
Delivery and newborn, dental, eye treatment and hospital cash built into the policy rather than bought on top of it.
Two hospital bills in year one, on ₹10 Lakh of cover.
| Bill | Star Comprehensive |
|---|---|
| 1st bill₹7,00,000 | CoveredPaid from Sum Insured ₹7,00,000 |
| 2nd bill₹12,00,000 | ₹9,00,000not coveredPaid from |
Tell us about your family and health - this list reorders around what matters to you.
Start the 90-second checkYour room is covered at a Private Single A/C Room, which the policy defines as the most economical single-occupancy room the hospital has - not a deluxe room or a suite.
Take a room above that category and the insurer cuts the same proportion from your nursing, operation theatre and doctor's fees too.
This policy has no cover for hospital non-payable items.
Medical expenses for up to 90 days after you are discharged are paid up to your Sum Insured. The follow-up has to be recommended by the doctor or hospital that treated you, the hospitalisation claim has to be admitted, and the expenses have to be for the same illness. No separate rupee cap applies.
Post-hospitalisation is not paid at all on a delivery or newborn claim. On bariatric surgery it is not paid on top either: the ₹2,50,000 or ₹5,00,000 bariatric limit has to cover the follow-up as well.
Once in a policy year the full Basic Sum Insured is added back, but only after both your Sum Insured and any accrued Cumulative Bonus are completely used up. The restored amount pays a later hospitalisation, including for an illness already claimed.
The refill starts only after the cover and the bonus are completely used. If a bill uses part of your Sum Insured, nothing is added back. Day care, modern treatments, home care and organ donor claims cannot draw on it at all.
This policy has no extra pool of cover sitting on top of your Sum Insured. The most a single hospitalisation can draw is your Basic Sum Insured plus any accrued Cumulative Bonus. The automatic restoration does not raise that limit either, because it pays only a subsequent hospitalisation.
Twelve modern procedures are covered, but nine of them carry their own rupee cap for the whole policy period, and the cap rises with your Sum Insured. Only bronchial thermoplasty, prostate vaporisation and nerve monitoring during surgery are paid up to the full Sum Insured. The caps sit well below the cover most buyers think they have. Deep Dive to know more.
If a procedure costs more than its printed cap, you pay the balance.
This policy does not pay a lump sum on diagnosis of cancer, a heart attack or a stroke. It pays hospital bills as they are incurred. The only lump-sum payment anywhere in it is for accidental death or permanent total disablement under Section II.23.
Anything a doctor diagnosed, advised or treated in the 36 months before your policy starts counts as pre-existing, and this policy pays nothing for it until you complete 36 months of continuous cover. You can buy that wait down to 12 months for extra premium, but only at your first purchase.
The buy-back needs a pre-acceptance medical test at a Star-nominated centre, and it is closed at renewal and closed if you ported in from another insurer. Even after 36 months, a pre-existing condition is paid only if you declared it in your application and the Company accepted it.
Fourteen groups of common conditions - cataract, hernia, kidney and gallbladder stones, joint replacement, spine and disc disease, piles, varicose veins and all transplants among them - are not paid for the first 24 months of continuous cover, even when the condition is new.
Raise your Sum Insured later and the 24-month wait starts again on the increase, so a planned cataract or knee replacement is paid only up to the old Sum Insured. No add-on shortens this 24-month wait.
Delivery is paid as a flat amount per delivery, not a share of your Sum Insured - ₹15,000 to ₹50,000 for a normal delivery and ₹20,000 to ₹1,00,000 for a caesarean, rising with the cover you buy. Pre-natal and post-natal expenses come out of that same amount. You wait 24 months, and only 2 deliveries are ever paid.
Both you and your spouse must have been covered under this policy for a continuous 24 months before a delivery is paid. After a delivery claim the 24-month wait starts again before the next delivery is paid. Pre-hospitalisation and post-hospitalisation expenses and the hospital cash benefit are not paid for this section.
Your newborn is covered from the day of birth for any disease, illness or accidental injury, congenital disorders included, up to ₹1,00,000 - ₹2,00,000 if your cover is ₹50,00,000 or more. These claims do not reduce your Sum Insured. The cover starts only if the delivery claim itself is admitted, which needs 24 months of policy behind it.
