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Why should you get a Advantage Top-Up plan?

A top-up plan is your umbrella for the days when it rains too hard, and you only have a raincoat. This extended plan is necessary because:

· The medical costs are rising more sharply than inflation.

· Only a higher sum insured can beat rising medical expenses.

· Critical medical situations need wider coverage.

· Lower premiums.

· Additional tax saving.

Why buy Advantage Top Up Plan

Flexible

We are open to all your conditions. You can get this policy even if you do not have a Mediclaim plan.

Floater Benefit

Unity is strength. We allow you to cover yourself, spouse and 3 or 5 dependent children up to the age of 25 years.

Portability

We welcome you with open arms. You can port your existing insurance plan with us easily.

Free Look Period

We wish you only the best. So, in case you do not like the plan, cancel it within 30 days from purchase.

Grace Period

We know you are occupied. So, we allow you 30 days of grace for policy renewal.

Quick Claim Settlement

We settle our dues in time. Give us 90 minutes to process cashless claims and 14 working days for reimbursements.

What is in for you?

THERE ARE ADDITIONAL BENEFITS FOR YOU!

Family discount if you cover two or more family members in one policy
Loyalty discount of 2.5% if you already have one of our health insurance plans
Long-term discount up to 10% if paying your premiums upfront
Premium payment option in monthly, quarterly or half-yearly instalments
No loading on premiums for adverse claims
Conversion option to any indemnity health insurance plan, specific to some conditions
Tax savings

FG Pocket Clinic

Get access to specialized doctor consultations right at your fingertips.

What is covered?

INCLUSIONS

Room Rent
ICU expenses
Nursing expenses
Medicines and drugs
Diagnostic costs
Operation Charges
Consultancy
Specialist Fees
Daycare Treatment
Pre-hospitalization
Post-hospitalization
Organ donor
Alternative Treatment
Emergency ambulance

What is not covered?

You deserve to have full and truthful information. Our top plan excludes:

EXCLUSIONS

Any unnatural cause of physical injury like alcohol, drug influence, etc.
Injury or illness caused in a war, invasion or other similar operations
Hormone or sex-change related treatment
Non-prescribed drugs & medicines

Plans and Eligibility

Our plans

Supreme plan: Includes all ailments, as well as heart issues and cancer
Elite plan: Includes cancer and heart ailments

We secure

Anyone who is 18 years of age can buy our plan. We also offer lifetime renewability
The plan covers children from day one up to 25 years

Policy term

Minimum – 1 year
Maximum – 3 years

Small waiting period for inclusion of specific benefits

WAITING PERIOD	DISEASES
30 days	Any illness, diagnosed or diagnosable except those incurred as a result of injury
24 months	Pre-existing conditions, Benign Prostatic Hypertrophy, Dysfunctional Uterine Bleeding, Hysterectomy, Surgery for Prolapsed Inter Vertebral Disc unless arising from Accident, etc.

How Can I Purchase
Future Advantage Top Up?

1
Get a quick quote

We only need some basic details to give you a quote.
2
Fill the form
Select a quote that suits you and fill our proposal form. Answer some questions about your health.
3
Pay and get your policy
Now pay the premium and get your policy in your inbox!

What happens after purchase?

Once you secure the insurance cover, you get a financial assurance for all your health needs. You also get documents for your better understanding and convenience.

Health Card for Cashless Treatment It is for utilising cashless facility at network hospitals. You can even avail discounts which are offered by our allied partners. Check out the FGH Privilege section for getting more details.
Policy Schedule You will receive the policy schedule. It is an outline of the cover which is provided by the purchased policy. Details of the policyholder, coverage amount, additional clauses, exclusions, warranties etc will be given in this policy.
Premiums Receipt You will receive the receipt of the premium amount you have paid to purchase this policy.
80D Tax Deduction Certificate 80D certificate for tax deduction if the premium is paid via Credit Card/ Debit Card, Net Banking, or Cheque except cash payment.
Policy Coverage and Terms & Conditions This is a comprehensive document which lists down the coverage offered by the policy along with terms and conditions. It is better to read this thoroughly and highlight important points. In case of any discrepancy or doubt, do get in touch with us immediately.
Claim Form You can either intimate your claim online or submit the form to a branch of your choice. You can also email the claim details to us.
Complaint / Feedback Form Should you have any complaints/feedback, you can fill in the form and submit it to the nearest branch or email us.
Grievance Redressal In case you aren’t satisfied with the resolution provided by us to your complaint, then you can approach the Insurance Ombudsman. This form will have details about the procedure to approach the insurance ombudsman along with the addresses of the ombudsman.

What is the reimbursement claim process?

Our claim settlement process is fast and relaible

1

Collate Documents
Upon discharge, pay all hospital bills and collect all original documents of treatment undergone and expenses incurred
2

Claim Form

Download and fill the FG health claim form
3

Document Submission

Submit original documents to the nearest Future Generali branch
4

Claim Settlement
We will settle the claim in subject to policy terms and conditions

What is cashless claim process?

