STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

Registered Office: No.1, New Tank Street, Valluvar Kottam High Road, Nungambakkam, [Link]- 28288800
Corporate Office: No. 148, Acropolis, Dr. Radha Krishnan Salai, Mylapore, Chennai - 600 004. Phone: 044 - 4788 6666
« Email : support@[Link] « Website : [Link] « CIN : L66010TN2005PLC056649 « IRDAI Regn. No. : 129

PROSPECTUS - STAR COMPREHENSIVE INSURANCE POLICY

Unique Identification No.: SHAHLIP25037V082425

The Specific Feature of this policy is it offers Health Cover, D. Road ambulance expenses: Subject to an admissible
Delivery and New born cover, Dental and Ophthalmological hospitalization claim, road ambulance expenses incurred
Treatment, Hospital cash Benefit-all under a single roof. Also for the following are payable :-
cover is extended for Bariatric surgery where it is performed for i. for transportation of the insured person by private
medical reasons ambulance service to go to hospital when this is
needed for medical reasons
µ Eligibility
Ø For Adults – 18yrs – 65 yrs or
Ø For Dependent Child - 91 days – 25 yrs ii. for transportation of the insured person by private
ambulance service from one hospital to another
µ Midterm inclusion of newly married / wedded spouse and hospital for better medical treatment
New Born Baby is permissible on paying additional premium.
or
The intimation about the marriage / new born should be given
within 60 days from the date of marriage or new born. The iii. for transportation of the insured person from the
cover will be from the date of payment of premium. hospital where treatment is taken to their place of
residence provided the requirement of an ambulance
µ Policy Term: 1 Year / 2 Years / 3 Years. For policies more than to the residence is certified by the medical practitioner.
one year, the Basic Sum Insured is for each year, without any
carry over benefit thereof E. Air Ambulance expenses Subject to an admissible
hospitalization claim, the Insured Person(s) is/are eligible
µ Long Term Discount: If the policy term opted is 2 years, for reimbursement of expenses incurred towards the cost
discount available is 3.5% and if policy term opted is 3 years, of air ambulance service up to Rs.2,50,000/- per
discount available is 6.5%, on total premium. hospitalization, not exceeding Rs.5,00,000/- per policy
µ Instalment Facility available: Premium can be paid period, if the said service was availed on the advice of the
Monthly, Quarterly and Half-yearly. Premium can also be treating Medical Practitioner/Hospital. Expenses towards
paid Annually, Biennial (Once in 2 years) and Triennial (Once Air ambulance service is payable for only from the place of
in 3 years) first occurrence of the illness / accident to the nearest
For instalment mode of payment, there will be loading as hospital. Such Air ambulance should have been duly
given below: licensed to operate as such by Competent Authorities of
• Monthly: 4%
the Government/s.
• Quarterly: 3%
• Half Yearly: 2% F. Relevant Pre-Hospitalization medical expenses incurred
for a period not exceeding 60 days prior to the date of
µ Sum Insured Options
hospitalization are payable subject to an admissible
Rs.5,00,000; Rs.7,50,000; Rs.10,00,000; Rs.15,00,000;
hospitalization claim
Rs.20,00,000; Rs.25,00,000; Rs.50,00,000; Rs.75,00,000 ;
Rs.1,00,00,000 G. Post Hospitalization: Medical expenses incurred for a
period up to 90 days from the date of discharge from the
µ What are the benefits available?
hospital wherever recommended by the Medical
Section 1 Hospitalization
Practitioner / Hospital, where the treatment was taken are
A. Room (Private Single A/C room), Boarding and Nursing
payable, provided
Expenses as provided by the Hospital / Nursing Home
i. such expenses so incurred are following an admissible
B. Surgeon, Anesthetist, Medical Practitioner, Consultants, claim for hospitalization
Specialist Fees.
and
C. Anesthesia, Blood, Oxygen, Operation Theatre charges,
ii. such expenses so incurred are in respect of ailment for
ICU charges, Surgical Appliances, Medicines and Drugs,
which the insured person was hospitalized.
Diagnostic Materials and X-ray, diagnostic imaging
modalities, Dialysis, Chemotherapy, Radiotherapy, cost of H. Expenses of Medical Consultations as an Out Patient
Pacemaker, stent and such other similar expenses. With incurred in a Networked Facility for other than Dental and
regard to coronary stenting, medicines, Implants and such Ophthalmic treatments, up to the limits mentioned in the
other similar items the Company will pay cost of stent as table below are payable. Payment under this benefit H
per the Drug Price Control Order (DPCO) / National does not form part of Sum Insured, and is payable while
Pharmaceuticals Pricing Authority (NPPA) Capping the policy is in force.
Star Comprehensive Insurance Policy Unique Identification No.: SHAHLIP25037V082425 PROS / COMP / V.13 / 2024 1 of 16
 Out-Patient Consultation Section 1-H Section 2 Delivery and New Born
Limit for Out Patient Limit for Delivery
Limit of
consultation per policy Delivery
Sum Insured Rs. period for other than Dental Company's
Sum Insured Rs. Normal by liability for
and Ophthalmic Treatments Caesarean
(up to Rs.) Delivery Rs. Section New Born
Rs. Cover Rs.
5,00,000/- 1,200/-
7,50,000/- 1,500/- 5,00,000/- 15,000/- 20,000/- 1,00,000/-
10,00,000/- 2,100/- 7,50,000/- 25,000/- 40,000/- 1,00,000/-
15,00,000/- 2,400/- 10,00,000/- to
30,000/- 50,000/- 1,00,000/-
25,00,000/-
20,00,000/- 3,000/-
50,00,000/- to
25,00,000/- 3,300/- 50,000/- 1,00,000/- 2,00,000/-
1,00,00,000/-
50,00,000/-, 75,00,000/- and
5,000/-
1,00,00,000/- C) Vaccination expenses for the new born baby are payable up to
Limit of per consultation is Rs. 300/- the limits mentioned in the table below, until the new born baby
completes one year of age and is added in the policy on renewal.
Note: Payment of any claim under this section shall not be Claim under this is admissible only if claim under A of Section-2
construed as a waiver of Company's right to repudiate any claim above has been admitted and while the policy is in force.
on grounds of nondisclosure of material fact or preexisting
Limits of Vaccination
disease for hospitalization expenses under hospitalization
provisions of the policy contract. Sum Insured Rs. Limit per policy period (Rs.)
5,00,000/- to 25,00,000/- 5,000/-
I. Domiciliary hospitalization: Coverage for medical
treatment (including AYUSH) for a period exceeding three Above 25,00,000/- 10,000/-
days, for an illness/disease/injury, which in the normal Special Conditions applicable for this Section
course, would require care and treatment at a Hospital but,
1. Benefit under this section is subject to a waiting period of
on the advice of the attending Medical Practitioner, is taken
24months from the date of first commencement of Star
whilst confined at home under any of the following
Comprehensive Insurance Policy and its continuous renewal
circumstances
thereof with the Company. A waiting period of 24 months will
The condition of the patient is such that he/she is not in a apply afresh following a claim under “A” of Section-2 above.
condition to be removed to a Hospital, or 2. Pre-hospitalisation and Post Hospitalization expenses and
The patient takes treatment at home on account of non- Hospital Cash Benefit are not applicable for this section.
availability of room in a hospital. 3. This cover is available only when
i. both Self and Spouse are covered under this policy either
However, this benefit shall not cover Asthma, Bronchitis, on floater basis or on individual basis and both Self and
Chronic Nephritis and Nephritic Syndrome, Diarrhoea and Spouse should have been covered for a continuous period
all types of Dysenteries including Gastro-enteritis, Diabetes of 24 months under Star Comprehensive Insurance Policy,
Mellitus and Insipidus, Epilepsy, Hypertension, Influenza, ii. the policy covering the self and spouse are in force when
Cough and Cold, all Psychiatric or Psychosomatic the benefit under this Section becomes payable.
Disorders, Pyrexia of unknown origin for less than 10 days, 4. Claims under this section
Tonsillitis and Upper Respiratory Tract infection including i. will not reduce the Basic Sum Insured;
Laryngitis and Pharingitis, Arthritis, Gout and Rheumatism. ii. will not affect the benefit under Section 6;
iii. will affect Cumulative Bonus
Section 2 Delivery and New Born
Section 3 Out-patient Dental and Ophthalmic Treatment
A. Expenses for a Delivery including Delivery by Caesarean
Expenses incurred on acute treatment to a natural tooth or teeth or
section (including pre-natal and post natal expenses) up-to
the limits mentioned in the table below per Delivery, subject to the services and supplies provided by a licensed dentist, up to
a maximum of 2 deliveries in the entire life time of the insured limits mentioned in the table below are payable.
person are payable while the policy is in force. Expenses incurred for the treatment of the eye or the services or
supplies provided by a licensed ophthalmologist, hospital or other
B. Expenses up-to the limits mentioned in the table below,
provider that are medically necessary to treat eye problem
incurred in a hospital/ nursing home on treatment of the New-
born for any disease, illness (including any congenital including cost of spectacles / contact lenses, not exceeding the
disorders) or accidental injuries are payable provided there is limit mentioned in the table below are payable.
an admissible claim under A of Section-2 above and while the The insured persons become eligible for this benefit after
policy is in force. In case of policy term is more than one year, continuous coverage under Star Comprehensive Insurance
such expenses are payable only till the expiry of the policy or Policy with the Company, after every block of 3 years and payable
policy anniversary whichever is earlier. while the policy is in force.
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Claims under this section will not reduce the Sum Insured and will policy is on individual sum insured basis a claim made by one
not impact the benefit under Section 6. insured person will not affect the Health Check-up benefit to other
Section 3 Out-patient Dental and Ophthalmic Treatment
insured persons.
Limit for Out Patient Dental and
Note: Payment of expenses towards cost of health check up will
Sum Insured Rs. Ophthalmic Treatments for each block not prejudice the company's right to deal with a claim in case of
of 3 continuous years (up to Rs.) non disclosure of material fact and / or Pre-Existing Diseases in
5,00,000/- and 7,50,000/- 5,000/-
terms of the policy
10,00,000/- to 25,00,000/- 10,000/-
Above 25,00,000/- 15,000/- Section 7 Bariatric Surgery
Expenses incurred on hospitalization for bariatric surgical
Note: Payment of any claim under this section shall not be
procedure and its complications thereof are payable subject to
construed as a waiver of Company's right to repudiate any claim limits mentioned in the table given below, during the policy period.
on grounds of nondisclosure of material fact or preexisting This maximum limit of Rs.2,50,000/- and Rs.5,00,000/- are
disease for hospitalization expenses under hospitalization inclusive of pre-hospitalization and post hospitalization expenses.
provisions of the policy contract.
Section 4 Organ Donor Expenses In patient hospitalization Sum Insured Rs. Limit per policy period (Rs.)
expenses incurred for organ transplantation from the Donor to the 5,00,000/- to 15,00,000/- 2,50,000/-
Recipient Insured Person are payable provided the claim for Above 15,00,000/- 5,00,000/-
transplantation is payable. In addition, the expenses incurred by
Special conditions:
the Donor, (if any) for the complications that necessitate a Redo
1. This benefit is subject to a waiting period of 36 months from the
Surgery / ICU admission will be covered. date of first commencement of this policy and continuous
The coverage limit under this section is over and above the Limit renewal thereof with the Company.
of Coverage and upto the Basic Sum Insured. This additional
2. The minimum age of the insured at the time of surgery should
Sum Insured can be utilized by the Donor and not by the be above 18 years.
Insured.
3. This benefit shall not apply where the surgery is performed for
Section 5 Hospital Cash Benefit: Subject to an admissible a) Reversible endocrine or other disorders that can cause
Hospitalization claim, Cash Benefit up to the limits mentioned in obesity
the table below for each completed day of Hospitalization for a b) Current drug or alcohol abuse
maximum of 7 days per occurrence is payable.
c) Uncontrolled, severe psychiatric illness
This Benefit is available for a maximum of 120 days during the
d) Lack of comprehension of risks, benefits, expected
entire policy period. outcome, alternatives and lifestyle changes required with
This benefit is subject to an excess of first 24 hours of bariatric surgery.
Hospitalization for each and every claim. Claims under this e) Bariatric surgery performed for Cosmetic reasons
section will not reduce the Sum Insured.
Section 5 Hospital Cash
4. The indication for the procedure should be found appropriate
Hospital Cash Benefit - Limit of by two qualified surgeons and the insured person shall obtain
Sum Insured Rs.
Company's liability per day (Rs.) prior approval for cashless treatment from the Company.
5,00,000/- 500/- 5. To make a claim, the insured person should satisfy the
7,50,000/- and 10,00,000/- 750/-
following criteria as devised by NIH (National Institute of
15,00,000/- and 20,00,000/- 1,000/-
25,00,000/- 1,500/-
Health)
50,00,000/-, 75,00,000/-, and 1,00,00,000/- 2,500/- a) The BMI should be greater than 40 or greater than 35 with
Section 6 Health Check Up Expenses incurred towards cost of co-morbidities (like Diabetes, High Blood Pressure etc.)
health check-up up to the limits mentioned in the table given below b) The Insured Person Is unable to lose weight through
for every claim free year are payable provided traditional methods like diet and exercise.
i. the health checkup is done at networked facility and Note: Claims under this section shall be processed only on
ii. the policy is in force. cashless basis. The limit of cover provided under this section forms
Payment under this benefit does not form part of the sum insured and part of the sum insured and will affect Cumulative Bonus
will not impact the Bonus. Section 8 Option for Second Medical Opinion
