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Super Top up Health Insurance

Super Top up Health Insurance

The average medical cover provided by an employer is generally in the range of Rs 3 Lakh to Rs 5 Lakh, however considering the medical expenses in current medical settings, do you think that the coverage by the employer is enough?

Yes because 85% of treatments currently in India get done within 3-5 lacs.
No because

The cost of healthcare is increasing exponentially. It is increasing at a much higher rate than normal inflation and our normal salary increases per year. So the gap is fast increasing and Insurance can cover that gap.
New diseases every year like Ebola, Corona, Swine Flu etc., are further increasing the risk.
Advancement in medical technology like Robotic and stem cells are blessings for mankind. But these blessings come at cost.

● Around 3-5 lacs expenses on health care may not impact my lifestyle. We can always depend on my friends and relatives or on my savings.
● But imagine if the treatment cost goes beyond 20 lacs or 40 lacs.
● It happens in accidents, cancer, joint replacements, heart attacks, kidney transplantation etc..
● Many of us will go back 2-5 years financially. Many will have to sell their houses to cover the cost.
● This is when we actually need health insurance.
● This is when Super Top up Health Insurance helps.

It covers higher value of claims and surprisingly very low cost of premiums. It does not cover the lower value of claims and that can be covered from your pocket or from your employer group health insurance or from any other regular health insurance policy.
In-fact it is a wise idea to first cover ourselves with a higher amount of claims through Super top up Insurance and then if our budget permits, we can cover for a lower amount of claims too.
A 1 crore health insurance plan for 30 years person will cost just Rs.687 per year with deductible of 10 lacs.

A Normal Health policy of 3 lacs and (it could be your corporate policy or you may choose to cover up to 3 lacs from your pocket. )
Super top up policy of 10 lacs with 3 lacs deductible.
Case 1: If the claim is of 9 lacs

Policy 1: will pay 3 lacs which is equal to its sum insured. If you don’t have a base policy or corporate policy, then this amount will be paid from your pocket.

Policy 2: This policy will pay above 3 lacs (which is deductible). That means 6 lacs (9-3=6) will be paid from this policy.You will be still having a balance sum insured of 4 lacs (10 lacs – 6 lacs = 4 lacs) in the super top up policy which can be utilised in any future claims.

Professional Indemnity Insurance?

Don’t get confused between Top up and Super top up :

A super top up comes to the rescue when a single claim does not cross the deductible limit of top up policy, but multiple claims do. Thus, if Mr.Raju submitted three different claims of Rs 3 lakhs, Rs 3 lakhs and Rs.3 lacs respectively, the top up plan would be useless since none of them exceed Rs 3 lakhs individually.

But in Super top up, all the three claims will be added up the total claim beyond 3 lacs deductible, which in this case will be 6 lacs is payable.

Thus one should always choose Super top up instead of Top up.

Coverage under Super Top up Health Insurance plan. :

Like any other health insurance policy it covers the inpatient hospitalization expenses incurred due to an illness or accident, for a minimum of 24 hours. It pays for medical expenses including room rent, nursing, medical practitioner, boarding expenses, ICU, Operation theatre, medicines and other related requirements.

With the advancement in medical technology, in certain surgeries, the inpatient Hospitalisation can be of less than 24 hours. Those are called day care procedures. Insurer keeps identifying those procedures and settles the claim and waives that 24 hours minimum hospitalisation clause. It is advisable to refer cases to the Insurer and take prior approval before hospitalisation.

It also Covers outpatient medical expenses such as Doctor Consultations, diagnostic tests, medicines etc. that occur during the specified number of days immediately before and after hospitalization.

The Pre-Existing Diseases are not covered under the policy for a certain period (known as a waiting period) as mentioned in the policy. Waiting period starts from the date of inception of first policy with the insurer. Under this period the policy should have continuous coverage and should not have any break.
It is necessary and in the interest of the Policyholder to declare all the known pre-existing diseases one is already having. The insurer may reject the claim if they find that the policyholder has intentionally not declared the existing disease at the time of first taking the policy even when the claim is made after the Pre-existing waiting period.

