What Is Restoration Benefit in Health Insurance?

Having medical insurance for a family is prudent for every individual in India. Keeping in mind the rise in treatment costs, health insurance in India can provide huge financial support to the policyholder. However, before opting for medical insurance, every individual must compare health insurance plans available and choose one that can fulfil every need. So, when we talk about health insurance plans, there are a few jargons related to the same, which every policyholder should know. Restoration benefit is one of such phrases related to insurance plans which not everyone is aware of. In this article, we will talk about restoration benefits in health insurance and how it helps.

What is the Restoration Benefit?

Opting for health insurance plans with restoration benefits implies that the insurer will restore the amount if the sum assured gets exhausted during treatment. For example, suppose you get a medical insurance plan with a sum assured of ₹5 lakh from a reputed insurer like Tata AIG.

But, you get diagnosed with a heart condition, and your insured sum gets exhausted during the treatment in the first few months. And, God forbid, if you get diagnosed with any other illness around the same time, your insurance company will restore the amount so that you still have money for your treatment and can claim for the same during the same year.

ence, if you buy a health insurance plan in future, it’s better to opt for the restoration benefit along with it.

Types of Restoration Benefits in Medical Insurance Plans

If you choose the restoration benefit along with your medical insurance for your family, you will make a wise decision. This is because it will act as a backup plan which will help you with the medical costs whenever the need arises. There are two types of restoration benefits in health insurance plans:

  1. Complete exhaustion of the sum assured: Here, you will get the benefit when the entire sum insured is exhausted.
  2. Partial exhaustion of the sum assured: In this type, you will get the benefit even when you exhaust the sum insured partially.

When Should You Opt for a Restoration Benefit?

It would help if you bought this add-on restoration benefit with your medical insurance for your family plan. This will allow you to enjoy maximum benefits of the same. Moreover, the restoration benefit will suit a family floater plan to add tangible value to the policy. This is because, in a family health insurance plan, the coverage usually floats between the policyholder’s family members. So, the restoration benefit can come in handy.

For example, if you have a family health plan with a sum insured of ₹6 lakh, and your spouse gets sick, you end up consuming the entire coverage amount for the treatment. Then, if another member of your family gets hospitalised during the same policy year, this benefit will help you restore the insured amount and pay for their treatment.

Will the Restoration Benefit Increase the Policy Premium?

The restoration benefit will help you when you require financial assistance. However, the rule of thumb in medical insurance policies is that the more benefits you will opt for, the higher will be the premiums. Likewise, even the restoration benefit would stretch the premium amount a little. There will be some extra costs that you will have to bear for this additional coverage plan. For example, if you are a 35-year-old and have bought a health insurance policy of ₹4 lakh, you will need to pay around ₹5,000 yearly as a premium. However, with a restoration benefit add-on, that annual cost would go up to around ₹6,000.

A Few Factors to Consider Before Opting for a Restoration Benefit

So, if you have now decided on buying a restoration benefit along with medical insurance for family policy, here are a few things that you should keep in mind:

  • It is an ‘Add-on’ coverage benefit that you can buy along with your insurance plan.
  • Restoration benefit will activate only when there will be an unforeseen medical condition in any one of the family members in the future.
  • You can opt for a restoration benefit while buying a health policy with a certain extra cost.
  • Restoration of the funds will happen on exhaustion of the complete sum insured or the partial sum insured during the treatments.
  • Restored sum insured will not be liable for carrying forward to the next policy year.
  • Restoration benefits will not apply during the first policy claim.
  • Restoration benefit isn’t just eligible for a higher sum insured. You can apply for the same for any given sum insured.
  • Restoration benefit restores the whole sum insured once you exhaust it in a single claim within the policy term/year.
  • Restoration benefits are only meant for future claims.


It is now clear that the restoration benefit could be an ideal cover plan for your health insurance policy. Although you can always go for a higher sum insured, it will mean that you’ll have to pay more premiums. However, you can get full financial support during a crisis without worrying about paying a huge premium amount yearly with the restoration benefit.