Summer Training Report

On

Star Health Family Optima Plan

Submitted in Partial Fulfillment of the requirement of

Masters of Business Administration

Under the guidance of: Submitted by:

Mr.Yashvir Singh Ankush Bathla

Manager of star health Mba 3rd sem

15101101

Haryana School of Business

Guru Jambheshwar University of Science and technology Hisar (Haryana)

(Session 2015-2017)

1
 ACKNOWLEDGEMENT

Training report is never the sole product of the person whose name appears on the
cover. Many people have lent technical assistance and service. I am graduated to Mr.
Yashvir Singh whose continuous encouragement and willing cooperation have been a
great help in the preparation of this training report.

I wish to express my gratitude to Mr. Yashvir Singh our project guides that
helped me in providing many books.

I express my deep sense of gratitude to Mr. Nitin Srivastav for her valuable
suggestion and up to date guidance at many stages of report which has
enabled me to complete the project on schedule.

Last but not the least I thank all who are responsible for the success of this
training report

Ankush

2
 DECLARATION

I Ankush Bathla student of GURU JAMBHESHWAR UNIVERSITY OF SCIENCE &

TECHNOLOGY, HISAR have undertaken this report in my training under the title

“STAR HEALTH FAMILY OPTIMA PLAN” at STAR HEALTH INSURANCE

COMPANY HISSAR

All the information in this reports is my own and original and not copied from anywhere
else.

I also declare that I have done my work sincerely and accurately even then if any
mistake or error had kept in it, I request the readers to point out these errors and guide
me to remove these errors in future.

3
 PREFACE

Summer training is a part of our studies. All students have to go for

summer training in an industrial or commercial organization. Their
main objective is to arrange an exposure to actual functioning of the
real atmosphere surrounding the organization. There are so many
aspects which are more complex in practical and their treatment is
possible only through bookish knowledge. I did my summer training in
STAR HEALTH INSUARNCE

Practical work experience is the integral part of individual learning. An

individual who is learning managerial concepts has to undergo this
practical experience for being a future executive.

STAR HEALTH INSURANCE is the market leader in health insurance

company offer project on Star Health Family Optima Plan to
understand the management work through data provided by them.

The training report is the presentation of our observation at insurance

sector

Ankush Bathla

4
 CONTENTS

Topic Page no.

1. Introduction to insurance 6-30

2. Company profile 30-32

3. About the product 33

4. SWOT analysis 35-36

5. Introduction to subject 44

6. Objective of study 44

7. Policy documents 47

8. Research methodology 48

9. Questionnaire 49

10. Conclusions 51

11. Bibliography 52

5
INTRODUCTION OF INSURANCE:

What is Insurance ?

Insurance is a mechanism that ensures an individual to thrive on adverse

consequences by compensating the individual, his/her loss financially. Every individual
in the world and all activities connected with him/her, be it life, profession, business,
travel or any other pursuits are subject to unforeseen and uncalled for hazards or
dangers. The benefit that an individual enjoys in his life by owning a car or a house or a
factory can be snatched by sudden accident which can render even the individual
immobile, and his family vulnerable. At this critical juncture, only insurance helps him
not only to survive but recover his loss and continue his life in a normal manner, which
would otherwise be unthinkable.

The concept of insurance is quite simple. People, who are in similar trade and are
exposed to the same risks, congregate and some to an agreement that if any individual
member suffers a loss, then the loss will be shared by others and minimized in order to
enable the individual member recover from the loss and cover his ground. Similarly the
different kinds of risks can be identified and separate groups can be formed to counter
such risks and reduce the impact to a manageable proportion, in which the share could
be collected from the members either after the loss or in advance, at the time of
admission to the group. This is an exemplary sign of humanity and insurance therefore
serves the mankind to a great extent; a point most of the individuals tend to overlook,
since monetary aspect is involved. Now such is for tangible assets.

The concept of insurance has been extended beyond the coverage of tangible assets.
Exporters run the risk of importers in other country defaulting as well as losses due to
sudden fluctuations in the currency exchange rates, economic policies turmoil. These
risk are now insured. Doctors run the risk of being charged with negligence and can
subsequently liable for damages. The amount in questions can be fairly large, beyond
the capacity of individuals to bear. These are insured. Thus insurance is extended to

6
intangible assets. In some countries even the voice of a singer, legs of a footballer can
be insured, even though the advantage of spread may not be available in these cases.
Satisfaction of economic needs requires generation of income from some source. If
the property, which is the source of such income, were lost fully or partially,

7
 Permanently or temporarily, the income too would stop. The purpose of insurance is a
safeguard against such misfortunes few, through the help of the fortune many, who
were

exposed to the same risk, but saved from the misfortune. Thus the essence of
insurance is to share losses and substitute certainty by uncertainty.

