Overview
The Extra Care Top-up plan from Bajaj General is a health insurance policy designed to provide additional coverage beyond the limits of an existing health insurance policy. It offers sum insured options from ₹10 lakh to ₹15 lakh and includes coverage for in-patient hospitalization, pre- and post-hospitalization expenses (60-90 days respectively), daycare procedures, and emergency ambulance services (Rs 3000/- per Hospitalisation). The plan requires a deductible of ₹3 lakh to ₹5 lakh, which must be paid before the policy kicks in. The policy is currently discontinued and not available for fresh purchase.
Experts' Review
Written by Nikhil Nair
Senior Writer
The Bajaj General Extra Care Top-up plan is a cost-effective solution for individuals seeking additional health insurance coverage without significantly increasing premiums. Basic coverage includes in-patient hospitalization, day care procedures, pre- and post-hospitalization (60-90 days), emergency ambulance services, no co-payment, no disease-specific sub-limits, no room rent restrictions, coverage for modern treatments (up to the base sum insured), and a 3-year waiting period for pre-existing illnesses, but excludes domiciliary treatment.
However, the plan's deductible requirement may delay access to coverage, and its limited sum insured options compared to other top-up plans like Extra Care Plus (which offers up to ₹50 lakh) might not provide adequate protection for high-cost medical emergencies.
The premium for this plan is generally 10-15% lower than comparable top-up plans due to its lower sum insured options. Bajaj Allianz's 3-year (2022-25) average claim settlement ratio is competitive (97%), supporting its operational efficiency.
Pros
Feature set is satisfactory.
Insurer has a solid track record with great claim and service metrics.
Cons
Premiums are relatively high.
No Restoration Benefit, which is a notable gap.
No Bonus for being healthy and not claiming insurance, which could be a drawback for some.
No coverage if you are forced to hospitalize at home, which is a key feature.
Bajaj General
Key Insights
Founded
2001
Bajaj General was established 25 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
97% CSR, calculated as a 3-year average
Bajaj General settles 97% of all claims it receives demonstrating strong credibility.
Network Hospitals
12,000+
Bajaj General has a strong network with over 12,000 hospitals, ensuring wide accessibility and convenience for policyholders.
Complaints
3 complaints per 10,000 claims registered
Bajaj General maintains a low volume of complaints, reflecting strong customer satisfaction and effective service.
Features
All
Great
Good
Maternity
STANDOUT
The insurer will also cover expenses related to maternity upto defined limits — Think hospitalization expenses incurred while giving birth Also, you’ll only get the benefits if both, you and your spouse are enrolled in a single-family floater plan.
Co-payment
The insurer will bear the entire cost of treatment (up to the sum insured). You won’t have to pay a single penny. Meaning this policy has no co-payment.
Room Rent
Shared room, single room, deluxe room or any room that’s available. The insurer won’t nitpick on your choice of room since the policy has no restrictions on room rent.
Disease sub-limit
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
Pre existing diseases waiting
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after just 1 year. It’s probably the best deal you can get to be honest.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Diagnostic expenses not related or incidental to current diagnosis and treatment are excluded.
Expenses for admission primarily for bed rest and not for treatment are excluded.
Custodial care at home or in a facility for help with daily activities is excluded.
Services for terminally ill individuals addressing non-medical needs are excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy for 1 years.
Any types of gastric or duodenal ulcers
Benign prostatic hypertrophy
All types of sinuses
Haemorrhoids
Dysfunctional uterine bleeding
Waiting Period
30 days Initial waiting period
1 year Specific illness waiting period
1 year Pre-existing disease waiting period
Ditto's Take
◦ Excellent ◦
Waiting periods on this policy are excellent. The specific illness waiting period and PED waiting period is better than usual.
What's missing in the policy
No Restoration Benefit.
No Bonus for being healthy and not claiming insurance.
No coverage if you are forced to hospitalize at home.
Doctor consultations are not covered.
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Frequently Asked Questions
Does Extra Care Plus Super Top-up have waiting periods?
- 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
- Specific Illness Waiting Period: There’s a 1-year waiting period for a list of diseases which is a mandate before you can start claiming.
- Pre-Existing Disease Waiting Period: There's a 1-year waiting period for any pre-existing disease you may have while buying the policy.
- Maternity and Newborn Waiting Period: There’s a 1-year waiting period before you can make claims related to pregnancy and childbirth.
Does Extra Care Plus Super Top-up have room rent restrictions?
Does Extra Care Plus Super Top-up offer a restoration benefit?
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