{"uin":"HDFHLIP26055V102526","name":"Optima Restore","url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526","insurer":{"slug":"hdfc-ergo-general-insurance","name":"HDFC ERGO General Insurance Company Limited","url":"https://indiainsurances.com/insurer/hdfc-ergo-general-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":"Individual","kind":"product","status":"active","approved_on":"2020-01-14","withdrawn_on":null,"summary":"Optima Restore from HDFC ERGO is an indemnity health policy for individuals or families, with basic sum insured from Rs 3 lakh to Rs 100 lakh and cover in India only. It restores 100% of the basic sum insured once a year and adds a multiplier of 50% of the base sum insured at each renewal irrespective of claims, up to 100%.","analysis":{"state":"extracted","analysed_at":"2026-10-16 07:11:54.587735+00","note":"Every stated fact carries a verbatim quote found in the cited clause."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"not-stated","value":null,"display":null,"note":"No named plans. The schedule of benefits is printed for 'Optima Restore Individual' and 'Optima Restore Family Floater', which are cover types (individual or floater sum insured), not plans.","quote":null,"sources":[],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"cross-checked","value":"The policy is issued for 1, 2 or 3 years; sum insured and benefits apply per policy year.","display":"1, 2 or 3 years","note":null,"quote":"The policy will be issued for 1/2/3 year period, the sum insured & benefits will be applicable on Policy Year basis.","sources":[{"clause":null,"heading":"Policy Period","page":8,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/141#c-policy-period"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"cross-checked","value":"Planned hospitalisation: immediately and at least 48 hours before admission. Emergency hospitalisation: within 24 hours of admission.","display":"At least 48 hours before planned admission; within 24 hours of emergency admission","note":"For benefits that depend on an accepted in-patient claim: within 7 days of discharge. Claim documents are due within 15 days of the insurer's request or of discharge, whichever is earlier. The prospectus also asks for contact at least 7 days before an event that may give rise to a claim.","quote":"If any treatment for which a claim may be made is to be taken and that treatment requires Hospitalisation: | Immediately and in any event at least 48 hours prior to the Insured Person’s admission. ... If any treatment for which a claim may be made is to be taken and that treatment requires Hospitalisation in an Emergency: | Within 24 hours of the Insured Person’s admission to Hospital. ... For all benefits which are contingent on Our prior acceptance of a claim under Section 1)a): | Within 7 days of the Insured Person’s discharge post-hospitalisation. ... within 15 days of the earlier of Our request or the Insured Person’s discharge from Hospitalisation or completion of treatment ... Please contact HDFC ERGO General Insurance Company at least 7 days prior to an event which might give rise to a claim.","sources":[{"clause":null,"heading":"Time Interval (calculated from policy risk start date)","page":35,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-time-interval-calculated-from-policy-risk-start"},{"clause":"Section 6","heading":"General Terms & Clauses","page":16,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/141#c-section-6"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"cross-checked","value":["Claim form, duly completed and signed","Original bills, receipts and prescriptions","All medical reports, case histories, investigation reports, treatment papers and discharge summaries","A precise diagnosis of the treatment","Detailed break-up of medical services with unit prices","Prescriptions naming the insured person, with drug prices and payment receipts","Pre and post investigation, treatment and follow-up records for the present ailment","Investigation, treatment and follow-up records of past ailments since first diagnosis","Treating doctor's certificate on missing information","Settlement letter from other insurer or TPA","Stickers and invoice of implants","MLC and FIR copies for accident claims","NEFT and KYC details","Legal heir certificate"],"display":"Claim form, original bills, medical records, discharge summary, prescriptions, implant invoices, MLC/FIR for accidents, NEFT and KYC","note":null,"quote":"i) Our claim form, duly completed and signed for on behalf of the Insured Person. ... ii) Original Bills (including but not limited to pharmacy purchase bill, consultation bill, diagnostic bill) and any attachments thereto like receipts or prescriptions in support of any amount claimed which will then become Our property. ... iii) All reports and records, including but not limited to all medical reports, case histories/indoor case papers, investigation reports, treatment papers, discharge summaries. ... iv) A precise diagnosis of the treatment for which a claim is made. ... v) A detailed list of the individual medical services and treatments provided and a unit price for each (detailed break up). ... vi) Prescriptions that name the Insured Person and in the case of drugs: the drugs prescribed, their price and a receipt for payment. ... vii) All pre and post investigation, treatment and follow up (consultation) records pertaining to the present ailment for which claim is being made ... viii) All investigation, treatment and follow up records pertaining to the past ailment(s) since their first diagnoses or detection ... ix) Treating doctor’s certificate regarding missing information in case histories ... x) Copy of settlement letter from other insurance company or TPA ... xi) Stickers and invoice of implants used during surgery ... xii) Copy of MLC (Medico legal case) records and FIR (First information report), in case of claims arising out of an accident ... currently mandatory NEFT (to enable direct credit of claim amount in bank account) and KYC (recent ID/Address proof and photograph) requirements ... xiv) Legal heir certificate","sources":[{"clause":null,"heading":"Time Interval (calculated from policy risk start date)","page":35,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-time-interval-calculated-from-policy-risk-start"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"cross-checked","value":"The insurer settles or rejects a reimbursement claim within 15 days from receipt of claim intimation; delay attracts interest at 2% above the bank rate from the date of intimation.","display":"Within 15 days of claim intimation (reimbursement)","note":"Interest at 2% above the bank rate if payment is delayed. CIS: cashless pre-authorisation decision within 1 hour; final bill authorisation within 3 hours of the hospital's discharge request.","quote":"i) The Company shall (other than cashless), settle or reject a claim, as the case may be, within 15 days from the date of receipt of intimation of claims. ... In the case of delay in the payment of a claim, the Company shall be liable to pay interest to the Policyholder from the date of receipt of intimation to the date of payment of claim at a rate 2% above the Bank Rate. ... Decision on cashless authorization to be provided within 1 hour from the time of receipt of request.. ... ii) TAT for cashless final bill authorization:Within 3 hours of the receipt of discharge authorization request from the hospital.","sources":[{"clause":"1(b)(i)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-b-i"},{"clause":"1(b)(ii)","heading":null,"page":25,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-b-ii"},{"clause":"35(i)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/142#c-35-i"},{"clause":"35(ii)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/142#c-35-ii"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"cross-checked","value":["Any illness in the first 30 days (accidents excepted)","Listed diseases and procedures for 24 months","Pre-existing diseases for 36 months","Admission primarily for investigation and evaluation","Rest cure, rehabilitation and respite care","Obesity and weight control surgery not meeting the stated conditions","Cosmetic or plastic surgery","Hazardous or adventure sports as a professional","Alcoholism, drug or substance abuse","Maternity","Sterility and infertility","War or similar situations","Intentional self-injury or attempted suicide","Treatment availed outside India","Non-medical expenses in List I of Annexure I"],"display":"Waiting periods (30 days, 24 months listed illnesses, 36 months pre-existing), plus standard and policy-specific exclusions","note":"See permanent_exclusions for the full list.","quote":"Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident ... Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage ... Expenses related to the treatment of a pre-existing disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage ... Expenses related to any treatment necessitated due to participation as a professional in Hazardous or Adventure Sports ... 3. Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof: Code – Excl12 4. Obesity/ Weight Control: Code – Excl06 Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions ... 6. Cosmetic or plastic Surgery: Code – Excl08 ... 9. Investigation & Evaluation: Code – Excl04 ... Rest Cure, rehabilitation and respite care: Code – Excl05 ... Maternity: Code – Excl18 ... Sterility and Infertility: Code – Excl17 ... 1. War or similar situations ... 2. Intentional self-injury or attempted suicide. ... 5. Treatment availed outside India ... 16. Any non-medical expenses mentioned in List – I of Annexure I.","sources":[{"clause":"1(a)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-a"},{"clause":"1(a)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-a-2"},{"clause":"1(a)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-a-3"},{"clause":"Excl09","heading":"Hazardous or Adventure sports: Code – Excl09","page":21,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-excl09"},{"clause":"Excl05","heading":"Rest Cure, rehabilitation and respite care: Code – Excl05","page":23,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-excl05"},{"clause":"Excl18","heading":"Maternity: Code – Excl18","page":23,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-excl18"},{"clause":"Excl17","heading":"Sterility and Infertility: Code – Excl17","page":23,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-excl17"},{"clause":"3","heading":"Specific General exclusions","page":24,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-3-2"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"cross-checked","value":"First contact HDFC ERGO on 022 6158 2020 / 022 6234 6234 or www.hdfcergo.com. Then the Complaints & Grievance Cell (grievance@hdfcergo.com, 18002677444), then the Chief Grievance Officer (cgo@hdfcergo.com) if there is no reply within 15 days or the reply is not satisfactory.","display":"HDFC ERGO (022 6158 2020 / 022 6234 6234), then Grievance Cell (grievance@hdfcergo.com), then Chief Grievance Officer (cgo@hdfcergo.com)","note":"Senior citizen helpline 022 6158 2026 (seniorcitizen@hdfcergo.com). Complaints can also go to the Council for Insurance Ombudsmen and IRDAI Bima Bharosa.","quote":"First Point of Contact | Call us at 022 6158 2020 / 022 6234 6234/www.hdfcergo.com ... Write to The Complaints & Grievance Cell (C&G Cell) ... You can also write an email to grievance@hdfcergo.com 3. Call on 18002677444 ... If you're not satisfied with the resolution or if no response was received within 15 days, you can: 1. Write to the Chief Grievance Officer ... You can also write an email to cgo@hdfcergo.com ... Senior Citizen | seniorcitizen@hdfcergo.com | 022 6158 2026 ... lodge an online complaint through the website of Council for Insurance Ombudsmen (CIO) ... Grievance may also be lodged at IRDAI Integrated Grievance Management System","sources":[{"clause":null,"heading":"Instalment premium payment through Auto Debit/ECS Facility","page":31,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-instalment-premium-payment-through-auto-debit-ec"},{"clause":"2","heading":"You can also write an email to cgo@hdfcergo.com","page":32,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-2-4"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"cross-checked","value":"Basic sum insured of Rs 3, 5, 10, 15, 20, 25, 50 or 100 lakh, on individual or family floater basis.","display":"Rs 3, 5, 10, 15, 20, 25, 50 or 100 lakh","note":null,"quote":"Basic Sum Insured: Rs. 3Lacs; 5 Lacs; 10 Lacs; 15 Lacs; 20 Lacs; 25 Lacs; 50 Lacs; 100 Lacs on individual as well as on family floater basis. ... Basic Sum Insured per Insured Person per Policy Year (Rs. in Lakh) | 3.00 | 5.00 | 10.00 | 15.00 | 20.00, 25.00, 50.00, 100.00","sources":[{"clause":"Section 2(V)","heading":null,"page":6,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/141#c-section-2-v"},{"clause":null,"heading":"Schedule of benefits Optima Restore Individual","page":51,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-schedule-of-benefits-optima-restore-individual"}],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":"Does not apply to accidents, or if the insured person has continuous cover for more than twelve months. Applies afresh to any enhanced sum insured.","quote":"i) 30-day waiting period: Code – Excl03: ... a) Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered. ... b) This exclusion shall not, however, apply if the insured person has continuous coverage for more than twelve months. ... c) The within referred waiting period is made applicable to the enhanced sum insured in the event of granting higher sum insured subsequently.","sources":[{"clause":"1(i)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-i"},{"clause":"1(a)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-a"},{"clause":"1(b)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-b"},{"clause":"1(c)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-c"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"cross-checked","value":{"unit":"months","amount":36},"display":"36 months","note":"Applies afresh to the increased part of an enhanced sum insured; reduced by prior continuous cover under portability or migration.","quote":"a) Expenses related to the treatment of a pre-existing disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer. ... b) In case of enhancement of sum insured the exclusion shall apply afresh to the extent of sum insured increase. ... then waiting period for the same would be reduced to the extent of prior coverage.","sources":[{"clause":"1(a)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-a-3"},{"clause":"1(b)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-b-3"},{"clause":"1(c)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-c-3"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"cross-checked","value":{"unit":"months","amount":24},"display":"24 months","note":"Not applicable to claims due to an accident or where the underlying cause is cancer. If a listed condition is also pre-existing, the longer waiting period applies.","quote":"a) Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us. This exclusion shall not be applicable for claims arising due to an accident or underlying cause is cancer(s). ... c) If any of the specified disease/procedure falls under the waiting period specified for pre-existing diseases, then the longer of the two waiting periods shall apply.","sources":[{"clause":"1(a)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-a-2"},{"clause":"1(c)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-c-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"cross-checked","value":["Sinusitis","Rhinitis","Tonsillitis","Adenoidectomy","Mastoidectomy","Tonsillectomy","Tympanoplasty","Surgery for Nasal septum deviation","Surgery for Turbinate hypertrophy","Nasal concha resection","Nasal polypectomy","Cysts, polyps including breast lumps","Polycystic ovarian diseases","Fibromyoma","Adenomyosis","Endometriosis","Prolapsed Uterus","Hysterectomy","Non infective arthritis","Gout and Rheumatism","Osteoporosis","Ligament, Tendon and Meniscal tear","Prolapsed inter vertebral disk","Joint replacement surgeries","Cholelithiasis","Cholecystitis","Pancreatitis","Fissure/fistula in anus, Haemorrhoids, Pilonidal sinus","Gastro Esophageal Reflux Disorder (GERD), Ulcer and erosion of stomach and duodenum","Cirrhosis (alcoholic cirrhosis is permanently excluded)","Perineal and Perianal Abscess","Rectal Prolapse","Cholecystectomy","Surgery of hernia","Calculus diseases of Urogenital system including Kidney, ureter, bladder stones","Benign Hyperplasia of prostate","Varicocele","Surgery on prostate","Surgery for Hydrocele/Rectocele","Cataract","Retinal