Employee Insurance Benefit Manual

2019 : July 1, 2019 to June 30, 2020

Agenda

Group Health
Personal Accident Term Life Insurance
Insurance
Insurance • Plan overview
• Coverage details
• Plan overview • Claim process
• Plan overview
• Disability compensation • Contact details
• Maternity benefit
• Exclusions
• Co-pay illustration
• Claim process
• Enrolment
• Inclusions & exclusions
• Third Party Administrator
services
• Cashless process
• Reimbursement process
• Contact details

STAR reserves the right to modify / extend the policy conditions without any prior notice
Group Health Insurance

July 1, 2019 to June 30, 2020

 Coverage details
Particulars Details

Insurer The New India Assurance Co. Ltd.

Third Party Administrator (TPA) Paramount Health Services & Insurance TPA Pvt. Ltd

Insurance Broker Willis Towers Watson India Insurance Brokers Pvt. Ltd.

Validity July 1, 2019 to June 30, 2020

Plan Type Family Floater

Sum insured INR. 500,000

Employee Full time employee on India Payroll of STAR Group of Companies

Spouse – declaration should be made within 30days from the date of marriage
LGBT Partner - Provided declaration made to Star that the person to be covered is a domestic partner.
Legally wedded Change in domestic partner during the policy period (mid – term) is not be allowed.
spouse or LGBT At the point of claim, the insurer reserves the right to the following only if there is a shade of doubt on eligibility:
partner (as domestic •
Both should have long term relationship and stay together as life partners (not a blood relative/cousin) for
Beneficiaries more than 12 months
partner)
(declaration should be at renewal •
Proof of living in the same residence will be required as and when required
or at the time of joining the •
In laws cannot be added. Only employee parents additions allowed
company)
Children can be enrolled under insurance up to 21 years; 25 years if in full time education
All children
New born child declaration should be made within 30 days from the date of birth

Parents or parents in law declaration should be done at the start of the policy . If one of the parent is deceased, then
Two parents/parents
the parent in law can be added and the cross combination will be allowed, subject to overall count of only two.
in law
Family Floater means employees and their dependents together are eligibleChange for theinentire
parentsum
details during. the
insured Anypolicy
one period
member (mid
or –allterm) is notcan
of them allowed.
use the
annual limit. There is no individual sub limit applicable.
STAR reserves the right to modify / extend the policy conditions without any prior notice
Plan overview
Features Applicability

Covered, towards active line of treatment which requires hospitalization for

In-patient hospitalization expenses
more than 24 hours

Pre-existing diseases Covered

Waiting periods Not applicable

Covered up to family sum insured limit, provided the employee declares the
Baby’s coverage from date of birth
new born within 30 days from date of birth

Ailment Caps Not applicable

Covered
Day care procedures
(Listed Day care procedures, where in 24 hours stay is not required)

Ambulance charges INR 1,500 / per incident

Standard Hospital room Single Pvt A/C Room

Room rent eligibility
ICU No limit applicable

30 days pre and 60 days post hospitalization expenses Covered

STAR reserves the right to modify / extend the policy conditions without any prior notice
Plan overview
Features Applicability

Co-pay on all parent claims 20% Co-pay on every parental claim payable by employee

Claims are restricted to 25% of the sum insured per family. The treatment needs
Ayurvedic treatment
to be taken in Government recognized and registered hospital

Hospitalization due to terrorism Covered

25% co-pay applicable on the eligible claim amount.

Cyber Knife Treatment & Stem Cell Transplantation
No co-pay on bone marrow transplantation which falls under Stem cell

Cochlear Implant treatment 50% of the sum insured payable

OPD expenses towards root canal, tooth removal and periodontal treatment
Dental treatment (for Employees only) will be covered up to INR 25,000 (fillings, braces, dentures, crown and
tooth cleaning will not be payable)

STAR reserves the right to modify / extend the policy conditions without any prior notice
Plan overview
Features Details Applicability

Two events of INR 100,000 each will be covered

In Vitro Fertilization (IVF) -
only during your tenure at Star Group

HIV related treatment

Reimbursement basis only Covered
(Hospitalization expenses)

Adjuvant Chemotherapy, Hormone therapy, Oral

Cancer treatment at home / hospital / Subcutaneous Chemotherapy taken at home or Payable up to INR 200,000 within policy period
hospital

Coverage only for employees. Lump sum one

Cash Benefit for Cancer Treatment time benefit, provided first time detected during INR 30,000 (over & above sum insured).
policy period.