File your claim in minutes with Future Generali’s easy four-step claim process

1

Visit Hospital

Approach an insurance desk of your nearest FG Network Hospitals and show your health card for Cashless Treatment
2

Verify Yourself
The Network Hospital will verify your identity and submit duly filled pre-authorization form with Future Generali
3

Get Admitted
You get admitted without any deposit and get cashless treatment
4

Peace of Mind
Once you are discharged, the hospital will send your claim documents to FG and the authorized amount will be settled directly with the hospital

FAQs – Frequently asked questions

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Can I port my existing high deductible policy to Future Advantage Top-up 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.

Can I cancel my policy and if yes will I get my premium back?

Yes, you can cancel the policy and refund of premium will be on prorata basis, for complete details, please read policy terms and conditions.

Is there any provision of enhancing the Sum Insured after taking the policy?

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.

What is the policy Tenure?

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

What is the entry age under Future Advantage Top-up Product?

The product is offered from Day 1 to Lifelong

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

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.

What is Future Advantage Top-up Policy?

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.

Can Future Advantage Top-Up be availed by an NRI?

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

Is there any waiting period in Future Advantage Top-up Policy?

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

Waiting Period	Diseases
30 days	Any illness, diagnosed or diagnosable except those incurred as a result of Injury
24 months	*Pre-existing Disease/ conditions Benign Prostatic Hypertrophy, Dysfunctional Uterine Bleeding, Fibromyoma, Endometriosis, Hysterectomy, all internal or external tumors/ cysts/ nodules/ polyps of any kind including breast lumps with exception of malignant tumor or growth, Surgery for Prolapsed Inter Vertebral Disc unless arising from Accident, any types of gastric or duodenal ulcers, stones in the Urinary and Biliary systems, Surgery on ears, Organ transplant, Rheumatoid Arthritis, Gout, Joint replacement Surgery due to Degenerative condition, Age related Osteoarthritis and Osteoporosis unless such joint replacement Surgery is necessitated by accidental Bodily Injury.

What are the Discounts available in the product?

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.

Family discount (Individual policies)
Age Bands	Discount
<=70	10%
71-75	7.5%
76 And above	5%

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

Number of years	Discount
1 year	Nil
2 year	5%
3 year	10%

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

How is the premium charged in this policy?

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

What are the plans available Future Advantage Top-up Product?

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

Do I need to undergo Medical tests for taking this policy?

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.

What are the Sum Insureds and deductible available in this policy?

Sum Insured (in ₹ )	Deductible (in ₹)
1 L	2 L	3 L	4 L	5 L	7.5 L	10 L	15 L	20 L	30 L	40 L
50000	v	–	–	–	–	–	–	–	–	–	–	–
100000	v	v	–	–	–	–	–	–	–	–	–	–
150000	v	–	–	–	–	–	–	–	–	–	–	–
200000	v	v	v	–	–	–	–	–	–	–	–	–
300000	v	v	v	v	–	–	–	–	–	–	–	–
500000	v	v	v	v	v	v	–	–	–	–	–	–
750000	–	–	v	v	v	v	v	–	–	–	–	–
1000000	–	–	v	v	v	v	v	v	–	–	–	–
1500000	–	–	v	v	v	v	v	v	v	–	–	–
2000000	–	–	v	v	v	v	v	v	v	v	–	–
2500000	–	–	v	v	v	v	v	v	v	v	–	–
3000000	–	–	–	–	–	v	v	v	v	v	v	–
4000000	–	–	–	–	–	v	v	v	v	v	v	v
5000000	–	–	–	–	–	v	v	v	v	v	v	v
10000000	–	–	–	–	–	v	v	v	v	v	v	v

Are pre-policy tests charges reimbursed and what is the amount?

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

What is the difference between Future Health Surplus (Top-Up plan) and Future Advantage Top up (Super Top-up plan)?

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.

Scenario	Future Health Surplus (Top-up Plan)	Future Advantage Top-up (Super Top-up Plan)
Policies	Mr Gupta has a base health insurance policy of ₹ 5 lacs sum insured.
Policies	In case he buys a Future Health Surplus (Top-up) policy of ₹ 10 lacs Sum Insured with ₹ 5 lacs deductible	In case he buys a Future Advantage Top-up (Super Top-up) policy of ₹ 10 lacs Sum Insured with ₹ 5 lacs deductible
Case 1: Single claim There is a single claim of ₹ 12 lacs	a) Base health Insurance plan will cover ₹ 5 lacs. b) Future Health Surplus (Top-up) policy will cover the remaining ₹ 7 lacs as it exceeds deductible (of ₹ 5 lacs).	a) Base health Insurance will pay ₹ 5 lacs. b) Future Advantage Top-up (Super Top-up) policy will cover the remaining ₹ 7 lakhs as it exceeds deductible (of ₹ 5 lacs).
Case 2: Multiple claims There are 2 claims: (i) 1st claim of ₹ 4 lacs (ii) 2nd claims of ₹ 4 lacs	a) Base health Insurance plan will cover ₹ 4 lacs for the 1st claim. b) Base health Insurance plan will cover ₹ 1 lac for the 2nd claim. c) There will be no claims pay-out from Future Health Surplus (Top-up) policy as the individual amount of claim does not exceed the deductible (of ₹ 5 lacs).	a) Base health Insurance plan will cover ₹ 4 lacs for the 1st claim. b) Base health Insurance plan will cover ₹ 1 lac for the 2nd claim. c) Future Advantage Top-up (Super Top-up) policy will cover the remaining ₹ 3 lakhs as the aggregate of both claims exceeds deductible (of ₹ 5 lacs)
Case 2: Multiple claims There are 2 claims: (i) 1st claim of ₹ 7 lacs (ii) 2nd claims of ₹ 4 lacs	a) Base health Insurance plan will cover ₹ 5 lacs for the 1st claim. b) Future Health Surplus (Top-up) policy will pay the remaining ₹ 2 lacs for the 1st claim. c) No claim is payable for the 2nd claim as it does not exceed the deductible limit (of ₹ 5 lacs).	a) Base health Insurance plan will cover ₹ 5 lacs for the 1st claim. b) Future Advantage Top-up (Super Top-up) policy will pay the remaining ₹ 2 lacs for the 1st claim. c) Future Advantage Top-up (Super Top-up) policy will pay ₹ 4 lacs for the 2nd claim.

