Star Health and Allied Insurance Co. Ltd. Presentation on DIABETES SAFE.

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Presentation transcript:

Star Health and Allied Insurance Co. Ltd. Presentation on DIABETES SAFE

Star Health and Allied Insurance Co. Ltd. This cover is exclusively designed for people diagnosed with Diabetes Mellitus Type II Presentation on Diabetes Safe Who can take this policy ?

Star Health and Allied Insurance Co. Ltd. Coverages Hospitalization Expenses incurred as an inpatient for treatment of the following complications Diabetic Retinopathy requiring Laser treatment Diabetic Nephoropathy leading to Chronic Renal Failure Diabetic Foot Ulcer requiring Micro Vascular Surgery Presentation on Diabetes Safe

Star Health and Allied Insurance Co. Ltd. What is a Hospital? Hospital, Nursing Home means any institution in India established for indoor care and treatment of sickness and injuries and which Either It has been registered with the local authorities and is under the supervision of a registered and qualified Medical Practitioner or Should comply with minimum criteria as under It should have at least 15 inpatient beds (10 in Class ‘C’ Towns). Fully equipped operation theatre of its own wherever surgical operation is carried out. Fully qualified nursing staff under its employment round the clock Fully qualified Doctor(s) should be in charge round the clock. Presentation on Diabetes Safe

Star Health and Allied Insurance Co. Ltd. Age Limits Entry Age : 26 Years to 65 Years Renewal will be accepted up to 70 years Presentation on Diabetes Safe

Star Health and Allied Insurance Co. Ltd. Pre Acceptance Medical Screening The following medical examination will be done at the cost of the Insurer. Blood Urea Serum Creatinine Micro Albuminuria Blood Pressure Recording Peripheral artery pulsations in the lower limbs(Dorsalis Pedis & Posterior Tibial) General examination of Skin and Foot Presentation on Diabetes Safe

Star Health and Allied Insurance Co. Ltd. Sum Insured Minimum Sum Insured - Rs. 50,000/- Maximum Sum Insured - Rs. 5,00,000/- (However maximum Sum Insured shall be restricted to Rs. 3,00,000/-) The following Sum Insured options are available Rs. 50,000/- Rs. 1,00,000/- Rs. 2,00,000/- Rs. 3,00,000/- Rs. 4,00,000/- Rs. 5,00,000/- Presentation on Diabetes Safe

Star Health and Allied Insurance Co. Ltd. Allowable Expenses Room rent & boarding charges per 2% of the sum insured up-to a maximum of Rs. 2,500/- in Class A cities and Rs. 1,250/- in other cities. Class A Cities – Ahmedabad, Bangalore, Chennai, Hyderabad, Kolkatta, Mumbai, Pune, New Delhi and Secunderabad. Nursing charges Surgeons, Anesthetist, Medical Practitioner, Consultants and Specialists fees Laser Treatment, Peritoneal Dialysis (PD) and Haemodialysis (HD). Presentation on Diabetes Safe

Star Health and Allied Insurance Co. Ltd. Allowable Expenses (Contd.) Anaesthesia, Blood, Oxygen and Operation Theatre charges, Surgical Appliances, Medicines and Drugs, Diagnostic Materials and Diagnostic Imaging modalities and X-ray Hospital expenses on donor of kidney for renal transplant surgery Post-renal complications on the insured person Second transplant following failure of the first transplant covered Presentation on Diabetes Safe

Star Health and Allied Insurance Co. Ltd. Allowable Expenses (Contd.) Pre-hospitalization expenses incurred for a period of 30 days prior to the date of hospitalization Post hospitalization expenses for 15 days after the discharge from the hospital for the covered disease Presentation on Diabetes Safe

Star Health and Allied Insurance Co. Ltd. Day Care Treatment Minimum of 24 hours Hospitalization is not necessary for the following Dialysis Laser procedure for treatment The above treatment shall be taken in the Hospital / Nursing Home and the Insured is discharged on the same day. Presentation on Diabetes Safe

Star Health and Allied Insurance Co. Ltd. Special Conditions applicable to Diabetic Nephropathy leading to Chronic Renal Failure Pre and Post Hospitalisation benefits not available for the purpose of Dialysis and/or Laser procedure under Diabetic Nephropathy Leading to Chronic Renal Failure Expenses for dialysis following Chronic Renal Failure is restricted to 10% of the sum insured or Rs. 50,000/- whichever is less, in the year succeeding the one under which a claim for Chronic renal Failure has been admitted. Expenses on Dialysis in the event of Insured Person developing Post-Transplant renal complications in the same policy period within which the transplant was undertaken, subject to a limit of 5% of the Sum Insured subject to a maximum of Rs. 25,000/-. Presentation on Diabetes Safe

Star Health and Allied Insurance Co. Ltd. Premium Rating Age Sum Insured (Rs.) 26 Years to 35 Years 36 Years to 45 Years 46 Years to 55 Years 56 Years to 65 Years 66 Years to 70 Years Premium figures are in Rs. excluding S. Tax Presentation on Diabetes Safe

Star Health and Allied Insurance Co. Ltd. Other Benefits Benefits under Section 80-D of the IT Act Cashless Service without involvement of TPA Direct Tie up with hospitals on an All India Basis Free advice from General Physician 24 X 7 In-House Call center ( ) Toll Free Telephone line assistance ( ) – for BSNL and MTNL Numbers Full knowledge based website to offer medical information, including Health Tips. Frequent health meets to disseminate information on health related topics Presentation on Diabetes Safe

Star Health and Allied Insurance Co. Ltd. Exclusions Treatment of Cataract Pre-existing diseases/conditions Expenses on treament towards Diabetes Mellitus Type II Expenses towards immuno suppressive drugs/medicines beyond what is allowed in post-hospitalisation benefit Expenses towards post-donation complications of the donor Expenses incurred in the first 90 days after taking policy Cost of walkers, artificial limbs, crutches, wheel chairs and such other similar aids Diagnostic charges Presentation on Diabetes Safe

Star Health and Allied Insurance Co. Ltd. Expenses on vitamins and tonics unless forming part of treatment for injury or disease Naturopathy Treatment Hospital registration charges, record charges, telephone charges and such other charges Expenses for Non Allopathic Treatment Expenses incurred for treatment on cosmetic or aesthetic treatment of any description and/or plastic surgery even if necessitated following any of the covered illness/disease Exclusions (Contd.) Presentation on Diabetes Safe

Star Health and Allied Insurance Co. Ltd. Claim Procedure In case of Network Hospitals Immediate intimation to the Call Centre ( / ) The insured has to send a request for ‘Pre Authorization Form’ signed by the Doctor in the Network Hospital Based on the intimation a field visit will be done by the Star Doctor Pre Authorization will be issued to the Hospital Based on the Pre Authorization and the Report by the Star Doctor, Cash Less Treatment will be given by the Network Hospital Presentation on Diabetes Safe

Star Health and Allied Insurance Co. Ltd. In case of Non Network Hospitals Immediate intimation to the Call Centre ( / ) Claim form will be sent to the Insured. Based on the intimation a field visit will be done by the Star Doctor Bills has to be settled by the Insured and will be reimbursed by Star on submitting the following documents Original Discharge Summary Main Hospital Bill with Break Up Investigation Reports with X-Ray Film Medical Bills with Prescriptions Claim Procedure (Contd.) Presentation on Diabetes Safe

Star Health and Allied Insurance Co. Ltd. Thank You