Revealed: The Truth about New India Assurance’s top-up policy

Newspapers have claimed that New India Assurance's newly launched top-up policy is the cheapest. These articles assert that you can even do cosmetic surgery and claim the amount over the deductible, for expenses covered by mediclaim. Here is the truth


New India Assurance (NIA) has launched a top-up plan, which is being hailed by few newspapers like the Times of India (ToI) and Economic Times (ET) as the cheapest product available. This is incorrect. The NIA top-up plan is not the cheapest and it is more expensive than super top-up products which are a better option.


The ToI article states - A unique aspect of NIA's cover is that for the threshold limit to be reached, all hospitalization expenses are taken into account irrespective of whether the expenses would qualify as an insurance claim. This means that the insured can spend Rs5 lakh on a cosmetic surgery (which is not covered under mediclaim) and recover any additional health expense (covered under mediclaim) under the top-up plan. This is absolutely incorrect information. Moneylife wrote about the discrepancies to New India Assurance, but there was no response till the writing of this article. In fact, there is no health insurance product that covers cosmetic surgery.


NIA top-up has deductible of Rs5 lakh and Rs8 lakh. It is a high deductible plan. There are top-up/super top-up products available in the market with deductible from Rs2 lakh onwards. The lower the threshold deductible, the higher are the chances of being able to file a claim and benefit from the policy. With NIA top-up limiting the deductible to be a high amount of Rs5 lakh and Rs8 lakh, the product has limited flexibility.


The premium for a 41 year old person buying NIA top-up with deductible of Rs5 lakh and coverage of Rs5 lakh, will be Rs1800 + tax, which is Rs2022. United India's  top-up for the same deductible and coverage will have a premium of Rs1910. Apollo Optima Plus is a top-up plan with a premium of Rs1348 for the same parameters. It is obvious that the NIA top-up plan is not the cheapest, as claimed by leading media publications.

L&T my: health Medisure Super Top Up and United India’s Super Top-Up are the only standalone super top-up policies available in the market as of now. The premium for L&T super top-up plan is Rs1112 for the same parameters and United India's super top-up is Rs2135. It means L&T super top-up is cheaper than NIA top-up and United India super top-up costs a little more premium. Moreover, you should prefer super top-up products over top-ups as these offer better benefits. 

The difference between super top-up and top-up is that in the case of a top-up policy, the expenses for a single treatment should be over the threshold, whereas in a super top-up the total expenses in a year must be above the threshold level for the policy to be useful. Thus, between a top-up and super top-up, the latter is more beneficial for customers. Examples of top-up products that you should avoid are - United India Insurance (Top-up medicare), Bajaj Allianz (Extra Care), Apollo Munich (Optima Plus), ICICI Lombard (Health Care Plus) and Star Health (Super Surplus). You can add NIA top-up plan to this list of products to avoid.

NIA's policy wording clearly states –

The following Hospitalisation expenses incurred in respect of all the Insured members shall be considered for determining the Threshold under the Policy:

• The admission in the Hospital should have happened during the policy period.

• The Insured should have been admitted as an inpatient (outpatient treatments are not to be considered).

• The Hospitalisation should be for an Injury or Illness.

• Pre–Hospitalisation and Post–Hospitalisation expenses will not be considered.

The exclusions section specifies following non-covered procedures - Circumcision, cosmetic or aesthetic treatment, plastic surgery unless required to treat Injury or Illness.

If the policy clearly states that deductible threshold will only considered hospitalisation for injury or illness and exclusions specifies cosmetic surgery as non-covered, then how can TOI and ET media get it wrong?

Uma Narayanan Mahesh
8 years ago
We have a New India Assurance Family Floater Policy,SA 5 Lakhs for 3 members of our Family . Would like to increase the SA.Is it advisable to get SA 8 Lakhs or buy a Top up for 5 Lakhs?
Sunil Ghotge
8 years ago
We have a NIA Family Floater policy in force; SA 5 Lakhs for persons aged 59 and 55 yrs, paying a Premium of Rs 28000/- approx which we consider very expensive. Need to increase the cover to 15 Lakhs, possibly by reducing SA of existing cover to 3 Lakhs and a Super Top-up with Threshold 3 Lakhs. 1. If there is NO CLAIM with NIA policy in last Four years, does the Super Top-up cover all pre-existing from Day One ? 2. Can you suggest Best / optimum options, with PORTING the Cover if necessary to LnT or any better option ??
Jagdish Motwani
Replied to Sunil Ghotge comment 8 years ago
Reducing SI not advisable as Room Rent Capping will reduce all claims. As it is Room @ 5000 Per Day will not suffice in Major Hospitals.
Sunil Ghotge
Replied to Jagdish Motwani comment 8 years ago
Can you kindly suggest Best / optimum options, with PORTING the Cover if necessary to LnT or any better option, if we wish to enhance the cover to 10-15 Lakhs please?
Augustine Francis
Replied to Sunil Ghotge comment 8 years ago
You can go for Super Top up from United India, wherein you can keep your current sum insured as 5 lacs and take a super top up for additional 10 lacs for a premium of 7400/- for 2 members
9 years ago
Dear motwani sir
you ar
e also missing a point all other companies offering super top up plans upto 10laks or 15 laks max but NIA offering 22LAKS COVER WITH DEDUCTIBLE 8LAKS that is also make some point
Jagdish Motwani
Replied to ketan comment 8 years ago
With New India Option of 5 Lacs Thresh=hold & Up To 15 Lacs Sum Insured also available.
Jagdish Motwani
10 years ago
Dear, there appears to be confusion. The example of Cosmetic Surgery related Hospitalisation Expenses is given for Reaching The Thresh-hold Limit i.e. if during the year insured has incurred Total Hospitalisation Expenses upto Rs.5/8 Lacs then Policy Benefits will Trigger but off-course claim payment as per policy T&C. For Example if Thresh-hold Limit is Rs.5 Lacs & insured is hospitalised for AIDS or Cosmetic Treatment & Hospital Bill is Rs.4 Lacs & again during policy year if he is Hospitalised & hospital bill is Rs.3 Lacs then Claim Eligibility Starts for Amount of Rs.2 Lacs as per Policy T&C. If second Hospitalisation is also for AIDS or Cosmetic Treatment then nothing payable. As regards pricing the Star Health's pricing is good as it is static irrespective of age band, but offcourse even Star's Top Up has certain limitations.
Jagdish Motwani
Pathways Insurance Solutions
raj pradhan
Replied to Jagdish Motwani comment 10 years ago
Dear Mr Motwani,

