How to File a Claim with Star Health & Allied Insurance?

The litmus test for any insurance health insurance company is when you make a claim for hospitalisation or other medical expenses covered under your insurance policy. 

The claim procedure should be hassle free and settlement must be within a reasonable time or as per the terms of the policy. Nothing is more frustrating for a policy holder than for him to run from pillar to post trying to settle a claim after the trauma of an illness and stay in a hospital.

Apart from looking at the amenities and other terms and conditions, it is also important to know how easy it is to deal with the claims departments and fast they clear your claims. Preferably, every insurance company must have a well trained and cooperative customer service support that guides you prior to hospitalisation or within a couple of days. It is their responsibility to guide you on the procedures required, documents required which have to be produced while making a claim.

Star Health Insurance Prompt Claims Disposal

Customer Centric Service is one of the main tenets in the Star Insurance’s Citizens Charter. In the past few years they have carved out a name for themselves not only for honestly dealing with all policy holder grievances but also clearing all claims in record time.

Star Insurance has a track record of settlement in the shortest time. They have cleared 87% of cashless claims within two hours from discharge. They have settled a total of 3,78,710 claims amounting to ₹ 1,378 Crores for the financial year 2016/ 2017.

Star Heath Claims Support is a customer friendly and hassle free process. They ensure that all settlements are made in a timely and just manner. The key components of their service are courtesy, speed, attention and the drive to work hard to meet and exceed customer expectations.

Contacting and Intimating Star Health Insurance

The policy holder or someone known to the patient must Intimate Star Insurance Company within 24 hours from the illness or accident.  This can be done by contacting their toll free number 1 800 425 2255 or the nearest Star Health Mediclaim office. Please keep the policy number and Star Health card number handy while making the call.

Types of Claims 

Star Health has two types of claims viz. Cashless Claims and Reimbursable claims:

Cashless Claims are made when the policy maker is treated in one the insurance company’s network hospital. Identify yourself as a policy holder with your Star Health ID card at the hospital admissions reception. The hospital will ask Star Health for authorisation after which you will be admitted for treatment and all expenses related to this hospitalisation will be borne by Star Insurance. In this case, the following documents must be handed over to Star Insurance;

            Copy of Health Card issued by Star Health

            Claim Form duly filled with all details

            Medical case papers issued by treating doctor

            Investigative reports (X-ray, blood analysis, MRI etc)

            Pharmacy bills supported by doctors’ prescription

            FIR or MLC (Medico Legal Certificate) in the case of accident

            Discharge Summary

            Other papers pertaining to your treatment

Reimbursement Claims are made when the policy holder is treated in a hospital not listed in the Company’s network of hospitals. You need to follow the procedure as detailed below:

Information regarding your illness must be intimated to the customer support   (toll free number)

Complete the form (can be downloaded from the company website) and

Include the following ORIGINAL documents:

          original bills, receipts and discharge card from the hospital

          Bills from pharmacist with the supporting prescription from the doctor

          Receipts of tests done during the period of illness

          Investigation test reports along with the requisition note from the  

          medical practitioner or surgeon prescribing the test(s).

          Details of surgery and surgeons bill and receipt

          Certificate from treating Doctor

          Self declaration or FIR in case of an accident

          Health registration certificate, if the hospital has less than 15 beds.

How to Claim Reimbursement

The claiming process is fairly simple and straight forward. After you have paid the bills of all expenses incurred, you will fill the claims form and send it to the closest Star office combined with all the documents mentioned above. Your entitlement will be cleared within the shortest possible time as per the policy terms and conditions.

Related : Claim Procedure for Star Health Insurance

Some Points to Remember While Making a Claim

If the form is incomplete, the authorisation request can be cancelled.

Non Reimbursable items will be borne by the insured

All claims must be submitted no later than 30 days from the date of discharge

Post hospitalisation claims have to be submitted within 30 days from discharge. 

