How does the Sum Insured Recharge in Care Plus work?

• Written by Riya Lohia

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When you file a claim against your health insurance, your sum insured is reduced or sometimes even exhausted. The remaining sum insured may not be sufficient to file another claim, so what will happen if you need to file another claim in a policy year? This is where a sum insured recharge feature comes to your help. In this article we’ll discuss about how sum insured recharge benefit in Care Plus plan comes to your rescue in case you exhaust your basic coverage of your policy. Stay connected!

What is the Sum Insured Recharge Benefit in Care Plus?

When a claim exhausts your sum insured, the insurer automatically reinstates the sum insured exhausted, which is known as the sum insured recharge benefit. Care Plus health insurance plan offers unlimited automatic recharge of the sum insured for hospitalisation due to both related and unrelated illnesses. Here are some important features of automatic recharge benefits:

• Unlimited automatic recharge is available for the same person with the same illness also.
• For hospitalisation due to the same illness, a gap of 45 days is required between the date of discharge from the hospital and the date of re-admission.
• The recharge amount is available from the second claim of the policy year.
• For a floater policy, recharge is also available on a floater basis.
• The unutilised recharge amount will not be carried forward until the next policy year.

How does Sum Insured Recharge Benefit Work?

Let us take an example to understand how the sum insured recharge benefit works. Suppose you opt for a sum insured of ₹ 10 lakh under the Care Plus plan. The table below presents three different scenarios of how automatic recharge of the sum insured works.

Here is an explanation of all three scenarios and what each tells about the unlimited automatic recharge.

Scenario 1

In scenario 1, the sum insured is exhausted after the first claim. So when the insured needs to file a second claim, the sum insured is recharged, and the insured files a second claim up to the sum insured again in the same policy year. 

The unlimited automatic recharge benefit allows the insured to claim up to the sum insured more than once in the policy year.

Scenario 2

In this scenario, the insured files a first claim of ₹ 4 lakh, after which a balance sum insured of ₹ 6 lakh is left. Now, the insured files a second claim of ₹ 9 lakh, which is more than the balance amount left after the first claim. Hence, the sum insured is recharged, and the balance sum insured after the second claim would be,

Balance Sum Insured after Claim 2 = (Policy sum insured-eligible claim 1) + (Recharged Sum Insured-eligible claim 2) 

= (10,00,000 - 4,00,000) + (10,00,000 - 9,00,000)

=   6,00,000 + 1,00,000

 =   7,00,000

If the sum insured is not fully utilised, the balance sum insured is available till it is fully exhausted.

Scenario 3

In this scenario, the first claim amount is more than the sum insured under the policy. Hence, a claim is eligible only up to the sum insured, which means eligible claim 1 is ₹ 10 lakh, and the remaining ₹ 1 lakh has to be borne by the insured. Since the sum insured is exhausted after the first claim, it is recharged when the insured files a second claim of ₹ 5 lakh, and the balance sum insured after claim 2 is ₹ 5 lakh.

Unlimited automatic recharge cannot exceed the sum insured. Any amount in excess of the sum insured has to be borne by the insured.

Secure the Health of Your Family with Care Plus 

Care Plus plan is a comprehensive health insurance plan with unique features and new-age benefits for all customer segments. The plan offers a sum insured ranging from ₹ 3 lakh to ₹ 25 lakh as per the need of the individuals with inbuilt personal accident cover, OPD cover for dental and ophthalmic consultations, unlimited e-consultations, No Claim Bonus of up to 200% sum insured and many more unique benefits. It is one of the most affordable health insurance plans with sum insured recharge benefit that offers coverage even after your sum insured is exhausted. Thus, with 48 lakh+ claims settled, Care Health Insurance assures you unlimited coverage with the Care Plus plan.

Disclaimers: All plan features, benefits, coverage, and claims underwriting are subject to policy terms and conditions. Kindly refer to the brochure, sales prospectus, and policy documents carefully.