Restoration Of Benefits

UPDATED: Jul 16, 2023Fact Checked

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Jeffrey Johnson

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Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...

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UPDATED: Jul 16, 2023

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UPDATED: Jul 16, 2023Fact Checked

Many policies have specific dollar maximums after which benefits are no longer payable. If you have received benefits under such a policy, the restoration of benefits provision restores the maximum if you go for a stated period of time without receiving benefits. For example, suppose that your policy has a maximum benefit of $100,000, and you receive $20,000 in benefits. At this point your remaining benefit maximum would be $80,000. Then, you do not receive additional benefits for, say, one year. The provision then restores your maximum to the original $100,000.

Case Studies: Restoration of Benefits in Insurance Policies

Case Study 1: Restoring Maximum Benefits

Mr. Thompson has a disability insurance policy with a maximum benefit of $100,000. He has already received $20,000 in benefits. According to the policy’s restoration of benefits provision, if he goes one year without receiving any additional benefits, the policy will restore his maximum benefit to the original $100,000. Since Mr. Thompson doesn’t require any further benefits during the specified period, his policy resets, allowing him to access the full $100,000 benefit if needed in the future.

Case Study 2: Utilizing Restoration Provision

Ms. Rodriguez has a long-term care insurance policy with a maximum benefit of $200,000. She receives $50,000 in benefits for her long-term care needs. However, her condition improves, and she no longer requires ongoing care for a specified period mentioned in the policy. As a result, the restoration provision comes into effect, restoring her maximum benefit to the original $200,000. This ensures that Ms. Rodriguez has access to the full benefit amount if her condition worsens in the future.

Case Study 3: Maximizing Policy Coverage

Mr. Lee has a health insurance policy that includes a restoration of benefits provision. His policy has a maximum benefit of $1 million, and he has already received $800,000 in benefits. Due to his improved health, Mr. Lee does not require any additional benefits for the specified period mentioned in the policy. As a result, his policy restores the remaining $200,000 of his maximum benefit. This restoration provision ensures that Mr. Lee has the potential to access the full policy coverage if he needs it in the future.

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Jeffrey Johnson

Insurance Lawyer

Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...

Insurance Lawyer

Mary Martin

Published Legal Expert

Mary Martin has been a legal writer and editor for over 20 years, responsible for ensuring that content is straightforward, correct, and helpful for the consumer. In addition, she worked on writing monthly newsletter columns for media, lawyers, and consumers. Ms. Martin also has experience with internal staff and HR operations. Mary was employed for almost 30 years by the nationwide legal publi...

Published Legal Expert

Editorial Guidelines: We are a free online resource for anyone interested in learning more about legal topics and insurance. Our goal is to be an objective, third-party resource for everything legal and insurance related. We update our site regularly, and all content is reviewed by experts.

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