| Min Entry Age |
91 days. Children between 91 days and 5 years can be insured if both parents are getting insured in this policy |
| Max Entry Age |
65 years |
| Max Policy Renewal Age |
No Limit |
| Policy Term |
1 or 2 years or 3 years |
| Sum Assured Options |
3/5/10/15/20/25/50 Lacs/1 Crore |
| Premium Payment Options |
1 or 2 Year or 3 years |
| In-patient Treatment |
Covered |
| Day-Care Procedures |
All day care procedures covered |
| Domiciliary Treatment |
Covered |
| Expenses for organ donor |
Covered |
| Pre hospitalisation |
Relevant medical expenses covered for 60 days prior hospitalisation |
| Post hospitalisation |
medical expenses covered for 180 days immediately after discharge from hospital |
| Emergency Ambulance |
Up to Rs 2,000 per hospitalisation |
| Health Check-up |
Available for sum insured of Rs. 5 lacs and above |
| Maternity Expenses |
Not Available |
| Ayush Benefit |
Not Available |
| No Claim Bonus |
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. |
| Restore Benefit |
Equal to 100% of Basic Sum Insured, |
| Cashless facility |
Available at empanelled hospitals in India. |
| Re-imbursement |
In case policyholder opts for non empanelled hosiptal. |
| Co-Pay |
Not Applicable |
| Claim Based Loading |
No Claim based loading on renewal premium |
| Renewal Premium Discount |
Premium discount of 7.5% on advance premium payment for 2 year policy term and premium discount of 10% on advance premium payment for 3 years policy term. |
| Family Premium Discount |
Family Discount of 10% if 2 or more family members are covered under Optima Restore Individual Sum Assured Plan. |
| Tax Benefit on Investment |
Premium paid is eligible for tax benefit under section 80D of the Income Tax Act |
| Riders |
Applicable |
| Pre Policy Medical CheckUp |
No medical checkup is required till certain age and certain sum insured, only tele verification call is required. |
| Pre-existing disease |
Pre-existing Diseases will be covered after a waiting period of 36 months |
| Waiting Period |
24 months for specific illnesses and treatments |
| No claim period |
Any disease contracted during the first 30 days of commencement of the policy except for accidental emergency |
| General exclusions |
Non allopathic treatment.AIDS or any related illness will not be coveredTreatment of any mental or related disease is also excluded. |
| Grace Period |
30 days grace period is allowed to policyholder for payment of premium at the insurers discretion. |
| Policy Termination |
Insurance company may terminate the policy by giving a written notice of 30 days. Policyholder is allowed to terminate the policy at anytime by giving a written notice. In case no claim has been made under the policy, percentage of premium will be refunded |
| Doctor Consultations (OPD) |
Not covered |
| Reimbursement (OPD) |
Not allowed |
| Annual Health CheckUp (OPD) |
Not allowed |
| Pros |
Sum Assured restoration, 50% No Claim Bonus, Lifelong Renewal, No Sub Limits, No claim based loading on premium
|
| Cons |
No critical Illness rider |