Optima Restore Health Insurance
Optima Restore Health insurance is the latest health insurance products from HDFC ERGO Health Formerly Apollo Munich. Optima Restore Health Insurance provides coverage ranging from 3 to 5 lakhs for both individual and family.
Restore benefit
- If your sum insured gets exhausted before a plan year ends and you still come across another medical emergency then the sum insured is restored.
- In case your family is covered under the floater policy and one of the family member uses up the entire sum insured for the treatment for his/her illness during a plan year, the entire sum insured will be restored which will cover other members of the family when they need treatment.
- This restore benefit process involves no extra cost for the new restored sum insured amount.
- Please note that this product will restore the extra sum insured amount only if the coverage is required for treatment arising from a different illness or if a different family member needs a coverage. This product does not restore the sum insured for the treatment required for same sickness and also for the same member in a the family floater plan.
Multiplier benefit
- If an insured has not had any claims in a plan year, the basic sum insured will be increased by 50% of the sum insured for the next year. This amount is called the claim bonus.
- If you still do not claim in the 2nd year, the basic sum insured will be increased by 100% which is double your initial sum insured. The multiplier benefit does not involve any extra charges.
Coverage Benefits
Overview
Benefit |
Optima Restore for Individual/Family |
Basic Sum Insured per insured person per policy year (Rs. in Lakh) |
3.00, 5.00, 10.00, 15.00 |
In-patient Treatment |
Covered |
Pre-Hospitalization |
Covered, upto 60 Days |
Post-Hospitalization |
Covered, upto 180 Days |
Day Care Treatment |
Covered |
Domiciliary Treatment/Home Treatment |
Covered |
Treatment for Organ Donor |
Covered |
Emergency Ambulance |
Upto Rs.2,000 per Hospitalisation |
Restore Benefit |
Equal to the sum insured. Will be restored only after the initial sum insured amount has been exhausted. This does not require extra payment. |
Multiplier Benefit |
50% of the initial sum insured for every year without claims and maximum is 100%. If there are claims, only the bonus is reduced by 50%, not the initial sum insured |
Overview of some of the unique benefits provided by HDFC ERGO Health Formerly Apollo Munich Optima Restore Health Insurance plan:
- Lifetime renewal: This plan can renewed forever as long as the insured customer is alive.
- No Sublimits on patient ward rent and hospitalization expenses: This benefit allows an insured customer to enjoy any kind of patient ward and the treatment without worrying about the associated costs.
- Cashless transactions: This product will allow a customer to get a treatment on cashless basis in any of the 4000 hospitals located in more than 800 cities.
- No Sublimits with respect to geography: It doesn´t matter where you purchase the policy in India, you can get a treatment in any hospital or city. This doesn´t involve additional copays or sublimits.
- Claim based loading is Nil: If you have made any claims in the previous year, this will not affect the premium you need to pay after the next renewal.
- Quick Pre-Authorization: 90% of the pre-authorization will not take more than 2 hours.
- Easy and fast Claim Settlement: HDFC ERGO Health Formerly Apollo Munich is one of the reputed company in the industry whose claim settlement process is the fastest.
- Simple Upgrade: While renewing a policy, you can easily upgrade you health plan easily to the next available slab.