Sum Insured Rs. Limit (Up to Rs) The Insured Person is given the facility of obtaining a Medical
5,00,000/- 2,000/- Second Opinion from a Doctor in the Company's network of
7,50,000/- 2,500/-
Medical Practitioners. All the medical records provided by the
10,00,000/- 3,000/-
15,00,000/- 4,000/-
Insured Person will be submitted to the Doctor chosen by him/her
20,00,000/- 4,500/- either online or through post/courier and the medical opinion will
25,00,000/- 4,500/- be made available directly to the Insured by the Doctor.
50,00,000/-, 75,00,000/- and 1,00,00,000/- 5,000/-
Subject to the following conditions :-
Where the policy is on a floater sum insured basis, if a claim is · This should be specifically requested for by the Insured
made either under Section 1 (other than Section 1H) or under Person
Section 4 by any of the insured persons, the health check up · This opinion is given without examining the patient, based only
benefits will not be available under the policy. However where the on the medical records submitted.
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· The second opinion should be only for medical reasons and 2. In the event of Permanent Total Disablement, the Insured
not for medico-legal purposes. Person will be under obligation:
· Any liability due to any errors or omission or consequences of a) To have himself/herself examined by doctors appointed by
any action taken in reliance of the second opinion provided by the Company / and the Company will pay the costs
the Medical Practitioner is outside the scope of this policy. involved thereof.
· Utilizing this facility alone will not amount to making a claim. b) To authorize doctors providing treatments or giving expert
opinion and any other authority to supply the Company any
Section 9 AYUSH Treatment: In patient Hospitalizations information that may be required. If the obligations are not
Expenses incurred on treatment under Ayurveda, Unani, met with due to whatsoever reason, the Company may be
Siddha and Homeopathy systems of medicines in a AYUSH relieved of its liability to pay.
Hospital or Day Care Centre as in patient is payable up to the
3. This Section is applicable for the person specifically
limits given below: mentioned in the Schedule.
Sum Insured Rs. Limit per policy period (Rs.) 4. The sum insured for this Section is equal to the sum insured
5,00,000/- to 15,00,000/- 15,000/- opted for Health Section
5. Where a claim has been paid during the policy period the
20,00,000/- and 25,00,000/- 20,000/-
cover under this Section ceases until the expiry of the policy.
50,00,000/-, 75,00,000/- and Upon renewal the cover applies to the person specifically
30,000/-
1,00,00,000/- chosen again. However even if the sum insured under this
Note: section is exhausted by way of claim, the coverage under
1) Payment under this benefit forms part of the sum insured and health section will continue until expiry of the policy period
also will impact the Bonus 6. At any point of time only one person will be eligible to be
2) Yoga and Naturopathy systems of treatment are excluded covered under this Section. Dependent Children and
from the scope of coverage under AYUSH treatment persons above 70 years can be covered under this
Important Note: Applicable for Section 1 (A) to Section 1 (C), section up to the Sum insured of Rs.10,00,000/-.
Section 2 (B), Section 4, Section 7, Section 9, Section 12 and 7. Any claim under health portion will not affect the Sum Insured
Section 13 under this section.
1. All Day Care Procedures are covered. 8. Where there is an admissible claim for Accidental Death
2. Expenses on Hospitalization are payable provided the during the policy period, the health cover will continue for the
hospitalization is for minimum period of 24 hours. However remaining insured persons.
this time limit will not apply for treatments / Day Care
9. Where there is an admissible claim for Permanent Total
procedures where taken in the Hospital / Nursing Home and
Disability during the policy period, the health cover would
the Insured are discharged on the same day.
continue until the expiry of the policy for all the insured persons
3. Hospitalization Expenses which vary based on the room rent
covered including the person who has made a claim for
occupied by the insured person will be considered in
Permanent Total Disability and renewal thereof.
proportion to the room rent limit / room category stated in the
policy or actuals whichever is less 10. Where there is an admissible claim for Permanent Total
Section 10 Accidental Death and Permanent Total Disability or Death during the policy period, the personal
Disablement accident cover will be applicable for another person chosen at
If at any time during the Period of Insurance, the Insured Person the time of renewal.
shall sustain any bodily injury resulting solely and directly from 11. Geographical Scope : The cover under this section applies
Accident caused by external, violent and visible means then the World Wide
Company will pay as under:
Table of Benefits - B1
1. Accidental Death of Insured Person: If following an
Accident that causes death of the Insured Person within 12 Percentage of the
Benefits
Calendar months from the date of Accident, then the Company Basic Sum Insured
will pay an amount as compensation the Sum Insured 1. Death 100%
mentioned in the Schedule 2. Permanent Total Disablement 100%
2. Permanent Total Disablement of the Insured Person: If Total and irrevocable loss of
following an Accident which caused permanent impairment of
(i) Sight of both eyes 100%
the Insured's mental or physical capabilities, then the
(ii) Physical separation of two entire hands 100%
Company will pay the benefits as provided in the “Table of
Benefits - B1”, depending upon the degree of disablement (iii) Physical separation of two entire foot 100%
provided that: (iv) One entire hand and one entire foot 100%
a) The disablement occurs within 12 Calendar months from (v) Sight of one eye and loss of one hand 100%
the date of the Accident. (vi) Sight of one eye and loss of one
b) The disablement is confirmed and claimed for, prior to the 100%
entire foot
expiry of a period of 60 days since occurrence of the (vii) Use of two hands 100%
disablement. (viii) Use of two foot 100%
Special Conditions:
(ix) Use of one hand and one foot 100%
1. If the Accident affects any physical function, which was
already impaired prior to the accident, a deduction as per (x) Sight of one eye and use of one hand 100%
“Table – B2” will be made in respect of this prior disablement. (xi) Sight of one eye and use of one foot 100%
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 Table - B2 *In case of floater policy the weightage is given as per the
following table :
Percentage of Sum Family Size Weightage
Physical function already impaired prior to accident
Insured Deducted
Self, Spouse 1:1
1 Loss of toes all All 20 Self, Spouse and Dependent Children
[Link]
(up to 18 years)
Loss of Great toe both phalanges 5
Self, Spouse and Dependent Children
Loss of Great toe one phalanx 2 [Link]
(aged above 18 years)
Other than Great, if more
than Note: In case of two year policy, total number of wellness points
One toe lost, for each toe For each toe 1
earned in two year period will be divided by two.
2 Loss of hearing both ears Both ears 75 Each Insured Person will be given an Individual log-in facility,
Loss of hearing one ear One ear 30 which will be linked to his/ her policy.
Loss of four fingers and
*Please refer the Illustrations to understand the calculation of
3 40 discount in premium, weightage and the calculation in case of two
thumbs of One hand
4 Loss of four fingers 35 year policy.
The wellness services and activities are categorized as below:
Loss of thumb both Maximum number
Both phalanges 25
phalanges of Wellness Points
Sr.
Activity that can be earned
One phalanx 10 No.
under each policy
Loss of index finger three in a policy year
5 Three phalanges 10
phalanges Manage and Track Health
Two phalanges Two phalanges 8 1. a) Online Health Risk Assessment (HRA) 50
One phalanx One phalanx 4 b) Preventive Risk Assessment 200
6 Loss of middle finger Three phalanges 6 Affinity to Wellness
Two phalanges 4 a) Participating in Walkathon, Marathon, Cyclothon and
2. 100
One phalanx 2 similar activities
b) Membership in a health club (for 1 year or more) 100
7 Loss of ring finger Three phalanges 5
Two phalanges 4 Stay Active – If the Insured member achieves the step
3. 200
count target on mobile app
One phalanx 2
a) Weight Management Program (for the Insured who is
8 Loss of little finger Three phalanges 4 100
Overweight / Obese)
Two phalanges 3 4. b) Sharing Insured Fitness Success Story through
One phalanx 2 adoption of Star Wellness Program (for the Insured who 50
9 Loss of metacarpals First or second 3 is not Overweight / Obese)
Additional (third fourth or fifth) 2 a) Chronic Condition Management Program (for the
Insured who is suffering from Chronic Condition/s -
Percentage as 250
Diabetes, Hypertension, Cardiovascular Disease or
assessed by the Asthma)
Any other Permanent
10 Medical Board or by 5.
partial disablement b) On Completion of De-Stress & Mind Body Healing
the government
doctor Program (for the Insured who is not suffering from
125
Chronic Condition/s - Diabetes, Hypertension,
Cardiovascular Disease or Asthma)
Section 11: Star Wellness Program: This program intends to
Additional Wellness Services
promote, incentivize and to reward the Insured Persons' healthy
life style through various wellness activities. The wellness 6. Online Chat with Doctor
activities as mentioned below are designed to help the Insured 7. Medical Concierge Services
person to earn wellness reward points which will be tracked and
8. Period & Fertility Tracker
monitored by the Company. The wellness points earned by the
9. Digital Health Vault
Insured Person(s) under the wellness program, can be utilized to
get discount in premium. 10. Wellness Content
This Wellness Program is enabled and administered online through 11. Health Quiz & Gamification
"Star Health" Mobile App. 12. Post-Operative Care
Note: The Wellness Activities mentioned in the table below (from 13. Discounts from Network Providers
Serial Number 1 to 5) are applicable for the Insured person(s)
aged 18 years and above only. 1. Manage and Track Health:
a) Completion of Health Risk Assessment (HRA): The Health
The following table shows the discount on premium available Risk Assessment (HRA) questionnaire is an online tool for
under the Wellness Program: evaluation of health and quality of life of the Insured. It helps
Wellness Points Earned Discount in Premium the Insured to introspect his/ her personal lifestyle. The
200 to 350 2% Insured can log into his/her account on the website
351 to 600 5% [Link] and complete the HRA questionnaire.
601 to 750 7% The Insured can undertake this once per policy year.
751 to 1000 10% On Completion of online HRA questionnaire, the Insured
earns 50 wellness points.
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 Note: To get the wellness points mentioned under HRA, the - An additional 50 wellness points will be awarded in
Insured has to complete the entire HRA within one month from case if the results are achieved and maintained as
the time he/she started HRA Activity. mentioned below;
b) Preventive Risk Assessment: The Insured can also earn Sr. Name of the Values to be Criteria to get the Wellness
wellness points by undergoing diagnostic / preventive tests No. Ailment submitted points
during the policy year. These tests should include the four
mandatory tests mentioned below. Insured can take these 1.
Obesity (If BMI is Height & Weight (to Achieving and maintaining the BMI
tests at any diagnostic centre at Insured's own expenses. above 29) calculate BMI) between 18 and 29
- If all the results of the submitted test reports are within Reducing BMI by two points and
Overweight (If BMI is Height & Weight (to
the normal range, Insured earns 200 wellness points. 2.
between 25 and 29) calculate BMI)
maintaining the same BMI in the
policy year
- If the result of any one test is not within the normal
range as specified in the lab report, Insured earns 150 - Values (for BMI) shall be submitted for every 2 months (up to 5 times in each policy year)
wellness points. b) Incase if the Insured is not Overweight / Obese, the Insured
- If two or more test results are not within the normal can submit his/her Fitness Success Story through
range, Insured earns 100 wellness points only. adoption of Star Wellness Activities with us. On submission
Note: These tests reports should be submitted together and of the Fitness Success Story through adoption of Star
within 30 days from the date of undergoing such Health Wellness Activities, Insured earns 50 wellness points.
Check-Up. 5. Chronic Condition Management Program:
List of mandatory tests under Preventive Risk Assessment
a) This Program will help the Insured suffering from Diabetes,
1. Complete Haemogram Test Hypertension, Cardiovascular Disease or Asthma to track
2. Blood Sugar (Fasting Blood Sugar (FBS) + Postprandial (PP) [or] HbA1c)
their health through the empanelled wellness experts who
3. Lipid profile (Total cholesterol, HDL, LDL, Triglycerides, Total Cholesterol / HDL
Cholesterol Ratio) will guide the insured in maintaining/ improving the health
4. Serum Creatinine condition.
2. Affinity towards wellness: Insured earns wellness points for - On acceptance of the Chronic Condition Management
undertaking any of the fitness and health related activities as Program, Insured earns 100 wellness points.
given below. List of Fitness Initiatives and Wellness points: - The Insured has to submit the test result values for
every 3 months maximum up to 3 times in a policy year.
Wellness - If the test result values are within +/- 10% range of the
Initiative
Points
values given below, for at least 2 times in a policy year,
Participating in Walkathon, Marathon, Cyclothon and similar activities an additional 150 wellness points will be awarded.
a.
On submission of BIB Number along with the details of the entry ticket
100 - These tests reports to be submitted within 1 month
taken to participate in the event. from the date of undergoing the Health Check-Up.
Membership in a health club (for 1 year or more) - In a Gym / Yoga Centre /
b. Zumba Classes / Aerobic Exercise/ Sports Club/ Pilates Classes/ 100 Sr. Test to be Values Criteria to get the
Name of the Ailment
Swimming / Tai Chi/ Martial Arts / Gymnastics/ Dance Classes No. submitted additional Wellness points

