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Bajaj Allianz Star Package- Family Floater Health Insurance

Objective

A special policy with an aim to provide a customised insurance plan depending on needs of a person.


Suited for

This policy can be bought as an individual cover or as a family floater cover. It is more suitable for those looking to buy multiple policies for different conditions.


What does it do?

This plan gives you freedom to customise the policy as per your needs. It offers eight standalone policy benefits under one policy. Each policy benefit is defined as a Section which has its own exclusions as well. It is upto the proposer to select any of the sections depending on his needs. A minimum of three sections are mandatory to select. For instance, you may select three sections- health guard (covering inpatient treatment and related expenses), critical illness and personal accident section. The policy will charge premiums based on the sections opted. This single policy can become a comprehensive package if customised in a manner.


Pros

No sub-limit on room rent and other expenses.
Higher policy terms of two and three years provide relief from renewal process on an annual basis.
It offers discount on selecting four or more sections.
It saves policyholder from task of managing multiple policies.
Premium paid under this policy will enjoy tax benefits under Section 80D.


Cons

The policy cannot be renewed throughout lifetime.
There is a co-payment clause which means 10 per cent of the admissible claim amount will have to be borne by the insured member if treated in non-network hospital.
Individuals between age 50 and 60 years entering the policy for the first time have to bear 20 per cent of the admissible claim amount.


Our View

An all-in-one plan which can be bought by those looking to purchase different policies covering against different conditions. Before buying evaluate your needs first to include all the required sections at once. A special advice is while filling proposal form for burglary or fire insurance (household contents), mention the details of all valuables that cost more than Rs 5,000 separately to enjoy an uninterrupted cover.

