STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

Regd. & Corporate Office: 1, New Tank Street, Valluvar Kottam High Road, Nungambakkam,
Chennai - 600 034. « Phone : 044 - 28288800 « Email : [email protected]
Website : www.starhealth.in « CIN : L66010TN2005PLC056649 « IRDAI Regn. No. : 129

PROSPECTUS - DIABETES SAFE INSURANCE POLICY

Unique Identification No.: SHAHLIP23081V082223

This policy is for persons who are diabetic both Type 1 and Type 2. The policy provides for payment of hospitalization expenses arising out of any complications of diabetes. This policy also
covers regular hospitalization expenses for other illness / disease / accidental injuries.
v Who can take this insurance?
— Any person between 18 years and 65 years of age who is already suffering from Diabetes Mellitus can take this insurance
— This limit of 65 years is for entry level only into this scheme. Beyond 65 years only renewals accepted. There is no capping on exit age
— The policy is available on Individual Basis as well as on Floater Basis
— Floater policy can be taken only for a family of 2 provided either of the person is a diabetic. Family for the purpose of this policy would mean Self and Spouse only.
v What are the sum insured options available?
The insurance is available for sum insured of Rs.3,00,000/-, Rs.4,00,000/-, Rs.5,00,000/- and Rs.10,00,000/-
v What is the Policy Term?
The policy is available for 1 year / 2 years / 3 years .For policies more than one year, the Basic Sum Insured is for each year, without any carry over benefit thereof
v Is Instalment Facility available?
Yes, Premium can be paid Half-yearly
Premium can also be paid Annual, Biennial (Once in 2 years) and Triennial (Once in 3 years)
Note: If Instalment Facility is opted for 2 year and 3 year term policies, the full premium applicable for 2 year or 3 year terms should be paid half yearly within the expiry of the first year.
v Is there any Pre-Acceptance Medical screening?
There are 2 plans available under this policy:-
— Plan A: Pre-acceptance medical examination is required for all persons opting for this plan.
— Plan B: No pre acceptance medical examination.
Change of Plan: Once a plan has been opted, the plan cannot be changed either during the currency of the policy or on renewal.
v What are the special features of this policy?
— Automatic Restoration There shall be automatic restoration of basic sum insured by 100% immediately upon exhaustion of the basic sum insured once during the policy period.
— Such restored Sum Insured can be utilized only for illness /disease/treatment unrelated to the illness /diseases/treatment for which claim/s was /were made.
— This Automatic Restoration benefit is not available if the policy is on floater basis.
— This Automatic Restoration benefit is applicable for Section 2 only.
v What are the benefits available under the insurance?
Benefits under both plans
Section 1: Hospitalization expenses under the following heads as a result of complications of Diabetes
a. Room (Single standard A/C room), Boarding and Nursing Expenses as provided by the Hospital / Nursing Home, Surgeon, Anesthetist, Medical Practitioner, Consultants,
Specialist Fees
b. Anesthesia, Blood, Oxygen and Operation Theatre charges, ICU Charges, Surgical Appliances, Medicines and Drugs, Diagnostic Materials and diagnostic imaging modalities,
X-ray and stent. With regard to coronary stenting, the company will pay such amount up to the extent of cost of bare metal stent/drug eluting cobalt-chromium stent/drug eluting
stainless steel stent only. In respect of medicines, Implants and such other similar items, the Company will pay up to the cost of alternate indigenous make
c. Emergency ambulance charges up-to a sum of Rs. 2,000/- per policy period for transportation of the insured person by private ambulance service when this is needed for
medical reasons to go to hospital for treatment, provided however there is an admissible claim under the policy
d. Relevant Pre-Hospitalization medical expenses incurred for a period not exceeding 30 days prior to the date of hospitalization, for the disease/illness, injury sustained following
an admissible claim under the policy.
e. Post-Hospitalization expenses incurred up to 60 days after discharge from the hospital. The amount payable shall not exceed the sum equivalent to 7% of the hospitalization
expenses subject to a maximum of Rs.5,000/- per hospitalization provided such expenses so incurred are in respect of ailment for which the insured person was hospitalized. For
the purpose of calculation of the 7%, only nursing expenses, surgeon's / consultants fees, diagnostic charges and cost of drugs and medicines will be taken.
v Special conditions applicable for Section 1
1. Donor expenses for kidney transplantation where the insured person is the recipient are payable provided the claim for transplantation is payable and subject to the availability of
the sum insured. Donor screening expenses and post-donation complications of the donor are not payable
2. Expenses incurred on dialysis (inclusive of AV fistula /graft creation charges) are payable up-to Rs.1,000/- per sitting commencing from the policy year in which Chronic
Kidney disease occurs and payable for up to 24 consecutive months provided the policy is in force.
3. Cost of artificial limbs following amputation is payable up-to 10% of Sum Insured, provided the claim for such amputation is admissible under the policy
Claims directly or indirectly relating to Cardio Vascular System, Renal System, Diseases of eye, Foot Ulcer, Diabetic Peripheral Vascular Diseases and other complications of
diabetes are eligible to be payable under Section 1 only, except where specifically provided for.
Claim for cataract surgery is payable under Section 2 only
The expenses as above are payable only where the in-patient hospitalization is for a minimum period of 24 hours. However this time limit will not apply for the day care treatments
/ procedures, where treatment is taken in the Hospital / Nursing Home and the Insured is discharged on the same day
Important Note: Expenses relating to Associated Medical Expenses will be considered in proportion to the eligible room rent/room category stated in the policy
schedule or actuals whichever is less. Proportionate deductions are not applied in respect of the hospitals which do not follow differential billing or for those
expenses in respect of which differential billing is not adopted based on the room rent.
Note: Only complications of Diabetes that are declared by the insured and accepted by the company shall be considered as covered under Section 1.
v Section 2: Regular Hospitalization expenses under the following heads (Applicable for Plan A and Plan B)
a. Room (Single standard A/C room), Boarding and Nursing Expenses as provided by the Hospital / Nursing Home, Surgeon, Anesthetist, Medical Practitioner, Consultants,
Specialist Fees. Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist Fees.
