Renewal is allowed except on superfluous or fraudulent grounds. A grace period of 30 days from the date of expiry of policy should be maintained. Changes in sum assured are applicable only at the time of the renewal. If policy is withdrawn or modified the insured is to be informed three months before such incident. Exclusions under plan by Star Health Family Health Optima: Pre Existing diseases as mentioned. Disease that creeps into the insured during the first 30 days of the policy period. Also expenses of defined and related diseases as mentioned would not be borne during the first two years of continuous operation of insurance. Dental treatment or surgery (excluding accidental damages). Injury due to nuclear weapons and war or breach of law on an intentional basis. Expenses on Vitamins and tonics not part of the treatment schedule. Hospital registration and admission charges, record and telephone charges. Star Health Family Optima Cancellation Policy: Misrepresentation, fraud, moral hazard or non-cooperation on behalf of the insured might lead to cancellation of policy making way for appropriate refund. *The above rates may vary. Please check the policy wordings for more details.
Expenses including room rent, nursing and boarding charges during hospitalisation of the insured are covered for a maximum of 24 hours. Fees of Anaesthetist, Surgeon, Medical Practitioner, Consultants and Specialist Fees, Anaesthesia, Blood, Oxygen, and Operation Theatre charges, Cost of Pacemaker, Cost of Medicine and drugs etc. are also taken for coverage. For emergency transportation, ambulance charges up to a sum of Rs.750/- per hospitalization and overall limit of Rs.1500/- per policy period are covered Pre Hospitalisation expenses up to 60 days prior to admission in the hospital. Post Hospitalisation expenses up to 90 days after discharge from the hospital. Co-Payment: A co-payment of 20% for every claim is applicablefor fresh as well as renewed policies for insured persons (age above 60 years at the time of entry). Pre-Existing Diseases/Illness: Are covered after 48 months of continuous Insurance Pre- Acceptance medical screening: Persons above 50 years will be required to undergo medical screening at the Company nominated centres, cost of which is borne by the Company. 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: It is a period for reviewing terms and conditions and making a judicious review. Cancellation in case of dissatisfaction can also be opted for in which case company will make due refunds. Portability: If the insured wants to port the policy to another towards renewal, application in the appropriate form should be made to the Company at least 45 days before from the date of renewal.
Premium chart for ZONE 1: Premium chart for ZONE 2: Premium chart for ZONE 3: Service Tax Extra To calculate premium, age of the oldest family member covered should be taken in consideration. *The above rates may vary. Please check the policy wordings for more details. Zone 1: Delhi including National Capital Region, Mumbai including Thane and the State of Gujarat Zone 2: Bangalore, Chennai, Coimbatore, Pune and State of Kerala Zone 3: Rest of India excluding areas falling under Zone 1 and Zone 2 Additional Features: Automatic Restoration of Sum Insured: Automatic Restoration of Sum Insured: Upon exhaustion of the limit of coverage during the policy period subject to the limits, the basic sum insured would be automatically restored. This restored sum insured may be utilized for the remaining policy period. The restored sum insured cannot be carried forward. Recharge Benefit: Recharge Benefit: When the sum insured is exhausted/exceeded this provides additional cover up to a certain limit. The recharge benefits are common for all the Zones and as follows: For sum insured Rs. 300000 – 75000 For sum insured Rs. 400000 – 100000 Sum insured Rs. 500000 – Rs.2500000 & Rs. 150000 Recharge amount cannot be carried forward by the policyholder. Also both the Recharge & Restore benefits cannot be utilized together for a single hospitalization
Family Health Optima from Star Health is a health insurance plan that gives protection to individual family member for a single premium under a single sum insured that covers all family members. Star Family Health Optima Eligibility: Minimum: 18 years and Maximum: 65 years of age at the time of entry (Infant can be covered from 16th day). Applicable for renewal for the whole lifetime of the Insured individual. On a Floater Basis the entire sum insured floats among all covered family (self, spouse and not exceeding 3 dependent children). Special Features of Star Family Health Optima Policy: Recharge Benefit: When the sum insured is exhausted/ exceeded, it provides additional cover up to a certain limit. 400 Day Care procedures/Expenses for Health Check-up. Covers expenses for new born Baby/ Domiciliary hospitalization. Donor expenses against organ transplantation: Up to a limit of 10% of the Sum Insured or Rupees One lakh, whichever is less Bonus: Bonus is given for a claim-free year subject to a certain limits. Automatic Restoration of Sum Insured: Upon exhaustion of the limit of coverage during the policy period subject to the limits, the basic sum would be automatically restored. This restored sum insured may be utilized in the remaining policy period.
