Need of the hour – Super Top-up Policy

This is a guest post by Priyanka Khandelwal who is heading eBusiness vertical  at MediManagea specialist health insurance advisory service for Individuals, Families and Corporates. Know more about Medimanage’s free advisory services here

Life is full of risk and unpredictable most of the time. A sudden situation might arise and end up making you physically, emotionally & financially stressed.

One grave example is the fact of not buying an additional cover & relying only on your company insurance. It is often believe that the coverage provided by the employer is sufficient to take care of any unforeseen medical expenses which may arise. Let us look at 2 important facts to get a clear understanding as to why we require a supplementary cover.

  • The average medical cover that a company insurance offers ranges from Rs. 2 to 4 lakhs.
  • In the last 5yrs the medical cost has increased making it difficult for a common man to borne the expenses from his pocket. Let us look at the cost of few medical treatments in India:-
Procedures 2008 2013 Increase %
Heart Valve Replacement Rs. 1,75,415 Rs. 3,43,145 52%
Knee Replacement Rs. 2,70,220 Rs. 4,36,730 61%
Cataract Removal Rs. 16,000 Rs. 25,000 56%
Angiography Rs. 14,000 Rs. 22,000 57%
Coronary Artery Bypass Graft Rs. 1,65,000 Rs. 2,40,000 45%
Appendectomy Rs. 28,000 Rs. 47,000 66%
Gall Bladder Removal Rs. 32,000 Rs. 59,000 84%
Angioplasty (PTCA) with 2 Stents Rs. 1,75,000 Rs. 2,65,000 51%

Please Note: Rates are as per the approximate cost of treatment.

Looking at the above figures, do you still feel that your coverage is sufficient enough ?The answer will be “NO”.

It is also important to note that along with the cost of the medical expenses the premium rates may also inflate Thus, it may not be practically possible to either enhance the current cover or buy an additional cover. So in such situation, what should be the solutions?

The answer is Super Top-up policies.

In this article, let us understand – What is a super Top-up Policy? How will this be beneficial? We will also be providing a detailed comparison between 2 notch products available in the market for your reference .

What is a Super Top-up Policy?

A Super Top-up Policy is a unique type of health insurance policy available which offers an additional coverage, beyond the “ Aggregate Threshold Limit”. Thus it acts as a cushion & comes in to action when you have exhausted the exisiting cover.

Let us understand with an Example:-

Let’s say if you have an individual Policy of Rs. 5Lac and a Super Top-up Policy of 10lac with 5 Lac Threshold Limit.

Incase there is a claim for 7Lakh, your individual health insurance policy will pay Rs. 5Lakh and the remaining claim amount of Rs. 2 Lakh will be paid by your Super Top-up Policy.

Now if there is another claim of 4Lakh in the same policy year, then the entire 4Lakh claim shall be paid by the super top-up policy. Because your aggregate threshold limit of 5 lakhs is crossed. This claim will be paid upto the limit of sum insured.

When you buy Super top-up, consider the below points:-

  • While buying a super Top-up policy it is not mandatory to have an existing health insurance cover
  • The threshold limit is applicable for each policy year
  • The threshold limit is the mandatory deductible, which needs to be take care by the customer either by way of a corporate policy or any other individual policy. You can also pay this from your pocket.
  • An aggregate threshold limit is sum total of all hospitalization expenses in a policy year.


Let us also look at the comparison – L&T Medisure Classic & Apollo Munich – Optima Super


Insurance Company L&T – Medisure – Super Top-up Apollo Munich – Optima Super
Sum Insured SI 3Lac & 8Lac – 2Lac Deductible
SI – 7 & 12Lac – 3Lac Deductible
SI – 6, 11 & 16Lac – 4Lac Deductible
SI – 5,10,15 & 20Lac – 5Lac Deductible
SI – 5Lac, 7Lac & 10Lac
Deductible – 1, 2, 3, 4, 5, 6, 7 & 10Lac
Min Entry Age Adult – 18yrs
Child – 91days
Adult – 18yrs
Child – 91 days
Max Entry Age Adult – 65yrs
Child – 23yrs
Adult – 65yrs
Child – 21yrs
Renewal Age Lifelong Lifelong
Pre Acceptance Medical Checkup 55yrs 45yrs
Cost of Medical On acceptance of proposal, 50% of the cost of medicals will be re-imbursed. On acceptance of proposal, 100% of the cost of medicals will be re-imbursed.
Family Defination Individual Cover – Self, Spouse, Children, Parents, Parent-in-laws, Siblings, Grandparents, Daughter-in-law, Son-in-Law, Nephew, Niece, Grand children.
Floater Cover – Self, Spouse, 2 Children (Parents & Parent-in-Laws can also be covered as a separate cover)
Individual – Spouse, dependent children and dependent parents (Max 4Adults & 5Children)
Floater – Self, Spouse, 2 Children (Max 2 Adults & 2 Children)
Parent-in-law – If financially dependant.
Family Discount 2 or more family members are enrolled 10% Discount 2 or more family members are enrolled 10% Discount
Policy Tenure 1 & 2yrs 1 & 2yrs
Tenure Discount 5% discount on premium 7.5% Discount on premium



