It is 2025 and in this new decade, the world is amidst dealing with a pandemic situation. Health that took a backseat in our daily hustle managing work and personal lives, has suddenly gained prominence. The adage, health is wealth has strengthened its foundation again. Keeping all of this in mind, availing a health insurance policy is of prime importance. When buying a health insurance policy, the first thought that strikes is what if it gets exhausted. But modern-day policies come equipped with a host of features, one among which is the restoration benefit.
How Does Restoration Benefit Work?
The restoration of sum insured in health insurance is activated only after the sum insured is fully or partially exhausted, depending on the type of benefit chosen. Here’s how it works:
1. Full Restoration
The sum insured is restored to its original value once completely used. For instance, if your INR 10,00,000 policy is entirely consumed, Bajaj Allianz General Insurance Company will reinstate INR 10,00,000 for subsequent claims.
2. Partial Restoration
The policy restores a portion of the used sum insured even when only part of it has been utilised, ensuring uninterrupted coverage for future claims. This restoration benefit in health insurance is particularly useful for families with a floater plan, where multiple members can benefit from the restored coverage.
હેલ્થ ઇન્શ્યોરન્સમાં કવરનું રિસ્ટોરેશન શું છે?
રિસ્ટોરેશન લાભ એ એક એવી સુવિધા છે જેમાં એક વાર વીમાકૃત રકમ પૂરેપૂરી ખર્ચાઈ ગયા બાદ ઇન્શ્યોરન્સ કંપની દ્વારા તમારી ઇન્શ્યોરન્સ કવરની રકમને તેની મૂળ રકમ સુધી ફરીથી સ્થાપિત કરવામાં આવે છે. આ સુવિધા હોવાથી, જો તમારા હેલ્થ કવરની સંપૂર્ણ વીમાકૃત રકમ ખર્ચાઈ જાય છે, તો પણ તમારે ચિંતા કરવાની જરૂર નથી. ચાલો રિસ્ટોરેશનને સમજીએ
હેલ્થ ઇન્શ્યોરન્સમાં લાભ એક ઉદાહરણથી. શ્રી કિશન ₹8 લાખનું, રિસ્ટોરેશન લાભ સહિતનું ફેમિલી હેલ્થ કવર ધરાવે છે. હૃદયની ગંભીર સ્થિતિને કારણે તેમનું ઓપરેશન કરવું પડ્યું હતું, જેમાં સંપૂર્ણ સં ઇન્શ્યોર્ડ રકમ ખર્ચાઈ ગઈ હતી. ત્યાર પછીના થોડા મહિનાની અંદર તેમને સ્ટ્રોક આવ્યો હતો અને ફરીથી ઓપરેશન કરાવવું પડયું હતું, જેની સારવારનો ખર્ચ ₹4 લાખ હતો. શ્રી કિશનની ઇન્શ્યોરન્સ પૉલિસી માટે રિસ્ટોરેશન લાભ ઉપલબ્ધ હોવાથી, બીજી સારવાર પણ તેમની ઇન્શ્યોરન્સ કંપની દ્વારા કવર કરવામાં આવે છે.
હેલ્થ ઇન્શ્યોરન્સ પ્લાન્સમાં રિસ્ટોરેશન લાભ હોવો શા માટે જરૂરી છે?
ઘણીવાર એમ બને છે કે જીવનશૈલી સંબંધિત રોગોમાં થઈ રહેલી વૃદ્ધિ અને સારવારના વધતા ખર્ચને કારણે વીમાકૃત રકમ થોડા વર્ષો પછી અપર્યાપ્ત સાબિત થાય છે. આ સમયે, રિસ્ટોરેશન લાભના રૂપમાં બૅકઅપ પ્લાન સુરક્ષા પૂરી પાડે છે, અને જરૂરી હોય તો વધારાનું કવરેજ પ્રદાન કરે છે. આમ, યોગ્ય પસંદગી કરો અને તમારી હેલ્થ ઇન્શ્યોરન્સ પૉલિસીમાં રિકવરી લાભ પસંદ કરો.
Types of Restoration Benefit
There are two main types of restoration in medical insurance, catering to different needs:
1. Complete exhaustion
This applies when the entire sum insured is used. For example, a policyholder with an INR 10,00,000 sum insured will have it restored only after the full amount is utilised.
2. Partial exhaustion
The policy activates the restoration benefit when a portion of the sum insured is used, without requiring complete exhaustion of the coverage. This ensures continuous protection for future claims. For instance, if INR 6,00,000 of an INR 10,00,000 policy is used,
બજાજ આલિયાન્ઝ જનરલ ઇન્શ્યોરન્સ કંપની restores a portion of the used amount, such as INR 4,00,000, offering continued protection. Both options have their advantages, and choosing the right type depends on individual medical requirements and financial planning.
