Restore Benefit in Health Insurance

In such situations, your standard health insurance coverage may not be enough. This is where the restore benefit in health insurance comes to your rescue. It is a financial safety net that helps you cover medical expenses after a part or the entire sum insured amount is over.

Reliance General offers an add-on for the restoration of the sum insured with a range of health insurance policies for added financial protection. Moreover, with Reliance health plans, you get a 100% claim settlement ratio, customisation flexibility and a user-friendly website.

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.

Let us look at them closely below.

• 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.

However, as he has not used the entire sum insured, he will only have ₹1,00,000 for his future claims, and the restore benefit will come into effect when this amount is used.

• 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

Additional Financial Security

With the restore benefit, you get an additional layer of financial security to ensure you have ample financial support to cover your medical expenses in times of need. The best part is it offers security even when you exhaust your sum insured amount fully, making it a beneficial add-on with both individual and family floater health plans.

Continuous Coverage with Breaks

Unlike standard health insurance plans, which may limit the number of claims or sum insured amount, health plans with restoration benefits offer continuous financial protection for the entire policy. This ensures continuous coverage to manage your medical expenses.

Flexibility

Depending on your needs, you can opt for a partial or full restoration benefit for your health plan. Moreover, some insurers also allow you to choose the frequency of restoration benefits to ensure your requirements are met with your chosen health plan.

Multiple Claims

At times, a severe health issue or accidental injuries can often require treatments that exhaust your total sum insured amount. With a standard plan, if this happens, you cannot file any more claims within the same policy year.

However, with partial or unlimited reinstatement of the sum insured, you can file multiple claims even after exhausting your sum insured.

Cost-Effective Solution

Restore benefit is commonly available as an add-on benefit with your health plans. Thus, it is a cost-effective solution when compared to buying a new health plan altogether. This is because this add-on only increases your premium slightly but offers extensive coverage in return.

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.

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, along with a 100% claim settlement ratio.

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 Reliance Health Insurance?

You can typically include the restore benefit add-on in your Reliance 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

• Step 1 - Visit our website.
• Step 2 - On the main page, select “Health” and enter the required details in the space provided.
• Step 3 - Once done, accept the terms and conditions, and then click on “View Prices”.
• Step 4 - 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.
• Step 5 - 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 an Existing Health Plan

• Step 1 - Visit our website.
• Step 2 - On the next page, select “Health” and then click on “Renew Your Health Insurance Policy”.
• Step 3 - On the next page, select and add either your mobile number or policy number and the requested details before clicking on “Go”.
• Step 4 - 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.
• Step 5 - 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.

Frequently Asked Questions

• Can I use the restore benefit multiple times in a year?

  Yes, depending on specific policy terms and conditions, you can typically use the restoration benefit multiple times within the same policy year. However, you must check the policy document before filing multiple claims.

• What is the impact on my health insurance premium when I combine the restore add-on with my base policy?

  As restoration benefit is an add-on, it does not have a significant impact on your health insurance premium. It does increase the premium a little, but in return, you benefit from extensive financial protection for medical emergencies.

• Is it possible to claim for any medical expenses under the restoration benefit in medical insurance?

  For most health plans, the scope of coverage under restoration benefits is the same as the coverage available under your policy. Thus, when filing a claim for any medical expense, check whether the same is included in your base health plan.

• Why should I choose restoration benefits instead of buying a new health plan for additional financial protection?

  There are multiple reasons why you should opt for restoration benefits instead of buying a new health insurance policy. Some of them include the following -

  • Combining restoration benefits with your existing health plan is more cost-effective.
  • The initial waiting period of 30 days for claims is not applicable when you file a claim under the restoration benefit.
  • When you choose a restoration benefit add-on instead of a new plan, you do not have to complete renewals twice.

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