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  • 8/7/2019 about maxima


    Welcome to Apollo Munich Health Insurance Co. Ltd

  • 8/7/2019 about maxima


    Urban Spending in Healthcare will increase due to a variety o actors

    Why Health Insurance ?

    FactorsIncrease inLi estyle Diseases

    Enhanced qualityo Hospitals

    Increasing A uence

    Healthcare Spend in India


    To double in next 5 years

    F i n a n c

    i a l Y e a r

    0 9

    F i n a n c

    i a l Y e a r

    1 3


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    How do you ensure you can get the best qualitytreatment even i it costs a lot?

    Reduce savings- Postpone a dream

    Borrow money- Lose dignity

    Do nothing- Pray

    Compromise- Feel guilty

    Take Health Insurance- Protect whats dear to you

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    Why Apollo Munich

    We know healthcare. We know insurance.

    Over 5000 Experts across26 locations Worldwide,Customers rom over 100 Countries

    50 Hospitals,1068 Pharmacies,8000 Doctors andTrust o 16 million patients

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    Lets Uncomplicate.Not only a positioning but a belie and journey. We make quality healthcare easy and accessible.Simple language, clear policies, transparent procedures and

    innovative products, making health insurance the way it ought to be.


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    Great Customer Service.100% Li elong Renewal.

    Clear Policy Wordings and Conditions.

    Cashless Access to the best 10,000 Doctors and4500 Hospitals in over 800 cities.

    Tax Deduction under Section 80D.

    Our Healthcare and Health Insurance expertise.

    One o the Fastest Claims settlement in the Industry.

    All our planscome with...

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    Indias First truly Comprehensive Health Insurance Plan

    Inpatient Treatment

    Annual Health Check Up

    Dental & Vision Care

    OPD treatment & medicine

    Critical illness Rider

    Diagnostic Tests


    We dont just care or the

    BIG ILLNESSES, Were or theLITTLEIllnesses too

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    Maxima provides an in-patient cover along with hoards o other benefts withan unique out-patient cover.

    Wide In-patient Hospitalisation cover: Maxima o ers ` 3,00,000 coveror In-patient hospitalization, pre and post hospitalization, 140 day care

    procedures, etc.

    Wide Out-patient cover: Flexible out-patient beneft within the OPD suminsured covering expenses or doctor consultation, pharmacy expenses,

    spectacles, contact lenses, health check-up and diagnostic tests. Cashless Hospitalisation: Cashless hospitalisation can be availed at over

    4000 hospitals across 800 cities.

    Life Long Renewal bene t: 100% li e long renewal beneft with no coverceasing age.

    Additional Critical Illness cover:Optional additional coverage against 8specifed critical illnesses is also available.

    Renewal bene ts: 10% cumulative bonus on in-patient hospitalizationSum Insured or every claim ree year and 50% carry orward bonus orunutilized OPD benefts(except Annual Health Check-up).

    Maxima Complete What makes it comprehensive?

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    Out-patient Consultations: 4/6/8 consultations as per plan optedor you and your amily anywhere.

    Pharmacy Expenses: Your pharmacy bills are covered as well.

    Diagnostics Tests: Cost o diagnostic tests taken by you or anyonecovered in your amily will also be paid.

    Specialist Services: Dental treatment, Spectacles and contact

    lenses are all taken care o up to a certain limit. Health Check-up: Any person above 18 years o age is provided

    with an Annual Health Check-up (person above 45 years canavail this beneft rom second year).

    Pre-existing illnesses under OPD Bene ts, covered: I you needmedicines or a Doctor consultation or any pre-existing illness,

    itll be covered without any waiting period. Flexibility:Enjoy reedom rom sub limits. Use the OPD vouchers

    as per your needs and requirements without worrying about anysublimits.

    Tax bene ts: You have the advantage o saving an optimumamount under section 80 D o Income Tax Act.

    Maxima unique What makes it di erent?

