Chola MS Top Up Healthline

Objective

A top-up policy that becomes active only with medical expenses above a certain limit. It is meant to be bought as an additional policy to take care of hefty claims.

Suited for

This policy is more effective for those who already have a basic health insurance cover and wish to increase the protection further. Those who do not hold any health insurance policy may also go in for this policy if they can pay small medical bills that are not covered by the top-up policy. This policy is available for both individual and family on a floater basis.

What does it do?

It is a top up plan that gets activated only when the claim crosses the deductible limit. A deductible is that portion of claim which has to be borne either by an existing policy or by the policyholder himself. In this plan, deductible limit applies afresh each time insured person is hospitalized during the policy term. For instance, an insured accesses hospitalisation services twice during a policy term. For the first time the total medical expenses amounted to Rs 2 lakh and Rs 2.5 lakh during second hospitalisation. If the deductible limit on his policy was Rs 3 lakh, the policyholder will not receive insurance benefit of this policy as the admissible claim expenses were below the deductible limit each time. This policy offers a wide range of deductible starting from as low as Rs 30,000 up to Rs 5 lakh.
It covers hospitalisation expenses including doctor's fee, nursing, room charges up to the daily limit stated in the policy document, ICU charges, oxygen, OT charges, anesthesia and other expenses incurred as an inpatient. This plan can be bought as an individual or as a family floater policy.

Pros

Premiums paid under this plan qualify for deduction under Section 80D of Income Tax Act.
Policyholder can escape from hassle of paying premiums annually by selecting a higher policy term of 2 or 3 years.
It provides for lifelong renewals as there is no policy ceasing age.
There is no need to undertake pre-policy medical check up upto 55 years of entry age.

Cons

There is capping on room rent expenses.
Deductible applies afresh on each claim.

Our View

Add-on plans are not intended to duplicate the existing cover, these plans are rather meant to pay for higher claims which are beyond the reach of basic insurance plans. Instead of buying another insurance policy, a top up is recommended if your current insurance cover seems inadequate. The only constraint to this product is that threshold limit applies to every single treatment undertaken as an inpatient in a hospital. In contrast, there are certain policies in the market that cover each hospitalisation after the expenses of previous hospitalisation(s) put together exceed threshold. Such top-up policies have an edge over the policies where deductible applies on each claim.