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Restore Benefit in Health Insurance

It is quite possible that one day you or someone in your family may face a health issue, and it is not uncommon for such problems to occur more than once. In those cases, a restoration benefit can provide an extra layer of financial protection if you exhaust the coverage amount for that particular policy year.

A restore benefit in health insurance is an add-on feature that you may combine with your base plan. It allows you to restore your sum insured if it is fully depleted following a claim. Therefore, it acts as a valuable addition to standard medical insurance plans covering emergency hospitalisation and treatments.

IndusInd General Insurance provides its customers with an Unlimited Restore Benefit add-on that fully restores the sum insured amount immediately after it is exhausted. Additionally, you can rely on our wide range of health insurance plans, which boast a high claim settlement record* and a straightforward website for smooth and efficient claim handling.

Advantages of Health Insurance With Restoration Benefit

Both individual and family floater health insurance policies include restoration benefits. If any person requires ongoing monitoring for chronic conditions like diabetes, asthma, arthritis, etc., this feature can prove to be highly beneficial.

Better Financial Coverage

Our Unlimited SI Restoration add-on automatically reloads the coverage amount if you have already claimed the primary amount allocated for that year. For example, if you have a ₹10 lakh cover for treatments, we restore the full sum insured as soon as you exhaust the primary ₹10 lakh in that year, subject to policy terms*. This feature shields you against unforeseen medical costs that can arise at any moment.

Can Claim More Than Once

With the restoration cover, you can submit unlimited claims in a single year. This is particularly helpful for those suffering from multiple ailments that require frequent hospital visits. For the refill, you do not have to inform us, as our system automatically adjusts the coverage once the sum is fully consumed. All the family members can share the restoration benefits if the add-on is taken with a family floater plan.

Budget-Friendly

Although the cost is relatively higher when opting for a restore benefit in health insurance, it offers comprehensive coverage. Including this add-on helps you secure a wider level of protection against escalating medical expenses without owning multiple plans. So, instead of chasing a higher insured amount, you can consider adding this benefit to ensure you get the desired coverage.

Provides Continued Coverage

The restoration benefit ensures that your health coverage remains active for the entire policy year, even if the original sum insured runs out. It appears to be crucial in cases of recurring medical crises or serious health conditions that often demand several hospitalisations. Furthermore, the guarantee of uninterrupted coverage lets you get the best treatment without any financial concern.

Types of Restoration Benefits

1 Complete or Full Restoration

This restoration benefit replenishes your coverage amount only after the primary limit has been used. For example, if you purchase a health plan with a coverage of ₹5 lakh, once you have used up the entire amount, the plan will automatically refill it with another ₹5 lakh for any additional claims within the same policy year. This feature helps you avoid financial burdens by providing ongoing coverage.

2

Partial Restoration

Under this optional cover, as you claim a part of the sum insured (SI), a predetermined percentage of the coverage amount is added to your limit for future claims. So, these plans activate when the SI is partially utilised. E.g., let’s say your ongoing medical costs amount to ₹4 lakh, with the total SI being ₹5 lakh. In this case, the restoration benefit will add additional funds, allowing you to make further claims.

Conditions Applicable to the Restore Benefit in Health Insurance

You are not eligible to carry forward any restored sum amount into the next year. All policyholders must use it for medical expenses within the same policy year.

Valid documents need to be submitted as proof that you have utilised the primary sum insured for medical purposes, thus leading to the limit exhaustion.

In the case of full restoration, your insurance company will only extend the benefit once you completely exhaust the sum insured.

You should compulsorily raise a claim to restore your coverage amount for the same policy year for further claims.

Based on the type of health insurance and its conditions, the restoration amount and frequency may vary. So, always read the policy documents before adding this add-on.

The first claim under your policy does not qualify for the restoration benefit. Claim settlements from the restored amount begin only for claims made after the first one.

For family floater plans, only one member can use the restore benefit at a time.

The restore benefits are available for any amount of the insured sum, big or small.

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Key Features of Restoration Add-On in Health Insurance

Activates Only Once Per Policy Year

This add-on allows the insured sum to be reset only once during a single policy year. Suppose you have an initial insured sum of ₹6 lakh, which is completely exhausted in the first claim. The restoration benefit replenishes the coverage back to the initial amount. Later, in the same policy year, let’s assume you face another medical emergency where the bills amount to ₹4 lakh. Here, you still have ₹1 lakh remaining to cover future claims within that year.

