In response to our article – How do I mix base and tremendous top-up medical health insurance insurance policies? – Two readers despatched us equivalent tales on what our base coverage and tremendous top-up coverage ought to have the identical renewal date.
Case 1: Shared by Mr. Srinivasan Sundarajan. The individual had a base (10L) and an excellent top-up (50L) from the identical insurer. The individual was concerned in an accident, say on Feb 1st. There was an preliminary hospitalisation. The declare was 8L. It was for the interval ending Feb fifteenth. The insurer paid it out.
After 15 days, the physician might additional diagnose, and the boy wanted surgical procedure. This was decided on Mar 1st. The tremendous top-up coverage was renewed on Feb twentieth. The bottom coverage was due for renewal on Mar tenth. That is when it turned difficult.
The surgical procedure would value a further 12 L. In the event that they determined to bear the surgical procedure on Mar 2nd, the bottom coverage would solely cowl 2 L, the tremendous top-up wouldn’t cowl the primary 10 L, and the ultimate 2 L could be lined. So they might exit of pocket for 8L.
Fortunately, the renewal of the bottom was solely 10 days away, they usually might wait (which was acceptable because of the well being state of affairs). So that they scheduled it for Mar twelfth – to get the bottom to pay 10L and the 2L from the tremendous top-up.
This was an actual shut name. Lesson learnt: Align the coverage renewal dates on each insurance policies to keep away from getting right into a lure. If the bottom coverage renewal had been one other 20 days later, they might have had no alternative however to pay the 8L, regardless of all of the protection.
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Case 2: Shared by Mr. Harpreet Gandhi. My acquaintance bought a ten lakh base coverage from Firm A, together with a 40 lac tremendous top-up, with a deductible of 10 lac from Firm B. In idea, they’d protection as much as 50 lac. Nonetheless, they purchased these insurance policies on totally different dates. The bottom coverage was bought on 1st January and the Tremendous Prime-up on 1st April of the identical 12 months.
It so occurred that they have been recognized with most cancers, and the chemotherapy bills exhausted the bottom cowl by 1st March. So whereas the bottom coverage was exhausted, the tremendous top-up coverage kicked in and offered cowl until thirty first March. Nonetheless, as we all know, most cancers remedy goes on for an extended length. The highest-up coverage was renewed in April, and Firm B then once more requested for the deductible situation of 10 lac to be met earlier than the tremendous top-up coverage kicks in. That is the place it shocked them. They have been unaware of this peculiarity of the way in which the tremendous top-up coverage works.
Had the insurance policies been purchased on the identical date, this example wouldn’t have occurred and would have saved 10 lac expense from their pocket.
Greater than the cash, additionally it is concerning the misery that the affected person’s household needed to undergo. They have been beneath the impression that they have been very nicely lined. Nonetheless, it turned out to be unfaithful attributable to this small element.
Editor’s word. What are you able to do? In my expertise, if the top-up is bought from the identical insurer as that of the bottom coverage and through an agent, this concern often doesn’t come up, because the renewal dates often match. Shopping for it on-line may be difficult, so it’s finest to buy near the renewal date of the present coverage and make sure the dates match.
Care must be taken when the top-up insurance coverage is from a unique insurer. An actual date match shouldn’t be all the time attainable, however so long as the hole is as quick as attainable (a number of days), it must be okay. However even right here, you may request a date match. They might or might not agree.
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