WIXLIB

1) What is Super Top Up Insurance Policy?Super Top Up policy is a Family Floater Policy which offers you coverage of Mediclaim above yourchosen deductible limit along with extra ordinary features.It offers you financial relaxation in the event when your hospitalisation claim bill crosses your suminsured under any other Mediclaim policy. Thus it acts as cushion & comes in to action when youhave exhausted the chosen limit.2) What is difference between Mediclaim and Super top-Up policy ?A Mediclaim policy pays the claim from Rs. 1/- till maximum Sum Insured under your base policy.Whereas Super top-up policy cover hospitalization expenses beyond the chosen Deductible limit. Thedeductible limit is chosen by you. In other word it is a Mediclaim policy which triggers after a certainpre-decided limit of expense has crossed.Further mediclaim and super top up policy can work along with one another. That is, if you have amediclaim you can also purchase a super top up policy to get an enhance cover. Even if you donot have a mediclaim policy you can opt for Super Top up Policy.3) Why should I take Super top-up policy when I already have Mediclaim Policy ?1)It increases your sum insured at very reasonable premium2)No capping, No Co-Pay, Just 1 Month waiting period.3)Pre-existing Disease are also covered from Day One.4)Opportunity to avoid heavy deduction due to Room Rent limits.5)Super Top Up plan is cheapest super top up plan available in the market.6)For higher age person above 55 years of age it is very difficult to increase the sum insured underyour mediclaim policy hence super top up policy is advisable where you can top up your mediclaim sum insuredby Rs. 15 lakh up to 80 years of age.7)For major surgeries like Replacement of Organ like Kidney Transplant, heart transplant where the claimcost crosses Rs. 20 Lakh this Super top Up policy can only cover such expenses.4) How Super top-up policy is more beneficial than general Top up policy?Whenever anyone hospitalization exceed your base policy sum insured then claim is payable under top uppolicy. It is rare incident that single hospitalisation can arise where total hospitalisation bill will cross Rs. 5 lakhor deductible selected by you. Whereas under Super Top Up Policy aggregate of all claims made by your familymembers once crosses the base policy sum insured then your super top policy will start making the claimpayment.

5) If I have floater mediclaim policy then how super top up policy will pay the claim ?In floater Mediclaim policy the base sum insured will be for all the members of the family. Hence either the claimamount should exceed the deductible amount or sum insured should be exhausted for super top up policy torespond. Under floater policy claims of one or more member of the family or one or more claim of one of thefamily member should exceed the deductible amount chosen under super top up sum insured.6) If I have Individual mediclaim policy then how super top up policy will respond ?In individual Mediclaim policy every family member will have his own sum insured under base policy. Hence forsuper top up policy to respond his claim amount should cross the deductible limit under super top up policy.His / her other family members sum insured still remaining balance under base policy.7) Who can be covered under Super Top Up Policy ?All Members of ICSI can get covered under Super top up policy.8) Who all from my family member can be covered under the Super Top UP policy?Your entire family can be covered under the policy maximum up to 4 members. Your self & Spouse upto theage of 80 Years ( or the maximum age as per policy terms), 2 dependent Children up to the age of 25 years ( Orthe maximum age as per policy terms) of age can be covered under the policy.9) What is the maximum age to be covered in the policy?Maximum age is as per the terms and conditions of the Master policy. However, Once join then they will becovered life long on renewal of policies.10) What is a base policy you are referring to?Base policy is your Mediclaim policy. It can be your Mediclaim Policy, Individual Mediclaim policy or a FamilyFloater Mediclaim policy. It can also be your group Mediclaim policy offered by your employer. The suminsured under your base policy is base policy sum insured.11) How to select Sum-Insured under super top up policy?Higher the better. You can select sum insured from Rs. 5 Lakhs, Rs. 10 Lakhs & Rs. 15 Lakhs option. However itis better you select Rs. 15 lakhs as sum insured to maximize your Coverage over and above your Base Policy.12) What you mean by deductible Limit ?Deductible limit is a pre-decided limit chosen in super top-up Policy by you. Super Top-up policy gets