detachment","Glaucoma","Surgery of varicose veins and varicose ulcers","Benign tumors of non infectious etiology (cysts, nodules, polyps, lump, growth)"],"display":"ENT, gynaecological, orthopaedic, gastrointestinal, urogenital and eye conditions and surgeries listed in the policy, plus benign tumours","note":null,"quote":"Ear, Nose & Throat (ENT) | • Sinusitis • Rhinitis • Tonsillitis | • Adenoidectomy • Mastoidectomy • Tonsillectomy • Tympanoplasty • Surgery for Nasal septum deviation • Surgery for Turbinate hypertrophy • Nasal concha resection • Nasal polypectomy ... Gynaecological | • Cysts, polyps including breast lumps • Polycystic ovarian diseases • Fibromyoma • Adenomyosis • Endometriosis • Prolapsed Uterus | • Hysterectomy ... Orthopedic | • Non infective arthritis • Gout and Rheumatism • Osteoporosis • Ligament, Tendon and Meniscal tear • Prolapsed inter vertebral disk | • Joint replacement surgeries ... Gastrointestinal | • Cholelithiasis • Cholecystitis • Pancreatitis • Fissure/fistula in anus, Haemorrhoids, Pilonidal sinus • Gastro Esophageal Reflux Disorder (GERD), Ulcer and erosion of stomach and duodenum • Cirrhosis (However Alcoholic cirrhosis is permanently excluded) • Perineal and Perianal Abscess • Rectal Prolapse | • Cholecystectomy • Surgery of hernia ... Urogenital | • Calculus diseases of Urogenital system including Kidney, ureter, | • Surgery on prostate • Surgery for Hydrocele/ ... bladder stones • Benign Hyperplasia of prostate • Varicocele | Rectocele ... Eye | • Cataract • Retinal detachment • Glaucoma | • Nil ... Others | • NIL | • Surgery of varicose veins and varicose ulcers ... General (Applicable to all organ systems/organs whether or not described above) | • Benign tumors of Non infectious etiologye. eg. cysts, nodules, polyps, lump, growth, etc","sources":[{"clause":"1(f)","heading":"List of specific diseases/procedures","page":20,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-f"}],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"cross-checked","value":{"unit":"months","amount":60},"display":"60 months","note":"Applies to the first policy's sum insured; for an enhanced sum insured the sixty months run from the date of enhancement, on the enhanced part only.","quote":"After completion of sixty continuous months of coverage (including portability and migration) in health insurance policy, no policy and claim shall be contestable by the insurer on grounds of non-disclosure, misrepresentation, except on grounds of established fraud.","sources":[{"clause":"1(k)","heading":null,"page":29,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-k"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"cross-checked","value":"Yes. The whole policy can be ported to another insurer by applying at least 30 days, but not earlier than 60 days, before the renewal date, with accrued continuity benefits in waiting periods.","display":"Yes, apply 30 to 60 days before renewal; waiting-period credit carried over","note":"Migration to another HDFC ERGO product is also allowed, applying at least 30 days before renewal.","quote":"The Insured Person will have the option to port the Policy to other insurers by applying to such Insurer to port the entire policy along with all the members of the family, if any, at least 30 days before, but not earlier than 60 days from the policy renewal date as per IRDAI guidelines related to Portability. If such person is presently covered and has been continuously covered without any lapses under any health insurance policy with an Indian General/Health insurer, the proposed Insured Person will get the accrued continuity benefits in waiting periods as per IRDAI guidelines on portability. ... The Insured Person will have the option to migrate the Policy to other health insurance products/plans offered by the Company by applying for Migration of the policyatleast30 days before the policy renewal date","sources":[{"clause":"1(l)","heading":null,"page":29,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-l"},{"clause":"1(m)","heading":null,"page":29,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-m"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"cross-checked","value":true,"display":"Yes, no cover ceasing age","note":"Renewal can be refused on grounds of established fraud, non-disclosure or misrepresentation, or if the product is withdrawn.","quote":"There shall be no cover ceasing age on renewal. ... A health insurance policy shall be renewable except on grounds of established fraud or non-disclosure or misrepresentation by the insured, provided the policy is not withdrawn","sources":[{"clause":null,"heading":"Renewability","page":22,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/141#c-renewability"},{"clause":"1(e)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-e-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"cross-checked","value":"No. No loading applies at renewal based on individual claims experience. The favourable claims experience discount does depend on hospitalisation claims in the last 2 policy years.","display":"No loading for claims; the claims-experience discount falls after claims","note":"The favourable claims experience discount (up to 15% for existing buyers, 20% in year one for new buyers) falls to 9% or 0% after claims, so the premium can rise after a claim through loss of discount.","quote":"iii) No loading shall apply on renewals based on individual claims experience ... This policy is eligible for a discount on premium basis Hospitalization claims (which includes either In-patient Care or Day Care treatment) made in the last 2 policy years. ... Discount (%) applicable on premium of each policy year basis policy tenure opted | 20% | 15% | 15% ... In case of claim in both last policy year & year prior to last policy year | 0% | 0% | 0% ... In case of claim in EITHER last policy year OR year prior to last policy year | 9% | 9% | 9%","sources":[{"clause":"1(e)","heading":null,"page":27,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-e-2"},{"clause":"2(c)(vi)","heading":null,"page":40,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-2-c-vi"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"cross-checked","value":["Investigation and evaluation (Excl04)","Rest cure, rehabilitation and respite care (Excl05)","Obesity/weight control surgery not meeting the stated conditions (Excl06)","Change-of-gender treatments (Excl07)","Cosmetic or plastic surgery (Excl08)","Hazardous or adventure sports as a professional (Excl09)","Breach of law (Excl10)","Excluded providers (Excl11)","Alcoholism, drug or substance abuse (Excl12)","Health hydros, nature cure clinics, spas (Excl13)","Dietary supplements without prescription (Excl14)","Refractive error less than 7.5 dioptres (Excl15)","Unproven treatments (Excl16)","Sterility and infertility (Excl17)","Maternity (Excl18)","War or similar situations","Intentional self-injury or attempted suicide","Naval, military or air force operations","Prosthetic and other devices removable without surgery","Treatment availed outside India","Treatment at a facility which is not a Hospital or Day Care Centre","Circumcisions unless necessitated by illness or injury","Non-allopathic treatment except in-patient AYUSH cover","Conditions that could have been treated on an outpatient basis","Preventive care, vaccination and immunisation (except post-bite)","Hearing aids, spectacles, contact lenses, alopecia treatment, elastic stockings, diabetic test strips","Sleep-apnoea","External congenital diseases, defects or anomalies","Expenses incurred by the insured on organ donation","Spinal subluxation adjustments and manipulation of the skeletal structure","Non-medical expenses in List I of Annexure I","Treatment by a practitioner outside his discipline","Treatment by a practitioner who is a family member","Treatment not of a reasonable charge and not medically necessary","Drugs or treatments not supported by a prescription","Time bound or lifetime exclusions specified in the Schedule","Admission for intra-articular or intra-lesional injections, Zolendronic acid or IV immunoglobulin infusion","Dental treatment unless requiring hospitalisation","Alcoholic cirrhosis"],"display":"Standard exclusions Excl04 to Excl18 plus the policy's own specific exclusions","note":"Excl06 covers only obesity surgery that does not meet the listed BMI and medical conditions. Excluded providers are paid up to stabilisation in life-threatening situations or after an accident.","quote":"9. Investigation & Evaluation: Code – Excl04 ... Rest Cure, rehabilitation and respite care: Code – Excl05 ... 