Currently, am holding a family floater Health Insurance with Insurance Provider A with Sum Assurance of 3L. I want to get a family floater super top up of 20L. Now, when I checked with provider A, they don't have the option of Sum Assurance of 20L for super top up. They have till 10L and the premium for the same in comparison to, say provider B, is approximately 5k higher.
Do you suggest:
Please suggest what step I should take.
To answer your question I spoke with a few financial advisors and also tried to dig up details online.
I am assuming that you have compared the exclusions and room rent limits in the both the plans. If not, go through this How does room rent limit affect claims in health insurance policies?
The renewal dates of your base policy and super top up policies should ideally be on the same day or be very close.
Super top up policies will only come into effect if there was an expense worth the deductible amount in the "super top up policy year". I'll explain this with an example.
Base policy runs from 1st Jan to 31st Dec, and has a cover of 5 lakhs. Super top up policy runs from 15th July to 14th July (next year), with a deductible of Rs 5 lakhs.
If you have a claim in March worth Rs 5 lakhs in march then it will be covered by the base policy.
Lets say you have another claim in September of Rs 7 lakhs. Now, while your base policy is active, you have already exhausted your cover of 5 lakhs in March. So base policy won't help you (it may if the sum insured is re-instated).
Super top up policy period starts on 15th July. The super top up policy requires that an expense worth Rs 5 lakhs (deductible amount) needs to happen 15th July onwards, only then will it come into effect. So out of your expense of Rs 7 lakhs, Rs 5 lakhs would have to be paid from your own pocket and the super top up plan will only pay for Rs 2 lakhs.
While there is no consensus for this, I'll stick my neck out and recommend that you get the super top up policy from a different insurance company. For 2 reasons:
Insurance companies, sometimes, approach IRDAI to make changes to their policies. These changes could be to add limits or exclusions as well. So if your insurance provider makes some changes, it may affect both the base plan and the super top up plan, if taken from the same provider.
If can spare 1.5 hours to watch a video on this topic, then definitely go through this webinar - How to choose a health insurance policy in 2019, by Deepak Mendiratta of plancover.com and hosted by freefincal.
Sachin Shah is a 30 year old Senior Software Engineer, working at an IT services company in Bengaluru. He and his wife want to plan for their retirement and also want to save for their child's education, wedding and for buying a car.View Case Study