Quote Form

Our representative will call you within few minutes
Health Insurance 2258 views March 4, 2020
One of the critical insurance needs in our daily life is Health Insurance without which we can’t think of getting a financial shield in case of any untoward incident. With more increased awareness now, every individual has a minimum of one health insurance plan for himself or his family, with several features and benefits, which are specifically designed to meet the financial requirement. An example can be taken for HDFC Ergo Health Optima Restore plan which has the benefit of restoration.
Table of Contents
One of the benefits which all of seeing in most of the health insurance plans is the Digit Maxima Restore Super or the Restoration Benefit. With the mounting cost of medical expenses and with complexities of diseases, it is likely that you may finish your existing sum assured in one single hospitalization, here the benefit of restoration comes of great use. It permits an insured person to restore the whole sum assured in the same policy year when it is exhausted fully or partially because of claims made. Maximum health plans in today’s time offer ‘restoration benefit’ which can be considered as a strong back up to boost your exhausted sum assured. After the sum insured gets exhausted, the same will be refilled automatically and will be available for the next hospitalization within any policy year.
Usually, health plans come as individual policies or as a family floater which covers the specified family members under one single umbrella and the sum insured is shared by all. There might be a high possibility that the complete sum assured may get exhausted because of a severe disease or injury of any family, whereas the other members remain uncovered. In this condition, when the sum assured is exhausted, restoration benefit demonstrates to be of great use both for family floater plans as well as for individual health insurance policies.
Let us take an example. You have bought a health policy with a sum assured of INR 4 Lakhs. Now, one of the family members gets identified with a severe illness and had to be hospitalized with expenses that occurred to the tune of INR 3.5 Lakhs. If he or she is again hospitalized, say after 4 months, and this time medical expenses are INR 3 Lakhs, you will get the cover of INR 50,000 and the residual amount of INR 2.5 Lakhs will have to be paid out from your purse. And, if you have a plan which has the restoration benefit, the plan will pay the whole expenses of INR 3 Lakh and you need not pay this time.
For maximum insurers, the benefit of restoration is made available for unconnected claims only. However, Apollo Munich or HDFC Ergo Optima Restore plan that offers restoration on all diseases but not for the same claim.
You must understand the terms and conditions of availing the benefit of Refurbishment or Reinstatement before you decide to buy a plan as knowing these you will be able to understand and then decide as per your need. Below are the main key conditions that will apply to this benefit:
Situations | Restoration under Complete Use of Sum Assured (INR) | Restoration under Part Use of Sum Assured (INR) |
---|---|---|
Sum Assured | 4 lakhs | 4 lakhs |
Claim Number 1 | 3.5 lakhs | 3.5 lakhs |
Remaining Sum Assured | 50,000 | 50,000 |
Claim Number 2 | 70,000 | 70,000 |
Restoration Benefit | No | Yes – 4 lakhs |
Claim Number 2 Paid | 50,000 | 70,000 |
Total Claims made in a year | 420000 | 420000 |
Total claims paid with a health plan in a policy year | 4 lakhs | 4,70,000 |
Conclusion
With the restoration benefit or Digit Maxima Restore Super, you can get real advantage of the increased sum assured, keeping in the mind inflation rate and the rising cost of medical expenses. However, do not forget to analyze the terms and conditions as mentioned to get the best of the restoration benefit.