4. Obesity/ Weight Control: Code – Excl06 Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions ... 7. Change-of-Gender treatments: Code – Excl07 ... 6. Cosmetic or plastic Surgery: Code – Excl08 ... Hazardous or Adventure sports: Code – Excl09 ... 1. Breach of law: Code – Excl10 ... Excluded Providers: Code – Excl11 ... 3. Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof: Code – Excl12 ... 11. Treatments received in heath hydros, nature cure clinics, spas or similar establishments or private beds registered as a nursing home attached to such establishments or where admission is arranged wholly or partly for domestic reasons. Code – Excl13 ... 12. Dietary supplements and substances that can be purchased without prescription, including but not limited to Vitamins, minerals and organic substances unless prescribed by a medical practitioner as part of hospitalization claim or day care procedure. Code – Excl14 ... 5. Expenses related to the treatment for correction of eye sight due to refractive error less than 7.5 dioptres. Code - Excl15 ... 8. Unproven Treatments: Expenses related to any unproven treatment, services and supplies for or in connection with any treatment. Unproven treatments are treatments, procedures or supplies that lack significant medical documentation to support their effectiveness. Code – Excl16 ... Sterility and Infertility: Code – Excl17 ... Maternity: Code – Excl18 ... 1. War or similar situations- Treatment arising from or consequent upon war ... 2. Intentional self-injury or attempted suicide. 3. Any Insured Person’s participation or involvement in naval, military or air force operation. ... 4. Prosthetic and other devices which are self-detachable /removable without surgery involving anaesthesia 5. Treatment availed outside India 6. Treatment at a healthcare facility which is NOT a Hospital or Day Care Centre. 7. Circumcisions (unless necessitated by Illness or injury and forming part of treatment) 8. Any non-allopathic treatment except to the extent of coverage provided for under 'In-patient Hospitalization treatment' cover. 9. Conditions for which treatment could have been done on an outpatient basis without any Hospitalisation. 10. Preventive care, vaccination including inoculation and immunisations (except in case of post-bite treatment); ... 11. Provision or fitting of hearing aids, spectacles or contact lenses including optometric therapy, any treatment and associated expenses for alopecia, baldness, wigs, or toupees, medical supplies including elastic stockings, diabetic test strips, and similar products. 12. Sleep-apnoea 13. External congenital diseases, defects or anomalies ... 14. The expense incurred by the insured on organ donation. ... 15. Treatment and supplies for analysis and adjustments of spinal subluxation, diagnosis and treatment by manipulation of the skeletal structure ... 16. Any non-medical expenses mentioned in List – I of Annexure I. ... 17. Treatment rendered by a Medical Practitioner which is outside his discipline or the discipline for which he is licensed. ... 18. Treatments rendered by a Medical Practitioner who is a member of the Insured Person’s family or stays with him ... 19. Any treatment or part of a treatment that is not of a reasonable charge and not Medically Necessary. ... 20. Drugs or treatments which are not supported by a prescription. ... 21. Any specific time bound or lifetime exclusion(s) applied by Us and specified in the Schedule and accepted by the insured. ... 22. Admission for administration of Intra-articular or Intra-lesional injections, Supplementary medications like Zolendronic acid (Trade name Zometa, Reclast, etc) or IV immunoglobulin infusion ... 23. Dental treatment and surgery of any kind, unless requiring Hospitalisation. ... Cirrhosis (However Alcoholic cirrhosis is permanently excluded) ... However, in case of life-threatening situations or following an accident, expenses up to the stage of stabilization are payable but not the complete claim.","sources":[{"clause":"2","heading":"Standard General exclusions","page":21,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-2-3"},{"clause":"Excl09","heading":"Hazardous or Adventure sports: Code – Excl09","page":21,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-excl09"},{"clause":"Excl05","heading":"Rest Cure, rehabilitation and respite care: Code – Excl05","page":23,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-excl05"},{"clause":"Excl05(a)(ii)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-excl05-a-ii"},{"clause":"Excl18","heading":"Maternity: Code – Excl18","page":23,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-excl18"},{"clause":"Excl17","heading":"Sterility and Infertility: Code – Excl17","page":23,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-excl17"},{"clause":"Excl11","heading":"Excluded Providers: Code – Excl11","page":23,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-excl11"},{"clause":"3","heading":"Specific General exclusions","page":24,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-3-2"},{"clause":"1(f)","heading":"List of specific diseases/procedures","page":20,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-f"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"cross-checked","value":"The policyholder can cancel with 7 days' written notice and gets a pro-rata refund of premium for the unexpired policy period. No refund if any claim has been admitted or any benefit availed.","display":"Pro-rata refund for the unexpired period; none if a claim was admitted","note":"Instalment policies: after an admissible claim, no refund during the policy year. No refund if the insurer cancels for established fraud, non-disclosure or misrepresentation.","quote":"g) Cancellation The Policyholder may cancel this policy by giving 7 days’ written notice and in such an event, the Company shall refund to the Insured a pro-rata premium for the unexpired Policy Period. ... For Policies where premium is paid by instalment: In case of admissible claim under the Policy, future instalment for the current Policy Year will be adjusted in the claim amount and no refund of any premium will be applicable during the Policy Year. ... iii) Notwithstanding anything contained herein or otherwise, no refunds of premium shall be made in respect of Cancellation where any claim has been admitted or any benefit has been availed by the Insured Person under the Policy. ... There would be no refund of premium on cancellation on grounds of established fraud or non-disclosure or misrepresentation","sources":[{"clause":"1(g)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-g"},{"clause":"1(g)(iii)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-g-iii"},{"clause":"1(g)(i)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-g-i"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"cross-checked","value":"India only.","display":"India only","note":"Treatment availed outside India is excluded.","quote":"a) Geography This Policy only covers medical treatment taken within India. All payments under this Policy will only be made in Indian Rupees within India.","sources":[{"clause":"2(a)","heading":null,"page":32,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-2-a-2"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":"New individual policies only, not renewals or porting/migration. Refund is less medical examination expenses, stamp duty and proportionate risk premium for the period covered.","quote":"The Insured Person shall be allowed free look period of 30 days from date of receipt of the policy document to review the terms and conditions of the policy, and to return the same if not acceptable. ... i) a refund of the premium paid less any expenses incurred by the Company on medical examination of the Insured Person and the stamp duty charges or ... a deduction towards the proportionate risk premium for period of cover","sources":[{"clause":"1(h)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-h"},{"clause":"1(i)","heading":null,"page":28,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-i-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days (15 days for monthly