By HDFC ERGO General Insurance Co. Ltd.
Indicative premium for a family of 4 with ₹10 Lakh cover. Actual premium varies by age, city, and cover amount.
The defining features that set HDFC Ergo Optima Restore apart
Once the sum insured is exhausted, it is restored fully - even for the same illness. No waiting for a second unrelated condition.
Your sum insured doubles after just 2 consecutive claim-free policy years at no extra premium, effectively giving you far more cover.
Choose any hospital room category including a private suite without proportionate deductions on associated costs.
Get a second medical opinion from leading specialists electronically for any critical illness diagnosis, at no extra cost.
All modern treatments, surgical procedures, and ICU charges are covered without separate caps or sub-limits.
Medically necessary treatment at home, recommended by a treating doctor, is covered under the plan.
HDFC Ergo settles 96.1% of all claims - one of the highest ratios in the Indian health insurance market.
Coverage for treatment at home for conditions where hospital admission is not feasible, per the doctor's recommendation.
Full breakdown of inclusions and exclusions in HDFC Ergo Optima Restore
| Coverage Feature | Details | Status |
|---|---|---|
| In-patient Hospitalisation | All hospitalisation above 24 hours | Fully Covered |
| Pre-hospitalisation | 60 days before admission | Covered |
| Post-hospitalisation | 180 days after discharge | Covered |
| Day-care Procedures | All IRDAI-listed procedures | Fully Covered |
| Room Rent | No cap - any category | No Sub-limit |
| ICU Charges | No sub-limit applicable | No Sub-limit |
| Restore Benefit | 100% restore, even for same illness | Same Illness |
| Multiplier Benefit | 2x cover after 2 claim-free years | Covered |
| E-opinion | Second medical opinion for critical illness | Covered |
| Home Health Care | Doctor-recommended home treatment | Covered |
| Road Ambulance | Per hospitalisation | Covered |
| Domiciliary Hospitalisation | Minimum 3-day at-home treatment | Covered |
| Organ Donor Expenses | Medical expenses of donor | Covered |
| Modern Treatments | Including robotic surgery | No Sub-limits |
| AYUSH Treatments | At recognised AYUSH hospitals | Covered |
| No Claim Bonus | Via Multiplier Benefit, up to 2x | Via Multiplier |
| Pre-existing Diseases | After 3-year waiting period | 3-yr Wait |
| Maternity Cover | Not covered in base plan | Not Covered |
| International Treatment | Not applicable under base plan | Not Covered |
| Cosmetic Surgery | Unless due to accident | Excluded |
Profiles best matched to HDFC Ergo Optima Restore
The same-illness restoration is ideal for policyholders managing diabetes, heart disease, or any recurring condition that may require multiple hospitalisations in a year.
The Multiplier Benefit is perfect for younger policyholders who stay healthy - their cover doubles over 2 years without paying extra premium.
Senior family members who may need multiple hospitalisations annually are best protected by the restore feature that refills coverage even for the same illness.
HDFC Ergo's 96.1% claim settlement ratio makes this a trusted option for those who prioritise insurer reliability above all else.
An honest assessment of HDFC Ergo Optima Restore
Common queries about HDFC Ergo Optima Restore
Our licensed advisors help you evaluate the restore and multiplier benefits against your specific health history at no cost.
Chat on WhatsApp: +91 99301 40305See how Optima Restore compares to other leading health insurance plans