Note: In case if Insured is not a member of any health club, he/she should join into club Diabetes(Insured can HbA1c ≤ 6.5
within 3 months from the date of the policy risk commencement date. Insured person submit either HbA1c
should submit the health club membership. test value (or) Fasting Blood
1. Fasting Blood Sugar Sugar (FBS)
(FBS) Range and Range and 100 to 125 mg/dl
3. Stay Active: Insured earns wellness points on achieving the Postprandial test Postprandial test
step count target on star mobile application as mentioned below: value) value below 160 mg/dl
Measured with - Systolic Range - 110 to 140 mmHg
Average number of steps per day in a policy year Wellness Points 2. Hypertension
BP apparatus Diastolic Range - 70 to 90 mmHg
· If the average number of steps per day in a policy year are LDL Cholesterol
100 100 to 159 mg/dl
between - 5000 and 7999 Cardiovascular and Total
3.
Disease Cholesterol / HDL
· If the average number of steps per day in a policy year are
150 Cholesterol Ratio ≤ 4.0
between - 8000 and 9999
PFT (Pulmonary FEV1 (PFC) is 75% or more
· If the average number of steps per day in a policy year are 4. Asthma
200 Function Test) FEV1/ FVC is 70% or more
- 10000 and above
Note: b) In case if the Insured is not suffering from Chronic Condition/s
· First month and last month in each policy year will not be taken into consideration for (Diabetes, Hypertension, Cardiovascular Disease or Asthma)
calculation of average number of steps per day under Stay Active. he/she can opt for “De-Stress & Mind Body Healing Program”.
· The mobile app must be downloaded within 30 days of the policy risk start date to This program helps the Insured to reduce stress caused due to
avail this benefit.
internal (self-generated) & external factors and increases the
· The average step count completed by an Insured member would be tracked on star
wellness mobile application.
ability to handle stress.
- On acceptance of De-stress & Mind Body Healing
4. Weight Management Program:
Program Insured earns 50 wellness points.
a) This Program will help the Insured persons with Over
- On completion of De-stress & Mind Body Healing
Weight and Obesity to manage their Body Mass Index (BMI)
Program Insured earns an additional 75 wellness points.
through the empanelled wellness experts who will guide the
Insured in losing excess weight and maintain their BMI. Note: This is a 10 weeks program which insured needs to
complete without any break.
- On acceptance of the Weight Management Program, 6. Online Chat with Doctor: Insured can consult qualified
Insured earns 50 wellness points. healthcare professionals at their convenience. The Doctor Chat
Star Comprehensive Insurance Policy Unique Identification No.: SHAHLIP25037V082425 PROS / COMP / V.13 / 2024 6 of 16
 feature allows Insured to “Chat” with qualified Doctors, · Star Health, its group entities, or affiliates, their respective
available from Monday to Friday between 9.00 AM and 6.00 PM directors, officers, employees, agents, vendors, are not
to help Insured with advice and quick consultations including on responsible or liable for, any actions, claims, demands,
Diet & Nutrition and Second Medical Opinion. They do not losses, damages, costs, charges and expenses which a
prescribe any medications or diagnose any health issues. Member claims to have suffered, sustained or incurred, by
7. Medical Concierge Services: The Insured can also contact way of and / or on account of the Wellness Program.
Star Health to avail the following services: - Emergency · Services offered are subject to guidelines issued by IRDAI
assistance information such as nearest ambulance / hospital / from time to time.
blood bank etc.
8. Period & Fertility Tracker: The online easy tracking program ILLUSTRATION OF BENEFITS
helps every woman with their period health and fertility care. Lets look how the Insured can avail discount on premium
The program gives access to trackers for period and ovulation through the “Star Wellness Program”
which maps out cycles for months. This helps in planning for
conception prevention and tracks peak ovulation if planning Scenario – 1
pregnancy. A 40 year old Individual Ramesh buys Star Comprehensive Insurance Policy (Individual
Sum Insured) with Sum Insured 25 Lacs, let's understand how he can earn Wellness
9. Digital Health Vault: A secured Personal Health records Points by doing different wellness activities. Ramesh has declared that his Body Mass
system for Insured to store/access and share health data with Index (BMI) as 24 and he is a Diabetic. Ramesh enrolled under the Star Wellness
trusted recipients. Using this portal, Insured can store their Program and completed the following wellness activities
health documents (prescriptions, lab reports, discharge
Sr. Name of the wellness activity taken up during
summaries etc.), track health data add family members. No the policy year
Wellness Points Earned
10. Wellness Content: The wellness portal provides rich 1. Completed Online Health Risk Assessment (HRA) 50
collection of health articles, blogs, tips and other health and Submitted Health Check-Up Report (two test
2. 100
wellness content. The contents have been written by experts results are not within normal values)
drawn from various fields. Insured will benefit from having one 3. Participated in Walkathon 100
single and reliable source for learning about various health 4. Attended to Gym 100
aspects and incorporating positive health changes. Achieved 10,000 average number of steps per
5. 200
day during the policy year
11. Health Quiz & Gamification: 6. Shared his fitness success story 50
- The wellness portal provides a host of Health & Wellness 7.
Managed Diabetes through Chronic Condition
250
Quizzes. The wellness quizzes are geared towards helping Management Program
the Insured to be more aware of various health choices. Total Number of Wellness Points earned 850

