CORONA KAVACH

Corona Kavach Policy, Star Health POLICY,

and Allied Insurance Co Ltd.
STAR HEALTH
AND ALLIED
INSURANCE CO LTD

SHIELDYOURSELFAGAINST THE
INVISIBLETHREAT

Shield Yourself UNIQUE ID:SHAHLIP21066V012021

A g a i n s t th e In v is i b le T h r e a t
STRICTLY FOR INTERNAL TRAINING PURPOSE ONLY
Corona Kavach Policy, Star Health and Allied Insurance Co Ltd_Version 1.3_July_20
 BENEFITS
Indemnity Policy specific to Corona

Covers all the hospitalisation expenses arises from Corona

Non payables like PPE kits, gloves, masks are covered

Hospital Daily Cash: Optional Cover, 0.5% of SI payable per day

Expenses incurred on Co-morbid also covered

Road Ambulance : Max Rs 2000 per hospitalisation

Homecare treatment Expenses : Upto 14 Days

AYUSH Up to Sum Insured

Waiting Period : 15 Days

 WHY THIS POLICY?

 The impact of COVID 19 not only does shatter the health of

individuals but the treatment cost at a medical facility will
drain the savings too.
 In order to help people to overcome the financial difficulties
while they are recovering from the COVID 19
 An indemnity policy that covers the hospitalization expenses
up to the sum insured
 COVID CASES INCREASING DAY BY DAY

WORLD INDIA

5,36,786
19,693

63,30,053
4,24,433

1,15,59,213
6,97,413

Cases Recovery Deaths Cases Recovery Deaths

Source: Business Standard as on

July 6, 20, 12:30 A.M
 WHO CAN TAKE POLICY?

Eligibility

• Adults: 18 years to 65 years

• Dependent Children: Day 1 to 25 years

Policy Term

• 3½months (105 days); 6½months (195 days); 9½months

(285 days) (No annual policy term)

5
 SUM INSURED OPTIONS
TEN SI OPTIONS AVAILABLE (RS)

0.50 Lac 1 Lac 1.5 Lac

2 Lac 2.5 Lac 3 Lac

3.5 Lac 4 Lac 4.5 Lac

5 Lac
 WHO CAN BUY & POLICY TYPE

Who can buy policy?

 Self
 Legally Wedded Spouse
 Parents and Parents in laws
 Dependent Children

Note: If the child above 18

years of age is financially

INDIVIDUAL
independent, he or
she shall be ineligible for
coverage
FLOATER
 COVID HOSPITALIZATION COVER

 Expenses incurred for treatment of Covid on Positive

diagnosis in a Government authorised diagnostic
center including the treatment for any comorbidity is
covered upto sum insured
 Expenses for hospitalisation : Minimum period of
24 consecutive hours is admissible

Cashless Reimbursement

Network
Hospitals
Non-Network
Hospitals
Agreed Network
Hospitals
 COVID HOSPITALIZATION COVER
*CONNECTED TREATMENT EXPENSES

 Covered up to Sum insured

 Room Rent, Boarding, Nursing Expenses as provided by the Hospital/ Nursing
Home
 Intensive Care Unit (ICU)/Intensive Cardiac Care Unit (lCCU) expenses
 Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees
 Anesthesia, blood, oxygen, operation theatre charges, surgical appliances,
ventilator charges, medicines and drugs, costs towards diagnostics, diagnostic
imaging modalities, PPE Kit, gloves, mask and such similar other expenses
 ROAD AMBULANCE

 Maximum of Rs.2000 per hospitalisation

 Transportation of the Insured Person from a

Hospital to the another Hospital
 HOME CARE TREATMENT EXPENSES

 Available up to Maximum of 14 Days

 Insured Person at home for Covid on positive diagnosis of Covid in a Government authorized
diagnostic Centre, which in normal course would require care and treatment at a hospital but
is actually taken at home

Coverage provided
 The Medical practitioner advices the Insured person to undergo treatment at home
 There is a continuous active line of treatment with monitoring of the health status for each
day
 Daily monitoring chart including records of treatment by the treating doctor is maintained.
 Both cashless and reimbursement is available
 For reimbursement a prior approval is needed
 BENEFITS
HOME CARE TREATMENT EXPENSES
COVERED

 Diagnostic tests undergone at home or at diagnostics centre

 Medicines prescribed in writing
 Consultation charges of the medical practitioner
 Nursing charges related to medical staff
 Medical procedures limited to parenteral administration of medicines
 Cost of Pulse oximeter, Oxygen cylinder and Nebulizer
 NON ALLOPATHIC
COVERAGE FOR AYUSH TREATMENT

