• Apollo Munich Optima Vital Health Insurance

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    • Premiums as low as Rs12/day for coverage of Rs.4 Lakhs*
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    • Claim up to Rs. 55,000 deduction under section 80D**

    Most health insurance companies in India have separate plans for critical illnesses that cover major diseases like cancer, stroke, heart attack, etc. Unlike regular health insurance plans, most of these critical illness covers provide a single lump sum payment upon the first diagnosis of a disease. This is mainly to ensure that the insured person has enough financial support to handle the medical expenses and other expenses associated with the disease. Apollo Munich Optima Vital is one such cover that provides coverage against a range of critical illnesses.

    Eligibility for Apollo Munich Optima Vital

    If you meet the following eligibility criteria, you can subscribe to Apollo Munich Optima Vital Policy:

    • The proposer of the policy must be between 18 years and 65 years.
    • A person between the age of 18 years and 25 years can be covered as a dependent provided both parents are simultaneously covered in the policy.
    • A maximum of 6 family members can be covered under the same policy.
    • Once entered, this critical illness policy can be renewed for life.

    Features of Apollo Munich Optima Vital

    Some of the notable features of Apollo Munich Optima Vital can be listed as follows:

    • This critical illness policy is available in multiple sum insured options ranging from Rs.1 lakh to Rs.50 lakh.
    • For people with entry age over 55, the maximum sum insured amount is restricted to Rs.20 lakh.
    • This policy provides lump sum coverage benefit for up to 37 critical illnesses including cancer of specified severity, stroke, coma, major burns, kidney failure, brain surgery, multiple sclerosis, total loss of speech, blindness, deafness, primary Parkinson’s disease, Alzheimer’s disease, etc.
    • The general waiting period applicable for this cover is 90 days.
    • Pre-existing illnesses can be covered after a period of 48 months of continuous policy coverage.
    • For certain conditions like cancer, multiple sclerosis, kidney failure, etc., a survival period of 30 days must be satisfied before the payment of the benefit amount.
    • Conditions like Alzheimer’s disease, Parkinson’s disease, etc. require a survival period of 90 days.
    • For blindness, deafness, total loss of speech, a survival period of 6 months is required from the date of first diagnosis.
    • This policy is available in 1 or 2-year policy terms. If you choose a 2-year policy term, you can get a premium discount of 7.5%.
    • There is a grace period of 30 days from the date of expiry to renew this policy cover.
    • The sum insured amount chosen by the insured can be enhanced only during the time of renewal subject to the discretion of the company. This can be done only if no claim was made in the previous year.
    • The insurer allows portability option without losing out on the accumulated benefits on a health insurance cover.
    • Policyholders are eligible for tax relief on the premium amount paid for this policy as per Section 80D of the Income Tax Act.

    Benefits of Apollo Munich Optima Vital

    The range of benefits offered by this critical illness health insurance plan can be given as follows:

    Benefit Extent of cover
    Lump sum benefit for critical illness (after the satisfaction of the survival period) Covered for up to 37 critical illnesses
    E-Opinion Second opinion available from a medical practitioner chosen from the company’s panel

    Exclusions of Apollo Munich Optima Vital

    Apollo Munich will not provide any compensation for the following conditions:

    • Injuries sustained while breaching the law with criminal intent
    • Injuries related to suicide attempt or other self-inflicted injuries
    • Illnesses or injuries arising as a result of war or warlike operations
    • Injuries sustained as a result of participation in extreme sports (e.g. scuba diving, bungee jumping, martial arts, etc.)
    • Medical issues that can be attributed to drug or alcohol abuse
    • Any illnesses that can be attributed to HIV or AIDS
    • Congenital diseases, birth defects, and anomalies
    • Medical expenses related to childbirth, pregnancy, miscarriage, etc.
    • Any expenses related to external aids and appliances
    • Any medical or non-medical expenses incurred during hospital stay (only the lumpsum benefit is available here.).

    Claim Procedure

    Any occurrence of an event that may give rise to a claim must be intimated to the company within 14 days of first diagnosis. After the completion of the survival period, the claim must be filed to the company within a maximum of 45 days. If the insurance company seeks any additional documents, it must be submitted within 15 days. The documents required by the company may include physician certificate, diagnostic reports, other medical records, etc.

    Upon submission of the required documents, the company will begin the verification process. Once the verification process is over, the company will send the admissible amount and the acceptance document to the insured person. The settlement amount will be provided to the insured within 7 days of acceptance of the claim. If the settlement is not provided within 7 days, the company will pay an interest of 2% as per the IRDAI regulations.

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