Common use of Reinstatement of Sum Insured Clause in Contracts

Reinstatement of Sum Insured. a) If a Claim is payable under the Policy, then the Company agrees to make the re-instatement of the Sum Insured for all Insured Members once for that Cover Period, provided that: i. The Reinstated amount shall be utilized only after the Sum Insured has been completely exhausted in that Cover Period. ii. Reinstatement of Sum Insured is applicable only for Benefit 2.1.1, Benefit 2.1.2, Benefit 2.1. 3 and Benefit 2.1.4 iii. The Reinstated amount shall be available only for all future Claims and not in relation to any Illness or Injury for which a Claim has already been admitted for that Insured Member during that Cover Period. iv. The total amount of Reinstatement shall not exceed the Sum Insured for that Cover Period. v. Any unutilized Reinstated amount cannot be carried forward to any subsequent Cover Period. vi. If the Policy is issued on a Floater basis, then the Reinstatement will also be available only on Floater basis. vii. For any single Claim during a Policy Year the maximum Claim amount payable shall be the Sum Insured. viii. During the Cover Period, the aggregate Claim amount payable under Benefit 1 (Hospitalization Expenses) subject to admissibility of the Claim, shall not exceed the sum of: I The Sum Insured under Hospitalization Expenses II Reinstatement of Sum Insured ix. The balance of the Reinstated amount shall be available during the Cover Period till it is exhausted completely. i. ‘Reinstatement of Sum Insured’ benefit can be taken by Policyholder/ Insured member either: • at the inception of Policy or at the time of Renewal on payment of additional premium; or • can be availed once the sum insured is exhausted during the Cover Period (pro-rated premium will be charged based on the remaining cover period). This additional premium should be received by the company within 15 days of exhaustion of Sum Insured under Benefit 1 (Hospitalization Expenses) for any future claim to be payable.