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Apollo Munich health plan

Posted By PolicyPartner.in Team
 

Apollo Munich Health Insurance has recently launched a unique health/mediclaim plan with restore benefit.  This restore benefit will automatically reinstate the basic sum assured in case it is exhausted during the policy term. The benefit to restore the sum assured will be given free of any additional cost. Definitely the premium will be higher compared to normal mediclaim plans. You need to compare the same before finalising the product. The plan is a first of its kind giving restore benefit.  The plans which are available till now don’t pay you anything above sum assured during one year after you exhaust the basic sum assured. This plan gives the additional benefit as it restores the sum assured again and can be utilised for any other illness or in case of any member of the family if it is family floater.

You have to note that there are certain conditions which are required to be fulfilled before availing this benefit. You must check these condition before coming to final conclusion. You are eligible to claim restore benefit only after the basic sum assured inclusive of bonuses are fully utilised in that year. It means suppose you have 3 lakhs restore plan and first claim is utilised by taking 2.5 lakhs in one case and subsequently new claim comes for another 1.5 lakhs during same policy period. In this case you will not be able claim the restore benefit as you have not fully utilised the 3 lakhs sum assured in 1st claim. You will get only Rs. 50,000 in second claim which is the balance from 3 lakhs basic sum assured and have to pay the balance of Rs. 1 lakh from your pocket. Now you have fully exhausted the sum assured and are eligible to claim the third claim under restore benefit if it comes during that policy year. Secondly it will not be available for the same disease/illness for the same person who has claimed the basic sum assured during that particular year.  The restore benefit is not eligible for bonus and will not be carried forward in subsequent year if not utilised in that year. You have also to note that Restore benefit is available only once in a policy year.

The plan is available as individual as well as family floater. The sum assured offered in the plans are 3,5,10 and 15 lakhs in both the category. Interestingly plan has also come with never before renewal incentive in case of claim free year. The basic sum assured will increase by 50% in 1st claim free year and 100% in 2nd claim free year. It gives 10% family discount if 2 or more members are covered under individual plan. It also gives additional 7.5% discount on premium if you pay 2 years premium at a time. This is not advisable if your premium comes above Rs. 15,000 as the tax benefit is restricted to Rs. 15,000 in a year. Other benefits like life time renewal, no co pays and sub limits and no additional loading at renewal are also there in the plan which also makes plan more attractive. Apollo Munich Health Insurance Company is standalone health insurance company and has a tie up with 4000 net work hospitals across India for cash less facility. Company has network of 50 branches with force of 25,000 agents across India. The optima health plan is also eligible for tax benefit u/s 80-D of the Income Tax Act.

Looking at features of the plan it is advisable to take family floater plan compared to individual plan. The chances of same person falling ill in the same year are less and also if the same person falls sick for the same reason for which he has been paid the claim earlier than the claim is not payable. The competition in the health insurance will definitely benefit society at large but one should also look at premiums payable, exclusions and claim ratio before entering to any insurance contract.
 

 
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