Star Family Delite Insurance Policy

Established in 2006, Star Health and Allied Insurance Company Limited is the first company to provide separate and only health insurance in India. In just a few years, the company has soon made its place in the health insurance market. In the year 2018-19, the Claim Ratio Settlement of Star Health and Allied Insurance was an impressive 90%.

Various customer-centric health insurance plans have been launched by the company. Most of the plans apart from being affordable are also transparent and easy to understand.

One such product is the Star Health and Allied Insurance Family Delite Policy. Family Delite Policy is a policy that offers multiple benefits for your family. Here, we are going to discuss everything you should know about the Family Delite Policy.

Star Health and Allied Insurance Family Delite Policy - Highlights

Here are some of the major features of Family Delite Policy –

• The plan offers health insurance for your whole family at an affordable price
• If admitted to a hospital for 24 hours or more, room charges, costs of medicines, nursing and boarding, doctors’ fee are all covered
• The entry age for this policy is from 5 months to 65 years
• Sum insured is available on floater basis
• The is no maximum age for cover, the plan comes with lifelong renewal
• Various specified day care procedures are covered
• Expenditure on ambulance during emergency hospitalisation is covered-INR 750 per hospitalisation and INR 1,500 per policy period
• Treatment-related expenses that are incurred before and also after hospitalisation are covered
• No medical screening is required, if you are below 50 years of age and have no major health condition

Star Health and Allied Insurance Family Delite Policy - Benefits 

Buying health insurance is indeed a prudent decision. 

1. Hospitalisation
   When you get admitted to a hospital for the treatment of an injury or an illness for 24 hours or more,  the policy would cover
   • Room rent, boarding and nursing at the rate of 1% sum insured per day
   • ICU charges at the rate of 1.5% of the sum insured
   • Fees of the Surgeon, Consultants, Specialists and Anesthetist
   • Blood, oxygen, anaesthesia, cost of pace makes, OT charges, drugs and medicines
   • Ambulance Charges (in case of an emergency) up to INR 1,500 per policy tenure
   • Expenses on Modern treatments are subjected to specific limits
2. Pre-Hospitalisation
   Treatment-related expenses made 30 days before the date of hospitalisation are covered under the  Family Delite Policy
3. Post Hospitalisation
   7% of the treatment-related expenses (except the room rent) up to INR 5,000 made till 60 days after the date of discharge is covered under the Family Delite Policy

Star Health and Allied Insurance Family Delite Policy - Premium Details

Here are the estimated premium details of a non-smoker male, his wife and 2 children –

Star Health and Allied Insurance Family Delite Policy - What is not covered?

• Pre-existing diseases (PED) are excluded until  4 years of continuous of break-free policy coverage and specified diseases have a waiting period of 2 years
• Treatment of any illness within the first 30 days of policy purchase is excluded unless it arises due to an accidental injury
• Diagnostic expenses that are unrelated to the current treatment
• Custodial care that is either at home or at a nursing facility
• Treatment required because of participation in adventure sports
• Treatment necessitated due to a malicious/unlawful activity
• Hospitalisation for Rehabilitation and Respite care and not receiving treatment
• Surgical treatment of obesity (under specific conditions)

Star Health and Allied Insurance Family Delite Policy-General Details 

1. Pre-Existing Diseases
   The pre-existing diseases or illnesses are covered after break-free4 years of continuous policy coverage
2. Pre-Acceptance Medical Screening 
   People above 50 years of age will have to undergo a Pre-Acceptance Medical screening at a healthcare centre recommended by the company. The cost of the screening is borne with the company, provided the policy is purchased
3. Tax Benefits
   The premium that is paid towards this policy is eligible for a tax deduction under the Income Tax Act, Section 80D. But remember, that if you pay the premium through cash, you would not be able to claim the tax benefits
4. Free Look Period
   After the purchase of the policy, if you feel unsatisfied with the terms and conditions of the policy, you have a time of 15 days to cancel the policy. If you have not made any claim during this period, you will get a refund of the premium that you paid after a deduction of the expenses for the pre-policy medical check-ups, stamp duties and a proportionate amount as the risk premium
5. Cancellation of the Policy
   If you want to cancel the policy, you need to give a 15 days notice in writing. It should be noted that after a claim has been made, a policy cannot be cancelled 
   The refund will be made in the following way:

