ManipalCigna Super Top Up Insurance Policy

Health insurance has become a necessity today. With changing times and evolving medical facilities, health insurance providers have also upgraded their offerings to ensure every individual is covered well. To keep you ahead and your health insurance updated, ManipalCigna offers ManipalCigna Super Top Up Plan that ensures you are adequately covered against sudden medical requirements, even when the healthcare costs are on the rise. The policy provides you with add-on benefits that are missing from your current policy. It acts as a backup plan for your health plan.

Key Features and Benefits

• 

  In-patient hospitalisation expenses cover

  If you are admitted to a hospital for more than 24 hours of illness or injury, the policy will cover the room charges, ICU expenses, nursing charges, doctor fees, surgeon fees, blood, oxygen, operation theatre charges and other medical expenses.
  
  Note: Coverage also includes:
  • Medical expenses for HIV, AIDS and related diseases, maximum up to Rs. 2 lakh after a waiting period of 2 years.
  • Medical expenses incurred towards modern and advanced treatment methods, maximum up to sum insured.
  • Expenses for artificial life maintenance including life support machine use, even if the treatment doesn’t result into recovery or restoration of the previous state.

• 

  Pre-hospitalisation

  The plan reimburses medical expenses incurred before the date of hospitalisation.

• 

  Post-hospitalisation

  It covers the medical expenses incurred after you are discharged from the hospital.

• 

  Day care treatment

  The plan covers medical expenses for treatment that needs less than 24 hours of hospitalisation.

• 

  Road ambulance cover

  The plan covers the expenses towards hospital transportation by registered ambulance services for the treatment of illness or injury during an emergency, up to Rs. 2,000 per hospitalisation.

• 

  AYUSH cover

  The plan covers in-patient medical expenses up to the limit of the sum insured towards non-allopathic treatments such as Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy for hospitalisation arising due to accident or illness undertaken in a government hospital or government recognised institute or registered AYUSH hospital.

• 

  Donor cover

  The plan covers in-patient medical expenses towards the donor, if the insured is required to go for a major organ transplant.

• Optional covers

  Here are two benefits offered under the option covers:

• • Guaranteed continuity on deductible

  From the fifth policy year onwards, you will have an option to opt for a separate base policy*, with guaranteed continuity on waiting periods. No fresh risk assessment shall be done for sum insured up to the deductible amount opted under ManipalCigna Super Top-Up.

• • Reduction in pre-existing diseases waiting period

  You will have the option to reduce pre-existing diseases waiting period to 24 months from the inception of the policy. This applies all the insured persons covered under this policy.

• Add-on cover

  This covers the following benefit:

• • Critical illness

  You will get a lump sum benefit up to your opted sum insured, in case of the first diagnosis of the covered 11 critical illnesses.

To purchase the policy, follow these steps:

• To apply for the ManipalCigna Super Top Up Insurance Policy, you can purchase it easily online by filling in your basic and health details.
• Ensure that the information given in the form is complete and accurate.
• You may be required to undergo a pre-policy medical examination at the insurer’s network diagnostic centres.
• On purchasing this plan online, your policy will be generated instantly along with your policy kit and card. This is applicable for cases that do not require further underwriting or medical check-up.

The following mandatory documents will be needed to purchase the policy:

• Photograph of the Applicant
• Age proof such as birth certificate, Voter’s ID, PAN card, passport etc.
• Identity proof such as passport, Aadhaar card, PAN card, Voter’s ID, etc.
• Income Proof such as Form 16, salary slips, employment certificate etc.
• Address proof such as telephone bill, electricity bill, passport, bank statement, Voter’s ID, etc.
• Medical Test that the insurer requires you to undergo.

Cashless Claims
Documents needed to process cashless claim:
With ManipalCigna Pro-health Group Insurance Plan, you can avail the benefit of cashless treatment from 6500+ network hospitals by following the below process:

• Get admitted to any one of Manipal Cigna network hospitals.
• Use your ManipalCigna Super Top-up Insurance card or share your policy number with the concerned team at the hospital along with your passport/PAN card/voter’s ID as identification proof.
• The network hospital will then verify your identity for validation and submit the pre-authorization request to the insurer.
• After validation, the insurer will review and provide their confirmation to the network hospital by fax and email. The insurer ensures you are also notified of the same through text message and email. The insurer will respond to your request within 30 minutes of filing the claim request.
• The only activity left to do now is the final settlement of your claim (as per the policy terms and conditions) with the hospital after completion of all the necessary formalities.

Reimbursement Claims
Documents needed to process reimbursement claim:

• If you get hospitalized, notify the insurer within 48 hours of admission in our network or non-network hospital. After getting admitted pay the amount directly to the hospital you were admitted to.
• After you get discharged from the hospital, make sure you have all the relevant documents, invoices, medical reports, and discharge certificates with you. The insurer would need the originals of all the mentioned documents to process your reimbursement.
• Send all the documents to the insurer which should be filled and signed in the claim form. Send your valid ID proof and age proof as well.
• After receiving your documents, the insurer will review your claim request and accordingly will give approval, raise a query or reject the same (as per the policy terms and conditions).
• Finally, the insurer will settle the claim (as per the policy terms and conditions) and reimburse the approved amount.

• Original investigation reports
• Final hospital discharge summary FIR or post-mortem report if happened
• Pharmacy bills along with the prescription
• Cancelled cheque or NEFT details for payment
• Original bills, receipts, and discharge report
• Indoor case papers and duly filled claim form
• Original hospital bills and a valid photo ID proof Treating doctor's report
• Original consultation notes Nature of operation performed and surgeon's bill and receipt
• Test reports along with attending doctor’s or surgeon’s report.

1. Dental treatments and cosmetic surgeries
2. Ailments requiring treatment due to use or abuse of any substance, drug, or alcohol and treatment for de-addiction.
3. Circumcision unless required for the treatment of Illness or accidental bodily injury.
4. Cosmetic, aesthetic, and re-shaping treatments & surgeries.
5. Psychiatric or psychological disorders, mental disorders.
6. Ailment wise capping and ambulance charges
7. Hearing aids, spectacles, or contact lenses including optometric therapy. Abuse or the consequences of the abuse of intoxicants or hallucinogenic substances.
8. Sexually transmitted diseases such as AIDS and HIV.
9. Waiting period:.
10. • First 30 days waiting period is applicable for all illnesses other than accidents.
    • 24 months waiting period is applicable on specified diseases/procedures.
    • Pre-existing diseases will not be covered for 48 months (option available to reduce to 24 months by paying one-time additional premium).
    • First 90 days waiting period and 30 days survival period is applicable
    • Critical illness add-on cover (if opted)


11. Refer to the policy document to know more exclusions in detail

BFL Helpline Number: – 08698010101

Manipal Cigna Helpline Number: – 1800-102-4462

E-mail –  wecare@bajajfinserv.in

Mailing address: 4th Floor, Bajaj Finserv Corporate Office, Off Pune-Ahmednagar Road, Viman Nagar, Pune – 411014