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Reviewed by Finzony Finance TeamLast updated:
SBIG Health Super Top-Up is a super top-up health plan. It does not replace your main policy. It pays hospital expenses above a deductible that you choose, from ₹2 lakh to ₹2 crore, up to a sum insured of ₹5 lakh to ₹4 crore. Claims in a policy year add up toward the deductible, and once your total expenses cross it, the plan pays the rest. It is meant to sit above an existing personal or employer policy. There are two plans. Plus has an annual aggregate deductible, for terms of 1, 2 or 3 years. Pro has a long term aggregate deductible and is available only for 2 and 3 year terms. The base cover pays in-patient treatment, pre-hospitalisation for 60 days and post-hospitalisation for 90 or 180 days, day care, organ donor expenses, modern treatments, AYUSH treatment, domiciliary treatment, home health care and road ambulance. A Cumulative Bonus adds 10% of your sum insured for each claim-free year, up to 100%, and it does not reduce if you claim. Optional covers include Unlimited Restore, Global Cover, maternity, newborn care, Consumables, Air Ambulance, Radio Cab, Recovery Benefit, Personal Accident, Hospital Daily Cash and options to shorten your waiting periods. Adults can join from 18 with no upper entry age, and children from 91 days to 25 years. Renewal is for life.
Super top-up cover of ₹5L to ₹4Cr that pays once your yearly deductible (₹2L to ₹2Cr) is used up.
Finzony reads this plan as a cost-effective way to raise your cover well above what your base or employer policy gives, if you can handle the deductible from your base cover or your own pocket. Its strengths are the range (up to ₹4 crore above deductibles from ₹2 lakh), a Cumulative Bonus that never reduces after a claim, and a base cover that already includes home health care, domiciliary treatment, modern treatments and AYUSH. The optional Unlimited Restore refills your cover as many times as needed in a year for related or unrelated illness, and you can shorten the pre-existing wait to 12 months or the specified disease wait to 12 months. Pre-existing diseases wait 24 months by default, and hypertension, diabetes and cardiac conditions that develop after you buy wait only 90 days. Know the limits. A super top-up pays nothing until your expenses in the year cross the deductible, so it does not help with small claims. Unlimited Restore is optional, not included, and there is no OPD cover. Consumables and other non-payable items are not paid unless you add Consumables. Maternity is optional, waits 36 months by default and is limited to women aged 18 to 45 with fewer than two children. The Pro plan carries a premium loading for its long-term deductible, which the prospectus puts between 20% and 50% depending on the deductible and term. The 30-day initial wait is waived only after more than 24 months of continuous cover, and medical tests can be required depending on your age and sum insured. Pick the deductible to match the cover you already hold, and compare it with a higher sum insured on your base plan before you decide. SBI General does not publish a starting premium in the prospectus, so get a quote.
SBI General Health Insurance
Key Insights
Founded
2009
SBI General Health Insurance was established 17 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
96.14% CSR, calculated as a 3-year average
SBI General Health Insurance settles 96.14% of all claims it receives, demonstrating strong credibility.
Network Hospitals
16,600+
SBI General Health Insurance has a network of 16,600+ hospitals, ensuring wide accessibility and convenience for policyholders.
Pays medical expenses above the deductible you choose, up to your sum insured. Claims in the policy year add up toward the deductible, so you do not need one single big claim to cross it.
It is meant to sit on top of an existing personal or employer policy. Nothing is paid until the deductible is crossed.
Choose a sum insured from ₹5 lakh to ₹4 crore and a deductible from ₹2 lakh to ₹2 crore. Which sum insured you can pair with which deductible is shown in the prospectus grid.
A family floater can include up to 4 adults and 6 children.
Plus has an annual aggregate deductible and is sold for 1, 2 or 3 years. Pro has a long term aggregate deductible and is sold only for 2 and 3 year policies.
In the prospectus examples, the Plus deductible applies afresh every policy year, while on Pro it is aggregated over the whole term. Pro carries a premium loading for the long-term deductible.
Pays treatment expenses above the deductible on a doctor's advice, including room rent, ICU or ICCU, nursing, doctor fees, medicines, diagnostics, operation theatre charges and implanted devices. Room rent is covered at actuals.
You can reduce the room rent limit to a Single Private AC Room or a Twin Sharing Room with an optional cover. A higher room cuts other expenses pro rata, but not in an ICU.
Pays expenses for 60 days before admission and for 90 or 180 days after discharge, as shown in your schedule, for the same condition.
Paid when a hospitalisation, day care, modern treatment, AYUSH or domiciliary claim is accepted.
Restores your base sum insured to its full amount, as many times as needed in the policy year, right after a claim is settled, for related or unrelated illness or injury.