Insurance Company L&T – Medisure – Super Top-up Apollo Munich – Optima Super
Room Rent Upto the Sum Insured Upto the Sum Insured
ICU Rent Upto the Sum Insured Upto the Sum Insured
Doctor’s fees and related charges, Other Medical Charges Upto the Sum Insured Upto the Sum Insured
Ambulance Charges Not Covered Rs. 2000 per Hospitalisation
Per & Post Hospitalization 30Days Pre & 60Days Post Hosptialization 60 Days Pre & 90Days Post
Day Care Procedures Covered – No Static List. Covered. 144 day care procedures
Organ Transplant Not Covered Covered – Only Hospitalization Expenses
Addo-on Benefits Service Guarantee. Cashless hospitalization Response in 6 hrs NA
Co-payment 10% Co-payment for Insured age 80yrs & above. No Co-payment



Insurance Company L&T – Medisure – Super Top-up Apollo Munich – Optima Super
Waiting Period for Accident None None
Waiting Period for Specific Ailments 24months 24months
Joint Replacement Waiting Period 24months 24months
Cataract – Limitation None None
Limitation on Major Illness None None
Waiting Period for Pre-Existing Diseases 36months 48months


Let us also look at an example – Mr. Rao wants to enhance his existing Health Insurance of cover.

Age: 35yrs                      Existing Health Insurance: 5Lac  Required Super Top Up Cover: 10Lac

How much premium will be charged to Mr. Rao?

Insurance Company L&T – Medisure – Super Top-up Apollo Munich – Optima Super
Premium Rs. 1,236 Rs. 2,475

Please Note: L&T Premium is Inclusive of ST & other companies Premium is exclusive of ST.

Our Opinion:

Super Top-up Policy are the best way to enhance your basic sum insured. If we look at the comparison both the products are good but there are few points where L&T – Medisure Classic takes an upper hand. Let us look at those points:

  1. In terms of premium, it is lighter on the pocket.
  2. Service Guarantee: Cashless hospitalization response in 6hrs.
  3. No Pre-Acceptance medical check up till the age of 55yrs.
  4. Option to add more extended family members under one policy (Customer has the choice of adding Grandparents, Siblings, Grandchildren, etc.)
  5. Family Discount of 10% in case you add 2 or more members in an Individual policy.
  6. The customer has the option of paying 2yrs premium at one shot and avail additional 5% discount.
  7. No Sub Limits on Room Rent, ICU, Nursing, Doctor’s expenses, medical bills, etc.
  8. Day Care procedures are covered without any static list.
  9. Pre-existing diseases covered after 36months.
  10. Under a single policy multiple relationships can be covered.

When you buy a policy always keep in mind the medical inflation while selecting the sum insured. Cost should not only be the deciding factor in choosing the Best Health Insurance plan. The ability of the plan to function when required should be the core of selection.

If you want to speak to Priyanka’s team of expert advisors for a one-to-one discussion on your requirements, post your inquiry here.


31 thoughts on “Need of the hour – Super Top-up Policy”

  1. Dear Sir, I have one doubt. Some insurers provide super top up for which pre-medical test is compulsory, while some don’t. Which insurer should we choose? I already have MaxBupa policy. Is super top up also available from MaxBupa?

    1. Yes i believe but again the other insurer should have a top up plans. Again everu insurance have different brackets or slabs

  2. I have two L&t Super Topup policies. One
    20 Lac individual for H,W & Son. 2nd
    20 Lac Family Floater SuperTop.
    My base policy is from United Insurance family floater of 5 lac.
    Can i take benefit of both L&T Supettopup plan. How it work?

  3. Hi
    I have family floater of 2lacs from oriental insurance since 2011.
    Now plz let me know is it possible to add my father whose age is 81 & parents in laws whose age is 72 & 61.
    My second question is on Top up insurance.
    Plz let me know of which insurance company it will be better as I want to take top up of 8-10lacs.
    What is the consequence of top up plan .
    What is 50% reimbursement cost of medical which I have seen and in L&T medisure top up plan.
    Plz suggest how it will help me.