The different types of human activities that come under the umbrella of insurance are
as follows.

• House/Office/factory or any moveable - Fire Insurance

Assets destroyed in life.

• Shipment or transportation of goods - Marine Insurance

by ship, destroyed in catastrophe.

• Jewellery/Cash/Household goods - Burglar Insurance

Stolen or robbed.

• Goods in transit by roads or railways - Carrier Insurance

Destroyed.

• Theft or accident of vehicles - Vehicle Insurance

• Financial cover in ailment/surgery etc. – Health Insurance

8
 All these are non-life insurance. In conclusion one can safely say that the purpose of
insurance be it life or non-life is to transfer the financial loss to the insurance company
who spreads in over to the policyholders.

9
Characteristics of Insurance

 It is a contract for compensating losses.


 Premium is charged for Insurance Contract.

 The payment of Insured as per terms of agreement in the event of loss. 

 It is a contract of good faith.

 It is a contract for mutual benefit.

 It is a future contract for compensating losses.

 It is an instrument of distributing the loss of few among many. 

 The occurrence of the loss must be accidental.

 Insurance must be consistent with public policy.

Nature of Insurance

 Sharing of Risks

 C0-operative Device

 Valuation of Risk

 Payment made on contingency

 Amount of Payment

 Large Number of Insured Persons 

 Insurance is not gambling

 Insurance is not charity

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SCOPE OR KINDS OF INSURANCE

Broadly, insurance may be classified into the following categories:

i. Classification on the basis of nature of insurance.

ii. Classification from business point of view.

iii. Classification from risk point of view.

I. ON THE BASIS OF NATURE OF BUSINESS

On the basis of nature of business, insurance may be the following types:

1. Life insurance

2. Fire insurance

3. Marine insurance

4. Social insurance,

5. Miscellaneous insurance.

LIFE INSURANCE

Life insurance may be defined as a contract in which the insurer, in

consideration of a certain premium, either in a lump sum or by other
periodical payments, agrees to pay to the assured, or to the person for

11
whosen benefit the policy is taken , the assured sum of money, on the
happening of a specified event contingent on the human life.
A contract of life insurance, as in other forms of insurance, requires
that the assured must have at the time of the contract an insurable
interest in his life
Upon which the insurance is affected. In a contract of life insurance, unlike
other Insurance, interest has only to be proved at the date of the
contract, and not Necessarily present at the time when the policy falls
due.
A person can assure in his own life and every part of it, and can
insure for any sum whatsoever, as he likes. Similarly, a wife has an
insurable interest in her husband and vice-versa. However, mere natural
love and affection is not sufficient to constitute an insurable interest. It
must be shown that the person Affectining an assurance on the life of
another is so related to that other person as to have a claim
for support. For example, a sister has an insurable interest in the life of a
brother who supports her.
A person not related to the other can have insurable
interest on that other person. For example creditor has insurable
interest in the life of his debtor to the extent of the debt. A creditor
can insure the life of his debtor up to the amount of the debt, at the
time of issue of the policy. An employee has an insurable interest in
the life of the employer arising out of contractual obligation to
employ him for a Stipulated period at fixed salary. Similarly, from an
employer to the employee who is bound by the contract to serve for a
certain period of time.

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FIRE INSURANCE

Fire insurance is a contract under which the insurer in return for a consideration
(premium) agrees to indemnify the insured for the financial loss which the latter may
suffer due to destruction of or damage to property or goods, caused by fire, during a
specified period. The contract specifies the maximum amount , agreed to by the parties
at the time of the contract, which the insured can claim in case of loss. This amount is
not , however , the measure of the loss. The loss can be ascertained only after the fire
has occurred. The insurer is liable to make good the actual amount of loss not
exceeding the maximum amount fixed under the policy.

A fire insurance policy cannot be assigned without the permission of the insurer
because the insured must have insurable interest in the property at the time of contract
as well as at the time of loss. The insurable interest in goods may arise out on account
of
(i) ownership, (ii) possession, or (iii) contract.
A person with a limited interest in a property or goods may insure them to cover not
only his own interest but also the interest of others in them.

Under fire insurance, the following persons have insurable interest in the subject
matter:-

 Owner
 Mortgagee
 Pawnee
 Pawn broker
 Official receiver or assignee in insolvency proceedings

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MARINE INSURANCE

A contract of marine insurance is an agreement whereby the insurer undertakes to

indemnity the assured in a manner and to the extent thereby agreed, against marine

Losses incidental to marine adventure perils of the seas, such as fire, war perils,
pirates, rovers, thieves, captures, Jettisons, barratry and any other perils which are
either of the like, kind or may be designed by the policy.

