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Cost effective Solution to increase your existing cover
Covers up to 2 Adults and 5 Children in a single policy
Income tax benefits under Section 80D¹

Cost effective Solution to increase your existing cover
Covers up to 2 Adults and 5 Children in a single policy
Income tax benefits under Section 80D¹

Overview
Plan Option
Exclusions
Disclaimer
FAQs

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Advantage Top Up

Advantage Top Up is a deductible health insurance plan with high Sum Insured options to provide extra coverage at low premium as compared to any traditional health insurance plan. In this plan you have an option to choose the deductible which can be managed either by self-pay or any other insurance and also choose the optimum Sum Insured to take care of your health care. Unlike many top up plans, you do not have to cross the deductible limit at every claims incidence.Read More

The deductible will apply on aggregate basis towards hospitalisation expenses incurred during the policy period.Read Less

FEATURES

Wide Range of Sum Insured

Choice of Sum Insured ranging from ₹50,000 to ₹1 Crore

Flexible deductible options

Deductible options varying from ₹50,000 to ₹40 lakh as per chosen Sum insured

Entry Age & Renewability²

Cradle to Grave Cover where you are covered from day 1 for life long. No bar on the entry age.

Policy Period

Option to choose multiyear (1, 2 or 3 year) policy period.

Mental and psychiatric illness

Covered in the policy

PLAN OPTIONS/VARIANTS

Advantage Top-Up Elite

Elite Plan – includes cover for Cancer and ailments related to Heart only, i.e. below features applicable to heart ailments and cancer only
Hospitalization Medical Expenses – A minimum period of 24 Inpatient Care consecutive hours.
Day Care Treatment expenses- Specified procedures/treatments, where such admission could be for a period of less than 24 consecutive hours.
Pre-hospitalisation Medical Expenses –Related medical expenses 60 days prior to hospitalisation.
Post-hospitalisation Medical Expenses - Related medical expenses post hospitalisation within 90 days from date of discharge from the hospital
Organ Donor Expenses - Charges incurred for an organ donor’s treatment for the harvesting of the organ donated. - covered after 2 year of continuous renewal
Road Ambulance Charges - maximum up to Rs. 2000 per Hospitalisation
Alternative Treatment Covered - covered
Cumulative Bonus - 10% for every claim-free year to max 50%

Advantage Top Up

Supreme Plan – includes cover for all ailments including Heart related conditions and Cancer
Hospitalization Medical Expenses – A minimum period of 24 Inpatient Care consecutive hours.
Day Care Treatment expenses- Specified procedures/treatments, where such admission could be for a period of less than 24 consecutive hours.
Pre-hospitalisation Medical Expenses –Related medical expenses 60 days prior to hospitalisation.
Post-hospitalisation Medical Expenses - Related medical expenses post hospitalisation within 90 days from date of discharge from the hospital
Organ Donor Expenses - Charges incurred for an organ donor’s treatment for the harvesting of the organ donated. - covered after 2 year of continuous renewal
Road Ambulance Charges - maximum up to Rs. 2000 per Hospitalisation
Alternative Treatment Covered - covered after 2 year of continuous renewal
Cumulative Bonus - 10% for every claim-free year to max 50%

Downloads

Eligibility

Entry Age – Minimum – 1 Day
Entry Age – Maximum – None
Cover type – Individual and Family Floater

Documentation

For transaction on net banking – no documentation

For transaction on Mobile App– no documentation

For paper based transactions

Health Insurance Proposal form
KYC Documents :ID Proof & address proof(PAN & Aadhar)

Exclusions

Pre-existing disease: Compulsory waiting period - 2 Years
30-day waiting period - fresh proposals excluding accidental hospitalisation
2-year waiting period for listed conditions
External Congenital Anomaly and related Illness/ defect
Dental Treatment or Surgery of any kind unless requiring Hospitalization as a result of Injury
Joint replacement surgery shall be covered after a waiting period of 2 years, unless required due to an accident
Use of intoxicating drugs or alcohol

Claims

Cashless Claim - Cashless treatment is only available at a Network hospital. In order to avail cashless treatment, the following procedure must be followed by You:

Choose the network hospital.
You can find the complete list of network hospitals on our website.
Fill in the cashless request form which is available with the Hospital Insurance Help Desk and get it certified by your treating doctor.
We will scrutinize the document and convey the decision to the hospital. We will sanction the cashless request or call for additional documents if required.
On approval of a cashless claim, the hospital bills will be settled directly.

