What Is Restore Benefit In Health Insurance Policy

  • Author :
  • TATA AIG Team
  • Last Updated On :
  • 04/05/2022

Restore benefit, as the name suggests, restores or replenishes your sum insured after it has been exhausted along with the accrued Cumulative Bonus, within a calendar year due to an ailment or hospitalisation.

Restore Benefit In Health Insurance

Have you ever wondered what would happen if you need your insurance, but you have exhausted the sum insured and cumulative bonus? It’s natural to worry about the future. Our health is the most important asset we have and we want it to be at its best. But a basic health insurance policy just doesn’t cut it anymore, and you will need to look for additional benefits for such cases.

One such benefit that you must look for in a health insurance plan is the ‘Restore Benefit

What is Restore Benefit?

Restore benefit, as the name suggests, restores or replenishes your sum insured after it has been exhausted along with the accrued Cumulative Bonus, within a calendar year due to an ailment or hospitalisation.

Example

For instance, you purchased a health insurance plan, with a cover of Rs 5 lakhs. You are diagnosed with an ailment that uses up the whole sum insured. Let’s say, within the same year, you get hospitalised again for another ailment which incurs a medical expense of Rs 3 lakhs. Without the Restore Benefit, your health insurance will not be able to cover the second hospitalisation, and you’ll have to foot the bill. However, if your health insurance policy does offer the restoration benefit, the cost of the second hospitalisation will get covered by your insurance upto base sum insured, relieving you of any financial burden.

Tata AIG MediCare policy understands the need for financial security and provides restoration benefit along with many unique features such as global cover, second opinion, coverage of high-end diagnostics, and many more.

What you need to know to claim restore benefit? How and when it can be used.

1. Works on Tenure basis

Restoration benefit is valid only once for the policy year and cannot be carried forward to the next year. As the name suggests, the benefit only restores, hence cannot be used for the first claim. Therefore, if your cost of treatment for the first ailment was Rs 7 lakh, the insurance would cover Rs 5 lakhs as the limit.

2. Works differently with related and unrelated ailment

With MediCare, you have different conditions for reinstatement of sum insured. Say your ailment relapsed the second time, the restoration benefit will not come into effect until after 45 days of your discharge, but if the two issues were unrelated, say one was heart trouble, and the other was a fracture, then you could have the Restore Benefit activated immediately. In case, another insured member of your family is hospitalised, it will be activated on immediate basis.

3. Family floater plans

If you’re on a family health insurance plan, the reinstatement of the sum insured will be on floater basis for all insured persons.

4. Application limits

This benefit is only available within India and does not apply in case you have claimed global cover and are getting treated anywhere else.

Tata AIG has a legacy built on trust and prioritises your health above all. So, let all the caveats rest with Tata AIG MediCare Premier which offers 100% restore benefit, for related as well as unrelated ailments, basis the above conditions!

Whether your ailment relapsed or there is a mishap, rest assured that your health insurance will stand by you. Not just that, Tata AIG MediCare Premier covers for over 541-day care treatments due to injury, illness or disease, offers maternity coverage, covers for vaccinations, bariatric surgeries and many more benefits.

Tata AIG will not compromise in the matters of your health and neither should you!
Undergoing regular health check-up should also be made a priority in life, learn how to get this done for free with a Tata AIG Health Insurance

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Disclaimer / TnC

Your policy is subjected to terms and conditions & inclusions and exclusions mentioned in your policy wording. Please go through the documents carefully.

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