- Gamification helps in creating fun and engaging health & Based on the number of Wellness Points earned Ramesh is eligible to get
10% discount on renewal premium.
wellness experiences. It helps to create a sense of
achievement in users and increases motivation levels.
12. Post Operative Care: It is done through follow up phone calls Lets look how the Insured can avail discount on premium
(primarily for surgical cases) for resolving their medical through the “Star Wellness Program”
queries.
Scenario – 2
13. Discounts from Network Providers: The Insured can avail A 42 year old Individual Suresh and his wife Lakshmi along with their two dependent children
discounts on the services offered by our network providers (aged below 18 yrs) buy a Star Comprehensive Insurance Policy (Floater Sum Insured) with
Sum Insured 25 Lacs, let's understand how they can earn Wellness Points under the Floater
which will be displayed in our website. Policy. Suresh has declared that he is suffering from Diabetes & Hypertension. Suresh has
Terms and conditions under wellness activity declared his Body Mass Index (BMI) as 30 & Lakshmi has declared her BMI as 25
Suresh and Lakshmi enrolled under the Star wellness program and completed the
· Any information provided by the Insured in this regard shall following wellness activities.
be kept confidential.
Wellness Wellness
· There will not be any cash redemption against the Sr. Name of the wellness activity taken up
Points Earned Points Earned
No during the policy year
wellness reward points. by Suresh by Lakshmi
· Insured should notify and submit relevant documents, 1. Completed Online Health Risk Assessment (HRA) 50 50
reports, receipts etc for various wellness activities within 1 2. Submitted Health Check-Up Report 200 200
month of undertaking such activity/test. 3. Participated in Marathon 100 0
· No activity, report, document, receipt can be submitted in 4. Attended to Gym 100 100
the last month of each policy year. 5.
Achieved 10,000 average number of steps per
200 200
day during the policy year
· For services that are provided through empaneled service
Suresh accepted the Weight management
provider, Star Health is only acting as a facilitator; hence program and reached 27 BMI
6. 100 100
would not be liable for any incremental costs or the Lakshmi accepted the Weight management
services. program and reached 23 BMI
Suresh Managed Diabetes & Hypertension
· All medical services are being provided by empaneled through Chronic Condition Management Program;
health care service provider. We ensure full due diligence 7. 250 125
Lakshmi has completed De-stress & Mind Body
before empanelment. However Insured should consult Healing Program
his/her doctor before availing/taking the medical Total Number of Wellness Points earned 1000 775
advices/services. The decision to utilize these No of wellness points based upon 500 388
advices/services is solely at Insured person's discretion. weightage - 1:1 (1000x1/2) (775x1/2)
Total Number of Wellness Points earned by Suresh and Lakshmi = 888 (500+388)
· We reserve the right to remove the wellness reward points Based on the no of Wellness Points earned, Suresh & Lakshmi are eligible to get
if found to be achieved in unfair manner. 10% discount on renewal premium

Star Comprehensive Insurance Policy Unique Identification No.: SHAHLIP25037V082425 PROS / COMP / V.13 / 2024 7 of 16
 Lets look how the Insured can avail discount on premium *Sublimit all inclusive with or without hospitalization where ever
through the “Star Wellness Program”Scenario – 3 hospitalization includes pre and post hospitalization.
Scenario – 3 µ Add-on cover: Star Extra Protect – Add on cover| UIN:
A 27 year old Individual Umesh buys Star Comprehensive Insurance Policy (Individual Sum
Insured) for two year period, with Sum Insured 25 Lacs, let's understand how he can earn SHAHLIA23061V012223 and its subsequent revisions.
Wellness Points by doing different wellness activities. Umesh has declared that his Body
Mass Index (BMI) is 24 and he is not suffering with any Chronic Condition. Umesh enrolled This Add on cover can be availed along with this Product.
under the Star Wellness Program and completed the following wellness activities. Please ask for the Prospectus and Proposal Form of the same
Sr. Name of the wellness activity taken Wellness Points Wellness Points at the time of purchase. All terms and conditions of the Add-on
Earned in the Earned in the
No up during the policy year First Year Second Year cover will apply.
1. Completed Online Health Risk Assessment (HRA) 50 50 µ Exclusions
2. Submitted Health Check-Up Report 200 200 A. The Company shall not be liable to make any payments under
3. Participated in Walkathon 100 100 this policy in respect of any expenses what so ever incurred by
4. Attended to Yoga Classes 100 100 the insured person in connection with or in respect of;
Achieved 10,000 average number of steps per 1. Pre-Existing Diseases - Code Excl 01
5. 200 200
day during the policy year
6. Submitted his fitness success story 50 50 A. Expenses related to the treatment of a pre-existing
Completed De-stress & Mind Body Healing Disease (PED) and its direct complications shall be
7. 125 125
Program excluded until the expiry of 36 months of continuous
Total Number of Wellness Points earned 825 825 coverage after the date of inception of the first policy with
Total Number of Wellness Points earned by Umesh = 1650 (825+825) insurer
Calculation of Wellness Points as per two year policy condition = 825 (1650/2)
Based on the number of Wellness Points earned, Umesh is eligible to get
B. In case of enhancement of sum insured the exclusion shall
10% discount on renewal premium. apply afresh to the extent of sum insured increase
µ Coverage for Modern Treatments: The expenses payable C. If the Insured Person is continuously covered without any
during the entire policy period for the following break as defined under the applicable norms on portability
treatment/procedure (either as a day care or as an in-patient stipulated by IRDAI, then waiting period for the same
exceeding 24hrs of admission in the hospital) is limited to the would be reduced to the extent of prior coverage.
amount mentioned in table below;
D. Coverage under the policy after the expiry of 36 months for
Immunotherapy-Monoclonal

any pre-existing disease is subject to the same being

and Post Hospitalisation)
(Sublimits including Pre

Antibody to be given as
Deep Brain Stimulation
Embolization and HIFU

Intra Vitreal injections

Oral Chemotherapy*

declared at the time of application and accepted by Insurer

Uterine artery

Sinuplasty

2. Specified disease / procedure waiting period - Code Excl 02

injection
Balloon
Sum Insured in Rs.

A. Expenses related to the treatment of the following listed

Conditions, surgeries/treatments shall be excluded until the
expiry of 24 months of continuous coverage after the date of
inception of the first policy with us. This exclusion shall not be
Sum Insured on Individual Basis: Limit per person, applicable for claims arising due to an accident
per policy period for each treatment / procedure
Sum Insured on Floater Basis: Limit per policy period B. In case of enhancement of sum insured the exclusion shall
for each treatment / procedure Rs. apply afresh to the extent of sum insured increase
5,00,000/- 1,25,000/- 50,000/- 2,50,000/- 1,25,000/- 2,50,000/- 50,000/-
C. If any of the specified disease/procedure falls under the
7,50,000/- 1,25,000/- 50,000/- 2,50,000/- 1,25,000/- 2,75,000/- 60,000/- waiting period specified for pre-existing diseases, then the
10,00,000/- 1,50,000/- 1,00,000/- 3,00,000/- 2,00,000/- 4,00,000/- 75,000/-
longer of the two waiting periods shall apply
15,00,000/- 1,75,000/- 1,25,000/- 4,00,000/- 2,50,000/- 5,00,000/- 1,00,000/-
20,00,000/- 2,00,000/- 1,50,000/- 4,50,000/- 2,75,000/- 5,50,000/- 1,25,000/- D. The waiting period for listed conditions shall apply even if
25,00,000/- 2,00,000/- 1,50,000/- 5,00,000/- 3,00,000/- 6,00,000/- 1,50,000/- contracted after the policy or declared and accepted
50,00,000/- 2,25,000/- 1,75,000/- 6,00,000/- 4,00,000/- 7,50,000/- 1,75,000/- without a specific exclusion
75,00,000/- 2,50,000/- 2,00,000/- 7,00,000/- 5,00,000/- 9,00,000/- 2,00,000/- E. If the Insured Person is continuously covered without any
1,00,00,000/- 3,00,000/- 2,00,000/- 7,50,000/- 6,00,000/- 10,00,000/- 2,00,000/-
break as defined under the applicable norms on portability
Vaporisation of the prostate

Hematopoietic stem cells for

stipulated by IRDAI, then waiting period for the same

bone marrow transplant for
haematological conditions
(Green laser treatment or
holmium laser treatment)

IONM-(Intra Operative

would be reduced to the extent of prior coverage

Neuro Monitoring)
Robotic surgeries

Stem cell therapy:

radio surgeries

Thermoplasty
Stereotactic

Bronchical

F. List of specific diseases/procedures;

Sum Insured in Rs.

