Human T-cell Lympho Trophic Virus type III (HTLV-III) or Lymphadenopathy Associated Virus

Star Health Gain Insurance Policy (LAV) or HIV / AIDS. It is however made clear that such of those who are positive for HIV
(Human Immuno Deficiency Virus) would be entitled for expenses incurred for treatment, other
Unique Identification No.: SHAHLIP18088V021718 than for opportunistic infections and for treatment of HIV/AIDS, provided at the time of first
v Features commencement of insurance under this policy, their CD4 count is not less than 350.
• Complete flexibility in choosing Sum Insured you need , premium you wish to pay and family 11. Expenses incurred on weight control services including surgical procedures such as Bariatric
size you would like to opt for Surgery and /or medical treatment of obesity.
• Ideal for your health care needs and a perfect Tax Saver 12. Expenses incurred on High Intensity Focused Ultra Sound, Uterine Fibroid Embolisation,
v Eligibility Balloon Sinoplasty, Enhanced External Counter Pulsation Therapy and related therapies,
• Any person aged between 18 years and 65 years, residing in India, can take this insurance. Chelation therapy, Deep Brain Stimulation, Hyperbaric Oxygen Therapy, Rotational Field
Quantum Magnetic Resonance Therapy, VAX-D, Low level laser therapy, Photodynamic
• Family : Proposer, spouse, dependent children from 91 days up to 25 years (children those
therapy and such other therapies similar to those mentioned herein under exclusion no12.
who are economically dependent on their parents)
13. Charges incurred on diagnostics that are not consistent with the treatment for which the
v Policy Term: 1 year
insured is admitted in the hospital / nursing home. Admission primarily for diagnostic purpose
v Sum Insured Type options: Individual and Floater with no positive existence of sickness / disease / ailment / injury and no further treatment is
v Premium / Sum Insured Options (Excluding Tax) indicated.
14. Expenses on vitamins and tonics unless forming part of treatment for injury or disease as
certified by the attending Physician of the hospital where the insured underwent treatment.
Options Premium Rs. Sum Insured Rs. 15. Unconventional, Untested, Unproven, Experimental therapies.
Option 1 15,000/- 16. Stem cell Therapy, Chondrocyte Implantation, Procedures using Platelet Rich plasma and
Option 2 20,000/- Intra articular injection therapy.
1,00,000/- 2,00,000/- 3,00,000/- 4,00,000/- 5,00,000/-
Option 3 25,000/- 17. Oral Chemotherapy, Immuno therapy and Biologicals, except when administered as an in-
Option 4 30,000/- patient, when clinically indicated and hospitalization warranted.
18. All types of Cosmetic, Aesthetic treatment of any description, all treatment for erectile
Out-Patient benefit will vary depending on the premium and sum insured options.
dysfunctions, Change of Sex.
Please refer the Out Patient benefit chart for details.
19. Plastic surgery (other than as necessitated due to an accident or as a part of any illness),
v Coverage: 20. Hospital record charges and such other charges
21. Inoculation or Vaccination (except for post–bite treatment and for medical treatment for
Section I In-patient Hospitalisation
therapeutic reasons.
Section II Outpatient expenses*
22. Dental treatment or surgery unless necessitated due to accidental injuries and requiring
*Your selection of Sum Insured & Premium shall decide your outpatient
expenses limit hospitalization. (Dental implants are not payable).
23. Treatment arising from or traceable to pregnancy, childbirth, family planning, miscarriage,
v Section I: In-patient Hospitalisation abortion and complications of any of these (other than ectopic pregnancy).
a) Room, Boarding, Nursing Expenses all inclusive as provided by the Hospital / Nursing Home 24. Treatment for Sub-Fertility, Assisted Conception and or other related complications of the
up to 1% of the sum insured per day. same.
b) Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist fee 25. Medical and / or surgical treatment of Sleep apnea, treatment for genetic and endocrine
disorders.
c) Anaesthesia, Blood, Oxygen, Operation Theatre charges, diagnostic materials , Cost of
Pacemaker and such other similar expenses 26. Expenses incurred on Lasik Laser or other procedures Refractive Error Correction and its
complications, all treatment for disorders of eye requiring intra-vitreal injections.
d) Cost of medicines , drugs,
27. Cochlear implants and` procedure related hospitalization expenses
e) Emergency Ambulance charges for transporting the patient to the hospital upto a sum of