Optional, and it does not carry over to the next year. On a floater, it is shared by the family. It is used after your sum insured and bonus.
Makes the items in the non-payable List I payable on an accepted hospital claim, such as consumables and other non-medical expenses, when prescribed by the treating doctor and medically necessary.
A 30-day wait applies to any illness except accidents, and it is waived only if you have more than 24 months of continuous cover. Hypertension, diabetes and cardiac conditions wait 90 days. The 39 listed conditions and procedures wait 24 months, and pre-existing diseases wait 24 months. Maternity and Global Cover each wait 36 months. You can change the pre-existing wait to 12 or 36 months, reduce the specified disease wait to 12 months, and change the maternity wait to 12, 24 or 48 months with optional covers. Waits are reduced to the extent of prior cover if you port or migrate, and they start again for any increase in sum insured.
Initial waiting period
Expenses for any illness in the first 30 days of the first policy are excluded, except for accidents. This is waived only if you have more than 24 months of continuous cover, and it does not apply to hypertension, diabetes and cardiac claims, which have their own wait.
Specified diseases and procedures
39 listed conditions and procedures, such as cataract, hernia, joint replacement and stones, wait 24 months, unless an accident caused them. You can reduce this to 12 months.
Pre-existing diseases
Declared and accepted pre-existing diseases are covered after 24 months. You can change this to 12 or 36 months. If a listed disease is also pre-existing, the longer wait applies.
Conditions or treatments that the policy clearly says it will not cover.
These conditions and procedures are excluded for the first 24 months of continuous cover, even if they begin after the policy starts and even if you declared them. You can reduce this to 12 months with the optional modifier. The wait does not apply to claims arising from an accident. If one of them is also a pre-existing disease, the longer wait applies.
Insurer
SBI General Health Insurance plans and claim process
It is a super top-up health insurance plan from SBI General with 9 base covers and 15 optional covers. It pays hospital expenses above a deductible you choose, up to a sum insured of ₹5 lakh to ₹4 crore, and is meant to sit on top of your existing health policy.
The plan pays only the part of your expenses that is above your deductible, and claims in the policy year add up toward it. In the prospectus example, with a ₹25 lakh sum insured and a ₹5 lakh deductible, a ₹5 lakh claim is not paid because it only uses up the deductible. A later ₹7 lakh claim in the same year is paid in full.
Plus has an annual aggregate deductible and can be bought for 1, 2 or 3 years. Pro has a long term aggregate deductible and is sold only for 2 and 3 year policies. Pro carries a premium loading for the long-term deductible, which the prospectus puts between 20% and 50% depending on the deductible and term.
Disclaimer: Premium amounts are indicative and may vary based on age, health, and plan selected. Claim settlement ratios are from IRDAI Annual Reports. Finzony is not an insurance broker or agent. Verify all details on the official SBI General Health Insurance website before purchasing.
Contact Details
1800 102 1111
Headquarters: 9th Floor, A & B Wing, Fulcrum Building, Sahar Road, Andheri (East), Mumbai – 400099, Maharashtra, India.
The aforementioned ratios have been averaged over three years (FY24-FY26)
Pays delivery expenses on in-patient admission, up to the sum insured above the deductible, and covers lawful termination only in a life-threatening situation on a doctor's advice.
Only for women aged 18 to 45, with a 36-month wait that you can change to 12, 24 or 48 months. It is limited to two deliveries, and women who already have two or more children are not eligible.
Covers the baby's medical expenses from day one up to 90 days of age, if the mother's maternity claim is accepted.
A baby older than 90 days and under 1 year can be added by endorsement or at renewal, with extra premium.
Pays in-patient or day care treatment abroad for 16 listed conditions and procedures, such as cancer surgery, heart valve replacement, bone marrow transplant, CABG after a heart attack, and kidney, liver, lung and heart transplants.
A 36-month wait applies. The illness must be diagnosed in India, your doctor must recommend treatment abroad, and it is paid on reimbursement in rupees.
Pays licensed air ambulance services within India to take you to a hospital where proper treatment is available, or between hospitals, when a doctor advises it in writing.
Paid on reimbursement, up to the limit in your schedule, and only when an in-patient or day care claim is accepted.
Pays a registered radio cab service to take you to the nearest hospital and from hospital to home, up to the amount in your schedule per hospitalisation.
Pays a lump sum if you are hospitalised for more than 5 continuous days, once for each insured person in a policy year.
Paid over and above the sum insured, with no deductible. The amount is in your schedule.
Pays 100% of the sum insured to the nominee if the primary insured person dies in an accident within 12 months, or to the insured for permanent total disablement caused by an accident.
Over and above the base sum insured, with no deductible, for the primary insured person only.
Pays a fixed daily amount for each day in hospital after a 24-hour deductible, and twice the amount for days in an ICU, for up to 10 days.