SOCIAL INSURANCE

Social insurance has been developed to provide economic security to weaker

sections of the society who are unable to pay the premium for adequate insurance.
Pension plans, disability benefits, unemployment benefits, sickness insurance,
etc.are the various forms of social insurance.

MISCELLANEOUS INSURANCE

The process of fast development in the society gave rise to a number of risks or
hazards. To provide security against such hazards, many other types of insurance
also have been developed. The important among them are:

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a. Vehicle insurance on buses, trucks, motorcycles, etc.,

b. Personal accident insurance (by paying an annual premium of Rs. 12/-policy

worth Rs. 12000/- can be insured.)

c. Burglary insurance-(against theft, dacoits etc.)

d. cattle insurance: : Crop insurance may be purchased by farmers to reduce or

manage various risks associated with growing crops

e. legality insurance

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II. Classification from business point of view

From business point insurance can be classified into two broad categories:

1. Life insurance; and

2 General Insurance

GENERAL INSURANCE

General insurance business refers to fire, marine , and miscellaneous insurance

business whether carried on singly or in combination with one or more of them but
does not include capital redemption business and annuity certain business.

III. Classification from risk point of view

From risk point of view, insurance can be classified into four categories:

1. Personal insurance

2. Property insurance

3. Liability insurance

4. Fidelity guarantee insurance

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FIDELITY GUARANTEE INSURANCE

In this type of the insurer undertakes to indemnify the assured (employer)

in consideration premium, for losses arising out of fraud,or embezzlement

Insurance Sector Reforms:

In 1993, Malhotra Committee headed by former Finance Secretary and RBI

Governor R. N. Malhotra was formed to evaluate the Indian insurance industry and
recommend its future direction.

The Malhotra committee was set up with the objective of completing the reforms
initiated in the financial sector.

The reforms were aimed at “creating a more efficient and competitive financial
system suitable for the requirements of the economy keeping in mind the structural
changes currently underway and recognizing that insurance is an important part of
the overall financial system where it was necessary to address the need for the
similar reforms….”

In 1994, the committee submitted the report and some of the key recommendations
Included:

i) Structure:

• Government stake in the insurance Companies to be brought down to 50%

• Government should take over the holdings of GIC and its subsidiaries so that
these subsidiaries can act as independent corporations.

• All these insurance companies should be given greater freedom to operate.

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ii) Competition

Private Companies with a minimum paid up capital of Rs. 1bn should be allowed to
enter the industry.

• No company should deal in both Life and General Insurance through a single
entity.

• Foreign companies should be allowed to enter the industry with the collaboration
with the domestic companies.

• Postal Life Insurance should be allowed to operate in the rural market.

• Only one State Level Life Insurance Company should be allowed to operate in
each state

iii) Regulatory Body

• The Insurance Act should be changed.

• An Insurance Regulatory body should be set up.

• Controller of Insurance (Currently a part from the Finance Ministry) should be

made independent.

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iv) Investments

• Mandatory Investments of LIC Life Fund in government securities to be reduced

from 75% to 50%.

• GIC and its subsidiaries are not to hold more than 5% in any company.

(There current holdings to be brought down to this level over a period of time)

v) Customer Service

• LIC should pay interest on delays in payments beyond 30 days.

• Insurance companies must be encouraged to set up unit linked pension plans.

• Computerization of operations and updating of technology to be carried out in the

insurance industry.

The committee emphasized that in order to improve the customer services and
increase the coverage of the insurance industry should be opened up to competition.
But at the same time, the committee felt the need to exercise caution as any failure
on the part of new players could ruin the public confidence in the industry.

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Hence, it was decided to allow competition in a limited way by
stipulating the minimum capital requirement of Rs. 100 crores. The
committee felt the need to provide greater autonomy to insurance
companies in order to improve their performance and enable them act
as independent companies with economic motives. For this purpose, it
had proposed setting up an independent regulatory body.

The Insurance Regulatory and Development Authority:

Reforms in the Insurance sector were initiated with the passage of the
IRDA Bill in Parliament in December 1999. The IRDA since its
incorporation as a statutory body in April 2000 has fastidiously stuck to
its schedule of framing regulations and registering the private sector
insurance companies.

The other decisions taken simultaneously to provide the supporting

systems to the insurance sector and in particular the life insurance
companies were the launch of the IRDA’s online service for issue and
renewal of licenses to agents. The approval of institutions for imparting
training to agents has also ensured that the insurance companies
would have a trained workforce of insurance agents in place to sell
their products, which are expected to be introduced by early next year.
Since being set up as an independent statutory body the IRDA has put
in a framework of globally compatible regulations. In the private sector
12 life Insurance and 6 general insurance companies have been
registered.