instalments)","note":"Monthly instalments: 15 days.","quote":"Option 1 | Multi-Year / Yearly | 30 days ... Option 2 | Half Yearly | 30 days ... Option 3 | Quarterly | 30 days ... Option 4 | Monthly | 15 Days","sources":[{"clause":"1(b)(i)","heading":null,"page":30,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-b-i-2"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"cross-checked","value":"From 91 days to 65 years. Adult dependents: 18 to 65 years.","display":"91 days to 65 years","note":"Children aged 91 days to 5 years only if a parent is insured under the policy. From the prospectus.","quote":"a) This policy covers persons in the age group 91 days to 65 years. The maximum entry age is restricted to 65 years. The Minimum entry age for adult dependent: is 18 years and maximum entry age is 65 years. ... b) Children between 91 days and 5 years can be insured provided either parent is getting insured under this policy.","sources":[{"clause":null,"heading":"Optima Restore - Prospectus","page":1,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/141#c-optima-restore-prospectus"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"cross-checked","value":["Multi-Year / Yearly","Half Yearly","Quarterly","Monthly"],"display":"Yearly or multi-year, half-yearly, quarterly, monthly","note":"Multi-year (2 or 3 year) policies paid in advance as a single premium get a 6% or 8% discount.","quote":"If the Insured Person has opted for payment of Premium on an installment basis i.e. Half Yearly, Quarterly or Monthly ... Option 1 | Multi-Year / Yearly | 30 days ... will be entitled to receive a discount of 6% and 8% will be offered in case a Policy is purchased for 2-year and 3-year tenure respectively, provided he has paid the premium in advance as a single premium","sources":[{"clause":"1(b)","heading":null,"page":30,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-b-6"},{"clause":"1(b)(i)","heading":null,"page":30,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-b-i-2"},{"clause":null,"heading":"The above mentioned discounts are cumulative in nature and the total discount","page":34,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-the-above-mentioned-discounts-are-cumulative-in"}],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"cross-checked","value":["Unlimited Restore Benefit","Aggregate Deductible","Co-Payment","Optima Wellbeing (outpatient benefits)","ABCD Chronic Care","Limitless","Parenthood","Individual Personal Accident Rider","Protector Rider","Hospital daily cash rider","Critical Advantage rider","my:health Critical Illness"],"display":"Unlimited Restore, Aggregate Deductible, Co-Payment, plus add-ons and riders","note":"Aggregate deductible 25K/50K/1L and co-payment 10% / 20% earn premium discounts. Unlimited Restore costs 0.50% extra on the premium.","quote":"2b) Unlimited Restore Benefit (Optional Benefit) ... 2c) Aggregate Deductible (Optional Benefit) ... 2d) Co-Payment (Optional Benefit) ... • Optima Wellbeing (Add on): Covers expenses for various outpatient benefits ... • ABCD Chronic Care: Covers hospitalization expenses for Asthma, Blood pressure, Cholesterol and Diabetes ... • Limitless: Specified number of claim of infinite value shall be payable in the lifetime of the policy. ... • Parenthood: Covers Maternity Expenses, Embryo storage costs and IVF treatments ... • lndividual Personal Accident Rider ... • Protector Rider: Covers expenses which are not payable under the Base Plan as per the List of Excluded items ... • Hospital daily cash rider ... • Critical Advantage rider: covers planned treatment abroad ... • my:health Critical Illness ... • Aggregate Deductible Discount: If Aggregate Deductible is opted for all Insured Person, following discount will be applicable on the Policy premium ... • Co-payment Discount: A premium discount of 10% or 20% shall apply, if you choose to opt for a co-payment of 10% or 20% respectively. ... Premium for Unlimited Restore Benefit (Optional benefit) : 0.50% will be applied on the Final Policy Premium","sources":[{"clause":null,"heading":"Schedule of benefits Optima Restore Individual","page":51,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-schedule-of-benefits-optima-restore-individual"},{"clause":"Section 6(v)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/141#c-section-6-v"},{"clause":null,"heading":"Optima Restore - Gross Premium - Tier 6 (Rest of India)","page":58,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/141#c-optima-restore-gross-premium-tier-6-rest-of-indi-2"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"cross-checked","value":"Yes if the premium is paid in instalments; with non-instalment payment there is no cover for the period for which no premium is received.","display":"Covered for instalment premiums only","note":null,"quote":"ii) If premium is paid in instalments then coverage will be available during the grace period also. ... Provided the insurers shall offer coverage during the grace period, if the premium is paid in instalments during the policy period (Note: In case of non-instalment premium payment, coverage shall not be available for the period for which no premium is received).","sources":[{"clause":"1(b)(ii)","heading":null,"page":30,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-b-ii-2"},{"clause":"Def. 18","heading":"Grace Period","page":5,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-def-18"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for the hospital room, or the room category allowed. If you take a costlier room, other bills can be cut in proportion.","status":"cross-checked","value":"No separate room rent limit is printed; hospital room rent or boarding is part of in-patient treatment, covered up to the sum insured.","display":"No room rent sub-limit; covered up to the sum insured","note":"A daily cash of Rs.800 per day, maximum Rs.4,800 (Rs.1000 per day, maximum Rs.6,000 for 20 lakh and above) is paid for choosing shared accommodation in a network hospital when the stay exceeds 48 hours.","quote":"a. In-patient Treatment. This includes • Hospital room rent or boarding; ... 1a) In-patient Treatment | Covered upto sum insured ... if the Insured Person is hospitalised in Shared Accommodation in a Network Hospital for each continuous and completed period of 24 hours if the Hospitalisation exceeds 48 hours ... 1h) Daily Cash for choosing Shared Accommodation | Rs.800 per day, Maximum Rs.4,800 ... Rs.1000 per day, Maximum Rs.6,000","sources":[{"clause":"1","heading":"In-patient Benefits","page":11,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-2"},{"clause":null,"heading":"Optima Restore Individual","page":30,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/141#c-optima-restore-individual"},{"clause":null,"heading":"Schedule of benefits Optima Restore Individual","page":51,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-schedule-of-benefits-optima-restore-individual"}],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"not-stated","value":null,"display":null,"note":"No room type limit is printed. The policy pays a daily cash allowance if shared accommodation is chosen in a network hospital.","quote":null,"sources":[],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"cross-checked","value":"No separate ICU limit is printed; intensive care unit charges are part of in-patient treatment, covered up to the sum insured.","display":"No ICU sub-limit; covered up to the sum insured","note":null,"quote":"a. In-patient Treatment. This includes • Hospital room rent or boarding; • Nursing; • Intensive Care Unit ... 1a) In-patient Treatment | Covered upto sum insured","sources":[{"clause":"1","heading":"In-patient Benefits","page":11,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-2"},{"clause":null,"heading":"Optima Restore Individual","page":30,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/141#c-optima-restore-individual"}],"law":[]},{"key":"proportionate_deduction","label":"Proportionate deduction","section":"Limits and co-pay","meaning":"If you choose a room above your limit, whether the insurer reduces associated charges (doctor fees, tests, procedures) by the same proportion.","status":"not-stated","value":null,"display":null,"note":"No proportionate deduction clause is printed; the documents set no room rent limit.","quote":null,"sources":[],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"cross-checked","value":"None unless the optional co-payment (10% or 20%) is chosen. No co-payment applies when a person from a lower-tier city is treated in a higher tier.","display":"None unless opted","note":"Optional co-payment of 10% or 20% on all eligible claims, with a matching premium discount; once opted it cannot be removed.","quote":"d. Co-Payment (Optional benefit) ... I. If opted and mentioned on the Policy Schedule that a Co-payment is effective ... 