Apollo Munich Individual Personal Accident Health Insurance Plan

Apollo Munich Individual Personal Accident Health Insurance Plan Introduction

Apollo Munich Individual Personal Accident Health Insurance policy offers insurance coverage against accidental risks of life. Apollo Munich Individual Personal Accident policy was based on the principle of prevention and wellness. Apollo Munich Individual Personal Accident policy will cover you against all unexpected medical costs, which are usually not covered in the regular health insurance plan.

Apollo Munich Individual Personal Accident plan can be issued to an individual and/or a family which includes Spouse, dependent Children and dependent Parents. This policy provides compensation during an event of accidental death or bodily injury. Apollo Munich Individual Personal Accident plan is available in 2 variants they are, Standard plan and Premium plan.

Key Features and Benefits of Apollo Munich Personal Accident Health Insurance Plan

Under Apollo Munich Individual Personal Accident plan, get a lump sum payment in the event of death due to an accident.
Apollo Munich Individual Personal Accident plan provides 50% of sum assured per dependent child (maximum of two children) for his/her education, in case of Accidental Death or Permanent Total Disablement.
Also get the reimbursement of medical expenses incurred in transporting one family member to the hospital.
In case of Temporary Total Disablement, get a weekly allowance.
Apollo Munich will reimburse your medical expenses for In-patient treatment in a hospital due to an accident.
In case of fracture of bone due to an accident, you will get a lump sum payment as per the scale.
Discount of 10% is available if two or more family members are covered under Apollo Munich Individual Personal Accident policy.
Apollo Munich Individual Personal Accident policy compensates for injuries sustained, occurred anywhere in the world.

Terms and Eligibility conditions of Apollo Munich Personal Accident Health Insurance Plan

Entry age:	Minimum: 91 days Maximum: 69 years
Policy term:	1 year
Sum assured:	Minimum: 5 lakhs Maximum: 5 crores
Tax Benefit:	Not available
Coverage type:	Individual
Renewable till age:	Lifelong
Maximum Cover ceasing age:	Nil
Grace period:	30 days from the expiry date to renew the policy.
Maximum Policy Renewal Age:	70 years
Documents Required for fresh policy:	Policyholder need to fill up an ‘Application form’ with accurate medical history along with ‘address proof’. Medical examination may be required in some cases, based on the sum assured and the age of the person.
Documents Required during Renewal:	Policyholder do not have to fill the Proposal Form or ‘Application form’ again at the time of renewal in case he/she renew the policy before renewal date or within the grace period of 30 days post the renewal date. Policyholder will require to apply for a fresh policy if he/she renew the policy beyond the renewal date.

Other Points to remember:

Insured Person will have the option to migrate to similar Personal Accident insurance policy available with the company at the time of renewal.
The sum assured for proposer is up to 10 times of the total annual income.
The sum assured for spouse and dependent parent is 50% of proposer’s accidental death sum assured, maximum Rs. 50,00,000.
And the sum assured for Children is 25% of proposer’s accidental death sum insured, maximum Rs. 10,00,000.
On renewal, the maximum sum assured available above 70 years of age is restricted upto Rs 5,00,000.
Apollo Munich Individual Personal Accident premium varies depending on the occupation.

Inclusions in Apollo Munich Individual Personal Accident Health Insurance Plan

Inclusions in Apollo Munich Individual Personal Accident Plan are,

Accidental Death (AD): In the event of death due to an accident, a lump sum amount would be made under Apollo Munich Individual Personal Accident policy.
Permanent Total Disablement (PTD): In case of Permanent Total Disability due to an accident, a lump sum payment would be made, as per the scale provided in the policy.
Permanent Partial Disablement (PPD): In case of Permanent Partial Disability due to an accident, a lump sum payment would be made, as per the scale provided in the policy.
Emergency Ambulance Cover: Expenses incurred on an ambulance used to transfer the insured person to the nearest hospital following an emergency caused due to an accident will be covered under Apollo Munich Individual Personal Accident plan.
Transportation of Mortal Remains: Expenses incurred in transporting the mortal remains of the insured person from the place of the accident or the hospital to his/her residence or hospital or to a cremation or burial ground will be covered.
Family Transportation: If a claim under Accident Death (AD) or Permanent Total Disablement (PTD) is accepted, Apollo Munich will reimburse expenses incurred in transporting one immediate family member to the hospital. Provided that such Hospital is located at least 200 km from the insured person’s residence.
Temporary Total Disablement (TTD): To compensate loss of income because of Temporary Total Disability caused by an accident, a weekly allowance would be paid to the insured person.
Accident Medical Expenses: For a claim under AD, PTD, PPD or TTD, the company will reimburse the medical expenses incurred in hospital.
Transportation of Imported Medicine: For a claim under AD, PTD, PPD or TTD, Apollo Munich will reimburse expenses incurred as freight charges for importing medicines to India. And provided that such medicines are not available in India and are medically necessary.
Purchase of Blood: For a claim under AD, PTD, PPD or TTD, the Company will reimburse expenses incurred in purchasing blood through a hospital or a legitimate blood bank for your treatment.
Modification of Residence/Vehicle: For a claim under PTD, Apollo Munich covers reasonable expenses incurred to modify the insured person’s vehicle or residential accommodation.
Accident In-patient Hospitalisation: The Company will reimburse the Medical Expenses incurred for in-patient treatment in a hospital, if any insured person suffers an accident during the policy period that requires hospitalisation.
Broken Bones: In case of fracture of bone due to an accident, a lump sum Payment would be made, as per the scale provided in the policy.
Renewal Benefit: This policy provides Cumulative discount of 5% for every claim-free year till it reaches to a maximum of 50% of the accidental death sum insured.

