Restoration benefit in health insurance: Why do you need it? Is it worth your money? All you need to know

Restoration benefit gives you added coverage in case of serious issues while being significantly cheaper than buying an additional health plan.

 benefit in health insurance policies

Should you avail of restoration benefit in health insurance? Well, the short answer is YES.

Imagine a scenario where a person has a health insurance cover of Rs 5 lakh and is diagnosed with an ailment that consumes the entire sum assured for the treatment. A few months later, while the health insurance plan is still active, the person has a relapse or needs follow-up treatment which will cost a further Rs 2 lakh. Considering that their cover has been maxed out, the person will have to bear all additional costs from their pocket. 

This is a very real probability. So, even if you have health insurance cover, such a medical exigency can cause financial ruin. A restoration benefit can provide added protection in times like these.

Also Read: These Medical Expenses May Not Be Covered By Your Health Insurance Policy. Should You Add Them As Riders?

What is the restoration benefit in health insurance?

As the name suggests, a restoration or refill benefit kicks in when the original sum assured has been exhausted. It gives the policyholder additional coverage under the same health plan. While most health insurance companies offer restoration benefits as an add-on to the policy, there are some plans where this feature comes in-built. 

The value and number of restorations in a policy year varies from one service provider to another, so you should closely examine the terms and conditions of your health plan to understand how the restoration of cover works with your service provider.

Also Read: Best Health Insurance Plans For Indian Women In 2022

What are the types of restoration benefit?

Different insurers may construct the restoration benefit in different ways, but primarily there are two versions:

  1. Complete exhaustion: Here, the restoration benefit is activated when the total sum assured is depleted. As with the example above, the refill benefit will not be triggered until the entire Rs 5 lakh has been utilised.
  2. Partial exhaustion: Under this version, the benefit is activated pre-emptively when 75%-80% of the total sum assured is utilised. In the scenario above, when the health insurance claim reaches Rs 4 lakh, the sum assured will be automatically reinstated to the original amount, even before you exhaust the entire limit.

Why opting for restoration of benefits is a good idea?

Restoration benefit gives you added health insurance coverage in case of serious issues while being significantly cheaper than buying an additional health plan. It ensures uninterrupted coverage and minimises the hassle of making multiple claims.

The benefit becomes essential if you have a family floater plan with aged parents and young children covered, so that you don’t have to pay anything out of pocket if multiple family members need medical assistance during the same policy year.

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