i. Treatment of Cataract and diseases of the anterior and

posterior chamber of the Eye, Diseases of ENT,
Diseases related to Thyroid, Benign diseases of the
breast
Sum Insured on Individual Basis: Limit per person, ii. Subcutaneous Benign Lumps, Sebaceous cyst,
per policy period for each treatment / procedure
Sum Insured on Floater Basis: Limit per policy period Dermoid cyst, Mucous cyst lip / cheek, Carpal Tunnel
for each treatment / procedure Rs. Syndrome, Trigger Finger, Lipoma, Neurofibroma,
5,00,000/- 2,50,000/- 2,00,000/- 2,50,000/- Fibroadenoma, Ganglion and similar pathology
7,50,000/- 2,75,000/- 2,25,000/- 2,75,000/- iii. All treatments (Conservative, Operative treatment)
10,00,000/- 3,00,000/- 2,50,000/- 4,00,000/- and all types of intervention for Diseases related to
15,00,000/- 4,00,000/- 2,75,000/- 5,00,000/-
Up to Sum Insured
Tendon, Ligament, Fascia, Bones and Joint Including
20,00,000/- 4,50,000/- 2,75,000/- 5,50,000/-
25,00,000/- 5,00,000/- 3,00,000/- 6,00,000/-
Arthroscopy and Arthroplasty / Joint Replacement
50,00,000/- 6,00,000/- 3,50,000/- 7,50,000/-
[other than caused by accident]
75,00,000/- 7,00,000/- 3,75,000/- 9,00,000/- iv. All types of treatment for Degenerative disc and
1,00,00,000/- 7,50,000/- 4,00,000/- 10,00,000/- Vertebral diseases including Replacement of bones
Star Comprehensive Insurance Policy Unique Identification No.: SHAHLIP25037V082425 PROS / COMP / V.13 / 2024 8 of 16
 and joints and Degenerative diseases of the Musculo- 2. greater than or equal to 35 in conjunction with any of
skeletal system, Prolapse of Intervertebral Disc (other the following severe co-morbidities following failure of
than caused by accident) less invasive methods of weight loss:
v. All treatments (conservative, interventional, a. Obesity-related cardiomyopathy
laparoscopic and open) related to Hepato-pancreato- b. Coronary heart disease
biliary diseases including Gall bladder and Pancreatic c. Severe Sleep Apnea
calculi. All types of management for Kidney and
Genitourinary tract calculi d. Uncontrolled Type2 Diabetes
vi. All types of Hernia 7. Change-of-Gender treatments - Code Excl 07: Expenses
related to any treatment, including surgical management, to
vii. Desmoid Tumor, Umbilical Granuloma, Umbilical
change characteristics of the body to those of the opposite
Sinus, Umbilical Fistula
sex.
viii. All treatments (conservative, interventional,
8. Cosmetic or plastic Surgery - Code Excl 08: Expenses for
laparoscopic and open) related to all Diseases of
cosmetic or plastic surgery or any treatment to change
Cervix, Uterus, Fallopian tubes, Ovaries, Uterine
Bleeding, Pelvic Inflammatory Diseases appearance unless for reconstruction following an Accident,
Burn(s) or Cancer or as part of medically necessary treatment
ix. All Diseases of Prostate, Stricture Urethra, all to remove a direct and immediate health risk to the insured.
Obstructive Uropathies For this to be considered a medical necessity, it must be
x. Benign Tumours of Epididymis, Spermatocele, certified by the attending Medical Practitioner.
Varicocele, Hydrocele
9. Hazardous or Adventure sports - Code Excl 09: Expenses
xi. Fistula, Fissure in Ano, Hemorrhoids, Pilonidal Sinus related to any treatment necessitated due to participation as a
and Fistula, Rectal Prolapse, Stress Incontinence professional in hazardous or adventure sports, including but
xii. Varicose veins and Varicose ulcers not limited to, para-jumping, rock climbing, mountaineering,
xiii. All types of transplant and related surgeries rafting, motor racing, horse racing or scuba diving, hand
xiv. Congenital Internal disease / defect (except to the gliding, sky diving, deep-sea diving.
extent provided under Section 2 for New Born) 10. Breach of law - Code Excl 10: Expenses for treatment
3. 30-day waiting period - Code Excl 03 directly arising from or consequent upon any Insured Person
A. Expenses related to the treatment of any illness within 30 committing or attempting to commit a breach of law with
days from the first policy commencement date shall be criminal intent.
excluded except claims arising due to an accident, 11. Excluded Providers - Code Excl 11: Expenses incurred
provided the same are covered towards treatment in any hospital or by any Medical
B. This exclusion shall not, however, apply if the Insured Practitioner or any other provider specifically excluded by the
Person has continuous coverage for more than twelve Insurer and disclosed in its website / notified to the
months policyholders are not admissible. However, in case of life
C. The within referred waiting period is made applicable to the threatening situations or following an accident, expenses up to
enhanced sum insured in the event of granting higher sum the stage of stabilization are payable but not the complete
insured subsequently claim.
4. Investigation & Evaluation - Code- Excl 04 12. Treatment for Alcoholism, drug or substance abuse or any
addictive condition and consequences thereof - Code Excl 12
A. Expenses related to any admission primarily for
diagnostics and evaluation purposes only are excluded 13. Treatments received in health hydros, nature cure clinics, spas
or similar establishments or private beds registered as a nursing
B. Any diagnostic expenses which are not related or not
home attached to such establishments or where admission is
incidental to the current diagnosis and treatment are
arranged wholly or partly for domestic reasons - Code Excl 13
excluded
14. Dietary supplements and substances that can be purchased
5. Rest Cure, rehabilitation and respite care - Code Excl 05:
without prescription, including but not limited to Vitamins,
Expenses related to any admission primarily for enforced bed
minerals and organic substances unless prescribed by a
rest and not for receiving treatment. This also includes; medical practitioner as part of hospitalization claim or day care
1. Custodial care either at home or in a nursing facility for procedure - Code Excl 14
personal care such as help with activities of daily living
15. Refractive Error - Code Excl 15: Expenses related to the
such as bathing, dressing, moving around either by skilled treatment for correction of eye sight due to refractive error less
nurses or assistant or non-skilled persons than 7. 5 dioptres.
2. Any services for people who are terminally ill to address 16. Unproven Treatments - Code Excl 16: Expenses related to
physical, social, emotional and spiritual needs any unproven treatment, services and supplies for or in
6. Obesity / Weight Control - Code Excl 06: Expenses related connection with any treatment. Unproven treatments are
to the surgical treatment of obesity that does not fulfill all the treatments, procedures or supplies that lack significant
below conditions; medical documentation to support their effectiveness.
A. Surgery to be conducted is upon the advice of the Doctor 17. Sterility and Infertility - Code Excl 17: Expenses related to
B. The surgery/Procedure conducted should be supported by sterility and infertility. This includes;
clinical protocols a. Any type of contraception, sterilization
C. The member has to be 18 years of age or older and b. Assisted Reproduction services including artificial
D. Body Mass Index (BMI); insemination and advanced reproductive technologies
1. greater than or equal to 40 or such as IVF, ZIFT, GIFT, ICSI
Star Comprehensive Insurance Policy Unique Identification No.: SHAHLIP25037V082425 PROS / COMP / V.13 / 2024 9 of 16
 c. Gestational Surrogacy 2. Any injuries/conditions which are Pre-existing conditions -
d. Reversal of sterilization Code Sec10 Excl 02
18. Maternity - Code Excl 18 3. Any claim arising out of Accidents that the Insured Person has
a. Medical treatment expenses traceable to childbirth caused - Code Sec10 Excl 03
(including complicated deliveries and caesarean sections i. intentionally or
incurred during hospitalization) except ectopic pregnancy ii. by committing a crime / involved in it or
and to the extent covered under Section 2 iii. as a result of / in a state of drunkenness or addiction
b. Expenses towards miscarriage (unless due to an accident) (drugs, alcohol)
and lawful medical termination of pregnancy during the 4. Insured Person engaging in Air Travel unless he/she flies as a
policy period fare-paying passenger on an aircraft properly licensed to carry
19. Circumcision (unless necessary for treatment of a disease not passengers. For the purpose of this exclusion Air Travel
excluded under this policy or necessitated due to an accident), means being in or on or boarding an aircraft for the purpose of
Preputioplasty, Frenuloplasty, Preputial Dilatation and flying therein or alighting there from - Code Sec10 Excl 04
Removal of SMEGMA - Code Excl 19 5. Accidents that are results of war and warlike occurrence or
20. Congenital External Condition / Defects / Anomalies (except to invasion, acts of foreign enemies, hostilities, civil war,
the extent provided under Section 2 for New Born) - Code rebellion, insurrection, civil commotion assuming the
Excl 20 proportions of or amounting to an uprising, military or usurped
21. Convalescence, general debility, run-down condition, power, seizure capture arrest restraints detainments of all
Nutritional deficiency states - Code Excl 21 kings princes and people of whatever nation, condition or
quality whatsoever - Code Sec10 Excl 05
22. Intentional self injury - Code Excl 22
6. Participation in riots, confiscation or nationalization or
23. Injury/disease caused by or arising from or attributable to war,