b. Anaesthesia, Blood, Oxygen and Operation Theatre charges, ICU charges, Surgical Appliances, Medicines and Drugs, Diagnostic Materials and diagnostic imaging modalities
and X-ray. With regard to coronary stenting, medicines, Implants and such other similar items the Company will pay cost of stent as per the Drug Price Control Order (DPCO) /
National Pharmaceuticals Pricing Authority (NPPA) Capping.
c. Emergency ambulance charges up-to a sum of Rs. 2,000/- per policy period for transportation of the insured person by private ambulance service when this is needed for
medical reasons to go to hospital for treatment, provided however there is an admissible claim under the policy.
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 d. Relevant Pre-Hospitalization medical expenses incurred for a period not exceeding 30 days prior to the date of hospitalization, for the disease/illness, injury sustained following
an admissible claim under the policy.
e. Post-Hospitalization expenses incurred up to 60 days after discharge from the hospital. The amount payable shall not exceed the sum equivalent to 7% of the hospitalization
expenses subject to a maximum of Rs.5,000/- per hospitalization provided such expenses so incurred are in respect of ailment for which the insured person was hospitalized. For
the purpose of calculation of the 7%, only nursing expenses, surgeon's / consultants fees, diagnostic charges and cost of drugs and medicines will be taken.
v Special conditions applicable for Section 2 (Applicable for Plan A and Plan B)
1. Expenses on Hospitalization for a minimum period of 24 hours only are admissible.
2. However this time limit will not apply for the day care treatments / procedures, where treatment is taken in the Hospital / Nursing Home and the Insured is discharged on the same day
3. The expenses incurred on treatment of cataract are limited to
Sum Insured Rs. Limit Rs.
3,00,000/- 4,00,000/- and 5,00,000/- Rs.20,000/- per eye per person and not exceeding Rs.30,000/- per policy period
10,00,000/- Rs.30,000/- per eye per person and not exceeding Rs.40,000/- per policy period
4. Expenses relating to Associated Medical Expenses will be considered in proportion to the eligible room rent/room category stated in the policy schedule or actuals whichever is
less. Proportionate deductions are not applied in respect of the hospitals which do not follow differential billing or for those expenses in respect of which differential billing is not
adopted based on the room rent.
v Section 3 – Outpatient Expenses for Plan A and Plan B: The Company will pay the amount of such expenses as are reasonably and necessarily incurred at the network
hospitals/diagnostic centers as an Out Patient, provided the policy is in force.
a. The Cost of Fasting and Post Parandial and HbA1C tests - once every six months – upto Rs.750/- per event upto Rs.1500/- per policy period.
b. Other expenses like medical consultation, other diagnostics, medicines and drugs upto the limits given below per policy period.
Applicable for Plan A
Individual
Sum Insured Rs. 3,00,000 4,00,000 5,00,000 10,00,000
Limit of OP Benefit 1000/- 2500/- 3500/- 5500/-
Floater
Sum Insured Rs. 3,00,000 4,00,000 5,00,000 10,00,000
Limit of OP Benefit 2000/- 3500/- 5500/- 7500/-
Applicable for Plan B
Individual
Sum Insured Rs. 3,00,000 4,00,000 5,00,000 10,00,000
Limit of OP Benefit 500/- 2000/- 3000/- 5000/-
Floater
Sum Insured Rs. 3,00,000 4,00,000 5,00,000 10,00,000
Limit of OP Benefit 1500/- 3000/- 5000/- 7000/-
This benefit forms part of Sum Insured.
Note: Payment of any claim under this section shall not be construed as a waiver of Company's right to repudiate any claim on grounds of non disclosure of material fact or preexisting
disease for hospitalization expenses under hospitalization provisions of the policy contract.
v Section 4 - Coverage for Modern Treatments: The expenses payable during the entire policy period for the following treatment/procedure (either as a day care or as an in-patient
exceeding 24hrs of admission in the hospital) is limited to the amount mentioned in table below;
Sum Insured Rs. 3,00,000/- 4,00,000/- 5,00,000/- 10,00,000/-
Sum Insured on Individual Basis: Limit per person, per policy period for each treatment / procedure
Treatment / Procedure
Sum Insured on Floater Basis: Limit per policy period for each treatment / procedure Rs.
Uterine artery Embolization and HIFU 37,500/- 1,00,000/- 1,25,000/- 1,50,000/-
Balloon Sinuplasty 15,000/- 40,000/- 50,000/- 1,00,000/-
Deep Brain Stimulation 75,000/- 2,00,000/- 2,50,000/- 3,00,000/-
Oral Chemotherapy* 37,500/- 1,00,000/- 1,25,000/- 2,00,000/-
Immunotherapy-Monoclonal Antibody to be given as injection 75,000/- 2,00,000/- 2,50,000/- 4,00,000/-
Intra Vitreal injections 15,000/- 40,000/- 50,000/- 75,000/-
Robotic surgeries 75,000/- 2,00,000/- 2,50,000/- 3,00,000/-
Stereotactic radio surgeries 75,000/- 1,75,000/- 2,00,000/- 2,25,000/-
Bronchical Thermoplasty
Vaporisation of the prostate (Green laser treatment or holmium Up to Sum Insured
laser treatment) IONM-(Intra Operative Neuro Monitoring)
Stem cell therapy: Hematopoietic stem cells for bone marrow
75,000/- 2,00,000/- 2,50,000/- 3,00,000/-
transplant for haematological conditions
*Sublimit all inclusive with or without hospitalization where ever hospitalization includes pre and post hospitalization.
v Section 5 - Personal Accident for Plan A and Plan B: If at any time during the Period of Insurance, the Insured Person shall sustain any bodily injury resulting solely and directly from
an Accident caused by external, violent and visible means and if such accident causes death of the Insured Person within 12 Calendar months from the date of that Accident, then the
Company will pay an amount as compensation the Sum Insured mentioned in the Schedule.
Note
1 This Section is applicable for the person specifically mentioned in the Schedule
2 At any point of time only one person will be eligible to be covered under this Section
3 Geographical Scope: The insurance cover applies Worldwide
4 The sum insured for this Section is equal to the sum insured opted for Section ½
5 Any claim under Section 1/2/3/4 will not effect the sum insured under this section.
v What are the Sub Limits?
For Cataract claims under both Plans the following sub limits apply
Sum Insured Rs. Limit Rs.
3,00,000/- 4,00,000/- and 5,00,000/- Rs.20,000/- per eye per person and not exceeding Rs.30,000/- per policy period
10,00,000/- Rs.30,000/- per eye per person and not exceeding Rs.40,000/- per policy period
Note: The expenses incurred towards Cataract is applicable for Section 2 only.
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 For Claims directly or indirectly relating to the Cardio Vascular System the following sub limits apply under Plan B
Sum Insured(Rs) Limit of the Company's Liability per policy period (Rs)
3,00,000 2,00,000
4,00,000 2,50,000
5,00,000 3,00,000
10,00,000 4,00,000

