Admin 06 Jun 2026 06:00

 

National Super Top Up Mediclaim Policy

Your health, secured anytime, anywhere.

Policy Overview

The National Super Top Up Mediclaim Policy is a flexible, highsuminsured health insurance product designed for individuals and families who already own a base mediclaim cover. It works as a topup the insurer steps in only after the primary policys limit is exhausted, providing an additional layer of financial protection against large medical bills.

Key highlights include:

  • Sum insured ranging from INR5Lakhs to INR10Crore.
  • Simple eligibility criteria and quick online enrollment.
  • Coverage for preexisting diseases after a 24month waiting period.
  • No restriction on claim frequency you can claim multiple times in a policy year as long as the aggregate limit is not exceeded.

Why Choose the Super Top Up?

This policy bridges the gap between ordinary mediclaim and catastrophic health expenses. The main benefits are:

  • CostEffective Protection: You pay a lower premium compared to buying a higher suminsured base plan.
  • Seamless Integration: Works handinhand with any existing mediclaim policy, whether public, private, or employersponsored.
  • Unlimited Hospitalisation: No limit on the number of days you can stay in a network hospital.
  • Worldwide Coverage: Treatment abroad is covered up to the policy limit, subject to certain conditions.

Quick tip: If you already have a policy with a sum insured of INR1Lakh, pairing it with a Super Top Up of INR5Lakhs effectively gives you a total cover of INR6Lakhs, without a proportional rise in premium.

Eligibility Criteria

The Super Top Up is open to Indian residents aged 18 to 70 years at the time of purchase. The applicant must already possess a primary health insurance policy (the base policy). There is no minimum premium requirement for the base policy, but the base policy must be active throughout the tenure of the topup cover.

Documents typically required during enrolment:

  • Proof of identity (Aadhaar, PAN, passport).
  • Proof of address (utility bill, bank statement).
  • Copy of the existing mediclaim policy (policy number, sum insured, expiry date).
  • Recent medical questionnaire (optional, based on underwriting).

Scope of Coverage

The Super Top Up provides indemnity after the deductible (the limit of the base policy) is exhausted. Coverage includes:

  • Inpatient hospitalization expenses (room charges, ICU, operation theatre, nursing, doctors fees).
  • Pre and posthospitalization costs for up to 30 days each.
  • Daycare procedures and minimally invasive surgeries.
  • Organ transplant expenses, including donor expenses.
  • Cashless treatment at network hospitals.
  • Rehospitalisation for the same illness, subject to policy terms.

Policyholders can also opt for an addon covering daycare procedures, ambulance charges, and Domiciliary Treatment (treatment at home) for a nominal additional premium.

Exclusions & Limitations

While the policy is extensive, certain situations are excluded:

  • Preexisting diseases within the first 24 months from policy inception.
  • Cosmetic or elective surgeries without medical necessity.
  • Selfinflicted injuries, attempted suicide, or injuries caused under the influence of alcohol/drugs.
  • Experimental or unproven treatments.
  • Dental procedures (unless part of a major surgery) and routine checkups.
  • Hospitalization due to war, nuclear risks, or natural disasters not covered under the main policy.

It is advisable to read the detailed Policy Wordings to understand specific sublimits and copay requirements, if any.

How to File a Claim

Filing a claim is straightforward, especially when you use a network hospital for cashless treatment.

Cashless Claim (Preferred)

  1. Inform the hospitals admission desk that you have a Super Top Up policy.
  2. Provide the insurers PreAuthorization Form (downloaded from the insurers portal) along with the base policy details.
  3. The insurer will verify eligibility and issue an Authorization Letter.
  4. Treatment proceeds, and the hospital settles the bill directly with the insurer up to the topup limit.

Reimbursement Claim (if cashless not possible)

  1. Pay the hospital bill in full.
  2. Gather original documents: hospital discharge summary, itemized bill, doctors prescription, and diagnostic reports.
  3. Fill the Reimbursement Claim Form available on the insurers website.
  4. Upload all documents through the online portal or submit at a claim office.
  5. The insurer processes the claim within 710 working days and releases the amount via NEFT or cheque.

Always retain copies of every document and note the claim reference number for future followup.

Network Hospitals & Cashless Facility

The insurer has a nationwide network of over 8,000 hospitals, ranging from multispecialty corporate hospitals to tier2 city medical centres. You can locate a network hospital using the Hospital Locator tool on the insurers website or mobile app.

Features of the network include:

  • 24/7 emergency services with direct claim settlement.
  • Prenegotiated rates for surgeries and procedures, reducing outofpocket expenses.
  • Dedicated claim managers for highvalue claims.

If your preferred hospital is not in the network, you can still claim on a reimbursement basis, provided you follow the documentation checklist.

Renewal, Premium, and Policy Term

The Super Top Up is offered for a policy term of 1 year, with automatic renewal options. Premium is calculated on the basis of:

  • Chosen sum insured.
  • Age of the primary insured.
  • Health questionnaire outcomes.
  • Geographical location (metro vs. nonmetro).

Premiums are payable annually, semiannually, or quarterly, with a nominal surcharge for more frequent payments. No medical tests are required for renewal unless the insurer requests a health update after a claim or after three consecutive claimfree years.

Get a Premium Quote

Tax Benefits

Premiums paid for the Super Top Up Mediclaim policy qualify for deduction under Section80D of the Income Tax Act, 1961. The maximum allowable deduction is:

  • INR25,000 for self and family (including parents).
  • Additional INR25,000 for senior citizen parents (INR50,000 if the insured is a senior citizen).

Ensure you retain the premium receipt and the policy schedule for filing your income tax return.

Frequently Asked Questions

1. Can I buy a Super Top Up without a base policy?

No. The product is designed to complement an existing health insurance cover. The base policys limit acts as the deductible.

2. What happens if my base policys limit is not fully utilized?

The Super Top Up will not be triggered until the base policys sum insured is exhausted. If the base cover remains partially unused, the topup remains dormant for that claim.

3. Is there a waiting period for preexisting illnesses?

Yes. Preexisting diseases are covered after a 24month waiting period from the policy start date. Some chronic conditions may have a longer waiting period as per the policy wording.

4. Can I increase the sum insured during the policy term?

Upgrades are possible only at the time of renewal. The insurer will recalculate the premium based on the new sum insured and age.

5. How is the deductible calculated?

The deductible equals the total sum insured of your primary mediclaim policy. For example, if the base policy has INR2Lakhs cover, the Super Top Up will start paying from the 2Lakh mark onward.

6. Are outpatient expenses covered?

Standard Super Top Up covers only inpatient expenses. However, you can purchase an optional Outpatient Cover rider for a modest additional premium.

7. What is the claim

Reference Files For National Super Top Up Mediclaim Policy
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