In view of the changing needs in respect of health insurance which is now being increasingly adopted by individuals in light of burgeoning health care cost, the health insurers are making time and again making changes to the plans to ensure better interest. So here are a few set of new features that you should know to make the most of your health care plan:
Restore of sum assured: This feature allows the insurer to refill the amount upto the sum insured value in case the amount plus the accumulated bonus if any gets exhausted during the term of the treatment.
The feature can be used only once in a particular year and is available for future claims and not against claims that have already been paid in a year. Notably, the feature is also not carry forwarded to the next year.
Recharge of sum assured: In it if as per the policy, the claim has reduced the sum insured amount due to the claim that has been processed, the health insurer company reinstates or recharges the amount to the prior sum assured value. The recharge sum also does not go past the sum assured value for that specific policy year.
It is to be noted that this feature cannot be used in case of claiming injuries or illnesses for which the person has already been admitted.
Also, any amount that has not been used in case of recharge is not carried to the following policy year as it discontinues to exists.
To make the point clear, in respect of both the features, let's see an example for both:
Restore: Herein say Mr X has a health insurance plan of Rs. 2 lakh and if he undergoes a treatment say due to Y disease during the term of that treatment in case the entire sum assured value gets exhausted, then if the restore feature is active then insurer will for the same policy year, restore the sum assured value to the original Rs. 2 lakh which can still be used for claims against other diseases other than Y. And if this amount also gets exhausted, he will be no longer given another restoration for the given year.
Now here we detail an example on recharge to understand this feature better: Say Mr X for a treatment exhausted Rs. 1.5 lakh out of his total sum insured value of Rs. 2 lakh. And if he further get admitted to hospital due to some other issue then his another bill could be reimbursed by the feature wherein the insurer will automatically recharge the sum insured value.
So, the difference is that the recharge feature reinstates the required amount as and when the need arises on an automatic basis during the next hospitalization upto 100% of the basic sum insured value when the initial sum assured amount gets reduced. But in the restoration feature, the sum is restored when only full exhaustion.