Age related macular degeneration Injection Avastin and Lucentis Payable up to 50% of admissible claim

if medical in nature (Cosmetic surgery not

Congenital external ailments Payable up to 50% of admissible claim
covered)

STAR reserves the right to modify / extend the policy conditions without any prior notice
Plan overview
Features Details Applicability

Sub limit of INR 25,000 per person per policy

Tuberculosis treatment on OPD basis Reimbursement basis only
period

Coverage only for employees. Not exceeding

actual salary as a loss of pay for employee INR 20,000 per week maximum payable up to 6
Loss of Pay
suffered accidental and critical ailment subject to weeks (over & above sum insured).
entire leave of employee has been exhausted.

100% settlement without any deduction in case of

Death cases (employee) death claims of employees Covered
( No co-pay, no non medical expenses)

Coverage to dependents of deceased employees till

Death cases (employee) - dependent coverage Covered
expiry of the policy           

STAR reserves the right to modify / extend the policy conditions without any prior notice
 Maternity benefit
Maternity benefit covers expenses related to normal delivery, caesarian section delivery, complications and maternity related cost as
per the insurance policy for Employees and their spouse.

Features Applicability

Normal delivery INR 50,000

Caesarian section delivery INR 75,000

Baby expenses within maternity limit Covered

OPD bases INR 5,000, within maternity sub limit

Pre & Post natal expenses
(within the maternity limit)
Hospitalization actual, within maternity sub-limit

• If the member has 2 living children, then third maternity event will not be payable.
• Expenses incurred in connection with voluntary medical termination of pregnancy during the first 12 weeks from the date of
conception are not covered.
• Reimbursement of cost towards infertility related treatments/ procedures paid within maternity limit i.e. INR 50,000 or actuals
which ever is lower.

STAR reserves the right to modify / extend the policy conditions without any prior notice
Co-Pay illustration
20% Co-pay is applicable towards all eligible parents/ in laws claims

Point Particulars Example 1 Example 2 Example 3

A Sum Insured 500,000 500,000 500,000

B Claimed Amount 250,000 550,000 750,000

C Non Medical Expenses 5,000 5,000 5,000

D Eligible Medical Amount (B-C) 245,000 545,000 745,000

E 20% Co-pay Amount on (D) 49,000 109,000 149,000

F Payable Expenses (D-E) 196,000 436,000 596,000

G Settlement Amount (lower of A or F) 196,000 436,000 500,000

H Member pocket expenses (B - G) 54,000 114,000 250,000

I Balance Sum Insured 304,000 64,000 -

STAR reserves the right to modify / extend the policy conditions without any prior notice
 Insurance Update
REFERENCE : Laboratory/ Diagnostic Reports

As per The New India Assurance Company policy guidelines :

• Laboratory Report can be counter signed only by a Registered Medical Practitioner with a post graduate qualification in Pathology.

• Any report (in the hospitalization / pre- post claim) submitted without duly signed and stamped by Registered Medical Practitioner with a post
graduate qualification on Pathology will not be accepted and claim shall be rejected fully or partially.

Surgeon/Anesthesia bills
• Surgeon & Anesthesia charges should be included in main final bill issued by hospital.
• The bills raised by Surgeon, Anesthetist directly and not included in the hospitalization bill may be reimbursed in the following manner:-
 The reasonable, customary and necessary Surgeon fee and Anesthetist fee would be reimbursed, limited to the maximum of 25% of
Sum Insured or actuals whichever is lower subject to payment is done through cheque.
 The payment shall be reimbursed provided the insured pays such fee(s) through cheque and the Surgeon / Anesthetist provides a
numbered bill. Bills given on letter-head of the Surgeon, Anesthetist would not be entertained.
 Fees paid in cash will be reimbursed up to a limit of Rs.10,000/- only, provided the Surgeon/ Anesthetist provides a numbered bill.