  4. Hi,
    I’ve the following queries related to usage of Super Top Up. Could you please clarify my doubts?

    Examples – Mr. Sharma has a personal Health Insurance policy of Rs. 1 Lakh and also a Super Top up health cover of Rs. 5 Lakhs sum insured (total coverage Rs. 6 Lakhs), with the threshold limit of Rs. 2 Lakhs.

    Scenario 1 – If there are two claims in a year, one for Rs. 1 Lakh (Claim 1- Heart Disease) & another for Rs 1.5 Lakhs (claim 2- Other medical reasons), regular policy will pay the claim 1 amount (Rs. 1 Lakh) and the total coverage is exhausted. Now for claim 2 amount (Rs. 1.5 Lakhs) how much will be paid by Super Top Up. Here Rs. 1 lakh is already exhausted in the first claim. Will the policy holder pay Rs. 1 lakh for claim 2 and remaining Rs. 50K be paid using Super Top Up? Please correct me if I’m wrong.

    Scenario 2 –If there are two claims in a year, one for Rs. 1 Lakh (claim 1- Heart Disease) & another for Rs. 4 Lakhs (claim 2- Other medical reasons), regular policy will pay up to Rs. 1 Lakh (claim 1) and the regular policy coverage is exhausted.
    Now, for claim 2 amount (Rs. 4 Lakhs) the policy holder has to pay Rs. 1 lakh or Rs. 2 lakhs (i.e. Threshold limit) to meet the threshold criteria as Rs. 1 lakh was already consumed in Claim 1 (of Scenario 2). Further, the remaining amount will be paid by his/her Super Top up.

    Please clarify my doubts.

    1. Dear Sameer,

      Your understanding is correct in scenario 1. The threshhold limit is Rs. 2 lacs and your total claim within one year is 2.5 lacs. So only Rs. 50k would be paid by super top up policy.

      Regarding your query on scenario 2, just to make the things more clear, you need to understand that the super top up company will pay you only that amount which is in excess of threshold. When you made a first claim of Rs. 1 lac, it was paid by the base policy. Now you got a 2nd claim of Rs. 4 lacs. So now what you need to do is carry all the bills of Rs. 5 lacs (1+4), and submit it to the super top up company. Since deductible was Rs. 2 lacs, so they will pay you the balance amount of Rs. 3 lacs. So in this case you were out of pocket by Rs. 1 lac.

      I hope you understood.

  5. I am having family floater of 10L through company provided group health insurance policy.

    My age is 47.

    Should I go in for additional family floater & critical illness.

    You can reach me on 9665356786

    1. Dear Ashish,

      Since you already have a family floater of Rs. 10 lacs from your company, so i would suggest you to go for a super top up policy with threshold limit as Rs. 10 lacs and the cover amount also of Rs. 10 lacs (you can take it lower also but i think keeping in mind the inflation cost of medical field), you should opt for Rs. 10 lacs of cover from super top up policy.

      10+10 combination is offered by “Optima Super” (a super top up policy from Apollo). Assuming you are 2+2 (2 adults and 2 child), premium will be Rs. 10,885.

      Reason i am recommending you “Optima super” is bcz at the age of 55 , you get an option to convert the super top up cover into a regular cover without any medical check up.

      Regarding critical illness policy, i would suggest you to opt for a standalone policy either from Maxbupa or Apollo or Religare.


  6. Can Super Top-up be bought on the Family floaters? I have a family floater of 4 lacs with Oriental insurance covering my parents aged 69 /60, my wife, 2 kids and me. I want to buy a Super Topup for all of us, is there a floater for all available?

  7. Any super top up policy for parents aged 69/65 available in market since above ones have age restriction of 65 years ?

  8. er 2, 2015
    I am a active follower of your site and its review on various policies. In some you have given importance to super topup policy considering the inflation ratio and low premium. So my doubt is that what is the ideal(atleast near to the term) amount of health insurance for a family of 2 adult+2 child. I am 38 years old and currently have a health insurance policy of 5 Lkahs

  9. Sir,
    I am a active follower of your site and its review on various policies. In some you have given importance to super topup policy considering the inflation ratio and low premium. So my doubt is that what is the ideal(atleast near to the term) amount of health insurance for a family of 2 adult+2 child. I am 38 years old and currently have a health insurance policy of 5 Lkahs

  10. Hi Priyanka,

    Appreviate your efforts in expalaining Super Top-up Policy detail, thank you!

    Would be really interested to know more on Term Policies currently available in the market.

