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Last updated on: September 19, 2025
The HDFC Ergo Optima Restore Plan and ICICI Lombard Health AdvantEdge Elevate Plan are popular health insurance policies offering comprehensive coverage but differ in some key aspects. The Optima Restore Plan stands out with its unique “restore benefit,” which automatically reinstates the sum insured if exhausted due to claims, and offers options for no-claim bonus and worldwide emergency coverage. In contrast, the Elevate Plan by ICICI Lombard provides higher annual sum insured options, extensive add-ons, OPD coverage, and access to global healthcare, making it suitable for those seeking wider benefits and coverage flexibility. Both plans offer cashless hospitalization, pre- and post-hospitalization coverage, and wellness programs, but Optima Restore is ideal for those prioritizing automatic sum insured restoration, while Elevate Plan is better for those desiring broader international and domestic coverage with customizable features.
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By 2025, health insurance will not be a safety net, but a necessity of every Indian family. It is not an easy task choosing the right insurance plan with increasing healthcare expenses and advancing healthcare demands. This paper presents a comparative analysis of two commonly used plans, HDFC Ergo optima restore plan. and ICICI Lombard Elevate Plan, made by a human. At the end, you will realize which policy is more suitable to your family needs and budget.
Both HDFC Ergo optima restore and ICICI Lombard Elevate are individual/family oriented health insurance policies. They ensure full cover, restoration of sum insured and a number of other benefits in 2025. Under either plan, you can have alternatives that provide cover to hospitalization, daycare processes and pre and post hospitalization costs as well as health checkups.
Did you know? According to industry pundits, the reset or restore benefit is a life savior to large families or chronic dishonest people in urban India.
The most important thing is the restore or reset facility which will be crucial to many buyers in 2025. In the Optima Restore Plan offered by HDFC Ergo, in the event you exhaust the amount of your insurance cover in a given year, the coverage is automatically restored automatically at no additional expense. This however, only kicks-in in case of future and unrelated illness.
In the case of ICICI Lombard Elevate Plan, a reset benefit is not only restored; it is also restored unlimited times in the course of the policy year. It is as well good to use both related and unrelated illnesses in particular- ones can have greater flexibility to make repeated claims.
| Characteristic | HDFC Ergo Optima Restore | ICIC Lombard Elevate. |
|---|---|---|
| Type of Benefit | Restore | Unlimited Reset |
| Restorations per year | One | Unlimited |
| Reimburses same illness yearly | No | Occasionally. |
| Instant Activation | Yes | Yes. |
Expert knowledge Customers do not understand reset limits. Always research policy wording or enquires with your advisor whether reset applies to same illnesses, since it can be a dealbreaker to sick patients of chronic diseases.
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Other questions also pose: Q: What is a reset or restore in health insurance? A: It means restoring your sum insured either once (restore) or a number of times (reset) in a policy year.
Although they are similar in terms of the basic, ICICI Lombard Elevate has a greater number of add-ons, including maternity cover, critical illness topups, and advanced OPD expenses. HDFC Ergo Optima Restore is designed to provide the consistency and simplicity- the cost of hospitalization and not the cost of outpatient services.
Did you know? The recent IRDAI policies ask to make the communication on waiting periods and exclusions more transparent, yet reading the fines is still necessary in 2025.
Premiums are based on age, city, sum insured and family composition. The average 35 year in a metro city with 10 lakh sum insured insured by HDFC Ergo Optima Restore is about 13,500 rupees per annum and ICICI Lombard Elevate should be about 14 200 rupees but may be more with add ons.
The claim processes in both are online. HDFC ergo provides instant cashless transactions via hospital helpdesks. ICICI Lombard has created an Elevate app that is geared towards quicker digital approvals. Both offer 24x7 helplines.
| Factor | HDFC Ergo Optima Restore | ICICI Lombard Elevate. |
|---|---|---|
| Average Premium (10 lakh sum) | 13,500 INR | 14,200 INR+ |
| Claim Settlement ratio (2024) | 98.0 percent | 97.7 percent |
| Time of Cashless Approval (avg) | 40 mins | 37 mins |
Premiums and ratios are indicative and are changed annually.
People also enquire: Q Which health insurance offers the best cashless network in India? A: HDFC Ergo and ICICI Lombard have a widespread network although HDFC overtakes slightly with more onboard hospitals in 2025.