Cannot be Carried Forward to the Upcoming Year

The benefits of restoration in health insurance are valid only for the current policy year. Any unused restored amount cannot be carried forward to subsequent years. Hence, reinstatement acts as a crucial safety measure for emergencies during a particular policy year and does not function as a means to build up coverage for future years.

Applies to Future Claims

To be eligible, you must have used the full or a part of the sum insured within a year (depending on the plan). The first claim of the year does not qualify for this benefit. For example, if you opt for our ₹5 lakh Unlimited SI restoration plan and make a claim of ₹2.5 lakh early in that year, the restoration will not be triggered at that point. However, if further claims during the same year exhaust the remaining amount, restoration will then be activated.

Can be Added as an Extra to the Base Plan

Your selected health insurance plan can be enhanced with add-ons like critical illness coverage and restoration benefits. These riders are designed to be added to the base plan for a more personalised coverage in exchange for a modest extra premium. They enable you to easily access regular health checkups, imaging tests, physical examinations, doctor consultations, etc., as per your needs.

Who Should Go for a Restoration Benefit in Health Insurance?

Policyholders with various health issues.
Those needing frequent health checkups that might necessitate additional coverage.
People going for family floater plans, as in that case, all the sum insured can be exhausted by one member. The rest of the amount can cover the other people for that policy year.

How to Purchase a Restoration Benefit Cover?

At IndusInd General Insurance, you can easily add the “Restore Benefit” from the list of add-ons while buying/renewing one of our health plans. You can complete this through our website or use our Self-i app.

All you need to do is enter your details on the form at the top to start the plan purchasing process. Then, select a plan that seems sufficient for you and your family’s health needs, choose the suitable add-ons, complete the KYC verification, and pay online. Your policy documents will be delivered instantly to your registered email address. You can also use the calculator below for instant policy quotes.

While renewing your plan, adding the restore benefit to your health insurance can be completed even more quickly. In this case, upon entering your policy number, you can check and modify coverage and then pay by clicking "Renew".

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Key Takeaways

The restore benefit in health insurance is like a backup plan that protects you from financial strains when medical expenses surpass your expected budget. It ensures your future remains secure, and at the same time, you never have to compromise on quality healthcare.

You normally get restoration benefits as an add-on to any standard medical insurance policy. At IndusInd General Insurance, we offer this facility along with our individual and family health insurance policies. You can choose us for our wide array of plan customisation, easy renewal and claims procedures through our mobile app, and smooth cashless hospitalisations at more than 10,000 hospitals nationwide*.

Health insurance starting at just ₹243 per month*!

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Medical bills can stack up fast, but your coverage won’t fall short. We refill your sum insured so you never have to hesitate during treatment.

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Frequently Asked Questions (FAQs)

Is the restoration benefit available for every claim, or does it have any limitations?

Usually, the restore benefit in health insurance has several conditions. It can be applicable for a few categories of claims or after a waiting period. Thus, you should carefully review a policy's terms and conditions before opting for this add-on.

What type of health insurance policies offer restoration benefits?

Restoration benefits are offered in various comprehensive health insurance plans, including family floater, individual health, and critical illness policies.

What is the difference between restore and recharge?

In health insurance, selecting the restore add-on replenishes the sum insured once the primary coverage is fully exhausted. In contrast, the recharge feature adds your most recent claim amount to the sum insured, even if the initial sum has not been used up. The restore benefit must be utilised for a different person or a separate illness during the same policy year. Meanwhile, the recharged amount can be immediately used for any subsequent claim within the same year.

What is the unlimited restore benefit?

With IndusInd General Insurance’s health plans, you have the option of Unlimited Sum Insured (SI) coverage, which automatically restores your sum once it is fully used. To get this benefit for pre-existing health conditions, a waiting period of 12 months applies. This facility is available for plans with a coverage limit of up to ₹5 crore.

Are there any hidden terms & conditions attached to the restoration benefit?

While there are no hidden terms and conditions in the restoration benefits, it is advisable to thoroughly read the policy wording to avoid miscommunication.

Before opting for a health insurance plan, ensure you understand the claim restoration process - how many times it can be used, whether it applies to the same or different treatments, if restoration occurs after full or partial utilisation, and the waiting period between claims after restoration.

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