STAR reserves the right to modify / extend the policy conditions without any prior notice
Enrolment

Renewal Enrolment Mid- term inclusions

• You and your existing dependants will be insured effective
July 1, 2019
• You will receive your login credentials in July, 2019 by
Paramount TPA via email id
helpdesk.phs@paramounttpa.com
• If you wish to make any changes or add/delete dependant
details, please email to benefits@startv.com
• The timeline to notify / make changes or include any
dependants is till end of July from the receipt of email send
by STAR HR team
• ID cards mailers will be triggered by Paramount TPA in last
week of Aug, 2019
• Dependant details of new joinees should be enrolled with in
20 days from date of joining
• Employee marriage – Spouse should be enrolled within 30
days from date of marriage
• New born baby - child should be enrolled within 30 days of
the birth (E.g. Baby of Employee Name)
• Adoption of a child – Named child should be enrolled with
30days

TPA ID cards Things to remember

• Download your ID card from the TPA portal
• This e-card is not transferable. Each insured life will be issued
an e-card. This card is a form of identification only and can be
used to gain admission in case of an emergency only.
However, the pre-authorization process has to be completed
to avail cashless hospitalization.
• Please enroll your dependants within the stipulated time
frame.
• Failing to do so will lead to the dependant being uninsured
until the next renewal i.e. in July 2020
• Any claim towards the un-insured dependant will not be
registered for the current policy period.

STAR reserves the right to modify / extend the policy conditions without any prior notice
Inclusions & exclusions

Includes
The expenses are payable provided they are incurred in India
and within the policy period.
Only “in-patient” hospitalization expenses – Room rent,
doctors fees, OT charges, medicines, ambulance charges up to
INR 1,500 (per occurrence),consumables etc.
Excludes
Non - Medical Expenses - Registration/Admission fees, hospital
surcharge, food bills for attendants, extra bed, private nurse,
telephone charges, pharmacy charges for non-medical items etc.
Duty doctor charges / RMO/ DMO charges will not be payable
separately

Active treatment with minimum 24 hours Hospitalization for diagnostic tests only not followed by active
hospitalization, however for certain day care procedures like line of treatment even if prescribed by a medical practitioner
cataract, chemotherapy, dialysis, lithotripsy this condition does
not apply
Pre-hospitalization expenses of 30 days before admission and Other standard policy exclusions
post hospitalization expenses for 60 days after discharge for an
eligible hospitalization.

STAR reserves the right to modify / extend the policy conditions without any prior notice
Exclusions
Exclusions
Dental treatment without hospitalization unless arising due to an accident
Lasik eye Surgery or eye correction surgery
Vitamins and tonics unrelated to treatment are not payable
Circumcision, vaccination, inoculation, cosmetic treatment, plastic surgery excluded
if not arising due to a accident or illness
Equipment used for hearing defects and Ambulatory devices are not within the scope
of the policy
Spectacles, contact lenses, hearing aids; external prosthetic devises, etc.
Any out come of a condition which is a directly or in directly because of AIDS is
excluded
Diagnostic, X-Ray or Laboratory examination not consistent with or incidental to the
diagnosis of positive existence and treatment of any ailment, sickness or injury, for
which confinement is required at a Hospital or Nursing Home.
Note: Above are general exclusions and should not be interpreted as exhaustive or conclusive in nature.
Instruments used for Sleep Apnea & Peritoneal Ambulatory dialysis. Oxygen
Concentrator for Bronchial Asthmatic condition.
Convalescence, general weakness, sterility , venereal disease, genetic disorder,
intentional self injury under influence/ use of intoxicating drugs/ alcohol, self injury,
psychiatric treatment, Expenses related to AIDS, use of tobacco leading to cancer
Out-patient diagnostic/medical/surgical procedures/treatments, non-prescribed
drugs/medical supplies/hormone replacement therapy, sex change or any treatment
related to this is not within the scope of the policy
Stay in hospital for domestic reason where no active regular treatment is given by
specialist
Naturopathy, unproven procedure/treatment not approved by Indian Medical
Council, experimental or alternative medicine/treatment including acupuncture,
acupressure, magneto-therapy, massages, steam bath and alike treatment under
Ayurvedic treatment; health hydro/nature care clinic & similar establishments are not
payable.
Injury or disease directly or indirectly caused by or arising from or attributable to war
or war-like situations and by nuclear weapons
Voluntary termination of pregnancy & Procedures related to contraception
Domiciliary Hospitalization, Experimental Treatment, change of treatment
from one system to another unless recommended by doctor, treatment taken
outside India
Paramount TPA Services
TPA – Paramount Health Services.
• ID - cards for identification at network hospitals
• Cashless Hospitalization
• Claims Administration
• 24 X 7 telephonic helpline
• Dedicated e-mail ID for general queries

