Super top health insurance

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Deal Lieutenant
Theranos

Hi I need some clarification regarding Super topup. Health insurance,so if you have any clarity or resources to get a better view It would help me a lot,Thanking all your help in Advance ,appreciate your time and effort 

This is going to be bit long so kindly read correctly before answering 

My brother who is 35+yrs old with no Pre existing illnesses  has a basic individual health cover of 3 LAKH with zero copay & restoration benifit (ie 3lakh+3lakh with lot of t and c) and  a super topup of 20 LAKH with 3 lakh deductable  via a group policy,which is in force since last 4years…so the cover is with min exclusions….both these plans cost him something like 6k/yr in annual premium,recently he thought to increase his cover to 50 lakh or more via super topup & approached the insurance Provider for increasing the cover but they don’t have any plans of 25 lakh and above in super topup  in the category of his earlier super topup,so they can only provide upto 25 lakh….which he thinks isn’t enough….so he got around on insurance marketplaces  to search where he found out that he has an amazing offer of upto 1cr super topup  with 10 LAKH deductable for just under 2k from niva bupa,so he bought it and is just past it 30 days 

Now he is considering to increase the base cover to 5 lakh ( as he thinks restoration benifit is there for any claim for post 5 lakh,which has lots of t and c so can’t get it in reality ),But I advised him to not do the mistake and told him to take base cover to 10 LAKH instead of 5 lakh and he is ready to take 10 LAKH base cover,but as the increased cover ie from 3 lakh -10 LAKH (7 lakh)of base cover will have to undergo waiting period to cover all exclusions and the new super topup also needs to be 4 years I force to get off waiting period,I suggested him to hold on 20 LAKH deductable super topup  for 4 years as it costs barely 600+/yr ,now considering his situation he is also ready to hold on to that and his total outgo would be 10k + for 10 LAKH base cover+2k for 1cr super topup +600 for 20 LAKH super topup so net outgo is 13 k 

Note that he comes under presumptive taxation for professional,so he can’t avail any tax benifits and even isn’t looking for any benifits apart fro. Pure risk cover 

Now my questions are 

1)is it legally valid for a person with 3 lakh base cover to purchase 10 LAKH deductable super topup (In this case he would simply say I would bear 7 LAKHs from my pocket)

2) can he choose to hold on two super topup  policies and claim all three ie say if his medical bill is 28 lakh while he get 3 lakh claim from base cover +upto 20 LAKH from earlier super topup and rest 8 lakh from new super topup upto 1 crore 

If yes he would get same 1 cr coverage  with added benifit of no major waiting period,with diversified insurance provider(note hospital coverage in his geography adds a few more hospitals apart from some favourable conditions in 20 LAKH super topup) with cherry on the cake is 8k +for 1 cr cover instead  of 13k if switched to 10 LAKH base cover

 3)will there be any other simple solution to get similar cover 

4) as per my information super topup can’t be ported is it possible to port super topup 

5) recently there are many startups providing subscription health plan coverage like pay subscription fee of 1500/month to get upto 50 lakh cover /yr with opd also covered  (like even.in) is that a better option 

Thank you in Advance again 

Looking ahead for your help




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1) Yes. It doesn’t matter how much deductible super topup you want to take. If policy is approved, and no fraud/misrepresentation and genuine claim is made, it will be honoured.

2) 3) no idea

4) Yes, super topup will be a bit difficult to port especially group policy ones

5) These are considered different than traditional health insurance. As these are new and mostly startups hard to trust them so easily. ICICI/Max are like time and tested.

6) It would be helpful if you can be a bit brief, so anyone can answer easily

@drjpatwa has helped lots of members on this website, he’ll definitely help u as well. Wait for his response provided you follow point 6 😄

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raman12 wrote:

1) Yes. It doesn’t matter how much deductible super topup you want to take. If policy is approved, and no fraud/misrepresentation and genuine claim is made, it will be honoured.

2) 3) no idea

4) Yes, super topup will be a bit difficult to port especially group policy ones

5) These are considered different than traditional health insurance. As these are new and mostly startups hard to trust them so easily. ICICI/Max are like time and tested.

6) It would be helpful if you can be a bit brief, so anyone can answer easily

@drjpatwa has helped lots of members on this website, he’ll definitely help u as well. Wait for his response provided you follow point 6 😄

I just wanted to provide context,so that non generic answers be presented which made it lengthy,but as the context is important here I gone that route

Kindly guide me to concise the narration is my humble request 

Thanks for the response and appreciate your help and time 

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