v What are the exclusions under the policy?

The Company shall not be liable to make any payments under this policy in respect of any expenses what so ever incurred by the insured person in connection with or in respect of
Standard Exclusions
1. Pre-Existing Diseases Applicable for Section 2 and Section 4 under Plan A and Plan B - Code Excl 01
A. Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 48 months of continuous coverage after
the date of inception of the first policy with insurer
B. In case of enhancement of sum insured the exclusion shall apply afresh to the extent of sum insured increase
C. If the Insured Person is continuously covered without any break as defined under the portability norms of the extant IRDAI (Health Insurance) Regulations, then waiting
period for the same would be reduced to the extent of prior coverage
D. Coverage under the policy after the expiry of 48 months for any pre-existing disease is subject to the same being declared at the time of application and accepted by Insurer
2. Specified disease / procedure waiting period - Code Excl 02
Applicable for Section 1 under Plan B
A. Expenses related to the treatment of following listed systems shall be excluded until the expiry of 12 months of continuous coverage after the date of inception of the first
policy with us. This exclusion shall not be applicable for claims arising due to an accident
B. In case of enhancement of sum insured the exclusion shall apply afresh to the extent of sum insured increase
C. The waiting period for listed conditions shall apply even if contracted after the policy or declared and accepted without a specific exclusion
D. List of Systems: Cardio Vascular System, Renal System, Diseases of eye, Diabetic Peripheral Vascular Diseases and Foot Ulcer
Applicable for Section 2 and Section 4 under Plan A and Plan B
A. Expenses related to the treatment of the following listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the
date of inception of the first policy with us. This exclusion shall not be applicable for claims arising due to an accident
B. In case of enhancement of sum insured the exclusion shall apply afresh to the extent of sum insured increase
C. If any of the specified disease/procedure falls under the waiting period specified for pre-existing diseases, then the longer of the two waiting periods shall apply
D. The waiting period for listed conditions shall apply even if contracted after the policy or declared and accepted without a specific exclusion
E. If the Insured Person is continuously covered without any break as defined under the applicable norms on portability stipulated by IRDAI, then waiting period for the same
would be reduced to the extent of prior coverage
F. List of specific diseases/procedures;
a. Cataract and diseases of the Anterior and Posterior Chamber of the Eye, Retinal detachment, Glaucoma, Diseases of ENT, Diseases related to Thyroid, Prolapse of
intervertebral disc (other than caused by accident), Varicose veins and Varicose ulcers, all Diseases of Prostrate, Stricture Urethra, all Obstructive Uropathies, benign
prostatic hypertrophy, stapedectomy, all types of Hernia, Epididymal Cyst, Benign Tumours of Epididymis, Spermatocele, Varicocoel, Hydrocele, Fistula / Fissure in
ano, Hemorrhoids, Pilonidal Sinus and Fistula, Rectal Prolapse, Stress Incontinence, and Congenital Internal disease / defect
b. Desmoid Tumour of anterior abdominal wall, Gall Bladder and Pancreatic diseases and All treatments (conservative, interventional, laparoscopic and open) for
Hepato pancreato biliary diseases including gall bladder and pancreatic calculi. All types of management for kidney calculi and genitourinary tract calculi
c. All treatments (conservative, interventional, laparoscopic and open) related to all Diseases of Uterus, Fallopian Tubes, Cervix and Ovaries, Uterine Bleeding, Pelvic
Inflammatory Diseases, Benign breast diseases, Umbilical Sinus, Umbilical Fistula
d. Conservative, operative treatment of all types of intervention for diseases related to tendon, ligament, Fascia, bones and joint including Arthroscopy and Arthroplasty
[other than caused by accident]
e. Degenerative disc and vertebral diseases including Replacement of bones and joints and degenerative diseases of the musculo-skeletal system
f. Subcutaneous benign lumps, sebaceous cyst, dermoid cyst, Mucous Cyst lip/cheek, Carpel Tunnel Syndrome, Trigger Finger, lipoma, neurofibroma, ganglion and
similar pathology
g. Any transplant and related surgery
3. 30-day waiting period - Code Excl 03
Applicable for Section 1 under Plan B;
1. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident,
provided the same are covered
2. This exclusion shall not, however, apply if the Insured Person has continuous coverage for more than twelve months
3. The within referred waiting period is made applicable to the enhanced sum insured in the event of granting higher sum insured subsequently
Applicable for Section 2 and Section 4 under Plan A and Plan B;
1. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident,
provided the same are covered
2. This exclusion shall not, however, apply if the Insured Person has continuous coverage for more than twelve months
3. The within referred waiting period is made applicable to the enhanced sum insured in the event of granting higher sum insured subsequently
4. 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
5. 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 non-skilled persons
2. Any services for people who are terminally ill to address physical, social, emotional and spiritual needs
6. Obesity/ Weight Control - Code Excl 06: Expenses related to the surgical treatment of obesity that does not fulfill 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. greater 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
7. Change-of-Gender treatments - Code Excl 07: Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the
opposite sex.
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 8. 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.
9. Hazardous or Adventure sports - Code Excl 09: Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports,
including but not limited to, para-jumping, rock climbing, mountaineering, rafting, motor racing, horse racing or scuba diving, hand gliding, sky diving, deep-sea diving.
10. Breach of law - Code Excl 10: Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with
criminal intent.
11. 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.
12. Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof - Code Excl 12
13. Treatments received in health hydros, nature cure clinics, spas or similar establishments or private beds registered as a nursing home attached to such establishments or where
admission is arranged wholly or partly for domestic reasons - Code Excl 13
14. 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
15. Refractive Error - Code Excl 15: Expenses related to the treatment for correction of eye sight due to refractive error less than 7.5 dioptres.
16. Unproven Treatments - Code Excl 16: Expenses related to any unproven treatment, services and supplies for or in connection with any treatment. Unproven treatments are
treatments, procedures or supplies that lack significant medical documentation to support their effectiveness.
17. 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
18. Maternity - Code Excl 18
a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy
b. Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period
Specific Exclusions
19. Circumcision (unless necessary for treatment of a disease not excluded under this policy or necessitated due to an accident), Preputioplasty, Frenuloplasty, Preputial Dilatation
and Removal of SMEGMA - Code Excl 19
20. Congenital External Condition / Defects / Anomalies - Code Excl 20
21. Convalescence, general debility, run-down condition, Nutritional deficiency states - Code Excl 21
22. Intentional self -injury - Code Excl 22
23. Injury/disease caused by or arising from or attributable to war, invasion, act of foreign enemy, warlike operations (whether war be declared or not) - Code Excl 24
24. Injury or disease caused by or contributed to by nuclear weapons/ materials - Code Excl 25
25. 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 and such other similar therapies - Code Excl 26
26. Unconventional, Untested, Experimental therapies - Code Excl 27
27. Artificial Pancreas, Chondrocyte Implantation, Procedures using Platelet Rich plasma and Intra articular injection therapy - Code Excl 28
28. Biologicals, except when administered as an in-patient, when clinically indicated and hospitalization warranted - Code Excl 29
29. Inoculation or Vaccination (except for post–bite treatment and for medical treatment for therapeutic reasons) - Code Excl 31
30. Hospital registration charges, admission charges, record charges, telephone charges and such other charges - Code Excl 34
31. Cost of spectacles and contact lens, hearing aids, Cochlear implants and procedures, walkers and crutches, wheel chairs, CPAP, BIPAP, Continuous Ambulatory Peritoneal
Dialysis, infusion pump and such other similar aids - Code Excl 35
32. Any hospitalization which are not medically necessary / does not warrant hospitalization - Code Excl 36
33. Other Excluded Expenses as detailed in the website www.starhealth.in - Code Excl 37
34. Existing disease/s, disclosed by the insured and mentioned in the policy schedule (based on insured's consent), for specified ICD codes - Code Excl 38