Rs.750/- per hospitalization and overall limit of Rs.1500/- per policy period. 28. Expenses incurred for treatment of diseases / illness / accidental injuries by systems of
medicine other than allopathy.
Note: Expenses relating to (a) to (c) as stated above will be considered in proportion to the
eligible room category 29. Hospital registration charges, admission charges, telephone charges and such other charges
30. Any hospitalizations which are not Medically Necessary
v Day Care Procedures: All day care procedures are covered.
31. Other Excluded Expenses as detailed in the website www.starhealth.in
v Limits for Cataract : Expenses incurred on treatment of Cataract is subject to the limits as per the
following table Note: Exclusion Nos.21 to Nos.28 are not applicable for Section II.
v Section II: Outpatient Benefit: Covers cost of treatment incurred as an outpatient at any
Sum Insured Rs. Limit per eye (in Rs.) Limit per policy period (in Rs.) Networked Facility in India. The unutilized amount under this benefit can be carried forward to the
next policy year on renewal. The maximum period of such carry over shall be limited to one
1,00,000/- and 2,00,000/- Up to 12,000/- per eye, per policy period
immediately succeeding year only.
3,00,000/- Up to 25,000/- Up to 35,000/- Note for Section II: Admission of a claim under this section II will not prejudice the Company's right to
4,00,000/- Up to 30,000/- Up to 45,000/- reject a claim under Section I.
v Free-look Period: A free look period of 15 days from the date of receipt of the policy by the insured is
5,00,000/- Up to 40,000/- Up to 60,000/-
available to the insured to review the terms and conditions of the policy. In case the insured is not
v Pre hospitalization: Medical expenses incurred up to 30 days prior to the date of admission in to satisfied with the terms and conditions, the insured may seek cancellation of the policy and in such
hospital are payable an event the Company may allow refund of premium paid after adjusting stamp duty charges and
proportionate risk premium for the period concerned provided no claim has been made until such
v Post hospitalization: Medical expenses incurred up to 60 days after discharge from the hospital
cancellation.
are payable.
Free look Period is not applicable at the time of renewal of the policy
v Waiting Periods:
v Renewal and Grace Period: The policy can be renewed except on grounds of misrepresentation /
· 30 days waiting period (not applicable for Accidents)
Non-disclosure of material fact as declared in the proposal form and at the time of claim, fraud
· 24 months waiting period for specified illness/ diseases/ treatments committed / moral hazard or non cooperation of the insured.
· 48 months waiting period for pre existing diseases. A grace period of 30 days from the date of expiry of the policy is available for renewal. If renewal is
v Co-payment: 20% of each and every claim if you are aged above 60 years during the first inception made within this 30 days period, the continuity of benefits with reference to waiting will be allowed.
of this policy. Such co-payment shall be applicable for renewals also Any Disease / illness contracted or injury sustained during the grace period will be deemed as Pre
If your age is up to 60 years during first inception of this policy then Co-payment condition shall not be existing and will be subject to waiting period of 48 months from the date of payment of renewal
applicable. premium.
v EXCLUSIONS: Note: 1. The actual period of cover will start only from the date of payment of premium.
1. Circumcision, Preputioplasty, Frenuloplasty, Preputial Dilatation and Removal of SMEGMA 2. Renewal premium is subject to change with prior approval from Regulator
2. Congenital External Condition / Defects / Anomalies v Withdrawal: The Company reserves the right to withdraw the product with prior approval of the
3. Convalescence, general debility, run-down condition or rest cure, Nutritional deficiency states. Competent Authority. In such an event the insured will be intimated three months in advance and the
insured shall have the option to choose to be covered by an equivalent or similar policy offered by the
4. Psychiatric, mental and behavioral disorders.
Company.
5. Intentional self injury
v Modification of the terms of the policy: The Company reserves the right to modify the policy terms
6. Use of intoxicating substances, substances abuse, drugs / alcohol, smoking and tobacco and conditions or modify the premium of the policy with the prior approval of the Competent
chewing Authority. In such an event the insured will be intimated three months in advance
7. Venereal Disease and Sexually Transmitted Diseases, v Revision of Sum insured: Reduction or enhancement of sum insured is permissible only at the
