Star Health Medi Classic Insurance Policy: Coverage, Claim & Renewal

Published: 02-04-2019 11:47:49 AM

Life is filled with countless moments of happiness and sorrows. Since all of these are unpredictable and consume a significant amount of financial burden on an individual, it is a good option to opt for Insurance. Insurance policies provide coverage and help in reducing the financial risk of an individual. Star Health insurance provides Medi Classic Insurance Policy for the reimbursement of hospital expenses related to the diseases/injuries and accidents covered in it.

What Is Star Medi Classic Insurance Policy?

Star Medi Classic Insurance Policy is an insurance policy that reimburses hospitalisation expenses incurred due to disease, sickness and accidental injuries. This policy is even offered for HIV positive person who has CD 4 count at the time of entry is above 350. However, reliable proof needs to be provided.

Types of Star Medi-Classic Insurance Policy

Star Medi-Classic Insurance policy is provided on an individual basis to the policyholders where one can opt for the Hospital cash and patient care cover as.

Eligibility Criteria

Criteria	Eligibility
Entry Age	Min: 5 months Max: 65 years
Policy Term	One year
Pre-Existing Disease	Covered after 48 months of continuous coverage
Sum Insured	Up to Rs 2,00,000/- Rs 3,00,000/-  – Rs 5,00,000/- Above Rs 5,00,000/-
Pre-Acceptance Medical Screening	It is mandatory for policyholders who are 50+ to undergo pre-acceptance medical screening at the company nominated centers. The cost will be born up by the company.

What Star Medi Classic Insurance Policy Covers?

This individual policy provides coverage for the following:

• Room, boarding and nursing expenses
• Surgeon and consultant fees
• Anaesthesia, cost of pacemaker etc
• Emergency ambulance charges
• In-patient hospitalisation expenses
• Non allopathic treatment

Claim Process

The claims procedure under Medi-Classic Insurance Policy is as follows:

• Contact the customer care 24 hour [TOLL-FREE] help-line for assistance – 1800 425 2255 / 1800 102 4477
• In a scenario when hospitalization is planned, inform 24 hours before admission
• In a scenario when hospitalization is done under an emergency, the details need to be provided as per 24 hours within the admission period
• All network hospitals provide Cashless Facility to the policyholders respectively
• In non-network hospitals, the payment is to be made up front and documents are submitted which in turn will initiate the reimbursement facility

Documents required to make claims under Medi-Classic Insurance Policy

The documents to be submitted under Reimbursement Claims:

• Claim form which is duly completed along with a copy of PAN card
• Original pre-admission treatment papers along with investigations
• Discharge summary in original documents from the hospital
• Cash receipts of hospitals and chemists in the original format to be provided as well
• Reports of tests and their cash receipts
• All original receipts from the medical staff who undertook the treatment
• Certificate from the doctor who attended the patient regarding diagnosis

  The documents to be submitted under Cashless Treatment are prescriptions and the relevant receipts with respect to pre and post hospitalization are required under Cashless treatment

Cases Where You Can’t Make Claim Star Medi Classic Insurance Policy (Exclusions)

Below are some of the cases where the insurance company is not liable to pay:

• All injuries/accidents which may be contributed via nuclear weapons/activities
• All acts of the foreign enemy along with warlike operations [declared or not]
• Expenses on vitamins and tonics incurred which do not form a part of the treatment as prescribed the doctor
• Naturopathy treatments
• Stem cell implementation therapy
• Lasik Laser expenses
• Dental treatment unless required due to an emergency caused due to an accident or an injury

How Long Does It Take To Pay Out A Claim?

The claims need to be intimated within the duration of 24 hours [under hospitalization]. Upon getting all the required documents, the insurance company will assess and evaluate them and accordingly settle the claim within 30 days.

Renewal Process Of Medi Classic Insurance Policy

Lifelong renewal is offered under this policy. If the insured wants to increase the sum insured, he can do so only at the time of renewal. The policyholder will get 30 days as a grace period from the date of expiry to renew his policy. It is recommended for an insured to pay timely premium from before his policy gets lapsed.

Important Things One Should Know

• Pre-existing disease will be covered under Star Health Medi-Classic Insurance Policy (Individual) after 48 months of continuous insurance with any Indian Insurance company
• Post hospitalisation expenses shall not exceed the sum calculated at 7% of the hospitalisation expenses subject to a maximum of Rs 5,000
• This policy will be automatically get terminated upon the exhaustion of the limit of coverage or the death of the insured person`
• No claim bonus is not available for Family Package plan

Advantages Of Buying Star Health Medi-Classic Insurance Policy

• Automatic restoration of sum insured by 200% when the basic sum insured is fully exhausted
• Free look period of 15 days is provided under this policy
• This policy is portable that means if the insured wants to port this policy, S/he needs to intimate the insurance company 45 days before but not earlier than 60 days from the date of renewal is due

Features of Medi-Classic Insurance Policy

 

Features	Particulars
Claim Type [In house or TPA]	In-house claim settlement
Pre-Hospitalization	Expenses covered for 30 days prior to the date of admission
Network Hospitals Count	More than 8800+ network hospitals are covered
Post-Hospitalization	Expenses incurred up to 60 days after the discharge from the hospital
Room Eligibility	Room, Boarding and Nursing expenses are provided by the Hospital respectively at 2% of the sum insured which is subject to a maximum of Rs 5000/- per day.
Share Claim Payments	10% of each and every claim amount for insured persons beyond 60 years
Restoration of Cover	Automatic restoration of 200% sum insured under this policy
No Claim Bonus	Under this policy, it is provided for 5% of each and every claim free year up to 25%
Worldwide Coverage	NA
Maternity Cover	NA
Hospitalization at Home	NA
Day-Care Treatment	Specified ay care treatments are covered under this policy
Non-Allopathic Treatment Coverage	Covered up to 25% of sum insured which is subject to a max of Rs 25,000/- per policy period.
Emergency Ambulance	Emergency Ambulance charges are covered up to sum insured of Rs 750/- per hospitalization and the overall limit of Rs 1500/- per policy period.
Health Check-up	Up to 1% of the average sum insured after every 4 claim free years subject to maximum Rs 5,000/-

FAQ’s

 

Q1- Is there any tax benefits provided under this policy?

Yes, Medi-Classic Insurance Policy does provide tax benefits under section 80D of The Income Tax Act, 1961.

Q2- How can a policyholder buy this insurance?

A policyholder can buy this insurance via Star Health’s nearest office and through online medium.

Q3- Does this policy support Non-Allopathic treatments?

Yes, this policy supports Non-Allopathic treatment subject to 25% of the sum insured which is subject to a maximum of Rs 25,000/- per policy period.

Q4- Does this policy support treatment of eye disorders with respect to intra-viteral injections?

No, treatment of eye disorders with respect to intra-viteral injections is excluded under this policy.

Q5- What is the policy term associated with this policy?

The policy term is for a period of one year. However, in case a premium for two years is paid in advance then a discount of 5% is availed on the total premium in the policy.