  11. Hi Shiv,

    Can you please review the SREI INFRASTRUCTURE LIMITED NCD issue that has opened today.

    Thank you.

  12. Hi Priyanka,

    Wants to know which medical tests are done by L&T in case of prexisting diseases. I have hypertension . Age 53
    What would be the cost of such tests as they may reimburse only 50 %

  13. Hi Priyanka,

    As a concept, no doubt, SUPER TOP is an excellent product.

    But i have only one hitch with regards to claim settlement.

    When i speak to the company (offering super top up), they say that cashless is possible if the hospital (TPA) co-operate or else for reimbursement, at the time of discharge make sure that you carry a xerox copy (with attestation by the hospital and doctor) also of original bills so that original bills(assuming i am going for reimbursement with my base company as well) can be send to insurance company from whom i have a basic health cover and xerox copies can be sent to the company from where i have a super top up.

    So isn’t it good to opt for base cover and super top up from the same company. But in this case for example if i opt for base cover and super top up from APOLLO, then i do not see major difference in premium if i wuld opt for a policy of larger cover (which includes the cover of base plus super top up), so then no point going for both the policies from same company.

    I can save significant amt of premium if my super top up is from LNT but if my base cover is from a different company then again claim settlement is a big issues.

    So i want your clear cut step by step view on “Claim settlement” from SUPER TOP UP policy.

    1. did you get reply on this? i do agree that it would be good to take policy from same insurer so that claim settlement become easy.

  14. Just looked at Medimanage. Not clear what exactly do u do? Are u like policybazaar or you provide your own health insurance? What is it one gains by going via Medimanage to buy health insurance?

    1. Founded by healthcare professionals in 1999, is a Health Insurance Specialist that truly represents the health insurance customer from advice to service to claims.

      1. Unbiased Advice: We believe Health Insurance is a product which has tremendous long term complexities. You therefore require a specialized, unbiased, integrated service provider who owns what she advises. Though Medimanage has a license to advise and deal in every Insurance product (Car Insurance, Life Insurance) available in the market, we have consciously focused Health Services, since our inception. Our 50 years of collective experience in Health Insurance advisory will empower you to take the right decisions on Health Insurance and the way forward.

      2. Personalized Services: Though we are a management run professional organization, we understand that you would need our personal attention to manage your Health Insurance. We have therefore perfectly blend the personalized services you or your father enjoyed with the neighborhood agent with technology and processes. We pick up your cheques and documents, in locations we are present; we keep your records; we remind you on renewal of your policies; we keep you updated with latest changes in procedures, and anything else that is related to the policy, we sold you.

      3. Professional Claims management: We understand that the least you expect when you buy a policy is a hassle free and transparent processing when it comes to your claims. Our trained team will handhold you right through the entire process, helping you/your family members with documentation and, updating you on the status of the claim and ensuring the claim is settled as early as possible.

      4. Single Point Contact (Account Manager): We take out the entire anxiety out of Health Insurance. Once you have placed your proposal with Medimanage, you would be allocated a Customer Support representative, who will hand hold you through various processes including:

      Keeping your records. Providing you copies.
      Answering your queries.
      Providing you with Tax Receipts.
      Reminding and Payment for Renewals.
      Coordinating your Claims.
      5. Strong Response Systems: Team Medimanage is trained to understand the importance of being responsive and prompt. To be doubly sure, in case of an exceptional event of no response or a unsatisfactory response, we have a clearly defined escalation matrix which ensures you are responded to. Every email to our customer service, operations or sales representatives have an auto-responder which will help you with the defined time you can expect a response, and a clear escalation process. Escalations are personally read and responded by topmost executives at

      6. No Extra Charges, Fees: You pay exactly the same premium, you would pay directly to the Health Insurance Company. We earn our brokerage from the Insurance company you select for your health insurance.

      Go ahead, give us a try. We will ensure you are pleasantly surprised!

      How to contact us?

      Post your detailed requirement to
      Write to with your contact details

  15. Thanks for article and as well the comments from Manikaran Singal and Sanjay Kudi. Most of my questions were asked by these two. Thanks.
    Will look forward to a reply from Ms Priyanka.

  16. Any reason why United India Super Top up plan was not considered for comparison. In fact they were the first to introduce such a plan


    1. Dear Mr. Sanjay,

      I agree United Insurance was pioneer in Super Top-up. There is no specific reason for not mentioning United policy. We have taken L&T & Apollo for comparison purpose.

      Incase you need detailed comparison/information on any product please let us know we will be happy to help you.

  17. Can you share example of person who actually used and got reimbursed under super-top-ups? This post just summarizes brochures but leaves many practical questions unanswered.

