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Manipal Cigna super top up

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15 Jul, 2023 by  Sridhar Gopal

Hi Beshak ,

I am planning to take a Manipal Cigna Super Top Up with 5l deductible and 20l/30l cover for my Mother aged 62. I went through the policy wording and I have a couple of questions in this regard-

a)Reg copay -

The policy wording does not mention any copay anywhere . The company reps state that there there is nopay at all . Is it fair to assume that if no copay is mentioned anywhere then there would be nocopay either now or post a certain age ( for eg. after 65 like Manipal prohealth applies 20% copay post 65 but none before 65)

a) Reg lifetime renewability -

The prospectus states " The Policy is ordinarily renewable on mutual consent for life, subject to application of Renewal and realisation of Renewal premium" .

The wording here seems ambiguous since it uses the word " mutual consent" seeming to imply that the insurer has the right refuse consent for renewal. The brouchure states " lifetime renewals available". Can you please confirm if we can read this as a clear statement of confirmation of lifetime renewal availability or not?

b) Reg disclosures , the prospectus states

""Insured Person shall disclose to Us in writing of any material change in the health condition at the time of seeking Renewal of this Policy, irrespective of any claim arising or made. The terms and condition of the existing policy will not be altered"

I always thought we policyholder is not under any obligation to disclose changes in health changes AFTER the policy is issued .But is this a legit expectation on the part of the insurer to expect disclosures post the policy issue?

Thanks in advance.


1 Answer

10 Aug, 2023

Hello Sridhar,

If the policy wordings explicitly state that there is no copay, then no copay would be applicable on claims.

Generally, you don't need to inform the insurer about any such changes after you've bought the policy - unless you want to upgrade the cover. But if the insurer is asking you to disclose the changes in health conditions during renewal, you'll have to do that.

However, the insurer cannot do anything with this information. Say you declare a chronic medical condition at renewal such as hypertension or diabetes - nothing changes in your coverage or premium.The insurer cannot charge differential renewal premiums or cancel your policy. As per regulation, insurers cannot cancel your policy, unless they prove a misrepresentation before the policy was issued

Hope this clarifies! Thank you!

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