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Restructuring of GIC

The GIC was converted into a national re-insurer and its four
subsidiaries were restructured as independent companies. In
December, 2000 the Parliament passed a bill de-linking the four
subsidiaries from GIC in July, 2002. These are
National insurance co.ltd

the oriental insurance co.ltd

The new India assurance co

United India Insurance Co. Ltd.

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 Life insurance industry today

There are 24 insurance companies registered as “Life Insurance”

companies. The list is given below.

Non-Life insurance industry today

There are 28 insurance companies registered as “General Insurance”

companies.

There are 5 standalone Health Insurance companies.

Rest of the companies handle all types of general insurance business.

List of life insurance companies:

1. AegonReligare Life Insurance 13. IDBI Federal Life Insurance

2. Aviva Life Insurance 14. India First Life Insurance
3. Bajaj Allianz Life Insurance 15. Kotak Mahindra Old Mutual Life

4. Bharti AXA Life Insurance Insurance

5. Birla Sun Life Insurance 16. Life Insurance Corporation

6. Canara HSBC OBC Life Insurance17. Max Life Insurance

7. DHFL Pramerica Life Insurance 18. PNB Metlife
8. Edelweiss Life Insurance 19. Reliance Life Insurance

9. Exide Life Insurance 20. Sahara India Life Insurance

10. Future Generali Life Insurance 21. SBI Life Insurance

11. HDFC Standard Life Insurance 22. Sriram Life Insurance
12. ICICI Prudential Life Insurance 23. Star Union Dai-Ichi Life Insurance

24. Tata AIA Life Insurance

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 List of standalone health insurance companies:

1. Apollo Munich Health Insurance

2. Cigna TTK Health Insurance

3. Max Bupa Health Insurance

4. Religare Health Insurance

5. Star Health Insurance

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What is Healthcare

You have heard of the saying “Health is Wealth”. The word ‘Health’
was derived from the word ‘hoelth’, which means ‘soundness of the
body’.

Over a period of time, modern medicine has evolved into a complex

science and the goal of modern medicine is no longer mere treatment
of sickness but includes prevention of disease and promotion of quality
of life. A widely accepted definition of health is the one given by World
Health Organization in 1948.
Definition

World Health Organization (WHO): Health is a state of complete

physical, mental and social wellbeing and not merely the absence of
disease.

Determinants of health

It is generally believed that the following factors determine the health of

any individual:

a) Lifestyle factors

Lifestyle factors are those which are mostly in the control of the
individual concerned e.g. exercising and eating within limits,
avoiding worry and the like leading to good health; and bad
lifestyles and habits such as smoking, drug abuse, unprotected sex
and sedentary life style (with no exercise) etc. leading to diseases
b) Environmental factors

Safe drinking water, sanitation and nutrition are crucial to health,

lack of which leads to serious health issues as seen all over the
world, especially in developing countries.e.g. People working in
certain manufacturing industries are prone to diseases related to
occupational hazards such as Asbestos in workers in asbestos
manufacture and also diseases of the lungs in coal miners.

c) Genetic factors

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 Diseases may be passed on from parents to children through
genes. Such genetic factors result in differing health trends
amongst the population spread across the globe based on race,
geographical location and even communities.

It is quite obvious that a country’s social and economic progress

depends on the health of its people. A healthy population not only
provides productive workforce for economic activity but also frees
precious resources which is all the more crucial for a developing
country like India. At an individual level, ill health can cause loss of
livelihood, inability to perform daily essential activities and push people
to poverty and even commit suicide.

Thus ‘spend’ on healthcare usually forms a significant part of every

country’s GDP

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Factors affecting the health systems
in India

The Indian health system has had and continues to face many
problems and challenges. These, in turn, affect the nature and extent
of the healthcare system and the requirement at the individual level
and healthcare organization at the structural level. These are
discussed below:

Demographic or Population related trends

India is second largest populated country in the world.

This exposes us to the problems associated with population

growth.

The level of poverty has also had its effect on the people’s
ability to pay for medical care.

Social trends

Increase in urbanization or people moving from rural to urban

areas has posed challenges in providing healthcare.

Health issues in rural areas also remain, mainly due to lack of

availability and accessibility to medical facilities as well as
affordability.

The move to a more sedentary lifestyle with reduced need to

exercise oneself has led to newer types of diseases like
diabetes and high blood pressure.

Life expectancy

Life expectancy refers to the expected number of years that a

child born today will survive.

Life expectancy has increased from 30 years at the time of

independence to over 60 years today but does not address the
issues related to quality of that longer lifespan.