One Click for everything in healthcare:

mWᴉSE – Paramount TPA App
Mobile app "Paramount TPA" for Android users
Mobile App can be downloaded from play store

STAR reserves the right to modify / extend the policy conditions without any prior notice
 Paramount website access

Access via website

• Log on to website https://www.paramounttpa.com/star/

• Click on employee log in

• Input new employee code as the USER NAME

• Input your date of birth as PASSWORD

• Click on “Policy Details” to view dependent details, policy number, policy period and insurance company details

• Click on E-card to download ID cards

• Click on claim details to check claim status

• Click on claim documents to check scan copies of submitted claim documents

STAR reserves the right to modify / extend the policy conditions without any prior notice
Hospitalization process
Planned & emergency in & out of network

Planned Hospitalization
Hospitalization • Check for network hospitals on the TPA
website
• Submit cashless request form to TPA at
• Planned least 4 days in advance
• Emergency • Follow the cashless process

Emergency Hospitalization
Network Hospital –
• Get the patient treated at the nearest hospital
Cashless Facility
• Notify the hospital that your TPA is
Paramount Health Services & Insurance
TPA Pvt Ltd
• Verify hospital is in TPA network or not
Non network Hospital - • Follow the cashless process
Reimbursement
• If the hospital is not on the network , then
follow the reimbursement process.
• Follow the reimbursement process

STAR reserves the right to modify / extend the policy conditions without any prior notice
Cashless process
Member approaches network hospital
with TPA ID Card
Hospital intimates TPA and sends the
Pre-authorization/Cashless request
TPA scrutinizes the request. Issues
Initial Approval letter/Additional
information
letter/Denial Letter as per requirement and
coverage
Member bears out pocket non medical
expenses or entire hospital bill if not
covered under policy conditions & any
other non-admissible items
At the time of discharge member signs the
final bill and
leaves back all the documents. Member takes
photocopies of all documents
STAR reserves the right to modify / extend the policy conditions without any prior notice
• Cashless can be availed in the listed network hospitals
• Please notify the hospital that your TPA is – Paramount Health Services & Insurance TPA
Pvt Ltd
• Till such time your e-cards are available, please quote your employee ID to the TPA call centre
• The network hospital will ask for some nominal deposit which is refundable
• Employee pays the expenses if hospitalization not covered under policy conditions & non-
medical expenses
• At the time of discharge employee signs the Final bill and leaves back all the original
documents
• Retain the photo copies of all the original documents(if required for personal reasons) before
leaving the hospital
• Collect all original receipts of all payments/deposits done to hospital, medicines purchased from
outside the hospital along with prescriptions
• Employee can represent a claim as reimbursement if denied at the cashless stage
• Minimum TAT of 3-4 Hours and in emergencies 2 hours, incomplete information can delay the
process
• Incase of planned hospitalization intimation at least 2-3 days before date of admission and
incase of emergency within 24 of admission.
• The denial of authorization for cashless access does not mean denial of treatment and does not
in any way prevent you from seeking necessary medical attention or hospitalization
Reimbursement process

• Contact call Centre / intimat
• Employee or Beneficiary gets e through online Claim Intimation on
admitted into hospital
TPA portal prior to/within 48 hrs from
date of admission
• During discharge settle all the bills
• Collect all the original documents like
Cash paid receipts, Discharge
summary, Test reports etc…

• Claim Settlement through NEF
T •
• Maximum TAT for payment
subject to availability of all
necessary documents will be 15-21
working days
• Submit the duly filled Claim form
Claims registered and Processed
• Deficiency Intimation email and along with all original
documents at the TPA office.
• Claims Approved / Denied
• Settlement/Denial Letter sent to Within the 15 days from date of
Claimant / Beneficiary discharge.

