Objective

This policy aims to provide complete health insurance for a family by including a comprehensive coverage for hospitalisation, outpatient treatment, maternity expenses, newborn baby cover, and other incidental expenses.

Suited for

This policy is most suitable for young couples who are planning to go the family way. Individuals looking to insure their spouse and dependent children can also buy this policy.

What does it do?

It is the third and most comprehensive variant of Easy Health policy from Apollo Munich. It is an all-inclusive policy that covers maternity expenses, newborn baby, out-patient dental treatment and provides daily cash benefit for an adult accompanying insured child. There is also an optional cover for Critical Illness which will pay a lump sum amount on confirmed diagnosis of any of the listed illnesses. Critical Illness cover will attract additional premium from policyholder. Maternity benefit and out-patient dental treatment will be covered only after the waiting period. Some other benefits such as external aids including spectacles, hearing machine and contact lenses and health check-up benefit will be allowed once after lapse of every certain number of claim free years.

Pros

There is no cover ceasing age. It offers a life long insurance.
It offers a discount of 7.5 per cent on advance payment of 2-year premium.
It gives a cumulative bonus of 10 per cent for every claim-free year up to a maximum of 50 per cent.
This policy can be purchased online.
It provides for homeopathic, ayurvedic, Unani and Sidha treatment.
Premium paid under this 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.
There is a waiting period before maternity expenses and out-patient dental treatment become eligible.

Our View

Shopping for insurance should be purely based on your needs and budget. Only if you think you require a comprehensive coverage, should you go for it. Or consider lower variants of 'Easy Health' policy which offer a coverage for lesser price. Ensure that you know the waiting period before taking this policy.

Eligibility

Entry Age (years)

Minimum

18; 3 months for children

Maximum

65

Maximum Policy Renewal Age (years)

No Limit

Policy Term (years)

1 or 2

Sum Insured (Rs)

Maximum

10 lakh

Minimum

4 lakh

Discount

Premium discount of 7.5% on advance premium payment for 2 year policy term.

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 a claim is made during a policy year, the cumulative bonus would reduce 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 also 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

Network Hospitals

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

Scope of Cover

Sum Insured (in Rs)

4 lakh and 5 lakh

7.50 lakh and 10 lakh

Cashless facility

Available if treatment taken in a network hospital

Re-imbursement Facility

Available if treatment taken in a non network hospital

Pre-hospitalisation

Covered for 30 days. 30 days extend to 60 days if informed 5 days in advance of hospitalisation

Post-hospitalisation

Covered from 60 days. 60 days extend upto 90 days if informed 5 days in advance of hospitalisation

In-patient Treatment

Covered

Day-Care Procedures

140 in number are covered

Domiciliary Treatment

Covered if the illness continues for atleast 3 consecutive days

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

Ayush Benefit

covered upto Rs 25000

Daily Cash for 1 adult accompanying an insured child

Rs 300 per day, maximum Rs 9000

Rs 500 per day, maximum Rs 15000

Maternity Expenses

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)

Newborn baby

Optional

Out-patient Dental Treatment

50% of reasonable cost, Upto 1% of Sum insured subject to a maximum of Rs 5000

Spectacles, Contact Lenses, Hearing Aid every third year

50% of the admissible expenses, maximum upto Rs 5000

E-Opinion in respect of a Critical Illness

Covered, one opinion per policy year (if no previous claim was made in current policy year) form any member of policyholder's choice from the insurance company's panel

Additional Cover for Critical Illness

Optional Optional 50% or 100% of in-patient Sum Insured

Health Check-up(after every 2 claim free years)

Upto 1% of Sum insured subject to a maximum of Rs 5000 per insured person

Exclusions and Waiting Period

Pre-existing disease

covered after 36 months of continuous policy renewal

No claim period

30 days from policy start date

Waiting Period

4 years for maternity benefit24 months for treatment of certain illnesses as stated in the policy document.3 years for outpatient dental treatment

General exclusion

AIDS/ HIV or any related conditionTreatment of any mental disorder