presentation on diabetes safe
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Presentation on DIABETES SAFE. Presentation on Diabetes Safe. Who can take this policy ?. This cover is exclusively designed for people diagnosed with Diabetes Mellitus Type II. Presentation on Diabetes Safe. Coverages. - PowerPoint PPT PresentationTRANSCRIPT
Star Health and Allied Insurance Co. Ltd.
Presentation on
DIABETES SAFE
Star Health and Allied Insurance Co. Ltd.
• This cover is exclusively designed for people diagnosed with Diabetes Mellitus Type II
Presentation on Diabetes Safe
Who can take this policy ?
Star Health and Allied Insurance Co. Ltd.
Coverages
Hospitalization Expenses incurred as an inpatient for treatment of the following complications
Diabetic Retinopathy requiring Laser treatment
Diabetic Nephoropathy leading to Chronic Renal Failure
Diabetic Foot Ulcer requiring Micro Vascular Surgery
Presentation on Diabetes Safe
Star Health and Allied Insurance Co. Ltd.
What is a Hospital?• Hospital, Nursing Home means any institution in
India established for indoor care and treatment of sickness and injuries and which
Either
• It has been registered with the local authorities and is under the supervision of a registered and qualified Medical Practitioner
or• Should comply with minimum criteria as under• It should have at least 15 inpatient beds (10 in Class ‘C’ Towns).• Fully equipped operation theatre of its own wherever surgical
operation is carried out.• Fully qualified nursing staff under its employment round the
clock• Fully qualified Doctor(s) should be in charge round the clock.
Presentation on Diabetes Safe
Star Health and Allied Insurance Co. Ltd.
Age Limits
Entry Age : 26 Years to 65 Years
Renewal will be accepted up to 70 years
Presentation on Diabetes Safe
Star Health and Allied Insurance Co. Ltd.
Pre Acceptance Medical Screening
The following medical examination will be done at the cost of the Insurer.
• Blood Urea• Serum Creatinine• Micro Albuminuria• Blood Pressure Recording• Peripheral artery pulsations in the lower limbs(Dorsalis
Pedis & Posterior Tibial)• General examination of Skin and Foot
Presentation on Diabetes Safe
Star Health and Allied Insurance Co. Ltd.
Sum Insured
• Minimum Sum Insured - Rs. 50,000/-
• Maximum Sum Insured - Rs. 5,00,000/- (However maximum Sum Insured shall be restricted to Rs. 3,00,000/-)
• The following Sum Insured options are available• Rs. 50,000/-• Rs. 1,00,000/-• Rs. 2,00,000/-• Rs. 3,00,000/-• Rs. 4,00,000/-• Rs. 5,00,000/-
Presentation on Diabetes Safe
Star Health and Allied Insurance Co. Ltd.
Allowable Expenses
Room rent & boarding charges per day @ 2% of the sum insured up-to a maximum of Rs. 2,500/- in Class A cities and Rs. 1,250/- in other locations.
Class A Cities – Ahmedabad, Bangalore, Chennai, Hyderabad, Kolkatta, Mumbai, Pune, New Delhi and Secunderabad.
• Nursing charges
• Surgeons, Anesthetist, Medical Practitioner, Consultants and Specialists fees
• Laser Treatment, Peritoneal Dialysis (PD) and Haemodialysis (HD).
Presentation on Diabetes Safe
Star Health and Allied Insurance Co. Ltd.
Allowable Expenses (Contd.)
Anaesthesia, Blood, Oxygen and Operation Theatre charges, Surgical Appliances, Medicines and Drugs, Diagnostic Materials and Diagnostic Imaging modalities and X-ray
Hospital expenses on donor of kidney for renal transplant surgery
Post-renal complications on the insured person
Second transplant following failure of the first transplant covered
Presentation on Diabetes Safe
Star Health and Allied Insurance Co. Ltd.
Allowable Expenses (Contd.)
Pre-hospitalization expenses incurred for a period of 30 days prior to the date of hospitalization
Post hospitalization expenses for 15 days after the discharge from the hospital for the covered disease
Presentation on Diabetes Safe
Star Health and Allied Insurance Co. Ltd.
