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PolicyWise AI

Insurance Intelligence

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INSURER

Star Health Insurance

Family Floater

EXPIRY

15 Mar 2026

245 days left

COVER

₹10,00,000

0% used

0
RISK
MEDIUM

Room rent cap detected

Potential Claim Reductions

Clauses that may reduce your payout

2 HIGH2 MED

Action Required Before Hospitalization

2 critical clauses detected that could significantly reduce your claim payout. Review each risk before admission.

AI
AI Explanation

Your policy caps room rent at ₹5,000 per day. If you choose a room that costs more — say ₹8,000/day — the insurer applies a proportionate deduction across almost all hospital expenses (doctor fees, nursing charges, OT charges). A 60% room rent breach can reduce your total claim payout by 30–40%, even if your sum insured is untouched.

Potential impact:Can reduce total claim by 30–40%

💡 Ask the AI Assistant below to understand any of these risks better

Policy Snapshot

What's in and out of coverage

Covered
  • ICU Charges

  • Ambulance (up to ₹2,000)

  • Day Care Procedures

    540+ listed

  • Organ Donor Expenses

  • AYUSH Treatments

    Ayurveda, Yoga, Unani

  • Pre & Post Hospitalisation

    30 & 60 days

Excluded
  • Cosmetic Surgery

  • Dental Procedures

    Unless accidental

  • Experimental Treatments

  • Self-inflicted Injuries

Policy No.P/211211/01/2024/019283

Policy Health Score

AI-assessed coverage quality

Good Protection
82out of 100PoorFairGood
Coverage Quality88/100
Claim Friendliness72/100
Risk Exposure65/100

Score improves when you upgrade room rent limit or remove co-pay

Analytics

Coverage Distribution

How your ₹10L is allocated

Hospitalization55%
Pre/Post Hospital15%
Day Care12%
Critical Illness10%
AYUSH5%
Others3%

Risk Factors

Risk score per clause (higher = more risk)

Benefit Categories

Effective coverage per benefit type

Inpatient Care₹9.5L
Day Care₹8L
AYUSH₹3L
Ambulance₹2,000
Organ Donor₹5L

AI Insurance Assistant

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