health gain nandagopal - 9994910202

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITEDPERSONAL & CARING

S.V.NANDAGOPAL SENIOR SALES MANAGER

THANKS FOR OPPORTUNITY TO SERVEMOBILE

99949 10202 , 94431 86864 , 83000 20102

www.licnanda.blogspot.com

[email protected] , [email protected]

வருமுன்னர்க்காவாதான்வாழ்க்கைகஎரிமுன்னர்

கைவத்தூறுப�ாலக்கெகடும். திருக்குறள்

mailto:[email protected],[email protected]


HEALTH GAIN INSURANCE


Flat premium of only Rs. 15,000/- including service tax Coverage for both inpatient and outpatient treatment Policy can be given for both individual and family floater basis. Any unutilised amount under outpatient benefit can be carried forward to

the next one year

Major Product Features..

Coverages..Section – IHospitalization Expenses incurred as an inpatient for Sickness/Illness/Diseases Accidental injuries

Section – IIHospitalization Expenses incurred at any Hospital / Nursing Home as an outpatient.


5 Months – 65 Yrs

Life long Renewal

Dependent Children can be covered only with any one of their Parents

Age Limits..

Family Size..

Proposer

Spouse

Dependent Children


For persons with adverse medical history and

For all persons above 50 years, acceptance subject to Medical Examination at Company’s Cost.

Pre - Insurance Medical Test

Sum Insured.. Minimum Sum Insured - Rs. 1,00,000/-

Maximum Sum Insured - Rs. 5,00,000/-

The following Sum Insured options are available• Rs. 1,00,000/-• Rs. 2,00,000/-• Rs. 3,00,000/-• Rs. 4,00,000/-• Rs. 5,00,000/-


1. Room rent & boarding charges as follows

Class A Cities – 2% of the Sum Insured subject to a maximum

of Rs. 5,000/- per day (Ahmedabad, Bangalore, Chennai, Hyderabad,

Kolkatta, Mumbai including Thane, Pune, New Delhi and

Secunderabad)

Class B Cities – 1% of the Sum Insured subject to a maximum of Rs.

3,000/- per day (Baroda, Coimbatore , Surat, Meerut and all State

Capitals other than those falling under Class A)

Class C Cities – 1 % of the Sum Insured subject to a maximum of Rs.

1,000/- per day (Other Cities)

2. Nursing charges

Allowable Expenses… Section - I


Anesthesia, Blood, Oxygen,Operation Theatre charges, medicines and drugs, diagnostic materials, cost of pace maker

Emergency Ambulance charges to go to Hospital for treatment @ Rs 750/- per hospitalisation upto maximum of Rs 1,500/- per policy period

Pre-hospitalization expenses incurred 30 days prior to the date of hospitalization

Post hospitalization expenses on a lump-sum basis @ 7% of the actual hospitalization expenses (excluding room rent and hospital registration charges), subject to a maximum of Rs 5,000/-

Allowable Expenses… Section - I


Name of the Ailment / Surgery / Procedure Sub Limit

Cataract surgery Rs. 15,000/- in the entire policy period

Sub limits…


Expenses on Hospitalization for minimum period of 24 hours are admissible. However, this time limit will not apply for

taken in the Hospital / Nursing Home and the Insured is discharged on the same day.

No limits for the above Day care procedures except Cataract surgery

Dialysis, Chemotherapy

Radiotherapy, Cataract surgery,

Dental Surgery, Lithotripsy (Kidney stone removal),

Tonsillectomy, Cutting and Draining of Abscess

Liver Aspiration Pleural Effusion Aspiration

Colonoscopy Sclerotheraphy

Day Care Treatment..


Medical expenses incurred at any Hospital / Nursing Home as an Out Patient.

Maternity expenses as Out Patient

Dental treatment as Out Patient

Unutilised benefit under this section can be carried forwarded to the next year on renewal

The maximum period of such carry over shall be limited to one immediately succeeding year only.

Allowable Expenses… Section - II


Limit of Outpatient benefits for individual

Sum insured for IP(Rs)

100000 200000 300000 400000 500000

5m-45 years 8700 7750 7000 6250 5750

46-55 years 7900 6350 5200 3000 NA

56-60 years 7500 5800 3700 NA NA

IP – Inpatient NA – Not Available


Limit of Outpatient benefits for family floaterSum insured for

IP(Rs)Age 100000 200000 300000 400000 500000

2A5mths-35yrs 8400 7400 6750 5900 5250

36y-45yrs 8400 7400 6500 5500 490046-55yrs NA 5650 4000 2000 NA56-60yrs NA 5000 2250 NA NA

