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Sum Insured Reinstatement Under Health Insurance

Sum Insured Reinstatement Benefit - Explained

A conventional health insurance policy provides coverage for medical expenses and hospitalization bills, only up to the specified sum insured limit. Considering increasing healthcare costs, you might end up exhausting the entire sum insured on a single claim within a policy year. It is here that the restoration or reinstatement benefit assumes significance.

With this feature, sum insured on your health insurance policy would get restored, should it be used up entirely within a single policy period. Usually common with family floater plans, this particular benefit provides coverage for all the members included in a health insurance plan.

What about additional premium?

Generally, more the number of add-on features bundled with your health insurance policy, higher the premium. However, a health insurer cannot charge an additional premium after you’ve filed a claim. The same rule applies to plans with restoration benefit as well – that is, you would be apprised of the costs of availing this benefit right from the first day.

Things you should know

  ✓    The restoration benefit kicks into effect for illnesses and injuries that you haven’t been paid out a claim for during a particular policy year.

  ✓    You cannot avail this benefit for the first claim that you make within a policy year. However, some insurance providers allow you to leverage this feature with the very first claim, provided you exhaust your sum insured on an accidental hospitalization.

  ✓   While most health insurance plans allow you to make use of the restoration feature upon complete exhaustion of the sum assured, some offer you increased flexibility and reinstate it upon partial exhaustion as well.

In conclusion, you should keep in mind that you cannot carry forward the reinstatement benefit to the subsequent policy year, in case it hasn’t been exhausted in the year of restoration.

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