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Key Features of Star Health Insurance Company

Star Health insurance offers comprehensive health insurance plans which make the best choice for you and your family. Some of the exclusive features offered by Star health insurance company are

Star Wellness Program:

This program intends to promote, incentivize and reward the insured person’s healthy lifestyle through various wellness activities. The wellness activities are designed to help the insured person to earn wellness reward points which will be tracked and monitored by the insurance company. These wellness points can be utilized by the insured to claim discounts on the renewal premium. The following table shows the discount on premium available under the wellness program:

Wellness points earned Discount on premium
200 -350 2%
351-600 5%
601-750 7%
751-1000 10%

Star Health In-House Claim Settlement:

Star Health & Allied insurance company has no Third-party administrators to settle the claim. All the reimbursement and cashless claims are settled through the in-house claim settlement team of Star insurance company. This is an advantage to the customer as the in-house claim settlement would be available round the clock. The customer’s reimbursement claim would also be settled within a few days as there would be no involvement of a third party in the claim settlement process. The in-house claim settlement process was proved to reduce the claim settlement time and has also improved customer satisfaction.

Faster & Hassle-free claim settlement:

The main purpose of taking a health insurance policy is to avail cashless/ reimbursement facility at the time of hospitalization and to reduce the chance of going bankrupt due to the hospitalization expenses which may involve in disposing of the assets such as Gold or other properties. If the claim settlement is not faster and hassle-free the insured customer would suffer a lot and the use of insurance policy would be limited. Star Health Insurance Company provides faster claim settlement service to their customers, in case of cashless claim settlement 90% of the claims are settled within 2 hours, and in case of reimbursement claim settlement would be done within 7 days from the receipt of all the required documents.

All the claims settled by Star Health Insurance Company are hassle-free as the claim settlement process is made simpler and faster. The duly filled claim settlement form should be filled by the insured customer and submitted to the insurance company along with the discharge summary and other bills for the claim to be processed within the time limit mentioned in the policy document.

Cashless facility:

Star Health Insurance Company has tied up with more than 10, 000 hospitals and diagnostic centers to provide cashless claim settlement service to its customers. The cashless claim settlement facility can be availed by the customers in any of the network hospitals or tie-up hospitals pan India. Most customers prefer to avail of cashless service at the time of hospitalization due to the comfort it offers to the customers. Almost 90% of the cashless claims are approved and settled within 2 hours of notifying the insurance company. All the major hospitals in India are tied up with Star Health and Allied insurance company.

Automatic Restoration of Sum Insured:

Automatic restoration of the sum insured is the restoration of the sum insured upon complete exhaustion during the policy period. The sum insured would be restored up to 3 times during the policy period without any extra premium to be paid. The sum insured restored under the policy can be used only for the new illness or a new family member for the same illness. It is to be noted that the restoration happens only after the complete exhaustion of the sum insured available in the policy.

Super Restoration of Sum Insured:

If the limit of coverage under this policy is exhausted during the policy period, an additional basic sum insured of 100% would be provided once, for the remaining policy period for subsequent hospitalization. Under the Super Restoration plan, the sum insured would be restored up to 100% of the basic sum insured and the same can be utilized for the same ailment in subsequent hospitalization.

The difference between the Automatic restoration of the sum insured and Super restoration of the sum insured is that the reinstated sum insured can be used for the same illness in the latter while the former doesn’t have this option. Super restoration of the sum insured is like an additional sum insured given to the insured for treatment of existing or new illnesses.

The unutilized additional basic sum insured cannot be carried forward at the end of the policy period during the renewal. The super restoration of the sum insured is not available for modern treatments. The super restoration of the sum insured is done only once during the policy period.

Installment options:

Star Health Insurance Company provides customers with installment options for the health insurance premiums. The health insurance premium can be paid in installments for long-term health insurance policy periods. Installment options help the customers to pay the health insurance premium more than once during the policy period. This way customers can save money by opting for higher coverage and paying later.

No pre-acceptance medical screening:

Most of the health insurance plans in Star Health Insurance Company do not require pre-acceptance medical screening for the policy issuance. The pre-acceptance medical screening would be required only in few cases such as Higher sum insured selection, adverse health conditions declared in the proposal form, etc. The pre-acceptance medical screening would be done at the company network diagnostic centers where the cost of screening would be borne by the Star health insurance company.

Documents required for Reimbursement Claim processing

There are certain documents required by the Star health insurance company to process the claims other than cashless. Any treatment taken in non-network hospital would be settled on reimbursement basis as the process involves the customer to pay the bill and then claim for the reimbursement after submitting all the necessary documents. The process of claim settlement under reimbursement basis would be as below.

Step 1:The first step under reimbursement claim process is to intimate the insurance company within 24 hours of admission in the hospital. For pre planned treatment intimation can be given even 48 hours prior to the admission in the hospital.

Step 2:The next step is to duly fill the claim intimation form and sign it. There are certain documents which are to be submitted to the insurance company along with the claim intimation form which are mentioned below:-

  • Details of the hospital in which the insured has undergone treatment which includes the details of patient, treatment undergone etc.
  • Policy copy or the Health card of the insurance company to prove the validity and the coverage.
  • Date of admission and date of discharge.
  • Discharge Summary.
  • Estimated claim amount for the treatment undergone at the hospital.
  • Authorization from doctor advising hospitalization/ diagnostic tests/ consultation.
  • Original hospital bills and the discharge summary.
  • Pathological reports and any other reports taken as a part of the treatment.
  • Police FIR and Post mortem report (for death claims)
  • Any other documents as requested by the insurance company.
  • Cancelled cheque leaf of the insured customer.

Step 3: The last step is where the insurance company would settle the bill after thorough enquiry and the quantum of claim would be decided by the insurance company subject to the terms and conditions mentioned under the policy. The insurance company would transfer the claim amount to the bank details submitted by the customer and any other bank details other than that of customer’s would not be accepted by the insurance for claim settlement.

Star Health Cashless Claim Settlement Process

Star Health insurance provides cashless treatment to its customers in more than 11,000 network hospitals across India. These hospitals are tied-up to offer comprehensive cashless services to the Star health insurance company customers. The procedure to claim cashless treatment from the network hospitals is listed below.

Step 1: In case of planned cashless treatment intimate the insurance company on their toll free number 1800-102-4488 and register the treatment for which the cashless service would be availed. In case of emergency hospitalization, it is required to intimate the insurance company before the treatment starts. The insurance company would provide go ahead to the hospital and the claim would be settled on cashless basis.

Step 2: The second step is to fill and submit the Claim intimation form / pre-authorization form available with the hospital. The E-card or the insurance policy copy should also be submitted along with the pre-authorization form to enable the insurance company to process the claim.

Step 3: The next step is to submit the cashless claim form along with all the other documents as required processing the claim..

Step 4: The form and the other documents submitted would be verified by the insurance company and if found satisfactory, a go ahead will be given by the insurance company for cashless claim.

Step 5: Once the treatment is done and the cashless request is accepted by the insurance company, Star Health Insurance Company would transfer the claim amount directly to the hospital without any involvement of the insured customer.

For any other claim related query please contact on the toll free number 1800-123-4003 to get the required assistance.

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