You seem to be missing a point.

The policy clearly states that "deductible threshold will only consider hospitalisation for injury or illness".

It clearly means that if your cosmetic surgery is not due to injury or illness then it will not be covered for considering the threshold deductible.

If I had got it wrong, New India Assurance would have corrected me. I have written to them well in advance of writing the article.
Jagdish Motwani
Replied to raj pradhan comment 10 years ago
Pl. share your email ID.
Thanks & regards
nilesh prabhu
10 years ago
Dear Raj,

Great work. Your are the expert on insurance. The government should utilise your and other such persons expertise.

Your and your like are helping ordinary citizen fight big business.

May your tribe increase
raj pradhan
Replied to nilesh prabhu comment 10 years ago
Thanks, Mr Prabhu. You are also doing wonderful job of fight against TNT India for insurance scam.
10 years ago
The Articles of Money Life brought out the fact of TOI. However, United India and L&T General Insurance are not the only company to offer super top up policy. Apollo Munich's Optima Super and Cigna TTK's health plan has super top up options.
raj pradhan
Replied to Pratik comment 10 years ago

Apollo Munich Optima Super is super top-up & mediclaim combo and hence little different than just super top-up. The pricing will be different for better benefit. In this example, it is Rs. 2511 for same parameters and hence better option than NIA top-up charging Rs2022. Please read about it in our latest cover story and separate article

Cigna TTK mediclaim has deductible option, not stand-alone super top-up product. But, yes it can be considered for comparison purposes.
10 years ago
TOI and ET are pro-establishment papers. The menace of paid up news is also rampant there. Intelligent readers ,therefore, can understand the reason for this publicity.
but the fact is beyond doubt that although NIA may be the top Nationalized non-_life Insurance company; it has been also worst for the Insured persons, especially seniors. If we study the pattern of Health Insurance complaints from IPs ; it will become evident that NIA is on top.
Sabapathy Narayanan
10 years ago
Wonderful Analysis with facts and figures by Raj. Red Salute!

It is clearly proved that it is a paid news and it is marketing gimmiks!
raj pradhan
Replied to Sabapathy Narayanan comment 10 years ago
thank you
Replied to raj pradhan comment 10 years ago
Raj , With regards to your statement that New India Top-Up Mediclaim is not a Super Top -Up , I had a different understanding reading the Policy Document in NIA website which states
If during the Period of Insurance, You or any Insured Person undergo Hospitalisation for Illness or Injury and incur Medical Expenses, by reason of which the Cumulative Hospitalisation Expenses for the Insured Persons during such Period exceeds the Threshold specified in the Schedule, We will reimburse subject to terms and conditions of this Policy, the portion of the Medical Expenses for such Hospitalisation or any Hospitalisation thereafter as exceeds the Threshold, to the extent specified under How Much We Will Reimburse section of this Policy.
a) Claim shall be made only for the Hospitalisation during which the Cumulative Medical Expenses exceeds Threshold or for any subsequent Hospitalisation, but not for earlier Hospitalisation or treatment.

Based on the wording in the policy document , Is it not clear that this is a Super Top-Up policy which is triggered when the previous cumulative hospitalisation expenses (i.e.aggregate of all previous) for the policy period exceeds the threshold limit ?

Parul Aggarwal
10 years ago
Deepak R Khemani
10 years ago
Wow Raj, That is really quick and good work done by you and the Moneylife team. It goes on to show that Newspapers are really not getting their facts correct before printing any article.
Suketu Shah
Replied to Deepak R Khemani comment 10 years ago
ET Wealth is 80% misleading.I have unsubscribed to it permanently wef Dec 2014.TOI and its group wl do anything for "money"
raj pradhan
Replied to Deepak R Khemani comment 10 years ago
thanks, Deepak
Jagdish Motwani
Replied to raj pradhan comment 10 years ago
Dear Raj
I have already requested for your email ID to share relevant material & await response. The policy wordings & presentation may clear your doubts.
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