Medi Classic Presentation

1. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
Presentation on

MEDI-CLASSIC

2. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
Coverages
Hospitalization Expenses incurred as an
inpatient for
• Sickness/Illness/Diseases
• Accidental injuries

3. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
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.

4. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
Age Limits
5 Months – 80 Yrs
Proposals from persons above 45 yrs, age proof
in the form of DL, Pass Port, Ration Card or
School Certificate is required.
Dependent Children can be covered only with
any one of their Parents

5. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
Medical Examination
For persons with adverse medical history
and
For all persons above 50 years, acceptance
subject to Medical Examination at Company’s
Cost.

6. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
Sum Insured
•Minimum Sum Insured - Rs. 50,000/-
•Maximum Sum Insured - Rs. 10,00,000/-
•The following Sum Insured options are available
•Rs. 50,000/-
•Rs. 1,00,000/-
•Rs. 1,50,000/-
•Rs. 2,00,000/-
•Rs. 2,50,000/-
•Rs. 3,00,000/-
•Rs. 3,50,000/-
•Rs. 4,00,000/-
•Rs. 5,00,000/-
•*Rs.10,00,000/- * for members from 5 months to 65 yrs only

7. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
Allowable Expenses
•Room rent & boarding charges @ 2% of the sum insured
up-to a maximum of Rs. 4,000/- per day
•Nursing charges
•Surgeons, Anesthetist, Consultants and Specialists fees
•Operation Theatre charges, drugs and medicines
diagnostic materials, cost of pace maker etc
•Emergency Ambulance charges to go to Hospital for
treatment @ Rs 750/- per hospitalisation upto a
maximum of Rs 1,500/- per policy period

8. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
Allowable Expenses (Contd.)
Pre-hospitalization expenses incurred for a period of 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/-

9. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
Day Care Treatment
Minimum of 24 hours Hospitalization is not necessary for the following
•Dialysis,
•Chemotherapy,
•Radiotherapy,
•Cataract surgery,
•Dental Surgery,
•Lithotripsy (Kidney stone removal),
•Tonsillectomy,
•Cutting and Draining of Abscess,
•Liver Aspiration,
•Pleural Effusion Aspiration,
•Colonoscopy,
•Sclerotheraphy,
The above treatment shall be taken in the Hospital / Nursing Home
and the Insured is discharged on the same day.

10. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
Sub limits
Name of the Ailment / Surgery /
Procedure
Sub Limit
Cataract surgery Rs. 20,000/- in respect of one eye and
Rs. 30,000/- in the entire policy period
Lithotripsy (Kidney stone removal) Rs. 20,000/-
Tonsillectomy Rs. 7,500/-
Cutting and Draining of Abscess Rs. 1,500/-
Liver Aspiration Rs. 2,000/-
Pleural Effusion Aspiration Rs. 2,000/-
Colonoscopy Rs. 2,000/-
Sclerotheraphy Rs. 5,000/-

11. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
Premium Rating
Age Sum Insured (Rs.)
50000 1 Lakh 1.5
Lacs
2 Lacs 2.5
Lacs
3 Lacs 3.5
Lacs
4 Lacs5 Lacs 10
Lacs
5 Months to
35 Years
575 1200 1800 2350 2800 3300 3750 42004900 7065
36 Years to
45 Years
700 1350 2000 2600 3150 3650 4150 45005400 7965
46 Years to
55 Years
1320 2447 3400 4583 5548 6170 7408 87001070013265
56 Years to
65 Years
NA 3000 4200 5300 7200 8200 10196114511395816525
66 Years to
70 Years
NA 4547 6717 87681069612625144341624219859 NA
71 Years to
75 Years
NA 4872 7284 95741174413914159641801522113 NA
76 Years to
80 Years
NA 6029 9284124201543318449213412423630023 NA

12. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
No Claim Discounts (NCD) in case of
Renewal
•5% Discount on Basic Premium for every Claim Free
Year
•Maximum 25%
•In the event of a Claim
•One Step back in NCD for Age Group 5M – 35 Yrs
•Two Steps back for Age Group 36 – 45 Yrs
•Above 45 Yrs – No NCD

13. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
Transfer of Policy
To obtain the following benefits there should be a
continuous renewal of the expiring policy
(a) Renewal with Cumulative Bonus details
•Cumulative Bonus as shown in the Renewal Notice is
given
•Additional 5% Discount on premium is also given
(b) No Renewal Notice or Renewal Notice without
Cumulative Bonus details
•Cumulative Bonus as shown in the Previous Policy is
given
•Additional 5% Discount on premium is also given
•A declaration stating No Claim under the expiring policy
has to be obtained from the insured

14. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
Transfer of Policy – An Illustration
•Sum Insured – Rs. 1 Lac
•Premium – Rs. 1,200/- + S.Tax
•CB shown in the expiring Policy – Rs. 10,000/- (10%)
•CB eligible at the time of Renewal – Rs. 15,000/- (15%)
•In Case of (a) – CB of Rs. 15,000/- will be given and
additional 5% discount on Rs. 1,200/- will also be given.
•In Case of (b) – CB of Rs. 10,000/- as shown in the
expiring policy will be given and additional 5% discount
on Rs. 1,200/- will also be given.

15. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
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
24 X 7 In-House Call center (044-2826 3300)
Toll Free Telephone line assistance
(1800 425 2255)
Full knowledge based website to offer medical
information, including Health Tips.
Health Check-up benefits in addition to NCD
Frequent health meets to disseminate
information on health related topics

16. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
Optional Benefits
The following Optional benefits can be availed on
payment of Additional Premium
Hospital Cash :
•This insurance provides for Cash benefit of Rs. 500/- for and
each and every completed day of Hospitalisation subject to a
maximum of Rs. 1,500/- per hospitalisation and Rs. 3,000/-
per policy period.
•Insured persons aged less than 21 years and more than 60
years are not entitled for this benefit.
•Premium Age Band Premium (Rs.)
0-35 Years 200
36-45 Years 250
46-55 Years 300
56-60 Years 350

17. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
Optional Benefits (contd.)
Patient Care :
•Applicable for persons aged above 65 Years
•This insurance is extended to provide for the cost incurred for
engaging one attendant at residence after discharge from the
hospital of the Insured Person following a covered occurrence
under the policy up to Rs. 400 per day for a maximum of 5
days per hospitalisation. Subject to Time excess of 2 days.
•Provided engagement of such an attendant is recommended
by the attending physician and agreed to by the Company, in
writing
•Premium – Rs.300/- per person

18. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
Covers Insured Person, Spouse and 2 Dependant Children
Age Limit : 5 Months to 45 Years
Sum Insured Equally apportioned among Insured family members
Rating
Family Package
Details
Sum Insured
2 Lacs 3 Lacs
2 Adults 2348 3400
2 Adults + 1 Child 2238 3825
2 Adults + 2 Children 2320 4080
1 Adult + 1 Child 2168 3230
1 Adult + 2 Children 2206 3280
• Provides cover to New Born from Birth up to expiry of policy period.
• The Sum Insured is restricted to 10% of the Mother’s Sum Insured on
Payment of 10% of the Policy Premium.

19. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
Exclusions
•Pre Existing Diseases (covers after 4 yrs of continuous
renewal with us without break)
•Any Disease contracted during first 30 days
•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
•Cataract
•hysterectomy following menorrhia or fibromyoma
•Knee Replacement Surgery
•Joint Replacement Surgery
•Prolapse of intervertibral
•Vericose veins/ulcers

20. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
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

21. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
Exclusions (Contd.)
Hospital registration charges, record charges,
telephone charges and such other similar charges.
Non Allopathic shall be restricted to Rs. 25,000/- per
occurrence and subject to an overall limit of 25% of the
sum insured during the entire policy period.

22. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
Claim Procedure
In case of Network Hospitals
Immediate intimation to the Call Centre
(1800 425 2255/044-28263300)
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

23. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
In case of Non Network Hospitals
Immediate intimation to the Call Centre
(1800 425 2255 /044-28263300)
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.)

24. . .
StarHealth and Allied Insurance Co Ltd
Presentation on Medi-Classic
Thank You