 Up to limit of sum insured

 On Positive diagnosis of COVID test in a
government authorized diagnostic centre
including the expenses incurred on treatment
of any comorbidity
 Treatment for Covid under Ayurveda, Yoga
and Naturopathy, Unani, Siddha and
Homeopathy systems of medicines
 Expenses incurred as an inpatient for
treatment of COVID including the treatment
for Co-morbid conditions in AYUSH hospital
 PRE & POST HOSPITALISATION

 Pre Hospitalization
Medical expenses incurred up to 15 days prior to the date of admissible
hospitalization/home care treatment

 Post Hospitalization
Medical expenses incurred, related to an admissible
hospitalization/home care treatment, for a fixed period of 30 days from
the date of discharge from the hospital
 HOSPITAL DAILY CASH
OPTIONAL COVER

 0.5% of sum insured for each 24 hours of continuous hospitalization

 Covered up to maximum of 15 days per policy period
 PRE MEDICAL SCREENING

 No Pre-acceptance medical screening

required
 PREMIUM DISCOUNT

 5% Premium Discount - Health Care workers

 The discount will be given only for the insured person

who is a healthcare worker even under floater policy

 Health care worker for the purpose of this policy shall

mean doctors, nurses, midwives, dental practitioners
and other health professionals including laboratory
assistants, pharmacists, physiotherapists, technicians
and people working in hospitals.
PREMIUM ILLUSTRATION
 TAX BENEFITS

Insured Person is eligible

for relief under Section 80 D
of the IT Act in respect of the
premium paid by any mode
other than cash
POLICY EXCLUSIONS
BE AWARE OF WAITING PERIODS &
EXCLUSIONS
 UNDERSTAND THE POLICY
WAITING PERIOD & EXCLUSIONS

 Initial waiting period : 15 days is

applicable from the date of
commencement of this policy

 Exclusions: Certains
diseases/conditions/treatments are not
paid for
 EXCLUSIONS
CERTAIN DISEASES/CONDITIONS/TREATMENTS ARE NOT PAID FOR:

 Any expenses incurred on Day Care treatment and

 Investigation & Evaluation
OPD treatment

 Diagnosis /Treatment outside the geographical

 Rest Cure, rehabilitation and respite care
limits of India

 Testing done at a Diagnostic centre which is not

 Dietary supplements
authorized by the Government

 If the Insured Person travels to any country placed

 Unproven Treatments under travel restriction by the Government of
India

 Any claim in relation to COVID where it has

been diagnosed prior to Policy Start Date

* For full list, please refer to the policy. wording

 POINTS TO REMEMBER
ALL THESE ARE NOT APPLICABLE
 Renewals

 Migration

 Portability

 FreeLook Period

* For full list, please refer to the policy.

 CLAIMS DOCUMENT REQUIRED
COVID HOSPITALISATION COVER

 Discharge summary including complete medical

 Duly filled and signed claim form
history of the patient along with other details.

 Copy of Insured Person's passport , if  Investigation reports including Insured Person's

available (All pages) Test Reports from Authorized diagnostic centre
for COVID.

 Photo Identity proof of the patient (if insured  OT notes or Surgeon's certificate giving details of
person does not own a passport) the operation performed, wherever applicable

 Sticker/Invoice of the Implants, wherever

 Medical practitioner's prescription applicable
advising admission
 NEFT Details (to enable direct credit of claim
 Original bills with itemized breakup amount in bank account) and cancelled cheque

 KYC (Identity proof with Address) of the proposer,

 Payment receipts, Legal heir/succession where claim liability is above Rs 1 Lakh as per
certificate, wherever applicable AML Guidelines & any other documents if any
 CLAIMS DOCUMENT REQUIRED
Home Care Treatment
Expenses

 Duly filled and signed claim form  A certificate from medical practitioner advising
treatment at home or consent from the insured
person on availing home care benefit.

 Copy of Insured Person's passport , if

available (All pages)
 Discharge Certificate from medical practitioner
specifying date of start and completion of home
care treatment.
 Photo Identity proof of the patient (if insured
person does not own a passport)
 Daily monitoring chart including records of
 Medical practitioner's prescription treatment administered duly signed by the
treating doctor is maintained.
advising admission
 PROCEDURE FOR CASHLESS

 Treatment may be taken in a network provider and is subject to pre-authorization by the Company or its
authorized TPA.

