Health Insurance - Great news! Health insurance plans now restore or recharge insured amount even if you make a claim
Many medical insurance companies have introduced new features such as Recharge of Sum Assured along with Restore of Sum Assured. However, are both the dame
With the Restore option, ensure that you are holding a good amount of medical cover as these plans work best along with a floater policy.
Health insurance is a serious requirement for everyone, and people
have definitely warmed up to this idea. Nowadays, many medical insurance
companies have introduced new features such as Recharge of Sum Assured
along with Restore of Sum Assured. The name of these features sound
alike and it is understandable that it could be confusing to buyers. The
truth is that both these features differ in the benefits that they
offer.
Recharge of Sum Assured
Essentially, recharge means the replenishment of the total sum that
is assured. If the particular claim being made is payable as per the
policy, the company shall mechanically reinstate the sum assured for the
specific policy year if the Sum Insured amount gets reduced owing to an
earlier claim that has been disbursed.
This is subject to certain factors. Specifically, it cannot be used
for any claim regarding illnesses/ injuries for which the person has
already been admitted in that particular year of the policy. The
complete recharge sum does not go beyond the assured sum for that
particular policy year.
Moreover, the Recharge sum balance can be availed through the year of
the policy, till its imminent conclusion. Lastly, any amount that has
not been used from the Recharge is not carried forward in the following
policy year as it ceases to exist.
For example, let’s consider Mr Gupta has a family floater health
policy with a sum assured of Rs 500,000 when he was hospitalised for a
serious knee injury and exhausted Rs 350,000. This expense is
effectively deducted from the Sum Assured. In the same year his wife got
hospitalized due to a viral infection and incurred a bill of Rs
200,000. Due to the Recharge feature, the Insurance Company would refill
the Sum Assured after the disbursement of Mr Gupta and the entire claim
of his wife can be fulfilled from the Sum Assured.
Restore of sum assured
If the basic Sum Insured amount and the accumulated bonuses (if any)
are exhausted fully during the course of a treatment, the Restore
benefit will refill the amount up to the basic Sum Insured for that
policy period.
The Restore sum insured is available only for future claims and not
for any issues related to claims that have already been paid in the
specific year. This Restore sum can be used just once during the
specific year. And if it is not used in the current policy year, then it
does not automatically carry forward to the next year.
For example, let’s consider Mrs Sharma has a family floater health
policy with a sum assured of Rs 500,000 when she was hospitalised for a
serious knee injury and exhausted Rs 350,000. This expense is
effectively deducted from the Sum Assured. In the same year her husband
got hospitalized due to a viral infection and incurred a bill of Rs
200,000. This time her husband would have to pay Rs 50,000 out of his
pocket and the rest Rs 150,000 would be disbursed by the insurance
company. The Restore feature would now come into action and it would
replenish the Sum Assured.
What works better?
There are multiple factors that go into deciding your specific
medical insurance policy. Some of them include waiting period,
exclusions, sub-limits etc. When it comes to the question of Recharge
versus Restore, it does seem like Recharge is a better option.
Yet, there is an issue with both these choice as the problem of
unrelated claims is common to both. Let us say that you have a cardiac
problem that has depleted your entire assured sum for the current year.
In that case, you will not be able to make use of Recharge or Restore.
These options will only be available for any claims that exist outside
of heart treatment. Another drawback is that the sum assured comes into
plan only after the sum assured as well as no claim bonus is used up.
This is true for the Restore option.
The main difference between the two is that the Restore option can be
availed only after you have completely finished your basic sum assured.
The Recharge option, on the other hand, is available even if the claim
amount made by the insured individual goes beyond the basic sum assured.
This is in regard to a second claim in the same policy year.
With the Restore option, ensure that you are holding a good amount of
medical cover as these plans work best along with a floater policy.
With the Restore option though, the sum insured gets refilled, with your
family members being able to use your covers. Your choices depend on
your immediate and future medical needs!
source : https://www.financialexpress.com/money/insurance/great-news-health-insurance-plans-now-restore-or-recharge-insured-amount-even-if-you-make-a-claim/1325716/