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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

  • In-patient Treatment - Covers hospitalisation expenses for period more than 24 hrs.
  • Pre-Hospitalisation - Medical expenses incurred in 60 days before the hospitalisation.
  • Post-Hospitalisation - Medical expenses incurred in 180 days after the hospitalisation.
  • Day-Care procedures - Medical expenses for day care procedures.
  • Domiciliary Treatment - Medical expenses incurred for availing medical treatment at home which would otherwise have required hospitalisation.
  • Organ Donor- Medical expenses on harvesting the organ from the donor for organ transplantation.
  • Emergency Ambulance - Upto Rs. 2,000 per hospitalisation for utilizing ambulance service for transporting insured person to hospital in case of an emergency.
  • Daily Cash for choosing shared accommodation - Daily cash amount if hospitalised in shared accommodation in network hospital and hospitalisation exceeds 48 hrs
  • E-Opinion in respect of a Critical Illness - Second opinion by a Medical Practitioner from Our panel, for a Critical Illness suffered during the policy period.

Re-instatement of the basic sum insured if the basic sum insured and multiplier benefit has been exhausted during the policy year. The 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.

Optima Restore Individual

Basic Sum Insured per Insured Person per policy Year (Rs. In Lakh) 3.00 , 5.00, 10.00, 15.00 20.00, 25.00, 50.00
1 a) In-patient Treatment Covered Covered
1 b) Pre-hospitalization Covered, upto 60 Days Covered, upto 60 Days
1 c) Post-hospitalization Covered, upto 180 Days Covered, upto 180 Days
1 d) Day Care Procedures Covered Covered
1 e) Domiciliary Treatment Covered Covered
1 f) Organ Donor Covered Covered
1 g) Emergency Ambulance Upto Rs.2,000 per Hospitalisation Upto Rs.2,000 per Hospitalisation
1 h) Daily Cash for choosing Shared Accommodation Rs.800 per day, Maximum Rs.4,800 Rs.1000 per day, Maximum Rs.6,000
1 i) E-Opinion in respect of a Critical Illness Covered Covered
2) Restore Benefit Equal to 100% of Basic Sum Insured Equal to 100% of Basic Sum Insured
3) Health Checkup Not Covered Upto 1% of Sum Insured subject to a Maximum of Rs.10,000 per Insured Person, only once at the end of a block of every continuous two policy years
4) Multiplier Benefit Bonus of 50% of the Basic Sum Insured for every claim free year, maximum upto 100%. In case of claim, bonus will be reduced by 50% of the Basic Sum Insured at the time of renewal Bonus of 50% of the Basic Sum Insured for every claim free year, maximum upto 100%. In case of claim, bonus will be reduced by 50% of the Basic Sum Insured at the time of renewal

Optima Restore Family

Basic Sum Insured per Insured Person per policy Year (Rs. In Lakh) 3.00 , 5.00, 10.00, 15.00 20.00, 25.00, 50.00
1 a) In-patient Treatment Covered Covered
1 b) Pre-hospitalization Covered, upto 60 Days Covered, upto 60 Days
1 c) Post-hospitalization Covered, upto 180 Days Covered, upto 180 Days
1 d) Day Care Procedures Covered Covered
1 e) Domiciliary Treatment Covered Covered
1 f) Organ Donor Covered Covered
1 g) Emergency Ambulance Upto Rs.2,000 per Hospitalisation Upto Rs.2,000 per Hospitalisation
1 h) Daily Cash for choosing Shared Accommodation Rs.800 per day, Maximum Rs.4,800 Rs.1000 per day, Maximum Rs.6,000
1 i) E-Opinion in respect of a Critical Illness Covered Covered
2) Restore Benefit Equal to 100% of Basic Sum Insured Equal to 100% of Basic Sum Insured
3) Health Checkup Not Covered Upto 1% of Sum Insured subject to a Maximum of Rs.10,000 per Insured Person, only once at the end of a block of every continuous two policy years
4) Multiplier Benefit Bonus of 50% of the Basic Sum Insured for every claim free year, maximum upto 100%. In case of claim, bonus will be reduced by 50% of the Basic Sum Insured at the time of renewal Bonus of 50% of the Basic Sum Insured for every claim free year, maximum upto 100%. In case of claim, bonus will be reduced by 50% of the Basic Sum Insured at the time of renewal
  • 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.
  • Health Check-up - At the end of a block of every continuous 2 policy years. We will pay upto the stated percentage of the Sum Insured towards cost of the medical check-up.
  • 30 days for all illnesses (except accident) in the first year and is not applicable in subsequent renewals
  • 24 months for specific illness and treatments in the first two years and is not applicable in subsequent renewals
  • Pre-existing Diseases will be covered after a waiting period 36 months.
  • War or any act of war, nuclear, chemical and biological weapons, radiation of any kind, breach of law with criminal intent, intentional or attempted suicide, participation or involvement in naval, military or air force operation, racing, diving, aviation, scuba diving, parachuting, hang-gliding, rock or mountain climbing, abuse of intoxicants or hallucinogenic substances such as intoxicating drugs and alcohol, treatment of obesity and any weight control program, Psychiatric, mental disorders, congenital internal or external diseases, defects or anomalies, genetic disorders; sleep apnoea, expenses arising from HIV or AIDs and related diseases, sterility, treatment to effect or to treat infertility, any fertility, sub-fertility, surrogate or vicarious pregnancy, birth control, circumcisions, treatment for correction of refractive error, plastic surgery or cosmetic surgery unless required due to an Accident, Cancer or Burns, any non allopathic treatment.

    Please refer to the policy wording for the complete list of exclusions.

    For premium paid on policies as per section 80D of the Income Tax Act. Tax benefits are subject to income tax laws.

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