Let’s Understand How Super Top-up Insurance Works

Are you considering buying an additional health insurance policy to expand your coverage? I suggest you go for super top-up plans instead. These are suited to those who are already covered under the corporate health cover or hold an individual health insurance but want to expand their insurance coverage. To sum up, super top-up plans are a great option to get extra insurance coverage without buying an additional health insurance.

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How does super top-up health insurance work?

A super top-up plan comes with a deductible limit which is a fixed initial amount that has to be first paid by the policyholder. Many people get confused between top-up and super top-up plans. However, both the policies are different. In the case of top-up plans, every claim is considered individually. However, in super top-up plans, all claims are aggregated within policy tenure.  Let’s understand how super top-up health insurance works.

Let’s assume you have a health insurance policy of Rs 5 lakhs and you go in for a top-up plan of Rs 10 lakhs with Rs 5 lakhs as deductible. In this situation, you get an extra insurance cover of Rs 5 lakhs over and above the base policy.

As mentioned above, the top-up plans consider every claim individually, therefore, if there are two claims of Rs 2 lakhs and 4 lakhs, nothing will be covered by top-ups. As none of the claims have crossed the threshold limit, which is Rs 5 lakhs in this case.

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This is where a super top-up policy comes to your rescue. In a super top-up, the sum of all claims is considered. Let’s continue with the example above.  Say, you take a super top-up policy of Rs 10 lakhs with a threshold limit of Rs 5 lakhs. Additionally, you already have a health insurance policy of Rs 5 lakhs. For a claim of Rs 2 lakhs, your primary health insurance coverage is sufficient. Then, say, you make another claim of Rs 4 lakhs in the year. Out of this amount, Rs 3 lakhs will be covered by your health insurance policy and the remaining Rs 1 lakh will be paid by the super top-up plan. This is because the total claim amount is Rs 6 lakhs (2+4), which is above the threshold limit.

Let’s understand it with the help of the following example:

Cases Top up Cover Super Top-Up Cover
Insurance policies you own Policy 1: Regular health insurance policy with Rs 5 lakhs coverage Policy 1: Regular health insurance policy with Rs 5 lakhs coverage
  Policy 2: A top-up cover of Rs 10 lakhs with a threshold limit of Rs 5 lakhs Policy 2: A super top-up cover of Rs 10 lakhs with a threshold limit of Rs 5 lakhs
Situation A
One claim of Rs 6 lakhs in a year Policy 1 will pay Rs 5 lakhs Policy 1 will pay Rs 5 lakhs
Policy 2 will pay Rs 1 lakh Policy 2 will pay Rs 1 lakh
Situation B
Two claims of Rs 3 lakhs each Policy 1 will pay Rs 3 lakhs for the first claim Policy 1 will pay Rs 3 lakhs for the first claim
Policy 1 will pay Rs 2 lakhs for the second claim Policy 1 will pay Rs 2 lakhs for the second claim
Policy 2 will not pay anything because no billing amount exceeds the threshold limit, which is Rs 5 lakhs Policy 2 will pay the remaining Rs 1 lakh
Situation C
Two different claims of amount Rs 7 lakhs and Rs 3 lakhs Policy 1 will pay Rs 5 lakhs Policy 1 will pay Rs 5 lakhs
Policy 2 will Pay Rs 2 lakhs as the bill crosses the threshold limit Policy 2 will Pay Rs 2 lakhs as the bill crosses the threshold limit
Policy 1 and 2 will not pay anything for the second claim. As Policy 1 exhausts its coverage, nothing will be paid. Similarly, the second bill doesn’t cross the threshold limit, therefore, nothing will be paid Policy 2 will pay the second claim amount of Rs 3 lakhs as the total claim in the year crosses the threshold limit

In short, super top-up plans consider the total of the bills in a year and not just a single instance. Further, the premium paid on super top-up policies is cheaper, and you don’t need to take the policy from the same insurance company as that of your base policy. Also, you can buy super top-ups even if you don’t have any health insurance coverage at all.

Given the rising medical costs, having a simple health insurance is not sufficient. You have to go the extra mile to ensure that the cover is adequate. It is here that the super top-up plan comes to your rescue.

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