Restoration Benefit in Health Insurance
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What is the Restore Benefit?
The restore benefit is an add-on feature that can be combined with health insurance policies to restore your sum insured if it is fully depleted during a claim. Restoration of the sum insured in health insurance is a valuable addition to your chosen policy.The standard health plan comes with a chosen sum insured value to cover medical expenses during emergency treatments and hospitalisation. However, when you file a claim, your total sum insured might not always be enough to cover the medical expenses or the sum insured may be exhausted with a single claim.
With this add-on, you can benefit from automatic restoration of the sum insured for future claims. In simple words, if your health plan’s sum insured is insufficient for medical claims, this add-on comes into effect to provide additional financial assistance. For example, the sum insured for a policy is ₹5,00,000, and you have used the entire sum insured in one policy year. In such situations, this add-on will offer an automatic restoration of the sum insured for the policy year for other claims.
Types of Restore Benefit
There are primarily two types of restorations under the restoration benefit in health insurance. In both types of restoration benefits, the sum insured amount is restored. However, the amount of restoration varies between both options.
Full Restoration
Under this benefit, if you use your sum insured amount fully, your insurance provider restores the entire sum insured amount for your policy. This allows you to file additional claims within a policy year without facing a financial burden.
Partial Restoration
Under this benefit, when you file a claim for a portion of the sum insured amount, a pre-decided percentage of the total sum insured is restored in your policy for future claims.
How Does Restore Benefit in Health Insurance Work?
The restoration benefit is simple and easy to understand. It is an add-on benefit that provides additional financial support when your sum insured is exhausted fully or reaches the threshold limit.
To understand how the restore benefit works, let us look at an example below.
Mr Pankaj has a health plan with a sum insured amount of ₹6,00,000.
He meets with an accident and files a claim for ₹5,00,000.
Now that you understand the impact of restoration benefit in health insurance meaning, there are two situations possible for Mr Pankaj, and they are as follows
Full Restoration - With a complete restoration add-on, he will get an automatic reinstatement of his sum insured amount of ₹6,00,000 when he uses the entire amount.
Partial Restoration - With a partial restoration add-on, he will get a portion of the total sum insured amount restored after he files this claim, even though he has only used up to ₹5,00,000. The amount of restoration is based on the predetermined percentage specified in the policy terms.
Advantages of Restoration in Medical Insurance
Conditions Applicable to Restore Benefit in Health Insurance
You cannot carry forward the restored sum insured amount into the next policy year. You can only use it for medical claims within the same policy year.
For a full restoration, you need to exhaust your total sum insured amount to get the restoration benefit.
Depending on the type of health plan and its terms and conditions, the amount and frequency can vary. Thus, you must read the policy document before purchasing this add-on.
You must submit valid documents regarding your medical claim that led to the use of the sum insured amount, along with proof of how much amount is used to get the restoration benefit.
Claim submission is mandatory to get your sum insured restored for the same policy year for future claims.
You cannot apply for the restoration benefit during the first claim of your health insurance policy. It is only applicable to the future claims after the first claim submission.
For family floater plans, only one family member can avail of the restoration benefit at a time.
Restoration benefit is applicable to all big or small amounts of the sum insured.
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Who Should Choose Restore Benefit in Health Insurance?
People who have a family history of chronic diseases or life-altering illnesses.
People who have pre-existing health conditions that require frequent treatments.
People who have high-risk jobs.
People with poor lifestyle habits.
Individuals or families who want additional financial protection for medical emergencies.
People with elderly parents.
People who travel a lot or reside in accident-prone areas.
Individuals with a health plan of lower sum insured coverage.
Key Considerations when Choosing the Restore Benefit in Health Insurance
Claim Convenience
The first thing to check is the claim convenience available with the chosen insurer. You must choose an insurer that offers a quick and easy claim process to save time and effort in times of medical emergencies. Reliance General offers the convenience of online claim filing in just a few steps.
Restoration Frequency and Amount
Understand your needs and then choose a plan that suits your coverage requirements. You can choose between a plan that offers full restoration or partial restoration of the sum insured amount determined by a fixed percentage. Moreover, before purchasing any plan, check for the permitted frequency of restoration to make the right choice.
Applicable Waiting Period
Some insurers or policies have an applicable waiting period to avail of the restoration benefit in health insurance. Check for these specific conditions before you purchase a plan, as it can affect your coverage requirements in times of need.
Policy Exclusions and Terms
Check the policy exclusions and terms before making the purchase. This will help you understand the eligibility and conditions applicable to your restoration benefit add-on beforehand for informed decision-making.
Premiums
Assess the additional cost of the restoration benefit carefully to determine whether it fits your budget or not. Typically, this add-on increases your base health plan premium by a small amount but ensures maximum financial security during medical emergencies.
Insurer’s Market Image
Opt for an insurer with a good market image. Before making the final decision, check the online customer reviews and testimonials, as well as the insurer’s claim settlement ratio.
How to Include Restore Benefit in your IndusInd Health Insurance?
You can typically include the restore benefit add-on in your IndusInd Health Insurance either when you are buying a new policy or when you are renewing an existing plan. Both the processes can be completed online in just a few steps, and they are as follows -
When Buying a New Health Plan
Visit our website.
On the main page, select “Health” and enter the required details in the space provided.
Once done, accept the terms and conditions, and then click on “View Prices”.
On the next page, a list of health plans will open on the screen. Choose the one that aligns with your needs, select a sum insured amount, and then select “Restore Benefit” from the list of add-ons.
After all the selections, a final premium quote will appear on the screen. If it is satisfactory, make the premium payment to buy the health plan with your restoration benefit.
When Renewing a Health Plan
Visit our website.
On the next page, select “Health” and then click on “Renew Your Health Insurance Policy”.
On the next page, select and add either your mobile number or policy number and the requested details before clicking on “Go”.
Your existing health plan will open on the screen. Review the policy details, assess the sum insured, and then add the “Restore Benefit” add-on to your policy.
Once you are done, a revised premium quote will be displayed on the screen. If satisfactory, make the premium payment to renew your health plan with the restoration benefit.
Conclusion
Restoration in medical insurance acts as a second weapon of financial protection during medical emergencies. This ensures your finances are secure from the financial burden without compromising on quality healthcare.
Most insurers offer restoration benefits as an add-on to their health insurance plans to allow choice-based customisation for maximum protection. Reliance General also offers restoration benefits with its individual and family health plans.
Moreover, you benefit from maximum customisation flexibility, online policy purchase, renewal or claim convenience, and cashless hospitalisation when you choose Reliance Health Insurance.
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