Star Health and Allied Insurance Family Delite Policy-Renewal Process

Unless due to a fraud or misinterpretation on behalf of the insured person, the company will grant the request of Renewal. However, there are a few things which you should remember at the time of renewal-

• If not done within the 30-day grace period, the policy will terminate automatically
• Make sure to register a request and pay the renewal amount before the policy expires
• You will not be able to avail a cover during the grace period
• Loading does not apply a renewal based on the individual claim history

Star Health and Allied Insurance Family Delite Policy - Eligibility

Star Health and Allied Insurance Family Delite Policy - Claim Process

Star Health and Allied Insurance Company settle the claims directly, without involving a Third-Party Administrator, making the claim settlement process quick and hassle-free. In case of a planned hospitalisation, inform the company 1-2 days in advance. In case of an emergency, make sure to do so in the first 24 hours of hospitalisation. Call customer care to register your request. You may call on 1800 425 2255/ 1800 102 4477.

There are two ways in which a claim can be made:

1. Cashless Claims
   As the name suggests, in a cashless claim you need not pay the expenses, up till the sum insured, from your pocket. However, this facility is available only at the network hospitals. 
   Your policy papers contain a list of all the hospitals that have a tie-up with the insurance company, and you must be aware of the hospitals that fall in your area. Knowing about these hospitals will help you reach out to them in case of an emergency hospitalisation quickly. Visit the company website: www.starhealth.in  to see the list of network hospitals.
   To make a cashless claim at a  network hospital, follow these steps:
   • On reaching the hospital, you need to produce the Company issued Customer ID card
   • Get the pre-authorisation form from the Help Desk, fill it and resubmit there along with the documents (listed below)
   • The hospital will get the signatures of the required authority and send the form to the company
   • The company will then process the request as per the terms and conditions.
2. Reimbursement Claims
   For some reasons, if you could not go to a network hospital for treatment, you would have to make all the payments up-front and then you can request for the reimbursement from an insurance company.
   
   The time limit for filing a Reimbursement Claim:

Documents Needed for the Claim

In case of a cashless claim, once the insurance company gives the authorisation, it will settle all the bills with the hospital itself. But for Reimbursement, you would be required to produce all the treatment-related documents. However, it is recommended that you keep all the documents handy in both procedures.

• The claim form, filled and signed
• Doctor’s referral letter which advises hospitalisation
• Pre-hospitalisation treatment-related bills and receipts
• Doctor’s prescriptions which advise medicines or diagnostic tests
• Original medical bills from the hospital and the pharmacy
• Original reports of diagnostic tests
• Original ambulance receipt
• Police FIR or Medico-Legal Certificate in case of accidental injuries
• Any other document which is needed by the insurance company

Star Health and Allied Insurance -  Cashless Hospital Network

Star Health and Allied Insurance have a network of over 9900 hospitals all over the country. In a network hospital, you can make a cashless claim of the expenses, up to your base sum insured. Hospitalisation in a network hospital becomes very easy and trouble-free as it saves you from the running around of raising funds for the treatment. Rather than worrying about the bills, you can concentrate on your or your family member’s treatment. 

Star Health and Allied Insurance - Customer Care Details 

Star Health and Allied Insurance provide the following ways of contacting the company for your queries or complaints.

Star Health and Allied Insurance Family Delite Policy - Review

COVID-19 has changed the outlook of many people towards health insurance. Though it has always been a wise decision, many people think that they are very fit and nothing wrong can ever happen to them. While it is nice to think positively, not being prepared for a medical emergency can put you in a very tight spot. 

Star Health and Allied Insurance Family Delite Policy is an inexpensive and uncomplicated health insurance plan that lets you keep yourself and your family under a protective shield. By investing in the Family Delite Policy you can save yourself from so many worries and disturbance that may be caused. The policy will cover the expenses that would be incurred because of an injury, an illness or a disease.