Health Insurance

GENERAL FAQ

1) How to make Intimation?
You may Intimate your Claim either on Apollo toll free no. 100-102-0333 or mail at customerservice@apollomunichinsurance.com.
2) What is a ‘Cashless’ Claim?
In Cashless Claim the Insured is required to Intimate to Apollo Munich Call Centre & get  the Claim No. On authorization by the Apollo Munich Health Insurance, the directly settles the claim to the network hospital and insured is not required to pay any charges except non-medical and expenses not covered under the policy.
3) What is a Reimbursement Claim?
In a Reimbursement Claim the insured has to pay upfront for all the expenses of hospital and seek reimbursement from the Insurer for the covered services.
4) How does one get Reimbursements in case of treatment in Non-Network Hospitals?
The Insured person or someone claiming on your behalf shall provide us with all Documentation, Medical Records and information the circumstances of the Claim, Apollo liability for the Claim within 15 days of the earlier of our request or the Insured Person’s discharge from hospitalization.
5) How will the payment of claim be made?
All Claims will be payable to Policyholder by NEFT/Cheque.
6) How do I find out which Hospitals are part of a given insurance network?
You can check to the list of empanelled hospitals on apollo website www.apollomunichinsurance.com.
7) Is Health check up covered under this policy?
Yes, but it varies from Plan to Plan.
8) What if I also have or intend to buy a medical policy of any other insurance company?
It’s your choice, but you would have to intimate Apollo of the same and the concerned insurance company.
9) What are the benefits of your Health Card?
A Health Card mentions your policy details. In case of a medical emergency, you can call on toll free number for any queries, clarifications and for seeking any kind of assistance. Moreover, you need to display your health card at the time of admission into the hospital.
10) Will my premium change at the time of renewal?
Yes, Renewal premium is calculated on the basis of age of the insured as on the renewal date. If the insured moves to a higher age band, Renewal premium applicable will be calculated as per the new age band.
11) How many days prior to policy expiry, can an insured make a payment for renewal?
You can make the payment for renewal prior to 60 days of policy expiry date.
12) How long is the policy valid for?
Apollo Munich offers policies with option of 1 Yr renewal & 2 advance payment option too, Policy period which can be Renewed Periodically.

 

OPTIMA RESTORE FAQ

1) What is Entry Age of Optima Restore Plan?
Minimum Entry age is 18 yr and Maximum is 65 yr.
2) How much Maximum and Minimum Sum Insured in Optima Restore Plan?
Minimum Sum Insured is 3 Lakh and Maximum Sum Insured 50 Lakh.
3) How many members are included in Individual Plan and Family Floater Plan?
In Individual Plan Maximum 6 people (4 adults & 2 children) and in Family Floater Plan also 6 people (2 adults & 4 children).
4) What is a Restore Benefit?
This is a Unique Restore benefit that automatically reinstates the basic sum insured in case you exhaust it in policy year. If you use up your coverage in an individual policy and fall in other illness, we will restore the entire Sum Insured for you to use, at no extra charge. Same in Floater Plan.
5) What is a meaning of Multiplier Benefit?
If you have had a Claim Free year, we will increase your basic sum insured by 50% as a no claim bonus. If you don’t claim even in second year, we will double your basic sum insured as a no claim bonus i.e. 100%.
6) How many years will my health insurance cover last?
Renew your cover Lifelong and stay covered forever.
7) How much discount offered on the premium if you choose a 2 year premium payment?
7.5 % discount is offered on the premium payment.
8) How many days are covered in day care procedure?
All day care treatments are covered.
9) Do I have to undergo any medical examination?
Medical examination may be required in some cases, based on the sum insured and the age of the person.
10) Is the Premium exempted from Income Tax?
Yes, the premium paid for health insurance policies qualifies for deduction under Section 80D of the Income Tax Act. A person is entitled to a deduction of Rs. 25000 in respect of medical insurance premium paid on the health of himself, his spouse and children. If he pays health insurance premium of his parents (Senior Citizen), he will be entitled to additional deduction of Rs. 30000/-.

 