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Evolution of Health Insurance in India

While the government had been busy with its policy decisions on
healthcare, it also put in place health insurance schemes.
Insurance companies came with their health insurance policies
only later. Here is how health insurance developed in India:

a) Employees’ State Insurance Scheme

Health Insurance in India formally began with the beginning of the

Employees’ State Insurance Scheme, introduced vide the ESI Act,
1948, shortly after the country’s independence in 1947. This
scheme was introduced for blue-collar workers employed in the
formal private sector and provides comprehensive health services
through a network of its own dispensaries and hospitals.
All workers earning wages up to Rs. 15,000 are covered under the
contributory scheme wherein employee and employer contribute
1.75% and 4.75% of pay roll respectively; state governments
contribute 12.5% of the medical expenses.

The benefits covered include:

Free comprehensive healthcare at ESIS facilities

Maternity benefit

Disability benefit

Cash compensation for loss of wages due to sickness and

survivorship and

Funeral expenses in case of death of worker

It is also supplemented by services purchased from authorized

medical attendants and private hospitals. The ESIS covers over
65.5 million Beneficiaries as of March 2012.

b) Central Government Health Scheme

27
The ESIS was soon followed by the Central Government Health
Scheme (CGHS), which was introduced in 1954 for the central
government employees including pensioners and their family
members working in civilian jobs. It aims to provide
Comprehensive medical care to employees and their families and is
partly funded by the employees and largely by the employer
(central government).
The contribution from employees is quite nominal though
progressively linked to salary scale – Rs.15 per month to Rs.150
per month.
In 2010, CGHS had a membership base of over 800,000 families
representing over 3 million beneficiaries.

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c) Commercial health insurance

Commercial health insurance was offered by some of the non-life

insurers before as well as after nationalization of insurance
industry. But, as it was mostly loss making for the insurers, in the
beginning, it was largely available for corporate clients only and that
too for a limited extent.

In 1986, the first standardized health insurance product for

individuals and their families was launched in the Indian market by
all the four nationalized non-life insurance companies
Today, more than 300 health insurance products are available in
the Indian market.

The health insurance market today consists of a number of players

some providing the health care facilities called providers, others the
insurance services and also various intermediaries

29
 COMPANY PROFILE

Industry Health Insurance

Founded 2006

Headquarters Chennai, Tamil Nadu, India

Products Health Insurance Accident Care Insurance Travel Insurance

Website www.starhealth.in

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OVERVIEW
Star Health and Allied Insurance Co Ltd commenced its operations in 2006
with the business interests in Health Insurance, Overseas Mediclaim Policy
and Personal Accident. With no other insurance category to focus and
divide our attention, we use our resources to focus on service excellence,
design products and use core competency of innovation to deliver the best
to our customers.

At Star Health Insurance, the company offers a wide range of health

insurance products at affordable prices to make health insurance every
human being’s right. As a company, single-mindedly dedicated to health
insurance.

CAPITAL
We have built a promising path for our future with a capital base of Rs.733
crores. We have emerged as India’s first stand-alone Health Insurance
Company, dealing in personal accident, medi-claim and overseas travel
insurance.
Under a decade, we have progressed by leaps and bounds. With a nation-
wide customer base to boast off, we have raised the benchmark of the
health insurance sector.
Tata Capital invested in the company in 2013, thus increasing the
company total capital to Rs5.49 billion

31
VISION:
To Become The Largest And Most Preferred Health Insurance
Company In India.
To Provide Financial Security for Health Care Management

MISSION:
To Offer Wide Range of Innovative Products / Services.
To Provide Prompt, Courteous And Quality Service To Customers.
To Leverage State Of Art Technology For Customer Satisfaction.
To Adopt Best Management Practices In Business Operations.

32
 PRODUCTS

Health insurance

a. Individual health plan

b. Family health plan

c. Senior citizen plan

Travel insurance

Accidental insurance plan

33
 FEATURES

 India’s First Stand-Alone Health Insurance Company

 Pan India Presence With More Than 290 Branch Offices
 Cashless Hospitalization And Reimbursement Facility In With More Than
7000 Hospitals Across India
 24*7 hours call centre facility
 Hassle-Free And Customer-Friendly Direct Claim Settlement Without
Intervention Of TPA
 Health Insurance Company Of The Year 2015 - Indian Insurance Awards
2015
 Personalized Doctor Visit For All Customers Getting Hospitalized

34
 SWOT ANALYSIS

[1] STRENGTHS: 1.

Earlier entry:

Star health commences it business in 2006 as very much early as earlier as

compared to 4 other health companies.

2. Business Growth:

They growth is very much higher as compared to other co. 3.

Emerging Middle Income Group-

India’s middle income group is rapidly increasing and would be

emerging as a profitable market.