STAR reserves the right to modify / extend the policy conditions without any prior notice
 Reimbursement process
Claim documents checklist
Collect all the documents in ORIGINAL from the hospital and submit it to TPA for reimbursement.
List of documents to be submitted to TPA
• Completed Claim form with Signature
• Hospital bills in original (with bill no; signed and stamped by the hospital) with all charges itemized and the original receipts
• Original Discharge Summary / Card
• Attending doctors’ bills and receipts and certificate regarding diagnosis (if separate from hospital bill)
• Original reports or attested copies of Bills and Receipts for Medicines, Investigations along with Doctors prescription in Original and Laboratory
• Doctors Prescription, Pre – Post Hospitalization bills (in original).
• Original Bills of surgical appliances if purchased by you.
• Provide Break up details including Pharmacy items, Materials, Investigations even though it is there in the main bill
• Follow-up advice or letter for line of treatment after discharge from hospital, from Doctor
• In case the hospital is not registered, please get a letter on the Hospital letterhead mentioning the number of beds and availability of doctors and nurses round the clock.
• In non- network hospital, you may have to get the hospital and doctor’s registration number in Hospital letterhead and get the same signed and stamped by the hospital, if
required
• Consultation papers with treatment details
• Photocopies of Indoor Case Sheet (wherever applicable) etc, attested by the hospital
• Government Photo ID proof of the claimant (patient)
• Aadhaar and PAN card copy of the employee
• Cancelled cheque of employee bank account

Note: All above documents in originals have to be submitted within 15 days from the date of discharge to the TPA. There may be additional documents other than the
above mentioned list, required by the TPA based on specific treatment.
Please retain a photocopy of all claim documents before submission

STAR reserves the right to modify / extend the policy conditions without any prior notice
 Reimbursement process
Important points to note
What happens when submitted documents are incomplete?
If there are discrepancies /requirements/deficiencies in the documents TPA will issue a letter/email listing the deficiencies . In case of non-receipt
of documents from your end at the end of the period, we will do the following:
• In case the missing documents are mandatory for e.g. the Signed Claim Form, Main Hospital Bill with breakups, Discharge Summary etc, the
entire claim will be sent back to you and the claim stands rejected.
• In case of any other missing documents, the claim will be assessed after deduction of the appropriate amount and process the balance amount.

How much time does it take to settle a claim?

•If the claim is complete in all respect TPA will normally settle within 21 working days from the date of receipt of complete documents.
Sometime TPA may settle the claim, deducting the amount pertaining to deficient document.
•When the deficient documents are submitted; TPA will reopen the file and pay for the same if they are payable under the policy.

What about pre and post hospitalization expenses?

If you have incurred any pre - post hospitalization expenses which are permissible under policy you may submit a supplementary claim along with relevant
documents immediately after permitted pre post hospitalization period.
TPA will scrutinize the same with reference to the main hospitalization claim and settle the same.

STAR reserves the right to modify / extend the policy conditions without any prior notice
 Do’s & don’t

Do's
•Enrollment of dependants within 30 days of marriage / birth
•Claim submission within 15 days from the date of discharge in case of non network hospital
•All non medical expenses will have to be paid at the hospital before discharge
•All original documents will have to be submitted at the time of the claim in case of reimbursement claims
•Please submit all the paid receipts if any amount has been paid at the hospital other than the non medical expenses and
co-pay

Don'ts
•Delayed or non declaration of a dependant within time will lead to the dependent being un-insured
•Delayed addition of dependant will lead to rejection of the claim
•Incomplete documentation will lead to rejection or reduction in reimbursement
•Delay in claim submission can lead to rejection of the claim

STAR reserves the right to modify / extend the policy conditions without any prior notice
Third party administrator
Contact details

For all medical queries and assistance please contact TPA

Website www.paramounttpa.com

Telephone number +91 22 6662 0808 contact.phs@paramounttpa.com

Account Manager – Mr. Devendra Matwandkar +91 770 09 07 720 devendra.matwandkar@paramounttpa.com

Paramount Health Services & Insurance TPA Pvt. Ltd.