8. Injury/disease directly or indirectly caused by or arising from or attributable to war, invasion, act time of renewal.
of foreign enemy, warlike operations (whether war be declared or not) Enhancement of sum insured is subject to no claim being lodged or paid under this policy, Both the
9. Injury or disease directly or indirectly caused by or contributed to by nuclear acceptance for enhancement and the amount of enhancement will be at the discretion of the
weapons/materials Company. Where the sum insured is enhanced, the amount of such additional sum insured including
10. All expenses arising out of any condition directly or indirectly caused due to or associated with
 the respective sublimits shall be subject to the following terms v Star Advantages
A Waiting period as under shall apply afresh from the date of such enhancement for the increase · No Third Party Administrator, direct in-house claims settlement.
in the sum insured, that is, the difference between the expiring policy sum insured and the · Faster and hassle – free claim settlement.
increased current sum insured. · Cashless hospitalization
i) First 30 days as under waiting period
v The Company
ii) 24 months with continuous coverage without break (with grace period) in respect of diseases /
Star Health and Allied Insurance Co. Ltd., commenced its operations in 2006 with the business
treatments falling under waiting period
interests in Health Insurance, Travel and Personal Accident. As an exclusive Health Insurance
iii) 48 months of continuous coverage without break (with grace period) in respect of Pre-Existing Company and the first of its kind in India, the Company is committed to setting international
diseases. benchmarks in service and personal caring.
iv) 48 months of continuous coverage without break (with grace period) for diseases / conditions
v Prohibition of rebates
diagnosed / treated irrespective of whether any claim is made or not in the immediately
preceding three policy periods (Section 41 of the Insurance Act) No person shall allow or offer to allow either directly or indirectly as
an inducement to any person to take out or renew or continue an insurance in respect of any kind of
The above applies to each relevant insured person
risk relation to lives or property in India, any rebate of the whole or part of the commission payable or
v Automatic Termination: The insurance under this policy with respect to each relevant insured any rebate of the premium shown on the policy, nor shall any person taking out or renewing or
person shall terminate immediately on the earlier of the following events: continuing a policy accept rebate, except such rebate as may be allowed in accordance with the
ü Upon the death of the Insured Person This also means that in case of family floater policy, cover published prospectuses or tables of the insurer.
for the other surviving members of the family will continue, subject to other terms of the policy
Any person making default in complying with the provision of this section shall be liable for a penalty
subject to other terms of the policy.
which may extend to ten lakh rupees.
ü Upon exhaustion of the sum insured under the policy
The information provided in this brochure is only indicative.
v Tax Benefits: Payment of premium by any mode other than cash for this insurance is eligible for For more details on the risk factors, terms and conditions,
relief under Section 80D of the Income Tax Act 1961. please read the policy wordings before concluding sale
v Cancellation: The Company may cancel this policy on grounds of misrepresentation, fraud, moral Or
hazard, non disclosure of material fact as declared in the proposal form and/or claim form at the time Visit our website www.starhealth.in
of claim and non co-operation of the insured by sending the Insured 30 days notice by registered
letter at the Insured person's last known address. No refund of premium will be made except where “IRDAI OR ITS OFFICIALS DO NOT INVOLVE IN ACTIVITIES LIKE SALE OF ANY
the cancellation is on the grounds of non co-operation of the insured, in which case the refund of KIND OF INSURANCE OR FINANCIAL PRODUCTS NOR INVEST PREMIUMS.
premium will be on pro-rata basis. The insured may at any time cancel this policy and in such event IRDAI DOES NOT ANNOUNCE ANY BONUS. THOSE RECEIVING SUCH PHONE
the Company shall allow refund after retaining premium at Company's short Period rate only (table CALLS ARE REQUESTED TO LODGE A POLICE COMPLAINT ALONG WITH
given below) provided no claim has occurred up to the date of cancellation DETAILS OF PHONE CALL AND NUMBER”

