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Apollo Munich Optima Vital Health Insurance Plan

Apollo Munich Optima Vital Health Insurance Plan Introduction

Apollo Munich Optima Vital Health Insurance Plan is an unique critical illness insurance policy which covers 37 Critical Illnesses. A basic health insurance policy may not be sufficient to cover all medical expenses, especially in case of critical illness or accident which are always associated with an increased cost and also they require a long term treatment. So, Apollo Munich Optima Vital plan was introduced by Apollo Munich which protects you financially in the event of any of the listed critical illnesses occurring.

Apollo Munich Optima Vital plan can be issued to an individual and/or a family namely Spouse, dependent Children and dependent Parents.

Key Features and Benefits of Apollo Munich Optima Vital Health Insurance Plan

Apollo Munich Optima Vital plan provides lumpsum payout irrespective of actual cost of treatment.
Lumpsum amount is paid for 37 identified critical illnesses, medical events or surgical procedures.
Apollo Munich provides E-opinion, in case required, from their panel doctor in respect of a critical illness. It can be availed once in a policy year.
You are eligible to receive the benefit amount in addition to payouts under any other insurance plan.
Apollo Munich Optima Vital Health policy offers you lifelong renewal.
Apollo Munich Optima Vital policy shall terminate on first occurrence of any one of the defined critical illness.

Other Benefits:

Portability: If you are insured under another Insurer’s health insurance policy you can transfer to Apollo Munich with all your accrued benefits after due allowances for waiting periods.
Tax benefits: Under Apollo Munich Optima Vital plan, you can avail tax benefits for the premium amount under Section 80D of the Income Tax Act.
Sum Assured Enhancement: Sum assured can be enhanced only at the time of renewal, subject to no claim having been paid under the policy.

Terms and Eligibility conditions of Apollo Munich Optima Vital Health Insurance Plan

Entry age:	Minimum: 18 years Maximum: 65 years (A dependent child can be covered from from 18 years to 25 years provided both parents are covered in an Apollo Munich Optima Vital policy)
Policy term:	Minimum: 1 year Maximum: 2 years (A 7.5% discount is offered on opting for a 2 year policy)
Sum assured:	Minimum: 1 lakh Maximum: 50 lakhs (Maximum sum insured available above 55 years of age is restricted upto Rs. 20,00,000)
Coverage type:	Individual
Renewable till age:	Lifelong
Maximum Cover ceasing age:	Nil
Grace period:	30 days from the expiry date to renew the policy.
Waiting period for pre-existing illness:	After continuous renewal of 3 years. (Waiting period will get reduced by 1 year on every continuous renewal of your Apollo Munich Optima Vital Health Insurance Policy)
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:

The sum insured is on yearly basis for both annual and 2-year policy.
Apollo Munich Optima Vital premium at renewal may change due to change in your age or changes in the applicable Tax rate. For more information regarding Income Tax Benefits, visit www.taxqueries.in.
The policy will be issued on individual sum insured basis only.
A maximum of 6 members can be added in a single policy.
In an individual policy, a maximum of 4 adults and a maximum of 5 children can be included in a single policy. The 4 adults can be a combination of self, spouse and parents.

Inclusions in Apollo Munich Optima Vital Health Insurance Plan

Apollo Munich Optima Vital Health Insurance will pay the insured person a lumpsum amount for the identified critical illness, medical events or surgical procedures listed below.

37 Critical illnesses covered under Apollo Munich Optima Vital plan are,

(The Insured Person must survive 30 days from the date of confirmed diagnosis and defined severity)

Cancer of specified severity.
Kidney failure requiring regular dialysis.
Multiple sclerosis with persisting symptoms.
End stage liver disease of specified severity.
First heart attack of specified severity.
COMA of specified severity.
Major burns.
Goodpasture’s syndrome.
Apallic syndrome.
Aplastic anaemia.
Systemic lupus erythematosis.
Bacterial meningitis.
Multiple system atrophy.
Progressive scleroderma. (Insured person must survive 30 days from the date of actual undergoing of the below procedures)
Open chest CABG.
Major organ/bone marrow transplant.
Aorta graft surgery
Open heart replacement or repair of heart valve.
Pneumonectomy
Pulmonary artery graft surgery (Insured Person must survive 90 days from the date of confirmed diagnosis of below defined events)
Primary parkinson’s disease
Alzheimer’s disease
Motor neuron disease with permanent symptoms
Stroke resulting in permanent symptoms
Permanent paralysis of limbs
Primary pulmonary arterial hypertension
Benign brain tumour [resulting in permanent neurological symptoms]
Cardiomyopathy
End stage lung disease
Brain surgery
Progressive supranuclear palsy
Creutzfeldt-jakob disease (CJD)
Major head trauma
Encephalitis (Insured person must exhibit permanent impairment for 6 months from the occurrence of below defined event)
Blindness
Deafness
Total loss of speech