requisition of or destruction of or damage to property by or
invasion, act of foreign enemy, warlike operations (whether
under the order of any government or local authority - Code
war be declared or not) - Code Excl 24
Sec10 Excl 06
24. Injury or disease caused by or contributed to by nuclear
7. Any claim resulting or arising from or any consequential loss
weapons/materials - Code Excl 25
directly or indirectly caused by or contributed to or arising from
25. Expenses incurred on Enhanced External Counter Pulsation - Code Sec10 Excl 07
Therapy and related therapies, Chelation therapy, Hyperbaric
a) Ionizing radiation or contamination by radioactivity from
Oxygen Therapy, Rotational Field Quantum Magnetic
any nuclear fuel or from any nuclear waste from the
Resonance Therapy, VAX-D, Low level laser therapy, combustion of nuclear fuel or from any nuclear waste from
Photodynamic therapy - Code Excl 26 combustion (including any self sustaining process of
26. Unconventional, Untested, Experimental therapies - Code nuclear fission) of nuclear fuel
Excl 27 b) Nuclear weapons material
27. Autologous derived Stromal vascular fraction, Chondrocyte c) The radioactive, toxic, explosive or other hazardous
Implantation, Procedures using Platelet Rich plasma and Intra properties of any explosive nuclear assembly or nuclear
articular injection therapy - Code Excl 28 component thereof
28. Biologicals, except when administered as an in-patient, when d) Nuclear, chemical and biological terrorism
clinically indicated and hospitalization warranted - Code Excl
29 8. Any claim arising out of sporting activities in so far as they
involve the training or participation in competitions of
29. Inoculation or Vaccination (except for post–bite treatment and professional or semi-professional sports persons - Code
for medical treatment for therapeutic reasons) - Code Excl 31 Sec10 Excl 08
30. Hospital registration charges, admission charges, record 9. Participation in Hazardous Sport / Hazardous Activities - Code
charges, telephone charges and such other charges - Code Sec10 Excl 09
Excl 34
10. Persons who are physically challenged unless specifically
31. Cochlear implants and procedure related hospitalization agreed and endorsed in the policy - Code Sec10 Excl 10
expenses. Cost of spectacles and contact lens(in excess of
what is specifically provided), hearing aids, walkers and 11. Any loss arising out of the Insured Person's actual or attempted
crutches, wheel chairs, CPAP, BIPAP, Continuous Ambulatory commission of or willful participation in an illegal act or any
Peritoneal Dialysis, infusion pump and such other similar aids violation or attempted violation of the law - Code Sec10 Excl 11
- Code Excl 35 12. Any payment in case of more than one claim under the policy
32. Any hospitalizations which are not Medically Necessary / does during the period of insurance by which the maximum liability
not warrant Hospitalization - Code Excl 36 of the Company in that period would exceed the amount
specified in the Schedule - Code Sec10 Excl 12
33. Other Excluded Expenses as detailed in the website
[Link] - Code Excl 37 13. Any other claim after a claim has been admitted by the
Company and becomes payable for Death or Permanent Total
34. Existing disease/s, disclosed by the Insured and mentioned in
Disablement, as mentioned In Table - Code Sec10 Excl 13
the policy schedule under Permanent Exclusion (based on
Insured's consent) - Code Excl 38 14. Any claim arising out of an accident related to pregnancy or
childbirth, infirmity, whether directly or indirectly - Code Sec10
B. Applicable for Section 10
Excl 14
1. Any claim relating to events occurring before the
15. Any claim for Death or Permanent Total Disablement of the
commencement of the cover or otherwise outside the Period
Insured Person from self-endangerment unless in self-
of Insurance - Code Sec10 Excl 01
defense or to save human life - Code Sec10 Excl 15
Star Comprehensive Insurance Policy Unique Identification No.: SHAHLIP25037V082425 PROS / COMP / V.13 / 2024 10 of 16
µ Moratorium Period: After completion of sixty continuous g. Certificate from the attending doctor regarding the
months of coverage (including portability and migration) diagnosis.
under the health insurance policy no look back to be applied. h. Copy of PAN card
This period of sixty months is called as moratorium period. The i. KYC (Identity proof with Address) of the proposer as per
moratorium would be applicable for the sums insured of the AML Guidelines
first policy and subsequently completion of sixty continuous j. NEFT documents viz., Customer name, Bank Account
months would be applicable from date of enhancement of No., Name of the Bank, IFSC code
sums insured only on the enhanced limits. After the expiry of
k. CKYC No. of the proposer (if available)
Moratorium Period no health insurance claim shall be
contestable except for proven fraud, nondisclosure, Note: For assistance call 24 hour help-line 044-69006900 or
misrepresentation and exclusions specified in the policy Toll Free No. 1800 425 2255, Senior Citizens may call
contract. The policies would however be subject to all limits, at 044-40020888.
sub limits, co-payments, deductibles as per the policy Claims of Out Patient Consultations / treatments will be
contract. settled on a reimbursement basis on production of cash
µ Claim Procedure receipts
Claiming process and documents to be submitted in support of For Accidental Death Claims:- Claim Form
claim: a. Death Certificate
A. For Cashless Treatment b. Post-mortem Certificate, if conducted
a. For assistance call 24 hour help-line 044-69006900 or Toll c. FIR (wherever required)
Free No. 1800 425 2255, Senior Citizens may call at 044- d. Police Investigation report (wherever required)
40020888. e. Viscera Sample Report (wherever required)
b. Inform the ID number for easy reference f. Forensic Science Laboratory report (wherever required)
c. On admission in the hospital, produce the customer ID g. Legal Heir Certificate
Card issued by the Company at the Hospital Helpdesk h. Succession Certificate (wherever required)
d. Obtain the Pre-authorisation Form from the Hospital Help For Permanent Total Disablement Claims
Desk, complete the Patient Information and resubmit to
the Hospital Help Desk. Certificate from Government doctor confirming the disability
and its percentage Note:
e. The Treating Doctor will complete the hospitalisation/
treatment information and the hospital will fill up expected 1. The Company authorized doctor may examine the insured
cost of treatment. This form is submitted to the Company if required
f. The Company will process the request and call for 2. The Company reserves the right to call for additional
additional documents / clarifications if the information documents wherever required
furnished is inadequate. µ Cumulative Bonus (Applicable for Section 1 other than 1H,
g. Once all the details are furnished, the Company will Section 2, Section 4, Section 7, Section 9, Section 12 and
process the request as per the terms and conditions as Section 13)
well as the exclusions therein and either approve or reject Where the sum insured under the policy is Rs.5,00,000/-, the
the request based on the merits. insured person would be entitled to the benefit of Cumulative
h. In case of emergency hospitalization information to be Bonus calculated at 50% of the basic sum insured under this
given within 24 hours after hospitalization policy following after every claim free year up to a maximum of
i. Cashless facility can be availed only in networked 100%.
Hospitals. For details of Networked Hospitals, the insured Where the sum insured under the policy is Rs.7,50,000/- or
may visit [Link] or contact the nearest branch. above, the insured person would be entitled to the benefit of
j. KYC (Identity proof with Address) of the proposer, as per Cumulative Bonus calculated at 100% of the basic sum
AML Guidelines insured under this policy following a claim free year. The
In non-network hospitals payment must be made up-front and maximum benefit of bonus is 100% of the basic sum insured.
then reimbursement will be effected on submission of Special Conditions
documents 1. For Cumulative Bonus will be calculated on the expiring
Note: The Company reserves the right to call for additional Basic Sum Insured or on the renewed Basic Sum Insured
documents wherever required. whichever is less.
Denial of a Pre-authorization request is in no way to be 2. If the insured opts to reduce the Basic Sum Insured at the
construed as denial of treatment or denial of coverage. The subsequent renewal, the limit of indemnity by way of such
Insured Person can go ahead with the treatment, settle the Cumulative Bonus shall not exceed such reduced basic
hospital bills and submit the claim for a possible sum insured.
reimbursement. 3. In the event of a claim resulting In
B. Documents to be submitted : a. Partial utilization of Basic Sum Insured, such
a. Duly completed claim form, and cumulative bonus so granted will be reduced at the
b. Pre Admission investigations and treatment papers. same rate at which it has accrued.
c. Discharge Summary from the hospital b. Full utilization of Basic Sum Insured and nil utilization
d. Cash receipts from hospital, chemists of cumulative bonus accrued, such cumulative bonus
e. Cash receipts and reports for tests done so granted will be reduced at the same rate at which it
f. Receipts from doctors, surgeons, anesthetist has accrued.