Vaccinations for the baby are paid up to ₹5,000, or ₹10,000 if your cover is above ₹25,00,000, until the baby turns one. On a policy longer than one year the newborn cover stops at the policy anniversary. To keep the baby covered after that you add it to the policy, and the baby's own waiting periods then run from the date it is added.
Out-patient doctor consultations at a Star Health network facility are paid from outside your Sum Insured, up to a yearly limit set by your Sum Insured - Rs.1,200 at Rs.5,00,000, rising to Rs.5,000 at Rs.50,00,000 and above. Each single consultation is capped at Rs.300, so the yearly limit buys four to sixteen visits. Tests and medicines are not covered.
Dental and eye consultations are not paid here; they come under a separate three-year limit. See a doctor outside the Star Health network and this benefit pays you nothing. Available on a cashless basis only.
Star Comprehensive carries no mental health benefit.
Each claim-free year adds bonus to your cover: 100% of the Basic Sum Insured at ₹7,50,000 and above, 50% at ₹5,00,000. Either way the bonus stops at 100% of the Basic Sum Insured. A claim cuts the accrued bonus back at the same rate it was earned, and a year that uses up both the cover and the bonus resets it to zero.
A claim can take back the bonus you built. If a year uses up your whole Basic Sum Insured and your whole accrued bonus, the bonus granted at renewal is zero and you start again from nothing.
This policy offers no deductible. You cannot agree to pay the first fixed amount of a year's medical bills yourself in return for a lower premium.
Do not read the 10% co-payment as a deductible. If your age when you joined was 61 or above, you pay 10% of every claim, on every claim; a deductible would instead be one yearly amount you clear before the cover starts paying.
52 named illnesses wait 24 months accidents from day 1 read by 10 body regions about 5 min
How long you wait, for what
Covered from the first day, with no waiting at all.
After the first month, ordinary illness is covered.
Each one is then covered, like any other illness.
Conditions you declared when you bought the plan.
After this, only proven fraud can be held against a claim.
Already diagnosed with one of these? A different rule applies - conditions you already have follow the pre-existing waiting period.
Eye lens clouding (Cataract)
Head & Face
A clouding of the eye lens that makes vision blurry.
“Treatment of Cataract and diseases of the anterior and posterior chamber of the Eye, Diseases of ENT, Diseases related to Thyroid, Benign diseases of the breast.”
Section III – Exclusions · 2. Specified disease/procedure waiting period – Code Excl 02 · F. List of specific diseases/procedures · pages 31–32
Retina tearing
Head & Face
A serious eye problem where the back layer of the eye pulls away.
“Treatment of Cataract and diseases of the anterior and posterior chamber of the Eye, Diseases of ENT, Diseases related to Thyroid, Benign diseases of the breast.”
Section III – Exclusions · 2. Specified disease/procedure waiting period – Code Excl 02 · F. List of specific diseases/procedures · pages 31–32
Retina problems
Head & Face
Diseases affecting the back screen of the eye which is crucial for seeing.
“Treatment of Cataract and diseases of the anterior and posterior chamber of the Eye, Diseases of ENT, Diseases related to Thyroid, Benign diseases of the breast.”
Section III – Exclusions · 2. Specified disease/procedure waiting period – Code Excl 02 · F. List of specific diseases/procedures · pages 31–32
Sinus and nasal allergy
Head & Face
Swelling inside the nose and face bones causing blockage or pain.
“Treatment of Cataract and diseases of the anterior and posterior chamber of the Eye, Diseases of ENT, Diseases related to Thyroid, Benign diseases of the breast.”
Section III – Exclusions · 2. Specified disease/procedure waiting period – Code Excl 02 · F. List of specific diseases/procedures · pages 31–32
Bent nose bone problem
Head & Face
A bent bone inside the nose that makes breathing difficult.
“Treatment of Cataract and diseases of the anterior and posterior chamber of the Eye, Diseases of ENT, Diseases related to Thyroid, Benign diseases of the breast.”