Eligibility
Entry Age (years) 
Minimum18; 3 months for children
Maximum60; 25 for children
Maximum Policy Renewal Age (years)60 for Hospital Cash benefit; 80 years for Health guard; 60 years for Critical Illness benefit; 65 for Education grant
Coverage TypeIndividual/ family floater
Sum Insured (Rs) 
MaximumHospital Cash(per day basis) 2500
Health Guard 5 lakh
Critical Illness 3 lakh
Personal Accident 5 lakh
Education Grant 5 lakh
Burglary/ Fire Insurance(Household Contents only) 4 lakh
Traveling Baggage 40000
Public Liability 5 lakh
MinimumHospital Cash(per day basis) 500/1000/2000
Health Guard 1.5 lakh/ 2 lakh/ 3 lakh
Critical Illness 1 lakh/ 1.5 lakh/ 2 lakh
Personal Accident 2 lakh/ 3 lakh/ 4 lakh
Education Grant 2 lakh/ 3 lakh/ 4 lakh
Burglary/ Fire Insurance(Household Contents only) 1 lakh/ 2 lakh/ 3 lakh
Traveling Baggage 10000/20000/30000
Public Liability 2 lakh/ 3 lakh/ 4 lakh
Policy Term (years)1 or 2 or 3
Tax BenefitPremium paid is eligible for tax benefit under section 80D of the Income Tax Act
DiscountSection Discount on selecting more than 3 sections.
4-5 sections: 10% discount
6-8 sections: 15%
10% discount on selecting a 2 years policy term and 15% discount on selecting a 3 years policy term
No Claim BonusHealth guard: 5% on each claim free year; maximum upto 50%. Applicable on Sum Insured of Rs 2 lakh and above.
Grace Period for Policy Renewal15 days for Health Guard cover
Policy TerminationBoth insurance company and Policyholder are allowed to terminate the policy at anytime by giving a 14 day written notice. The insurer will refund premium on pro rata basis depending upon policy period elapsed.
Customer Service 
AddressBajaj Allianz General Insurance Company Limited. GE Plaza, Airport Road, Yerawad, Pune - 411006
Mail to[email protected]
Call to1800 22 5858(BSNL/ MTNL); 1800 209 5858 (Any mobile/ landline) or 020 30305858
Additions to the Plan
Scope of Cover
Cashless facilityAvailable at empanelled hospitals in India
Re-imbursementIn case policyholder opts for non empanelled hospital with a Co-payment clause of 10%
Minimum three sections (any) are mandatory
Section IHospital Cash
Daily Cash AmountCovered; maximum of 30 days (including ICU treatment) per policy period regardless of number of confinements to the hospital.
ICU BenefitCovered; double the daily cash amount for a maximum of 7 days per policy period
Section IIHealth Guard
In patient treatmentCovered
Pre-post hospitalisationRelevant medical expenses covered from 60 days prior and 90 days post hospitalisation
Day Care Procedures130 day care procedures are covered
Add on Coverage (requires payment of extra premium)
Ambulance ExpensesCovered; upto maximum of Rs 1000 per valid hospitalisation
Accommodation to RelativeRs 500 per day for 10 days
Organ transplant expenses of donorCovered upto Rs 1 lakh
Accidental Emergency, reconstructive Surgery (in case of accident), Physiotherapy, Medical evacuationcovered upto Rs 50000
Burial, Cremation ExpensesCovered; Rs 25000
Medical expenses for accidental hospitalisationCovered; twice the Health Guard Sum Insured
Free medical checkupCovered; after 4 claim free years
Section IIICritical IllnessCovered; pays a lump sum amount provided insured person survives 30 days after confirm diagnosis of critical illness. It covers critical illnesses namely: First Heart Attack, Coronary Artery Disease Requiring Surgery, Cancer, Kidney Failure (End-stage renal disease), Major Organ Transplantation, Multiple Sclerosis, Surgery of Aorta, Primary Pulmonary Arterial Hypertension, Paralysis, Neuron Surgery and joint replacement
Section IVPersonal Accident
Accidental deathCovered; 100% of Sum Insured
Cost of transporting remains from hospital to cremation ground/ residenceCovered; 2% of Sum Insured or Rs 5000, whichever is lower
Permanent Total disabilityCovered; 125% of Sum Insured
Permanent Partial DisabilityCovered; pays predefined percentage of sum insured
Temporary Total Disability Weekly payment of 1% of the Sum Insured maximum upto 100 weeks
Medical Expensesreimburses upto 40% of the admissible claim
Section VEducation Grantpayable in case of Accidental Death and Permanent Total Disability for continuing education of children
Section VIBurglary and Fire
Standard Fire Policy(including earthquake) and burglary for household contents onlycovers loss or damage to household property.Covered on the first loss basis @ 25% of the value at risk. Items with value more than 5% of Sum Insured have to be specially disclosed in the proposal form.
Section VIITraveling Baggage
Loss, damage or theft of baggage while traveling anywhere in the worldCovered
Section VIIIPublic Liability
Bodily injury or damage to property of third partyCovered
Exclusions and Waiting Period
Hospital CashPre-existing diseases and related complications.Hospitalisation within 30 days from the commencement of policy.Certain diseases will be covered from second year and onwards.Pregnancy/ childbirth Surgery/ dentalNatural perilsAccidents due to drunken driving
Health GuardPre-existing diseases will be covered after waiting period of 4 years.Some diseases such as hernia, piles, sinusitis, cataract shall be covered after a waiting period of 2 years.Medical expenses for treatment of any disease or illness diagnosed within 30 days of commencement of policy.dental/ spectacles/ contact lenses or hearing aids.non allopathic medicine, congenital diseases, all expenses arising from AIDS, cosmetic, aesthetic, intoxicating drugs/ alcohol, joint replacement surgery(unless caused by an accident)
Critical Illness PolicyPre existing critical illnessAny illness diagnosed during first 90 days from commencement date of the policy.
Personal Accident & Education GrantSuicide, self-inflicted injury, pre-existing physical or mental defects, alcoholic, influence of drugs, AIDS or related diseases etc.
Traveling BaggageTheft from car except from fully enclosed saloon cars having all the doors, windows and other opening securely locked, loss or damage to jeweler or valuables.Loss by any carrier under contract and Loss to money securities, gold and silver ornaments, travel tickets, cheque, draft, jeweler, share certificates and articles of consumable nature
Public LiabilityArising out of deliberate or willful or International noncompliance with any statutory provisions, connected with fines, penalties, in connection with any motor vehicles, watercraft, hovercraft or spacecraft
Co Payment ClauseHealth Guard: Individuals between age group 56-60 years taking the policy for the first time have to bear 20% of the admissible expenses. further in case of treatment in a non empanelled hospital, 10% of admissible claim has to be borne by policyholder
Annual Premium Option under Hospital Cash (Section I)
Age (in years)Daily Cash Benefit (in Rs)
500100020002500
upto 25250300600800
25-404006008501100
40-5065090017002600
50-55900130028003500
56-601200180036004600
Indicative premiums; exclusive of service tax.
Under family floater policy, it can cover spouse with 50% additional premium and children with 25% additional premium
Annual Premium Option under Health Guard (Section II)
Age (in years)Sum Insured (in Rs)
1.5 lakh2 lakh3 lakh5 lakh
upto 251882233833065244
25-402532328344306156
40-503272430960659576
50-5550286703838015236
56-607696102601282617879
Indicative premiums; exclusive of service tax.
Under family floater policy, it can cover spouse with 50% additional premium and children with 25% additional premium.
Premium Rates for Add On Coverage
Add on Coverage (requires payment of extra premium)Additional Premium
Accommodation to Relative0.25
Organ transplant expenses of donor0.25
Accidental Emergency, reconstructive Surgery (in case of accident), Physiotherapy, Medical evacuation0.1
Burial, Cremation Expenses0.1
Medical expenses for accidental hospitalisation0.25
Deductible Discount
Deductible Amount (in Rs)Discount on premium (%)
1000010
1500015
2500017.5
5000020
7500022.5
10000025
15000027.5
20000030
25000032.5
Annual Premium Option for Critical Illness Cover (Section III)
Age (in years)Sum Insured (in Rs)
1 lakh1.5 lakh2 lakh3 lakh
6.-25200300400600
26-404256388501275
41-45800120016002400
46-501200180024003600
51-551750262535005250
56-603000450060009000
Indicative premiums; exclusive of service tax
For family floater coverage, an additional premium of 50% for spouse and 25% for children below 25 years of age has to be paid.
Annual Premium Option for Personal Accident Cover (Section IV)
Sum Insured (in Rs)2 lakh3 lakh4 lakh5 lakh
Premium375563750938
Indicative premiums; exclusive of service tax
Annual Premium Option for Education Grant Benefit (Section V)
Sum Insured (in Rs)2 lakh3 lakh4 lakh5 lakh
Premium120180240300
Indicative premiums; exclusive of service tax
Annual Premium Option for Burglary / Fire Insurance (Household Contents) (Section VI)
Sum Insured (in Rs)1 lakh2 lakh3 lakh4 lakh
Premium40080012001600
Indicative premiums; exclusive of service tax
Annual Premium Option for Travelling Baggage Cover (Section VII)
Sum Insured (in Rs)10000200003000040000
Premium200400500800
Indicative premiums; exclusive of service tax
Annual Premium Option for Public Liability Cover (Section VIII)
Sum Insured (in Rs)2 lakh3 lakh4 lakh5 lakh
Premium100150200250
Indicative premiums; exclusive of service tax

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