Apollo Munich Insurance Plans

HDFC ERGO Health Optima Restore Health Insurance

  • Individual
  • Family

Optima Restore Health insurance quotes

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HDFC Ergo Health Quotes for Family

HDFC ERGO Health Optima Restore Family health insurance plans provide coverage for the entire family within the scope of a single health plan. find quotes, compare & buy HDFC ERGO Health Optima Restore Quotes for Family

Buy HDFC ERGO Health Optima Restore for Family

Key features of HDFC Ergo Health (Apollo Munich) Optima Restore plan

  • Room Rent: No Room Rent Restrictions across all plans.
  • Co - pay: NIL Co-pay under this plan.
  • Restoration Benefit: Upto 100% of Base Sum Insured per year.

HDFC Ergo Health Insurance Review

HDFC Ergo Health Insurance
Number of policies issued *
1,063,052
Maximum family floater coverage
Self, Spouse + 5 dependent children
List of network hospitals
10,000+ hospitals
Claims Settlement Ratio **
89.50%
Tenure options
1 to 2 years
Sum insured
1 lac − 50 lacs options available
* As per IRDAI report for 2018-19   |   ** As per NL25 data published on the Insurance Company website

HDFC ERGO Health Optima Restore comprehensive health insurance review

  • Multiplier Benefit
  • Benefit Table
  • Restore Benefit
  • Exclusions

HDFC ERGO Health Optima Restore Health Insurance 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.

Optima Restore Individual Health Insurance benefit table

Coverage Benefits Optima Restore
Basic Sum Insured 3Lakhs, 5Lakhs, 10Lakhs, 15Lakhs, 20Lakhs, 25Lakhs & 50Lakhs
In-patient Treatment Covered upto sum insured
Pre-Hospitalization Covered, upto 60 Days
Post-Hospitalization Covered, upto 180 Days
Day Care Treatment All day care treatment covered
Domiciliary Treatment Covered upto sum insured
Organ Donor Covered upto sum insured
E-Opinion in respect of a Critical Illness One opinion per policy year
Restore Benefit Equal to 100% of Basic Sum Insured
Emergency Ambulance Upto Rs.2,000 per Hospitalisation
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. However this reduction will not reduce the Sum Insured below the basic Sum Insured of the policy

Optima Restore Family Health Insurance benefit table

Coverage Benefits Optima Restore
Basic Sum Insured 3Lakhs, 5Lakhs, 10Lakhs, 15Lakhs, 20Lakhs, 25Lakhs & 50Lakhs
In-patient Treatment Covered upto sum insured
Pre-Hospitalization Covered, upto 60 Days
Post-Hospitalization Covered, upto 180 Days
Day Care Treatment All day care treatment covered
Domiciliary Treatment Covered upto sum insured
Organ Donor Covered upto sum insured
Ambulance Cover Upto Rs. 2,000 / Hospitalisation
E-Opinion in respect of a Critical Illness One opinion per policy year
Restore Benefit Equal to 100% of Basic Sum Insured
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. However this reduction will not reduce the Sum Insured below the basic Sum Insured of the policy


Optima Restore Health Insurance benefit

A Health Plan which restores your Sum Insured when you need it the most. Instant addition of 100% Basic Sum Insured on complete or partial utilization of Your existing Policy Sum Insured and Multiplier Benefit (if applicable) during the Policy Year. This total amount (Basic sum insured, Multiplier benefit and Restore sum insured) will be available to all Insured Persons for all claims under In-patient Benefit during the current Policy Year.

Too good to be true, here’s how it will work:

If you have a base Sum Insured of 5 lakhs, and you claim Rs.1,00,000 in the beginning of the year, we will restore the base Sum Insured of 5 lakhs to your remaining balance, i.e. you will now have Rs.9,00,000 which can be used for subsequent claims in the remaining policy year for all claims under In-patient Benefits.

However, single claim in a Policy Year cannot exceed the sum of Basic Sum Insured and Multiplier Benefit (if any).

Optima Restore Health Insurance coverage exclusions

  • Any treatment within first 30 days of cover except any accidental injury.
  • Any Pre-existing diseases/conditions will be covered after a waiting period of 3 years.
  • 2 years exclusion for specific diseases like cataract, hernia, hysterectomy, joint replacement etc.
  • Abuse of intoxicant or hallucinogenic substance like drugs and alcohol.
  • Pregnancy, dental treatment, external aids and appliances.
  • Hospitalization due to war or an act of war or due to nuclear, chemical or biological weapon and radiation of any kind.
  • Non-allopathic treatment, congenital external diseases, cosmetic surgery

Brochure

Review HDFC ERGO Health Optima Restore Health Insurance insurance brochure to understand coverage details.

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Policy wordings

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CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2025