 Cashless request form available with the network provider and TPA shall be completed and sent to the
Company/TPAfor authorization.

 The Company/ TPA upon getting cashless request form and related medical information from the insured
person / network provider will issue pre-authorization letter to the hospital after verification.

 At the time of discharge , the insured person has to verify and sign the discharge papers , pay
for non-medical and inadmissible expenses.

 The Company/ TPA reserves the right to deny pre-authorization in case the insured person is
unable to provide the relevant medical details.

 In case of denial of cashless access, the insured person may obtain the treatment as per
treating doctor 's advice and submit the claim documents to the Company I TPAfor
reimbursement.
 PROCEDURE FOR REIMBURSEMENT

SI.No Type of Claim Prescribed Time limit

With in 30 Days - From Date of
1 Reimbursement of hospitalization discharge
and pre hospitalization expenses from hospital

With in 15 Days - From

2 Reimbursement of post hospitalization completion of
expenses post hospitalization treatment

3 Reimbursement of Home Care With in 30 Days - From

expenses completion of
home care treatment
 PREMIUM FOR BASE COVER ( INCLUDING TAX 18%)
Policy
3.5 months 6.5 months 9.5 months
Period
Sum
Insured Rs.
0-45 46-65 Above 65 0-45 46-65 Above 65 0-45 46-65 Above 65
Age in
years
0.50 Lac 413 496 644 496 595 773 558 669 870
1 Lac 620 743 966 743 892 1,160 836 1,004 1,305
1.5 Lac 805 966 1,256 966 1,160 1,508 1,087 1,305 1,696
2 Lac 966 1,160 1,508 1,160 1,392 1,809 1,305 1,566 2,035
2.5 Lac 1,111 1,334 1,734 1,334 1,600 2,081 1,500 1,800 2,341
3 Lac 1,245 1,494 1,942 1,494 1,792 2,330 1,680 2,016 2,621
3.5 Lac 1,369 1,643 2,136 1,643 1,972 2,563 1,848 2,218 2,884
4 Lac 1,479 1,775 2,307 1,775 2,129 2,768 1,996 2,396 3,114
4.5 Lac 1,582 1,899 2,468 1,899 2,278 2,962 2,136 2,563 3,332
5 Lac 1,661 1,994 2,592 1,994 2,392 3,110 2,243 2,691 3,499
PREMIUM FOR OPTIONAL COVER ( INCLUDING TAX 18%)
Policy
3.5 months 6.5 months 9.5 months
Period
Sum
Insured Rs.
0-45 46-65 Above 65 0-45 46-65 Above 65 0-45 46-65 Above 65
Age in
years
0.50 Lac 23 27 35 27 33 42 31 37 48
1 Lac 64 76 99 76 91 119 86 103 134
1.5 Lac 95 114 149 114 137 178 129 154 201
2 Lac 127 152 198 152 183 238 172 206 268
2.5 Lac 159 191 248 191 229 297 214 257 335
3 Lac 191 229 297 229 274 357 257 309 401
3.5 Lac 222 267 347 267 320 416 300 360 468
4 Lac 254 305 396 305 366 476 343 412 535
4.5 Lac 286 343 446 343 412 535 386 463 602
5 Lac 318 381 496 381 457 595 429 515 669
 ONE PAGER
IN A NUTSHELL

Corona
Kavach_One Pager_version 1.0_July_2020.pdf
 PROPOSAL FORM

Policy - Corona
Kavach Policy, Star Health and Allied Insurance Co Ltd - V.1.pdf
 TELE CONSULTATION FACILITY
TALK TO STAR - FREE-OF-COST FACILITY !

 Provided by our Star Health in the time of need and it can help us to
realize our Moto - PERSONAL & CARING 
 It is the unique facility offered by our technology platform
 Provided with Specialist Doctors in the grim period of COVID 19 Pandemic
and as advised by Government Authorities, to avoid visiting hospitals

The services are:

 For orthopedic queries - Senior Ortho Consultant
 For worries about COVID - 19 - Panel of Doctors
 Women health related problems - Gynaecologist
 Issues in self isolation - Psychiatrist
 For questions on diabetic - Diabetic consultants
 To avail this facility Call 18004252255 or mail to telemedicine@starhealth.in
 AML
ANTI- MONEY LAUNDERING

AML_Version
1.0_Apr 20.pdf
 THANK
YOU

STRICTLY FOR INTERNAL TRAINING PURPOSE ONLY Corona Kavach Policy, Star Health and Allied Insurance Co Ltd_Version 1.3_July_20