Overview
Star Health Assure is a fairly comprehensive health insurance policy that offers coverage of up to ₹2 crore with unique features like unlimited automatic restoration of sum insured and wellness discounts up to 20%. It covers up to 9 family members under a floater policy and includes benefits like air ambulance, in-utero fetal surgery, and assisted reproduction treatment. With coverage for modern treatments, AYUSH, and home care, it aims to provide extensive protection against rising healthcare costs.
Experts Review
Written by Nikhil Nair
Senior Writer
The Star Health Assure plan packs quite a punch with its range of benefits and high sum insured options. The standout feature here is the unlimited automatic restoration of sum insured, which keeps you covered even if you have multiple hospitalizations in a year.
The inclusion of some unique benefits, like in-utero fetal surgery coverage and assisted reproduction treatment, is appealing as these are often overlooked in standard health plans, but can be crucial for some families. The air ambulance coverage is also a nice touch, showing that the insurer is thinking about emergency situations.
However, it's not all perfect. The waiting periods for certain conditions and treatments are worth noting. Also, the plan comes with room rent limits that are less disruptive for higher sum insured of ₹50 lakhs and higher policies. This is why you'll want to pay attention to these details to avoid surprises during claims.
Pros
Feature set is satisfactory.
Insurer has a solid track record with great claim and service metrics.
Cons
Doctor consultations are not covered, which is a notable gap.
Star Health
Key Insights
Founded
2006
Star Health was established 19 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
85% claims settled in 30 Days
Star Health settles only 85% of claims it receives, which is relatively low and may raise concerns about reliability during claim payouts.
Network Hospitals
14,000+
Star Health has a strong network with over 14,000 hospitals, ensuring wide accessibility and convenience for policyholders.
Complaints
52 complaints per 10,000 claims registered
Star Health has a relatively high volume of complaints, which may point to ongoing issues in customer service or claim handling.
Features
All
Great
Good
Co-payment
If you bought this policy after you turned 61, you have to pay 10% of the bill every time you make a claim. Otherwise, you are good to go. The insurer will pay all costs up to the sum insured.
Room Rent
Your insurer won’t let you stay in a room whose rent exceeds 1% of the sum insured. But in the event, you breach this limit, get ready to pay a lot more.
Disease sub-limit
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
Pre existing diseases waiting
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after you wait for 3 years.
Pre/Post hospitalization
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 60 days before you are hospitalized and 180 days after discharge. This includes the cost of medication by the way.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Expenses incurred on Enhanced External Counter Pulsation Therapy and related therapies, Chelation therapy, Hyperbaric Oxygen Therapy, Rotational Field Quantum Magnetic Resonance Therapy, VAX-D, Low level laser therapy, Photodynamic therapy & other similar therapies
Autologous-derived Stromal vascular fraction, Chondrocyte Implantation, Procedures using Platelet Rich plasma and Intra-articular injection therapy
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Diagnostic expenses not related or incidental to current diagnosis and treatment are excluded.
Expenses for admission primarily for bed rest and not for treatment are excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy for 2 years.
Cataract and diseases of the anterior and posterior chamber of the eye
ENT diseases
Thyroid-related diseases
Benign diseases of the breast
Subcutaneous benign lumps (e.g., sebaceous cyst, dermoid cyst, mucous cyst on lip/cheek)
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
3 years Pre-existing disease waiting period
Ditto's Take
◦ Standard ◦
After a close look at the waiting periods, it’s safe to say they are fairly standard.
What's missing in the policy
Doctor consultations are not covered.
Customer Reviews
R
Rajesh K.
This plan is really good, covers a lot of things and the process was smooth. Very happy with the service.
P
Priya S.
Policy terms are clear and easy to understand. Claim settlement was hassle-free. Recommend it!
A
Amit Varma
Got this for my family, provides good coverage for everyone. Peace of mind hai ab.
S
Sameer Gupta
Wish there were more options for wellness benefits included.
S
Sanjay R.
The plan comes with room rent restrictions, which might affect hospital room choices in some cases.
D
Deepika P.
Premiums are reasonable for the benefits offered. Worth the money spent.
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Frequently Asked Questions
Does Assure have waiting periods?
- 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
- Specific Illness Waiting Period: There’s a 2-year waiting period for a list of diseases which is a mandate before you can start claiming.
- Pre-Existing Disease Waiting Period: There's a 3-year waiting period for any pre-existing disease you may have while buying the policy or 30-months, if you pay for 3 years in a single go.
- Maternity and Newborn Waiting Period: There’s a 2-year waiting period before you can make claims related to pregnancy and childbirth.
Does Assure have room rent restrictions?
Does Assure offer a restoration benefit?
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