4.Huge population [2]

WEAKNESS: 1. Low

investment-

Its capital investment capital base of Rs.733 crores.Which is low?

2. Lack of awareness:

There is a lack of awareness about health insurance among people

.3. Increasing competition:

There is rising competition in health insurance market from other co. such as
Hdfchealth, maxbupa etc.
[3] OPPORTUNITIES:

1. Creation of stronger demand-

India’s improving economic fundamentals will support faster growth

in per capita income in the coming years, which will translate into stronger demand for
insurance products.

35
2. Strong future growth:

Strong growth can be sustained for 10-20 years,. There is plenty of room for growth in
personal accident, health and other liability classes.

3. Rise in Income and Awareness:

Rising household income and risk awareness will be the rise in more demand for these
lines of health business in the future.

[4]THREATS:

1. New Arrival:

There is danger of coming new arrival into market in health sector

2. Govt. policies:

There is chance of opposing rules and regulations by govt.

36
 HEALTH INSURANCE PLAN

Family Health Optima Insurance Plan

Features:
1. Over 400 Day Care procedures

2. Expenses incurred towards cost of Health Check up after 3 years worth Rs-5,000/-

3. Coverage for New born Baby after 16 days

4. Coverage for Domiciliary hospitalization treatments

5. Get auto recharge at no extra cost,upto 30% of sum insured.

6. Donor expenses for organ transplantation

37
A policy to cover the entire family

Entry Age 16 days to 65 years; only renewals allowed after 65 years.

Sum assured Rs.1 lakh to Rs.15 lakhs

Rs.3,890 to Rs.34,700;Depends on sum assured, age, family

Premiums charged
size and zone; based on age of oldest insured member

Bonus 15% to 35% depending on the sum assured

Reinstatement of
100% for coverage of Rs.3 lakhs and above
sum assured

Co-payment 20% of all claims for insured members of ages 61 to 65 years

Cataract surgery, Ambulance charges, Pre-Existing diseases,

Covers
Pre and Post-hospitalization expenses, Day-care expenses

38
Senior Citizens Red Carpet Health Insurance Policy :

Parents have spent their life trying to make our life secure. It’s time you do the same
for them in their old age. Senior Citizen Red Carpet Policy will help parents live worry
free and experience absolute security.
Features:

 For Senior citizens aged between 60 to 75 years.

 No pre-insurance medical test required. Covers pre-existing diseases from

the second year onwards

 Medical Consultations as an Out Patient in a Network Hospital Higher Sum

Insured coverage upto Rs.10Lakhs

 Guaranteed lifetime renewals

Co-Payment:
50% of each and every claim relating to pre-existing diseases and 30% of each and
every claim for all other claims

Pre-Existing Diseases/Illness:
Covered after 12 months of continuous coverage

Pre-Acceptance medical screening:

There is no pre-acceptance medical screening.

Tax Benefits:
Amount paid by any mode other than by cash for this insurance is eligible for relief
under Section 80D of the Income Tax Act.

FreeLook Period:
A free look period of 15 days from the date of receipt of the policy is available for
reviewing the policy terms and conditions.

39
 Star Health Travel Insurance

Travelling is no more a rare, complicated .this is due to huge leaps in technology,

transportation and communication. Everyday there are people travelling across
borders and seas with the risks associated with travelling. Insurance companies
provide travelers with travel insurance that protect them from unanticipated events
like accidents, medical emergencies and even contingencies such as flight delays,
baggage delay and lost passport..

Types of Star Health Travel Insurance Policy :

Star Health Insurance recognizes the fact that their customers are looking for
different requirements .They offer different plans, each specially to suit these
requirements.
1. Star Travel Protect Insurance
2. Star Student Travel Protect Insurance
3. star health corporate travel health policy

1. Star Travel Protect Insurance Policy:

Health related emergencies while travelling will be covered by this policy.
Everything from flight delays, missed flights, emergency expenses, repatriation,
compensation for accidental injuries etc. will be covered with this policy

Eligibility :
This policy can be purchased for anyone above the age of 6
months. Only Indian citizens can get this cover.

Benefits:
Policyholders who are travelling outside India on vacation or business can make
use of this policy. General cover also includes possibilities like hijack distress,
medical emergencies, flight delay, repatriation etc.

40
 It even covers third party bodily injury and property loss. Monetary loss because
of trip cancellation due to the death/injury of a family member will be reimbursed
by the company.

2. Star Student Travel Protect Insurance Policy :

If you are planning for education abroad, there are certain risks that you may face
such as medical emergencies, bereavement, litigation related risks and others.
Star Student Travel Protect Insurance Policy offers coverage for all these and
much more.
Benefits:
Reimbursed for tickets to fly home in the event of an emergency

As compassionate benefits, visit of an immediate family member and

reimbursement of academic tuition fee in case of sponsor’s death is offered with
this student travel insurance scheme.