          

About Star Health Insurance

Star Health and Allied Insurance is the first standalone insurance company covering personal accident, mediclaim and overseas travel insurance. It is headquartered in Chennai and was launched in 2006.

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Star Health Insurance Plans - Compare and Buy

Started in 2006, Star Health Insurance Company is an undertaking between four companies that have their base in UAE, Singapore, and India. The Indian companies that are a part of the venture are Tata Capitals and ICICI Ventures and Fund management. 

With a wide network of hospitals and a good number of awards and accolades, the company has set a reputation in the field of health insurance. 

Star Health Insurance Features and Benefits

Star Health Insurance offers a wide gamut of Star Health Mediclaim Plans and other health insurance plans with unique features. These features are a part of different plans.  A few of them are briefed below.

• Most Star Health mediclaim plans can be renewed for a lifetime. They also offer lifelong coverage.

• It covers most pre-existing  diseases after a waiting period of four years

• Some plans cover room rent expenses at 2% of total sum insured. 

• The total network of hospitals under Star Health Insurance Company is more than 8200 across India.

Star Health Insurance Company Plans 

A brief on some of the most sought-after Star Health Mediclaim plans are given below. 

i. Family Health Optima Insurance Plan

This is a single policy for the entire family. You can get extra sum insured without an extra cost. There is a health check-up benefit for every year there is no claim. This plan covers newborn babies from the sixteenth day and also covers assisted reproductive technique. 

ii. Red Carpet Health Insurance Plan for Senior Citizens

This Star Health Mediclaim plan is for people aged between 60 years to 75 years. The waiting period for pre-existing diseases is just one year.  This plan also covers OPD consultations in the network hospitals. The renewals are for a lifetime and the coverage offered is up to Rs 10 lakhs.

iii. Comprehensive Insurance Plan

This plan by Star Health Insurance is a reputed one offering a lot of benefits. With this plan, there is no limit for coverage offered towards treatment cost and room rent.  The other benefits offered are:

• Air ambulance coverage during emergency

• Coverage for Dental OPD and ophthalmic OPD consultations

• Offers maternity coverage and even covers newborn

• Coverage for several daycare procedures (approximately more than 400)

• Offers personal accident cover against disability and death (there is no additional cost for this coverage)

iv. Individual Medi-Classic Insurance Policy

This individual Star Health Mediclaim plan offers interesting benefits like coverage for close to 101-day care procedures. Customers can avail a no claims bonus of 5% for every claim free year up to 25%. Customers can also choose optional covers such as patient care cover and hospital cash. 

v. Super Surplus Policy

This is a top-up plan by Star Health Insurance. This plan provides a higher sum insured and the premium is affordable. The pre-existing diseases are covered after a three year wait and no screening is required before policy confirmation.  Customers can also avail this plan on a floater basis. 

vi. Star Unique Health Plan

The policy term of this Star Health Mediclaim plan is only two years. The post-hospitalization coverage is paid as a lump sum (only up to the limit specified in the policy brochure). Pre-hospitalization charges covered for thirty days prior to hospitalization. The waiting period for coverage of pre-existing disease is 11 months and the plan also covers ambulance charges for emergency hospitalization. 

You may like read : Best Health Insurance Plan & Medical Insurance Policy Online

vii. Diabetes Safe Plan

This is a specialty policy by Star Health Insurance that covers expenses related to hospitalization for diabetic complications. Certain benefits of the policy include:

• Accidental death compensation for the insured

• Coverage for the donor in case of a kidney transplantation

• Coverage of dialysis expenses (terms apply)

• Limited coverage for amputation of limbs

• Two plans available namely Plan A and Plan B

• Plan A has pre-acceptance screening medically and no waiting period

• Plan B has no pre-acceptance screening medically and a 15 month waiting period

viii. Cardiac Care Insurance Plan

This plan is for people with any existing cardiac disease who have undergone correction or surgery. There are two plans namely Gold plans and Silver Plan. The other aspects covered under the plan include:

