SYNOPSIS

Friday, April 22, 2016

Recharge vs Restore option in Health Insurance

Source: Mint


You can use your health insurance policy only up to the sum insured limit in a policy year. Once the cover is exhausted, you can’t make any further claims. However, on renewal the next year, the entire sum insured is available to you again.

Insurers are now launching products that recharge the sum insured if you happen to exhaust it within the policy year.

How recharge plans work

Recharge or restore health insurance plans are regular health insurance policies that pay for your hospitalization including pre- and post-hospitalization days. An added feature is that once you exhaust the original sum insured limit, the plan restores the same sum insured for future hospitalization the same year. For example, suppose a policyholder buys a health insurance policy with the restore option with Rs.3 lakh of sum insured and a policy term of a year. She gets hospitalized and needs to pay a bill of Rs.3 lakh. The policy will help her do so and, at the same time, recharge the policy with another Rs.3 lakh. If there is a subsequent hospitalization the same year, the policyholder gets a cushion of Rs.3 lakh. Next year, when your policy is up for renewal, the recharged amount will go away and your policy will start with the original sum insured of Rs.3 lakh.

Beware of

This extra recharge comes with some important fine print. To start with, plans will not extend this recharge limit for the same illness or injury for which the policyholder made a claim earlier. In the example above, say, the policyholder made a claim on account of a heart problem and exhausted the cover. If the heart condition triggers subsequent hospitalization, the recharged policy will not come in handy.

Also, in some plans the restore option will kick in only when the entire sum insured limit is exhausted. So, if the sum insured in an individual policy is Rs.3 lakh, and the hospitalization bill is Rs.2 lakh in the first incident and Rs.3 lakh in the second, you will have to pay Rs.2 lakh from your pocket for the second incident of hospitalization. But for any subsequent hospitalization, the policy will come to the rescue. Then there are plans that would pick up the tab for the second instance of hospitalization and you will not have to shell out the Rs.2 lakh from your pocket. Go through the fine print carefully.

What should you do?

The concept works well, but given the caveat, you need to make sure that even under the restore option, you have a decent level of cover. Recharge plans work well in case you have a floater policy. A floater policy covers the entire family as one unit so if the cover is used by one member, the insurance cover gets reduced by that much amount for the remaining members in a policy year. But under the restore option, the sum insured would get replenished and other members of the family will be able to use the cover.

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