Future Health Surplus Top Up Plan: Coverage, Claim & Renewal

Updated: 18-03-2019 09:31:41 AM

Every other day, we are reading of some new disease that’s entered our zone and of course, would cost quite a few doubloons to be treated. Your usual health insurance might not support such situations all the time. That’s why Future Generali has come up with Future Health Surplus Top Up Plan that one can use to enhance the coverage along with sum insured too, if need be.

What is Future Health Surplus Top Up Plan?

It’s a rarity that what we plan for actually happens. So is the case with health insurance plans. There’s always scope of improvement and thus it’s a good thing to actually extend your cover with time as with everything evolving around us, health issues are also taking the front row. And thus it’s very important to review these health plans every year and add or subtract whatever is need of the hour.  One can choose from a range of options available under Future Health Surplus Top Up Plan ranging from Rs.3 lakh to a whopping Rs.10 lakh.

If the basic health plan is falling short to cover the medical expenses (either due to an accident or some illness), you can always use this top up plan for that extra support. So, in a way it would work as your back-up plan, which is always a good idea.

Your Basic Health Plan + Future Health Surplus Top Up Plan = Low Premium + High Sum Insured

Eligibility Criteria

Particulars	Details
Minimum Entry Age	Child: 3 Months Adult: 18 years
Maximum Entry Age	Child: 25 years Adult: 65 years
Renewal Age	Lifetime
Family Floater Coverage	For self, spouse and 2 dependent children
Sum Insured	Rs.3 Lakh to Rs.10 Lakh

 

• Medical expenses incurred during hospitalization for 24 hours or more can be claimed
• Expenses like room charges, operation theatre charges, surgeon’s fee, doctors’ consultation fee, blood, oxygen, are included
• This top up plan is available as both individual and family-floater basis
• Medical examination is waived off up to the age of 55 years
• One can avail portability facility if you have a similar health insurance policy from any other company
• In the case of a pre-policy health check-up (for applicants over the age of 55 years), 50% charges are paid by Future Generali
• Sum insured offered under this top up plan is quite comprehensive and can be further elaborated as follows:

 

Max. Sum Insured (in Rs.)	Deductibles per hospitalization (in Rs.)
3,00,000	2,00,000
5,00,000	2,00,000 – 3,00,000
7,00,000	3,00,000
10,00,000	5,00,000

What all Future Generali Health Insurance Top Up Plan covers?

Following expenses are covered in this top-up plan:

• Hospitalization Expenses: For the sum insured one opts for, the expenses incurred at the time of hospitalization is covered under this plan. Please note that the amount should not exceed the sum insured
• In-patient Expenses: Boarding, nursing and room expenses (for a min. period of 24 hours) are covered
• Extra In-patient Expenses: Diagnostic & X-ray, medicines, drugs, operational charges, consultation fees, etc. is also covered

Claim Process

For Cashless Claim:

• To avail cashless claim, it is highly imperative to check whether if the hospital chosen is included in the network of Future Generali or not
• Once the hospital is confirmed, one may straight-away walk-in with their health card and photo ID
• The hospital will assess the case and send an estimate for the approval of Future Generali
• Future Generali will send the approval based on the hospital’s report and your health insurance policy details
• After approval, you can avail treatment at the hospital without worrying about the hospital It will be paid directly by the company

For Reimbursement:

• In case your hospital is not in the network of Future Generali hospital, you can avail your eligible claim amount as reimbursement
• You are required to pay at the hospital and collect the receipt, detailed bills and medical reports
• Compile every document and send it to Future Generali with duly filled claim-form
• Within 14 days of submission, your claim amount shall be credited to your bank account after due assessment and approval processed by Future Generali

Documents required to claim this top-up plan

• Duly filled and signed claim-form
• Copy of other basic health insurance policy (if using this plan as a top-up only)
• Operation theatre notes, if operated
• Intimation letter/reference
• Discharge Summary validated by the hospital
• Death Certificate(as the case maybe)
• Payment receipt and bills from the hospital with detailed bifurcation
• Test reports
• Doctor’s prescription
• Invoices of pharmacy

How Long Does It Take to Payout the Claim?

Future Generali has its in-house claim processing division. Thanks to the same, cashless claim is approved within 90 minutes. The reimbursement claim is approved and paid within 14 days. This time-limit is subject to receipt of all forms and documents as necessary.

Cases where you can’t make a claim

• Damaged or loss of receipt, prescription, etc.
• Non-allopathic treatment and congenital treatment
• Expenses insured for treatment of AIDS and related diseases
• Use of intoxicating drugs and/or alcohol
• Any disease contracted within first 30 days of commencement of the plan

Renewal  

A 30-day grace period from the expiry of the plan is offered in which one can renew this plan and keep it in continuance.

Important Aspects

• Check Your Existing Policy

The top-up plan is meant for additional coverage over and above sum insured in your existing policy. If your existing health policy covers Rs.5 lakh and you avail Future Health Surplus Top Up Plan of Rs.3 lakh with deductible of Rs.2 lakh, your real benefit will be negligible as the top-up will not come into practice. Ideally, you can avail the top-up plan with a deductible amount equivalent to sum insured of your existing health policy.

• Disclose What You Know

It is advisable to disclose your existing disease and your existing policy details. The insurance is availed in good faith to cope up with an emergency and not to avail the benefit of any known circumstances. If the existing fact is hidden intentionally, you may not get the claim amount, your policy may be forfeited and you may not get blacklisted from other insurance providers too.

• Avail Early and Review Periodically

Health-related expenses are on the rise due to inflationary pressure. Also, as your age increases, you are more prone to diseases. Hence, it is advisable to avail top-up plan at an early age. Review it every year by comparing prevailing medical cost and avail additional top-up plan, like Future Health Surplus Top Up Plan, for the difference amount.

Advantages of Buying Future Health Surplus Top Up Plan

• Low premium and higher sum insured
• Continued benefit of your previous health insurance policy
• Income tax benefit under section 80(D) of the Income Tax Act, 1961
• Ease of portability
• This plan comes with an option to avail it as a floater too (i.e. you + your spouse + 2 dependent children)
• Free-look period of 15 days is provided in which the plan can be opted out from if one doesn’t feel satisfied with the same

FAQs

Q1. Can Children be covered under Future Generali Top up Insurance policy?

Yes, this plan gives the option of including up to 2 dependent children in the floater plan.

Q2. When can I use the top-up insurance policy?

Your basic health care expenses are covered by your earlier health insurance policy. When the limit of sum assured is exhausted in existing policy, you can utilize this Future Health Surplus Top Up Plan.

Q3. If I don’t have any other health insurance policy, can I avail Future Health Surplus Top Up Plan?

Yes, you can avail Future Generali top-up insurance plan even if you don’t have any other health insurance policy. However, the hospitalization expenses up to the deductible amount have to be paid by you.