Objective

This is a supplementary policy that aims to meet certain expenses which other health policies do not cover. It provides a specific daily cash benefit in the event of hospitalisation. This policy is available online for purchase.

Suited for

This policy may be bought by any individual eligible under the policy. Anyone aged between 5 and 65 years may take this policy. It covers individual and family on an individual basis.

What does it do?

Optima Cash Policy pays a pre-specified cash benefit upon each continuous and completed stay of 24 hours in a hospital as an inpatient due to sickness or accident. The daily cash benefit doubles in case Intensive Care Unit (ICU) services are accessed. The insured person may utilize the daily cash amount towards medical or non-medical expenditure. But, the basic idea is to provide for expenses such as attendant's food, travel and accommodation which are otherwise, not covered. It pays half of sickness daily cash amount if the insured undergoes 10 identified day-care procedures.
In an event where two or more insured members meet with an accident and get hospitalized jointly, the policy pays twice the accident daily cash amount in addition to accident daily cash. This benefit is payable only till both are hospitalized concurrently. Apart from hospitalisation benefit, Convalescence cash if hospitalisation extends beyond 7 consecutive days is payable. Parent accommodation charge is also paid if insured person is below 12 years of age. Also, an amount equal to twice the daily cash amount upon childbirth is paid. All the benefits are capped either by maximum number of days for which the daily cash benefit is payable or by number of times the benefit can be availed during policyholder's lifetime.

Pros

It pays an additional benefit upon joint hospitalisation of two or more insured members as a result of an accident.
It also pays a convalescence charge for expenses during period of recovery.
This policy can be bought online.
Premium paid towards this policy is eligible for tax benefit under section 80D of Income Tax Act.

Cons

Pre existing diseases are not covered.

Our View

This is an additional policy which can be taken as an add on to basic health policy and not in lieu of it. This policy is more useful for those who are covered under employer's group insurance policy to pay for incidental expenses that group policy does not cover.

Eligibility

Entry Age (years)

Minimum

5; 3 months for children

Maximum

65

Maximum Policy Renewal Age (years)

66 for 1 year policy term and 67 years for 2 years policy term

Coverage Type

Individual

Policy Term (years)

1 or 2 years

Sum Insured (Rs)

Maximum

Daily Cash Benefit of Rs 3000

Minimum

Daily Cash Benefit of Rs 1000

Tax Benefit

Tax benefit under Section 80D is available

Discount

Family discount of 10% is applicable if 2 or more family members included.
5% discount for online purchase.
10% discount for taking 2 years policy

Pre Policy Medical Check Up

Not required

Grace Period for Policy Renewal

30 days grace period is allowed to policyholder for payment of premium at the insurers discretion.

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

CASH to 56767333

Network Hospitals

Http://www.apollomunichinsurance.com/our-hospital-network.aspx

Scope of Cover

Sickness Hospital Cash and ICU Cash

(a) Daily Cash Amount for each continuous and completed 24 hours hospitalisation upto maximum of 90 days per policy year. (b) Twice the Daily Sickness Cash amount for each continuous and completed period of 24 hours stay in ICU upto a maximum of 15 days per policy year.

Accident Hospital Cash and Accident ICU Cash

(a) Daily Cash Amount for each continuous and completed 24 hours hospitalisation upto maximum of 90 days per policy year. (b) Twice the Accident Daily Cash amount for each continuous and completed period of 24 hours stay in ICU upto a maximum of 15 days per policy year.

Day Care Procedure Cash

10 Day Care Procedures covered; 50% of Sickness Daily Cash Amount for maximum upto 6 Day Care Procedures per policy year

Joint Hospitalisation (2 or more insured persons) due to an Accident

Twice the Accident Daily Cash Amount in addition to Accident Daily Cash benefit; upto maximum of 10 days per Policy Year

Convalescence Cash

Lumpsum Amount on continuous hospitalisation beyond 7 days; Payable once per policy year

Child Birth

Applicable after a waiting period of 2 years; Lumpsum amount twice the Daily Cash Amount; maximum upto 2 times during the life time of the insured female.

Parent Accommodation

Daily Cash amount for parentu0092s accommodation if the Insured child is aged 12 years or less and is hospitalized for more than 72 hours; Maximum upto 30 days per policy year

Exclusions and Waiting Period

Pre Existing Diseases

Not Covered

Waiting period

Any disease contracted during the first 30 days of commencement of the policy except for accidental emergency.For specific diseases such as cataract, sinus etc. cover starts after two years.Child birth benefit is covered after a waiting period of two years.

General Exclusions

Non allopathic treatmentAny psychiatric or mental disorders.AIDS or any other related conditions.