    Who has onus of proving the deductible limit has been exhausted?

    What documents are accepted?

    Should insurance company be informed on ongoing basis about expenses or only during hospitalization?

    If ongoing, will they keep running total to prove that eligibility kicks in after deductible has been exhausted?

    If during hospitalization, then in emergency when one is admitted, will person bother about hospital admission or hunt for past documents to prove that he has spent enough deductible to qualify for super-top-up reimbursement?

    Does deductible has to be covered with prior insurance or can be cash?

    Does deductible include reimbursable expenses or total (including non-medical non-reimbursable expenses)?

  18. Hi Priyanka. Nice and informative Post.

    As you are from a dedicated health insurance brokerage firm, so i have few queries for you, which i believe you can comfortably answer:

    1. Since these days policies are coming up with features of Restore ( by apollo) and Recharge (by religare)…there’s something like this in L&T also…what do you think?..does super top up policies makes sense? Though both restore and recharge works in different ways, which one ( if) you recommend to your clients.
    And if you recommend among these , then do you also recommend super top up policies over and above

    2. As there’s no calculation which tells how much of health cover one should opt for, what cover you generally advise your clients to have and why?

    3. If some one has basic health policy from company X, which can be used as deductible or having a group policy from employer…how convenient is it to make claim from super top up ( if required)? Does it get settled in cash less or insured has to apply for reimbursement?

    4. what is the cost difference you have found in having a combination of Basic+ super top up and only basic with high sum assured. say for e.g. 3 lac ( basic cover)+5 lac ( super top up) or 7-10 lakh of basic cover.

    From convenience perspective, when there’s no group cover available, isn’t it better to have single high coverage rather than involving multiple insurers.

    5. What is the average claim amount that you guys have experienced at medimanage?

    With so many add on features and different policy coverages…health insurance industry is getting confusing these days.

    1. Dear Sir,

      Firstly I appreciate your knowledge in this regard. Please find my responses below:

      Point 1: We feel Recharge option by Religare is most suitable as in this feature the infusion of sum insured happens even if entire basic sum insured is not completely exhausted. Whereas in other options ( Restore), complete sum insured must be used & then this benefit gets activated.

      Super top up policies are the best option when you want to enhance your sum insured at a reasonable cost. They provide additional cushion to your basic sum insured so that your Hospital expenses can be managed without disturbing your savings.

      Now if we compare Super top up with above mentioned Recharge/restore options, then it is important to note that the Super top-up plans does not come with the clause of-claim different ailments only. It simply triggers once you cross the basic threshold deductible limit and pays for all ailments irrespective whether a similar claim has been made during the year. Secondly you have an option to choose a higher cover. This means even if you have a base cover of Rs 3 lakhs, you can always opt for a Rs 10 lakh super top-up. In Recharge/restore options, the maximum you get equivalent to the sum insured. Thus we recommend buying a basic health insurance & topping it with a Super top-up.

      Point 2: I agree that there is no thumb rule to deciding the exact amount of sum insured under Health Insurance.. Each individual is different and hence his health insurance coverage need is also different,
      First important factor in deciding the health insurance cover is your ability to spend on premium. Because premium is directly, proportionate to the sum insured.
      Another point to consider is family history of lifestyle diseases, the probability of it getting passed on to the next generation is higher. Any individual who is in a genetically high risk category should buy wider health insurance coverage when he is young and healthy.
      With the medical cost rising, anticipating the amount that you would need to spend on medical expenses is difficult. However, your past medical expenses could form a basis of understanding the amount of coverage that you would need. Averaging the amount that you have exhausted on medical expenses in the past 2-3 years can be considered. We at typically advise customers to opt for minimum 10 lakhs sum insured for a Family floater ( 2 Adults- age 30-35yrs & 1 Kid (2-4yrs)

      Point 3: Cashless option is convenient & possible in Super top up policies only if the basic policy is with the same insurer. Though there is no clarity in this aspect, it is logically simple & faster if the insurer is same.
      Reimbursement is usually preferred by Insurance companies for settling super top up claims as all the documentations & other details are available.

      Point 4 : To share this information, Please provide us with Age & Family member details. Agree on high cover in a single policy. Had this been happening, then there was no need for Super top up plans to exist.

      Point 5: We will be happy to share this with you on a Phone call. Please share your contact details & we shall connect with you.

      Yes we agree there are many add on features and different policy coverage making health insurance industry complicated. Thus it is important to seek an expert opinion before buying a Policy so that you and your family are adequately covered & don’t find any surprises in the future. For more details & free consultation, Please feel free to contact our trusted experts at

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