The costs related to legal claims including that for bail bond (for false arrest or
detention) will be covered.

If the insured has caused bodily injury to third party or damage to third party
property, the costs will be covered.

3. Star Corporate Travel Protect Insurance Policy :

Travelling across the globe for business is the norm now days, and there are
many risks associated with it. Everything from delayed baggage, accidental
injuries, missed flights travel-related risks are covered in this policy.

Available for a sum insured limit of USD 1,00,000, USD 2,50,000 and USD
5,00,000, this corporate insurance plan is available for travel to countries across
the world including Canada and USA.

Eligibility:
An insured person, his/her spouse and up to two dependent children below
18 years can be covered. They must all be Indian citizens.

The following exigency will be covered in this policy:

 Emergency medical expenses

 Hijack distress
 Compensation following accidental injuries
 Repatriation of mortal remains
 Repatriation in case of medical emergency Missed departure/connection
 Loss of your checked in baggage(up to the limits)
 Reasonable expenses incurred for obtaining new passport
 Flight delay
 paid for the amount you lost due to cancellation of your trip because of death
of a family member.
 Legal Liability charges; bodily injury or property damage to third party.

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Star Health Travel Insurance Claim Process:
o call the toll-free number to contact Star Health Insurance claims
assistance and register your claim.
o You will be asked to fill out a claims form and send it either by fax or
mail,
o must keep the following ready before making a claim: copy of passport
with immigration stamp, policy copy, original bills/invoices/receipts,
copy of police complaint
o Approval and reference number of assistance company, proof of
expenses and a copy of your e-ticket.
o Once the surveyor has assessed your case and documents, your claim
will be processed.

Star health Accidental Care Insurance:

Features:
o Cover for Accident death, Permanent Disability and temporary
Disablement. Compensation for Permanent Total Disablement is 150%
of the sum insured. Enhanced weekly compensation up to Rs.15000/-
per week (maximum 100
o weeks).
o Educational Grant for dependent children
o Cumulative bonus 5% per annum maximum 50%

Benefits:
Additional free benefits

Medical Expenses Extension

Coverage for Winter Sports

Policy Benefits:

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Table A – covers Accidental Death

Table B – covers Accidental Death and Permanent Disablement

Table C – covers Accidental Death, Permanent Disablement and Temporary Total

Disablement (Weekly Compensation)

Additional Free Benefits:

o Educational Grant: Maximum of Rs.10,000/- per child upto 2 children in

case of Death/Permanent Total Disability of the insured person
o Ambulance Charges / Transportation Expenses of Mortal Remains:
The limit of Company’s liability is Rs.5,000/- only during the policy
period.
o Travel Expenses for One Relative (Applicable for Death claims only):
1% of
o Total Sum Insured upto Rs.50,000/- subject to actual for the transport
expenses to one relative of the insured person.
o .
o Purchase of Blood: Upto 5% of the Total sum insured subject to a
maximum of Rs.10,000/- towards the expenses incurred in purchasing
blood through a Hospital or Government approved blood bank.
o Transportation of Imported Medicines: Upto 5% of Total sum insured
subject to a maximum of Rs.20,000/- towards the expenses incurred on
freight charges for importing medicines.
o The above mentioned amounts are payable in addition to the sum
insured.

Eligibility:

o Any person between 18 and 70 years of age at the time of entry can
take this insurance. Lifelong renewal.
o Dependent children covered from 5 months
o Policy benefits are applicable individually for each person covered
under family.

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 INTRODUCTION TO TOPIC

STAR Health Family Optima plan :

STAR health insurance given you an option to choose your family health
plan. Premium and policy according to your budget and requirements

OBJECTIVE OF THE STUDY

To know about market share of star health in Indian health insurance sector?
To understand about the company policy
How to calculate premium?

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 STAR FAMILY HEALTH OPTIMA INSURANCE PLAN

Features:

 Over 400 Day Care procedures

 Expenses incurred towards cost of Health Check up after 3 years worth Rs-
5,000/-

 Coverage for New born Baby after 16 days

 Coverage for Domiciliary hospitalization treatments

 Get auto recharge at no extra cost, up to 30% of sum insured.

 Donor expenses for organ transplantation

Bonus:
Bonus in respect of a claim-free year of insurance is allowable upto the limits
specified. The bonus so granted will be reduced in the same order in which it was
given following a claim. However the Basic sum insured shall not be reduced.

Automatic Restoration of Sum Insured:

Immediately upon exhaustion of the limit of coverage during the policy period, there
shall be an automatic restoration of the basic sum insured by 100% where the sum
insured is Rs.3,00,000/- and above.

