Optima Enhance is an aggregate deductible plan, here deductible will be calculated as a sum of all claims in a Policy year.
Example of Deductible: Mr. X has policy (Policy Period - 1st Jan 2017 to 31st Dec 2018) with Sum Insured of Rs. 500,000 and with a deductible of Rs. 500,000.
Scenario 1: For multiple claims in a year
In May 2017, he is hospitalized and a claim is filed for Rs. 400,000. Claim is not admissible in this scenario since his deductible is Rs. 500,000.
In June 2017, he is hospitalized and a claim is filed for Rs. 200,000. As the total claims under the policy for the year is Rs. 6,00,000 (4,00,000 +2,00,000), he is eligible to claim for Rs. 1,00,000 (i.e. Rs. 6,00,000 - Rs. 5,00,000).
Scenario 2: For a single claim
In May 2017, he is hospitalized and a claim for Rs. 6,00,000 is filed, in this scenario claim payment will be made for Rs. 100,000 [Rs. 6,00,000-Rs. 5,00,000]