Star Health Personal Accident Insurance

Star Health Personal Accident Insurance

Star Health and Allied Insurance Co. Ltd., founded in 2006 is a joint collaboration between leading Indian businessmen, M/S ICICI Ventures Funds Management, M/S Sequoia Capital, M/s Tata Capital Growth Fund, M/s Alpha TC holdings, Singapore and M/s Oman Insurance Company UAE. The company is known for its customized, tailor made and diverse plans which are there to meet the insurance needs of the individuals, families, students, senior citizens, travelers and rural customers.

Why one should choose Star Health Insurance Plans

• Cashless hospitalization plans and Reimbursement facility in more than 7000 network hospitals in India.
• 90% of all cashless claims almost under all plans are approved just within one hour.
• Pan India presence with more than 290 Branch Offices.
• Hassle Free and user friendly direct claim settlement process without any TPA.
• The company has been awarded with many prestigious awards in the past. And in recent times, the company has been awarded as the “Health Insurance Company of the Year 2015” by Indian Insurance Awards, 2015.
• The company is rated as the Best Claim Settlement Insurer.
• Personal doctor visit for all customers getting hospitalized.
• Wide range of insurance plans which caters to the insurance requirements of all individuals.

Accident Care is one of the insurance plans provided by Star health which provides coverage against accidental death, permanent disability and temporary total disablement.

Lets have an overview of Star Health Accident Plan.

Features and Benefits of Accident care Plan

• Coverage Benefit under the plan includes
  • Accidental Death Plan: In case of Death within 12 months from the occurrence of the accidental bodily injury which is caused due to Accident solely and directly caused by external, violent and visible means, the sum assured is paid which is specified in the Schedule of Insurance Certificate.
  • Permanent or Partial Disability Plan due to an accident: If the insured person meets with an accident resulting to unfortunate death and disablement, the company will provide the insurance coverage under the plan as follows:
    • Death of the Insured person: If death occurs within 12 months from the date of the accident, then the company will pay the maximum Sum Insured.
    • Permanent Disablement : If an accident causes permanent impairment  or injury to the insured physical and mental capabilities, then the company will compensate from any one as mentioned above provided
• The disablement occurs within 12 calender months from the date of Accident.
• The disablement is confirmed and claimed for, prior to the expiry of a period of 60 days since the occurrence of the disablement.
• Temporary Total Disablement Plan: During the plan period, if the Insured Person sustains any bodily injury resulting solely and directly from an accident, then the insured person is eligible for a weekly benefit at 1% of Capital Sum Assured subject to a maximum of Rs 5000/- per week for a 100 weeks. This benefit is payable for only one occurrence during the entire plan tenure. The compensation never increases the sum insured under the plan. Also the payment is made only after the termination of such disablement.
• Free Benefits under the plan: This includes the following coverages:
  • Educational funding: Under this plan, in case the insured person is met with Permanent Total Disability or unfortunate death, educational funding is provided to children below 18 years of age at Rs 5000/- for one dependent child and Rs 10000/-for two  dependent  children below 18 years of age (maximum 2 children).
  • Travel expenses of one relative: Under this plan, if the death of the Insured Person occurs outside the place of his/her residence, the company will pay for the transport expense upto a maximum of Rs 1000/- to the place of accident.
  • Transportation expenses of the mortal remains upto a maximum of Rs 3000/-.
• Cumulative Bonus: Cumulative Bonus of 5% of the sum insured is allowed for every claim free    year subject to a maximum of 50%.
• Upon payment of additional premium, the plan can be extended to cover the medical expenses as well.

Risks are classified into three categories for the purpose of rating under all the plans:

• Risk Group I: Individuals who are engaged mainly in Administrative Departments.
• Risk Group II: Individuals who are engaged in manual work other than mentioned in Risk Group III.
• Risk Group III: Individuals who are engaged in explosive industry, mines and /or magazine workers, high tension electric supply, horse racing( including jockey), atheletes and those in occupation with similar hazards.

Policy Premium

Group Policy

Group Plans are eligible for discounts which are as follows:

Eligibility

• This plan can be availed by both individuals as well as Groups.
• Family package under the plan includes children from 3 years along with parents.

Exclusions:

There are certain exclusions under the plan under which the claim will not be admissible. The following are the exclusions:

• If any expenses has been incurred before the policy inception or otherwise outside the period of insurance plan.
• Claims which arises due to not following the Doctor’s Advise.
• Pre-existing condition under the plans.
• Any claim under the plan which the insured person has caused deliberately or any crime committed due to intoxication or drug addiction.
• Sports activities which are hazardous.
• Mental Disorder, suicide or attempted suicide, self injected injuries, or sexually transmitted conditions, anxiety etc.
• Individuals who are mentally challenged unless agreed and mentioned in the plan.
• Nuclear, chemical and Biological Terrorism.

Renewal

The plan can be renewed unless there has been any misrepresentation of facts or frauds involved in the plan or the policy. A  Grace Period of 30 days is available from the expiry date of the plan for renewal.

Cancellation

The Company has the right to cancel the insurance plans in the following cases:

• Misrepresentation of facts.
• Frauds.
• Moral hazard.
• Non Disclosure of material fact.
• Non cooperation by the Insured person.

Also the Insured may cancel the plan at any time, however the company will refund the premium after retaining the premium at company’s short period rate as below:         

Free look Period for all the plans

In case the Insured wants to cancel the plan due to dissatisfaction in the terms and conditions, a free look period of 15 days from the receipt of the policy document is allowed for cancellation. The company will refund the premium after adjusting the cost of medical check ups done before the processing of the plan, the stamp duty charges and proportionate risk premium for the period provided no claim has been made till such cancellation.