Star Comprehensive Insurance Policy Unique Identification No.: SHAHLIP25037V082425 PROS / COMP / V.13 / 2024 11 of 16
 c. Full utilization of Basic Sum Insured and partial Periods" in the event of payment of premium within the
utilization of cumulative bonus accrued, the cumulative stipulated grace Period.
bonus granted on renewal will be the balance iv. No interest will be charged lf the instalment premium is not
cumulative bonus available and after the reduction at paid on due date
the same rate at which it has accrued. At any point of v. ln case of instalment premium due not received within the
time, the cumulative bonus will not be less than “zero” grace period, the policy will get cancelled.
d. Full utilization of Basic Sum Insured and full utilization vi. ln the event of a claim, all subsequent premium
of cumulative bonus accrued, the cumulative bonus instalments shall immediately become due and payable.
granted on renewal will be “nil” or “zero vii. The company has the right to recover and deduct all the
µ Automatic Restoration of Sum Insured Applicable for pending installments from the claim amount due under the
Section 1 (other than Section 1H) and Section 9: There shall policy.
be automatic restoration of the Basic Sum Insured by 100% viii. For premium paid in instalments during the policy period,
immediately upon exhaustion of the Basic Sum Insured and coverage is available during the grace period also
accrued Cumulative Bonus if any, once during the policy period µ Revision of Sum Insured: Reduction or enhancement of
It is made clear that such restored Basic Sum Insured can be Basic Sum Insured is permissible only at the time of renewal.
utilized for the subsequent hospitalization even for the illness The acceptance for enhancement and the amount of
/disease for which claim/s was / were already made. enhancement will be at the discretion of the Company. Where
Such restoration will be available for Section 1 (other than the basic sum insured is enhanced, the amount of such
Section 1H) and Section 9. additional basic sum insured including the respective
µ Co-Payment: This policy is subject to co-payment of 10% of sublimits shall be subject to the following terms. Exclusions as
each and every claim amount for fresh as well as renewal under shall apply afresh from the date of such enhancement
policies for insured persons whose age at the time of entry is for theincrease in the Basic Sum Insured, that is, the
61 years and above. This co-payment will not apply for those difference between the expiring policy Basic Sum Insured and
insured persons who have entered the policy before attaining the increased current Basic Sum Insured.
61 years of age and renew the policy continuously without any
i) First 30 days as stated under exclusion Excl Code 03
break. This co-payment is applicable for Section 1 A to 1 G, 1 I,
Section 4, Section 7, Section 9, Section 12 and Section 13 ii) 24 months with continuous coverage without break (with
grace period) in respect of diseases / treatments as stated
µ What is the renewal procedure?
under exclusion Excl Code 02
Renewal of policy: The policy shall ordinarily be renewable
except on grounds of fraud, misrepresentation by the Insured iii) 36 months of continuous coverage without break (with
Person. grace period) in respect of Pre-Existing diseases as stated
under exclusion Excl Code 01
1. Renewal shall not be denied on the ground that the insured
person had made a claim or claims in the preceding policy iv) 36 months of continuous coverage without break (with
years. grace period) for diseases / conditions diagnosed / treated
2. Request for renewal along with requisite premium shall be irrespective of whether any claim is made or not in the
received by the Company before the end of the policy period. immediately preceding three policy periods
3. At the end of the policy period, the policy shall terminate v) The above applies to each relevant insured person
and can be renewed within the Grace Period of 30 days to µ What are the optional covers available on payment of
maintain continuity of benefits without break in policy. additional premium under the policy?(Section 12)
4. Coverage is not available during the grace period. The prospect has the option to opt for reduction of waiting
5. No loading shall apply on renewals based on individual period in respect of Pre-Existing Diseases from 36 months to
claims experience 12 months on payment of additional premium. This option is
Following an admissible claim under Section-10 the coverage available only for the first purchase of Star Comprehensive
under Personal Accident insurance upon renewal will be Insurance Policy and also only upto Sum Insured chosen at
applicable for the person to be chosen by the Proposer at the that [Link] option is not available for renewal or policies
time of renewal, subject to other terms, conditions contained ported from other Insurance Companies. The prospect has to
herein undergo pre-acceptance medical screening at Company's
µ Premium Payment in Instalments: lf the insured person has nominated centre. At present 100% of cost of the pre-
opted for Payment of Premium on an instalment basis i.e. Half acceptance medical screening will be borne by the Company.
Yearly or Quarterly or Monthly as mentioned in the policy The Company may require the prospect to share this cost
Schedule/Certificate of Insurance, the following Conditions (maximum 50%).
shall apply (notwithstanding any terms contrary elsewhere in Where the Insured person has opted for this benefit the
the policy) exclusions shall read as follows :-
i. For monthly instalment option: Grace Period of 15 days 1. Pre-Existing Diseases : Code- Excl01
would be given to pay the instalment premium due for the A. Expenses related to the treatment of a pre-existing
policy. Disease (PED) and its direct complications shall be
ii. For Quarterly and Half yearly instalment option: Grace excluded until the expiry of 12 months of continuous
Period of 30 days would be given to pay the instalment coverage after the date of inception of the first policy with
premium due for the policy. insurer.
iii. The insured person will get the accrued continuity benefit B. In case of enhancement of sum insured the exclusion shall
in respect of the "Waiting Periods", "Specific Waiting apply afresh to the extent of sum insured increase.
Star Comprehensive Insurance Policy Unique Identification No.: SHAHLIP25037V082425 PROS / COMP / V.13 / 2024 12 of 16
 C. Coverage under the policy after the expiry of 12 months for terms of the policy including the premium rates as per the
any pre-existing disease is subject to the same being extant Guidelines. The insured person shall be notified thirty
declared at the time of application and accepted by days before the changes are effected.
Insurer. µ Withdrawal of the policy
2. Specified disease / procedure – Code- Excl02 i. In the likelihood of this product being withdrawn in future,
A. Expenses related to the treatment of the following listed the Company will intimate the insured person about the
Conditions, surgeries/treatments shall be excluded until the same 90 days prior to expiry of the policy.
expiry of 24 months of continuous coverage after the date of ii. lnsured Person will have the option to migrate to similar
inception of the first policy with us. This exclusion shall not be health insurance product available with the Company at
applicable for claims arising due to an accident. the time of renewal with all the accrued continuity benefits
B. In case of enhancement of sum insured the exclusion shall such as cumulative bonus, waiver of waiting period as per
apply afresh to the extent of sum insured increase. IRDAI guidelines, provided the policy has been maintained
C. If any of the specified disease/procedure falls under the without a break.
waiting period specified for pre- existing diseases, then the µ Free Look Period: The Free Look Period shall be applicable
longer of the two waiting periods shall apply. on new individual health insurance policies and not on
D. The waiting period for listed conditions shall apply even if renewals or at the time of porting/migrating the policy.
contracted after the policy or declared and accepted The insured person shall be allowed free look period of thirty
without a specific exclusion. days from date of receipt of the policy document whether
E. List of specific diseases/procedures electronically or otherwise to review the terms and conditions
of the policy, and to return the same if not acceptable.
i. Treatment of Cataract and diseases of the anterior and
posterior chamber of the Eye, Diseases of ENT, lf the insured has not incurred any claim during the Free Look
Diseases related to Thyroid, Benign diseases of the Period, the insured shall be entitled to
breast. i. a refund of the premium paid less any expenses incurred by the
ii. Subcutaneous Benign Lumps, Sebaceous cyst, Company on medical examination of the insured person and
Dermoid cyst, Mucous cyst lip / cheek, Carpal Tunnel the stamp duty charges or
Syndrome, Trigger Finger, Lipoma, Neurofibroma, ii. where the risk has already commenced and the option of
Fibroadenoma, Ganglion and similar pathology return of the policy is exercised by the insured person, a
iii. All treatments (Conservative, Operative treatment) deduction towards the proportionate risk premium for
and all types of intervention for Diseases related to period of cover or
Tendon, Ligament, Fascia, Bones and Joint Including iii. where only a part of the insurance coverage has
Arthroscopy and Arthroplasty / Joint Replacement commenced, such proportionate premium commensurate
[other than caused by accident]. with the insurance coverage during such period
iv. All types of treatment for Degenerative disc and µ Migration: The insured person will have the option to migrate
Vertebral diseases including Replacement of bones the policy to other health insurance products/plans offered by
and joints and Degenerative diseases of the Musculo- the company by applying for migration of the Policy atleast 30
skeletal system, Prolapse of Intervertebral Disc (other days before the policy renewal date as per IRDAI guidelines
than caused by accident), on Migration. lf such person is presently covered and has been
continuously covered without any lapses under any health
v. All treatments (conservative, interventional, insurance product/plan offered by the company, the insured
laparoscopic and open) related to Hepato- pancreato- person will get the accrued continuity benefits in waiting
biliary diseases including Gall bladder and Pancreatic periods as per IRDAI guidelines on migration.
calculi. All types of management for Kidney and
µ Portability: The insured person will have the option to port the
Genitourinary tract calculi. policy to other insurers by applying to such insurer to port the
vi. All types of Hernia, entire policy along with all the members of the family, if any, at
vii. Desmoid Tumor, Umbilical Granuloma, Umbilical least 30 days before, but not earlier than 60 days from the
Sinus, Umbilical Fistula, policy renewal date as per IRDAI guidelines related to
viii. All treatments (conservative, interventional, portability. lf such person is presently covered and has been
laparoscopic and open) related to all Diseases of continuously covered without any lapses under any health
Cervix, Uterus, Fallopian tubes, Ovaries, Uterine insurance policy with an lndian General/Health insurer, the
Bleeding, Pelvic Inflammatory Diseases proposed insured person will get the accrued continuity
benefits in waiting periods as per IRDAI guidelines on
ix. All Diseases of Prostate, Stricture Urethra, all
portability.
Obstructive Uropathies,
µ Disclosure of information: The policy shall be void and all
x. Benign Tumours of Epididymis, Spermatocele,
Varicocele, Hydrocele, premium paid thereon shall be forfeited to the Company, in the
event of mis-representation, mis description or non-disclosure
xi. Fistula, Fissure in Ano, Hemorrhoids, Pilonidal Sinus of any material fact by the policy holder
and Fistula, Rectal Prolapse, Stress Incontinence
µ Cancellation
xii. Varicose veins and Varicose ulcers
i. The Policyholder may cancel his policy any time during the
xiii. All types of transplant and related surgeries
term by giving 7 days written notice. In such an event, The
xiv. Congenital Internal disease / defect (except to the Company shall
extent provided under Section 2 for New Born)
a. refund proportionate premium for unexpired policy
µ Possibility of Revision of Terms of the Policy lncluding period, if policy term upto one year and there is no
the Premium Rates: The Company, may revise or modify the claim (s) made during the policy period.
Star Comprehensive Insurance Policy Unique Identification No.: SHAHLIP25037V082425 PROS / COMP / V.13 / 2024 13 of 16
 b. refund premium for the unexpired policy period, in Courier/: Star Health and Allied Insurance CompanyLimited.,
respect of policies with policy term more than 1 year Post 4th Floor., Balaji Complex, No.15, Whites Lane
and risk coverage for such policy years has not Whites Road,Royapettah, Chennai - 600014
commenced. lnsured person may also approach the grievance cell at any of
ii. The Company may cancel the policy at any time on the company's branches with the details of grievance.
grounds of misrepresentation, non-disclosure of material lf lnsured person is not satisfied with the redressal of
facts, fraud by the Insured Person by giving 15 days' written grievance through one of the above methods, insured person
notice. There would be no refund of premium on may contact the grievance officer at 044-43664600.
cancellation on grounds of misrepresentation, non- For updated details of grievance officer, kindly refer the link
disclosure of material facts or fraud [Link]
Note: Incase of long term policies the refund will be given after lf lnsured person is not satisfied with the redressal of
adjusting the long term discount availed by the insured/ grievance through above methods, the insured person may
also approach the office of lnsurance Ombudsman of the
policyholder. respective area/region for redressal of grievance as per
µ Medical Underwriting Loading: lnsurance Ombudsman Rules.
Company may apply a risk loading on the premium payable Grievance may also be lodged at IRDAI lntegrated Grievance
(based upon the declarations made in the proposal form and Management System - [Link]
the health status of the persons proposed for insurance). µ Important Note: IRDAI or its officials do not involve in
• The quantum of loading / discount shall be applied as per activities like selling insurance policies, announcing bonus or
the extant of U/W guidelines. investment of premiums. Public receiving such phone calls
• This loading is applied from the Commencement Date of are requested to lodge a police complaint.
the Policy including subsequent renewal(s) with the µ Prohibition of Rebates: Section 41 of Insurance Act 1938
Company. (Prohibition of rebates): No person shall allow or offer to allow,
• Company will inform about the applicable risk loading or either directly or indirectly, as an inducement to any person to
exclusion or both as the case may be through a counter take out or renew or continue an insurance in respect of any
offer. kind of risk relating to lives or property in India, any rebate of
• The Insured need to revert to the Company with consent the whole or part of the commission payable or any rebate of
and additional premium (if any), within 7 days of the receipt the premium shown on the policy, nor shall any person taking
of such counter offer. out or renewing or continuing a policy accept any rebate,
• In case, the Insured neither accept the counter offer nor revert except such rebate as may be allowed in accordance with the
to the Company within 7 days, the Company shall cancel the published prospectuses or tables of the insurer. Any person
Insured's proposal and refund the premium. making default in complying with the provisions of this section
• The Company will issue Policy only after getting Insured's shall be liable for a penalty which may extend to ten lakh
consent and additional premium (if any). rupees.
µ Automatic Expiry: The insurance under this policy with
respect to each relevant Insured Person shall expire
immediately on the earlier of the following events:
ü Upon the death of the Insured Person. This also means
that in case of family floater policy, cover for the other
surviving members of the family will continue, subject to
other terms of the policy.
ü Upon exhaustion of the Limit of Coverage
µ Excluded Hospitals (providers): Insured can refer the
company website using the following link to get the list of
excluded hospitals.
[Link]
µ How to buy this insurance?
Please contact our nearest Branch Office/our Agent or visit our
website [Link] for online purchase and avail
discount of 5%.
µ Relief under Sec 80D of Income Tax Act: Insured Person is
eligible for relief under Section 80-D of the IT Act in respect of
the premium paid by any mode other than cash.
µ Redressal of Grievance: Incase of any grievance the insured
person may contact the Company through
Website : [Link]
E-mail : gro@[Link],
grievances@[Link]
Ph. No. : 044-69006900 | Toll Free No. 1800 425 2255
Senior Citizens may call at 044-69007500
Star Comprehensive Insurance Policy Unique Identification No.: SHAHLIP25037V082425 PROS / COMP / V.13 / 2024 14 of16
Star Health and Allied Insurance Company Limited Prospectus