35. Expenses incurred for treatment of diseases/illness/accidental injuries by systems of medicine other than allopathy - Code Excl 39
Note: Exclusion nos. 15, 17, 18, 29, 31 and 35 are not applicable for Section 3
Exclusions applicable for Section 5
1. Any claim relating to events occurring before the commencement of the cover or otherwise outside the Period of Insurance - Code Sec-5 Excl 01
2. Code Sec-5 Excl 02 Any claim arising out of Accident of the Insured Person from;
a. Intentional self injury / suicide or attempted suicide or
b. Whilst under the influence of intoxicating liquor or drugs or
c. Self endangerment unless in self defense or to save human life
3. Any claim arising out of suicide or attempted suicide self inflicted injuries, or sexually transmitted conditions, anxiety, stress, depression, venereal disease (Other than HIV) -
Code Sec-5 Excl 03
4. Insured Person engaging in Air Travel unless he/she flies as a fare-paying passenger on an aircraft properly licensed to carry passengers. For the purpose of this exclusion Air
Travel means being in or on or boarding an aircraft for the purpose of flying therein or alighting there from - Code Sec-5 Excl 04
5. Accidents that are results of war and warlike occurrence or invasion, acts of foreign enemies, hostilities, civil war, rebellion, insurrection, civil commotion assuming the
proportions of or amounting to an uprising, military or usurped power, seizure capture arrest restraints detainments of all kings princes and people of whatever nation, condition
or quality whatsoever - Code Sec-5 Excl 05
6. Participation in riots, confiscation or nationalization or requisition of or destruction of or damage to property by or under the order of any government or local authority -
Code Sec-5 Excl 06
7. Any claim resulting or arising from or any consequential loss directly or indirectly caused by or contributed to or arising from - Code Sec-5 Excl 07
a. Ionizing radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel or from any nuclear waste from
combustion (including any self sustaining process of nuclear fission) of nuclear fuel
b. Nuclear weapons material
c. The radioactive, toxic, explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof
d. Nuclear, chemical and biological terrorism
8. Any claim arising out of sporting activities in so far as they involve the training or participation in competitions of professional or semi-professional sports persons - Code Sec-5 Excl 08
9. Participation in Hazardous Sport / Hazardous Activities - Code Sec-5 Excl 09
10. Persons who are physically challenged, unless specifically agreed and endorsed in the policy - Code Sec-5 Excl 10
11. Any loss arising out of the Insured Person's actual or attempted commission of or willful, participation in an illegal act or any violation or attempted violation of the law -
Code Sec5- Excl 11
12. Any claim arising out of an accident related to pregnancy or childbirth, infirmity, whether directly or indirectly - Code Sec5 Excl 12
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v Moratorium Period: After completion of eight continuous years under the policy no look back to be applied. This period of eight years is called as moratorium period. The moratorium
would be applicable for the sums insured of the first policy and subsequently completion of 8 continuous years would be applicable from date of enhancement of sums insured only on
the enhanced limits. After the expiry of Moratorium Period no health insurance claim shall be contestable except for proven fraud and permanent exclusions specified in the policy
contract. The policies would however be subject to all limits, sub limits, co-payments, deductibles as per the policy contract.
v Special Condition
Premium Payment in Instalments: lf the insured person has opted for Payment of Premium on an instalment basis i.e. Half Yearly as mentioned in the policy Schedule/Certificate of
Insurance, the following Conditions shall apply (notwithstanding any terms contrary elsewhere in the policy)
1. Grace Period of 7 days would be given to pay the instalment premium due for the policy.
2. During such grace period, coverage will not be available from the due date of instalment premium till the date of receipt of premium by Company.
3. The insured person will get the accrued continuity benefit in respect of the "Waiting Periods", "Specific Waiting Periods" in the event of payment of premium within the stipulated
grace Period.
4. No interest will be charged lf the instalment premium is not paid on due date
5. ln case of instalment premium due not received within the grace period, the policy will get cancelled.
6. ln the event of a claim, all subsequent premium instalments shall immediately become due and payable.
7. The company has the right to recover and deduct all the pending installments from the claim amount due under the policy.
Note
· In case of policy cancellation due to non-payment of the instalment within grace period, Company will refund the premium as per the cancellation table.
· If Instalment facility is opted for 2 year and 3 year term policies, the full premium applicable for 2 year or 3 year terms should be paid half yearly within the expiry of the first year.
v Free Look Period: The Free Look Period shall be applicable on new individual health insurance policies and not on renewals or at the time of porting/migrating the policy.
The insured person shall be allowed free look period of fifteen days from date of receipt of the policy document to review the terms and conditions of the policy, and to return the same if
not acceptable.
lf the insured has not made any claim during the Free Look Period, the insured shall be entitled to
i. a refund of the premium paid less any expenses incurred by the Company on medical examination of the insured person and the stamp duty charges or
ii. where the risk has already commenced and the option of return of the policy is exercised by the insured person, a deduction towards the proportionate risk premium for period of
cover or
iii. Where only a part of the insurance coverage has commenced, such proportionate premium commensurate with the insurance coverage during such period;
v Disclosure of Information: The policy shall be void and all premium paid thereon shall be forfeited to the Company, in the event of mis-representation, mis description or non-
disclosure of any material fact by the policy holder.
v Renewal of policy: The policy shall ordinarily be renewable except on grounds of fraud, misrepresentation by the Insured Person.
1. The Company shall endeavor to give notice for renewal. However, the Company is not under obligation to give any notice for renewal.
2. Renewal shall not be denied on the ground that the insured person had made a claim or claims in the preceding policy years.
3. Request for renewal along with requisite premium shall be received by the Company before the end of the policy period.
4. At the end of the policy period, the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy.
5. Coverage is not available during the grace period.
6. No loading shall apply on renewals based on individual claims experience
v Possibility of Revision of Terms of the Policy lncluding the Premium Rates: The Company, with prior approval of lRDAl, may revise or modify the terms of the policy including the
premium rates. The insured person shall be notified three months before the changes are effected
v Revision of Sum Insured applicable for both plans: Reduction or enhancement of sum insured is permissible only at the time of renewal.
Enhancement of sum insured is subject to no claim being lodged or paid under this policy, Both the acceptance for enhancement and the amount of enhancement will be at the
discretion of the Company. Where the sum insured is enhanced, the amount of such additional sum insured including the respective sublimits shall be subject to the following terms
Exclusion given below shall apply afresh from the date of such enhancement for the increase in the sum insured, that is, the difference between the expiring policy sum insured and
the increased current sum insured.
I. First 30 days exclusion as under Code Excl 03
II. 24 months with continuous coverage without break (with grace period) in respect of diseases / treatments falling under exclusion Code Excl 02
III. 48 months of continuous coverage without break (with grace period) in respect of Pre-Existing diseases as under exclusion Code Excl 01
IV. 48 months of continuous coverage without break (with grace period) for diseases / conditions diagnosed / treated irrespective of whether any claim is made or not in the
immediately preceding three policy periods
The above applies to each relevant insured person
v Withdrawal of policy
1. In the likelihood of this product being withdrawn in future, the Company will intimate the insured person about the same 90 days prior to expiry of the policy.
2. lnsured Person will have the option to migrate to similar health insurance product available with the Company at the time of renewal with all the accrued continuity benefits such
as cumulative bonus, waiver of waiting period as per IRDAI guidelines, provided the policy has been maintained without a break.
v Automatic Expiry of the Policy : The insurance under this policy with respect to each relevant Insured Person shall expire immediately on the earlier of the following events
