Last Updated on February 23, 2022 at 11:45 am
United India has intimated policyholders of a major revision in their Super Top Policy with effect from 1st March 2022. This includes a significant increase in the maximum sum insured of Rs. 15 lakhs to Rs. 95 lakhs. The revised policy terms and conditions will apply to all policies due for renewal after this date. A look at the major changes.
Readers may recall that United India made major changes to both its Family Medicare and Super Top Up Policies in the third quarter of 2021. Among the main changes:
- Room Rent sub-limits: Rs. 5 Lacs and Above sum insured (Family Medicare only): 1% of Sum Insured (SI) or Single Occupancy Standard Air-conditioned room charges, whichever is higher. Earlier it was only 1% of the sum insured. For some hospitals, the 1% of SI can offer better than a standard AC room, and for some hospitals, the standard AC single occupancy can be a better deal. So at the very least, the policyholder is assured of standard AC single occupancy.
- “The base policy for Rs. 5 Lacs and above “(Family Medicare only) does not have any ICU room rent sub-limits.
- The room rent sub-limits were removed for the Super Top Policy <= United India has not acknowledged this explicitly in their email claiming “The existing Super Top-Up Medicare Policy has not been revised since its launch in January 2009”. However, I have confirmed from the policy wordings that the 1% room rent and 2% ICU clause has been removed when our policy was renewed in Nov 2021.
Readers may also be aware that we hold a base and super top-up policy from United India (in addition to private insurer policies for my wife and son). Our policies are close to 15 years old, with four claims paid. We hold both base and super top-up policies from United India (in addition to private insurer policies for my wife and son). For full details, see: Why we purchased a 2nd set of base & super top-up health insurance policies.
When the above changes were announced, we increased our base sum insured to Rs. 25 L for self, wife and son (total cost Rs. 61K approx incl taxes). My mom has a 6L cover costing Rs. 46K incl taxes (she is almost 75 and United has been reluctant to increase her cover and after several years increased it from 5L to 6L).
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This is in addition to Rs. 15L (5L threshold) super top-up cover for all of us from United. The base policy was increased to 25L to reduce the probability of invoking top-up insurance which can be a hassle even in cashless mode from the same insurer.
Revised United India Super Top Up Policy
New Policy Name: Revised Super Top-Up Medicare Policy (UIN: UIIHLIP22187V032122)
Old Policy Name: Super Top Up Medicare Policy (UIN: UIIHLIP21230V022021)
These are the major changes. Readers are advised to read the full policy terms and conditions. Policy Prospectus. Policy Wordings.
- The changes apply to both individual and floater super top-up plans
- There are no room rent or ICU rent sub-limits.
- The revised sum insured and threshold limits (aka deductible in brackets) are given below.
- 3 Lacs, 5 Lacs (2 Lacs)
- 3 Lacs, 5 Lacs, 7 Lacs (3 Lacs)
- 5 Lacs, 10 Lacs, 15 Lacs, 20 Lacs, 45 Lacs, 70 Lacs, 95 Lacs (5 Lacs)
- 10 Lacs, 15 Lacs, 20 Lacs, 40 Lacs, 65 Lacs, 90 Lacs (10 Lacs)
- 15 Lacs, 35 Lacs, 60 Lacs, 85 Lacs (15 Lacs)
- 20 Lacs, 30 Lacs, 55 Lacs, 80 Lacs (20 Lacs)
- 25 Lacs, 50 Lacs, 75 Lacs (25 Lacs)
- It is quite strange that the maximum sum insured keep reducing with an increasing threshold but there you have it!
- In-laws aged 65 or younger are now included in the definition of “family”
- Pre-hospitalisation & Post-hospitalisation Expenses depend on the threshold.
- Pre-hospitalisation Medical Expenses
- <10 Lacs up to 30 days immediately prior to hospitalisation
- 10 Lacs and above up to 60 days immediately prior to hospitalisation
- Post- hospitalisation Medical Expenses
- <10 Lacs up to 60 days immediately after the discharge from the hospital
- 10 Lacs and above up to 90 days immediately after the discharge from the hospital
- Pre-hospitalisation Medical Expenses
- Unani, Siddha and Homeopathic treatments are included in the existing Ayurvedic cover.
- The premiums have been revised (this typically means an increase but does not seem to be the case for all options).
- The premiums for Rs. 3L sum insured for self, Spouse and 2 Dependent Children (floater/individual) have decreased has decreased by about 13% for individual plans and about 22% for floater plans.
- The Rs. 95 lakh sum insured (on floater basis) with Rs. 5 lakh deductible for a couple is, Rs. 41,580. This will drop to Rs. 33,810 after a 19% no-claim discount.
- Of course, this is much more expensive than private insurers offering a similar cover but private insurers do not have much of a market share and therefore claims experience. Once they have enough super top claims experience buyers can expect premiums to shoot up. The situation is akin to an MF AMC sharing a lesser expense ratio to invite AUM only to jack it up later.
- We have already pointed out the perils of private players’ indiscriminately selling policies. See for example the case with Star Health: How to get claim settlement ratio for health insurers? Star Health rejected the most number of claims and it lost the entire premiums collected to claims last financial years. The PSUs can afford to do this every year as long as there is enough govt hold (even after listing). The privates cannot. So buyers must appreciate that there is more to a health insurance purchase than cheap premiums.
- The worst move a buyer can do is to listen to the agent, excuse me “intermediary” and conceal pre-existing conditions to get the policy approved.
- In my opinion Rs. 41.5K (before loading and no claim discount) for a 1 Crore cover (nearly) is quite reasonable and I will apply for this option when my policy is up for renewal later this year. Whether the insurer accepts my application or not remains to be seen.
- Exclusions for HIV/AIDS; Genetic disorders; Psychiatric and psychosomatic disorders have been removed.
- The policy now has IRDAI prescribed standard exclusion wordings.
In summary, these Super Top-up policy revisions are welcome, especially by existing policyholders who can afford an increase in sum insured. It must be made clear that a PSU policy is not a bed of roses. As mentioned above, please read all the policy terms and conditions and ascertain suitability before buying.
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