitalization is covered under Section 1 and all Cardiac related ailments are covered under Section 2.
  • Out Patient Benefit is available.
  • Personal Accident: Accidental Death Cover.
  • No Pre acceptance medical screening.
  • 405 day-care procedures covered.

Policy Benefits: (Applicable for Both Silver Plan and Gold Plan)

Hospitalization cover

  • Protects the insured for in patient hospitalisation expenses for a minimum of 24 hrs. These expenses include room, nursing and boarding charges, Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist Fees, Oxygen, Operation Theatre, Diagnostics, imaging modalities and Cost of Medicines and Drugs, Oxygen, Blood, Operation theatre, Diagnostic and Imaging modalities.
  • Ambulance charges for emergency transportation to hospital as per specified limits.
  • Pre-Hospitalization expenses up to 30 days prior to admission in the hospital.
  • Post-hospitalisation expenses incurred up to specified limits.
  • 405 Day-care treatments covered
  • Pre-Existing Diseases / Illness are covered after 48 months of continuous coverage without break with any Indian Non-Life Insurer, under Section 1
  • After a waiting period of 90 days, this policy covers all treatments relating to Cardiac diseases. This waiting period will not apply for renewals.

Out-Patient Expenses

The Company will pay the amount of such expenses as are reasonably and necessarily incurred at the network hospitals/diagnostic centres as an Out Patient, provided the policy is in force

The limit of benefit under this Section is Rs.500/- per event subject to a maximum of Rs.1500/- per policy period, provided policy is in force. This benefit forms part of the Sum Insured.

Personal Accident

If at any time during the Period of Insurance, the Insured Person shall sustain any bodily injury resulting solely and directly from an Accident caused by external, violent and visible means and if such accident causes death of the Insured Person within 12 Calendar months from the date of Accident, then the Company will pay the Sum Insured mentioned in the schedule as compensation.


Star Cardiac Care Insurance Policy ELIGIBILITY


  • Star Cardiac Care Insurance can be taken by any person between 10 years and 65 years of age, who has undergone for the first time.
  • PTCA (Stenting) or CABG (By-pass) procedure,  within 7 years prior to the date of policy purchase or
  • Atrial Septal Defect (ASD) or Ventricular Septal Defect (VSD) that has been corrected  or
  • Patent Ductus Arteriosus (PDA) that has been treated or
  • RF Ablation done to correct the underlying cardiac condition or
  • Had an Angiogram done but no intervention was medically found necessary.

Star Cardiac Care Insurance Policy GENERAL TERMS

Tax Benefits

Amount paid by any mode other than by cash for this insurance is eligible for relief under Section 80D of the Income Tax Act.

Free Look Period

A free look period of 15 days from the date of receipt of the policy is available for reviewing the policy terms and conditions. In case insured is not satisfied he can seek cancellation of the policy and in such event the Company will allow refund of premium after adjusting the cost of pre-acceptance of medical screening, stamp duty charges and proportionate risk premium for the period concerned provided no claim has been made until such cancellation. Free look cancellation is not applicable at the time of renewal.


Star Health Insurance Policy







































Guaranteed Lifetime Renewals

Life-long renewals beyond 65 years are offered under this policy.



Star Cardiac Care Insurance Policy Details & Features
Age at Entry
10 Years to 65 years
Who can Buy
1. Undergone Percutaneous Transluminal Coronary Angioplasty - PTCA or Coronary Artery
Bypass Graft (CABG) - Within 7 years
2. Artial Septal Defect - ASD or Ventricular Septal Defect - VSD - Corrected
3. Patent Ducutus Arteriosus (PAD) - Treated
4. RF Ablation or RF Ablation done to correct Cardiac Condition
5. Angiogram done - But intervention not found necessary
Sum Insured
3 Lac and 4 Lac
Sum Insured Enhancement
SI can be enhanced on renewal - Subject to company's discretion - Only when no Claim lodged or Paid - Waiting period will be applied on the enhanced Sum Insured
Policy Period
One year
Renewal Guarantee
Life Long
Renewal Grace Period
30 days
Section - 1
Regular Hospitalisations - Other than Cardiac related
Room Rent, Boarding and Nursing
Expenses
Rs. 5000 per day
Professional Fees
Surgeon, Anesthetist, Medical Practitioner, Consultant, Specialist Fees - Actual
Other Medical Expenses
Anesthesia, Blood, Oxygen, OT Charges, Surgical Appliances, Medicines and Drugs, Diagnostic materials, X-ray, Diagnostic Imaging, Dialysis, Chemotherapy, Radiotherapy etc. -
Actual
Ambulance Charges
Rs. 750 per hospitalisation - Rs. 1500 per policy year
Pre - Hospitalisaton
30 days prior to the date of hospitalisation - Actual
Post - Hospitalisation
60 days - (7% of nursing expenses, Surgeon/consultant Fees, Diagnostic Charges, Cost of
medicines and drugs with Max Rs. 5000)
Section - 2 - Gold
1. Cardiac related Complications - resulting in Surgery or intervention
2. Cardiac Medical Management
Section - 2 - Silver
Cardiac related Complications - resulting in Surgery or intervention only
Cardiac Medical Management not covered
Both Gold and Silver
a. Room Rent, Boarding and Nursing Expenses
b. Professional Fees
c. Other Medical Expenses
d. Ambulance Charges
e. Pre-Hospitalisation
f. Post - Hospitalisation
Same as Section 1
Section - 3
Out Patient Consultation - Max. Rs. 500 per consultation
Max - Rs. 1500 per policy year - Payout forms part of Sum Insured
Section - 4
Personal Accident - Death Cover - Accident Cover Sum Insured Equivalent to Health Sum
Insured
Day - Care Treatment
405 - Day Care Procedures
Sublimit for Cataract
Max Rs. 20,000 per hospitalisation - Max Rs. 30,000 for policy period
Treatment on Package Charges basis
80% of Package Charges paid - for Section 1 hospitalisations only
30 days - Waiting Period
Any Disease Contracted by the insured
90 days - Waiting Period
PEDs related to Cardiac ailments
24 Months - Waiting Period
Like - Cataract, ENT, Thyroid, Prolapse of intervertebral Disc (Non-Accidental), Vericose - veins & Ulcers, Prostate Disease, Hernia, Fistula/Fissure, Congenital Internal Disease, - For full
list refer product broucher
48 Months - Waiting Period
PEDs - Other than Cardiac related PED - Declared in Proposal and Endorsed in Policy
Permanent Exclusions
Like - Congenital External defects, Dental Treatments(Non-Accidental), Psychiatric treatment, Venereal diseases, Intentional Self Injury, Pregnancy and child birth related, Weight Control, Cosmetic treatments, Plastic Surgery - For full list refer product broucher
Pre Acceptance Medical Screening
Not Required - But all the past medical records of the proposed insured to be submitted
Co Payment
10% on every Hospitalisation - Under Section 1 only - For Age above 60 years at ENTRY