In a significant move to enhance customer convenience, SBI General Insurance has introduced the SBIG Health Super Top-Up Plan, aligning with a growing trend among general and health insurers to offer similar products. Super top-up plans are designed to provide additional financial protection in the event of critical illnesses or hospitalization that may incur exorbitant costs, often exceeding the coverage provided by standard base health insurance policies.
High Coverage at a Low Cost
One of the key advantages of opting for a super top-up is the ability to secure high coverage at a relatively low premium. For instance, Siddharth Singhal, head of health insurance at Policybazaar, illustrates a typical scenario: “If a 45-year-old buys a health cover of ₹1 crore, with a base cover of ₹10 lakh and a super top-up of ₹90 lakh, the premium for the base policy would range from ₹11,000 to ₹13,000, while the super top-up would add only ₹2,000 to ₹5,000 to the total cost. Hence, the overall expense would be around ₹18,000. In contrast, a standalone base cover for ₹1 crore would cost about ₹36,000.”
Moreover, Anushri Pawar, senior manager of employee benefit practice at Anand Rathi Insurance Brokers, emphasizes the additional benefit of tax deductions available under Section 80D for this policy, making it even more attractive for consumers.
Understanding Deductibles
A critical aspect of super top-up plans is the concept of deductibles—the amount an insured individual must pay out of pocket or through their base policy before the super top-up coverage is triggered. According to Subramanyam Brahmajosyula, chief product and marketing officer at SBI General Insurance, “Ideally, the deductible should match the sum insured of the base policy.” For example, if an individual’s base policy is ₹10 lakh, the deductible should also be ₹10 lakh.
However, complications can arise if a customer assumes that the deductible applies to each hospitalization. “It’s important to note that the deductible is calculated annually for a super top-up,” explains Aayush Dubey, co-founder and head of research at Beshak.org. He cautions that if the base policy covers ₹5 lakh but the deductible for the super top-up is ₹10 lakh, an ₹8 lakh hospital bill would leave the policyholder responsible for ₹3 lakh out of pocket.
The Importance of Buying from the Same Insurer
Purchasing both the base policy and the super top-up from the same insurer is highly advisable. Brahmajosyula states, “This approach simplifies the claims process and reduces paperwork significantly.” Additionally, aligning both policies with the same insurer typically means that the waiting periods, exclusions, and other terms will also be consistent, minimizing potential disputes or confusion during claims processing.
Dubey warns that dealing with different insurers complicates matters, as it necessitates managing two separate claims procedures. When both policies are from the same provider, consumers can often enjoy a cashless experience for the full insured amount. “Otherwise, while you may receive cashless treatment for the base policy, you might have to file for reimbursement with the super top-up,” Singhal adds. Pawar notes that many insurers also provide discounts for clients who opt to purchase multiple plans from them.
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Key Considerations
When choosing a super top-up plan, it’s vital to ensure that the sum insured is adequate to cover worst-case scenarios. “Opting for a low sum insured could leave you financially vulnerable,” warns Pawar. It is also essential to ensure that the features of both policies match. Singhal advises that if the base policy allows any room category and has a three-year waiting period for pre-existing conditions, the super top-up should offer similar terms.
Brahmajosyula suggests maintaining similar room rent limits in both policies to prevent deductions. Furthermore, ensuring that exclusions in both policies align can create a smoother claims experience. Lastly, Dubey emphasizes the importance of checking that the hospital network included in the super top-up plan is extensive and includes the insured’s preferred hospitals, enhancing the policy’s overall utility.
The introduction of super top-up plans, like SBI General Insurance’s SBIG Health Super Top-Up Plan, reflects a significant advancement in the health insurance landscape, offering consumers the opportunity for enhanced financial protection without exorbitant premiums. By carefully considering deductibles, purchasing from the same insurer, and ensuring the alignment of policy features, individuals can simplify their claims process and enjoy peace of mind during medical emergencies.
