Inbuilt restoration benefit is a boon you must consider 8^th February 2023

Recent studies indicated a 0.4% penetration rate of health insurance in India in 2022. The true gravity of the situation is not felt when viewed in isolation but when compared to the 4.1% penetration rate in the US. Experts pin this lag on inaccessible insurance products and a general lack of awareness in the country.

Misinformation is undoubtedly the most significant concern that the insurance industry faces. An excellent example of misconceptions leading to losing out on benefits is unawareness regarding the restoration benefit offered under health insurance in India. If you have ever wondered about what happens when you need additional coverage after raising a claim and exhausting the insured sum within the policy period, here are all your answers about the restoration benefit, its advantages, and the types.

What is the restoration benefit?

A restoration benefit may be the most significant inbuilt feature insurers offer when purchasing the best health insurance policy in India. It is a benefit that is of greater significance in the case of family floater policies.

According to widespread misinformation, most policyholders believe they can no longer raise a claim in case of a second instance of hospitalisation against the same policy during the policy period. However, if your health insurance provides restoration benefits, you are insured for a greater sum than the insurance policy states. Your best health insurance in India offers a refill benefit, allowing you to claim up to 100% of the insured sum even after it is exhausted.

And, if your policy does not provide this feature, you can purchase a restoration benefit add-on to act as a security net in case of multiple occurrences of the event you are insured against during the policy tenure.

Types of restoration benefit.

1. Partial exhaustion:
As the name suggests, upon partial exhaustion of the insured sum, the restoration feature comes into play, renewing the insured sum to the maximum amount stated in the policy. If you have to purchase the add-on feature, it is preferred to have this type of restoration benefit.

2. Complete exhaustion:
The restoration feature only activates upon using the entire insured sum. Commonly, health insurance providers offer this type of benefit to policyholders since it minimises their exposure to risk by making restoration only applicable after the whole insured sum is exhausted.

Critical attributes of restoration benefit.

While the feature offers excellent benefits, you must not blindly purchase it or rely upon it without being aware of some of its essential characteristics:

1. The restored insured sum is not eligible for utilisation in the renewed policy period, irrespective of whether or not it is used in the relevant period.

2. Depending on your policy’s fine print, the restored amount may be up to 100-150% of the insured sum, depending on the cause for raising a claim.

3. The benefit does not apply to the first claim during the policy period but becomes applicable from the second claim onwards.

4. In the case of individual or family floater plans, multiple policyholders cannot enjoy the benefit of the restored insured sum simultaneously.

5. While it provides a backup in emergencies, it does not suffice as a replacement for increasing the insured sum in case of critical diseases or high-risk family members covered under the policy.

While purchasing the best health insurance policy in India, it is essential to check if the policy offers restoration benefits within the policy framework. Although it may not be a substitute for the need to increase your insured sum in your individual or family floater plan, it certainly provides a backup option to rely on in case of emergencies to cover insurance claims.

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Disclaimer: The information provided above is for illustrative purposes only. To get more details, please refer to policy wordings and prospectus before purchasing a policy.