આ પણ વાંચો:
હૃદયને લગતી તકલીફ ધરાવતા વ્યક્તિઓ માટેના હેલ્થ ઇન્શ્યોરન્સ વિશે સઘળી માહિતી
Features of Restoration Benefits in Health Insurance
The restoration benefit in health insurance is a valuable add-on that enhances the utility of your policy, ensuring financial protection during unexpected medical emergencies. Here are the key features that make this benefit indispensable:
1. Applicable for Future Claims
The restoration benefit applies exclusively to new claims that occur after the original sum insured has been exhausted. It cannot be applied retroactively to ongoing treatments or claims. This ensures that policyholders have additional financial backup for subsequent medical expenses within the same policy year.
2. One-Time Activation Per Policy Year
Bajaj Allianz General Insurance Company allows the sum insured to be reinstated only once in a policy year. This limitation ensures the fair usage of the feature, providing a safety net for emergencies without increasing policy costs excessively.
3. No Carry Forward to the Next Year
The restored sum insured is strictly valid for the current policy year and cannot be rolled over to the next year. This ensures that the benefit serves its intended purpose of addressing immediate, unforeseen medical expenses rather than creating a surplus for future years.
4. Available as an Add-On Feature
Restoration in medical insurance can be purchased as an additional rider at a nominal premium, making it accessible to a wide range of policyholders. This flexibility allows individuals to customise their coverage according to their financial and medical needs. These features highlight the practicality and effectiveness of the restoration of sum insured in health insurance, making it a cost-effective solution for managing multiple hospitalisations or recurring medical expenses.
Benefits of Buying a Health Insurance Plan with Restoration Benefits
The restoration benefit in health insurance is a powerful add-on that offers a host of advantages to policyholders, enhancing their financial security during medical emergencies. Here’s a closer look at the key benefits:
1. Increased Coverage
One of the most significant benefits of the restoration feature is the ability to reinstate the sum insured once it is exhausted. This ensures continuous financial protection for multiple hospitalisations within the same policy year, making it particularly useful in the event of severe illnesses or repeated treatments.
2. Cost-Effective Solution
While purchasing a new
હેલ્થ ઇન્શ્યોરન્સ પૉલિસી for additional coverage may be expensive, opting for a restoration benefit is a cost-effective alternative. For a nominal additional premium, policyholders can enjoy enhanced financial protection without the need for a second policy.
3. Peace of Mind During Emergencies
The restoration benefit eliminates the stress of depleting the sum insured, offering reassurance that additional coverage is available for unforeseen circumstances. This peace of mind can be invaluable, especially during prolonged or unexpected medical treatments.
4. Multiple Claims in a Policy Year
This benefit is ideal for individuals or families with recurring medical needs. For family floater plans, where multiple members share the sum insured, the restoration feature ensures adequate coverage is available for all, even after substantial claims. Such benefits make this add-on feature a prudent choice for enhanced financial security.
આ પણ વાંચો:
ઓપીડી કવર સાથે હેલ્થ ઇન્શ્યોરન્સના લાભો
Importance of Restoration Benefit in Health Insurance
Medical emergencies can arise unexpectedly, and the restoration benefit in health insurance ensures that policyholders are not financially burdened. It acts as a safety net, providing additional coverage and safeguarding against rising medical costs. This feature is especially crucial for families or individuals with a history of frequent hospitalisations.
Who should opt for a Restoration Benefit?
અમારી સલાહ છે કે દરેક વ્યક્તિ કે જેમને આ અતિરિક્ત સુવિધા પરવડે તેમણે આ ખરીદવી જોઈએ. એકથી વધુ વાર હૉસ્પિટલાઇઝેશનની ઘટના ઓછી બનતી હોય છે, પરંતુ મેડિકલ ઇમરજન્સી પણ ક્યારેક જ ઉદ્ભવતી હોય છે. પરંતુ જો બધા માટે ન હોય, તો ઓછામાં ઓછું
પરિવાર માટે હેલ્થ ઇન્શ્યોરન્સ પ્લાન should be loaded with a restoration benefit. When you purchase a recovery benefit in your health insurance plan, the entire sum assured that ‘floats’ between the beneficiaries can be restored for it to be available for other members of the policy.
Things to Consider While Opting for Restoration Benefit in Health Insurance
- Eligibility Criteria: Understand the conditions under which restoration benefits are applicable, such as whether they cover all illnesses or are limited to unrelated claims.
- Coverage for Same Illness: Most restoration benefits do not apply to the same illness or hospitalization in the same policy year. Verify if your insurer offers flexibility in this regard.
- Type of Health Insurance Plan: If you're considering a family floater plan, ensure the restoration benefit applies to all members and offers sufficient coverage for multiple claims.
- Cost of Premiums: While restoration benefits enhance your coverage, they may increase your premium. Compare the additional cost with the benefits provided to assess its value.
- Number of Restorations Allowed: Check how many times the sum insured can be restored in a single policy year. Some plans allow multiple restorations, while others may limit it to one.
- Nature of Claims: Determine if the restoration benefit applies only to inpatient treatments or if it includes day-care procedures and other medical expenses.
- No Carry-Forward Provision: Restoration benefits are generally valid only for the current policy year and cannot be carried forward. Utilize the feature within the policy term if needed.
- Waiting Period and Exclusions: Ensure that the restoration benefit is available from the first policy year and check for exclusions that might restrict its use.