Plot No. A-442,Road No. 28,
M.I.D.C., Industrial Area,
Reimbursement documents need to be submitted to:-
Wagale Estate, Ram Nagar,
Vitthal Rukhmani Mandir,
Thane West - 400604

STAR reserves the right to modify / extend the policy conditions without any prior notice
Paramount TPA Helpdesk Schedule – STAR
offices

Sr. No Location Day Timing

1 Mumbai Monday to Friday 10 am to 6 pm

2 Hyderabad Every Thursday 3 pm to 5 pm

3 Bangalore Every Wednesday 11 am to 1 pm

4 Chennai Every Monday / Thursday 11 am to 1 pm

5 Kolkata Every Tuesday 11 am to 1 pm

6 Gurgaon Every Tuesday 11 am to 1 pm

STAR reserves the right to modify / extend the policy conditions without any prior notice
Willis Towers Watson
Contact details

Willis Towers Watson will act as an escalation point to TPA

Contact person Custodio Fernandes

Email ID custodio.fernandes@willistowerswatson.com

Telephone +91 932 39 56 589

Willis Towers Watson India Insurance Brokers Pvt Ltd

Level – 5, Grande Palladium,
175,CST Road,
Address
Off Bandra Kurla Complex,
Kalina, Santacruz (East)
Mumbai– 400 098

STAR reserves the right to modify / extend the policy conditions without any prior notice
Personal Accident Insurance
July 1, 2019 to June 30, 2020
Plan overview

Sum Insured: 72 times monthly basic salary with a minimum of 20 lakhs

Insured member: Employee
Insurer: The New India Assurance Co Ltd
Cover: Disability arising out of an accident
Geographical Limits: World Wide

Coverage under Disability:

• Temporary Total Disability(TTD): If an employee is temporarily disabled and cannot engage in any employment or occupation then 1% of
the 24 times monthly basic salary or INR 25,000 which ever is less is payable up to 100 weeks
• Permanent Partial Disability(PPD): If an employee is partially disabled wherein the result is irrecoverable loss or use or actual loss by
physical separation of body part, then a certain compensation is payable as per schedule
• Permanent Total Disability(PTD): If an employee is permanently and totally disabled wherein the employee cannot engage in
employment or occupation then 100% of the sum insured is payable as per the schedule
• Medical Expenses: Medical Expenses up to 40% of claim amount or 10% of Sum insured or actual medical bills submitted which ever is
lower. This is applicable only when the claim is admissible under benefit disability.

STAR reserves the right to modify / extend the policy conditions without any prior notice
Disability compensation

Sr. No Type of disability Percentage of Sum Insured

1 Loss of both eyes 100%
2 Loss of both hands 100%
3 Loss of both feet 100%
4 Loss of one entire hand and one entire foot 100%
5 Loss of one eye and such loss of one entire hand 100%
6 Loss of use of two hands or two feet, or of one hand and one foot 100%
7 loss of sight of one eye and such loss of use of one hand or one foot 100%
8 Permanent inability of engaging in being occupied with or giving attention to any employment or occupation 100%
9 Loss of sight of one eye, or of the actual loss by physical separation of one entire hand or of one entire foot 50%
10 Total and irrecoverable loss of use of a hand or a foot without physical separation 50%

11 Loss of toes – all 20%

  Great – both phalanges 5%
  Great – one phalanx 2%
  Other than great, if more then one toe lost for each 1%

12 Loss of hearing – both ears 75%

  Loss of hearing – one ear 30%

13 Loss of four fingers and thumb of one hand 40%

  Loss of four fingers 35%
  Loss of thumb – one phalanx 25%
  both phalanges 10%
  Loss of index finger – three phalanges or two phalanges or one phalanx 10%
  Loss of middle finger – three phalanges two phalanges or one phalanx 6%
  Loss of ring finger – three phalanges or two phalanges or one phalanx 5%
  Loss of little finger – three phalanges two phalanges or one phalanx 4%
  Loss of metacarpals – first or second or third, fourth or fifth (additional) 3%