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    In-patient benefts

    1 Member 2 Members 2 Adults +Upto 2 Children

    Sum Insured per Policy year ` 300,000 ` 300,000 ` 300,000

    a) In-patient Hospitalisation Covered

    b) Pre-Hospitalisation 30 days

    c) Post-Hospitalisation 60 days

    d) Day Care Procedures 140 procedures Covered

    e) Domiciliary Treatment Covered) Daily Cash or choosing Shared Accommodation ` 500 per day, Maximum ` 3,000

    g) Organ Donor Covered

    h) Emergency Ambulance up to ` 2,000 per hospitalisation

    i) Daily Cash or Accompanying an Insured Child ` 300 per day; Maximum ` 9,000

    j) Maternity Expenses* (Waiting Period 4 years) Normal Delivery- ` 15,000;Caesarean Delivery- ` 25, 000 (Including Pre/Post Natal

    limit o ` 1,500 and in ant baby limit o ` 2,000)k) Newborn baby cover Optional

    Optional Beneft

    Critical Illness* (O ered on Individual basis) ` 300,000

    * Benefts do not dip into In-patient Sum Insured

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    Out-patient benefts

    1 Member 2 Members 2 Adults +

    Upto 2 Children

    a) Doctor consultations* 4 consultations 6 consultations 8 consultations

    b) Diagnostic tests#

    c) Pharmacy# ` 5,000 ` 5,500 ` 7,000

    d) Dental treatment#

    e) Spectacles, Contact lenses#

    ) Annual Health Check-up within 1 Entitlement 2 Entitlement 2 Entitlementspecifed Network** Certifcate Certifcates Certifcates

    *The reimbursement against non-network out-patient consultation is restricted up tolower o actual expenses or ` 400

    #The reimbursement against Diagnostic tests, OPD Dental treatment, Spectacles, Contactlenses outside Apollo Munich network is restricted upto lower o actual expenses or the

    Sum Insured mentioned herein.**Health check-up is available only within the specifed network and not available onreimbursement basis.

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    30 days waiting period: For the irst 30 days o your policy we would provide cover only or medexpenses arising out o accidental emergency conditions.

    2 years disease specific waiting period: For speci ic diseases like cataract, hernia, hysterectomy, joint replacement, hydrocele etc your claims would be payable only a ter you have completed 2 consective years as our insured customer.

    Pre-existing disease: In case you have any diseases at the time o taking the policy then the claimspertaining to the same would be payable only rom the 4th year onwards o taking the policy. Pleaseremember to declare all medical conditions at the time o taking the policy so that we can pay your cla

    aster. This condition is not applicable or OPD bene its.

    Apollo Munich would not provide cover or... Expenses arising out of medical conditions like HIV, AIDS & related disease.

    Expenses arising out of medical conditions pertaining to internal & external congenital diseases.

    Non-allopathic treatments.

    Expenses for artificial limb and external devices.

    Expenses for Cosmetic treatment or items of personal comfort and convenience.

    Please re er to the policy wording or the comprehensive set o exclusions


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    O erings Apollo Munich Majority o othersLi e Long Policy Renewal-Cover rom Cradle to Grave

    YES O er cover around 75 years only

    No Sub-limits on Room Rent-No need to compromise on acilitieswhen it comes to healthcare

    O ered Limit o room rent up to 1% o thesum insured

    Portability o Benefts-Carry orward o benefts rom exist-ing Health Insurance Policy

    O ered Not o ered resulting in loss o ac-crued benefts

    Outpatient benefts O ered Most Insurers dont o er

    Additional Cover or Critical Illness O ered as optional rider beneft withcore inpatient o ering

    Others o er as a separate product

    New Born & Maternity Benefts O eredwith a waiting period Most Insurers dont o er

    Health Line Supportor any time medical assistance

    O ered Most Insurers dont o er

    Annual Health Check-up O ered Most Insurers dont o er

    What We OFFER & Others DONT

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    2 Adults between the

    age o 18 45 years

    1 Adults between the

    age o 18 45 years

    MAXIMA Premium (Incl. Taxes) ` 15,216Tax Beneft U/S 80D^ ` 4,635OPD Entitlement Certifcates ` 10,100E ective Inpatient Premium ` 480

    MAXIMA Premium (Incl. Taxes) ` 21,105Tax Beneft U/S 80D^ ` 4,635

    OPD Entitlement Certifcates ` 14,900E ective Inpatient Premium ` 1570

    Maxima maths What makes it a steal.

    Its like money coming back to you along withhealth Insurance cover o ` 3,00,000.

    ^Indicative fgures. Consult your Tax Advisor or applicablbenefts. Tax benefts are subject to changes in Tax Laws.

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    Policy Issuance:Over 93% o the policies are issued within 7 working days while83% o the times the policy is issued within 3 working days.

    Cashless Authorization:Over 90% o the times, the cashless authorization is done within2 hours o claim intimation.

    Claim Settlement:Over 95% o the claims are settled within 30 days with averageclaims settlement duratio

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