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Room Rent Limit cap in Super Topup policy

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15 Oct, 2020 by  Pratik Goel

Hi.


Employer of my wife and I has provided a health cover for Rs 4L each (total 8L). I additionally want to buy a super top up. Suppose I buy a super topup of SI 15L, and knowing that room rents are usually capped at 1% of SI, what SI will be considered in this case? 4L or 19L?


Thanks.

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Health Insurance

1 Answer

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17 Oct, 2020

Hello Pratik,


  1. There is nothing "standard" or "usual" regarding Room Rent capping across policies. You need to look at your employer's policy/benefit document to know the limits your are eligible for. In case there are limits, then these will be applied only to this (4L) part of the coverage.
  2. Usually Super Top-up plans do not have a Room Rent Limit. If there are any you have seen - avoid them.
  3. Top-up will start paying immediately when your aggregate hospitalization expenses (not the claim amount) for you and your wife cross the deductible amount of Rs. 4 Lakhs in the policy year.
  4. Please also note that Personal policies like Super Top-up will come with initial waiting periods for specified illnesses and pre-existing diseases. So for these specific illnesses - there won't be any cover for first 24 months.


Recommendation:

You have not mentioned about your age. Insurance companies and plans become restrictive once you grow older and/or suffer from a chronic health condition. We therefore recommend you invest in a personal base cover of Rs. 15 Lakhs (instead of a top-up) for your retirement or any future gap you have in your employment. This way you also end up crossing through all the waiting periods that exist in a personal health insurance policy.

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30 Oct, 2020
Pratik Goel
Thanks for the reply/suggestions. I am 34, and the reason I wanted to go for a super topup is the cost difference between a base policy and super topup. Any suggestions? Thank you.
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