Benefits Grid:

Benefits	Plans
Benefits	Standard	Premium
Accidental Death (AD) Sum Insured * Options (Rupee in Lakhs)	1, 2, 3, 5, 7.5, 10, 25, 50	5, 10, 15, 25, 50, 100, 200, 500
Permanent Total Disablement (PTD)	AD Sum Insured	AD Sum Insured
Permanent Partial Disablement (PPD)	AD Sum Insured	AD Sum Insured
Emergency Ambulance Charges	Rs. 2,000	Rs. 2,000
Family Transportation	1 % of AD Sum Insured; maximum Rs. 50,000	1 % of AD Sum Insured; maximum Rs. 1,00,000
Transportation of Mortal Remains	2 % of AD Sum Insured; maximum Rs. 10,000	Rs. 10,000
Education Fund	10 % of AD Sum Insured; maximum Rs. 20,000	Rs. 20,000
Temporary Total Disablement (TTD)	100% of AD Sum Insured; maximum Rs. 5,00,000	100% of AD Sum Insured; maximum Rs. 15,00,000
Accident Medical Expenses	10% of AD Sum Insured; maximum 50,000	–
Broken Bones	–	Rs. 1,00,000
Transportation of Imported Medicine	–	Rs. 20,000
Purchase of Blood	–	Rs. 10,000
Modification of Residence/Vehicle	–	10% of AD Sum Insured; maximum Rs. 1,00,000
Accident Hospitalisation (In-patient)	–	Rs. 1,00,000

*Sum Insured for adult dependent is 50% of proposer’s AD Sum Insured, maximum up to Rs. 50,00,000 and Sum insured for children is 25% of proposer’s AD Sum Insured, maximum up to Rs. 10,00,000.

The benefit in respect of accident medical expenses and accident in-patient hospitalisation shall be paid only for medical expenses incurred in India, irrespective of the place where the injury was sustained / accident occurred.
The benefit towards Modification of residence/vehicle shall be payable only if the modification is performed in India.

For the complete list of benefits under Apollo Munich Individual Personal Accident Insurance refer to the policy document attached below.

Exclusions in Apollo Munich Individual Personal Accident Health Insurance Plan

There are some exclusions under Apollo Munich Individual Personal Accident Plan, they are

Claim due to abuse of intoxicants or self-inflicted injury, suicide or attempted suicide are excluded.
Apollo Munich Individual Personal Accident insurance plan will not compensate for claim due to participation or involvement in naval, air-force operations or military, racing, aviation, diving, any breach of law with criminal intent, rock or mountain climbing.
Any Pre-existing Condition or any complication arising from the same will be excluded.
Pregnancy or childbirth or its complications, expenses arising from HIV or AIDS and related diseases is not covered under this plan.
Hospitalisation due to war or any act of war, public defense, act of foreign enemy, revolution, military acts, chemical, radioactive or nuclear contamination etc., is excluded.
Abuse of intoxicant substance like drugs and alcohol is excluded.

For detailed information refer the Apollo Munich Individual Accident forms and Apollo Munich Individual Accident Brochure attached below.

Claim procedure under Apollo Munich Individual Personal Accident Health Insurance Plan

Assistance:

You can contact Apollo Munich through Toll Free Line at 1800-102-0333 or log on to their website www.apollomunichinsurance.com or email at customerservice@apollomunichinsurance.com for any information or for clarifying your doubts.

Claim procedure in case of an unfortunate claim:

You need to provide a written notice with full particulars immediately to Apollo Munich.
Collect the claim form available at all their offices. You can also download the Apollo Munich Individual Personal Accident Claim form from our website www.policydunia.com.
Submit the duly filled and signed claim form to the company along with the documents mentioned in the claim form such as,

Policy copy.
Copy of FIR (First Information Report) /Spot Panchnama / Inquest Panchnama.
Death Certificate in case of Accidental death.
Original treating doctor certificate describing disablement in case of PTD or PPD or TTD etc.,.

For total list of required documents, refer Apollo Munich Individual Personal Accident Claim form attached below.

Apollo Munich Individual Personal Accident Premium

Apollo Munich Individual Personal Accident premium varies depending on the occupation as shown in below table.

Annual Premium:

The premium for the policy will remain the same for the policy period as mentioned in the policy schedule.
Note that your premium at renewal may change due to a change in your age or changes in the applicable Tax rate.