A loading on your premium amount may be applicable as per nature of such pre-existing disease. Not all pre-existing diseases will attract loading. Applicability & percentage of loading will be ascertained by a medical underwriter. If loading is applicable for your health insurance proposal, the insurer will send you a counter offer. Only if you accept this offer and pay an additional premium, the insurer will issue the policy. If you do not accept such a counter offer within 15 days, the policy will not be issued, and the premium will be refunded after adjusting for expenses incurred by us on your pre-policy medical check-up.
There is no claim-based loading. However, if there was a loading based on the customer’s health condition on policy premium at the time of the first issuance of this policy, the same loading will be applicable at the time of renewal as well.

You are eligible for a deduction of INR 25000 for a premium paid on the health for yourself, for your spouse and children. Also, if you pay the health insurance premium for your parents (Senior Citizen), you will be entitled to an additional deduction of Rs. 30000/- Tax benefit is applicable if the premium is paid by any mode of payment, other than cash

Good news is that the premium will not change and neither the insurer can refuse to renew the policy, irrespective of the claims in previous year policy.
Your policy premium can change in case of following conditions:

If age band changes: If age band changes, the premium will be as per the age band applicable

If Tax/ cess is changed: If government changes/ adds any tax or cess, the premium will change accordingly

Product pricing revision: If the product pricing is revised, as per approval from IRDAI, premiums would change

A detailed chart of more than 12 Insurance companies in India who provide Super top up Health Insurance plan is presented here for your reference.
As all the insurers have Super top up plans with different deductibles and sum insured, it becomes sometimes complex to choose the right super top up health insurance plan.

Professional Indemnity Insurance?

Is there any advantage of buying this policy from an Insurance Broker?

You can buy from Broker, Agent, Directly from the Insurance company office or from their website or Online from a web aggregator website.

An Insurance broker is bound by the Insurance Regulator to perform as per the terms laid to them. They need to protect the interest of the client (you) at every step of insurance, be it buying or claiming assistance and representing the clients to the Insurer and not the other way around. That is why they are the only legal entity which is not tied with any particular Insurance company. They can deal with any Insurance company.

Now, because they are experienced and have worked with various clients, they know the best practices and hence can help you set up the best insurance policy for your organisation with ease, saving your time and effort.

Check the most suitable super top up plan with your choice of deductible here at www.ethika.co.in

Check our testimonials of our insured who claimed here.

Reach us through whats up @ 6304901240

Get in touch with us

At Ethika, we understand that Insurance Broking is about ensuring the best interest of our customers and establishing trust. Our team has diverse experience and strong expertise which enables us to understand your business needs and your risks well. Our experts are highly innovative and they deploy the latest technology tools to bring Speed, Effectiveness and Utmost Responsiveness to your doorstep.

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Gachibowli – Miyapur Rd,
Hyderabad. 500032

+ 91 84980 94601


Wework Raheja platinum Building Sag Baug Road, Off, Andheri – Kurla Rd, Marol, Andheri East, Mumbai, Maharashtra 400059

+ 91 84980 94603

Workafella Business Centre,  150, 1, Infantry Rd, Opp. Commissioner Office, Vasanth Nagar, Bengaluru, Karnataka 560001

Ethika Insurance Broking Pvt. Ltd. IRDAI Certificate No: 574, Date of License: 3rd Aug 2019, License valid till 7th Aug 2022,
Registered Address: 517, B Block, Vijaya Raghwa Township, Nallagandla Bypass Road, Lingampally. 500019
Principal Officer: Susheel Agarwal, Contact Details of Principal Officer: susheel@ethika.co.in +91 8498094600,
Directors: Susheel Agarwal and Suresh Agarwal, Category of License: Direct (Life and General).

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