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Apollo Munich Insure Health

Objective

This is a low cost and instant policy wherein, the time lag between submission of proposal form and policy activation is minimal. It aims at relieving proposer of any tedious procedures involved in buying insurance.


Suited for

This policy is suitable for young and single individuals as a starter policy only, if their budget does not allow to buy a more comprehensive one. Self, spouse, dependent children and dependent parents can be covered under this policy on an individual sum insured basis.


What does it do?

This is an instant policy wherein the Proposer can fill and submit the proposal form at any of Apollo Munich sales counters. Unlike other policies, there is no time lag between submission of form and policy activation. The policy gets authorized at the point of sale itself.
It covers medical expenses incurred as an inpatient in a hospital. Pre and post hospitalisation expenses are covered with a ceiling imposed on maximum claim amount. It also covers Ayurveda, Unani, Sidha and Homeopathy treatments. Hospitalisation expenses of organ donor and day care procedures which do not require a 24-hour stay in a hospital due to technological advancement are also covered. It must be noted however that co-payment clause applies to all the covered expenses, according to which a policyholder has to pay 15 per cent of each admissible claim and insurance company will pay the remaining.


Pros

It covers pre and post hospitalisation expenses as well.
In addition to allopathic treatment, it covers traditional forms of treatments such as Ayurveda, Unani, Sidha and Homeopathy, jointly known as 'Ayush'.
Policyholder enjoys a loyalty discount of 5 per cent at the time of renewal.
Family discount of 10 per cent is applicable if two or more members are insured simultaneously.
Sum Insured enhancement is permitted at subsequent renewal.
Premium paid under this policy qualifies for deduction under section 80D of Income Tax Act.


Cons

It does not provide for emergency ambulance.
There is a capping on room rent for each sum insured level.
Pre and post hospitalisation cover is capped too.
Cover for 'Ayush' treatment is capped at certain percentage of sum insured.
There is a co-payment clause where policyholder has to bear a certain percentage of every single claim under the policy.


Our View

A low cost policy offering narrow coverage. Most of the benefits are capped to certain percentage of sum insured. It may act as a starter policy for young individuals only if budget restrains to buy a more inclusive policy. Once policyholder feels the need of an enhanced cover, the option to shift to another more comprehensive policy may be exercised. Do not get swayed by low policy premiums as the policy offers lesser features as compared to other health policies. Above all, a co-payment clause of 15 per cent on each claim acts as an impingement.

Eligibility
Entry Age (years) 
Minimum5; 3 months for children
Maximum50
Maximum Policy Renewal Age (years)75
Coverage TypeIndividual
Sum Insured (Rs) 
Maximum2 lakh
Minimum25000
Policy Term (years)1
Tax BenefitPremium paid is eligible for tax benefit under section 80D of the Income Tax Act
DiscountLoyalty discount of 5% on renewal premium.
A cross selling credit to buy any other apollo munich health product within 365 days from renewal date.
Family discount of 10% is applicable if 2 or more family members included.
Pre Policy Medical Check UpNot required
Grace Period for Policy Renewal15 days grace period is allowed to policyholder for payment of premium at the insurers discretion.
Co Payment Clause15% of medical expense will have to be borne by policyholder for each claim.
Policy TerminationInsurance company may terminate the policy by giving a written notice of 30 days. Policyholder is allowed to terminate the policy at anytime by giving a written notice. In case no claim has been made under the policy, percentage of premium will be refunded
Customer Service 
AddressApollo Munich Health Insurance Company Limited
Corporate Office: 10th floor, Tower B, Building No. 10, DLF Cyber City, Phase -II, Gurgaon, Haryana-122002
Registered Office: Apollo Hospital Complex, Jubilee Hills, Hyderabad - 500033
Mail to[email protected]
Call to1800-102-0333
SMSHealth' to 56767333
Network HospitalsHttp://www.apollomunichinsurance.com/our-hospital-network.aspx
Additions to the Plan
Scope of Cover
Cashless facilityAvailable at empanelled hospitals in India.
Re-imbursementIn case policyholder opts for non empanelled hospital
Pre-post hospitalisationpays a lumpsum of 1% of admissible claim amount towards each of pre and post hospitalisation expenses
In-patient TreatmentCovered and includes all hospitalisation expenses
Day-Care Procedures140 in number are covered
Ayurveda, Unani, Sidha and Homeopathy TreatmentCovered, upto maximum of 10% of Sum Insured
Expenses for organ donor of transplantCovered
Room rent Limit
Sum Insured (R) per person per policyRoom Rent per day (R)ICU Rent per day (R)
250005001000
500005001000
750007501500
10000010002000
20000020002000
Exclusions and Waiting Period
Pre-existing diseasecovered after 48 months
No claim periodAny disease contracted during the first 30 days of commencement of the policy
Waiting Period24 months for certain diseases such as hernia, surgery of sinusitis etc mentioned in policy document
General ExclusionsAIDS or any related illness will not be covered.Treatment of any mental or related disease is also excluded.
Annual Premium
Age (in years)Sum Insured (in Rs )
250005000075000100000200000
91days-3553074390210611593
36-458491168143316462124
46-5013801911233627083983
51-55*15402336265529744568
56-60*18052496308035055046
61-65*29744143515258438552
66-70*393055246852775510996
71-75*451562687808887112218
Premiums are exclusive of service tax and education cess
*Premium rates only for renewal