ü Upon the death of the Insured Person. This also means that in case of family floater policy, the cover for the surviving members of the family will continue, subject to other terms of
the policy.
ü Upon exhaustion of the Basic sum insured under the policy as a whole
v Cancellation
ii. The policyholder may cancel this policy by giving 15 days written notice and in such an event, the Company shall refund premium for the unexpired policy period as detailed below;
Cancellation table applicable for Policy Term 1 Year without installment option
Period on risk Rate of premium to be retained
Up to 1 mth 25% of the policy premium
Exceeding 1 mth up to 3 mths 37.5% of the policy premium
Exceeding 3 mths up to 6 mths 57.5% of the policy premium
Exceeding 6 mths up to 9 mths 80% of the policy premium
Exceeding 9 mths 100% of the policy premium
Cancellation table applicable for installment option of Half-yearly premium payment for Policy Term 1 Year
Period on risk Rate of premium to be retained
Up to 1 Mth 47.5% of the total premium received
Exceeding 1 mth up to 4 mths 90% of the total premium received
Exceeding 4 mths up to 6 mths 100% of the total premium received
Exceeding 6 mths up to 7 mths 65% of the total premium received
Exceeding 7 mths up to 10 mths 85% of the total premium received
Exceeding 10 mths 100% of the total premium received
Diabetes Safe Insurance Policy Unique Identification No.: SHAHLIP23081V082223 PROS / DIA / V.11 / 2023 5 of 11
 Cancellation table applicable for Policy Term 2 Year without installment option
Period on risk Rate of premium to be retained
Up to 1 Mth 12.5% of the policy premium
Exceeding 1 mth up to 3 mths 20% of the policy premium
Exceeding 3 mths up to 6 mths 30% of the policy premium
Exceeding 6 mths up to 9 mths 40% of the policy premium
Exceeding 9 mths up to 12 mths 50% of the policy premium
Exceeding 12 mths up to 15 mths 70% of the policy premium
Exceeding 15 mths up to 18 mths 80% of the policy premium
Exceeding 18 mths up to 21 mths 90% of the policy premium
Exceeding 21 mths 100% of the policy premium
Cancellation table applicable for installment option of Half-yearly premium payment for Policy Term 2 Year
Period on risk Rate of premium to be retained
Up to 1 Mth 24% of the total premium received
Exceeding 1 mth up to 4 mths 44.5% of the total premium received
Exceeding 4 mths up to 6 mths 58.5% of the total premium received
Exceeding 6 mths up to 7 mths 32.5% of the total premium received
Exceeding 7 mths up to 10 mths 43% of the total premium received
Exceeding 10 mths up to 12 mths 50% of the total premium received
Exceeding 12 mths up to 16 mths 72.5% of the total premium received
Exceeding 16 mths up to 19 mths 82.5% of the total premium received
Exceeding 19 mths up to 22 mths 93% of the total premium received
Exceeding 22 mths 100% of the total premium received
Cancellation table applicable for Policy Term 3 Year without installment option
Period on risk Rate of premium to be retained
Up to 1 Mth 7.5% of the policy premium
Exceeding 1 mth up to 3 mths 12.5% of the policy premium
Exceeding 3 mths up to 6 mths 20% of the policy premium
Exceeding 6 mths up to 9 mths 27.5% of the policy premium
Exceeding 9 mths up to 12 mths 32.5% of the policy premium
Exceeding 12 mths up to 15 mths 45% of the policy premium
Exceeding 15 mths up to 18 mths 52.5% of the policy premium
Exceeding 18 mths up to 21 mths 60% of the policy premium
Exceeding 21 mths up to 24 mths 67.5% of the policy premium
Exceeding 24 mths up to 27 mths 80% of the policy premium
Exceeding 27 mths up to 30 mths 85% of the policy premium
Exceeding 30 mths up to 33 mths 92.5% of the policy premium
Exceeding 33 mths 100% of the policy premium
Cancellation table applicable for installment option of Half-yearly premium payment for Policy Term 3 Year
Period on risk Rate of premium to be retained
Up to 1 Mth 16% of the total premium received
Exceeding 1 mth up to 4 mths 30% of the total premium received
Exceeding 4 mths up to 6 mths 39% of the total premium received
Exceeding 6 mths up to 7 mths 22% of the total premium received
Exceeding 7 mths up to 10 mths 28.5% of the total premium received
Exceeding 10 mths up to 12 mths 33.5% of the total premium received
Exceeding 12 mths up to 15 mths 46% of the total premium received
Exceeding 15 mths up to 21 mths 60% of the total premium received
Exceeding 21 mths up to 24 mths 66.5% of the total premium received
Exceeding 24 mths up to 27 mths 79.5% of the total premium received
Exceeding 27 mths up to 33 mths 93% of the total premium received
Exceeding 33 mths 100% of the total premium received
Notwithstanding anything contained herein or otherwise, no refunds of premium shall be made in respect of Cancellation where, any claim has been admitted or has been lodged or
any benefit has been availed by the insured person under the policy.
ii. The Company may cancel the policy at any time on grounds of misrepresentation, non-disclosure of material facts, fraud by the insured person by giving 15 days’ written notice.
There would be no refund of premium on cancellation on grounds of misrepresentation, non-disclosure of material facts or fraud
v Migration (Applicable only for Section 2 and Section 4): The insured person will have the option to migrate the policy to other health insurance products/plans offered by the
company by applying for migration of the Policy atleast 30 days before the policy renewal date as per IRDAI guidelines on Migration. lf such person is presently covered and has been
continuously covered without any lapses under any health insurance product/plan offered by the company, the insured person will get the accrued continuity benefits in waiting
periods as per IRDAI guidelines on migration.
For Detailed Guidelines on migration, kindly refer the link
https://www.irdai.gov.in/ADMINCMS/cms/frmGuidelines_Layout.aspx?page=PageNo3987
Diabetes Safe Insurance Policy Unique Identification No.: SHAHLIP23081V082223 PROS / DIA / V.11 / 2023 6 of 11
v Portability (Applicable only for Section 2 and Section 4): The insured person will have the option to port the policy to other insurers by applying to such insurer to port the entire
policy along with all the members of the family, if any, at least 45 days before, but not earlier than 60 days from the policy renewal date as per IRDAI guidelines related to portability. lf
such person is presently covered and has been continuously covered without any lapses under any health insurance policy with an lndian General/Health insurer, the proposed
insured person will get the accrued continuity benefits in waiting periods as per IRDAI guidelines on portability.
For Detailed Guidelines on portability, kindly refer the link
https://www.irdai.gov.in/ADMINCMS/cms/frmGuidelines_Layout.aspx?page=PageNo3987
v Is Income Tax Benefit available?
Insured Person is eligible for relief under Section 80-D of the Income Tax Act 1961 in respect of the amount paid by any mode other than cash.
v How to buy this insurance?
All that needs to be done is to call the nearest office.
Online discount: 5% discount for first purchased online and its renewals (If the policy is first purchased online and the same is renewed online, then 5% discount will be given for such
renewals too). For Intermediary online sales this will be offset against their remuneration.
v Claims Procedure
Applicable for Both the Plans
For Cashless Treatment (Section 1, Section 2 and Section 4)
a. For assistance call 24 hours help-line 044-69006900 or Toll Free No. 1800 425 2255. Senior Citizens may call at 044-40020888
b. Inform the ID number for easy reference
c. On admission in the hospital, produce the ID Card issued by the Company at the Hospital Helpdesk
d. Obtain the Pre-authorization Form from the Hospital Help Desk, complete the Patient Information and resubmit to the Hospital Help Desk.
e. The Treating Doctor will complete the hospitalization / treatment information and the hospital will fill up expected cost of treatment.
f. This form should be submitted to the Company
g. The Company will process the request and call for additional documents/ clarifications if the information furnished is inadequate.
h. Once all the details are furnished, the Company will process the request as per the terms and conditions as well as the exclusions therein and either approve or reject the request
based on the merits.
i. In case of emergency hospitalization information to be given within 24 hours after hospitalization
j. Cashless facility can be availed only in networked Hospitals
k. KYC (Identity proof with Address) of the proposer, as per AML Guidelines
In non-network hospitals payment must be made up-front by Insured / Insured Person and then reimbursement will be effected on submission of documents upon its admissibility.
Note: The Company reserves the right to call for additional documents wherever required.
Denial of a Pre-authorization request is in no way to be construed as denial of treatment or denial of coverage. The Insured Person can go ahead with the treatment, settle the hospital
bills and submit the claim for a permissible reimbursement.
For Reimbursement claims: Time limit for submission of
Sl.No. Type of Claim Prescribed Time Limit
1 Reimbursement of hospitalization, day care and pre hospitalization expenses Claim must be filed within 15 days from the date of discharge from the Hospital.
2 Reimbursement of Post hospitalization within 15 days after completion of 60 days from the date of discharge from hospital.