1A+1C5mths-35yrs 8500 7700 6950 5750 5500


1A+2C5mths-35yrs 8450 7500 6900 6000 5500


1A+3C5mths-35yrs 8350 7400 6650 5750 5250

36y-45yrs 8350 7200 6450 5500 475046-55yrs NA 5500 4000 NA NA56-60yrs NA 4750 2250 NA NA

A- Adult C- Child IP- Inpatient OP- Outpatient NA- Not Available (policy cannot be given)


Sum insured for IP(Rs) Age 100000 200000 300000 400000 500000

2A+1C

5mths-35yrs 8250 7250 6600 5750 5000

36y-45yrs 8250 7000 6150 5450 4500

46-55yrs NA 5250 3750 NA NA

56-60yrs NA 4500 1500 NA NA

2A+2C

5mths-35yrs 8250 7000 6500 5500 4650

36y-45yrs 8250 7000 5950 5000 3750

46-55yrs NA 5000 3500 NA NA

56-60yrs NA 4250 1500 NA NA

2A+3C

5mths-35yrs 8250 7000 6250 5250 4250

36y-45yrs 8250 6700 5750 4900 3700

46-55yrs NA 4750 3250 NA NA

56-60yrs NA 4000 1150 NA NA

A- Adult C- Child IP- Inpatient OP- Outpatient NA- Not Available policy cannot be given

Limit of Outpatient benefits for family floater


Renewal Discount.. Renewal Discount on Basic Premium is allowed on renewal for every

Claim Free Year as per chart

It is not Cumulative

No Claim Discount for Individual basis

For Individuals Sum Insured in Rupees

Age 100000 200000 300000 400000 500000

5 Months – 35 Years 120 235 330 420 490

36 Years – 45 Years 135 260 365 450 540

46 Years – 55 Years 245 458 617 870 NA

56 Years – 60 Years 300 530 820 NA NA


FAMILY COVER ON Floater Basis (FAMILY SIZE)

Sum Insured in Rupees

100000 200000 300000 400000 500000

2 Adults Discount in Rupees5 Months – 35 Years 177 289 399 520 59236 Years – 45 Years 177 314 436 557 65346 Years – 55 Years NA 554 761 1051 NA56 Years – 60 Years NA 640 1003 NA NA

1 Adult + 1 Child5 Months – 35 Years 152 272 371 475 53736 Years – 45 Years 152 301 394 507 59646 Years – 55 Years NA 527 693 966 NA56 Years – 60 Years NA 612 919 NA NA

1 Adult + 2 Child5 Months – 35 Years 164 284 383 491 56336 Years – 45 Years 164 308 411 525 62946 Years – 55 Years NA 541 716 1015 NA56 Years – 60 Years NA 623 973 NA NA

No Claim Discount for Family Floater basis


FAMILY COVER ON Floater Basis (FAMILY

SIZE)

Sum Insured in Rupees

100000 200000 300000 400000 500000

1 Adult + 3 Child Discount in Rupees5 Months – 35 Years 179 309 413 537 60436 Years – 45 Years 179 342 444 573 67746 Years – 55 Years NA 572 763 NA NA56 Years – 60 Years NA 665 1010 NA NA

2 Adult + 1 Child5 Months – 35 Years 189 330 419 530 63536 Years – 45 Years 189 356 483 578 70546 Years – 55 Years NA 593 787 NA NA56 Years – 60 Years NA 697 1063 NA NA



No Claim Discount for Family Floater basis


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

Other Benefits:

Exclusions..

48 months exclusion for Pre Existing Diseases (as per GIC council) Any Disease contracted during first 30 days First Year Exclusions

• Benign prostate hypertrophy• Hernia, Hydrocele, Fistula in Anus, Piles• Sinusitis• Renal stone and Gall stone removal• Congenital internal disease/defect


First Two Years Exclusions• Cataract• hysterectomy following menorrhia or fibromyoma• Knee Replacement Surgery• Joint Replacement Surgery• Prolapse of intervertibral• Vericose veins/ulcers

Naturopathy Treatment

Expenses incurred on Non Allopathic Treatment.

Exclusions..

STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITEDPERSONAL & CARINGFHO-rev2014/cpu/ver1.4/16 Oct 2014 19

• ALSO WE PROVIDE • LIFE INSURANCE• HEALTH INSURANCE• CHILD FUTURE PLANS• TAX SAVING & PLANNING• PAN CARD & PASSPORT • MOTOR VEHICLE INSURANCE• IMPORT & EXPORT INSURANCE• INDIVIDUAL,FAMILY,GROUP &

CORPORATE INSURANCE NEEDS


Thank You

May 2, 202320

health gain nandagopal - 9994910202

Health & Medicine