Reimbursement Claim - If treatment is taken in a Hospital which is not on our Network or if You do not wish to avail cashless facility the following procedure must be followed by You for reporting a claim:

Intimate Us through the toll free number - 1800 103 8889 immediately on admission not later than 15 days from the date of discharge from a Hospital.
Avail treatment and settle all the bills with the hospital and then file a claim for reimbursement.
Claim documents may be submitted at below address:
Claims Department,
Generali Central Health (GCH),
Qubix Business Park, Building No. Block IT – 1,
Ground Floor, Plot No. 2, Blueridge Township, Near Rajiv Gandhi Infotech Park, Phase – 1,
Village Hinjewadi, Taluka Mulshi, Pune, Maharashtra,
Toll Free Number: 1800 103 8889,
Toll Free Fax: 1800 103 9998,
Email: GCH@genralicentral.com

Claim Documents

The indicative list of claim documents required is mentioned below
The claim form specified by Us duly completed and signed by the claimant or a family member
First consultation letter
First prescription from the Medical Practitioner
Original vouchers
Original Hospital bills giving a detailed break up of all expense heads mentioned in the bill
Money receipt duly signed with a revenue stamp
Birth/death certificate (as applicable)
The original Hospital discharge card
All original laboratory and diagnostic test Reports such as X-Ray, E.C.G, USG, MRI Scan, Haemogram, etc
If medicines have been purchased in cash and if this has not been reflected in the Hospital bill, please enclose a prescription from the Medical Practitioner and the supporting medicine bill from the chemist
If diagnostic or radiology tests have been paid for in cash and it has not been reflected in the Hospital bill, please enclose a prescription from the Medical Practitioner advising the tests, the actual test reports and the bill from the diagnostic centre for the tests.

Disclaimer

¹Tax deductions under Section 80D is as per applicable provision of the Act (including any amendments thereto) and are subject to changes in the tax laws. ²Factors determining the renewal premium are (i) age slab of the senior most insured member at the time of renewal (ii) any change in the renewing policy. ¹⁰Following is an indicative list of the policy exclusions. Please refer to the policy clause for the complete list.Read More

“For detailed information on risk factors, term & conditions etc., please refer to the product brochure and policy wordings, consult your advisor/agent or visit Generali’s website before concluding a sale” Advantage Top-Up . FGIHLIP2155V022021.Read Less

FREQUENTLY ASKED QUESTIONS

What is Advantage Top Up Policy?

Advantage Top Up is a high deductible health insurance plan which pays for inpatient medical expenses in excess of the prescribed deductible limit. The deductible will apply on aggregate basis towards hospitalisation expenses incurred during the policy period.

What is deductible?

Deductible means a cost sharing requirement under a health insurance policy where the insurance company will not be liable for eligible medical expenses up to a specified rupee amount, that incur in a policy period, as opted i.e. it is the amount up to which the insurance company will not pay for all the claims incurred in a policy year under the policy.

Why should I prefer high deductible policy?

In cases where the actual medical expenses cross the threshold limit i.e. deductible, this policy will help. Moreover this policy provide extra coverage at low premium and can be opted in combination with other Health Insurance Policies (e.g. Health Suraksha/ Health Total) to provide higher coverage at reasonable premium.

Can one take Advantage Top Up Policy as a stand-alone plan?

Yes, Advantage Top Up Policy can be taken as a stand-alone plan. It can also be taken along with other Health Insurance Policies (e.g. Future Health Suraksha) or Group Insurance Plans.

Supreme Plan – includes cover for all ailments including Heart related conditions and Cancer.

Elite Plan – includes cover for Cancer and ailments related to Heart/

Yes, Pre-insurance medical examination will be conducted on the basis of adverse medical declarations in the proposal form, age of member, sum insured and deductible opted.

There is 100% reimbursement of Pre-Policy Tests charges, subject to policy issuance and 64 VB compliance.

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