Indicative list - Any other permanent partial disablement, as assessed by the panel doctor of the company
STAR reserves the right to modify / extend the policy conditions without any prior notice
Exclusions

Below mentioned activities shall be outside the scope of the policy:

• Professional sports team in respect of specific benefit for inability to perform
• Participation in any kind of motor speed contest.
• While engaged in aviation, or whilst mounting or dismounting from or traveling in any aircraft.
• Underground mining & contractor specializing in tunneling
• Naval, military or air force personnel
• Radioactivity, Nuclear risks, ionizing radiation

Exclusions
• Suicide, attempt to Suicide or intentionally self- inflicted injury, sexually transmitted conditions, mental disorder, anxiety, stress or
depression.
• Being under influence of drugs, alcohol, or other intoxication or hallucinogens
• Participation in actual or attempted felony, riot, civil commotion, crime misdemeanor
• Committing any breach of law of land with criminal intent.
• Death or disablement resulting from Pregnancy or childbirth

Note: Above are general exclusions and should not be interpreted as exhaustive or conclusive in nature.

STAR reserves the right to modify / extend the policy conditions without any prior notice
 Claim process

•Accident Intimation to insurance company within 48 hours.

•Claim needs to be submitted within a week once the employee has joined back after medical leave of absence due to accident
•Following documents are required to be submitted
•Claim form
•Doctor's certificate, (Fitness certificate in case of TTD)
•Leave certificate from the employer (TTD)
•Salary statement (TTD)
•Medical records if any ( prescriptions, bills, tests).
Note:
•In case of a disability related claim, please notify your HR so that the claim can be intimated to the Insurance Company.
•Above is only an indicative list of documents. Additional documents could be called for based upon the disability type.

STAR reserves the right to modify / extend the policy conditions without any prior notice
 Group Term Life
July 1, 2019 to June 30, 2020
 Plan overview

Sum Insured : 72 times monthly basic salary with a minimum of 20 lakhs

Insured Member : Employee

Insurer : Aditya Birla Sun Life Insurance Co Ltd

Covers : Natural or Accidental death and Terminal Illness Rider

Criteria under the Group Term Life Insurance

•Sum insured is calculated based on Monthly Basic Salary of the employee as on July 01, 2019 or the date of hire whichever is later. The sum
insured does not change with mid year salary changes. It gets updated only at the time of policy renewal.
•On the criteria of age or coverage; some employees will have to undergo certain medical tests which will be made known by the insurer.
•Employees who need to undergo medical underwriting are requested to comply with all requests from the insurer at the earliest to ensure the full
amount of coverage.
•The cost of the medical tests will be borne by the insurer and will be coordinated by the insurer with the employee/Human resource team.
•If an Insured Member does not designate a beneficiary to the company, or if all the designated beneficiaries predecease the insured member, any
benefit payable under this contract upon the Insured Member’s death shall be paid to the legal heirs based on production of Succession
Certificate.

STAR reserves the right to modify / extend the policy conditions without any prior notice
 Claim process

•Death intimation to insurance company within 48 hours

•Claim needs to be submitted as early as possible.
•Following documents are required to be submitted
• Claim form
• Certified copy of the post mortem report
• Copy of FIR, if any lodged
• Death certificate
• Brief write up on the location & cause of death

Note:
•In case of a sickness related death claim, leave records of the deceased employee will be required
•Above is only an indicative list of documents. Additional documents could be called for if required.

STAR reserves the right to modify / extend the policy conditions without any prior notice
Willis Towers Watson
Contact details

All claims in case of accident and death to be reported to

Contact person Custodio Fernandes

Email ID custodio.fernandes@willistowerswatson.com

Telephone +91 932 39 56 589

Willis Towers Watson India Insurance Brokers Pvt Lt

d
Level – 5, Grande Palladium,
Address 175,CST Road,
Off Bandra Kurla Complex,
Kalina, Santacruz (East)
Mumbai– 400 098

STAR reserves the right to modify / extend the policy conditions without any prior notice