Star Health and Allied Insurance Co. Ltd. Presentation on Micro Health Insurance Presentation on MICRO HEALTH INSURANCE

Star Health and Allied Insurance Co. Ltd. Presentation on Micro Health Insurance Coverages Hospitalization Expenses incurred as an inpatient for Sickness/Illness/Diseases Accident

Star Health and Allied Insurance Co. Ltd. Presentation on Micro Health Insurance What is a Hospital? Hospital, Nursing Home means any institution in India established for indoor care and treatment of sickness and injuries 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 Fully qualified nursing staff under its employment round the clock Fully qualified Doctor(s) should be in charge round the clock.

Star Health and Allied Insurance Co. Ltd. Presentation on Micro Health Insurance Age Limits 5 Years – 50 Years Dependent Children can be covered only with any one of their Parents

Star Health and Allied Insurance Co. Ltd. Presentation on Micro Health Insurance Sum Insured Per Hospitalization Maximum - Rs. 15,000/- Per Policy Period Maximum - Rs. 30,000/-

Star Health and Allied Insurance Co. Ltd. Presentation on Micro Health Insurance Allowable Expenses Room rent & boarding charges & Nursing Rs.150/- per day and Rs. 5,000/- per hospitalisation Surgeons, Anesthetist, Consultants and Specialists fees subject to a maximum of Rs. 4,500/- per hospitalisation Operation Theatre charges, drugs and medicines diagnostic materials, cost of pace maker etc Rs. 4,500/- per hospitalisation Emergency Ambulance charges to go to Hospital for Rs 350/- per hospitalisation upto maximum of Rs 1,000/- per policy period

Star Health and Allied Insurance Co. Ltd. Presentation on Micro Health Insurance Day Care Treatment Expenses on Hospitalization for minimum period of 24 hours are admissible. However, this time limit will not apply for Dialysis, Chemotherapy, Radiotherapy, Cataract surgery, Dental Surgery, Lithotripsy (Kidney stone removal), Tonsillectomy, Cutting and Draining of Abscess, Liver Aspiration, Pleural Effusion Aspiration, Colonoscopy, Sclerotheraphy, taken in the Hospital / Nursing Home and the Insured is discharged on the same day.

Star Health and Allied Insurance Co. Ltd. Presentation on Micro Health Insurance Rating AgePremium 5 Years to 25 Years Years to 35 Years Years to 45 Years Years to 50 Years500

Star Health and Allied Insurance Co. Ltd. Presentation on Micro Health Insurance Other Benefits Benefits under Section 80-D of the IT Act Cashless Service without intervention of TPA Direct Tie up with hospitals on an All India Basis 24 X 7 In-House Call center Toll Free Telephone line assistance Full knowledge based website to offer medical information, including Health Tips. Health Check-up benefits Frequent health meets to disseminate info on the health related topics

Star Health and Allied Insurance Co. Ltd. Presentation on Micro Health Insurance Group policies can be given Group Discount of 5% of the premium for a Group Exceeding 100 members Group Policies

Star Health and Allied Insurance Co. Ltd. Presentation on Micro Health Insurance Exclusions Pre Existing Diseases Any Disease contracted during first 30 days Cataract First Year Exclusions Benign prostate hypertrophy Hernia, Hydrocele, Fistula in Anus, Piles Sinusitis Congenital internal disease/defect Renal stone and Gall stone removal First Two Years Exclusions Hysterectomy following Menorrhia or Fibromyoma Knee Replacement Surgery Joint Replacement Surgery

Star Health and Allied Insurance Co. Ltd. Presentation on Micro Health Insurance Exclusions (Contd.) Injury / Disease arising due to War, Invasion, Act of Foreign Enemy, Warlike operations Circumcision unless necessary for treatment of a disease Cost of spectacles and contact lens, hearing aids, walkers, crutches wheel chairs and such other aids Dental treatment or surgery Convalescence, general debility, Run-down condition or rest cure, congenital external disease or defects or anomalies, sterility, venereal disease, intentional self injury and use of intoxicating drugs/alcohol Naturopathy Treatment Expenses incurred on Lasik Laser or Refractive Error Correction treatment

Star Health and Allied Insurance Co. Ltd. Presentation on Micro Health Insurance Exclusions (Contd.) Hospital registration charges, record charges, telephone charges and such other similar charges. Non Allopathic Treatment

Star Health and Allied Insurance Co. Ltd. Presentation on Micro Health Insurance 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

Star Health and Allied Insurance Co. Ltd. Presentation on Micro Health Insurance 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.)

Star Health and Allied Insurance Co. Ltd. Presentation on Micro Health Insurance Thank You