They say lightning never strikes twice in the same place. However, medical misfortunes do revisit and at times in the same policy year too. A restoration benefit comes handy at such times.
With restoration benefits under the Health Insurance plan, if your sum insured gets exhausted towards the treatment of an illness, the insurance company restores the sum assured.
Say ‘X’ suffered two mishaps in a policy year – a car accident in March resulting in a treatment cost of Rs. 10 lakh and then a diagnosis of cancer after two months. But he only has a health cover of Rs. 10 lakh.
Restoration benefits here would ensure that once the sum insured is exhausted after the first hospitalisation, the Health Insurance company would restore the sum insured to be used for another instance of hospitalisation within the same policy year.
God forbid, if such events were to happen to you, your sum insured restoration would allow you to bear the expenses of the second hospitalisation.
Health Insurance plans come in many variants. There are various add-on features available in the market offering restore, recharge, and reload benefits. ‘Recharge’ and ‘reload’ are not quite the same as ‘restore’ but have the potential to cover your back when you’ve exhausted your sum insured for the year.
Under a health plan with restoration, the benefit kicks in automatically under pre-defined conditions. In a plan with refilling and recharging options, the insured has to make an additional payment to regain his coverage for the year.
Additionally, there are now insurance plans that offer unlimited recharge benefits as well.
Things To Keep In Mind
The benefits of restoration come with the following conditions.
- Restore benefits don’t apply to related ailments. That is to say, if you have once exhausted your sum insured for treatment of a heart-related ailment, you can’t claim the restore benefits in case of a relapse or another heart-related ailment in the same year.
- Restoration typically happens once a year. However, some recently-launched insurance products have unlimited restoration benefits.
- The restore sum insured cannot be carried forward to the next year if it is not utilised in a year.
- This feature doesn’t provide for expenses over and above the sum insured for a single illness.
- Some plans offer recharge or refill benefits, where the sum insured for the same year can be restored by making an additional payment.
For a paltry addition to the premium, restore benefits give you double the cover. That’s definitely tempting but you might want to weigh your chances of facing such misfortune twice in a policy year. If you are looking for a family floater, ‘restore’ policy is ideal so that even if an individual exhausts his sum insured, other members of the family remain covered for the year.
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