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HDFC ERGO
Optima Restore
The plan that doubles itself - the Multiplier adds 50% of your Sum Insured every year, claim or no claim, up to double the base; any hospital room is paid with no rent cap, and post-hospitalisation care runs 180 days.
PLAN SELECTION
1 plan available with 8 sum insured options
What you should know first
Where this plan is strong, where to watch - and how it performs on what matters most.
At a glance
5 strong5 to watch
What's strong
- Room rent uncapped - any room is paid to your Sum Insured, with no proportionate deduction.
- Multiplier Benefit adds 50% a year to 100%, claim or not - a ₹10 lakh cover reaches ₹20 lakh in two years.
- Post-hospitalisation runs 180 days with no separate cap, against the 60 or 90 days most policies give.
- Domiciliary treatment paid to your Sum Insured with no disease shut out - it must run past three days.
- Restoration triggers on partial use of your Sum Insured, not only full exhaustion - 100% of the Basic Sum Insured comes back, once a policy year.
What to watch
- One bill is capped at Sum Insured plus Multiplier - a ₹7 lakh claim on ₹5 lakh cover leaves ₹2 lakh to you.
- IRDAI List I consumables are not paid without the Protector Rider - about ₹40,000 on a ₹4 lakh bill.
- A baby has no cover for its first 90 days - neonatal intensive care is paid from your own pocket.
- Road ambulance pays ₹2,000 per hospitalisation, the same cap on a ₹1 crore cover.
- No modern treatment clause - robotic surgery is paid as in-patient care, with no cap but no express promise.
What Matters Most
FeatureKey DetailOur Verdict
Strong
Strong
Standard
Standard
Strong
Strong
Standard
Standard
Standard
Standard
Not covered
Not covered
Next
You’ve read the shape of this cover. Now put a real bill through it.
Policy Features Breakdown
Filter by the worry on your mind to see how this plan handles each concern - its sub-limits, waiting periods and the catches.
What are you worried about?
All Policy Features41 features
StrongCommonly Missed
There is no room rent cap. Hospital room and boarding sit inside the in-patient benefit and are paid up to your Sum Insured, with no room category and no daily rupee ceiling. Because there is no cap, the wording carries no proportionate deduction clause, so picking a costlier room does not cut what is paid on the rest of your bill.
Coverage detailstap any row to understand it
Watch out
The stay has to be a hospital admission of at least 24 hours to count as hospitalisation, unless it is a day care procedure. Room rent is defined here to include associated medical expenses, so those charges are paid from the same Sum Insured.
StandardCommonly Missed
A condition you already have when the policy starts is not covered for the first 36 months of continuous cover. The clock runs from your first policy with this insurer, not from each renewal.
Coverage detailstap any row to understand it
Watch out
After 36 months, only a condition you declare when applying and the insurer accepts is paid. Nothing in either document sells an option to shorten this wait.
Strong
ICU has no separate cap. Intensive Care Unit charges are listed inside the in-patient benefit and are paid up to your Sum Insured, with no per-day limit and no percentage ceiling. A long stay in intensive care is limited only by the cover you bought.
Coverage detailstap any row to understand it
Watch out
ICU days do not earn the daily cash benefit for shared accommodation, because that benefit excludes time spent in an intensive care unit. Nothing is set aside for ICU either, so a long stay can use up the whole Sum Insured.
StandardCommonly Missed
If a claim uses up part or all of your cover, the policy adds back 100% of the Basic Sum Insured at once. That money pays your later hospital stays in the same year, and it refills once a year. One single bill is still never paid more than the Basic Sum Insured plus the Multiplier Benefit.
Coverage detailstap any row to understand it
The catch
One claim is never paid more than the Basic Sum Insured plus the Multiplier Benefit. In the insurer's own illustration on a ₹5 Lakh cover, a fourth claim of ₹7,00,000 is settled at ₹5,00,000 and you pay the remaining ₹2,00,000 from your own pocket.
