Star Health Super Surplus
Claim settlement Ratio 84% Network Hospital 15000+
Claim settlement Ratio 84% Network Hospital 15000+
Star Health Young Star Neo
Star Health Assure
Star Health Super Star Plan
Star Health Super Surplus Plan
Star Health Super Surplus Insurance Policy is a combination of top-up and super top-up together under one product. It provides additional coverage when eligible hospitalization expenses exceed your selected deductible amount and helping you get higher coverage at a lower premium.
The plan comes in two variants Silver and Gold. The Silver variant has a lower range of sum insured options and works like a top-up plan, while the Gold variant works like a super top-up plan. The cover also differs between the individual and floater options. So, before buying, check the details carefully to understand which variant and coverage option you are choosing
Eligibility Criteria of Star Health Super Surplus
When it comes to Star Health Super Surplus plan eligibility then the sum insured options and coverage depend on the variant and category you choose. So, lets take a look at its eligibility criteria as mentioned below:
| Particular | Eligibility |
| Adult Entry Age | 18 to 65 years |
| Child Entry Age | 91 days to 25 years |
| Family Members | Self, spouse and dependent children |
| Policy Type | Individual, Floater and Multi Individual |
| Policy Term | 1, 2 and 3 years |
| Renewal | Lifelong |
| Medical Screening | Not required before acceptance |
| Plan Variants | Silver & Gold |
| Sum Insured | 5 lakh to 1 crore |
| Deductible | 3 lakh to 25 lakh |
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Star Health Super Surplus Additional Benefit
The Gold variant of the Star Health Super Surplus plan offers a Waiver of Deductible option. From the sixth policy year onwards, you can request to switch at renewal to a regular health insurance policy without a deductible, subject to underwriting approval.
To qualify, all insured members must have joined before turning 50, the policy must have been renewed without a break, and no claims must have been made during the previous five years. This option applies to all insured members, with continuity benefits based on the average sum insured over the preceding five years.
The Star Health Super Surplus Floater policy also requires no pre-insurance medical screening. However, you must accurately disclose your medical history when applying.
What Are the Exclusions Under Star Health Super Surplus?
Star Health Super Surplus contains exclusions applicable to both the Silver and Gold Plans. Important exclusions include:
- Treatment primarily undertaken for investigation or evaluation.
- Rest cure, rehabilitation, respite and custodial care.
- Change of gender treatment and Cosmetic or plastic surgery except in specifically permitted medically necessary circumstances.
- Treatment arising from professional participation in hazardous or adventure sports.
- Expenses arising from a breach of law with criminal intent.
- Treatment related to alcohol, drugs, substance abuse or addictive conditions.
- Unproven, unconventional, untested or experimental treatments.
- Congenital external conditions, defects and anomalies.
- Intentional self-injury.
- Injuries or diseases caused by war, invasion or foreign enemy action.
- Injury or disease related to nuclear weapons or nuclear materials.
The detailed policy wording should always be checked for the complete exclusion and any specific permanent exclusions in your policy.
Waiting Period for Star Health Super Surplus
When it comes to waiting periods, the Star Health Super Surplus plan generally follows those commonly found in health insurance policies. Lets look at the key waiting periods that apply:
- Initial Waiting Period:Â A 30-day waiting period applies to illness-related treatment from the first policy commencement date. Eligible claims arising from accidents are not subject to this initial waiting period.
- Pre-Existing Disease Waiting Period:Â The PED waiting period differs between the two plans. For the Silver Plan, treatment for pre-existing diseases and their direct complications is excluded for 36 months of continuous coverage. For the Gold Plan, the waiting period is 12 months.
- Specified Disease/Procedure Waiting Period:Â For the Silver Plan, listed specified diseases and procedures have a 24-month waiting period. Under the Gold Plan, the waiting period is 12 months.
- Delivery Expenses Waiting Period:Â The Gold variant covers delivery benefit and has 12 month waiting period from the commencement of the first Star Super Surplus policy and continuous renewal with the insurer.
Star Health Super Surplus Insurance Claim Process
Star Health Super Surplus provides cashless treatment wherever possible at network hospitals. At non-network hospitals, the insured person needs to pay the expenses upfront and can subsequently seek reimbursement by submitting the required documents, subject to claim admissibility:
| Claim Process | Cashless Claim | Reimbursement Claim |
| Where to take treatment | Star Health network hospital | Eligible non-network hospital |
| Planned hospitalization | Inform Star Health at least 24 hours before admission | Inform Star Health as per the applicable claim process |
| Emergency hospitalization | Inform Star Health within 24 hours after hospitalization | Inform Star Health within the applicable timeline |
| At hospital | Follow the cashless authorization process | Take treatment and pay the hospital expenses initially |
| Pre-authorization | Hospital submits the required request to Star Health | Not applicable |
| Assessment | Claim is reviewed against the deductible/defined limit, coverage and policy conditions | Claim is reviewed against the applicable deductible/defined limit, coverage and policy conditions |
| Settlement | Eligible amount is settled with the network hospital after approval | Eligible amount is reimbursed after approval |
| Customer payment | Deductible/defined limit and non-payable expenses, where applicable, are borne by the insured | Deductible/defined limit and non-payable expenses are borne by the insured |
| Documents | Medical and claim documents as required | Claim documents, KYC, NEFT/bank details and supporting medical records as required |
For reimbursement claims, Star Health requires payment-related and identification information such as KYC, bank account details and IFSC, along with the relevant claim documents.
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Benefits of Star Health Super Surplus Plan
The coverage and benefit structure of Super Surplus plan differ between the Silver and Gold variants. So lets look at the common features offered by both variants as mentioned below:
Being admitted to a hospital for at least 24 hours to receive medical treatment for an illness or injury are covered and it include room charges, doctor fee, nurse fees, medicine, diagnostic etc.
