It is common knowledge if you have health insurance that there is a maximum amount that it can cover in the event of a health emergency. The insurance company can only make payments up to this maximum.
There is, however, a way out. Some insurance policies provide a reload benefit that allows the insured to pay an appropriate premium and reset the sum insured amount once the limit has been reached. You can always use a health insurance premium calculator to compare different plans and pricing based on your requirements and find a reload benefit plan that suits your needs.
But, before that, let’s examine how this benefit works.
Reload of Sum Insured is a feature of health insurance plans that enables policyholders to reinstate their sum insured if it is used up. The insurer can provide a 100% reload if the policyholder needs coverage for any accident or unrelated illness. The reload benefit is only made available following the initial claim. If necessary, the insurer may reload the sum insured even if it has yet to be used up completely.*
What is the process for Reload Benefit in a health insurance plan?
Let’s use an example to grasp this better.
Mr Sharma purchased a health insurance plan with a sum assured of 5 lakh rupees. But only a few months after purchasing the policy, he was hospitalised, using up INR 4 lakhs of his insurance, leaving him only with Rs. 1 lakh in coverage. Sometime later, but within a year of purchasing the coverage, he was hospitalised once more for a different illness. Ordinarily, he would have been able to only use the remaining INR 1 lakh and pay the rest out of his pocket. But because he had a special plan with a reload benefit, the insurance company reset the insured amount back to Rs 5 lakh, and he could claim it.
However, do remember if the claim amount is lower, the insurance company may reload the claim amount instead of the higher sum insured.*
This advantage enables policyholders to file a reasonable claim (up to the coverage amount) for healthcare costs made for the second time in the same year because the insurance company reset the covered amount back to the sum assured or the claim amount (whichever is smaller).*
Important information about the Reload Benefit:
In order to reload up to the lowest of the claim amount or the original sum insured, the claim should be made for an unrelated disease to the initial condition or, in the case of family health insurance plans for a different family member.*
Should you opt for a Reload Benefit Policy?
Reload benefits in health insurance might assist you in paying for medical expenses above and beyond your initial sum insured. However, read all terms & conditions of the policy and do your research well before you opt for one. It is more beneficial in family health insurance plans due to a higher number of members being covered. So, even when one family member uses up the entire original sum insured, other family members can still claim the initial sum insured or the claim amount, whichever is lower.*
*Standard T&C apply
Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.