Star Health recently launched their new product – Star Health Unique, which covers select Pre-existing diseases/conditions after a waiting period of 11 months.
Apart from the standard hospitalization cover for accident and sickness, the main highlights of this health plan are:
- Covers select Pre-existing diseases/conditions after a waiting period of 11 months, which is considerably low compared to the earlier lowest of 3 years waiting by Apollo Munich.
- Covers Individuals upto 65 years without a Medical Check-up.
The important conditions you need to know before you buy Star Unique Health Insurance:
- The premium of this product is higher than the premium of standard products including the ones from Star.
- 30% Co-pay on all claims.
- Select Pre-existing Diseases are covered for 50% of the Sum Insured.
- Select Pre-existing Diseases are not covered.
- Differential city-wise premium.
- Sub-limit on various ailments
- Mandatory cover for 2 years. If you claim in the first year, the second year's premium is deducted from the admissable claim amount.
- Cover ceases at the age of 70 years, after which the insured has the option to move to any other existing product of Star.
- The pre-existing ailments which are included in the 1 year, 2 year and 4 year exclusions are mostly those which require a hospitalization treatment in the short term, even before the policy has been applied for. The ailments not part of the waiting period seem to be those which are generally controllable diseases like Hypertension and Diabetes, which do not have an immediate requirement for a treatment.
- In a time where most other private insurers add a permanent exclusion in the policy on any treatment directly or indirectly related to Hypertension or Diabetes, Star Health’s inclusion of these diseases is a welcome step.
The policy opens up cover for an entire Indian population who has chronic but controllable health conditions like hypertension or diabetes (including those who have undergone a Bypass Surgery (CABG)
Why a Declaration based Health Insurance underwriting system could work better, compared to a Medical Check-up one in India?
In absence of any civic medical records, Health Insurance Companies depend on Medical Tests for underwriting (pricing) the Health Insurance coverage for people beyond a particular age. Medical Tests come with their own flaws. Firstly they capture information only for the particular time period. So if I have climbed 3 floors to reach a laboratory and got my blood pressure checked immediately, it would show High Blood Pressure, and the lab test would conclude me as a Hypertensive. Those who are from Healthcare would agree, that Medical Check-ups are also prone to errors. I have experienced a case in the past where the mother of a renowned doctor was denied coverage based on pus cells detected in her urine. The daughter put her mother on medication and contested the results with the Insurance Company demanding a check in another lab after a week. The new check-up reports did not show any trace of pus cells, and the mother was covered without any exclusions. This instance clearly deleted all my dependence on medical checks as the critical data point for underwriting.
On the other hand, a clear declaration of health conditions from the customer makes him/her responsible for entering all the information he is aware of.