2d) Co-Payment (Optional Benefit) | 10% / 20% ... No co-payment shall apply if Insured Person from a lower tier avails a treatment in higher tier. ... III. This benefit once opted, cannot be opted out at any time during the Policy Year or at subsequent Renewals. ... • Co-payment Discount: A premium discount of 10% or 20% shall apply, if you choose to opt for a co-payment of 10% or 20% respectively.","sources":[{"clause":"2(V)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-2-v"},{"clause":null,"heading":"Schedule of benefits Optima Restore Individual","page":51,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-schedule-of-benefits-optima-restore-individual"},{"clause":"2(f)","heading":"Tier 6","page":32,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-2-f"},{"clause":"Section 6(v)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/141#c-section-6-v"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"An amount of each claim or each year that you bear before the policy pays.","status":"cross-checked","value":"None unless the optional aggregate deductible is chosen (25K, 50K or 1L per policy year).","display":"None unless opted","note":"Optional aggregate deductible per policy year, per insured person (individual) or per policy (floater); once opted it cannot be removed or reduced.","quote":"2c) Aggregate Deductible (Optional Benefit) | 25K/50K/1L ... I) This Cover is applicable on annual aggregate basis and can be opted only at inception of the Policy or at subsequent Renewals. ... II) Once the Aggregate Deductible option is opted by the Insured Person, it cannot be opted out or reduced at any time during the Policy Year or at subsequent Renewals. ... the entire amount of Aggregate Deductible must first be exhausted on per Insured Person basis ... the entire amount of Aggregate Deductible must first be exhausted by any one or more of the Insured Persons","sources":[{"clause":null,"heading":"Schedule of benefits Optima Restore Individual","page":51,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-schedule-of-benefits-optima-restore-individual"},{"clause":"2(I)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-2-i"},{"clause":"2(II)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-2-ii"},{"clause":"2(III)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-2-iii"},{"clause":"2(IV)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-2-iv"}],"law":[]},{"key":"disease_sublimits","label":"Disease or procedure sub-limits","section":"Limits and co-pay","meaning":"Caps on what is paid for named treatments (cataract, knee replacement...), even if the sum insured is higher.","status":"cross-checked","value":["None for named diseases or procedures"],"display":"None for named diseases or procedures","note":"The CIS list of financial limits, headed 'for the following diseases/ procedures', names only road ambulance, daily cash, health check-up and the optional deductible and co-payment; no named disease or procedure has a cap. In-patient and day care treatment are covered up to the sum insured.","quote":"The policy will pay only up to the limits specified here under for the following diseases/ procedures: Base Cover (limits basis plan/sum insured chosen): 1. Road Ambulance : Up to 2K 2. Daily Cash for choosing Shared Accommodation : Upto Rs 800/1K per day up to 4.8/6K per day 3. Preventive Health Checkup: • Individual (Per Insured) : Upto Rs 1.5/2/4/5K • Floater(Per Policy): Upto Rs 2.5/5/8/10K 4. Aggregate Deductible (Optional Cover) : 25k/50k/100k 5. Co-Payment (Optional cover): 10% / 20%","sources":[{"clause":"35","heading":"Expenses towards miscarriage (unless due to an","page":6,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/142#c-35"}],"law":[]},{"key":"pre_hospitalisation","label":"Pre-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days before admission that are paid if related to the hospitalisation.","status":"cross-checked","value":{"unit":"days","amount":60},"display":"60 days","note":null,"quote":"b. Pre-Hospitalisation expenses for consultations, investigations and medicines incurred upto 60 days before the date of admission to the hospital (In-patient OR Day Care OR Domiciliary treatment).","sources":[{"clause":"1","heading":"In-patient Benefits","page":11,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-2"}],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days after discharge that are paid if related to the hospitalisation.","status":"cross-checked","value":{"unit":"days","amount":180},"display":"180 days","note":null,"quote":"1c) Post- Hospitalization | Covered, upto 180 Days","sources":[{"clause":null,"heading":"Schedule of benefits Optima Restore Individual","page":51,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-schedule-of-benefits-optima-restore-individual"}],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital (chemotherapy, dialysis, cataract) and whether all or only listed ones are covered.","status":"cross-checked","value":"Day care procedures under general or local anaesthesia needing less than 24 hours' admission are covered up to the sum insured; treatment usually taken as an outpatient is not covered.","display":"Covered up to the sum insured","note":"No fixed list of day care procedures is printed.","quote":"d. Day Care Procedures Medical treatment or surgical procedure which is undertaken under general or local anaesthesia, which require admission in a Hospital/Day Care Centre for stay less than 24 hours. ... i) Treatment that can be and is usually taken on an out-patient basis is not covered. ... 1d) Day Care Procedures | Covered upto sum insured","sources":[{"clause":"1","heading":"In-patient Benefits","page":11,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-2"},{"clause":null,"heading":"Optima Restore Individual","page":30,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/141#c-optima-restore-individual"}],"law":[]},{"key":"domiciliary","label":"Treatment at home","section":"Cover","meaning":"Whether treatment at home is covered when hospital admission is not possible or a doctor advises it.","status":"cross-checked","value":"Covered up to the sum insured when the patient cannot be moved to hospital or no hospital room is available; treatment of less than 3 days is not covered.","display":"Covered up to the sum insured","note":"Pre and post hospitalisation expenses (60 and 180 days) also apply.","quote":"e. Domiciliary Treatment Medical treatment for an Illness/disease/injury which in the normal course would require care and treatment at a Hospital but is actually taken while confined at home under any of the following circumstances: i. The condition of the patient is such that he/she is not in a condition to be removed to a Hospital or, ii. The patient takes treatment at home on account of non availability of room in a Hospital. ... i) Treatment of less than 3 days ... 1e) Domiciliary Treatment | Covered upto sum insured ... Pre and Post Hospitalisation expenses for consultations, investigations and medicines incurred upto 60 days before hospitalisation and 180 days after hospitalization respectively will be covered in case of domiciliary treatment.","sources":[{"clause":"1","heading":"In-patient Benefits","page":11,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-2"},{"clause":null,"heading":"Optima Restore Individual","page":30,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/141#c-optima-restore-individual"}],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"cross-checked","value":"In-patient AYUSH treatment in an AYUSH Hospital is covered under in-patient treatment, with no separate limit printed; other AYUSH expenses are not covered.","display":"In-patient AYUSH covered within the sum insured","note":null,"quote":"Note pertaining specifically to AYUSH Treatments only: Medical expenses pertaining only to In-patient care AYUSH treatment are also covered under 'In-patient treatment' cover if undertaken in an AYUSH Hospital. Any medical expense other than In-patient care AYUSH treatment expenses are not covered under this policy.","sources":[{"clause":"1","heading":"In-patient Benefits","page":11,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-2"}],"law":[{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 1","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 2","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 1","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II A.I(1)","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"modern_treatments","label":"Modern treatments","section":"Cover","meaning":"Robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and the like, and any cap on them.","status":"not-stated","value":null,"display":null,"note":"Robotic surgery, immunotherapy, stem cell therapy and similar treatments are not mentioned. Admission for intra-articular or intra-lesional injections, Zolendronic acid or IV immunoglobulin infusion is excluded.