Period on risk Rate of premium to be retained Star Health Gain Insurance Policy
Up to one month 25% of the annual premium Unique Identification No.: SHAHLIP18088V021718
Exceeding one month up to 3 months 40% of the annual p remium Buy this insurance online at www.starhealth.in
Exceeding 3 months up to 6 months 60% of the annual premium Call Toll-free: 1800-425-2255 / 1800-102-4477, sms STAR to 56677
Exceeding 6 months up to 9 months 80% of the annual premium Fax Toll Free No: 1800-425-5522 « Email : support@starhealth.in
Insurance is the subject ma er of solicita on

CIN : U66010TN2005PLC056649 « IRDAI Regn. No: 129

Exceeding 9 months Full annual premium

v Portability: This policy is portable. If the insured is desirous of porting this policy, application in the

BRO / GAIN / V.7 / 2017 - 18

appropriate form should be made to the Company at least 45 days before but not earlier than 60
days from the date when the renewal is due. For details contact “portability@starhealth.in” or call
Telephone No +91-044-28288869
v Claims Procedure Health
· Call the 24 hour help-line for assistance - 1800 425 2255 / 1800 102 4477
Personal & Caring Insurance
· In case of planned hospitalization, inform 24 hours prior to admission in the hospital. The Health Insurance Specialist
· In case of emergency hospitalization information to be given within 24 hours after
STAR HEALTH AND ALLIED INSURANCE CO LTD
hospitalization.
Regd. & Corporate Office: 1, New Tank Street,
· Cashless facility wherever possible in network hospital
Valluvar Kottam High Road, Nungambakkam, Chennai - 600 034.
· In non-network hospitals payment must be made up-front and then reimbursement will be
effected on submission of documents.
 OUT PATIENT BENEFIT CHART
Sum Option 1 : Premium Rs. 15,000/- excluding tax Option 2 : Premium Rs. 20,000/- excluding tax
Family
Insured /
Size 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000
Age in Yrs
3mths-35 10,865 10,480 9,855 9,175 8,635 15,865 15,480 14,855 14,175 13,635
36-45 10,410 9,990 9,310 8,575 7,990 15,410 14,990 14,310 13,575 12,990
46-55 9,670 9,190 7,955 7,135 6,480 14,670 14,190 12,955 12,135 11,480
56-60 8,085 7,480 6,055 5,045 4,230 13,085 12,480 11,055 10,045 9,230
1A 61-65 6,305 5,550 3,915 2,685 1,695 11,305 10,550 8,915 7,685 6,695
66-70 4,745 3,870 2,045 NA NA 9,745 8,870 7,045 5,630 4,485
71-75 3,215 2,215 NA NA NA 8,215 7,215 5,205 3,610 2,310
76-80 2,045 NA NA NA NA 7,045 5,950 3,795 2,060 NA
above 80 NA NA NA NA NA 5,755 4,555 2,245 NA NA
3mths-35 9,840 9,375 8,625 7,825 7,185 14,840 14,375 13,625 12,825 12,185
36-45 9,275 8,765 7,945 7,075 6,380 14,275 13,765 12,945 12,075 11,380
46-55 8,350 7,765 6,370 5,390 4,605 13,350 12,765 11,370 10,390 9,605
56-60 6,370 5,625 3,995 2,775 1,795 11,370 10,625 8,995 7,775 6,795
1A+1C 61-65 4,140 3,215 1,315 NA NA 9,140 8,215 6,315 4,830 3,625
66-70 2,195 1,115 NA NA NA 7,195 6,115 3,980 2,260 NA
71-75 NA NA NA NA NA 5,285 4,045 1,685 NA NA
76-80 NA NA NA NA NA 3,820 2,460 NA NA NA
above 80 NA NA NA NA NA 2,205 NA NA NA NA
3mths-35 8,940 8,405 7,545 6,635 5,905 13,940 13,405 12,545 11,635 10,905
36-45 8,275 7,680 6,740 5,750 4,955 13,275 12,680 11,740 10,750 9,955
46-55 7,185 6,505 4,975 3,855 2,950 12,185 11,505 9,975 8,855 7,950
56-60 4,860 3,990 2,175 NA NA 9,860 8,990 7,175 5,775 4,645
1A+2C 61-65 2,235 1,155 NA NA NA 7,235 6,155 4,025 2,310 NA
66-70 NA NA NA NA NA 4,945 3,680 1,280 NA NA
71-75 NA NA NA NA NA 2,695 1,250 NA NA NA
76-80 NA NA NA NA NA NA NA NA NA NA
above 80 NA NA NA NA NA NA NA NA NA NA
3mths-35 6,840 6,130 5,020 3,855 2,920 11,840 11,130 10,020 8,855 7,920
36-45 5,935 5,155 3,935 2,665 1,640 10,935 10,155 8,935 7,665 6,640
46-55 4,470 3,570 1,710 NA NA 9,470 8,570 6,710 5,265 4,090
56-60 1,325 NA NA NA NA 6,325 5,175 2,935 1,110 NA
1A+3C 61-65 NA NA NA NA NA 2,785 1,345 NA NA NA
66-70 NA NA NA NA NA NA NA NA NA NA
71-75 NA NA NA NA NA NA NA NA NA NA
76-80 NA NA NA NA NA NA NA NA NA NA
above 80 NA NA NA NA NA NA NA NA NA NA

