APOLLO MUNICH HEALTH INSURANCE COMPANY LTD.

IRDA REGISTRATION NO. 131

Apollo Munich Health Insurance Co. Ltd., erstwhile called Apollo DKV Insurance Company, is a
joint venture between Apollo Hospitals Group and Munich Health. Apollo Hospitals Group is the
largest integrated health provider in Asia and Munich Health is the new business segment of
Munich Re, a Germany based Reinsurance Company.  Apollo Munich Health Insurance
Company has its headquarters in Gurgaon, Haryana.  Apollo Munich India came into being
because of their re-branding purpose.  This is also the first time that a leading hospital group
has entered into a completely different entity, namely health insurance.
The name change from Apollo DKV Insurance to Apollo Munich Health Insurance is seen as a re-
branding exercise, since in peoples mind Apollo name was very popular and synonymous with
quality health care but the same could not be said about DKV. The company has strong growth
plans and with their expertise in the industry, they are planning to penetrate deeper in the
retail insurance market.
“Let’s Uncomplicate” is the new motto for Apollo Munich Medical Insurance and the company
wants to simplify all aspects of health insurance for clients; whether it is buying, understanding
the contingencies, or making claims. Apollo Munich Insurance Company wants to be a hassle
free and user friendly health insurance company.
 Aims to make healthcare and health insurance easy and uncomplicated
 Apollo Munich insurance co. has tied up with a network of 4000+ hospitals in India
 Customers can avail the facility of cashless hospitalization by displaying the health card
issued to the policy holder
 Easy Health Plan offers coverage for healthcare needs of insured and also keeps a check
on the health of the customer.
 3 variants of Easy Health plan: Standard Plan which has the lowest premium; then
Premium Plan and Exclusive Plan which has the highest premium.
 Their health insurance plan starts from just Rs. 3 per day and more depending upon
one’s needs.
Apart from health insurance via their two plans namely Easy Health Insurance and Maxima 360
Health Plan, they have even personal accident insurance.  The Apollo Munich Health Insurance
helpline number is 1800-102-0333.  They even have the option of buying the health insurance
online.

Chief Executive Officer – Antony Jacob.

Gurgaon, India

Health Insurance Policies and Products

Apollo Munich Health Insurance Co. Ltd has the following options
in healthcare insurance products for the benefit of Indian consumers namely:
a) Easy Health Standard
b) Easy Health Exclusive
c) Easy Health Premium
These products are available on individual basis as well as floater policy.

Plan Standard Exclusive Premium

Sum Insured per 1.00, 2.00, 3.00, 3.00, 4.00, 7.50 4.00, 5.00 7.50, 10.00
Insured  4.00, 5.00 5.00
Person per Policy
Year
(in lakhs)
1 In-patient
Treatment
2 Pre-
hospitalisation
3 Post-
hospitalisation
4 Day Care
Procedures
5 Domiciliary
Treatment
6 Daily Cash for Rs. 500 per day,  Rs. 500 Rs. 800 per Rs. 500 Rs. 800 per
choosing Maximum per day, day, per day, day,
Shared Rs. 3,000 Maximum Maximum Maximum Maximum
Accommodation Rs. 3,000 Rs. 4,800 Rs. 3,000 Rs. 4 ,800
7 Organ Donor
8 Emergency Upto Rs. 2,000 Upto Rs. Upto Rs. Upto Rs. Upto Rs.
Ambulance 2,000 2,000 2,000 2,000
9 Daily Cash for - Rs. 300 Rs. 500 per Rs. 300 Rs. 500 per
accompanying per day, day, per day, day,
an insured child Maximum Maximum  Maximum Maximum
Rs. 9,000 Rs. 15,000 Rs. 9,000 Rs. 15,000
1 Newborn baby - Optional Optional Optional Optional
0
1 Maternity - Normal Normal Normal Normal
1 Expenses with Delivery Delivery  Delivery Delivery
Waiting Period Rs. Rs. 25,000* Rs. Rs.
of 6 years 15,000*  15,000* 25,000*
Caesarean
Caesarean Delivery Caesarean Caesarean
Delivery Rs. 40,000* Delivery Delivery
Rs. (* Rs. Rs.
25,000* Including 25,000* 40,000*
(* Pre/Post (* (*
Including Natal limit Including Including
 Pre/Post of Rs. Pre/Post Pre/Post
Natal limit 2,500 and Natal limit Natal limit
of New Born of of Rs.
Rs.1,500 limit of Rs. Rs.1,500 2,500 and
and New 3,500) and New New Born
Born limit Born limit limit of Rs.
of Rs. of Rs. 3,500)
2,000) 2,000)
1 Outpatient - - - Upto 1 % of Sum
2 Dental insured subject to a
Treatment with Maximum of Rs.5,000
Waiting Period
of 3 years
1 Spectacles, - - - Upto Upto
3 Contact Lenses, Rs.5,000 Rs.5,000
Hearing
Aid Every Third
Year
1 E-Opinion in - - - Covered, one opinion
4 respect per policy year
of a Critical
Illness
1 Additional Not Offered Optional 50% or 100% of basic Sum Insured
5 Cover for
Critical Illness
1 Health Checkup Upto 1% of Sum Upto 1% of Sum Insured Upto 1% of Sum Insured
6 Insured per subject to a Maximum of subject to a Maximum of
Insured Person, Rs.5,000 per Insured Rs.5,000 per Insured
only once at the Person, only once at the Person, only once at the
end of a block of end of a block of every end of a block of every
every continuous continuous three claim continuous two claim
four claim free free years. free years.
years.
Benefits under 12, 13, 14 and 16 are subject to pre-authorisation by the TPA

