Health insurance cover: In simple terms, the restore option works as a refill by automatically restoring the basic sum assured if it is exhausted during the policy period.
Are you planning to buy a health insurance cover? One of the options before you would be to choose a cover that offers the ‘restore’ facility. Most standalone health insurers and some general insurance companies offer the ‘restore’ option.
So what is the ‘restore’ option and should you opt for it? In simple terms, the restore option works as a refill by automatically restoring the basic sum assured if it is exhausted during the policy period.
“Restoration benefit gives you mental peace in case of hospitalisation twice in a policy year keeping the worry of hefty hospital bills away,” says Naval Goel, CEO & Founder, PolicyX.com.
Goel explains the mechanics of the restore option through an example. Suppose, you have taken a health insurance cover of Rs 5 lakhs and have to pay a bill of Rs 3.5 lakhs for an illness in case of hospitalisation. In case you fall ill again after 8 months and the bill reaches to another Rs 4 lakhs, in case of a normal health insurance, you would have got the cover left of Rs 1.5 lakhs with you and would have paid the rest Rs 2.5 lakh from your pocket. However, a plan with restore benefit will take care of the entire Rs 4 lakhs as it comes with a 100 per cent restoration benefit. This, in effect means by paying a slightly higher premium you can cover yourself for Rs 10 lakhs by purchasing a policy of Rs 5 lakhs.
“Though availing restore option involves slightly higher premium it could be a wise decision to opt for it. Compared with a top-up plan, a restoration benefit costs lesser. In a family floater plan, in case one member of the family exhausts the entire cover, the insurance company refills the cover to keep rest of the members covered,” Goel told FeMoney.
Saroj Satapathy, CEO, Ideal Insurance Brokers Pvt Ltd agrees. “It is advisable to go in for restore facility as one would be paying much lesser premium for the similar amount of restoration sum insured compared to the actual chosen amount. However, if one is choosing the right sum assured for a longer term then there may not be any necessity to go in for restoration,” Satapathy said.
Among the companies that offer restore facilities are Cigna TTK Health, Religare Health, Max Bupa Health, Apollo Munich Health, Star Health and private general insurance companies like SBI General Insurance and L&T General Insurance.
A restoration benefit works both for an individual or a family, “In case of an individual if one falls seriously ill and uses the entire cover and has an accident after 6 months that needs another hospitalisation, he won’t have to dig into his savings and look for support from friends and relatives as the insurance company will take care of it through restoration cover. In case of a family floater, if one person out of four uses entire cover in a policy year, insurance company will refill it for rest of the insured members,” Goel argues.
However, the restore facility will not work for the same illness during the policy period. “Restoration gets triggered when the entire sum insured under the policy stands exhausted. However, if there is another claim arising due to the same illness, the policy will not pay for it,” says Satapathy.