આ પણ વાંચો:
હેલ્થ ઇન્શ્યોરન્સ પૉલિસી પોર્ટ કરવાના લાભો
તારણ
The restoration benefit in health insurance is an essential feature that enhances the overall utility of your policy. It provides financial protection against unforeseen medical expenses, ensuring uninterrupted coverage for you and your loved ones. Whether you’re an individual with recurring health concerns or a family sharing a floater plan, this benefit can offer peace of mind and financial security. When choosing a health insurance plan from Bajaj Allianz General Insurance Company, consider opting for one with restoration benefits. This small step can make a significant difference in times of need, ensuring that medical emergencies never become financial emergencies.
વારંવાર પૂછાતા પ્રશ્નો
What is the period of restoration?
The period of restoration refers to the timeframe within which the sum insured is reinstated after being exhausted due to medical claims. It is typically effective immediately after the insured amount is used up and remains valid for the remaining policy period.
What is the extended period of restoration?
The extended period of restoration allows for the restoration of the sum insured beyond the policy term in certain cases, such as when a claim is filed close to the policy expiration date. It ensures coverage for an additional period as specified by the insurer.
What is the time limit for restoration?
The time limit for restoration benefits is usually the same as the policy period. Restoration can be utilized only during the ongoing policy year and does not carry over to the next renewal period.
Can two members of the family suffering from the same disease claim restoration benefits?
No, most policies with restoration benefits do not cover claims for the same illness or disease under the restored sum insured. Restoration benefits are typically applicable to unrelated illnesses or accidents.
What is the restoration period in insurance?
The restoration period in insurance refers to the duration within a policy year when the sum insured is replenished after being completely utilized. It ensures continuous coverage for new and unrelated medical events during the same policy year.
Can you avail of restoration benefits in health insurance in the same claim?
No, restoration benefits only apply to future claims. They come into effect once the existing sum insured has been fully exhausted. This feature ensures additional coverage for subsequent medical expenses within the same policy year but cannot be utilised for ongoing claims that have already depleted the sum insured.
Are recharge and restore the same benefits in health insurance?
While they share similarities, restore benefits reactivate the full sum insured after complete exhaustion, whereas recharge benefits top up the sum insured when it reduces due to partial claims. Both features provide financial protection but differ in their applicability based on claim amounts and conditions in the policy.
Is recharge benefit useful in health insurance?
Yes, a recharge benefit is highly beneficial as it allows partial restoration of the sum insured. This feature ensures continued financial security by replenishing coverage, enabling policyholders to make further claims without out-of-pocket expenses for subsequent medical emergencies.
Can I carry forward the restored sum insured to the next policy year if I don't use it?
No, the restored sum insured is only valid for the ongoing policy year. If unused, it does not roll over to the next year. Restoration benefits are designed for immediate, unforeseen medical needs within the policy's active term.
Is restoration benefit available for pre-existing conditions?
Restoration benefits typically exclude pre-existing conditions unless explicitly stated in the policy terms. It’s crucial to carefully review the policy document or consult Bajaj Allianz General Insurance Company to determine whether the benefit applies to specific medical conditions covered under your plan.
*સ્ટાન્ડર્ડ નિયમો અને શરતો લાગુ
ડિસ્ક્લેમર: આ પેજનું કન્ટેન્ટ સામાન્ય છે અને માત્ર માહિતીપૂર્ણ અને સ્પષ્ટીકરણના હેતુઓ માટે શેર કરવામાં આવેલ છે. તે ઇન્ટરનેટ પરના કેટલાક સેકન્ડરી સ્રોતો પર આધારિત છે અને તે ફેરફારોને આધિન હોય છે. કોઈપણ સંબંધિત નિર્ણયો લેતા પહેલાં, કૃપા કરીને નિષ્ણાતની સલાહ લો.
ઇન્શ્યોરન્સ એ આગ્રહની વિષયવસ્તુ છે. લાભો, બાકાત, મર્યાદાઓ, નિયમો અને શરતો વિશે વધુ વિગતો માટે, કૃપા કરીને વેચાણ પૂર્ણ કરતા પહેલાં સેલ્સ બ્રોશર/પૉલિસી નિયમાવલીને કાળજીપૂર્વક વાંચો.
ક્લેઇમ હેલ્થ ઇન્શ્યોરન્સ પૉલિસી હેઠળ નિર્ધારિત નિયમો અને શરતોને આધિન છે.
પ્રસ્તુત કરેલી માહિતીનો અર્થ તબીબી સલાહનો વિકલ્પ નથી. ઉલ્લેખિત કોઈપણ સૂચનોને માત્ર સામાન્ય ઉપયોગ માટે ધ્યાનમાં લેવી જોઈએ. કોઈપણ સ્વાસ્થ્યની બિમારી અથવા તબીબી સમસ્યા અથવા કોઈપણ સારવાર/પ્રક્રિયા વિશે નિષ્ણાત માર્ગદર્શન માટે, કૃપા કરીને પ્રમાણિત મેડિકલ પ્રોફેશનલની સલાહ લો.
સર્વિસ ચૅટ: 
