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Restore Benefit in Health Insurance

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.

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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.

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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.

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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.

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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

1

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.

2

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.

3

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

4

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

5

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.

6

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.

7

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

8

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.

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West Godavari

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The journey of purchasing Health insurance from Reliance General Insurance (now IndusInd General Insurance) felt effortless and user-friendly. It aligns well with what I needed from an insurance policy. I am satisfied with the main policy and don't see a need for extras. The process felt reliable and I would recommend it to others.
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I recently purchased my health insurance and found the experience to be smooth. I will provide dertailed feedback post my claim settlement process has been completed.
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Buying a Health policy through the platform of Reliance General Insurance (now IndusInd General Insurance) was straightforward and quick. The coverage provided matches my expectations and feels comprehensive. I am satisfied with the main policy and don't see a need for extras.
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I recently purchased my Health insurance from Reliance Insurance (now IndusInd Insurance) and found the experience very smooth. I felt that my protection needs were well addressed with this policy. Currently, I don't think I require any additional plans or add-ons.
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The journey of purchasing Health insurance from Reliance Insurance Company (now IndusInd Insurance Company) felt effortless and user-friendly. It aligns well with what I needed from an insurance policy. Currently, I don't think I require any additional plans or add-ons. I found the entire process trustworthy and efficient.
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The journey of purchasing Health insurance from Reliance (now IndusInd) felt effortless and user-friendly. The plan offered exactly the type of coverage I was expecting. No complementary product was necessary for me at this stage. The process felt reliable and I would recommend it to others.
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I recently purchased my health insurance from Reliance Insurance (now IndusInd Insurance) and found the experience very smooth. I felt that my protection needs were well addressed with this policy. No additional coverage seemed required for my needs.
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Anoop T M

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Health Insurance - Disclaimer

Disclaimer: Health insurance coverage is subject to policy terms, conditions, exclusions, waiting periods, sub-limits, co-payments, deductibles and underwriting guidelines. Benefits, add-ons, discounts and eligibility criteria vary by product, plan, sum insured, age and family composition. Certain products provide fixed benefit payouts and are not indemnity-based reimbursement policies.

Applicable UINs:
Health Infinity – RELHLIP23120V042223 | Health Gain UIN: INIHLIP26040V042526 | Health Super Top-Up – RELHLIP21617V012021 | Health Global – IRDAN103RP0001V01202324 | Personal Accident 360Shield – RELPAIP25035V022425 | Hospi Care – RELHLIP20027V012021

For detailed disclosures, premium illustrations and coverage limitations, please refer to the Health Insurance Disclaimer page.

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