A=Adult, C=Child, 2A = Self + Spouse, NA : Policy Not Available Amount in Rs.

 OUT PATIENT BENEFIT CHART
Sum Option 3 : Premium Rs. 25,000/- excluding tax Option 4 : Premium Rs. 30,000/- excluding tax
Family
Insured /
Size 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000
Age in Yrs
3mths-35 20,865 20,480 19,855 19,175 18,635 25,865 25,480 24,855 24,175 23,635
36-45 20,410 19,990 19,310 18,575 17,990 25,410 24,990 24,310 23,575 22,990
46-55 19,670 19,190 17,955 17,135 16,480 24,670 24,190 22,955 22,135 21,480
56-60 18,085 17,480 16,055 15,045 14,230 23,085 22,480 21,055 20,045 19,230
1A 61-65 16,305 15,550 13,915 12,685 11,695 21,305 20,550 18,915 17,685 16,695
66-70 14,745 13,870 12,045 10,630 9,485 19,745 18,870 17,045 15,630 14,485
71-75 13,215 12,215 10,205 8,610 7,310 18,215 17,215 15,205 13,610 12,310
76-80 12,045 10,950 8,795 7,060 5,645 17,045 15,950 13,795 12,060 10,645
above 80 10,755 9,555 7,245 5,355 3,815 15,755 14,555 12,245 10,355 8,815
3mths-35 19,840 19,375 18,625 17,825 17,185 24,840 24,375 23,625 22,825 22,185
36-45 19,275 18,765 17,945 17,075 16,380 24,275 23,765 22,945 22,075 21,380
46-55 18,350 17,765 16,370 15,390 14,605 23,350 22,765 21,370 20,390 19,605
56-60 16,370 15,625 13,995 12,775 11,795 21,370 20,625 18,995 17,775 16,795
1A+1C 61-65 14,140 13,215 11,315 9,830 8,625 19,140 18,215 16,315 14,830 13,625
66-70 12,195 11,115 8,980 7,260 5,865 17,195 16,115 13,980 12,260 10,865
71-75 10,285 9,045 6,685 4,735 3,145 15,285 14,045 11,685 9,735 8,145
76-80 8,820 7,460 4,920 2,795 1,065 13,820 12,460 9,920 7,795 6,065
above 80 7,205 5,715 2,985 NA NA 12,205 10,715 7,985 5,665 3,775
3mths-35 18,940 18,405 17,545 16,635 15,905 23,940 23,405 22,545 21,635 20,905
36-45 18,275 17,680 16,740 15,750 14,955 23,275 22,680 21,740 20,750 19,955
46-55 17,185 16,505 14,975 13,855 12,950 22,185 21,505 19,975 18,855 17,950
56-60 14,860 13,990 12,175 10,775 9,645 19,860 18,990 17,175 15,775 14,645
1A+2C 61-65 12,235 11,155 9,025 7,310 5,915 17,235 16,155 14,025 12,310 10,915
66-70 9,945 8,680 6,280 4,290 2,665 14,945 13,680 11,280 9,290 7,665
71-75 7,695 6,250 3,575 1,315 NA 12,695 11,250 8,575 6,315 4,470
76-80 5,970 4,385 1,505 NA NA 10,970 9,385 6,505 4,035 2,020
above 80 4,075 2,330 NA NA NA 9,075 7,330 4,225 1,530 NA
3mths-35 16,840 16,130 15,020 13,855 12,920 21,840 21,130 20,020 18,855 17,920
36-45 15,935 15,155 13,935 12,665 11,640 20,935 20,155 18,935 17,665 16,640
46-55 14,470 13,570 11,710 10,265 9,090 19,470 18,570 16,710 15,265 14,090
56-60 11,325 10,175 7,935 6,110 4,630 16,325 15,175 12,935 11,110 9,630
1A+3C 61-65 7,785 6,345 3,680 1,430 NA 12,785 11,345 8,680 6,430 4,600
66-70 4,695 3,005 NA NA NA 9,695 8,005 4,970 2,350 NA
71-75 1,660 NA NA NA NA 6,660 4,720 1,325 NA NA
76-80 NA NA NA NA NA 4,330 2,205 NA NA NA
above 80 NA NA NA NA NA 1,770 NA NA NA NA