Standard
Every year you renew without a break, the policy adds 50% of the Base Sum Insured as Multiplier Benefit, whether you claimed that year or not. It stops growing at 100% of the Basic Sum Insured, so a ₹10 Lakh cover reaches ₹20 Lakh in two years and stays there.
Coverage detailstap any row to understand it
Watch out
The accrued Multiplier Benefit carries forward only if there is no break in the policy. On a ₹10 Lakh cover that can mean losing up to ₹10 Lakh of extra cover, and you start again from the Basic Sum Insured.
Not covered
This policy has no extra pool of cover sitting above your Sum Insured. A single claim is paid at most the Basic Sum Insured plus the accrued Multiplier Benefit, and the Restore Benefit only brings cover back for later claims. The paid Limitless add-on is the only route to a claim above that ceiling.
Coverage detailstap any row to understand it
Watch out
The Multiplier Benefit does raise what one claim can be paid, but only by the amount you have actually accrued, and it is spent before the Restore Benefit is touched.
Specific Illness Waiting Periods
These conditions are covered after a waiting period - not excluded. Once the wait is over, they're treated like any other illness. Select a body region, or view the entire body, to see which ones this plan names.
How long you wait, for what
Accidents
Day 1Covered from the first day, with no waiting at all.
Illness, in general
30 daysAfter the first month, ordinary illness is covered.
The listed conditions
24 monthsEach one is then covered, like any other illness.
What you already had
36 monthsConditions you declared when you bought the plan.
Nothing more to prove
60 monthsAfter this, only proven fraud can be held against a claim.
Already diagnosed with one of these? A different rule applies - conditions you already have follow the pre-existing waiting period. See how that works
Entire Body
39 ConditionsWaiting Period: 24 months
Eyes, ENT & Thyroid
Otitis Media and Mastoiditis
Middle ear infection
Head & Face
An infection inside or just behind the ear that causes pain.
The exact words
“Mastoidectomy”
Section C.1.ii(f) · pages 20–21
Tympanic Membrane Perforation
Ruptured Eardrum
Head & Face
A hole or tear in the eardrum that can cause hearing loss or infection.
The exact words
“Tympanoplasty”
Section C.1.ii(f) · pages 20–21
Deviated Nasal Septum
Bent nose bone problem
Head & Face
A bent bone inside the nose that makes breathing difficult.
The exact words
“Surgery for Nasal septum deviation”
Section C.1.ii(f) · pages 20–21
Sinusitis and Rhinitis
Sinus and nasal allergy
Head & Face
Swelling inside the nose and face bones causing blockage or pain.
The exact words
“Sinusitis”
“Rhinitis”
“Surgery for Turbinate hypertrophy”
“Nasal concha resection”
“Nasal polypectomy”
Section C.1.ii(f) · pages 20–21
Tonsillitis and Adenoiditis
Tonsil and throat swelling
Head & Face
Swollen throat glands that cause pain and trouble swallowing.
The exact words
“Tonsillitis”
“Adenoidectomy”
“Tonsillectomy”
Section C.1.ii(f) · pages 20–21
Policy Exclusions
What this plan won’t pay for
We read all 45 exclusion clauses in this policy. 22 clauses change what you’d actually claim.
Never paid
13 clausesNo waiting period reaches these - the plan does not cover them at all.
Paid, but only if…
9 clausesWritten as exclusions, but the policy states a way in. The condition is the whole point.
Premium discounts
Ways to pay less
Every discount printed in this policy’s own documents - what it’s worth, who qualifies, and what it asks in return.
Just for qualifying
7 discountsNothing is given up in return - you either meet the condition or you don't.
Policy discount
5%
About the provider
HDFC ERGO
Filed plan · UIN HDFHLIP26055V102526
Comparisons· 10 pairs
Put it next to another plan
Optima Restore beside each of the other plans on the shelf: every clause that differs, read from the policy wording.
Sources
Everything on this page is read from the insurer’s own filings. It is an educational summary - not advice, not a recommendation to buy, and we sell nothing.
Plan facts last updated 2 Sept 2026.
IRDAI UIN: HDFHLIP26055V102526