OPTIMA VITAL

1) What is Entry Age of Optima Vital Plan?
Minimum Entry age is 18 yr and Maximum is 65 yr.
2) How much Maximum and Minimum Sum Insured in Optima Vital Plan?
Minimum Sum Insured is 5 Lakh in the multiple of 1 lakh and Maximum Sum Insured 50 Lakh in the multiple of 5 lakh.
3) How many members are included in Optima Vital Plan?
In Individual Plan Maximum 6 People(4 adults & 2 children).
4) What is a key benefits of Optima Vital Plan?
Optima Vital Insurance will pay you a lumpsum amount for the 37 identified Critical Illness, medical events or surgical procedure.
5) How many years will my Critical Illnesses Cover last?
Renew your cover Lifelong and stay covered forever.
6) How much discount offered on the premium if you choose a 2 year premium payment?
7.5 % Discount is offered on the premium payment.
7) How many days are given in Grace Period?
For renewing the Policy 30 days grace period are given.
8) Why should I buy a Critical Illness Cover?
With rapidly changing demographics and lifestyles prevalence of Critical Illness is on the rise in India. With rise in life expectancy and chronic nature of critical illness there is a requirement of additional funds to afford high medical costs for treating such critical illnesses. This policy also covers 8 most common Critical Illnesses were an insured member is compensated by a lumpsum payment. Cancer, Kidney Failure, Heart Attack, Aorta Graft Surgery, Open Heart Replacement, Major Head Truma, Stroke & Cardiomyopathy.
9) Is the Premium exempted from Income Tax?
Yes, the premium paid for Critical Illness policies qualifies for deduction under Section 80D of the Income Tax Benefit. A person is entitled to a Deduction of Rs. 25000 in respect of medical insurance premium paid on the health of himself, his spouse and children. If he pays health insurance premium of his Parents (Senior Citizen), he will be entitled to additional deduction of Rs. 30000/-.

 

IPA

1) What is Entry Age of Individual Personal Accident?
Minimum Entry age is 18 yr and Maximum is 69 yr.
2) What is benefit of IPA?
i) Accidental Death (AD)
ii) Permanent Total Disablement (PTD)
iii) Permanent Partial Disablement (PPD)
iv) Temporary Total Disability (TTD)
3) How we calculate Sum Insured?
This is base on the Income Eligibility. Accidental Sum insured for Proposer would be maximum 10 times of Annual Income for Salaried person and 20 times for Businessman. Adult dependant is restricted to 50% of proposer Sum Insured and for Child dependent is restricted to 25% of proposer Sum Insured.
4) How much Maximum and Minimum Sum Insured of Individual Personal Accident in Accidental Death?
Maximum Sum Insured is 1 to 50 Lakh (standard) and Maximum Sum Insured 5 Lakh to 5 Crores (premium).
5) How much Maximum and Minimum Sum Insured of Individual Personal Accident in PTD & PPD?
PTD & PPD both dependents on Accidental Death Sum Insured.
6) How much Maximum and Minimum Sum Insured of Individual Personal Accident in Temporary Total Disability?
In Standard Plan Max Sum Insured is 5 lakh (100% of AD sum insured) and Premium Plan Maximum Sum Insured 15 lakh(100% of AD sum insured).Sum Assured are given in TTD is Two times of Annual Income.
7) How many years will my Health Insurance Cover last?
Renew your cover Lifelong and stay covered forever.t.
8) How much education fund given in IPA?
10% of Accidental death sum insured or maximum 20,000 in standard plan and in premium plan 20,000.
9) How much discount available for 2 & more family members are covered in same Policy?
10% discount is available.
10) How much Emergency Ambulance charge and Family transportation are given?
Ambulance charge 2000 Rs. are given & Family transportation are given 1% of AD sum insured or max 50,000 in standard plan and 1% of AD sum insured or max 1,00,000 in Premium Plan.
11) Is the Premium exempted from Income Tax?
No, the premium paid for IPA Is not qualifies for deduction under Section 80D of the Income Tax Act but the Claim Amount is Tax Free.

 

EASY HEALTH FAQ

1) What is Entry Age of Easy Health Plan?
Minimum Entry age is 18 yr and Maximum is 65 yr.
2) How much Maximum and Minimum Sum Insured in Optima Restore Plan?
Minimum Sum Insured is 3 Lakh and Maximum Sum Insured 50 Lakh.
3) How many members are included in Individual Plan and Family Floater Plan?
In Individual Plan Maximum 6 People (4 adults & 2 children) and in Family Floater Plan also 6 People (2 adults & 4children can be).
4) What is a Ayush Benefit?
The medical expenses In-patient treatment taken under Ayureda, Unani, Sidha and Homeopathy(Upto 2000).
5) What is a meaning of Cumulative Bonus?
You get a Cumulative Bonus of 10% for every claim- free year accumulating up to 100%.
6) How many years will my health insurance cover last?
Renew your cover Lifelong and stay covered forever.
7) How much discount offered on the premium if you choose a 2 year premium payment?
7.5 % Discount is offered on the premium payment.
8) How many days are covered in day care procedure?
144 Days care treatments are covered.
9) Do I have to undergo any medical examination?
Medical examination upto 1% of Sum Insured per policy, only once at the end of a block of every continuous four claim free years.
10) Is the Premium exempted from Income Tax?
Yes, the premium paid for Health Insurance Policies qualifies for deduction under Section 80D of the Income Tax Benefit. A person is entitled to a Deduction of Rs. 25000 in respect of medical insurance premium paid on the health of himself, his spouse and children. If he pays health insurance premium of his Parents (Senior Citizen), he will be entitled to additional deduction of Rs. 30000/-.