Section III – Exclusions · 2. Specified disease/procedure waiting period – Code Excl 02 · F. List of specific diseases/procedures · pages 31–32
10 never paid 10 paid only if a condition is met 15 in every policy read from all 35 under a minute
No waiting period reaches these - the plan does not cover them at all.
A disease you declared can be listed on your own policy schedule as a permanent exclusion, with your consent. No waiting period ends it. Read your schedule, because this exclusion is personal to you and appears nowhere else in the policy.
Existing disease/s, disclosed by the insured and mentioned in the policy schedule under Permanent Exclusion (based on insured's consent) - Code Excl 38
policy p.34 Excl 38
If the insurer judges that the admission did not need to happen, it refuses the whole claim, not part of it. Keep the treating doctor's reasons for admitting you on the file.
Any hospitalizations which are not Medically Necessary / does not warrant Hospitalization - Code Excl 36
policy p.34 Excl 36
An admission for recovery, weakness or a nutritional deficiency is not paid. If an elderly patient is kept in hospital after the acute treatment has finished, you pay for those days from your own pocket.
Convalescence, general debility, run-down condition, Nutritional deficiency states - Code Excl 21
policy p.33 Excl 21
If the treatment could have been given without admitting you, this plan treats the admission as unwarranted and does not pay the hospital bill. You pay for it yourself.
Any hospitalizations which are not Medically Necessary / does not warrant Hospitalization - Code Excl 36
policy p.34 Excl 36
Seven therapies are excluded by name, including hyperbaric oxygen therapy, which hospitals routinely offer for a diabetic foot ulcer that will not heal, and chelation therapy. If you have one of these treatments, the plan does not pay for it and you pay the cost from your own pocket.
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 - Code Excl 26
policy p.34 Excl 26
Insurance may not pay for general caretaking. Staying at a facility just to rest is not covered. Hiring helpers for daily tasks like walking or dressing may also be paid from your own pocket.
Rest Cure, rehabilitation and respite care – Code Excl 05: Expenses related to any admission primarily for enforced bed rest and not for receiving treatment. This also includes: 1. Custodial care either at home or in a nursing facility for personal care such as help with activities of daily living such as bathing, dressing, moving around either by skilled nurses or assistant or nonskilled persons 2. Any services for people who are terminally ill to address physical, emotional, social and spiritual needs
policy p.32 Excl 05
One clause adds to the exclusion list by pointing to a page on the insurer's website. What is on that page is not printed in the policy you were issued, so the document in your hand is not the whole list of what will not be paid.
Other Excluded Expenses as detailed in the website www.starhealth.in – Code Excl 37
policy p.34 Excl 37
This clause excludes hearing aids, cochlear implants and the hospitalisation for fitting them, walkers, crutches, wheelchairs, CPAP and BiPAP machines, home peritoneal dialysis equipment and infusion pumps. Nothing brings those back into cover. Spectacles and contact lenses are treated differently: they are excluded only 'in excess of what is specifically provided', and what Section II.17 provides is Rs.5,000 to Rs.15,000 for each block of 3 continuous years, shared with dental treatment.
Cochlear implants and procedure related hospitalization expenses. Cost of spectacles and contact lens (in excess of what is specifically provided), hearing aids, walkers and crutches, wheel chairs, CPAP, BIPAP, Continuous Ambulatory Peritoneal Dialysis, infusion pump and such other similar aids - Code Excl 35
policy p.34 Excl 35; spectacles cover at Section II.17, policy p.16
PRP and intra-articular injections are excluded outright. These are among the most common treatments offered for knee and joint pain from the mid-forties on, so if you need one, you pay for it from your own pocket.
Autologous derived Stromal vascular fraction, Chondrocyte Implantation, Procedures using Platelet Rich plasma and Intra articular injection therapy - Code Excl 28
policy p.34 Excl 28
Medical costs for family planning are not covered. This means the policy may not pay for treatments to prevent pregnancy. It also may not pay for treatments to get pregnant.