• Hospitalization charges for cardiac ailments

• Outpatient charges

• Personal accident cover and accidental death cover also covered

• More than 405 daycare procedures covered

ix. Cancer Care Gold Plan

This plan by Star Health Mediclaim is amongst the first health plans for people diagnosed with cancer. This is a pilot product by Star Insurance Company. The eligibility is from 5 months to 65 years. The benefits include:

• Coverage of 50% of sum insured for second malignancy or metastasis that is not related to the existing cancer

• Regular cover for illness and accident that are not related to cancer

• No medical tests required for acceptance

Other Plans by Star health mediclaim include:

x. Wedding Gift Insurance

xi. Net Plus Plan

xii. Micro Insurance Policy

xiii. Critic Care Plus Insurance Plan

xiv. Family Delite Insurance Plan

xv. Star Special Care Plan

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Star vs Apollo Munich Health Insurance

Today, uncertainties and unforeseen situations make it necessary for all of us to buy a good and comprehensive health insurance plan for ourselves and our family. So are you searching for a health ins plan in the market? This article comprises of a comparison of some vital features and benefits offered by Star Health Mediclaim Policy and Apollo Health Ins Plans.

Choices Everywhere! How Do You Choose Your Health Ins Plan?

The world is full of choices when we talk about health ins plans. Competition within the products enables buyers to choose the best product depending on their needs. All of these products provide various benefits and coverage options. Even then, why is it necessary for you to compare health ins plans?

Price, inclusions, coverage, benefits, etc. are vital aspects while choosing the best health ins plan. Along with the features, your requirement is also significant while making a choice. When you match your needs, go through the product reviews and gather the necessary information, you should be able to choose the plan to be purchased.

Which Options Do You Have For Health Ins Plans?

As mentioned earlier, there are many. But some of the most popular ones are,

✓      Star Health Mediclaim Policy

✓      Apollo Health Ins Plans

✓      Max Bupa

✓      Religare Health Insurance

✓      Cigna TTK Prohealth Protect Plan

✓      Oriental Happy Family Floated Health Plan

✓      Star Health Mediclassic Insurance Policy and many more.

Remember, each one of the above plans in the market offers a USP. It could be low premium, low claim processing time, etc. One should not be confused with the options or the USP. Instead, if required, make an apple to apple comparison and then take a wise decision.

Comparison of Star Health Mediclaim Policy vs Apollo Munich Health Ins Plans

Now, we will be comparing the comprehensive health ins plan offered by Star Health Mediclaim policy and, Easy Health and Optima Restore plan offered by Apollo Health Ins Plans.