For more details regarding the specific definitions and listed conditions, refer Apollo Munich Optima Vital policy wordings and documents.

Exclusions in Apollo Munich Optima Vital Health Insurance Plan

There are some exclusions under Apollo Munich Optima Vital Health Insurance plan, they are

All illnesses and treatments within the first 90 days of policy cover are excluded.
Any Pre-existing diseases will be covered after a waiting period of 48 months.
Any critical illness in presence of HIV infection and / or any AIDS is excluded.
Abuse of intoxicant substances like drugs and alcohol is excluded.
Pregnancy, miscarriage, maternity or birth, any critical illness in presence of HIV or AIDS and related diseases, etc., is not covered under Apollo Munich Optima Vital plan.
Congenital internal and external diseases, defects or anomalies, are not covered.
Hospitalization due to war or due to nuclear, biological or chemical weapon and radiation of any kind are excluded.

For detailed information of exclusions refer Apollo Munich Optima Vital documents and forms attached below.

Buying procedure of Apollo Munich Optima Vital Health Insurance Plan

To buy Apollo Munich Optima Vital Health Insurance Plan,

Fill the application form with complete and accurate personal information and health profile.
Submit the application form and the premium amount along with necessary documents to the company representative.
Pre-policy check-up is required, depending on age and sum insured. It will be organized at a network center.
On acceptance of your proposal, company would reimburse up to 50% of expenses incurred by you to conduct these tests. No reimbursement will be provided, in case your policy is declined.
If your you proposal is not accepted, company will inform you with a proper reason.
Final policy document and kit will be sent to you, in case of acceptance.

Claim procedure under Apollo Munich Optima Vital Health Insurance Plan

Intimation and Assistance:

Intimate the company within 14 days of diagnosis of first occurrence of Critical Illness.
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 to avail Critical Illness:

Intimate the company within 14 days of diagnosis of first occurrence of Critical Illness.
Submit a duly filled claim form along with specified documents within 45 days of completion of survival period for the critical Illness.
Specified documents along with claim form are, Hospital Main Bill, Hospital Bill Payment Receipt, Pharmacy Bill, ECG, Doctor’s Prescription, etc.,.
For total list of documents during claim, refer Apollo Munich Optima Vital Claim form.
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.
Any additional information requested by the company must be submitted within 15 days.

Claim Procedure for E-Opinion:

Submit duly filled claim form along with the copy of all medical reports (including investigation reports and discharge summary (if any)) at any of Apollo Munich branch office.
You need to select Company Panel Doctor from whom you would prefer to take the e-opinion.
On receipt of the complete set of documents Apollo Munich will forward the same to the concerned doctor.
E-Opinion will be send to the member within 7 working days of the receipt of the complete set of documents.
The e-opinion can be availed once in a policy year.

Apollo Munich Optima Vital Health Insurance Plan premium calculator

You can calculate the premium using Apollo Munich Optima Vital premium calculator. Policy period, Number of members, Age and Sum assured are required to calculate the premium.

Apollo Munich Optima Vital Health Insurance Plan premium rates

Premium rates exclusive of Tax are given in below Apollo Munich Optima Vital premium table,

Apollo Munich Optima Vital premium table

Frequently asked questions (FAQ’s) of Apollo Munich Optima Vital Health Insurance Plan

What is meant by Critical Illness?

Critical Illness means any one of the listed illnesses or conditions that occurs or manifests itself during the policy period as a first incidence and the insured survives the defined survival period.

Who can buy this Apollo Munich Optima Vital Health policy?

An individual and/or his family members namely spouse, dependent children, dependent parents are eligible for buying this policy.

Can I terminate this policy?

You may terminate Apollo Munich Optima Vital Health Policy at any time by giving written notice to the company, and the Policy shall terminate when such written notice is received.