Another factor that is determined is the No Claim Bonus (NCB). The HDFC Ergo optima restore doubles your initial amount of sum insured at every one year of claim free insurance. You can have a 2x higher cover at no additional cost in case you do not make any claim in 4 years.
ICICI Lombard has wellness rewards through their Elevate app-you receive points by walking, doing health check-ups and preventive programs. In this case the NCB is 20 per cent per claim free year up to 100 per cent.
| Year No Claims | HDFC Ergo (10 lakh cover) | ICIC Lombard (10 lakh cover) |
|---|---|---|
| Year 2 | 15 lakh | 12 lakh |
| Year 3 | 20 lakh | 14 lakh |
| Year 5 | 20 lakh (maxed) | 20 lakh |
Expert insight When you want to take an active part in your health, ICICI wellness rewards can save you money either in premiums or on medical expense later down the line.
Maternity and child cover will be essential to young couples and growing families in 2025. ICICI Lombard Elevate provides maternity cover, newborn cover and even the IVF treatment add ons in certain variations and waiting periods.
HDFC Ergo Optima Restore is not specifically oriented on maternity benefits and is thus less appropriate to the couple considering the family growth in the near future.
Did you know? The insurance firms are allowed by the IRDAI 2025 rules to standardize their waiting period and benefits on maternity, always read the fine print of the insurance before you buy.
The customer experience of 2025 is highly online. Both insurance providers have mobile applications to manage claims, monitor the waiting period of pre existing diseases, policy renewal notifications, and tele consultations.
Other questions also arise: Q: Which policy will be the best in case I would desire hassle free digital claims in the large cities such as Mumbai and Bangalore? A: HDFC Ergo and ICICI Lombard have very convenient digital accompaniment of claims, but the application of the ICICI reward system can attract young, urban adults.
Waiting period is a significant factor to pre existing diseases. The waiting period that both policies follow is similar, which is 2 to 3 years, in PEDs. Nonetheless, special insurance that covers a particular disease or operation such as joint replacement or cataract can have a specific waiting period. Always have a look back at your own health history.
Select HDFC Ergo when: You desire no frills and frills plan that has high level of hospital coverage and settlement of claims. Select ICICI Lombard Elevate when: You want to have the latest features, be able to customize and you care about having rewards to stay healthy.
Q. Better between HDFC Ergo Optima Restore and ICICI Lombard Elevate Plan?–family floater cover. They are both serving as family floater plans. HDFC Ergo is best suited to bare-bone hospital cover. ICICI Lombard has a greater number of add ons and flexibility.
Q. Is it possible to transfer HDFC Ergo Optima Restore to ICICI Lombard Elevate? Yes, portability is admissible according to the IRDAI rules, but underwriting and terms of the policies.
Q. Is wellness points effective in lowering premium? Yes, in case of ICICI Lombard you can earn wellness rewards and redeem them to get a discount or health check-ups which can be translated into actual savings.
Q. Is it possible to have cashless hospitals outside of the metro cities? Both the insurers possess pan India cashless hospital networks of non metro cities and towns.
Q. What is the highest amount that can be insured in these plans in 2025? The two provide up to 50 lakh rupees to individuals and families.
Q. Is it possible to cover parents over 60 years in these policies? Yes, parents can cover both plans but the premiums increase with age.
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Written by Prem Anand, a content writer with over 10+ years of experience in the Banking, Financial Services, and Insurance sectors.
Prem Anand is a seasoned content writer with over 10+ years of experience in the Banking, Financial Services, and Insurance sectors. He has a strong command of industry-specific language and compliance regulations. He specializes in writing insightful blog posts, detailed articles, and content that educates and engages the Indian audience.
The content is prepared by thoroughly researching multiple trustworthy sources such as official websites, financial portals, customer reviews, policy documents and IRDAI guidelines. The goal is to bring accurate and reader-friendly insights.
This content is created to help readers make informed decisions. It aims to simplify complex insurance and finance topics so that you can understand your options clearly and take the right steps with confidence. Every article is written keeping transparency, clarity, and trust in mind.
Based on Google's Helpful Content System, this article emphasizes user value, transparency, and accuracy. It incorporates principles of E-E-A-T (Experience, Expertise, Authoritativeness, Trustworthiness).
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