For Reimbursement Claims

a. Duly completed claim form, and
b. Pre Admission investigations and treatment papers.
c. Discharge Summary from the hospital in original
d. Cash receipts from hospital, chemists
e. Cash receipts and reports for tests done
f. Receipts from doctors, surgeons, anesthetist
g. Certificate from the attending doctor regarding the diagnosis.
h. Copy of PAN card
i. KYC (Identity proof with Address) of the proposer, as per AML Guidelines
Claims of Out Patient Consultations / treatments (Section 3) will be settled on a reimbursement basis on production of cash receipts
For Section 5:
For Accidental Death Claims:- Claim Form
a. Death Certificate
b. Post-mortem Certificate, if conducted
c. FIR (wherever required)
d. Police Investigation report (wherever required)
e. Viscera Sample Report (wherever required)
f. Forensic Science Laboratory report (wherever required)
g. Legal Heir Certificate
h. Succession Certificate (wherever required)
i. KYC (Identity proof with Address) of the proposer, as per AML Guidelines
Note: For assistance call 24 hours help-line 044-69006900 or Toll Free No. 1800 425 2255, Senior Citizens may call at 044-40020888
v Provision for Penal Interest
a) The Company shall settle or reject a claim, as the case may be, within 30 days from the date of receipt of last necessary document.
b) ln the case of delay in the payment of a claim, the Company shall be liable to pay interest to the policyholder from the date of receipt of last necessary document to the date of
payment of claim at a rate 2% above the bank rate.
c) However, where the circumstances of a claim warrant an investigation in the opinion of the Company, it shall initiate and complete such investigation at the earliest, in any case
not later than 30 days from the date of receipt of last necessary document- ln such cases, the Company shall settle or reject the claim within 45 days from the date of receipt of last
necessary document.
d) ln case of delay beyond stipulated 45 days, the Company shall be liable to pay interest to the policyholder at a rate 2% above the bank rate from the date of receipt of last
necessary document to the date of payment of claim.
e) "Bank rate" shall mean the rate fixed by the Reserve Bank of lndia (RBI) at the beginning of the financial year in which claim has fallen due.
v Important Note: IRDAI is not involved in activities like selling insurance policies, announcing bonus or investment of premiums. Public receiving such phone calls are requested to
lodge a police complaint
v Prohibition of Rebates: Section 41 of Insurance Act 1938 (Prohibition of rebates) - No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person
to take out or renew or continue an insurance in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate
of the premium shown on the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate, except such rebate as may be allowed in accordance with the
published prospectuses or tables of the insurer. Any person making default in complying with the provisions of this section shall be liable for a penalty which may extend to ten lakhs
rupees.
Diabetes Safe Insurance Policy Unique Identification No.: SHAHLIP23081V082223 PROS / DIA / V.11 / 2023 7 of 11
 Premium Chart - One Year Policy Term Premium in (Rs.) Excluding Tax

Policy Type Individual Policy Floater Policy

Age Band / SI 3,00,000 4,00,000 5,00,000 10,00,000 3,00,000 4,00,000 5,00,000 10,00,000

18-30 12,231 13,454 14,142 17,002 17,123 18,836 19,798 23,803

31-35 13,799 15,179 15,954 19,182 19,318 21,250 22,336 26,854

36-40 15,514 17,066 17,938 21,566 21,720 23,892 25,113 30,192

41-45 17,500 19,250 20,233 24,326 24,499 26,949 28,327 34,057

46-50 19,878 21,866 22,983 27,632 27,829 30,612 32,177 38,685

Plan A
51-55 22,772 25,049 26,329 31,655 31,881 35,069 36,861 44,317

56-60 26,304 28,934 30,413 37,245 36,826 40,508 42,579 51,975

61-65 30,597 33,657 37,205 48,370 42,836 47,119 51,820 67,365

66-70 35,773 43,275 49,765 64,700 50,083 60,200 69,230 90,000

71-75 44,500 55,625 63,970 83,160 61,840 77,300 88,900 1,15,570

76-80 55,585 69,485 79,910 1,03,880 77,205 96,510 1,10,990 1,44,290

Above 80 67,930 84,910 97,650 1,26,945 94,300 1,17,880 1,35,560 1,76,230

Policy Type Individual Policy Floater Policy

Age Band / SI 3,00,000 4,00,000 5,00,000 10,00,000 3,00,000 4,00,000 5,00,000 10,00,000

18-30 13,590 14,949 16,070 18,481 19,026 20,929 22,498 25,873

31-35 15,332 16,865 18,130 20,850 21,465 23,611 25,382 29,189

36-40 17,238 18,962 20,384 23,441 24,133 26,546 28,537 32,818

41-45 19,444 21,388 22,993 26,441 27,222 29,944 32,190 37,018

46-50 22,087 24,295 26,117 30,045 30,921 34,013 36,564 42,049

Plan B
51-55 25,302 27,832 29,920 38,210 35,423 38,965 41,888 52,975

56-60 29,227 32,149 36,970 48,060 40,917 45,009 51,250 66,630

61-65 35,995 44,995 51,750 67,275 49,910 62,390 71,750 93,275

66-70 47,565 59,455 68,375 88,890 65,950 82,435 94,805 1,23,245

71-75 57,850 72,310 83,160 1,08,115 80,210 1,00,260 1,15,300 1,49,895

76-80 74,560 93,200 1,07,185 1,39,340 1,03,380 1,29,225 1,48,615 1,93,200

Above 80 89,985 1,12,480 1,29,350 1,68,160 1,24,765 1,55,960 1,79,355 2,33,165

Diabetes Safe Insurance Policy Unique Identification No.: SHAHLIP23081V082223 PROS / DIA / V.11 / 2023 8 of 11
 Premium Chart - Two Years Policy Term Premium in (Rs.) Excluding Tax
Policy Type Individual Policy Floater Policy
Age Band / SI 3,00,000 4,00,000 5,00,000 10,00,000 3,00,000 4,00,000 5,00,000 10,00,000
18-29 23,239 25,563 26,869 32,304 32,534 35,788 37,617 45,226
30 24,650 27,115 28,501 34,266 34,510 37,961 39,901 47,972
31-34 26,218 28,839 30,313 36,445 36,705 40,375 42,439 51,023
35 27,761 30,538 32,098 38,591 38,866 42,753 44,938 54,027
36-39 29,477 32,424 34,082 40,975 41,267 45,394 47,714 57,366
40 31,264 34,390 36,148 43,460 43,769 48,146 50,607 60,843
41-44 33,249 36,574 38,444 46,220 46,549 51,204 53,821 64,707
45 35,390 38,929 40,918 49,195 49,546 54,500 57,286 68,873
46-49 37,768 41,545 43,668 52,501 52,875 58,163 61,136 73,502
50 40,373 44,410 46,680 56,122 56,522 62,174 65,352 78,571

