FAMILY FLOATER : STAR

HEALTH Vs ICICI
LOMBARD

PRESENTED BY,
SOUMIK PARUA(09DF057)
FAMILY FLOTER
A comprehensive Health Insurance policy that
ensures health cover for the entire family with
affordable premium.
Family Floater Health Insurance plan lets you share
the entire sum insured among the family
members covered under the policy, without any
individual upper limits.


ICICI LOMBARD
INTRODUCTION


 ICICI Lombard is a joint venture between ICICI Bank

Limited and Fairfax Financial Holdings Limited, a
Canada based financial services company engaged
in general insurance, reinsurance.

ICICI Lombard is the largest private sector general

insurance company in India with a Gross Written
Premium (GWP) of Rs. 34,198.4 million for the year
ended March 31, 2009.
 ICICI LOMBARD
KEY FEATURES


 Comprehensive coverage for your family with floater benefit.


 Cashless claims facility at over 3,500+ network hospitals across
India.

 No sub-limits on room rent, doctor fees, and hospital charges or
for any disease.

 No co-payments for any disease or any hospitalisation
expenses.

 No health check-up up to the age of 55 years (age as on last
birthday).

 Avail tax benefits under Section 80D of the Indian Income Tax
Act 1961.
CONT..
Now get a Free health check-up coupon for any one
insured family member, valid for the policy period

Buy Online and pay in EMIs without any extra charges.

Options for one or two year covers (auto renewal)
available.

Get additional Sum Insured for every claim free year.

Keep your family secured even against expenses for
hospitalisation due to terrorist activities .

 ICICI LOMBARD
What is covered


 Medical expenses incurred as an inpatient during hospitalisation for

more than 24 hours, including room charges, doctor/ surgeon's fee,
medicines bills, etc

 Medical expenses incurred 30 days prior and 60 days post
hospitalisation

 Day Care expenses incurred on named advanced technological
surgeries and procedures requiring less than 24 hours of
hospitalisation. (Including Dialysis,
Radiotherapy and Chemotherapy)

 Pre-existing diseases can be covered after four continuous years of
coverage with
the Company.

 This policy also covers you for hospitalisation in case of Swine Flu /
influenza.

 ICICI LOMBARD
Exclusions valid for the first 30 Days


 Any illness contracted within 30 days of the inception date of the

Policy, except those that are incurred as a result of an accident.
This clause is not applicable on the subsequent renewals 
Exclusions valid for the first 2 Years


 Treatment of the following diseases/illness/ailments:

 Cataract
 Benign Prostatic Hypertrophy.
 Myomectomy, Hysterectomy unless because of malignancy .
 Hernia, Hydrocele .
 Fistula in Anus, Piles .
 Arthritis, Gout, Rheumatism .
 Joint replacement, unless due to accident.
 Sinusitis and related disorders.
 Stone in the urinary and biliary systems.
 Dilatation & Curettage.
 Skin and all internal tumors / cysts / nodules / polyps of any kind,
including breast.
lumps, unless malignant / adenoids and hemorrhoids.

 ICICI LOMBARD
Permanent exclusions


 Any illness/ disease/ injury/ pre-existing disease before the

inception of the policy.
However, this exclusion ceases to apply if the policy is
renewed with the Company for 4 consecutive years.

 Non-allopathic treatment, pregnancy and childbirth related
complications, cosmetic, aesthetic and obesity related
treatment.

 Expenses arising from HIV or AIDS and related diseases, use or
misuse of liquor, intoxicating substances or drugs as well as
intentional self injury .

 War, riots, strike, nuclear weapon, induced treatment.

 ICICI LOMBARD
Eligibility


 The customer can buy the policy for any family member(s) children
and / or parents.
 The senior most person to be insured should be between 5 to 60
years of age.
 The Proposer needs to be aged above 18 years.
 To cover children aged between 91 days to 5 years, the policy must
also cover at least 1 adult under the same policy.
 Children under less than 91 days old cannot be covered.
 Individual(s) proposed for Insurance whose age is 56 years &
above have to undergo medical tests at ICICI Lombard
designated diagnostic centers.
 The policy cover is renewable till the age of 70 years.
 Income Tax benefits u/s 80D can only be availed for policies bought
for Self, Spouse,Children or Parents.
 Floater benefit under the policy is available up to the age of 60
years. All floater policies thereafter will be renewed under
individual plan up to the age of 70 years.
 

Introduction
Star Health and Allied Insurance co. ltd is a
joint venture between Oman Insurance
Company, UAE and leading NRIs and Indian
business houses. It has a capital based of INR
108 crores that far exceeds the requirement
to form a full- fledged general insurance
company.
MAJOR PRODUCT FEATURES

The policy offers the benefits of wider

protection at a lesser price. This policy is
available on individual basis and also on
floater basis, covering the entire family
Family means two adults and two children
(children economically dependant and upto
25 years)

POLICY BENEFITS

Hospitalization Cover : Protects the insured

person for in-patient hospitalization expenses
for a minimum of 24 hours. These expenses
include room and boarding expenses to a
maximum of Rs.4,000/- per day
No ceiling on ICU, medicine, diagnostic charges
or consultation fee
Nursing expenses
Surgeon's fees, Consultant's fees,
Anaesthetist's and Specialist's fees
Cost of medicines and drugs

ELIGIBILITY

Any person aged between 5 months and 60

years can take this insurance upto a
maximum sum insured of Rs10,00,000/-
Renewals granted upto 75 years

EXCLUSIONS
Expenses for the treatment of any
illness/diseases/condition which is pre-existing
Treatment of illness/diseases/sickness contracted
by the insured person during the first 30 days
from the commencement date of this policy
Naturopathy treatment
Expenses which are purely diagnostic in nature,
with no positive existence of any disease
Expenses incurred for non-allopathic treatment
Treatment of congenital
diseases/defects/anomalies
Expenses which are mainly cosmetic in nature

CLAIMS PROCEDURE
Inform the ID number for easy reference
In case of planned hospitalization, please
inform 24 hours prior to admission into the
hospital
In case of emergency hospitalization,
information to be given within 24 hours after
hospitalization
In non-network hospitals, payment must be
made upfront and then reimbursement will be
effected on the submission of documents

Star Advantages
No Third Party Administrator (TPA), direct in-
house claims settlement
Faster & hassle-free claims settlement
Cashless facility if the treatment is taken in any
designated hospital
Network of more than 4000 hospitals across
India
Doctor-on-Call
24x7 toll-free helpline

Comparison (1 year plan
2A+1C)
Parameter STAR HEALTH ICICI LOMBARD
S u m In su re d 4,00,000 4,00,000
N a m e o f P o licy Star family health optima Family floater health
insurance plan insurance

P re m iu m ( in clu d in g 6,652 9776

se rvice ta x )
R e n e w a lu p to w h a t 75 70
age
C o o lin g o ff p e rio d 30 30
( days )
P re e xistin g d ise a se s Up to 2 years 4 years
co ve d a fte r ye a rs

C a sh le ss fa cility & yes Yes

N e tw o rk o f h o sp ita l
A m b u la n ce ch a rg e s Rs. 750 per hospitalization Full Covered
 Comparison
Parameter STAR HEALTH ICICI LOMBARD

R o o m & B o a rd in g 2% of SI 1% of SI
E xp e n se s
A ccid e n ta lco ve r covered covered
No claim bonus NA NA
cumulative
No claim discount 10% 5%
Free health checkup covered covered
Pre-hospitalization Up to 30 days 30 days
(days)
Post – hospitalization Up to 7% of the 60 days
hospitalization
expenses