Recently got a call from a colleague that during his Covid treatment his entire floater policy sum insured (SI) with accrued cumulative bonus got exhausted. He was wondering whether he or his family members if admitted again in same policy period can get the claim or not.

Restore:

• It triggers if due to a single large claim or multiple claims in same policy period; your SI along with accrued Cumulative Bonus is exhausted. Your SI gets restored or replenished up to original SI, this restored SI cannot be used in current claim but only in future claims. However, restore normally is allowed for unrelated illness / disease
• e.g. Family floater SI is 3 lacs & husband’s Covid claim is of 4 lacs. Claim can be settled upto 3 lacs and rest 1 lac will go from your pocket. Restore will trigger now since entire SI is exhausted and 3 lacs will be replenished. Now in case husband is detected again with Covid, then he cannot use the restored SI 3 lacs in same policy period as it is same disease. However, if any other family member is admitted then they can use the restored SI even for Covid. If husband is detected with Malaria in same policy period, then he too can use the restored SI, being unrelated disease then previous one Covid.
• Hence Restore is there for future claim & not the current one. Also, it cannot be used for same person + same disease; except for few insurers who allow it post a gap of 45 days of discharge from hospital. Restored SI cannot be carried forward in the next year policy. And Restore does not trigger in case claim is taken under Global Cover benefit.

Recharge:

• Few insurers offer additional indemnity limit depending on the SI which can be used in case your SI with accrued Cumulative Bonus is exhausted in single or multiple claims in a policy period.
• We take the same example of Family floater of 3 lacs SI. Here Recharge limit let us say is 75,000. So total SI with recharge is 3.75 lacs. Husband’s covid claim is of 3.5 lacs. Claim can be settled by using 3 lacs SI & balance 50,000 can be taken from Recharge limit of 75,000. So still you are left with 25,000 balance. In case husband is admitted again in hospital because of Covid then you can very well use the amount upto balance 25,000.
• Hence Recharge limit can be used in current claim as well as for same person + same disease also.

Do I still need a Super Top Up policy if Restore benefit is there in my policy?

• Like Restore, Super Top Up does not have any restriction of unrelated illness / disease. So even if same disease & same person claim is there again in policy period then Super Top Up can cover it upto the available SI.
• Restore is helpful in future claims but not in current. While Super Top Up can be of help in current claim also moment the specified deductible limit is crossed.
• Hence Restore is not a substitute of Super Top Up & both have its own advantages.

Stay insured. Stay safe.

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Birju Shah – Founder, Customer First Marketing Services
We provide tailor-made solutions in Health, Life, Motor & SME insurance.
You can reach me on ops@customerfirstmktg.com & Mobile No. 859-1314-007