Benefits of the Plan	Insurance Provider
	Star Health Mediclaim Policy	Apollo Health Ins Plans
	Comprehensive Health Insurance	Easy Health	Optima Restore
Policy Term	1 Year	1 Year/ 2 Years	1 Year/ 2 Years
Sum Insured Option	2 Lakhs INR to 25 Lakhs INR	2 Lakhs INR to 10 Lakhs INR	2 Lakhs INR to 25 Lakhs INR
Eligibility Criteria	Three months to 65 Years	Three Months to 60 Years	Three Months to 60 Years
In-Patient Treatment	Covered up to the sum insured	Covered up to the sum insured	Covered up to the sum insured
Renewal Coverage	Whole life renewal	Whole life renewal	Whole life renewal
Pre Hospitalization	30 Days	30 Days (60 Days, provided, the insured person intimates 5 days in advance before getting hospitalized)	60 Days
Post Hospitalization	60 Days	60 Days (90 Days, provided, the insured person intimates 5 days in advance before getting hospitalized)	180 Days
Home Care	Covered	Covered up to the sum insured	Covered up to the sum insured
Emergency Ambulance Service	5 lakhs sum insured –2000 INR 7.5 lakhs sum insured –3000 INR 10 lakhs sum insured –3500 INR 15 lakhs sum insured –4000 INR 20 lakhs sum insured –4500 INR 25 lakhs sum insured –5000 INR	Up to 2000 INR per hospitalization	Up to 2000 INR per hospitalization
Organ Donor Cost	Not covered	Covered up to the sum insured	Covered up to the sum insured
Dental Treatment	Not covered	Covered	Not covered
Day Care Procedures	Coverage for 101-day care procedures	Coverage for 140-day care procedures	Coverage for 140-day care procedures
Ayush Benefit	Not covered	Covered	Not covered
Benefits of Maternity	Delivery charges are covered after 3 years	Covered after 6 years	Not covered
Daily Cash For Accompanying the Insured Person	5 lakhs sum insured: 500 INR 7.5 lakhs sum insured: 750 INR 10 lakhs sum insured: 750 INR 15 lakhs sum insured: 1000 INR 20 lakhs sum insured: 1000 INR 25 lakhs sum insured: 1500 INR	For an insured child Easy Health Exclusive 3,4,5 lakhs sum insured : 300 INR per day, maximum 9000 INR 7.50 lakhs sum insured : 500 INR per day, maximum 15000 INR Easy Health Premium 4,5 lakhs sum insured : 300 INR per day, maximum 9000 INR 7.50 lakhs sum insured : 500 INR per day, maximum 15000 INR	Not covered
Health Check-Up	Covered after three years	Covered after four years	Not covered
Vaccination (In case of post-bite treatment)	Not covered	Not covered	Not covered
Daily Allowance – Hospital	Per day 1500 INR up to 7 days	Not covered	Not covered
Coverage for pre-existing diseases	Coverage rendered after a continuous renewal for 4 years	Coverage rendered after a continuous renewal for 3 years	Coverage rendered after a continuous renewal for 3 years
General waiting time	30 days	30 days	30 days
Restore Benefit	100% - after exhaustion of the sum insured	-	Yes
Cumulative Bonus	NA	10% cumulative bonus for each claim free year accumulating up to 50%	50%
Sub-limits – inpatient treatment	Covered up to sum insured	Covered up to sum insured	Covered up to sum insured
Co-Pay	10% of each claim made by insured people who are above the age of 60 at the entry level	No copay	No copay
Claims Loading	Yes	Applicable	Applicable
Tax Benefit Limit	15000 INR For senior citizens (above 60 years of age) – 20000 INR	15000 INR For senior citizens (above 60 years of age) – 20000 INR	15000 INR For senior citizens (above 60 years of age) – 20000 INR
Newborn Baby Cover	5 lakhs sum insured: 50,000 INR 7.5 lakhs sum insured: 1,00,000 INR 10 lakhs sum insured: 1,00,000 INR 15 lakhs sum insured: 1,00,000 INR 20 lakhs sum insured: 1,00,000 INR 25 lakhs sum insured: 1,00,000 INR	Newborn baby from the age of 1-90 days.	-

Are Health Insurance Reviews As Well Important?

Yes, checking reviews also are necessary. Reviews help you with an understanding of the way the product is faring in the market. Besides, customer comments also help you in knowing remarks, bouquets, and brickbats associated with the health ins plan that you wish to buy.

Apollo Health Ins Plans Reviews

Apollo Munich offers a wide range of health ins plans. Overall, a couple of plans such as Apollo Munich Easy Health std Plan and Apollo Munich Easy Health Excl Plan have rated 5 stars. Apollo Munich Easy Health Prem. Plan, on the other hand, has rated 3 stars.

Given the fact that there are many other choices in the market, to know about other health ins plans when compared with Star Health Mediclaim Policy and Apollo Health Ins Plans, try comparing max Bupa vs Star Health vs Apollo Munich. Along with this, you may also compare Apollo Munich vs Religare Health Insurance and Star Health vs National Insurance.

I have compared most of the inclusions of Star Health Mediclaim Policy, and Apollo Health Insurance Plans by the above chart. But, for any questions or technical understanding of any term, it is better to visit health insurance expert and have the doubts clarified. Consulting a health insurance expert will also help make you a decision on opting for the most appropriate health ins plan suiting your needs.

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