What is a TopUp Mediclaim Policy?
A TopUp Mediclaim policy is an additional healthinsurance cover that kicks in only after the sum insured of your primary health policy is exhausted. It works like a safety net, providing extra financial protection against large medical bills without the need to purchase an entirely new comprehensive policy.
Why Choose New Indias TopUp Mediclaim?
New India offers a range of benefits that differentiate its TopUp Mediclaim from other players in the market:
- High Sum Insured Options: Covers up to 5crore, helping you manage catastrophic health expenses.
- Low Waiting Periods: Hospitalisation waiting period of only 30 days for most illnesses.
- Broad Network Hospitals: Cashless treatment at over 12,000 network hospitals across India.
- Simple Claim Process: Online claim submission, rapid turnaround and dedicated claim assistance.
- Tax Benefits: Premiums qualify for deduction under Section80D of the Income Tax Act.
Key Features at a Glance
| Sum Insured | 1lac 5crore (in multiples of 1lac) |
| Eligibility | Individuals, families & senior citizens (60+years) |
| Policy Term | 1year (renewable) |
| Waiting Period | 30days (hospitalisation); 2years for preexisting diseases |
| Copay | 0% (no copay) |
| PreExisting Disease Cover | Covered after 2years of continuous renewal |
| No Claim Bonus | 10% increase in sum insured for every claimfree year, up to 50% |
How Does the TopUp Mechanism Work?
Assume you have a base Mediclaim policy with a sum insured of 4lakhs. You incur a hospital bill of 7lakhs. The base policy will pay up to 4lakhs. The remaining 3lakhs is automatically transferred to the New India TopUp policy, which will pay the excess, subject to its own terms and limits. This seamless integration ensures you are not left battling large outofpocket expenses.
Eligibility and Enrollment
Anyone holding a primary health insurance policy can opt for the TopUp cover. The enrollment process is straightforward:
- Visit the New India website or nearest branch.
- Provide details of your existing Mediclaim policy (policy number, sum insured, renewal date).
- Choose the desired TopUp sum insured and term.
- Complete KYC (Aadhaar/PAN) and make the first premium payment.
- Receive the policy documents electronically within 24hours.
Claim Procedure
Filing a claim under the TopUp Mediclaim is as easy as filing a claim on your primary policy. Follow these steps:
- Inform the hospital about the TopUp cover at admission.
- Collect the discharge summary, itemised bill and original receipts.
- Log in to the New India portal or use the mobile app.
- Upload the required documents, fill the claim form and submit.
- Track claim status online; most claims are settled within 710 business days.
For cashless claims, the hospital coordinates directly with New Indias network, and you receive treatment without paying upfront (subject to network eligibility).
Exclusions to Keep in Mind
While the TopUp policy offers extensive coverage, it does not cover the following:
- Cosmetic or plastic surgery not medically necessary.
- Preexisting diseases within the first 2years of continuity.
- Selfinflicted injuries, accidents under intoxication, or wilful misconduct.
- Alternative therapies (Ayurveda, Homeopathy, etc.) unless specifically covered.
- Any expenses incurred outside the network without prior approval for cashless treatment.
Comparing TopUp with SuperTopUp
Both products provide additional coverage, but they differ in how the excess is calculated:
- TopUp: Pays the amount exceeding the base sum insured, after the base policys limit is fully exhausted.
- SuperTopUp: Pays the excess only after the aggregate claim amount (base + topup) crosses a predetermined threshold (e.g., 10lakhs).
If you anticipate occasional highvalue claims, a TopUp is usually more costeffective. For frequent highvalue expenses, a SuperTopUp may be worth evaluating.
Frequently Asked Questions
- Can I buy a TopUp policy without an existing Mediclaim?
- No. A TopUp is an addon cover and requires an active primary health policy.
- Is the premium paid annually or can I opt for monthly?
- Both options are available. Monthly premiums may attract a nominal surcharge.
- What happens if my base policy is renewed with a higher sum insured?
- The TopUp cover automatically adjusts, provided the combined sum insured does not exceed the maximum limit of the TopUp policy.
- Do I need to submit the base policy claim documents while filing TopUp claim?
- Yes. The insurer verifies that the base policy has settled its portion before paying the excess.
- Are there any age restrictions?
- Individuals up to 75years can subscribe. For senior citizens (60+years), a medical underwriting may be required.
How to Get Started
Protect yourself from unexpected hospital bills by adding a New India TopUp Mediclaim to your existing health plan. Click the button below to request a free quote or speak with an insurance advisor.
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