Sterility and Infertility – Code Excl 17: Expenses related to sterility and infertility. This includes; a. Any type of contraception, sterilization b. Assisted Reproduction services including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI c. Gestational Surrogacy d. Reversal of sterilization
policy p.33 Excl 17
Written as exclusions, but the policy states a way in. The condition is the whole point.
Paid when the same drug is given as an in-patient, where it is clinically indicated and hospitalisation is warranted.
Biologic drugs for rheumatoid arthritis, psoriasis, inflammatory bowel disease and many cancers are usually given as day-care or outpatient infusions. This plan pays for them only if you are admitted as an in-patient and the admission is clinically indicated. These are among the most expensive medicines people claim for.
Biologicals, except when administered as an in-patient, when clinically indicated and hospitalization warranted - Code Excl 29
policy p.34 Excl 29
In a life-threatening situation or after an accident, expenses up to the stage of stabilisation are payable - but only up to that point, not the complete claim.
Insurance companies have a list of banned hospitals and doctors. If you go to them, your claim may be rejected. The exceptions are a life-threatening emergency or an accident - and even then the policy pays only up to the point you are stabilised.
Excluded Providers – Code Excl 11: Expenses incurred towards treatment in any hospital or by any Medical Practitioner or any other provider specifically excluded by the Insurer and disclosed in its website / notified to the policyholders are not admissible. However, in case of life threatening situations or following an accident, expenses up to the stage of stabilization are payable but not the complete claim.
policy p.33 Excl 11
Diagnostics related or incidental to the treatment you were actually admitted for stay covered.
Health insurance pays for actual medical treatments. If you stay in a hospital purely for diagnostic tests or scans, the bill may not be covered. There must be an active treatment going on.
Investigation & Evaluation – Code Excl 04: A. Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded B. Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment are excluded
policy p.32 Excl 04
Paid when a medical practitioner prescribes them as part of a hospitalisation claim or a day-care procedure.
General vitamins and supplements are not covered. You may have to pay for them yourself. Insurance may only pay if a doctor strictly prescribes them during a hospital stay.
Dietary supplements and substances that can be purchased without prescription, including but not limited to Vitamins, minerals and organic substances unless prescribed by a medical practitioner as part of hospitalization claim or day care procedure – Code Excl 14
policy p.33 Excl 14
Paid for reconstruction following an accident, burns or cancer, or where it removes a direct and immediate health risk - with the attending doctor's certificate.
Surgeries done just to look better are excluded. However, plastic surgery needed after a bad accident may be covered. Surgeries for burns or cancer reconstruction are also covered.
Cosmetic or plastic Surgery – Code Excl 08: Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an Accident, Burn(s) or Cancer or as part of medically necessary treatment to remove a direct and immediate health risk to the insured. For this to be considered a medical necessity, it must be certified by the attending Medical Practitioner.
policy p.32 Excl 08
Two doors in. As hospitalisation: paid only when BOTH are true - an accident caused it AND it needs admission. As an out-patient: Section II.17 pays Rs.5,000 / Rs.10,000 / Rs.15,000 by Sum Insured for each block of 3 continuous years, one pot shared with eye treatment. Dental implants are never payable, on either route.
Dental treatment is excluded, and then paid back through two narrow routes. As hospitalisation it is paid only when an accident caused it and it needs admission; as an out-patient, routine dentistry is paid from one pot of money shared with eye care for each block of three continuous years. Dental implants are never paid on either route.
Dental treatment or surgery unless necessitated due to accidental injuries and requiring hospitalization (Dental implants are not payable) (except to the extent covered under Section II.17) - Code Excl 32
policy p.34 Excl 32; out-patient cover at Section II.17, policy p.16
At 7.5 dioptres or worse the correction is paid.
Surgeries to remove your glasses are usually not covered. They are seen as a cosmetic choice. The policy pays only when your eyesight is very weak - 7.5 dioptres or worse.