The premium depends on age of the Insured person and the Sum Insured option selected by an
individual. A detailed premium table is enlisted as follows:-

Premium Table (In Rs.) (Excluding Service Tax)

Age Group (In
SI-25,000/- SI-50,000/- SI-75,000/- SI-100,000/- SI-200,000/-
Yrs)
91 days - 35 530/- 743/- 902/- 1,061/- 1,593/-
36-45 849/- 1,168/- 1,433/- 1,646/- 2,124/-
46-50 1,380/- 1,911/- 2,336/- 2,708/- 3,983/-
51-55* 1,540/- 2,336/- 2,655/- 2,974/- 4,568/-
56-60* 1,805/- 2,496/- 3,080/- 3,505/- 5,046/-
61-65* 2,974/- 4,143/- 5,152/- 5,843/- 8,552/-
66-70* 3,930/- 5,524/- 6,852/- 7,755/- 10,996/-
71-75* 4,515/- 6,268/- 7,808/- 8,871/- 12,218/-
Service Tax to be charged as applicable

The rates are valid till further notification

*Premium rates only for Renewal

Salient Features

1. Policy is issued for a period of one year for an individual and/or family. 

2. In a Floater policy the entire family can be covered. As per the Terms and Conditions the
family comprises of spouse, dependent children and dependent parents. 
3. Individuals from the age of 5 years onwards are covered under this policy. A child can be
covered from the 91st day provided if both parents are covered under this particular policy. The
upper age limit for availing the Easy Health Policy is 50 years. 

Benefits of Insure Health

Benefits of Apollo DKV’s Insure Health are:

• In-patient treatment: This includes all hospitalization expenses. 

• Pre-hospitalization: Through this the insured is eligible for lump sum amount equivalent to
1% of admissible claim amount towards pre-hospitalization expenses. 

• Post-hospitalization: Through this the Insured is eligible for lump sum amount equivalent to
1% of admissible claim amount towards post-hospitalization expenses. 

• Day-Care procedures: This provides the insured with the cover for the medical expenses for
140 Day-care procedures which do not require 24 hours hospitalization due to technological
advancement. 

• Organ Donor: This entitles the insured for the medical expenses incurred for an organ donor’s
treatment for the harvesting of the organ donated. 

• Ayush: The Insured can avail Medical Expenses for in-patient Ayurveda, Unani, Siddha and
Homeopathy treatment up to 10% of the Sum Insured. 

Important Note:- Pre-existing diseases are covered from 5th year onwards. As per the policy
cover the term "Pre-Existing Diseases" includes any condition, ailment or injury or related
condition(s) for which Insured Person had sign or symptoms, and/or were diagnosed, and/or
received medical advice/treatment, within the 48 months prior to the commencement of the
policy.

Points to remember
Room rents have sub-limits
based on the table
below: Sum Insured per 25,000/- 50,000/- 75,000/- 100,000/- 200,000/-
Insured person per Policy
(Rs.)
Room rent per day (Rs.) 500/- 500/- 750/- 1,000/- 2,000/-
ICU rent per day (Rs.) 1,000/- 1,000/- 1,500/- 2,000/- 2,000/-

a. The policy offers coverage on individual Sum Insured basis only. 

b. The cover ceasing age in this policy would be 75 years. 

c. Co-Payment of 15% will be applicable for each and every claim under this policy. 

