FUTURE ADVANTAGE TOP UP

Future 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.

Future Health Surplus (Top-Up plan) is a high deductible health plan which pays for inpatient medical expenses in excess of the prescribed deductible limit. The deductible is applied on each and every claim.

Future Advantage Top-Up (Super Top-up plan) is similar to top—up plan, except that in top-up plan the deductible is applied on each and every claim whereas in super top-up plan the deductible will apply on aggregate basis towards hospitalisation expenses incurred during the policy period.

The illustration below will help you better understand how both these plans are beneficial.

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.

• The Deductible will apply on Individual basis in case of Individual Policy and on family floater basis in case of Family Floater Policy.
• A Deductible does not reduce the Sum Insured.

Example of Deductible:
Insured A has policy (Policy Period - 1st Jan 2018 to 31st Dec 2018)

Yes, pre (60 days) and post (90 days) hospitalisation is covered

Yes, cashless facility is available

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. Future Health Suraksha/ Health Total) to provide higher coverage at reasonable premium.

You have an option to opt for waiver of the Deductible and opt for any indemnity health insurance policy (without any Deductible) offered by Us for the same Sum Insured without re-valuation of health status or any Pre-Policy check-up provided that:

You/ Insured Person has been insured with Us for the first time under this Policy before the age of 50 years and have Renewed with Us continuously and without any break in insurance for a minimum period of 5 years.

This option for waiver of Deductible can be exercised by You/ Insured person at Renewal when Your/ Insured Person’s completed age is within the age group of 54-60 years however only after being continuously renewed under this Policy without any break for a period of 5 years or more.

Yes, Future 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.

The product is offered from Day 1 to Lifelong

Lifelong Renewability is available under Future Advantage Top-up.

The policy terms are 1 year, 2 years and 3 years.

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.

Yes, there are waiting periods as detailed in the table below:

Yes, you can insure yourself, your spouse and up to 3 dependent children under a floater policy.

Or, you can insure yourself, your spouse and 5 dependent children under a floater policy.

Yes, Portability will be granted to Policy holders of a similar Health Policy of another Insurer to Future Advantage Top-up Policy. Insured may apply 45 days in advance of the policy renewal date, but not earlier than 60 days from the premium renewal date of his/ herexisting policy to avail portability benefits..

Yes. Tax benefits are available for health insurance policies under Sec. 80D of the Income Tax Act.

An individual of age 18 years can buy this policy.

For 1-yearpolicy term, premium can be paid on:

• annual basis

For 2 and 3 years policy term, premium can be paid on:

• Single premium payment with Long term discount
• Instalment basis - Half-yearly/ Quarterly/Monthly mode.

Please note instalment facility is currently available for policy terms of 2 years and 3 years only &Insureds have an option of paying premium on instalment basis.
Instalment Loading – Loading will be applicable on Standard premiums in case of instalments

We will provide cumulative bonus for every claim free year. We shall increase in the Sum Insured by 10% towards Cumulative Bonus for every claim free year on the basic Sum Insured up to the maximum of 50% of the sum insured.

The Discounts available under the Future Advantage Top-up are

Family discount – 10% Family discount, in case if more than one insured covered under the same policy on individual sum insured basis. For the policy with coverage for one adult with one or more children, the family discount shall be on basis of age of the Adult specified in the table below.

Long term discount – Applicable in case of single premium payment for policy term of more than one year

Loyalty discount – 2.5% loyalty discount if the client already has a separate health insurance policy (other than Future Advantage Top-up/ Personal Accident/ Travel) from Future Generali India Insurance Co. Ltd. The loyalty discount shall continue only if the insured maintains the separate health insurance policy with us. Please provide the policy copy to avail the discount. In case the policy copy is not submitted, discount shall not be allowed
Direct Sales Discount – A discount of 15% in lieu of intermediary commissions if policy is taken directly from the insurer and /or Online.
Plan Discount – If an Insured opts for Elite Plan, then a discount of 30% shall be available on the premium applicable for Supreme Plan

Applicable based on health status of the proposed Insured person. Underwriting loading of premium will be applicable on the particular Insured’s premium in case of Individual policy and Floater policy

No, Future Advantage Top-Up can be availed by Indian National only.

Yes, you can cancel the policy – Client will need to submit nil claim declaration against the said policy. However refund amount will depend on duration of coverage of policy period. No refund of premium shall be due on cancellation if the Insured Person has made a claim under this Policy.

In case the Policy Period is of one year, We shall refund premium on short term rates for the unexpired Policy.
In case the Policy Period exceeds one year, this Policy may be cancelled by You at any time by giving at least 15 days written notice to Us. We shall refund premium on a prorate basis by reference to the time period for which cover is provided, subject to a minimum retention of premium of 25%.
In case of Policy Period more than one year, with instalment premium, the Rate of Premium refunded on cancellation will be basis the Instalment Frequency & Cancellation request received.

Client can cover Up to 5 Dependent children and 2 dependent parents under Individual plan in the single policy.
Sisters and brothers cannot be covered as dependants.

No, one member cannot buy multiple policies.

Premium is charged on the basis of Age of Insured person, Sum Insured & Deductible opted.

Yes, however the waiting period of 24 months will be applicable from inception of Your first Future Advantage Top-Up Policy with Us. We cover the Medical Expenses incurred under Alternative Treatment with respect to the Hospitalization under Ayurveda, Unani, Siddha or Homeopathy provided that the Treatment has been undergone in a government Hospital or in any institute recognized by government and/or accredited by Quality Council of India/ National Accreditation Board on Health for that Alternative Treatment.

A Grace Period of 30 days is permissible for all policies. Policy will be considered as continuous for the purpose of all waiting periods and cooling off period. For Renewal Proposal received after completion of Grace Period of 30 days, all waiting periods would apply afresh.

No increase/ decrease in Sum Insured during the currency of the Policy. However increase/ decrease in Sum Insured and/or deductible or change in cover, can be requested at the time of Renewal of the Policy. You can submit a request for the changes by filling the Proposal before the expiry of the Policy.The enhancement is subject to underwriting guidelines and policy terms & conditions.

Yes, A person may be added as an insured during the Policy Period after his application has been accepted by Us, an additional premium has been paid and Our agreement to extend cover has been indicated.

Product will cover claims of only those benefits that are mentioned in the Policy Wordings. Claims that are out of scope of the coverage / excluded in the product will get declined. Also in the event of misrepresentation, misdescription or non-disclosure of any material fact, fraud, Non-cooperation the claim will get declined.