Overview
The Star Smart Health Pro is a comprehensive plan that provides flexibility with sum insured options ranging from ₹5 lakhs to ₹1 crore, along with customizable policy terms. It includes benefits such as in-patient hospitalization, pre- and post-hospitalization expenses for 60 & 180 days respectively, daycare treatments, domiciliary hospitalization, air ambulance services, and coverage for modern treatments like robotic surgeries up to the cover amount. The plan also comes with add-ons for unlimited restoration of the sum insured, reduction in pre-existing disease waiting periods, and consumables cover.
Experts Review
Written by Nikhil Nair
Senior Writer
The Star Smart Health Pro plan is a versatile health insurance option that caters to diverse healthcare needs with its wide array of benefits and customizable features. One of its standout features is the cumulative bonus booster, which increases the sum insured by 50% for every claim-free year, up to a maximum of 600%. This incentivizes maintaining a healthy lifestyle while providing inflation-adjusted protection. The plan also includes unlimited restoration of the sum insured as an optional cover, ensuring financial security during multiple claims within the policy year.
The inclusion of modern treatments like robotic surgeries and air ambulance services adds significant value for policyholders requiring advanced medical care. Additionally, wellness programs encourage preventive care by offering up to 20% discounts on premiums during renewals based on healthy habits tracked through Star Health’s mobile app. The plan’s flexibility extends to room rent preferences and optional riders that reduce waiting periods for pre-existing conditions from 36 months to as low as 12 months.
However, the insurer’s average claim settlement ratio of 83% (which is below industry standards for 2021-24) and recent allegations of fraudulent activities may raise concerns about operational efficiency during claims processing. While the plan offers robust coverage options and attractive features, its relatively high premium pricing may deter cost-sensitive buyers.
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
The insurer will bear the entire cost of treatment (up to the sum insured). You won’t have to pay a single penny. Meaning this policy has no co-payment.
Room Rent
You can share a room or you could have a single room for yourself. But if you are looking for anything slightly fancy, be ready to foot a part of the bill.
Customisable
Change Single Private Room to Any Room or Shared Room.
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.
Customisable
For any illness: Pre existing disease waiting period is modified/reduced from 3 Years to 1 or 2 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.
Add-ons
Reduction in PED Waiting Period
Recommended
For any illness: Pre existing disease waiting period is modified/reduced from 3 Years to 1 or 2 Years.
Consumables Cover
Recommended
Covers list of 68 non-medical items as per list I
Cumulative Bonus Booster
Recommended
Additional bonus of 50% up to a maximum of 600%, irrespective of any claim in the previous year.
Unlimited Restoration
Recommended
Restores the cover unlimited times up to 100% of the sum insured for any illness.
Room Rent Modifier
Change Single Private Room to Any Room or Shared Room.
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 (Ear, Nose, Throat) diseases
Thyroid-related diseases
Benign diseases of the breast
Subcutaneous benign lumps (e.g., sebaceous cyst, dermoid cyst, mucous cyst of lip/cheek)
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
3 years Pre-existing disease waiting periodCustomisable
Ditto's Take
◦ Excellent ◦
Waiting periods on this policy are excellent. This policy also further allows to reduce the PED waiting period to 1 or 2 Years for all diseases.
What's missing in the policy
Doctor consultations are not covered.
Customer Reviews
N
Nikhil Sharma
Flexible sum insured options from ₹5 lakhs to ₹1 crore cater to diverse needs.
N
Nirmala Verma
Customizable policy terms allow tailoring the plan to specific requirements.
N
Nishant Gupta
Covers modern treatments like robotic surgeries, which is very up-to-date.
P
Pradeep Joshi
Need to check if 'unlimited restoration' has any conditions or is truly unlimited for all claims.
P
Pavan Khan
Star Health's claim settlement record and service can be a concern based on general feedback.
P
Padma Patel
Option to reduce pre-existing disease waiting periods via add-on is useful.
R
Rakesh G.
Cumulative bonus booster of 50% per claim-free year, up to 600% is fantastic! My SI has grown massively.
D
Divya S.
Unlimited restoration of SI (as an add-on) is great for peace of mind with multiple claims.
A
Amit K.
Modern treatments like robotic surgeries are covered, which is essential these days.
T
Tarun L.
Heard some negative things about their customer service and claim processing.
A
Anil V.
Star Health's claim settlement ratio is not the best, around 83%. Makes me a bit wary.
P
Pooja B.
Air ambulance service inclusion is a valuable feature for emergencies.
R
Rohan Singh
Flexibility in sum insured and policy terms is great. I chose what suited me.
A
Ananya Kumar
Air ambulance service included, very important for emergencies in remote areas.
V
Vikram Patel
Robotic surgeries covered! This is what I call a modern plan.
D
Diya Iyer
The list of network hospitals for cashless could be wider in some smaller towns.
I
Isha Reddy
Premium with all add-ons thoda costly ho gaya. But features are good.
P
Pooja D.
Unlimited restoration add-on gives full peace of mind. Highly recommend.
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Frequently Asked Questions
Does Smart Health Pro 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.
Does Smart Health Pro have room rent restrictions?
Does Smart Health Pro offer a restoration benefit?
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