View and download policies, proposal forms, detailed wordings and network hospital list etc.
See escalation matrix, send service requests, track progress, get acknowledgements etc.
Intimate claim, fill claim form, share documents, track status, get reminders etc.
Fraud or dishonesty of any sort will result in the claim being rejected.
Claims which are made on account of pre-existing ailments usually get rejected by insurers in case they are not revealed in the proposal form. Such pre-existing diseases, if any, should be declared and not withheld.
One of the most important conditions in Top Up Health Insurance is Deductibles. The company will not be liable for any payment unless the medical expenses exceed the deductible and will pay only the cost above deductibles.
Duly filled claim form (signed by the insured and the treating doctor), Discharge summary (with details of complaints and the treatment availed), Final Hospital Bill (detailed breakup) along with interim bills, Payment Receipts, Doctor's consultation Papers, All investigation reports (e.g. blood report, X-ray, Sonography, MRI, etc.).
Some Add on to cover include : Hospital daily cash, Personal Accident and Long term Plans.
Typical exclusions are: All diseases/illnesses existing prior to or at the time of proposing this insurance for certain period, All expenses arising out of AIDS and related diseases, Use of intoxicating drugs or alcohol.
We have specialized underwriters and tie-ups with international experts.
We work with all insurers to get you the best options- both in terms of price and features.
Cover notes are issued within hours of request. This documentation is sufficient for any contractual requirement.
We manage all aspects of your claim - from preparing documentation to follow-up with the insurer.
We will advice you on risk management best practices.
See all your contracts and renewal information. Place service requests on PAM.
The biggest difference between a Top Up Health Insurance and a Super Top Up Health Insurance is the way they calculate the deductible amount
In case of a Top Up medical insurance, each and every hospitalisation is treated as a separate instance and deductible is calculated for each of the instances.
In case of Super Top Up health insurance, as long as you have reached your deductible limit in aggregate, the super top up will pay.
For Example: You have a Deductible Limit of Rs 2 Lakhs and you have 2 Hospitalization claims in a year. First claim is for Rs 1 Lakhs and second one is for Rs 1.5 Lakhs. So, If you have a Top Up Health Insurance Plan you will not be able to claim anything as each of your claim will be treated separately. But in case of Super Top Up, the claims will be seen in aggregate for a year and you will Rs 50,000 (2.5 Lakhs - 2 Lakhs) reimbursed.
