HDFC ERGO Health Optima Restore Health Insurance

HDFC ERGO Health Optima Restore Health Insurance Multiplier benefit

50% increase in your basic sum insured for every claim free year, subject to a maximum of 100%. In case a claim is made during a policy year, the limit under this benefit would be reduced by 50% of the basic sum insured in the following year. However, this reduction will not reduce the Sum Insured below the basic Sum Insured of the policy.

Optima Restore Health Insurance benefit

A Health Plan which restores your Sum Insured when you need it the most. Instant addition of 100% Basic Sum Insured on complete or partial utilization of Your existing Policy Sum Insured and Multiplier Benefit (if applicable) during the Policy Year. This total amount (Basic sum insured, Multiplier benefit and Restore sum insured) will be available to all Insured Persons for all claims under In-patient Benefit during the current Policy Year.

Too good to be true, here’s how it will work:

If you have a base Sum Insured of 5 lakhs, and you claim Rs.1,00,000 in the beginning of the year, we will restore the base Sum Insured of 5 lakhs to your remaining balance, i.e. you will now have Rs.9,00,000 which can be used for subsequent claims in the remaining policy year for all claims under In-patient Benefits.

However, single claim in a Policy Year cannot exceed the sum of Basic Sum Insured and Multiplier Benefit (if any).

Optima Restore Health Insurance coverage exclusions

• Any treatment within first 30 days of cover except any accidental injury.
• Any Pre-existing diseases/conditions will be covered after a waiting period of 3 years.
• 2 years exclusion for specific diseases like cataract, hernia, hysterectomy, joint replacement etc.
• Abuse of intoxicant or hallucinogenic substance like drugs and alcohol.
• Pregnancy, dental treatment, external aids and appliances.
• Hospitalization due to war or an act of war or due to nuclear, chemical or biological weapon and radiation of any kind.
• Non-allopathic treatment, congenital external diseases, cosmetic surgery