Overview
The Star Health Super Surplus Gold plan is a super top-up health insurance policy designed for families, offering sum insured options up to ₹1 crore. Its deductible or defined limit options are based on the sum insured, including ₹3 lakhs, ₹5 lakhs, ₹10 lakhs, ₹15 lakhs, ₹20 lakhs, and ₹25 lakhs. The policy requires no pre-policy medical checkup and offers lifelong renewability, making it suitable for those seeking enhanced financial protection.
Experts Review
Written by Nikhil Nair
Senior Writer
The Star Health Super Surplus Gold plan is a solid super top-up option, especially for those with pre-existing conditions, as it covers related complications after just one year, a notably shorter waiting period compared to many of its peers. Its maximum sum insured of ₹1 crore provides ample coverage for most high-cost medical events. The Gold plan’s benefits include air ambulance coverage (up to 10% of sum insured per policy period for SI 7L and above), organ donor expenses, and a recharge facility that adds 50K up to ₹2.5L, depending on the Base SI, enhancing financial flexibility.
However, the plan mandates room rent limits for Single Private A/C Rooms, which may lead to out-of-pocket expenses if higher room categories are chosen. Premiums tend to be on the higher side—approximately 15-20% more than comparable super top-up plans, reflecting its comprehensive benefits, but impacting affordability. Operationally, Star Health’s average claim settlement ratio is 83% [avg. Of 2021-24], with a high complaint volume, indicating potential challenges in claims processing and customer service.
Pros
Feature set is satisfactory.
Insurer has a solid track record with great claim and service metrics.
Cons
No Bonus for being healthy and not claiming insurance, which is a notable gap.
Your insurer doesn’t provide free health check-ups, which could be a drawback for some.
No coverage if you are forced to hospitalize at home, which is a key feature.
Star Health
Key Insights
Founded
2006
Star Health was established 19 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
85% claims settled in 30 Days
Star Health settles only 85% of claims it receives, which is relatively low and may raise concerns about reliability during claim payouts.
Network Hospitals
14,000+
Star Health has a strong network with over 14,000 hospitals, ensuring wide accessibility and convenience for policyholders.
Complaints
52 complaints per 10,000 claims registered
Star Health has a relatively high volume of complaints, which may point to ongoing issues in customer service or claim handling.
Features
All
Great
Good
Co-payment
The insurer will bear the entire cost of treatment (up to the sum insured). You won’t have to pay a single penny. Meaning this policy has no co-payment.
Room Rent
You can share a room or you could have a single room for yourself. But if you are looking for anything slightly fancy, be ready to foot a part of the bill.
Disease sub-limit
Your insurance cover won’t be fully available in case you are treated for modern treatments and a few other diseases. Meaning the insurance company has a cap on the total amount they’ll pay out if you are treated for these specific illnesses.
Pre existing diseases waiting
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after just 1 year. It’s probably the best deal you can get to be honest.
Pre/Post hospitalization
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 60 days before you are hospitalized and 90 days after discharge. This includes the cost of medication by the way.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
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 & other similar therapies
Autologous-derived Stromal vascular fraction, Chondrocyte Implantation, Procedures using Platelet Rich plasma, and Intra-articular injection therapy
All treatment for Priapism and erectile dysfunctions
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Diagnostic expenses not related or incidental to current diagnosis and treatment are excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy for 1 years.
Cataract and diseases of the anterior and posterior chamber of the eye
ENT diseases (ear, nose, throat)
Thyroid-related diseases
Benign diseases of the breast
Subcutaneous benign lumps (e.g., sebaceous cyst, dermoid cyst, mucous cyst of lip/cheek)
Waiting Period
30 days Initial waiting period
1 years Specific illness waiting period
1 years Pre-existing disease waiting period
Ditto's Take
◦ Excellent ◦
Waiting periods on this policy are excellent. The specific illness waiting period and PED waiting period is better than usual.
What's missing in the policy
No Bonus for being healthy and not claiming insurance.
Your insurer doesn’t provide free health check-ups.
No coverage if you are forced to hospitalize at home.
Doctor consultations are not covered.
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Frequently Asked Questions
Does Super Surplus Gold have waiting periods?
- 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
- Specific Illness Waiting Period: There’s a 1-year waiting period for a list of diseases which is a mandate before you can start claiming.
- Pre-Existing Disease Waiting Period: There's a 1-year waiting period for any pre-existing disease you may have while buying the policy.
- Maternity and Newborn Waiting Period: There’s a 1-year waiting period before you can make claims related to pregnancy and childbirth.
Does Super Surplus Gold have room rent restrictions?
Does Super Surplus Gold offer a restoration benefit?
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