Plan A 51-54 43,267 47,593 50,026 60,145 60,573 66,631 70,036 84,202
55 46,445 51,090 53,701 65,176 65,024 71,526 75,182 91,095
56-59 49,978 54,975 57,785 70,766 69,969 76,965 80,899 98,753
60 53,841 59,225 63,898 80,778 75,378 82,915 89,217 1,12,604
61-64 58,134 63,947 70,690 91,903 81,388 89,526 98,458 1,27,994
65 62,793 72,604 81,994 1,06,600 87,910 1,01,299 1,14,127 1,48,365
66-69 67,969 82,223 94,554 1,22,930 95,157 1,14,380 1,31,537 1,71,000
70 75,823 93,338 1,07,338 1,39,544 1,05,739 1,29,770 1,49,240 1,94,013
71-74 84,550 1,05,688 1,21,543 1,58,004 1,17,496 1,46,870 1,68,910 2,19,583
75 94,527 1,18,162 1,35,889 1,76,652 1,31,325 1,64,159 1,88,791 2,45,431
76-79 1,05,612 1,32,022 1,51,829 1,97,372 1,46,690 1,83,369 2,10,881 2,74,151
80 1,16,722 1,45,904 1,67,795 2,18,131 1,62,075 2,02,602 2,32,994 3,02,897
Above80 1,29,067 1,61,329 1,85,535 2,41,196 1,79,170 2,23,972 2,57,564 3,34,837
Policy Type Individual Policy Floater Policy
Age Band / SI 3,00,000 4,00,000 5,00,000 10,00,000 3,00,000 4,00,000 5,00,000 10,00,000
18-29 25,821 28,403 30,533 35,113 36,149 39,764 42,747 49,159
30 27,389 30,128 32,387 37,245 38,344 42,179 45,342 52,143
31-34 29,131 32,044 34,447 39,614 40,783 44,861 48,226 55,460
35 30,846 33,931 36,475 41,947 43,184 47,503 51,066 58,726
36-39 32,752 36,027 38,729 44,539 45,853 50,438 54,221 62,354
40 34,737 38,211 41,077 47,239 48,632 53,496 57,508 66,134
41-44 36,944 40,638 43,686 50,239 51,721 56,893 61,160 70,334
45 39,322 43,254 46,498 53,482 55,051 60,556 65,098 74,862
46-49 41,965 46,161 49,623 57,086 58,751 64,626 69,472 79,893
50 44,859 49,344 53,045 64,434 62,802 69,082 74,263 89,727

Plan B 51-54 48,074 52,881 56,847 72,599 67,304 74,034 79,586 1,00,653
55 51,606 56,767 63,193 81,464 72,248 79,473 88,013 1,12,942
56-59 55,531 61,084 70,243 91,314 77,743 85,517 97,375 1,26,597
60 61,622 72,645 83,545 1,08,608 85,836 1,01,160 1,15,825 1,50,578
61-64 68,391 85,491 98,325 1,27,823 94,829 1,18,541 1,36,325 1,77,223
65 78,804 98,505 1,13,288 1,47,276 1,09,265 1,36,582 1,57,075 2,04,196
66-69 90,374 1,12,965 1,29,913 1,68,891 1,25,305 1,56,627 1,80,130 2,34,166
70 99,630 1,24,534 1,43,219 1,86,194 1,38,139 1,72,669 1,98,575 2,58,151
71-74 1,09,915 1,37,389 1,58,004 2,05,419 1,52,399 1,90,494 2,19,070 2,84,801
75 1,24,954 1,56,190 1,79,627 2,33,521 1,73,252 2,16,563 2,49,054 3,23,775
76-79 1,41,664 1,77,080 2,03,652 2,64,746 1,96,422 2,45,528 2,82,369 3,67,080
80 1,55,547 1,94,432 2,23,600 2,90,684 2,15,669 2,69,589 3,10,035 4,03,049
Above80 1,70,972 2,13,712 2,45,765 3,19,504 2,37,054 2,96,324 3,40,775 4,43,014

