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HDFC Ergo Optima Restore logo

HDFC Ergo Optima Restore

beshak-icon star
4.3/ 5
Claims Experience:
4.8
4.8/5
Customer Service:
4.6
4.6/5
Product Benefits:
4.0
3.96/5

Introduction to HDFC Ergo Optima Restore

HDFC Ergo Optima Restore is a health insurance policy offered by HDFC ERGO General Insurance Company Limited. A health insurance plan promises to pay for hospitalization expenses as well as expenses incurred before and after a hospitalization. When it comes to protecting your family's health, selecting the right health insurance plan is crucial. HDFC Ergo’s Optima Restore Plan offers various benefits, features, and a range of add-on covers that cater to your and your family’s common healthcare needs - making it a popular choice.

beshak ratings
INDIA’S FIRST UNBIASED, CONFLICT-FREE INSURANCE RATING
Verdict: HDFC Ergo Optima Restore

This plan by HDFC Ergo provides comprehensive coverage and covers a variety of expenses in addition to hospitalization and related expenses. It also has some distinct features and benefits, such as the option of automatically increasing your sum insured in accordance with the previous year’s inflation. On the flip side, however, it is more expensive than other products in the market and does not provide a monthly premium payment option. Further, as per our research, the insurer has received fewer claim settlement complaints but a higher number of policy purchase complaints.

Pros & Cons: HDFC Ergo Optima Restore

  • arrow No restrictions on the type of hospital room you choose
  • arrow Option to automatically increase the cover amount based on previous year's inflation
  • arrow Covers non-medical expenses or the cost of consumables such as gloves, oxygen masks, nebulization kits, etc.
  • arrow Received fewer complaints on claim settlement compared to other insurers
  • arrow Expensive than other products in the market
  • arrow Monthly premium payment mode not available
  • arrow Received higher number of complaints during policy purchase compared to other insurers
  • arrow Our study observed their responses on Twitter to be average in comparison to other insurers

Specific Exclusions: HDFC Ergo Optima Restore

01 Injury or illness directly or indirectly due to terrorism, nuclear emissions, war, civil war, etc.
02 Treatment related to intentional self inflicted Injury or attempted suicide by any means
03 Injury or illness due to participation or involvement in naval, military or air force operation
04 Self-detachable/removable prosthetics and other devices that do not require surgery or anaesthesia
+ Show 8 more

Special Conditions: HDFC Ergo Optima Restore

01 There is an add-on available where No Claim Bonus will not reduce for claims made, if the claim is up to Rs. 50,000

About HDFC Ergo General Insurance Company Limited

HDFC Ergo General Insurance Company Limited logo

HDFC ERGO General Insurance Company Limited is a joint venture between HDFC Ltd. and ERGO International AG. The company offers a wide range of general insurance products ranging from Motor, Health, Travel, Home, and Personal Accident in the retail space to Property, Marine, and Liability Insurance in the corporate space. It was founded in 2002 and is headquartered in Mumbai, Maharashtra. Mr. Ritesh Kumar is the company's CEO.

Founded in
2002
JV Partners
HDFC and Ergo International AG
Turnover (GWP)
945.13 Crores
Number of Policies
22,77,486
Number of Claims
11,99,047

Detailed Product Specs: HDFC Ergo Optima Restore

Claims Experience 4.8/5 star green
Customer Service 4.6/5 star green
Product Benefits (10L Sum Insured) 3.96/5 star green
Limits and Exclusions advisor
% of claims settled in less than 30 days
Reflects on the speed of settling valid claims
95.75%
% of Complaints received on overall claims
% customers unhappy with claims experience
0.08%
Claims Incurred Ratio
83.53%
Claim Settlement Ratio (No. of claims)
What % of the claims received were paid?
83.31%
No. of Cashless Hospitals
12,000+

Compare HDFC Ergo Optima Restore with top health insurance plans

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Beshak Rating
4.8
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Beshak Rating
4.5
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Beshak Rating
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Notes
  1. The health insurance data was last updated in June 2023. All data has been sourced from product brochures, policy wordings, prospectus, public disclosures (Q1, FY 2023-2024), IRDAI annual report (2021-22), insurer websites, and the IRDAI website. 
  2. For now, we have considered the most comprehensive plans from leading insurance companies. We will keep updating the product pages with new plans in the coming days.
  3. We have rated only those plans that can be serviced by individual advisors. This is because of our strong belief that health insurance customers need professional assistance from individual advisors before and after purchase. We do not recommend and hence do not rate direct-to-customer health insurance plans or plans where there aren't enough advisors available to service. 
  4. Affordability assessment of plans: 
    • The affordability of comprehensive plans is assessed using premiums for a family of two adults (30 years old) and one child (1 year old) residing in Zone 1 opting for a cover of ₹10 Lakhs. And, the premiums are as of 31st June 2023.
    • The affordability of Care Freedom Plan is assessed using premiums for a 30-year-old male residing in Zone 1 opting for a cover of ₹5 Lakhs. And, the premiums are as of 31st June 2023.
  5. The product benefits section is based on a sum insured of ₹10 Lakhs and only highlights the top benefits and features of health insurance plans. 
  6. Only those hidden and special conditions that apply to the benefits and features we have considered are included in the product pages. 
  7. The product pages only include the most significant specific exclusions under each plan.
  8. The product pages do not include any generic terms, conditions, or exclusions (those that are the same and apply to all health insurance plans).
  9. If the policy wording, brochure, or prospectus state that a benefit/feature is available with a specific plan but it is not available online when generating the premium quote, we have not considered that benefit/feature to be available with the plan.
  10. The response time on Twitter (Beta) was calculated using a sample set of tweets from April, May, and June 2022 (analyzed in August, September, and October 2022). 
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