Paid for each eligible insured person, and it does not reduce the base sum insured.
Lets you limit your room rent to a Single Private AC Room or a Twin Sharing Room instead of actuals.
A higher room than the one chosen cuts other expenses pro rata, except in an ICU.
Change the pre-existing disease wait from 24 months to 12 or 36 months, reduce the specified disease wait from 24 to 12 months, and change the maternity wait from 36 months to 12, 24 or 48 months.
Each change must be shown in your policy schedule and affects your premium.
Gives you a second opinion from SBI General's panel doctors on a medical condition during the policy year, on the documents you share.
It does not replace a visit to your own doctor, and it is not for emergency care. No deductible applies.
A preventive check-up once a policy year for every adult above 18, covering 18 tests such as blood count, ECG, lipid profile, HbA1c, thyroid, liver and kidney function, vitamin D, treadmill test and ultrasound.
Arranged cashless at network providers, up to a limit in your schedule. It is over and above the sum insured and does not affect your bonus.
Hypertension, diabetes and cardiac conditions
A 90-day wait applies to all claims for hypertension, diabetes and cardiac conditions, except where the condition is pre-existing and disclosed when you buy.
Maternity
If you add the optional Maternity Expenses cover, a 36-month wait applies. You can change it to 12, 24 or 48 months.
Global Cover
Treatment abroad for the 16 listed conditions is excluded for the first 36 months from the first policy start date.
Higher sum insured
If you raise your sum insured, the waits start again only for the added amount. Waits are reduced to the extent of prior cover if you port or migrate without a break.
You can choose a sum insured from ₹5 lakh to ₹4 crore and a deductible from ₹2 lakh to ₹2 crore. Which sum insured pairs with which deductible is set out in the prospectus grid.
SBI General does not publish a starting price in the prospectus. As an illustration, with a ₹5 lakh sum insured and a ₹5 lakh deductible, six members aged 35, 30, 15, 10, 60 and 56 pay ₹10,208 a year when each is covered separately, ₹9,698 under one policy with a 5% discount, and ₹7,146 on a floater, before loading and taxes. Your premium depends on your age, sum insured and deductible.
Yes. SBI General describes it as a plan that can be added to an existing health policy, personal or corporate, from any insurer. Choose a deductible that matches the sum insured on your base policy, so that the two fit together.
At the end of each claim-free policy year, SBI General increases your sum insured by 10% of the previous year's sum insured, up to 100%. If you claim, the bonus you already earned is not reduced, but no new bonus is added at that renewal.
Only if you add the optional Unlimited Restore Benefit. It restores your base sum insured in full after each settled claim, as many times as needed in a policy year, for related or unrelated illness. It does not carry over to the next year.
Any illness waits 30 days, except accidents, and this is waived only after more than 24 months of continuous cover. Pre-existing diseases and the 39 specified diseases and procedures wait 24 months. Hypertension, diabetes and cardiac conditions wait 90 days. Maternity and Global Cover wait 36 months. You can shorten some of these waits with optional covers.
Yes, as an optional cover for women aged 18 to 45, with a 36-month wait that you can change to 12, 24 or 48 months. It covers up to two deliveries, and women who already have two or more children are not eligible. New-born Baby Cover protects the baby for 90 days.
Yes, with optional covers. Global Cover pays treatment abroad for 16 listed conditions after a 36-month wait, on reimbursement in rupees. Air Ambulance pays licensed air ambulance services within India when a doctor advises it, up to the limit in your schedule.
Adults can join from 18 with no upper entry age, and children from 91 days to 25 years. A floater can include up to 4 adults and 6 children, covering you, your spouse, children, and parents or parents-in-law. An individual policy can also cover siblings, grandparents, grandchildren and sons and daughters-in-law.
A floater gets 20% to 30%, online or direct purchase gets 10%, and a 2 or 3 year single-payment term gets 6% or 9%. Welcome, renewal, cross-sell, girl child, paperless, early entry and BMI discounts give 5% each. All discounts together are capped at 40%, not counting the floater and individual-family discounts.
For cashless treatment, intimate SBI General within 24 hours of an emergency admission or at least 72 hours before a planned one, and use a network hospital. For reimbursement, intimate within 48 hours of admission or before discharge, and send the documents within 30 days of discharge. SBI General must settle or reject a claim within 30 days, or 45 days if it needs an investigation. The claims toll-free numbers are 1800 210 3366 and 1800 210 6366.
Yes. Renewal cannot be refused because you claimed, and there is no loading for your own claims. After 60 continuous months, no claim can be contested except for proven fraud. A new policy has a 30-day free look period, with a refund of the premium less a proportionate risk premium, medical examination costs and stamp duty if you have not claimed.