When I will be eligible for waiver of deductible?

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.

Do I get tax benefit under section 80D of IT act for premium paid to take Future Advantage Top-up Policy?

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

Under what all circumstances, Future Generali can decline a claim, even though the treatment was genuine?

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.

Will I get a discount on renewal if no claim is made during the year?

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.

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.

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)

	Scenario 1	Scenario 2	Scenario 3
Sum Insured	500000	500000	500000
Deductible	100000	200000	300000
*Claim 1	75000	100000	100000
*Claim 2	125000 (Claim is for the same illness within 45 days)	125000	150000
*Claim 3	100000 (Claim is for ailment falling in 2 years waiting period)	100000	50000
*Claim 4	100000	500000	100000
Payable Amount for Claim 1	Nil	Nil	Nil
Payable Amount for Claim 2	100000	25000	Nil
Payable Amount for Claim 3	Nil (As there is waiting period of 2 years)	100000	Nil
Payable Amount for Claim 4	100000	375000	100000
Remaining Sum Insured	300000	Nil	400000

Is there medical loading applicable under Future Advantage Top up?

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

What are the Premium mode available under Future Advantage Top-up:

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

Instalment frequency	Loading on standard premiums
Monthly	5%
Quarterly	4%
Half-yearly	3%

In case of instalment, if monthly mode is opted, minimum 2 months premium needs to be collected for policy issuance.

Are Ayurvedic, Homeopathic,Unani treatments covered under the policy?

Yes, we will cover the medical expenses incurred under Alternative Treatment with respect to the Hospitalization under Ayurveda, Yoga and Naturopathy,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.

Can a newly married spouse/new born child be added in the Health policy?

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.

Is there any grace period available to renew the policy with a customer forgets to renew before the expiry date of the expiring policy

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.

What is the renewal age under Future Advantage Top-up Product?

Lifelong Renewability is available under Future Advantage Top-up.

Can I buy more than 1 policy?

No, one member cannot buy multiple policies.

Is cashless mode of claim settlement available for Future Advantage Top-up Policy?

Yes, cashless facility is available

Can I cover my parents, brothers and sisters as dependants?

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.

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

What should be my age if I want to buy this policy?

An individual of age 18 years can buy this policy.

Is pre and post hospitalisation covered under Future Advantage Top-up Policy?

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

Can I avail Future Advantage Top-up Policy as floater option?

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.

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PRODUCT NAME: FUTURE ADVANTAGE TOP UP | UIN NO: FGIHLIP23053V032223 | LAUNCH DATE: 05TH-SEP-2022

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Get more coverage on your insurance

Enjoy more protection with a top-up today

Why should you get a Advantage Top-Up plan?

Why buy Advantage Top Up Plan

Flexible

Floater Benefit

Portability

Free Look Period

Grace Period

Quick Claim Settlement

What is in for you?

FG Pocket Clinic

What is covered?

What is not covered?

Plans and Eligibility

Small waiting period for inclusion of specific benefits

How Can I Purchase
Future Advantage Top Up?

Get a quick quote

Fill the form

Pay and get your policy

What is the reimbursement claim process?

What is cashless claim process?

FAQs – Frequently asked questions

Need to know more about Health Insurance?

Download documents

Get more coverage on your insurance

Enjoy more protection with a top-up today

Why should you get a Advantage Top-Up plan?

Why buy Advantage Top Up Plan

Flexible

Floater Benefit

Portability

Free Look Period

Grace Period

Quick Claim Settlement

What is in for you?

FG Pocket Clinic

What is covered?

What is not covered?

Plans and Eligibility

Small waiting period for inclusion of specific benefits

How Can I Purchase Future Advantage Top Up?

Get a quick quote

Fill the form

Pay and get your policy

What is the reimbursement claim process?

What is cashless claim process?

FAQs – Frequently asked questions

Need to know more about Health Insurance?

Download documents

How Can I Purchase
Future Advantage Top Up?