ManipalCigna Super Top-up Plan
A super top-up policy provides enhanced protection to the insured, over and above his/her existing base health insurance plan. In medical situations, when the sum insured under the base insurance policy gets exhausted, a super top-up plan comes into the picture.
ManipalCigna Super Top-up plan is one such policy that provides much-needed financial protection, in case the base health insurance policy gets exhausted.
What is ManipalCigna Super Top-up Plan?
ManipalCigna Super Top-up is an annual aggregate deductible policy. This means that the company is liable to pay for the medical expenses of the insured if and only the expenses exceed the deductible amount, on an annual basis. This policy provides the option of individual policy as well as a family floater option.
It is pivotal to understand the difference between top-up and a super top-up policy to make wise decisions. Under both top-up and super top-up plan, the insurance provider is not liable to pay for the medical expenses of the insured if the expenses do not exceed the deductible amount. The only difference between the two policies is that under a top-up policy, the expenses should exceed the deductible for every single claim whereas, under a super top-up policy, the cumulative expenses for all the claims should exceed the deductible amount.
Features of the ManipalCigna Super Top-Up Plan
This policy from ManipalCigna Health Insurance comes with the following features:
- Reduced Waiting Period: This plan provides an option to reduce the waiting period for pre-existing conditions to 24 months on the payment of the applicable premium.
- Savings: By covering 2 or more family members under the same individual policy, one can save up to 10% of the premium. By purchasing a policy for 2 years or 3 years under a single policy term, one can save 7.5% and 10% of the premium respectively. In case of online renewal of the ManipalCigna Super Top-Up policy, one can save up to 3% of the premium.
(All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C apply)
- Income Tax Benefit: One can avail the benefits available under section 80D of the Income Tax Act, 1961.
- Free Look Period: One gets the benefit of a free-look period of at least 15 days to read the terms and conditions of the policy. This period is extended to 30 days in case of policies taken on an electronic policy. One can cancel the policy within the look period in case he/she does not agree with the terms and conditions of the policy, provided no claim has been made during the look period.
- Grace Period: A grace period of 30 days is provided under this policy for renewal with all continuation benefits of the policy.
- Family Floater Option: ManipalCigna Super Top-Up planprovides a family floater option. This means the insured can float the option to his/her dependants under this policy.
- Lifetime Renewal Option: This policy provides a lifetime renewal option to the insured provided the premiums are paid in full and in time.
Benefits of the ManipalCigna Super Top-up Plan
The policyholder is provided with the following benefits under this ManipalCigna Health Insurance:
- In-patient Hospitalisation: Any expenses arising out of the hospitalisation of the insured will be covered under this policy, provided, such hospitalisation was for more than 24 hours. The insurance provider is liable to pay for room rent, intensive care unit charges, operation theatre charges, fees of the medical practitioner, anaesthetist, nurses, specialists, diagnostic tests, medicines, drugs and consumables, blood, oxygen, surgical, and prosthetic devices that are inserted in the body of the insured during a surgery.
- Pre-hospitalisation Expenses: Any medical expense arising during a policy year, immediately preceding the hospitalisation of the insured, will be covered under this plan, up to the limits specified. These expenses will be covered only if they relate to the same medical condition that required subsequent hospitalisation and the patient has made a claim for in-patient hospitalisation expenses.
- Post-hospitalisation Expenses: The medical expenses arising during a policy year, immediately succeeding the hospitalisation of the insured will be covered if and only, they relate to the same condition he/she has been admitted to the hospital for and, the insured has made a claim for in-patient hospitalisation expenses.
- In-patient Hospitalisation for AYUSH Cover: Medical expenses incurred by the policyholder for availing AYUSH treatments (Ayurveda, Yoga, Unani, Siddha, Homoeopathy) are covered under this policy, subject to certain conditions regarding the place of such treatment.
- Daycare Treatment Expenses: ManipalCigna Super Top-up policy covers medical expenses incurred by the insured for treatments requiring hospitalisation for less than 24 hours. Such a treatment must have been undertaken in the in-patient department of a hospital or a daycare centre. The treatment taken in an outpatient department is not claimable under the policy. Pre and post-hospitalisation expenses are also covered for daycare treatments.
- Non-medical Expenses: Certain non-medical expenses like toiletries, etc. as listed in the wordings of the policy are also claimable under this plan provided, such expenses relate to the same medical condition and, the insured has made a claim for the in-patient hospitalisation or daycare treatment of such condition.
- Road Ambulance Cover: The expenses incurred for transporting the insured to the nearest hospital in case of an emergency are claimable. A medical practitioner should certify the use of an ambulance. The insurance provider is also liable to pay for the shifting of the insured from one hospital to the other in case such necessity arises.
- Donor Expenses: The in-patient hospitalisation expenses of the donor are covered under ManipalCigna Super Top-up plan provided, the organ donated is used for the insured and, such donation has been made in compliance with the provisions of the Transplantation of the Human Organs Act. The pre and post-hospitalisation expenses and any subsequent expenses of the donor, after harvesting the organ are not covered. The insurance provider is also not liable for the expenses regarding the screening of the donor and the costs incurred to acquire such an organ.
- Guaranteed Cumulative Bonus: In case of the continued renewal of the ManipalCigna Super Top-up policy, the insurance provider guarantees a 5% increase in the sum insured, every year subject to a maximum of 50% of the sum insured.
Exclusions of the ManipalCigna Super Top-up Policy
Under the below circumstances, the policy becomes null & void:
- Pre-Existing Conditions: Pre-existing conditions are not covered under the policy for a period of 48 years from the date of purchasing a health insurance in India. Such term may be reduced, subject to certain conditions.
