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Should I get a 90 Lakhs Super Top-up Health Insurance with Care Health Base Policy (10 Lacs) for my Family?

Milind Vadjikar |1232 Answers |Ask -Follow

Insurance, Stocks, MF, PF Expert - Answered on Jan 13, 2025

Milind Vadjikar is an independent MF distributor registered with Association of Mutual Funds in India (AMFI) and a retirement financial planning advisor registered with Pension Fund Regulatory and Development Authority (PFRDA).
He has a mechanical engineering degree from Government Engineering College, Sambhajinagar, and an MBA in international business from the Symbiosis Institute of Business Management, Pune.
With over 16 years of experience in stock investments, and over six year experience in investment guidance and support, he believes that balanced asset allocation and goal-focused disciplined investing is the key to achieving investor goals.... more

Question by AVIJIT on Jan 12, 2025Hindi

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I HAVE CARE HEALTH INSURANCE BASE POLICY 1000000 FOR 2 ADULTS 1 KID , AGED 60 YEARS, 45 YEARS AND 16 YEARS. AND FROM THE LAST 15 YEARS NO CLAIM. 2023 I PORTED MY MEDICLAIM POLICY FROM NATIONAL INSURANCE TO CARE HEALTH INSURANCE WITH 1000000 L BASE AND 50% NCB. I GOT A RENEWAL ON DEC/24 AND NCB 50% WAS ADDED WITH MY BASE INSURANCE. NOW I WANTED TO TAKE A SUPER TOP-UP OF NIVA BUPA HEALTH RECHARGE OF 90 LAKH. IS IT GOOD FOR MY FAMILY? PL ADVISE ME.

Ans: Hello;

It is certainly a good proposition.

Just check on the deductible, sub-limits on some diseases if any, cap on room rent, if any. Any exclusions.

Best wishes;

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I have an individual health policy with Nivabupa. The current renewed policy document mentions: 1. Base Sum Insured Rs 5 lakh 2. Loyalty Additions Rs 2 lakh 3. Next Column Sum Insured (Base Sum Insured + Loyalty Additions + Refill amount ^) (in Rs) 12,00,000 My 2 claims totalling Rs 6.25 lakh for Angiography and Bypass Surgery were settled only for Rs 500,000. Is this in line with norms?

Ans: Hi Pannkaj,to answer your question we need to understand the plan details and the type of deduction done by the insurance company during the claim.

I suggest you speak with your insurer on why only Rs 500,000 was settled against your bills.

Also as a rule, do read all the terms and conditions on your policy document and the claim settlement process followed by your insurer.

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Question by Pradeep - Oct 12, 2022Hindi

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I am an employee of central govt. PSU. My family consists of myself, spouse, two minor children and mother. I am covered by a corporate group medical insurance policy for Rs 2 lakh with an additional emergency coverage of Rs 4 lakh by the employer. I also have a personal Family Floater policy for Rs 3 lakh and a Sr. Ctzn. Policy for Rs 1 lakh. I have not used the personal policies till date for any hospitalisation claim. I am aware that a claim exceeding the corporate policy limit can be claimed in the personal policy. Recently I was made to know that any planned hospitalisation exceeding the corporate claim limit, cannot be done using the second policy. I also know that there is a product called as top up policy which can be used in such cases. I have 8 years of remaining service where there is a medical insurance cover during the period. After retirement, the employer provides a basic policy of 1.5 lakh for the family. The same feels to be insufficient in today’s times. What would be your advice with regards to the existing medical insurance policies and their amounts? Should I need to undertake any tweaking of the policy amounts or switch to a top up policy?

Ans: Hi Pradeep, yours is a legit concern. It would be best if you take advice from a professional person or company – having the necessary qualifications -- after discussing your issue with them.

Insurance is each to its own. Depending on your concerns and requirements a professional service provider will be able to give you the best advice, whether to tweak policy amount or switch to top up.

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