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Health Insurance

Optima Restore

Health Plan with unbelievable benefits and no hidden sublimits

For claims call on 1800 – 200 – 3003

No Medical Tests

No medical tests on enrolment for applicants upto 50 years of age and/or for sum insured upto Rs. 10 lakhs.

Restore Benefit

Restore benefit that automatically reinstates the basic sum insured in case you exhaust it in a policy year.

Tax Savings

Save upto Rs. 55,000 under section 80D

Cashless Hospitalisation

Avail cashless hospitalisation at 4000 hospitals

Features and Benefits

A maximum of 6 members can be added in a single policy, whether individual or floater basis. In an individual policy a maximum of 4 adults and maximum of 5 children can be covered. The 4 adults can be a combination of self, spouse and either set of dependent parents or parents in law. In a family floater policy, a maximum of 2 adults and a maximum of 5 children can be covered.

Restore Benefit automatically re-instates the basic sum insured, if the basic sum insured and multiplier benefit has been exhausted during the policy year. Basic sum insured will be re-instated only once in a policy year. Restore Sum Insured can be used for only future claims made by the Insured Person and not against any claim for an illness/disease (including its complications) for which a claim has been paid in the current policy year. If the restore sum insured is not utilised in a policy year, it shall not be carried forward to any subsequent policy year.

Consider a Optima Restore policy with Base Sum Insured: 3 lacs Multiplier Benefit: 1.5 lacs Hence total cover in the given year is 4.5 lacs
Scenarios Restore Benefit Triggered Amount of cover under the policy for remainder of the year
Scenario 1: A claim of 4.5 lacs is incurred Yes 3 lacs (Restore benefit is triggered and the base sum insured is reinstated)
Scenario 2: A claim of 3 lacs in incurred No 1.5 lacs (Restore benefit not triggered as the Restore Benefit will be triggered as the Restore Benefit will be triggered only if the insured person completely exhaust the total cover eligible for the year i.e. Base Sum Insured and Multiplier Benefit)
Scenario 3: A claim of 2 lacs in incurred No 2.5 lacs (Restore benefit not triggered as the Restore Benefit will be triggered only if the insured person completely exhaust the total cover eligible for the year i.e. Base Sum Insured and Multiplier Benefit)

No additional premium would be required in case the Restore Benefit is triggered.

Basic sum insured will be re-instated only once in a policy year. The Restore benefit can be reinstated once every year and there would be no policy lifetime limit.

Multiplier Benefit is a no claim benefit and will be offered as renewal incentive. Under Multiplier benefit, a Bonus of 50% of the basic sum insured will be provided for every claim free year accumulating up to 100%. In the event of a claim, the bonus will be reduced by 50% of the Basic Sum Insured at the time of renewal. However this reduction will not reduce the Sum Insured below the basic Sum Insured of the policy.

Scenario: If client opts for Optima Restore Policy with 5 Lacs Sum Insured & claimed in 3th year. Multiplier Benefit will be functional as follows-:

Year 1 Year 2 Year 3 Year 4 Year 5
Base Sum Insured 5 5 5 5 5
Multiplier Benefit NA 2.5 5 2.5 5
Total Amount (at the beginning of the year) 7.5 10 7.5 10

A family discount of 10% would apply if 2 or more family members are covered under same Policy. Furthermore, a discount of 7.5% can be availed if insured person is paying 2 year premium in advance

Yes, premium paid under Optima Restore policy (Except mode of payment as Cash) is eligible for deduction under Section 80 D of Income Tax (Amendment) Act 1986.

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