A=Adult, C=Child, 2A = Self + Spouse, NA : Policy Not Available Amount in Rs.

 OUT PATIENT BENEFIT CHART
Sum Option 1 : Premium Rs. 15,000/- excluding tax Option 2 : Premium Rs. 20,000/- excluding tax
Family
Insured /
Size 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000
Age in Yrs
3mths-35 8,665 8,105 7,210 6,270 5,510 13,665 13,105 12,210 11,270 10,510
36-45 7,965 7,350 6,370 5,345 4,520 12,965 12,350 11,370 10,345 9,520
46-55 6,830 6,120 4,545 3,380 2,440 11,830 11,120 9,545 8,380 7,440
56-60 4,395 3,485 1,620 NA NA 9,395 8,485 6,620 5,160 3,980
2A 61-65 1,650 NA NA NA NA 6,650 5,520 3,320 1,535 NA
66-70 NA NA NA NA NA 4,255 2,930 NA NA NA
71-75 NA NA NA NA NA 1,900 NA NA NA NA
76-80 NA NA NA NA NA NA NA NA NA NA
above 80 NA NA NA NA NA NA NA NA NA NA
3mths-35 7,090 6,405 5,325 4,190 3,280 12,090 11,405 10,325 9,190 8,280
36-45 6,220 5,460 4,275 3,040 2,040 11,220 10,460 9,275 8,040 7,040
46-55 4,800 3,925 2,105 NA NA 9,800 8,925 7,105 5,700 4,560
56-60 1,755 NA NA NA NA 6,755 5,635 3,450 1,675 NA
2A+1C 61-65 NA NA NA NA NA 3,325 1,925 NA NA NA
66-70 NA NA NA NA NA NA NA NA NA NA
71-75 NA NA NA NA NA NA NA NA NA NA
76-80 NA NA NA NA NA NA NA NA NA NA
above 80 NA NA NA NA NA NA NA NA NA NA
3mths-35 5,705 4,905 3,660 2,360 1,310 10,705 9,905 8,660 7,360 6,310
36-45 4,680 3,795 2,425 1,005 NA 9,680 8,795 7,425 6,005 4,850
46-55 3,010 1,990 NA NA NA 8,010 6,990 4,955 3,330 2,015
56-60 NA NA NA NA NA 4,425 3,115 NA NA NA
2A+2C 61-65 NA NA NA NA NA NA NA NA NA NA
66-70 NA NA NA NA NA NA NA NA NA NA
71-75 NA NA NA NA NA NA NA NA NA NA
76-80 NA NA NA NA NA NA NA NA NA NA
above 80 NA NA NA NA NA NA NA NA NA NA
3mths-35 2,470 1,410 NA NA NA 7,470 6,410 4,775 3,085 1,715
36-45 1,085 NA NA NA NA 6,085 4,910 3,110 1,255 NA
46-55 NA NA NA NA NA 3,830 2,470 NA NA NA
56-60 NA NA NA NA NA NA NA NA NA NA
2A+3C 61-65 NA NA NA NA NA NA NA NA NA NA
66-70 NA NA NA NA NA NA NA NA NA NA
71-75 NA NA NA NA NA NA NA NA NA NA
76-80 NA NA NA NA NA NA NA NA NA NA
above 80 NA NA NA NA NA NA NA NA NA NA

A=Adult, C=Child, 2A = Self + Spouse, NA : Policy Not Available Amount in Rs.

