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The auto restoration of sum insured is applicable only for a sum insured of Rs 3 lakh and above

THE PRODUCT: Family Health Optima is a family health insurance policy, which provides coverage for the entire family on the payment of a single premium and single sum insured.

WHO CAN BUY THE PRODUCT: Married individuals with one or more dependent children.
WHAT IT PROMISES: Hospitalisation cover, including room rent, fees for nursing, surgeons, anesthetists and consultants and emergency ambulance services up to a sum of Rs 750, with an overall limit of Rs 1,500.

WHAT IS SPECIAL: The highlight of the product is the auto restoration of the sum insured. If the sum insured in the policy has been exhausted by various claims and new medical expenses crop up, the policy allows the sum insured to be doubled at no additional cost.

The doubled sum insured, however, can be used only for illnesses or diseases unrelated to conditions for which claims were made earlier. Also, the auto restoration of sum insured is applicable only for a sum insured of Rs 3 lakh and above.
of age People above 45 years would be required to undergo pre-acceptance medical screening, but, the cost would be borne by the company.

WHAT ARE THE EXCLUSIONS? Conditions like cataract, hysterectomy and knee-joint treatments are excluded in the first two years, while hernia, hydrocele, piles, sinusitis and gall stone/renal stone treatments are excluded in the first year alone.

WHAT YOU SHOULD NOTE: The policy does not cover any daycare procedure. The hospitalisation limit is not applicable for 101 daycare procedures.

Additionally, the premiums also differ across different cities. The premium amount to be paid by those in Mumbai, Delhi and Gujarat is 5-8 per cent higher than those paid by people in other regions for the same level of coverage.

Any family member with one or more children could consider this policy. The auto restoration of sum insured at no additional cost may appear very attractive. But, one should remember that the cost of the auto restoration facility has been factored in while pricing the premium of the policy. Depending on the probability of the need for restoration of sum insured, one could consider this policy.

Also, the dependents who can be covered by this family policy includes only dependent children and not parents of individuals who are more prone to medical conditions and treatments due to advancing age.