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Ref. No. KLI/22-23/E-BB/492
A restoration benefit is a feature of health insurance that effectively restores your health cover back to the original amount in the same year if you exhaust it. Visit to know more!
What Is the Restoration Benefit in Health Insurance?
When you are planning to buy health insurance, you may come across many terms related to the features and benefits of a health insurance plan. It is crucial to understand how all the features of a health insurance policy work to make the most of the policy. You don’t want to be in a situation where your health claim is not approved because you misunderstood the features. One such term that is thrown around a lot by insurance companies is the restoration benefit.
Let us understand what a restoration benefit is and how it works as an excellent health insurance benefit.
What is the restoration benefit?
When you buy health insurance, you are offered a sum insured in a given year. This means that if you have medical expenses covered under your policy, you will be paid only up to the coverage amount. So, if you have a policy with Rs. 5 lakh coverage, you can claim your policy for medical costs amounting to only this amount.
A restoration benefit is a feature of health insurance that effectively restores your health cover back to the original amount in the same year if you exhaust it. If you make multiple claims on your health insurance policy in the same year and use up your coverage amount, a restoration benefit will restore your health cover again.
For example, let us assume you bought a health policy with a cover of Rs. 5 lakhs with a restoration benefit according to the terms of the policy. You made a claim for Rs. 3 lakhs initially for treatment cost that was fulfilled by the policy. Unfortunately, you had to undergo a second treatment amounting to Rs. 2 lakhs in the same year, which was also fulfilled by your policy. Now your policy cover is exhausted, and hence it will be restored to Rs. 5 lakhs for the same year due to the restoration benefit. However, the restoration benefit cannot be used for the same treatments claimed earlier in the year.
How does a restoration benefit help?
A restoration benefit is most helpful if you have bought a family floater health insurance plan for your entire family. In case you’re in a situation where a family member requires treatment, the chances are that you will end up exhausting your health coverage amount. If another family member requires treatment in the same year, your policy won’t be able to cover it due to exhaustion of the limit. However, if your family floater policy had a restoration benefit, your health cover would be restored after exhaustion, and you can still use your policy in the same year.
Thus, a restoration benefit can come in handy if you make multiple health claims in a given year on your policy. Do note that a restoration benefit can only be used once during the policy tenure, and it is only provided on complete exhaustion of your insured sum. You can make the most of a restoration benefit, especially if you have a family floater health insurance plan.
Ref. No. KLI/22-23/E-BB/2435