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PW Stalwart
The top-up policy will start paying claim, when the insured hit the threshold. Insured having a Top Up of 5 Lakhs with Threshold 5 Lakhs, then in this case once the 5 lakh policy cover is exhausted then the top-up policy start paying. Second point of your question, if your top-up policy is family floater then your assumption is correct.
Threshold calculation under the Policy include:
- 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.
I would ask you to go through the example provided in the New India website in CLAIMS ADJUDICATION Section.
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