triggered and starts paying claim once the aggregate expense crosses this deductible limit.Example-1: Multiple Claims in a policy yearBase Policy Sum Super Top Up SumInsuredInsured OptedClaim AmountBase policy willSuper Top Upeligiblepay (Rs.)Policy will payAt Inception500,000500,000Claim 1200,000500,000350,000350,000Claim 2200,000500,000200,000150,00050,000Claim 3200,000500,000200,0000200,000Claim 0Total Paid013) Can I choose deductible limit less then/ more then my base policy sum insured?Ideally we should choose deductible limit which is equal to your Mediclaim policy sum insured so youshould get optimum cover. However it is not compulsory to choose only the same. You can chooselower than/ Higher then your base policy sum insured. We have option of Rs. 5 Lakh or Rs. 10 Lakh asdeductible sum insured. You can choose any of the above.14) What are the deductible option available in Super Top-Up policy ?Member with or without Base Policy : Deductibles Rs. 5 lakh and Rs. 10 lakh15) Can I get super top up policy if I don’t have base Mediclaim policy?If you or your family member does not have Mediclaim policy then you can still get super top up policy.Moreover, it is recommended as it is imperative that you limit your expenses.16) If some of my family member do not have cover under any mediclaim policy , Can I get super topup policy?Yes. Still you will get super top up policy and cover these members also in super top up policy. However forthose members who do not have any other mediclaim policy their deductible under super top up policy willbe minimum Rs. 5 Lakh.17) High value claim is rare to occur then why I should take super top up policy ?It is not necessary that in single hospitalisation your sum insured should be exhausted. Even in aggregate

of multiple hospitalisation of smaller claims, cross your base policy sum insured then super top up policywill come to your rescue and pay the balance hospitalisation bills. All the hospitalisation bills for morethan one member of your family can also be accumulated to claim under super top up policy.18) Can I accumulate hospitalisation bills of my all family members to exhaust the deductiblelimit?In super top up policy, all the hospitalisation claims of all the members covered under the policy canbe accumulated. So super top up policy will trigger once multiple hospitalisation claims of your all familymembers crosses the deductible limit.19) Wha t period’s hospitalization claims I can get under super top up policy?You can claim all the bills for which hospitalization has occurred during super top up policy period. Ifststyour base policy period is 1 Jan, 2018 to 31 December, 2018. Super top up policy period is 1stApril,th2018 to 30 March, 2019 and If you have claims paid under base policy before inception of super top upstpolicy i.e. 1 April 2018 then the same will not be considered for exhaustion of deductible limit of supertop up policy.20) How is the premium calculated for group policy ?If a group policy is issued for the first time then the general claim ratio of individual policies is considered. Furtherthe fact that the company receives huge number of policy holders at one time, the reduced advertisement costscan be passed on by way of discount on premium.For renewal of group policy, the premiums are decided on the basis of past claim ratio, agecomposition of the policy holders, types of claims made earlier and assumptions made for futureclaims.21) What cover super top up policy offers to you ?Super top up policy covers all hospitalisation expenses covered under your base policy. In additionwhether your base policy is covering Pre- existing disease or not it covers Pre existing disease fromDay 1 under the policy. If your base policy has waiting period for PED cover then you opt fordeductible more than Rs. 5 lakh in which case your PED claims will also be paid under Super TopUp Policy.1)Hospitalisation expenses covered Pan India occurred either due to adent or natural diseases.2)In patient hospitalisation expenses will be covered in reimbursement basis.3)No Medical test to be done prior taking this policy.

4)1 Month Waiting Period is applicable under the policy for hospitalization claims.5)30 days pre hospitalization expenses are included: Medical expenses incurred 30 days prior to thehospitalization are reimbursed.6)Post Hospitalization expenses up to 60 days are covered.7)Internal congenital diseases covered.8)Minimum Hospitalization of 24 hours required for the treatment, which cannot be taken at home.9)The minimum hospitalization clause is not applicable for Cataract, Chemotherapy & fracture orany Day Care treatment.22) What will be the general exclusions as per policy terms and conditions?The list of exclusions are mentioned in Terms and condition applicable to super top up policy. All theexclusions are common between your base policy and super top up policy. However under super topup policyexclusions like Pre-existing diseases, Waiting period of special disease & 30days are notapplicable23) I am a proposer & my age is 60 years, my husband’s age is 65 years. Which slabpremium will be applicable to me?Since maximum age of the one of the family member is above 61 years you will be chargedpremium of 61 – 80 years of age.24) Am I eligible for Tax Benefit under Super Top UP PolicyYes, you will get Tax benefit under section 80D25) Is there any co-payment under Super Top Up PolicyNo. There is no co-payment applicable to Super Top Up Policy.26) Would this policy is subject to any medical test?No, this is Super Top Up Policy need not to undergo any medical test.27) What would be the period of the policy?The policy would be for one year from the date of inception.28) What is the name of Insurance Company?Aditya Birla Health Insurance Company Ltd.