Discounts 

a. A family discount of 10% can be availed if 2 or more members of a family are covered under
the same policy on Individual sum Insured basis. 

b. Loyalty Discount of 5% on the renewal premium of the Insure Health Policy can be availed at

the time of renewal, as a cross selling credit to buy any other Apollo DKV product within 365
days from the renewal date. 

Key Exclusions

• Any treatment within the first 30 days of cover except for accidental injuries. 

• Pre-existing conditions will not be covered until 48 months of continuous coverage have
elapsed since inception of the first Insure Health Policy with Us. 

• Abuse of intoxicant or hallucinogenic substances like drug and alcohol. 

• Expenses arising from HIV or AIDS and related diseases. 

• Hospitalization due to war or an act of war or due to a nuclear, chemical or biological weapon
and radiation of any kind. 

• Experimental, investigative and unproven treatment devices and pharmacological regimens. 

Terms of Renewal

• We offer renewal unless the Insured Person or any one acting on behalf of an Insured Person
has acted in a dishonest or fraudulent manner or any misrepresentation under or in relation to
this policy or the Policy poses a moral hazard. 

• Maximum Age – Maximum cover ceasing age in this policy would be 75 years. 

• Cumulative Bonus – No cumulative bonus is offered under this policy. 

• Waiting Period - The Waiting Periods mentioned in the policy wording will get reduced by 1
year on every continuous renewal of your Insure Health policy. 

• Renewal Premium- Renewal premium are subject to change with prior approval from IRDA. 

• Sum Insured Enhancement – Sum Insured can be enhanced only at the time of renewal
subject to no claim have been lodged/ paid under the policy. If the Insured increases the Sum
Insured, no Pre Policy Check-up will be required but the case will be subject to medical
underwriting. In case of increase in the Sum Insured waiting period will apply afresh in relation
to the amount by which the Sum Insured has been enhanced. However the quantum of
increase shall be at the discretion of the company.

Apart from these, Apollo Munich Health Insurance Co. Ltd. issues Accident Policy covers which
are of two types:-

a) Individual Personal Accident Standard

b) Individual Personal Accident Premium

INDIVIDUAL PERSONAL ACCIDENT STANDARD

Benefits Sum Insured
Accidental Death [AD] Sum Insured* 1 Lakh, 2 Lakhs, 3 Lakhs, 5 Lakhs, 7 Lakhs, 5
Options Lakhs, 10 Lakhs, 25 Lakhs, 50 Lakhs
Permanent Total Disablement [PTD] AD Sum Insured
Permanent Partial Disablement [PPD] AD Sum Insured
Emergency Ambulance Charges  Rs. 2,000/-
Family Transportation 1% of AD Sum Insured; max Rs. 1,00,000/-
Transportation of Mortal Remains  2% of AD Sum Insured; max Rs. 10,000/-
Education Fund 10% of AD Sum Insured; max Rs. 20,000/-
Temporary Total Disablement 100% of AD Sum Insured; max Rs. 5,00,000/-
Accident Medical Expenses 10% of AD Sum Insured; max Rs. 50,000/-
Broken Bones -
Transportation of Imported Medicine -
Purchase of Blood -
Modification of Residence/Vehicle -
Accident Hospitalization (In-patient) -
*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/-.

INDIVIDUAL PERSONAL ACCIDENT PREMIUM

Benefits Sum Insured
Accidental Death [AD] Sum Insured* 5 Lakhs, 10 Lakhs, 15 Lakhs, 25 Lakhs, 50 Lakhs,
Options 100 Lakhs, 200 Lakhs, 500 Lakhs
Permanent Total Disablement [PTD] AD Sum Insured
Permanent Partial Disablement [PPD] AD Sum Insured
Emergency Ambulance Charges  Rs. 2,000/-
Family Transportation 1% of AD Sum Insured; max Rs. 1,00,000/-
Transportation of Mortal Remains  2% of AD Sum Insured; max Rs. 10,000/-
Education Fund 10% of AD Sum Insured; max Rs. 20,000/-
Temporary Total Disablement 100% of AD Sum Insured; max Rs. 15,00,000/-
Accident Medical Expenses -
Broken Bones 10% of AD Sum Insured; max Rs. 100,000/-
Transportation of Imported Medicine 5% of AD Sum Insured; max Rs. 20,000/-
Purchase of Blood 5% of AD Sum Insured; max Rs. 10,000/-
Modification of Residence/Vehicle 10% of AD Sum Insured; max Rs. 1,00,000/-
Accident Hospitalization (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/-.