Refractive Error – Code Excl 15: Expenses related to the treatment for correction of eye sight due to refractive error less than 7.5 dioptres.
policy p.33 Excl 15
Paid on the doctor's advice, at 18 or older, with BMI 40 or more - or 35 or more alongside obesity-related cardiomyopathy, coronary heart disease, severe sleep apnoea or uncontrolled Type 2 diabetes, after less invasive weight-loss methods have failed. This plan then pays it as a named benefit: Section II.15 Bariatric Surgery, Rs.2,50,000 or Rs.5,00,000 by Sum Insured, after a 36-month wait, cashless only.
The policy pays for weight-loss surgery only when your doctor advises it, you are 18 or older, and your BMI is 40 or more - or 35 or more together with a condition like heart disease, severe sleep apnoea or uncontrolled diabetes. Surgery to change how you look is not covered.
Obesity/ Weight Control – Code Excl 06: Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions; A. Surgery to be conducted is upon the advice of the Doctor B. The surgery/Procedure conducted should be supported by clinical protocols C. The member has to be 18 years of age or older and D. Body Mass Index (BMI); 1. greater than or equal to 40 or 2. than or equal to 35 in conjunction with any of the following severe co-morbidities following failure of less invasive methods of weight loss: a. Obesity-related cardiomyopathy b. Coronary heart disease c. Severe Sleep Apnea d. Uncontrolled Type2 Diabetes
policy pp.32–33 Excl 06; positive cover at Section II.15, policy pp.14–15
Bought back for a new born under Section II.14 - congenital disorders, internal and external, up to Rs.1,00,000 or Rs.2,00,000 by Sum Insured, while the baby is on the policy in its first year and the delivery claim was admitted.
Birth defects visible on the outside of the body are not paid for anyone on the policy. The one exception is the newborn benefit: if the baby is on the policy in its first year, it pays for external congenital disorders up to Rs.1,00,000 or Rs.2,00,000 by Sum Insured. Internal congenital defects are covered, but only after the 24-month specified-disease waiting period.
Congenital External Condition / Defects / Anomalies (except to the extent provided under Section II.14 for New Born) - Code Excl 20
policy p.33 Excl 20; Section II.14.B New Born Cover, policy p.14
Delivery IS paid under Section II.14 - Rs.15,000 to Rs.1,00,000 per delivery by Sum Insured, after 24 months with both self and spouse covered continuously, up to 2 deliveries in a lifetime, and the 24-month clock restarts after each claim. Ectopic pregnancy sits outside the exclusion entirely and is paid as ordinary hospitalisation. Lawful medical termination stays out, and a miscarriage is paid only when an accident caused it.
Standard health policies may not cover the costs of pregnancy or childbirth. Normal deliveries and C-sections are excluded. The usual exception is an ectopic pregnancy; where a policy pays maternity as a benefit, its own wording says so.
Maternity – Code Excl 18: a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean Sections incurred during hospitalization) except ectopic pregnancy and to the extent covered under Section II.14 b. Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the Policy Period
policy p.33 Excl 18; positive cover at Section II.14, policy p.14
5 just for qualifying about 3 min
Set at purchase - an early cancellation refund is net of it
At renewal only - one claim over ₹25,000 in three years removes it
Stated for the purchase - renewal is not mentioned
99.06% claims settled 14,000 cashless hospitals 2.21 solvency under a minute

10 comparisons, every clause that differs under a minute
Sources
Everything on this page is read from the insurer’s own filings. It is an educational summary - not advice, not a recommendation to buy, and we sell nothing.
Plan facts last updated 9 Sept 2026.
IRDAI UIN: SHAHLIP26044V092526
2 documents we read this from under a minute
Sum Insured, bonus and extra pools only. Room rent, co-pay and other limits are separate rules, not in these figures.
Star Health and Allied Insurance began operations in 2006 as India's first standalone health insurance company (SAHI). Headquartered in Chennai, it runs an in-house claims settlement model rather than relying on third-party administrators, and is the market leader in retail health insurance in India. It has been listed on the NSE and BSE since 2021.
99.06%
of claims settled, counted by number of claims
66.47%
share of premium paid back out as claims
2.21
capital cushion held - IRDAI floor is 1.5
14,000+
where claims can be settled without you paying first
Every insurer sits inside the same regulated safety net. You are never left with only the insurer's answer.
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