Day Care Treatment
Minimum of 24 hours Hospitalization is not necessary for the following
• Dialysis• Laser procedure for treatment
The above treatment shall be taken in the Hospital / Nursing Home and the Insured is discharged on the same day.
Presentation on Diabetes Safe
Star Health and Allied Insurance Co. Ltd.
Special Conditions applicable to Diabetic Nephropathy leading to Chronic Renal Failure
Pre and Post Hospitalisation benefits not available for the purpose of Dialysis and/or Laser procedure under Diabetic Nephropathy Leading to Chronic Renal Failure
Expenses for dialysis following Chronic Renal Failure is restricted to 10% of the sum insured or Rs. 50,000/- whichever is less, in the year succeeding the one under which a claim for Chronic renal Failure has been admitted.
Expenses on Dialysis in the event of Insured Person developing Post-Transplant renal complications in the same policy period within which the transplant was undertaken, subject to a limit of 5% of the Sum Insured subject to a maximum of Rs. 25,000/-.
Presentation on Diabetes Safe
Star Health and Allied Insurance Co. Ltd.
Premium Rating
79807315665049904655400000
1094510035912068406385500000
50204600418031352300300000
41053765342025651885200000
24702185190016151140100000
22251485123599080550000
66 Years to 70 Years
56 Years to 65 Years
46 Years to 55 Years
36 Years to 45 Years
26 Years to 35 Years
Age
Sum Insured (Rs.)
Premium figures are in Rs. excluding S. Tax
Presentation on Diabetes Safe
Star Health and Allied Insurance Co. Ltd.
Other Benefits
Benefits under Section 80-D of the IT ActCashless Service without involvement of TPADirect Tie up with hospitals on an All India BasisFree advice from General Physician24 X 7 In-House Call center (044-2826 3300)Toll Free Telephone line assistance
(1800 425 2255) – for BSNL and MTNL NumbersFull knowledge based website to offer medical information, including Health Tips. Frequent health meets to disseminate information on health related topics
Presentation on Diabetes Safe
Star Health and Allied Insurance Co. Ltd.
Exclusions
Treatment of Cataract
Pre-existing diseases/conditions
Expenses on treament towards Diabetes Mellitus Type II
Expenses towards immuno suppressive drugs/medicines beyond what is allowed in post-hospitalisation benefit
Expenses towards post-donation complications of the donor
Expenses incurred in the first 90 days after taking policy
Cost of walkers, artificial limbs, crutches, wheel chairs and such other similar aids
Diagnostic charges
Presentation on Diabetes Safe
Star Health and Allied Insurance Co. Ltd.
Expenses on vitamins and tonics unless forming part of treatment for injury or disease
Naturopathy Treatment
Hospital registration charges, record charges, telephone charges and such other charges
Expenses for Non Allopathic Treatment
Expenses incurred for treatment on cosmetic or aesthetic treatment of any description and/or plastic surgery even if necessitated following any of the covered illness/disease
Exclusions (Contd.)
Presentation on Diabetes Safe
Star Health and Allied Insurance Co. Ltd.
Claim Procedure
In case of Network HospitalsImmediate intimation to the Call Centre
(1800 425 2255/044-28263300)The insured has to send a request for ‘Pre Authorization Form’ signed by the Doctor in the Network HospitalBased on the intimation a field visit will be done by the Star DoctorPre Authorization will be issued to the HospitalBased on the Pre Authorization and the Report by the Star Doctor, Cash Less Treatment will be given by the Network Hospital
Presentation on Diabetes Safe
Star Health and Allied Insurance Co. Ltd.
In case of Non Network HospitalsImmediate intimation to the Call Centre
(1800 425 2255 /044-28263300)Claim form will be sent to the Insured.Based on the intimation a field visit will be done by the Star DoctorBills has to be settled by the Insured and will be reimbursed by Star on submitting the following documents
• Original Discharge Summary• Main Hospital Bill with Break Up• Investigation Reports with X-Ray Film• Medical Bills with Prescriptions
Claim Procedure (Contd.)
Presentation on Diabetes Safe
Star Health and Allied Insurance Co. Ltd.
Thank You