PREMIUM CHART (Excluding Tax)

Premium Chart for 1 year (Excluding Tax) (in Rs.)
Plan type Age band 5,00,000 7,50,000 10,00,000 15,00,000 20,00,000 25,00,000 50,00,000 75,00,000 1,00,00,000
3m-35 7,576 9,223 10,503 13,203 15,228 16,486 18,139 19,683 21,065
36-45 8,721 10,935 12,717 15,417 17,442 19,024 20,930 22,712 24,305
46-50 14,256 18,214 21,454 24,154 26,390 28,312 31,147 33,799 36,169
51-55 17,388 21,206 24,187 28,523 32,265 34,711 38,183 41,434 44,339
1A 56-60 20,196 24,716 28,264 33,464 37,714 40,678 44,750 48,557 51,959
61-65 27,810 33,075 37,039 43,859 48,362 51,359 56,500 61,306 65,599
66-70 38,140 44,096 48,325 53,282 55,868 58,196 64,017 69,460 74,326
71-75 44,723 53,195 59,584 66,890 70,135 73,067 80,379 87,215 93,323
Above 75 58,574 69,325 77,355 86,195 90,374 94,154 1,03,572 1,12,379 1,20,247
3m-35 9,914 12,247 14,310 17,528 20,228 22,820 25,105 27,243 29,155
36-45 10,930 13,327 15,844 19,872 22,572 25,812 28,393 30,807 32,967
46-50 15,379 18,544 22,367 27,767 30,467 33,707 37,082 40,235 43,054
51-55 17,485 22,248 26,557 31,957 35,197 38,437 42,282 45,878 49,091
1A+1C 56-60 21,276 29,030 34,884 40,284 43,524 46,764 51,440 55,814 59,724
61-65 33,934 40,673 48,570 55,590 63,105 79,845 87,831 95,299 1,01,974
66-70 42,422 50,846 60,718 66,712 75,730 95,818 1,05,403 1,14,367 1,22,375
71-75 55,156 66,107 78,937 86,735 98,453 1,24,567 1,37,025 1,48,673 1,59,084
Above 75 71,712 85,946 1,02,622 1,12,763 1,27,991 1,61,946 1,78,141 1,93,288 2,06,820
3m-35 11,826 14,396 16,200 20,520 23,360 26,060 28,669 31,109 33,291
36-45 12,982 15,649 17,863 23,263 26,795 30,035 33,043 35,856 38,367
46-50 21,038 25,196 29,074 34,474 37,714 40,954 45,052 48,886 52,310
51-55 22,151 26,568 31,363 36,763 40,003 43,243 47,569 51,613 55,231
1A+2C 56-60 25,466 31,828 37,865 45,425 49,205 53,525 58,882 63,887 68,364
61-65 39,949 47,584 51,004 58,024 82,715 1,01,615 1,11,780 1,21,284 1,29,778
66-70 49,939 59,486 63,763 69,638 99,263 1,21,943 1,34,141 1,45,546 1,55,736
71-75 64,930 77,339 82,901 90,536 1,29,049 1,58,533 1,74,388 1,89,211 2,02,457
Above 75 84,413 1,00,548 1,07,773 1,17,698 1,67,767 2,06,096 2,26,708 2,45,981 2,63,201
3m-35 16,837 20,509 22,626 28,566 32,195 35,975 39,577 42,941 45,949
36-45 18,425 22,270 24,872 31,892 36,331 40,327 44,361 48,136 51,505
46-50 25,337 31,147 35,910 46,710 52,110 56,430 62,073 67,354 72,074
51-55 29,052 36,234 42,390 54,270 59,670 63,990 70,389 76,372 81,724
1A+3C 56-60 32,692 41,051 48,492 63,612 69,552 74,952 82,447 89,456 95,720
61-65 44,669 52,991 65,524 79,024 1,02,325 1,21,225 1,33,348 1,44,682 1,54,813
66-70 55,836 66,247 81,907 94,835 1,22,796 1,45,476 1,60,024 1,73,626 1,85,782
71-75 72,587 86,130 1,06,488 1,23,293 1,59,635 1,89,119 2,08,035 2,25,720 2,41,520
Above 75 94,370 1,11,974 1,38,434 1,60,283 2,07,533 2,45,862 2,70,448 2,93,441 3,13,983
3m-35 11,254 14,375 16,805 21,125 24,365 27,065 29,776 32,308 34,571
36-45 13,090 17,636 20,347 24,667 27,907 30,607 33,669 36,531 39,091
46-50 24,192 30,262 36,569 40,889 44,129 46,829 51,516 55,895 59,810
51-55 25,531 31,882 38,696 43,556 46,796 49,712 54,686 59,335 63,493
2A 56-60 30,845 38,524 46,948 51,808 55,048 57,964 63,763 69,185 74,029
61-65 41,904 50,792 61,852 66,712 69,952 72,868 80,158 86,972 93,064
66-70 52,380 63,493 77,317 80,060 83,948 87,448 96,196 1,04,377 1,11,688
71-75 68,094 82,544 1,00,516 1,04,080 1,09,134 1,13,692 1,25,064 1,35,697 1,45,201
Above 75 88,528 1,07,309 1,30,680 1,35,313 1,41,880 1,47,809 1,62,594 1,76,418 1,88,768
3m-35 14,224 17,993 20,639 25,661 28,901 31,601 34,765 37,724 40,370
36-45 15,487 19,926 23,231 28,631 31,871 34,571 38,032 41,267 44,156
46-50 25,423 31,666 37,703 43,103 46,343 49,043 53,951 58,541 62,640
51-55 27,875 34,862 41,850 47,790 51,246 54,162 59,578 64,643 69,169
2A+1C 56-60 33,556 41,375 49,183 55,123 58,903 61,819 68,002 73,786 78,953
61-65 53,784 63,974 78,826 88,276 1,05,016 1,23,916 1,36,312 1,47,901 1,58,258
66-70 67,230 79,974 98,539 1,05,937 1,26,025 1,48,705 1,63,577 1,77,482 1,89,907
71-75 87,404 1,03,972 1,28,110 1,37,722 1,63,836 1,93,320 2,12,652 2,30,731 2,46,883
Above 75 1,13,627 1,35,173 1,66,547 1,79,042 2,12,987 2,51,316 2,76,448 2,99,948 3,20,949

Star Comprehensive Insurance Policy Unique Identification No.: SHAHLIP25037V082425 PROS / COMP / V.13 / 2024 15 of 16
Star Health and Allied Insurance Company Limited Prospectus

Plan type Age band 5,00,000 7,50,000 10,00,000 15,00,000 20,00,000 25,00,000 50,00,000 75,00,000 1,00,00,000
3m-35 15,984 19,958 22,594 27,605 30,845 33,761 37,141 40,300 43,124
36-45 17,723 21,881 25,402 30,802 34,042 36,958 40,657 44,113 47,201
46-50 27,421 34,020 40,057 45,457 48,697 51,613 56,776 61,603 65,918
51-55 30,424 37,746 44,939 50,339 54,119 57,359 63,099 68,467 73,262
2A+2C 56-60 35,996 44,658 53,536 59,476 63,256 66,496 73,148 79,369 84,926
61-65 57,672 69,535 83,607 93,057 1,09,797 1,28,697 1,41,572 1,53,608 1,64,365
66-70 72,090 86,918 1,04,512 1,11,672 1,31,760 1,54,440 1,69,884 1,84,329 1,97,235
71-75 93,722 1,13,000 1,35,875 1,45,174 1,71,288 2,00,772 2,20,849 2,39,625 2,56,403
Above 75 1,21,846 1,46,902 1,76,645 1,88,730 2,22,674 2,61,004 2,87,107 3,11,515 3,33,326
3m-35 18,360 22,702 25,520 33,080 37,897 42,239 46,467 50,420 53,951
36-45 20,682 24,818 28,307 35,867 40,727 45,047 49,556 53,773 57,542
46-50 30,791 37,228 42,638 50,198 55,058 59,378 65,318 70,875 75,838
51-55 33,696 41,450 47,520 55,620 60,480 65,340 71,874 77,987 83,446
2A+3C 56-60 39,344 49,064 58,482 70,362 76,302 82,242 90,466 98,161 1,05,035
61-65 60,480 72,069 87,591 1,01,091 1,17,831 1,36,731 1,50,406 1,63,193 1,74,620
66-70 75,600 90,094 1,09,490 1,21,316 1,41,404 1,64,084 1,80,495 1,95,842 2,09,552
71-75 98,280 1,17,126 1,42,344 1,57,712 1,83,827 2,13,311 2,34,646 2,54,594 2,72,419
Above 75 1,27,764 1,52,269 1,85,047 2,05,027 2,38,982 2,77,312 3,05,046 3,30,977 3,54,148

PED Buy-back loading

Age in years Loading on premium for 1st year
3m-35 20%
36-45 30%
46-50 35%
Above 50 50%

Benefit Illustration in respect of policies offered on individual and family floater basis
Coverage opted on Coverage opted on individual basiscovering Coverage opted on family floater basis with overall
individual basis covering multiple members of thefamily under a single Sum insured
each member of the
Age of the family separately policy (Sum insured is available for each (Only one sum insured is available for the entire
Members (at a single point of time) member of the family) family)
insured Premium Premium or Premium
(in yrs) Sum Sum consolidated Floater
Premium Premium Discount, after after Sum insured
insured insured premium for discount,
(Rs.) (Rs.) if any discount all members of discount (Rs.)
(Rs.) (Rs.) if any
(Rs.) family (Rs.) (Rs.)

Illustration 1
64 27,810 5,00,000 27,810 27,810 5,00,000
Nil 48,006 6,102 41,904 5,00,000
58 20,196 5,00,000 20,196 20,196 5,00,000
Total Premium for all members of the Total Premium for all members of the family is
Total Premium when policy is opted on floater basis is
family is Rs.48,006/-, Rs.48,006/-,
Rs.41,904/-
when each member is covered when they are covered under a single policy.
Sum insured of Rs.5,00,000/-, is available for the entire
separately. Sum insured available for Sum insured available for each family member
family (2A)
each individual is Rs. 5,00,000/- is Rs.5,00,000/-
Illustration 2
47 14,256 5,00,000 14,256 14,256 5,00,000
44 8,721 5,00,000 8,721 Nil 8,721 5,00,000 30,553 5,130 25,423 5,00,000
19 7,576 5,00,000 7,576 7,576 5,00,000

Total Premium for all members of the Total Premium for all members of the family is
family is Rs.30,553/-, Rs. 30,553/-, Total Premium when policy is opted on floater basis is Rs.25,423/-
when each member is covered when they are covered under a single policy. Sum insured of Rs.5,00,000/-, is available for the entire family
separately. Sum insured available for Sum insured available for each family member (2A+1C)
each individual is Rs. 5,00,000/- is Rs.5,00,000/-

Note: Premium rates specified in the above illustration are standard premium rates without considering any loading. Also, the premium rates are exclusive
of taxes applicable. Floater discount shown here is difference between Premium applicable for Individual Sum Insured and Floater Sum Insured.
A-Adult, C-Child
Star Comprehensive Insurance Policy Unique Identification No.: SHAHLIP25037V082425 PROS / COMP / V.13 / 2024 16 of 16