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Apollo Munich Individual Personal Accident- Standard

Objective

This is a basic accidental policy paying a specified sum insured upon accidental death or accidental disablement. It pays accidental medical expenses and for education of insured's child,  in case insured member falls victim to accidental death or acquires permanent total disability.


Suited for

Every individual must be covered under a personal accident policy to get financial respite from rising number of accidental eventualities. Since sum insured under this policy is fixed at 10 times the annual salary of proposer, those who fulfill the eligibility conditions and earn up to Rs 5 lakh per annum may buy this policy.


What does it do?

A basic accidental cover which claims to immune against financial losses incurred due to accidental death or disablement, whether it is partial or total. Apart from these basic benefits, it covers ambulance cost to transfer insured person from site of accident to hospital or from hospital to home, family transportation to hospital and transportation of mortal remains. It allows a certain lump sum amount to support the education in case of permanent total disability or unfortunate demise of insured person. Education funding is allowed for maximum two children. It covers accidental medical expenses as well. Each benefit is capped at a specific percentage of sum insured.


Pros

Policyholder enjoys a cumulative bonus of 5 per cent for every claim-free year up to maximum of 50 per cent of basic sum insured.
Family discount of 10 per cent is applicable if two or more members are covered.


Cons

There is a ceiling on maximum amount under each benefit.
It does not provide any tax relief.


Our View

This policy aims to mitigate risk of loss of income in case of accidental death or accidental disability of the insured person, hence it is recommended. It should be noted that premiums payable are a function of nature of occupation that insured person is involved in. Though the premiums are higher for occupations carrying high risk, it is advised to furnish the true nature of occupation to avoid trouble at the time of filing claim, just in case.

Eligibility
Entry Age (years) 
Minimum5; 3 months for children
Maximum69
Maximum Policy Renewal Age (years)70
Coverage TypeIndividual
Sum Insured (Rs) 
Maximum50 lakh
Minimum1 lakh
Policy Term (years)1
Tax BenefitNot Available
DiscountFamily discount of 10% is applicable if 2 or more family members included
No Claim Bonus5% increase in Sum Insured would be applicable for every claim free years till it reaches to a maximum of 50% of initial Sum Insured. a cumulative bonus has been applied and a claim is made, then in the
subsequent Policy Year the cumulative bonus will automatically reduce to zero.
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 on prorata basis
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
Network HospitalsHttp://www.apollomunichinsurance.com/our-hospital-network.aspx
Additions to the Plan
Scope of Cover
Accidental Death (AD)Covered; pays Sum Insured
Permanent Total Disablement [PTD]Predetremined percentage of Sum insured depending on nature of permanent total disablement
Permanent Partial Disablement [PPD]Predetremined percentage of Sum insured depending on nature of permanent partial disablement
Temporary Total Disablement weekly benefit upto maximum of 100 weeks. 1% of the Sum Insured for each week; maximum Rs 5 lakh
Emergency AmbulanceUp to Rs 2,000
Family Transportation to hospital (atleast 200 kms away) where insured is admitted 1% of AD Sum Insured; max Rs. 50000 . Restricted to one immediate member
Transportation of Mortal Remains2% of AD Sum Insured; max Rs. 10,000
Education Fundallowed upto 2 children. 10% of Accidental Death Sum Insured upto a maximum of Rs 20000
Accident Medical Expensescovered upto lowest of the actual expenses, 40% of admitted claim, 10% of AD Sum Insured or Rs. 50,000
Exclusions and Waiting period
Special Exclusions for Accidental death, disablement and medical expensesBacterial infections (except pyogenic infection which occurs through an Accidental cut or wound).Hernia
General ExclusionsPre existing condition or any complication arising from the same.Any psychiatric or mental disorders.AIDS or any other related conditions.
Annual Premium
Proposer Sum Insured (SI) (R)1 lakh2 lakh3 lakh5 lakh7.5 lakh10 lakh25 lakh50 lakh
Occupation Class I120240360600850110026005100
Occupation Class II1803605409001275165039007650
Occupation Class III250500750125017752300545010700
Adult Dependent SI (R)5000010000015000025000037500050000012500002500000
Occupation Class I6012018030045060013502600
Occupation Class II9018027045067590020253900
Occupation Class III125250375625937.5125028255450
Child Dependent SI (R)2500050000750001250001875002500006250001000000
Occupation Class I3060901502253007251100
Proposer TTD SI (R)100000200000300000500000500000500000500000500000
Occupation Class I255075125125125125125
Occupation Class II37.575112.5187.5187.5187.5187.5187.5
Earning Spouse TTD SI (R)50000100000150000250000250000500000500000500000
Occupation Class I12.52537.562.562.5125125125
Occupation Class II18.7537.556.2593.7593.75187.5187.5187.5
Premiums depend upon nature of occupation and level of risk involved. Occupation class I is low risk category, Occupation class II is medium risk category and Occupation class III is high risk category. Premiums are exclusive of service tax.
* Sum insured depends upon Income. Accidental Sum Insured for The proposer would be maximum 10 x Annual income. Sum Insured for Adult dependent would be 50% of proposer's Sum Insured subject to maximum of Rs 25 lakhs. Sum Insured for Child Dependent would be 25% of proposer's Sum Insured subject to maximum of Rs 10 lakh and Temporary Total Disablement benefit would be twice the annual income upto a maximum of Rs 5 lakh.

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