Diabetes Safe Insurance Policy Unique Identification No.: SHAHLIP23081V082223 PROS / DIA / V.11 / 2023 9 of 11
 Premium Chart - Three Years Policy Term Premium in (Rs.) Excluding Tax
Policy Type Individual Policy Floater Policy
Age Band / SI 3,00,000 4,00,000 5,00,000 10,00,000 3,00,000 4,00,000 5,00,000 10,00,000
18-28 33,941 37,335 39,243 47,181 47,517 52,269 54,941 66,054
29 35,332 38,866 40,852 49,115 49,465 54,412 57,193 68,762
30 36,724 40,396 42,461 51,050 51,413 56,555 59,445 71,469
31-33 38,292 42,121 44,274 53,229 53,608 58,969 61,983 74,521
34 39,814 43,795 46,034 55,345 55,740 61,313 64,447 77,483
35 41,336 45,470 47,794 57,461 57,871 63,658 66,912 80,446
36-38 43,052 47,357 49,777 59,846 60,272 66,299 69,688 83,784
39 44,814 49,295 51,815 62,295 62,739 69,013 72,541 87,213
40 46,576 51,233 53,852 64,745 65,206 71,727 75,393 90,643
41-43 48,561 53,418 56,148 67,505 67,986 74,785 78,607 94,507
44 50,672 55,739 58,588 70,439 70,941 78,035 82,024 98,615
45 52,783 58,061 61,029 73,373 73,896 81,286 85,440 1,02,723
46-48 55,161 60,678 63,779 76,680 77,226 84,949 89,290 1,07,351
49 57,730 63,503 66,748 80,250 80,822 88,904 93,448 1,12,350
50 60,298 66,328 69,718 83,820 84,417 92,859 97,605 1,17,348
51-53 63,192 69,511 73,064 87,843 88,469 97,316 1,02,290 1,22,980
Plan A
54 66,327 72,959 76,688 92,804 92,857 1,02,143 1,07,364 1,29,776
55 69,461 76,408 80,313 97,765 97,246 1,06,971 1,12,438 1,36,573
56-58 72,993 80,293 84,397 1,03,355 1,02,191 1,12,410 1,18,155 1,44,231
59 76,803 84,484 90,424 1,13,228 1,07,525 1,18,277 1,26,357 1,57,889
60 80,613 88,675 96,452 1,23,102 1,12,859 1,24,145 1,34,559 1,71,548
61-63 84,906 93,397 1,03,244 1,34,227 1,18,869 1,30,756 1,43,801 1,86,938
64 89,500 1,01,933 1,14,391 1,48,720 1,25,300 1,42,365 1,59,252 2,07,026
65 94,094 1,10,470 1,25,538 1,63,213 1,31,732 1,53,974 1,74,703 2,27,115
66-68 99,271 1,20,088 1,38,098 1,79,543 1,38,979 1,67,055 1,92,113 2,49,750
69 1,07,016 1,31,049 1,50,705 1,95,926 1,49,414 1,82,231 2,09,570 2,72,443
70 1,14,761 1,42,009 1,63,312 2,12,309 1,59,849 1,97,408 2,27,028 2,95,137
71-73 1,23,488 1,54,359 1,77,517 2,30,769 1,71,606 2,14,508 2,46,698 3,20,707
74 1,33,325 1,66,660 1,91,664 2,49,158 1,85,242 2,31,556 2,66,302 3,46,196
75 1,43,163 1,78,961 2,05,810 2,67,547 1,98,879 2,48,605 2,85,907 3,71,685
76-78 1,54,248 1,92,821 2,21,750 2,88,267 2,14,244 2,67,815 3,07,997 4,00,405
79 1,65,205 2,06,511 2,37,495 3,08,737 2,29,416 2,86,781 3,29,803 4,28,752
80 1,76,161 2,20,200 2,53,239 3,29,207 2,44,588 3,05,747 3,51,609 4,57,098
Above80 1,88,506 2,35,625 2,70,979 3,52,272 2,61,683 3,27,117 3,76,179 4,89,038
Policy Type Individual Policy Floater Policy
Age Band / SI 3,00,000 4,00,000 5,00,000 10,00,000 3,00,000 4,00,000 5,00,000 10,00,000
18-28 37,712 41,483 44,595 51,284 52,797 58,077 62,433 71,798
29 39,258 43,184 46,423 53,386 54,962 60,458 64,992 74,741
30 40,804 44,885 48,251 55,489 57,126 62,839 67,551 77,684
31-33 42,546 46,801 50,311 57,858 59,565 65,521 70,435 81,001
34 44,238 48,661 52,311 60,158 61,933 68,126 73,236 84,221
35 45,929 50,522 54,311 62,458 64,301 70,731 76,036 87,441
36-38 47,835 52,619 56,565 65,050 66,969 73,666 79,191 91,070
39 49,793 54,772 58,880 67,712 69,710 76,681 82,432 94,797
40 51,751 56,926 61,196 70,375 72,451 79,697 85,674 98,525
41-43 53,957 59,353 63,804 73,375 75,540 83,094 89,326 1,02,725
44 56,302 61,933 66,578 76,573 78,823 86,706 93,209 1,07,190
45 58,648 64,513 69,351 79,771 82,107 90,318 97,091 1,11,655
46-48 61,290 67,420 72,476 83,375 85,807 94,387 1,01,466 1,16,686
49 64,144 70,559 75,850 90,621 89,802 98,782 1,06,191 1,26,383
50 66,998 73,698 79,225 97,868 93,797 1,03,177 1,10,915 1,36,080
51-53 70,213 77,235 83,027 1,06,033 98,299 1,08,129 1,16,238 1,47,006
Plan B
54 73,696 81,066 89,284 1,14,775 1,03,175 1,13,492 1,24,547 1,59,124
55 77,179 84,897 95,541 1,23,517 1,08,051 1,18,856 1,32,856 1,71,243
56-58 81,104 89,214 1,02,592 1,33,367 1,13,545 1,24,900 1,42,219 1,84,898
59 87,111 1,00,615 1,15,709 1,50,420 1,21,526 1,40,326 1,60,413 2,08,546
60 93,118 1,12,015 1,28,826 1,67,473 1,29,508 1,55,751 1,78,606 2,32,193
61-63 99,886 1,24,861 1,43,606 1,86,688 1,38,500 1,73,132 1,99,106 2,58,838
64 1,10,155 1,37,694 1,58,361 2,05,871 1,52,736 1,90,922 2,19,568 2,85,437
65 1,20,423 1,50,528 1,73,116 2,25,055 1,66,971 2,08,712 2,40,029 3,12,035
66-68 1,31,993 1,64,988 1,89,741 2,46,670 1,83,011 2,28,757 2,63,084 3,42,005
69 1,41,121 1,76,396 2,02,862 2,63,732 1,95,667 2,44,577 2,81,273 3,65,657
70 1,50,249 1,87,805 2,15,984 2,80,794 2,08,323 2,60,397 2,99,463 3,89,309
71-73 1,60,534 2,00,660 2,30,769 3,00,019 2,22,583 2,78,222 3,19,958 4,15,959
74 1,75,364 2,19,200 2,52,091 3,27,731 2,43,146 3,03,928 3,49,525 4,54,392
75 1,90,194 2,37,740 2,73,413 3,55,444 2,63,710 3,29,634 3,79,092 4,92,825
76-78 2,06,904 2,58,630 2,97,438 3,86,669 2,86,880 3,58,599 4,12,407 5,36,130
79 2,20,594 2,75,741 3,17,110 4,12,246 3,05,859 3,82,327 4,39,688 5,71,599
80 2,34,283 2,92,852 3,36,781 4,37,824 3,24,838 4,06,054 4,66,970 6,07,068
Above80 2,49,708 3,12,132 3,58,946 4,66,644 3,46,223 4,32,789 4,97,710 6,47,033
Diabetes Safe Insurance Policy Unique Identification No.: SHAHLIP23081V082223 PROS / DIA / V.11 / 2023 10 of 11
 Benefit Illustration in respect of Policies offered on Individual and Family Floater Basis - Plan A

Coverage opted on individual basis covering Coverage opted on family floater basis with
Coverage opted on individual basis covering each member
multiple members of the family under a single policy overall Sum insured
of the family separately (at a single point of time)
(Sum insured is available for each member of the family) (Only one sum insured is available for the entire family)

Diabetes Safe Insurance Policy

Age
of the
Members
insured Premium or
(in yrs) Premium Premium
consolidated
Premium Sum Insured Premium Discount, After Floater Discount, After Sum Insured
Sum Insured (Rs.) premium for all
(Rs.) (Rs.) (Rs.) (if any) Discount (if any) Discount (Rs.)
members of family
(Rs.) (Rs.)
(Rs.)

Illustration - 1

64 37,205 5,00,000 37,205 37,205 5,00,000

Nil 67,618 15,798 51,820 5,00,000
58 30,413 5,00,000 30,413 30,413 5,00,000

Total Premium for all members of the family is Rs.67,618/-, when each member is Total Premium for all members of the family is
Total Premium when policy is opted on floater basis is Rs.51,820/-,
covered separately. Rs.67,618/-, when they are covered under a single policy.
Sum insured of Rs.5,00,000/- is available for the entire family (2A)
Sum insured available for each individual is Rs.5,00,000/- Sum insured available for each family member is Rs.5,00,000/-

Unique Identification No.: SHAHLIP23081V082223

Illustration - 2

47 22,983 5,00,000 22,983 22,983 5,00,000

Nil 43,216 11,039 32,177 5,00,000
44 20,233 5,00,000 20,233 20,233 5,00,000

Total Premium for all members of the family is Rs.43,216/-, when each member is Total Premium for all members of the family is Total Premium when policy is opted on floater basis is Rs.32,177/-

PROS / DIA / V.11 / 2023

covered separately. Rs.43,216/-, when they are covered under a single policy. Sum insured of 5,00,000/- is available for the entire family
Sum insured available for each individual is Rs.5,00,000/- Sum insured available for each family member is Rs.5,00,000/- (2A)

Note: Premium rates specified in the above illustration are standard premium rates without considering any loading. Also, the premium rates are exclusive of taxes applicable.

A - Adult

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