 OUT PATIENT BENEFIT CHART
Sum Option 3 : Premium Rs. 25,000/- excluding tax Option 4 : Premium Rs. 30,000/- excluding tax
Family
Insured /
Size 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000
Age in Yrs
3mths-35 18,665 18,105 17,210 16,270 15,510 23,665 23,105 22,210 21,270 20,510
36-45 17,965 17,350 16,370 15,345 14,520 22,965 22,350 21,370 20,345 19,520
46-55 16,830 16,120 14,545 13,380 12,440 21,830 21,120 19,545 18,380 17,440
56-60 14,395 13,485 11,620 10,160 8,980 19,395 18,485 16,620 15,160 13,980
2A 61-65 11,650 10,520 8,320 6,535 5,085 16,650 15,520 13,320 11,535 10,085
66-70 9,255 7,930 5,445 3,375 1,685 14,255 12,930 10,445 8,375 6,685
71-75 6,900 5,390 2,620 NA NA 11,900 10,390 7,620 5,265 3,340
76-80 5,095 3,435 NA NA NA 10,095 8,435 5,450 2,880 NA
above 80 3,110 1,290 NA NA NA 8,110 6,290 3,065 NA NA
3mths-35 17,090 16,405 15,325 14,190 13,280 22,090 21,405 20,325 19,190 18,280
36-45 16,220 15,460 14,275 13,040 12,040 21,220 20,460 19,275 18,040 17,040
46-55 14,800 13,925 12,105 10,700 9,560 19,800 18,925 17,105 15,700 14,560
56-60 11,755 10,635 8,450 6,675 5,235 16,755 15,635 13,450 11,675 10,235
2A+1C 61-65 8,325 6,925 4,330 2,145 NA 13,325 11,925 9,330 7,145 5,360
66-70 5,330 3,690 NA NA NA 10,330 8,690 5,735 3,190 1,110
71-75 2,390 NA NA NA NA 7,390 5,510 2,200 NA NA
76-80 NA NA NA NA NA 5,135 3,070 NA NA NA
above 80 NA NA NA NA NA 2,650 NA NA NA NA
3mths-35 15,705 14,905 13,660 12,360 11,310 20,705 19,905 18,660 17,360 16,310
36-45 14,680 13,795 12,425 11,005 9,850 19,680 18,795 17,425 16,005 14,850
46-55 13,010 11,990 9,955 8,330 7,015 18,010 16,990 14,955 13,330 12,015
56-60 9,425 8,115 5,650 3,600 1,925 14,425 13,115 10,650 8,600 6,925
2A+2C 61-65 5,390 3,755 NA NA NA 10,390 8,755 5,805 3,265 1,195
66-70 1,870 NA NA NA NA 6,870 4,950 1,575 NA NA
71-75 NA NA NA NA NA 3,410 1,205 NA NA NA
76-80 NA NA NA NA NA NA NA NA NA NA
above 80 NA NA NA NA NA NA NA NA NA NA
3mths-35 12,470 11,410 9,775 8,085 6,715 17,470 16,410 14,775 13,085 11,715
36-45 11,085 9,910 8,110 6,255 4,750 16,085 14,910 13,110 11,255 9,750
46-55 8,830 7,470 4,935 2,810 1,080 13,830 12,470 9,935 7,810 6,080
56-60 3,995 2,245 NA NA NA 8,995 7,245 4,125 1,420 NA
2A+3C 61-65 NA NA NA NA NA 3,545 1,355 NA NA NA
66-70 NA NA NA NA NA NA NA NA NA NA
71-75 NA NA NA NA NA NA NA NA NA NA
76-80 NA NA NA NA NA NA NA NA NA NA
above 80 NA NA NA NA NA NA NA NA NA NA

A=Adult, C=Child, 2A = Self + Spouse, NA : Policy Not Available Amount in Rs.