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Star Health and Allied Insurance - Accident Care Policy (2009-10)


Accident Care Policy (2009-10)

Accident Care Benefits

  • Accidental death
  • Permanent disability – total or partial – following an accident
  • Temporary total disablement – the Insured Person is eligible for a weekly benefit at 1% of Capital Sum Insured (following an accident) subject to maximum of Rs.5000/- per week for a for 100 weeks
  • Educational grant to children (1 Child – Rs.5000/-, 2 Children– Rs.10,000/-)
  • Transportation expenses of mortal remains (Rs.3000/-)
  • Travel expenses of one relative (Rs.1000/-)
  • Cumulative Bonus of 5% accrues to the Insured Person for every claim free year, subject to a maximum of 50%

Optional Benefits

Policy can be extended to cover Medical Expenses on payment of Additional Premium

Risk Features

  • For purpose of rating, persons proposed for insurance are classified under three risk groups
  • Risk Group I – Persons engaged primarily in administrative functions
  • Risk Group II – Persons engaged in manual work other than what is specifically provided for under Group III
  • Risk Group III – Persons working in explosives industry, mines workers, high tension electric supply, horse racing including jockeys, athletes and occupations of similar hazards

Claim Procedure

  • Call the Star Health 24 hour help-line to register the details of hospitalization.
  • Kindly mention your Star Health ID number for easy access to your policy details.
  • In case of a planned hospitalization, please register 24 hours prior to admission to the hospital
  • In case of emergency hospitalization, please register within 24 hours of hospitalization
  • In all network hospitals, the cashless facility on payments can be availed
  • For treatment in non-network hospitals, payments must be made up-front to the hospital. Reimbursement of the expenses will be effected by Star Health, on submission of the necessary documents.
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Exclusions

  • Expenses incurred on events occurring before the commencement of the cover or otherwise outside the Period of Insurance
  • Any claim in respect of Pre-existing condition
  • Any claim if the insured acts against the advice of a physician
  • Any claim arising out of Accidents that the Insured Person has caused intentionally or by committing a crime or as a result of drunkenness or addiction (drugs, alcohol, etc)
  • Any claim arising out of mental disorder, suicide or attempted suicide self inflicted injuries, or sexually transmitted conditions, anxiety, etc
  • Participation in Hazardous Sport/Hazardous activities
  • Persons who are physically and mentally challenged unless specifically agreed and endorsed in the policy.

How much to pay (for individuals)?

Coverage / Risk Group Group I Group II Group III
Table I 0.45 per mile 0.60 per mile 0.80 per mile
Table II 0.80 per mile 1.30 per mile 1.75 per mile
Table III 1.25 per mile 1.75 per mile 2.00 per mile
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For groups

Group Size % of discount on Premium (Excluding add-on Covers & Service Tax)
2 - 100 Persons 5%
101 - 1000 10%

Can this policy be taken by a group?

Group Policies are allowed without additional benefits. But Group Policies are eligible for a discount on the basic premium when the size of the group increases substantially.

Renewal

The Insurance may be renewed under mutual consent.

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