Basic Sum Insured (Rs) % of Restoration on the Basic Sum Insured

Up to 200,000 Nil
300,000 and above 100%

This benefit provides additional indemnity upto specified limits, when the sum
insured under the policy is exhausted / exceeded. This can be utilized for any claim
payable under the policy.

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Policy Benefits :

 Hospitalization Cover Protects the insured for in - patient hospitalization

expenses for a minimum of 24 hrs.These expenses include room rent,
nursing and boarding charges.
 Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees,
Anesthesia, Blood, Oxygen, and Operation Theatre charges, Cost of
Pacemaker, Cost of Medicine and drugs etc.
 Ambulance charges for emergency transportation upto a sum of Rs.750/-
per hospitalization and overall limit of Rs.1500/- per policy period.
 Pre Hospitalization expenses up to 60 days prior to admission in the
hospital. Post Hospitalization expenses upto 90 days after discharge
from the hospital.

Eligibility:
 Any person aged between 18 years and 65 years
 Beyond 65 years. It can be renewed for life time.
 Lifelong renewal. This policy is on floater basis.
 Family: Proposer, spouse, dependent children from 16 days up to 25 years
 Child from 16th day of age can be covered as part of family

Co-Payment:

A co-payment of 20% of each and every claim applicable for fresh as well as renewal
policies for insured persons whose age at the time of entry is above 60 years.

Pre-Existing Diseases/Illness:
Coverage available after 48 months of continuous insurance without break with any
Indian insurance company.

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Pre-Acceptance medical screening:

Persons above 50 years will be required to undergo pre-acceptance medical

screening at the Company nominated centers, cost of which is currently borne by the
company.

Tax Benefits:

Amount paid by any mode other than by cash for this insurance is eligible for relief
under Section 80D of the Income Tax Act.

Free Look Period :

A free look period of 15 days from the date of receipt of the policy is available for
reviewing the policy terms and conditions. In case insured is not satisfied he can
seek cancellation of the policy and in such event the Company will allow refund of
premium after adjusting the cost of pre-acceptance of medical screening , stamp
duty charges and proportionate risk premium for the period concerned provided no
claim has been made until such cancellation

ADVANTAGE:

No Third Party Administrator, direct in-house claim settlement.

Faster claim settlement.
Network of more than 7000 hospitals across India.
Facility for maintaining personal health records in electronic format.

DOCUMENTATION REQUIRED FOR POLICY:

 One id proof of head of family
 DOB of all members covered
 One photo of all members covered
 Height and weight of all members being covered under policy

PREMIUM CALCULATION

Premium is calculated by agent on the basis of premium chart depending upon on

the age of person of elder member of family & no of person assured.

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 RESEARCH METHODOLOGY

DATA COLLECTION:

Primary: Through structured Questionnaire

Secondary: Through Internet, Journals, Newspapers, Company website, brochure &

Misc. sources.

Procedure: Survey method

RESEARCH INSTRUMENT: Structured Questionnaire.

SAMPLING PLAN

Sample Design: Convenience

sampling Sample size: 100

Sample Area: Study was conducted at Anaj Mandi Bhuna

Sample unit: Data was gathered from student, government job & private person

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 QUESTIONAIRE DESIGN
QUESTIONNAIRE ANALYSIS

Respondents =100

Respondents Responded =100

Response Rate =100%

Respondents are taken from student, private , government and business

sectors.

(1)Have you got a health insurance plan for you and your family?

(A) yes (b) no

Yes No Total
4 96 100

(2)If yes, whether your co. provides cashless treatment?

(A) yes (b) no

Yes No Total
2 98 100

(3)Do you think health insurance is important in today world?

(a) yes (b) no

Yes No Total
50 50 100

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(4)If yes, what according to you should be minimum sum insured?

(A)3 lacs (b) 5lacs (c) 10lacs (d) 15 lacs

3lacs 5lacs 10lacs 15lacs Total

20 60 5 5 100

Name……………………………Age..............................................

Family members................................Occupation.........................................

Mobile no.......................................................

Address..........................................................................

FINDINGS

1. People are unaware about health insurance product

2. Most of people know about only life insurance companies .e.g. LIC
3. They consider the fact health insurance is important in today world

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 CONCLUSION

 There are 5health insurance companies in India and the market

share of the STAR HEALTH INSUARANCE is 1.89% in insurance
sector & growth rate is 33.6% in July 2016 as compared to July
2015.
 The policy of the company is designed according to the budget
and requirements of the customer.

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 BIBLIOGRAPHY
WEBSITES:

www.google.com

www.starhealth.in

www.wikipedia.org

NEWSPAPERS:

Times of india

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