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 2","url":"https://indiainsurances.com/law/irdai-health-mc-2024"}]},{"key":"organ_donor","label":"Organ donor expenses","section":"Cover","meaning":"Whether the donor's hospital costs for an organ transplant are paid.","status":"cross-checked","value":"Yes. The donor's medical and surgical expenses for harvesting the organ are paid where the insured person is the recipient, up to the sum insured; the donor's pre and post hospitalisation expenses are not covered.","display":"Yes, donor's harvesting costs covered","note":"The claim must be admissible under in-patient treatment and comply with the Transplantation of Human Organs Act, 1994.","quote":"f. Organ Donor: Medical and surgical Expenses of the organ donor for harvesting the organ where an Insured Person is the recipient. ... iii) The organ donor’s Pre and Post-Hospitalisation expenses. ... 1f) Organ Donor | Covered upto sum insured ... ii) Admission not compliant under the Transplantation of Human Organs Act, 1994 (as amended).","sources":[{"clause":"1","heading":"In-patient Benefits","page":11,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-2"},{"clause":null,"heading":"Optima Restore Individual","page":30,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/141#c-optima-restore-individual"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"cross-checked","value":"Road ambulance up to Rs. 2,000 per hospitalisation in an emergency. Emergency air ambulance: actual expenses or Rs. 2.5 lacs per hospitalisation, whichever is lower, within India.","display":"Road: up to Rs. 2,000 per hospitalisation; air: up to Rs. 2.5 lacs per hospitalisation","note":"Air ambulance is not covered for 3 and 5 lakh sum insured; it is covered from 10 lakh. Air ambulance is limited to India and the basic sum insured for a year; return transport is excluded.","quote":"g. Ambulance Cover Expenses incurred on transportation of Insured Person to a Hospital for treatment in case of an Emergency, subject to Rs. 2000 per Hospitalisation. ... J(1) The amount payable in case of Air ambulance facility shall be either the actual expenses or Rs. 2.5 Lacs per hospitalisation, ... 1j) Emergency Air Ambulance Cover | Not Covered | Not Covered | Covered | Covered | Covered ... The insured person is in India and the treatment is required in India only ... whichever is lower; upto basic sum insured limit for a year. ... ii) Expenses incurred in return transportation to the insured’s home by air ambulance is excluded.","sources":[{"clause":"1","heading":"In-patient Benefits","page":11,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-2"},{"clause":null,"heading":"Schedule of benefits Optima Restore Individual","page":51,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-schedule-of-benefits-optima-restore-individual"}],"law":[]},{"key":"restoration","label":"Restoration of sum insured","section":"Cover","meaning":"Whether the sum insured is refilled after it is used up in a year, how much, how often, and whether it works for the same illness.","status":"cross-checked","value":"Yes. 100% of the basic sum insured is added once a policy year on complete or partial use of the sum insured and multiplier benefit; it is available for all claims of all insured persons, but a single claim cannot exceed basic sum insured plus multiplier. Unused restored amount expires.","display":"100% of basic sum insured, once a year","note":"The optional Unlimited Restore Benefit adds 100% of basic sum insured unlimited times in a policy year. No restriction to a different illness is printed.","quote":"a) Restore Benefit Instant addition of 100% Basic Sum Insured on complete or partial utilization of Your existing Policy Sum Insured and Multiplier Benefit (if applicable) during the Policy Year. The Total amount (Basic sum insured, Multiplier benefit and Restore sum insured) will be available to all Insured Persons for all claims under In-patient Benefit during the current Policy Year and subject to the condition that single claim in a Policy Year cannot exceed the sum of Basic Sum Insured and the Multiplier Benefit (if applicable). ... i) The Basic Sum Insured will be restored only once in a Policy Year. ... ii) If the Restored Sum Insured is not utilized in a Policy Year, it will expire. ... This optional cover will trigger unlimited times and is available for all subsequent claims in a Policy Year.","sources":[{"clause":"2(a)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-2-a"},{"clause":"2(b)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-2-b"}],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"cross-checked","value":"Multiplier Benefit: 50% of the base sum insured is added at each renewal without a break, irrespective of claims, up to a maximum of 100% of the basic sum insured.","display":"50% of base sum insured per renewal, up to 100%, irrespective of claims","note":"Not reduced after a claim. In multi-year policies it is applied after each policy year.","quote":"On Renewal of this Policy with the Company without a break, a sum equal to 50% of the Base Sum Insured of the expiring Policy shall be provided as multiplier benefit irrespective of any claims ... a) The maximum multiplier bonus will not exceed 100% of the Basic Sum Insured in any Policy Year. ... g) In policies with a 2 years or 3 years Policy Period, the application of above guidelines of Multiplier Benefit shall be post completion of each policy year.","sources":[{"clause":"4","heading":"Multiplier Benefit","page":18,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-4"}],"law":[]},{"key":"consumables","label":"Consumables and non-medical items","section":"Cover","meaning":"Gloves, PPE, syringes and other items hospitals bill that standard policies exclude; whether this policy pays them.","status":"cross-checked","value":"Non-payable items in List I of Annexure I (for example gloves and masks) are excluded; the Protector Rider add-on covers such excluded items.","display":"Not covered (List I items); covered with the Protector Rider","note":"In-patient treatment includes medicines, drugs & consumables; items in Lists II to IV are paid if within the scope of cover.","quote":"16. Any non-medical expenses mentioned in List – I of Annexure I. ... List I - Items for which coverage is not available in the policy ... GLOVES ... MASK ... • Protector Rider: Covers expenses which are not payable under the Base Plan as per the List of Excluded items released by IRDA ... • Medicines, drugs & consumables; ... Items mentioned under List II, List III and List IV are allowed if these are within the scope of coverage","sources":[{"clause":"3","heading":"Specific General exclusions","page":24,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-3-2"},{"clause":"Annexure I","heading":null,"page":47,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-annexure-i"},{"clause":null,"heading":"Schedule of benefits Optima Restore Individual","page":51,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-schedule-of-benefits-optima-restore-individual"},{"clause":"1","heading":"In-patient Benefits","page":11,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-2"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"cross-checked","value":"Not covered; childbirth and lawful termination of pregnancy are excluded (Excl18), except ectopic pregnancy.","display":"Not covered (Excl18)","note":"The Parenthood add-on covers maternity expenses after a waiting period of 2 years.","quote":"Maternity: Code – Excl18 ... i) Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; ... ii) Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period. ... • Parenthood: Covers Maternity Expenses, Embryo storage costs and IVF treatments post waiting period of 2 years.","sources":[{"clause":"Excl18","heading":"Maternity: Code – Excl18","page":23,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-excl18"},{"clause":null,"heading":"Schedule of benefits Optima Restore Individual","page":51,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-schedule-of-benefits-optima-restore-individual"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"not-stated","value":null,"display":null,"note":"No newborn cover is printed. Children can be insured from 91 days of age; maternity is excluded.","quote":null,"sources":[],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"not-stated","value":null,"display":null,"note":"Mental illness is not mentioned in the documents.