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) | |
Minimum | 5; 3 months for children |
Maximum | 50 |
Maximum Policy Renewal Age (years) | 75 |
Coverage Type | Individual |
Sum Insured (Rs) | |
Maximum | 2 lakh |
Minimum | 25000 |
Policy Term (years) | 1 |
Tax Benefit | Premium paid is eligible for tax benefit under section 80D of the Income Tax Act |
Discount | Loyalty 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 Up | Not required |
Grace Period for Policy Renewal | 15 days grace period is allowed to policyholder for payment of premium at the insurers discretion. |
Co Payment Clause | 15% of medical expense will have to be borne by policyholder for each claim. |
Policy Termination | Insurance 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 | |
Address | Apollo 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 to | 1800-102-0333 |
SMS | Health' to 56767333 |
Network Hospitals | Http://www.apollomunichinsurance.com/our-hospital-network.aspx |
Additions to the Plan
Scope of Cover | ||
Cashless facility | Available at empanelled hospitals in India. | |
Re-imbursement | In case policyholder opts for non empanelled hospital | |
Pre-post hospitalisation | pays a lumpsum of 1% of admissible claim amount towards each of pre and post hospitalisation expenses | |
In-patient Treatment | Covered and includes all hospitalisation expenses | |
Day-Care Procedures | 140 in number are covered | |
Ayurveda, Unani, Sidha and Homeopathy Treatment | Covered, upto maximum of 10% of Sum Insured | |
Expenses for organ donor of transplant | Covered | |
Room rent Limit | ||
Sum Insured (R) per person per policy | Room Rent per day (R) | ICU Rent per day (R) |
25000 | 500 | 1000 |
50000 | 500 | 1000 |
75000 | 750 | 1500 |
100000 | 1000 | 2000 |
200000 | 2000 | 2000 |
Exclusions and Waiting Period | ||
Pre-existing disease | covered after 48 months | |
No claim period | Any disease contracted during the first 30 days of commencement of the policy | |
Waiting Period | 24 months for certain diseases such as hernia, surgery of sinusitis etc mentioned in policy document | |
General Exclusions | AIDS 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 ) | |||||
25000 | 50000 | 75000 | 100000 | 200000 | ||
91days-35 | 530 | 743 | 902 | 1061 | 1593 | |
36-45 | 849 | 1168 | 1433 | 1646 | 2124 | |
46-50 | 1380 | 1911 | 2336 | 2708 | 3983 | |
51-55* | 1540 | 2336 | 2655 | 2974 | 4568 | |
56-60* | 1805 | 2496 | 3080 | 3505 | 5046 | |
61-65* | 2974 | 4143 | 5152 | 5843 | 8552 | |
66-70* | 3930 | 5524 | 6852 | 7755 | 10996 | |
71-75* | 4515 | 6268 | 7808 | 8871 | 12218 | |
Premiums are exclusive of service tax and education cess | ||||||
*Premium rates only for renewal |