What Is Restoration Benefit In Health Insurance Policy?

Unexpected medical emergencies not only take a toll on your physical and mental health but can also be a huge financial burden. Hence, as part of your health insurance, you can avail a certain benefit that can ease this burden. The meaning of restoration benefit in health insurance is essential that the original sum of money is restored by the insurer while paying for medical treatment expenses. Hence, even if the full principal amount is used up, you do not need to worry about your future as your insurance provider can restore the full amount.

For instance, if a medical treatment costs you a total of Rs.5 lakhs, and your original insurance sum was Rs.5 lakhs, your insurance balance will be exhausted. However, if you have opted for the restoration benefit while buying your health insurance plan, your insurer will then restore this balance. So a year down the line if you require a follow-up surgery costing Rs.3 lakhs, the expenses will be covered by the original sum insured of Rs.5 lakhs

Choosing the restoration benefit equips you with an important backup plan that can rescue you in times of need. Read on to learn more about the restoration benefit in health insurance

Types of Restoration Benefit

There are two main types of restoration benefits. They can be categorised according to the extent of exhaustion of the original sum. The two kinds are as follows:

1. Partial Exhaustion

With this type, you can avail the restoration benefit even if your sum insured has only been used partially. For example, if your original sum is Rs.5 lakhs and you put forth an insurance claim for Rs. 4 lakhs, you will be left with only 1 lakh. Here, the restoration of the sum insured will come into effect and the insurance balance will be restored to the original Rs. 5 lakhs even if that is greater than the amount you’ve had to claim.

2. Complete Exhaustion

If the entirety of your sum insured is used for expenses, this restoration benefit is applicable. Almost all health insurance plans offer this type of benefit so that the sum insured is restored upon total exhaustion.

What Do You Need to Know to Claim Restore Benefit?

While claiming restoration benefit, there are a few important points you should keep in mind:

  • The restoration benefit is not inherently present in every plan; rather it is an add-on you can buy with your policy.

    You can opt for restoration benefits while purchasing your main plan by paying a nominal fee.

  • Restoration can happen on partial or complete exhaustion of the sum insured depending on the chosen type.

    Restoration benefit restores the full insurance amount when it is exhausted in a single claim during the term of the policy.

  • Restoration benefits are only for claims made in the future, i.e. if your expenses exceed the amount of your insured sum, the restoration will not help you fund the remaining gap. It will only be made available for future claims.

  • In case you are suffering from a medical condition unrelated to the illnesses covered by your insurance policy, restoration benefits will not be triggered.

How to Buy a Restoration Benefit Plan?

The restoration benefit is available in the form of an add-on for your health insurance plan. You can buy it at an additional cost or premium at the time of buying a new insurance policy or renewing a pre-existing plan. It is considered a valuable add-on for family floater plans; if one member of the family exhausts the base cover, other family members can still benefit from the cover. In order to get the maximum possible coverage at minimum cost, ensure that you opt for the restoration benefit as part of the policy.

Conclusion

A health insurance plan is a vital safeguard for you and your family’s health. Moreover, it can protect your finances to a significant extent in the event of a medical emergency. An additional cover like the restoration benefit add-on extends this protection further. Thanks to platforms like Finserv MARKETS, where you can compare a variety of insurance plans and find the best plan for you, quickly and efficiently.

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FAQs on Restoration Benefit

  • ✔️Can you avail the restoration benefit within health insurance in the very same claim?

    The restoration benefit is applicable mostly for future claims, and cannot be availed on the same claim. The additional money that exceeds the sum insured will have to be paid from your own pocket. However, some health plans trigger an automatic restoration of the sum insured if the total expenses exceed the insurance amount.

  • ✔️How to Buy a Restoration Benefit Plan?

    The restoration benefit is available in the form of an add-on for your health insurance plan. You can buy it at an additional cost or premium at the time of buying a new insurance policy or renewing a pre-existing plan.

  • ✔️How can the restoration benefit be a valuable add-on for family floater plans?

    It is considered a valuable add-on for family floater plans; if one member of the family exhausts the base cover, other family members can still benefit from the cover. In order to get the maximum possible coverage at minimum cost, ensure that you opt for the restoration benefit as part of the policy.

  • ✔️What are the types of restoration benefit add-on?

    There are two main types of restoration benefits. They can be categorised according to the extent of exhaustion of the original sum:

    1. Partial Exhaustion

    With this type, you can avail the restoration benefit even if your sum insured has only been used partially.

            2.Complete Exhaustion

    If the entirety of your sum insured is used for expenses, this restoration benefit is applicable.

  • ✔️How does restoration benefit health insurance work?

    Restoration benefit is an add-on for your health insurance plan. In this, the insurer will replenish your sum insured in case it is partially exhausted by a claim, or if it is fully exhausted by a claim.