What is The Restoration Benefit in Health Insurance and How to Use it?

Health insurance is a non-skippable investment in 2022. With people learning to live their lives after the effects of the pandemic, having a health insurance policy is critical. Financial Express reports that there was a rise of 41% in the health insurance industry in India. Moreover, many young buyers have realised the importance of a health insurance policy and now are buying one. 

Considering the rising medical treatment costs, buying a policy with small coverage can soon prove to be inadequate or even insufficient. Hence, many insurance companies are marketing higher sum assured insurance plans, for instance, a ₹1 crore policy. Such a large amount can be adequate to cover even major treatments along with being sufficient to tackle the expected rise in the treatment costs. But it may not always be required. As the premiums are linked to the policy’s sum assured amount, buying a plan with such a large sum assured will increase the premiums. Alternatively, you can buy a policy with restoration benefit which is also known as recharge benefit. * Standard T&C Apply

Let’s understand it:

What is the restoration benefit in health insurance plans?

Restoration benefit in health insurance plans is where the sum assured amount gets refilled or reinstated to its original amount when the coverage is exhausted. 

For instance, you have a policy with ₹5 lakh coverage and the medical bill comes to ₹6 lakhs. After paying for the incremental ₹1 lakh, your policy will be restored to its original sum assured of ₹5 lakhs in the same policy period thus, making it available for another instance of treatment, if required. The restoration benefit acts like a stepney in your car helping you be covered despite exhausting your sum assured. *

How to use the restoration benefit?

Before you understand how to maximise the restoration benefit, you must have answers to some critical questions like: what is health insurance, what is covered in my policy, what are its exclusions, etc. Only after understanding these questions, you must choose a policy that offers necessary coverage and includes the restoration feature. *

To use the restoration benefits, there is no special requirement as your policy is automatically topped up with the original sum assured once it is exhausted. However, there are a few points that you need to know:

  1. Restoration benefits are applicable only for unrelated illnesses. Thus, any subsequent claims, if made, must be for a treatment that is not sought earlier. In case it is the same treatment for a case of relapse of the ailment, no coverage is available under the restoration feature. *
  2. Insurance terms require you to completely exhaust the existing sum assured only after which the restoration benefit kicks in. Thus, any used sum insured will not be restored till it is exhausted in full. *
  3. The amount of restoration benefit is generally 100% of the sum assured. However, some insurance terms may limit such restoration to only 50% of the original sum assured. It is essential to know exactly how much coverage your policy offers and hence, must read the terms thoroughly. *

With these restoration benefits of health insurance, you can take advantage of your sum assured being reinstated once it is exhausted. *

* Standard T&C Apply

Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms and conditions, please read sales brochure/policy wording carefully before concluding a sale.