Restoration Benefit – Is it beneficial for the insurers?

Restoration benefit is a supplemental coverage offered by insurance companies to help insurers cope with unexpected medical expenses that occur twice in the same fiscal year, after they exhaust their maximum insured sum.

The whole purpose of buying online health insurance is to safeguard you and your family against unforeseen medical expenses – due to illness, an accident or an operational procedure. Whatever the situation is, if you have paid your premium and stay insured you can rely on the insurance company to take care of the expenses.

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Why Restoration Benefit is Important?

In a sample case, if you have insured for a total claim of Rs. 5 lakhs for yourself and get admitted for a major surgery chances are high that the entire sum may be availed at once. If you have to get admitted for a different illness the same year, your insurance policy won’t cover the expenses because you have availed the maximum sum.

This is when Restoration Benefit comes into picture. However, before you actually invest money, it is better to compare health insurance policies and understand the terms. Some may charge a much higher premium than previously because they restore the entire sum of incurred claims.

Besides, whenever a policy is availed for the entire family, the probability of draining out the entire coverage within a year is higher. In such scenarios, the benefits of opting for a restoration policy are undeniable. With this type of policy, you get covered for twice the insured amount, for Rs. 10 lakhs in the place of Rs. 5 lakhs in the same year in case an emergency occurs.

When Can Restoration be Availed?

Like most online health insurance policies, there are some terms and conditions to be met. A user cannot claim the policy twice within the same year for the same illness. The restoration will be done by the insurance provider only for two different medical requirements of the same person. However, it is better to ask your insurance company for the diseases and expenditures covered.

The system will not trigger on the first claim. If medical expenses go beyond the insured sum, the excess sum has to be paid by the insurer and restoration benefit is applicable. It can be availed again the second time a medical requirement arises for the individual or a family member, in case of full coverage policy.

It is advisable to compare health insurance online and find the best one that suits your requirement. Each one of them differs in terms of premium paid, restoration benefits offered and coverage terms. However, most policies don’t offer partial restoration. Insurance companies refill your account with the claim amount only when you have fully exhausted your balance.

Restoration benefit is a highly beneficial solution for insurers as they can make multiple claims in the same year, insure their entire family for a lower premium and be assured that the company will always back them up during unforeseen medical circumstances that happen within the same year. Online aggregators such as Paybima can be used for comparing insurance policies when you are looking for an appropriate coverage plan for your family.

 

 

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