Objective

This policy has three variants, of which 'Easy Health-Exclusive' is the second one. It is a basic health insurance policy that provides maternity cover and an optional cover for newly born child along with cover for inpatient hospitalisation. This policy can be purchased online. An add-on critical illness benefit to insure against eight chronic diseases is available as an optional benefit on payment of extra premium.

Suited for

This policy is most suitable for young females as the policy covers maternity related expenses after a 6-year waiting period. The policy allows life long renewals which makes it preferable over others.

What does it do?

It provides Maternity cover up to a specified amount. On acceptance of maternity claim, this policy offers to include the new born under same policy. Other allowances include daily compensation of expenses incurred by one adult in accompanying the insured child to the hospital, day care procedures which do not require a 24-hour stay in hospital due to technological upgradation, domiciliary treatment (treatment taken at home on doctor's advice) and specified daily compensation of shared accommodation in a network hospital.
Expenses incurred towards inpatient hospitalisation including diagnostic procedures, boarding and lodging, ICU, Operation theatre, Anesthesia, blood, oxygen, medicines, drugs, nursing and medical practitioner charges are covered. Relevant medical expenses incurred prior to and post hospitalisation and emergency ambulance also fall under the policy ambit. Free health check up is allowed at the end of 3 years that have been claim free consecutively.
To widen the scope of insurance cover, a policyholder can take an additional cover for 8 critical illnesses upon payment of extra premium. This add on cover is available till 70 years of age and not beyond that.

Pros

There is no cover ceasing age. It offers life long insurance.
The policy provides a flat discount of 7.5 percent on advance payment of 2-year premium.
Family discount of 10 per cent is available on including 3 or more family members under the same policy.
It gives a cumulative bonus of 10 per cent for every claim-free year up to a maximum of 50 per cent.
It provides for a free health check up at the end of 3 continuous claim free years.
This policy can be purchased online.
Premium paid towards the policy qualifies for deduction under section 80D of Income Tax Act.

Cons

In case, cumulative bonus has been passed and a claim arises during that year, cumulative bonus would be reduced by 20 per cent in the following year.
Maternity benefit can be availed only after a waiting period of 6 years which is the longest waiting period in industry.

Our View

The major advantage of this policy is that it covers a policyholder during golden years when healthcare costs are expected to be relatively higher. There is no ceiling on policy renewal age. So, the policy actually stands by the individual in later years when health cover is direly needed. If planned well in advance, it takes care of maternity expenses as well. This policy is recommended as it passes the benefit-to-cost test. Optional Critical Illness Cover is an another worthwhile feature and can be chosen for a wider coverage.

Eligibility

Entry Age (years)

Minimum

18; 3 months for children

Maximum

60

Maximum Policy Renewal Age (years)

No Limit

Coverage Type

Individual

Policy Term (years)

1 or 2

Sum Insured (Rs)

Maximum

7.5 lakh

Minimum

3 lakh

Tax Benefit

Premium paid is eligible for tax benefit under section 80D of the Income Tax Act

Discount

Premium discount of 7.5% on advance premium payment for 2 year policy term.
Family discount of 10% is applicable if 3 or more family members included.

No Claim Bonus

10% increase in your annual inpatient benefit sum insured for every claim free year, till it reaches 50% of the Sum insured. In case of a claim, the cumulative bonus reduces by 20% in the following year

Grace Period for Policy Renewal

15 days

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

customerservice@apollomunichinsurance.com

Call to

1800-102-0333

SMS

'easyhealth' to 56767333

Scope of Cover

Sum Insured (in Rs)

3 lakh, Rs 4 lakh and Rs 5 lakh

7.50 lakh

Cashless facility

Available at empanelled hospitals in India. The policyholder must inform and obtain pre-authorization in case of planned hospitalisation atleast 48 hours prior to actual admission or 24 hours after hospitalisation in case of an emergency admission

Re-imbursement

In case policyholder opts for non empanelled hospital , expenses are re-imbursed within 14 working days from date of submission of all records

Pre-post hospitalisation

Relevant medical expenses covered from 60 days prior and 90 days post hospitalisation

In-patient Treatment

Covered

Pre-hospitalisation

Post-hospitalisation

Day-Care Procedures

140 in number are covered

Domiciliary Treatment

Covered

Daily cash for choosing shared accommodation

Rs 500 per day, Maximum Rs 3,000

Rs 800 per day, maximum Rs 4800

Expenses for organ donor of transplant

Covered

Emergency Ambulance

Up to Rs 2,000 per hospitalisation

Daily Cash for 1 adult accompanying an insured child upto 12 years of age

Rs 300 per day, maximum Rs 9000

Rs 500 per day, maximum Rs 15000

Newborn baby cover

Optional if policyholder proposes the same to insurance company within 90 days of child birth

Maternity Expenses with waiting period of 6 years

Normal Delivery Rs 15000Caesarean Delivery Rs 25000 (Sums are including pre/post natal limit of Rs 1500 and new born limit of Rs 2000)

Normal Delivery Rs 25000Caesarean Delivery Rs 40000 (Sums are including pre/post natal limit of Rs 2500 and new born limit of Rs 3500)

Additional Cover for Critical Illness

Optional, 50% or 100% of in patient Sum insured. It covers 8 critical illnesses namely: cancer, coronary artery (bypass) surgery, first heart attack (myocardial infarction), kidney failure (end stage renal disease), major organ transplantation, multiple sclerosis, paralysis and stroke after a waiting period of 30 days. Maximum cover ceasing age is 70 years.

Health Check-up

Upto 1% of Sum insured subject to a maximum of Rs 5000 per insured person, only at the end of a block of every continuous 3 claim free years

Exclusions and Waiting Period

Pre-existing disease

covered after a waiting period of three years

No claim period

30 days from start date of the policy except any accidental injury

Waiting Period

2 years for specific diseases such as cataract, hernia, joint replacement surgery etc.6 years for maternity benefits.Domiciliary Treatment will be covered only if illness continues for atleast 3 days consecutive days.

General Exclusions

Naturopathy treatment and non allopathic treatmentCosmetic, beauty or slimming treatment.AIDS or any related illnessTreatment of any mental or related disease