When it comes to room charges, the Silver variant covers up to ?4,000 per day under both individual and family floater options, while the Gold variant covers a single private AC room.
The Silver variant covers medical expenses incurred up to 30 days before hospitalisation and 60 days after hospitalisation
The Gold variant covers expenses incurred up to 60 days before hospitalisation and 90 days after hospitalisation
The policy covers eligible day care treatments surgeries or medical procedures that do not require 24 hour hospitalization are covered and subject to the plan’s terms and conditions.
Eligible inpatient treatment under Ayurveda, Unani, Siddha and Homeopathy is covered up to the Sum Insured at an AYUSH hospital. Claims under Yoga and Naturopathy are payable subject to prior approval from Star Health
Under the gold variant emergency ambulance expenses are covered up to ?3,000 per Policy Period for transportation of the insured person to a hospital.
Eligible air ambulance expenses are covered up to 10% of the Sum Insured per hospitalization for Sum Insured options of ?10 lakh and above, subject to the policy conditions.
Eligible expenses for organ transplantation are covered when the insured person is the recipient and the transplant claim itself is admissible. However, donor screening expenses and post-donation complications of the donor are not covered under this benefit.
Only the Gold variant of the Star Health Super Surplus plan covers maternity expenses, including delivery charges, up to ?50,000 per policy period. This benefit comes with a one year waiting period
If the Sum Insured is exhausted or exceeded during the Policy Period, Star Health Super Surplus Gold provides an additional indemnity once for the remaining Policy Period.
The policy provides a facility for obtaining an E-Medical Opinion, subject to the applicable service conditions.
Star Health Super Surplus Additional Benefit
The Gold variant of the Star Health Super Surplus plan offers a Waiver of Deductible option. From the sixth policy year onwards, you can request to switch at renewal to a regular health insurance policy without a deductible, subject to underwriting approval.
To qualify, all insured members must have joined before turning 50, the policy must have been renewed without a break, and no claims must have been made during the previous five years. This option applies to all insured members, with continuity benefits based on the average sum insured over the preceding five years.
The Star Health Super Surplus Floater policy also requires no pre-insurance medical screening. However, you must accurately disclose your medical history when applying.
What Are the Exclusions Under Star Health Super Surplus?
Star Health Super Surplus contains exclusions applicable to both the Silver and Gold Plans. Important exclusions include:
- Treatment primarily undertaken for investigation or evaluation.
- Rest cure, rehabilitation, respite and custodial care.
- Change of gender treatment and Cosmetic or plastic surgery except in specifically permitted medically necessary circumstances.
- Treatment arising from professional participation in hazardous or adventure sports.
- Expenses arising from a breach of law with criminal intent.
- Treatment related to alcohol, drugs, substance abuse or addictive conditions.
- Unproven, unconventional, untested or experimental treatments.
- Congenital external conditions, defects and anomalies.
- Intentional self-injury.
- Injuries or diseases caused by war, invasion or foreign enemy action.
- Injury or disease related to nuclear weapons or nuclear materials.
- Certain external aids and devices such as hearing aids, spectacles, walkers, crutches, wheelchairs, CPAP, BIPAP and similar equipment.
The detailed policy wording should always be checked for the complete exclusion and any specific permanent exclusions in your policy.
Waiting Period for Star Health Super Surplus
When it comes to waiting periods, the Star Health Super Surplus plan generally follows those commonly found in health insurance policies. Lets look at the key waiting periods that apply:
- Initial Waiting Period:Â A 30-day waiting period applies to illness-related treatment from the first policy commencement date. Eligible claims arising from accidents are not subject to this initial waiting period.
- Pre-Existing Disease Waiting Period:Â The PED waiting period differs between the two plans. For the Silver Plan, treatment for pre-existing diseases and their direct complications is excluded for 36 months of continuous coverage. For the Gold Plan, the waiting period is 12 months.
- Specified Disease Waiting Period:Â For the Silver Plan, listed specified diseases and procedures have a 24-month waiting period. Under the Gold Plan, the waiting period is 12 months.
- Delivery Expenses Waiting Period:Â The Gold variant covers delivery benefit and it has a 12-month waiting period from the commencement of the first Star Super Surplus policy and continuous renewal with the insurer.
Star Health Super Surplus Insurance Claim Process
Star Health Super Surplus provides cashless treatment wherever possible at network hospitals. At non-network hospitals, the insured person needs to pay the expenses upfront and can subsequently seek reimbursement by submitting the required documents, subject to claim admissibility:
| Claim Process | Cashless Claim | Reimbursement Claim |
| Where to take treatment | Star Health network hospital | Eligible non-network hospital |
| Planned hospitalization | Inform Star Health at least 24 hours before admission | Inform Star Health as per the applicable claim process |
| Emergency hospitalization | Inform Star Health within 24 hours after hospitalization | Inform Star Health within the applicable timeline |
| At hospital | Follow the cashless authorization process | Take treatment and pay the hospital expenses initially |
| Pre-authorization | Hospital submits the required request to Star Health | Not applicable |
| Assessment | Claim is reviewed against the deductible/defined limit, coverage and policy conditions | Claim is reviewed against the applicable deductible/defined limit, coverage and policy conditions |
| Settlement | Eligible amount is settled with the network hospital after approval | Eligible amount is reimbursed after approval |
| Customer payment | Deductible/defined limit and non-payable expenses, where applicable, are borne by the insured | Deductible/defined limit and non-payable expenses are borne by the insured |
| Documents | Medical and claim documents as required | Claim documents, KYC, NEFT/bank details and supporting medical records as required |
For reimbursement claims, Star Health requires payment-related and identification information such as KYC, bank account details and IFSC, along with the relevant claim documents.
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