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"cross-checked","value":"Yes, from 5 lakh sum insured. Individual: Rs.1,500 per person once every 2 continuous policy years (5 lakh); Rs.2,000 (10 lakh), Rs.4,000 (15 lakh) or Rs. 5,000 (20 lakh and above) per person every year at renewal. Not available at 3 lakh.","display":"Yes, Rs.1,500 to Rs. 5,000 per person depending on sum insured","note":"Family floater: Rs.2,500 / 5,000 / 8,000 / 10,000 per policy. Does not carry forward if not claimed.","quote":"Plan | 3 Lacs | 5 Lacs | 10 Lacs | 15 Lacs | 20,25,50, 100 Lacs ... Optima Restore Individual | Not Applicable | Upto a maximum of Rs.1,500 per insured person, only once at the end of a block of every continuous two Policy Years. | Upto a maximum of Rs.2,000 per insured person at the end of each year at renewal. | Upto a maximum of Rs.4,000 per insured person, at the end of each year at renewal | Upto Maximum of Rs. 5,000 per Insured Person, at the end of each year at renewal ... Optima Restore Family | Not Applicable | Upto a maximum of Rs.2,500 per policy, only once at the end of a block of every continuous two Policy Years. | Upto a maximum of Rs.5,000 per policy at the end of each year at renewal | Upto a maximum of Rs.8,000 per policy, at the end of each year at renewal. | Upto Maximum of Rs. 10,000 per policy, at the end of each year at renewal. ... Basic Sum Insured per Insured Person per Policy Year (Rs. in Lakh) | 3.00 | 5.00 | 10.00 | 15.00 | 20.00, 25.00, 50.00, 100.00 ... 3) Preventive Health Checkup (per person) | Not Applicable | Upto Rs 1500 | Upto Rs. 2000 | Upto Rs. 4000 | Upto Rs. 5000 ... IMPORTANT: This benefit does NOT carry forward if it is not claimed","sources":[{"clause":"3(a)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-3-a"},{"clause":null,"heading":"Schedule of benefits Optima Restore Individual","page":51,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-schedule-of-benefits-optima-restore-individual"}],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"cross-checked","value":"Not covered in the base policy; conditions treatable on an outpatient basis are excluded. The Optima Wellbeing add-on covers outpatient benefits.","display":"Not covered (available with Optima Wellbeing add-on)","note":null,"quote":"9. Conditions for which treatment could have been done on an outpatient basis without any Hospitalisation. ... • Optima Wellbeing (Add on): Covers expenses for various outpatient benefits","sources":[{"clause":"3","heading":"Specific General exclusions","page":24,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-3-2"},{"clause":null,"heading":"Schedule of benefits Optima Restore Individual","page":51,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-schedule-of-benefits-optima-restore-individual"}],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"cross-checked","value":"Yes. Premium is based on the city of residence, in Tier 1 to Tier 6 zones. No co-payment applies when a person from a lower tier is treated in a higher tier.","display":"Premium by city tier; no co-payment for treatment in a higher tier","note":null,"quote":"For the purpose of policy issuance, the premium will be computed basis the city of residence provided by the insured person in the proposal form. ... a) Tier 1: Delhi, Surat, Gurugram, Faridabad, Ghaziabad, Greater Noida. ... f) Tier 6: Rest of India. ... No co-payment shall apply if Insured Person from a lower tier avails a treatment in higher tier.","sources":[{"clause":"2(a)","heading":null,"page":32,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-2-a-2"},{"clause":"2(a)","heading":"Tier 1","page":32,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-2-a-3"},{"clause":"2(f)","heading":"Tier 6","page":32,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-2-f"}],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"cross-checked","value":"Yes, at network hospitals, with notice at least 48 hours before planned treatment or within 24 hours after emergency hospitalisation.","display":"Yes, at network hospitals","note":null,"quote":"vii) Cashless service: If any treatment, consultation or procedure for which a claim may be made is to be taken at a Network Hospital, then We will provide a cashless service by making payment to the extent of Our liability direct to the Network Hospital as long as We are given notice that the Insured Person wishes to take advantage of a cashless service accompanied by full particulars at least 48 hours before any planned treatment or Hospitalisation or within 24 hours after Hospitalisation in the case of an emergency.","sources":[{"clause":"1(b)(vii)","heading":"Cashless service","page":26,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-1-b-vii"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"cross-checked","value":"The insurer itself, HDFC ERGO General Insurance Company Limited.","display":"HDFC ERGO (in-house)","note":"The policy wording defines a TPA as the administrator appointed by the insurer as specified in the Schedule.","quote":"HDFC ERGO General Insurance Company Limited will process all claims under this policy. ... TPA means the third party administrator that We appoint from time to time as specified in the Schedule.","sources":[{"clause":"Section 6","heading":"General Terms & Clauses","page":16,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/141#c-section-6"},{"clause":"Def. 22","heading":"TPA","page":10,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140#c-def-22-2"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"cross-checked","value":true,"display":"Yes","note":"Up to 2 adults and 5 children on a floater.","quote":"f) The policy offers option of covering on individual sum insured basis and on family floater basis. ... h) In a family floater policy, a maximum of 2 adults and a maximum of 5 children can be included in a single policy.","sources":[{"clause":null,"heading":"Optima Restore - Prospectus","page":1,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/141#c-optima-restore-prospectus"}],"law":[]}],"documents":[{"kind":"wording","label":"Optima Restore (for policies with period of Insurance starting 03-March- 2026 onwards.)","pages":53,"fetched_at":"2026-10-16 07:11:38.645533+00","source_url":"https://customer-portal-assets.hdfcergo.com/documents/PolicyWordings_OptimaRestore-811520192624.pdf","url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/140"},{"kind":"prospectus","label":"Optima Restore","pages":70,"fetched_at":"2026-10-16 07:11:38.645533+00","source_url":"https://customer-portal-assets.hdfcergo.com/documents/Prospectus_OptimaRestore-835159031432.pdf","url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/141"},{"kind":"cis","label":"Optima Restore","pages":12,"fetched_at":"2026-10-16 07:11:38.645533+00","source_url":"https://customer-portal-assets.hdfcergo.com/documents/CIS_Website_OptimaRestore-207342910205.pdf","url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526/document/142"}],"versions":[{"uin":"APOHLIP20106V051920","version":null,"approved_on":null},{"uin":"HDFHLIP26055V102526","version":null,"approved_on":null}],"where_to_buy":[],"claims_and_complaints":[],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"Optima Restore (UIN HDFHLIP26055V102526), IndiaInsurances, https://indiainsurances.com/policy/hdfc-ergo-general-insurance/optima-restore-hdfhlip26055v102526"}