- Dental Treatment: Medical expenses incurred on the dental treatment of the insured is not covered under this plan unless such treatment is necessitated by accident and requires a minimum of 24 hours of hospitalisation. Expenses incurred on irreversible bone disease included the jaw are also covered.
- Self-inflicted Injuries: Any injuries incurred due to self-involvement in the cause such as suicides, involvement in crimes, etc. are not covered.
- Substance Abuses: Any illness or disease resulting from substance abuse such as drugs, nicotine, alcohol etc. is permanently excluded from ManipalCigna Super Top-up Option. Expenses incurred on treatment for substance addiction are also not covered under the policy.
- Other Exclusions: Routine eye-checkups, diseases or illness inflicted by war, sexually transmitted diseases, birth control procedures, cosmetic or plastic surgery, etc. are not covered under this policy.
Eligibility Criteria Buying the ManipalCigna Super Top-Up Plan
The minimum entry age limit for buying this policy is 18 years. However, one can insure children of the age 91 days and above under this policy. There is no maximum age of entry for adults under this policy.
The minimum entry to age to opt for a family floater option is 18 years. However, one can insure children of the age 91 days and above under this policy.
In case of a family floater option, the maximum age limit for children is 23 years.
One can insure up to a maximum of 2 adults and 3 children under the same policy.
Claim Process of the ManipalCigna Super Top-Up Plan
The claim steps are quite similar to other health insurance policies when t comes to claiming ManipalCigna Health Insurance:
Intimation of a Claim: The insurance provider must be informed regarding the condition of the insured for seeking a claim.
- Planned hospitalisation: In the case of planned hospitalisation of the insured, the insurance provider must be informed at least 3 days prior to the admission of the insured in the hospital. When the medical expenditure exceeds the deductible amount at a later date, the provider must be informed on the day of such event.
- Emergency hospitalisation: In the event of emergency hospitalisation of the policyholder, the insurance provider must be informed within 48 hours from the hospitalisation or the discharge date, whichever is earlier.
The relevant details of the policy and policyholder must also be intimated to the provider for claims.
- Cashless Settlement for Claims: One can opt for cashless settlement of a claim. However, such a facility is only available at a network hospital of the provider.
- Claim Reimbursement Process: To make claims, the insured must submit the necessary documents to the insurance provider within the stipulated time. Upon scrutinisation of the documents, the provider will assess the claim amount. Following which, the claim investigation will be undertaken by the provider, and thereafter, the claim will be reimbursed, subject to a few more minor steps.
Required Documents for ManipalCigna Super Top-Up Plan
The insured has to produce the following documents:
- For Purchasing the Policy: One must fill up the proposal form with all the necessary details including medical history, to opt for the ManipalCigna Super Top-Up Option.
Certain individuals may be required to undergo a few medical tests depending on their age or sum insured. The provider may also ask individuals to go for medical tests where extreme medical history is present in the proposal form.
- For Making Claims: A duly signed claim form, hospital bills, operation theatre bills, diagnostic and other investigation reports, doctors’ reference slips, pharmacy bills, FIR report or post mortem report (in the event of the death of the insured) are among the pivotal documents required for making claims. The provider may ask for other relevant documents as well.
How to Buy the ManipalCigna Super Top-up Policy?
One can opt for the policy either online or offline. It is pivotal to understand and discuss the wordings and terms and conditions of the policy before purchasing. If such conditions are acceptable to you, you must fill the proposal form. Such duly filled proposal form along with the necessary documents and premium should be sent to the provider who will process and scrutinise the application.
The policy can be bought online through Paisawiki.com as well. One can visit the website and go through the buying process. The premiums can be paid online and upon successful payment, the policy document will be sent to the registered email Id.
Renewal of the ManipalCigna Super Top-Up Plan
ManipalCigna Super Top-up Policy offers lifelong renewal opportunity to the insured if and only if the premium is paid in full and in time.
A grace period of 30 days is provided for the payment of premium for the renewal of the policy. Any failure to pay the premium within the grace period will lead to the termination of the policy.
To renew the policy:
- Visit paisawiki.com.
- Go to the ‘helath’option and clickon ‘Renew’ policy.
- Provide necessary details of the policy and calculate the premiums online.
- The fresh policy documents will be mailed upon successful payment of the premiums.
Ans: A super top-up policy acts as an umbrella to prevent the insured from the burden of unforeseen medical emergencies and subsequent treatments. It comes in picture when the sum insured under the base plan reaches its threshold limit.
Ans: No, a base health insurance policy is not mandatory to opt for a super top-up plan. However, one will be required to meet the medical expenses out of his/her pocket until such expenses do not exceed the deductible amount to qualify for the claim under the super top-up plan.
Ans: No, there is no room rent cap applicable to this policy. Rent for rooms of all hospitals is claimable under the policy.
Ans: The policy covers non-medical expenses to the extent they are necessary and incurred during the hospitalisation. So, maternity expenses and other fertility-related complications are not covered under this policy.
Ans: Yes, NRIs are eligible to opt for ManipalCigna Super Top-up provided he/she is available in India for signing up the proposal form and undergoing medical tests (if applicable). It must be noted that the applicant must have an Indian address for communication and coverage under this policy is restricted to the geographical boundaries of India only.
Ans: A foreign national is eligible to opt for this policy provided he/she has an Indian address for communication and is residing in India for 180 days or more.
Written By: Paisawiki - Updated: 09 April 2021