Apollo Munich Health Insurance

About Apollo Munich Health Insurance

Apollo Munich Health Insurance Company merged with HDFC Ergo in 2020. HDFC signed a definitive agreement with Apollo Munich Health Insurance to buy out the entire Apollo Hospitals Group’s stake of 50.8% for ₹1,136 crore and another 0.4% stake held by a few employees for ₹10.84 crore.

After merging with HDFC Ergo Health Insurance, Apollo Munich expanded its insurance product portfolio. The insurer offers insurance products ranging from motor, health, travel, home, and personal accident.

Key Highlights

• 16,000+ Network Hospitals
• 98.59% Claim Settlement Ratio
• 2 Claims Per Minute
• Global Coverage Available
• 24X7 Customer Support

Apollo Health Insurance Plans

Of the above-mentioned plans, HDFC ERGO currently offers the first three plans, i.e., Optima Restore, Optima Secure & Optima Senior.

Existing policyholders of ENERGY and Easy Health can still renew their policies if they choose to. They also have the option to port their policy to a different one.

Features That Set Them Apart

• Special health plans for autism and diabetes
• A comprehensive wellness system to promote a healthy lifestyle
• Emergency air ambulance services
• International travel for treatments
• Unlimited teleconsultations

Coverage for Inadmissible/Uncovered Expenses

During hospitalization, insurers do not cover certain expenses, which are coined as inadmissible expenses. For example, expenses incurred on diagnostic tests, surgical accessories, or costs of the patient’s attendant.

Combined Product Suite

Policyholders, both existing and new, have gained access to a considerably larger, combined product offering of both the parties involved in the transaction.

Wider Distribution Network

HDFC ERGO General has access to the agency network, comprising over 85,000 agents, previously established by Apollo Munich Health Insurance. This has further expanded the distribution capabilities, enabling effective issuance of the combined product suite of HDFC ERGO General and Apollo Munich.

Enhanced Customer Experience

Customer Support Service has been improved and updated to include digital and 24x7 multi-lingual in-house servicing capabilities.

Cashless Network of 12,000+ Hospitals

Customers can now access cashless hospitalization at over 12,000 network hospitals. Further, HDFC ERGO now has a geographical reach of 203 branch offices and over 250 digital offices.

Impact on Existing Customers of Apollo Munich Health Insurance Policies

While the transaction has been mutually beneficial for both firms, old customers of Apollo Munich have raised several concerns over their existing policies and claims. The following pointers shed light on how the transition to HDFC ERGO is likely to affect their purchases.

1. Policy Terms & Conditions

   There will be no changes in your policy terms & conditions, and they will remain the same as detailed in the existing policy document.

2. Policy Renewal

   On renewal, all continuity benefits shall be available as per the existing policy terms & conditions.

3. Claim Process

   Existing claim processes remain unchanged.

4. Health Card

   Your existing Health Card will continue to be valid.

5. Accrued Benefits

   All benefits accrued thus far will continue to be available. Also, there will be no changes in premiums.

6. Claim Settlement

   All claims, including pending ones, will be honored as per the mentioned policy terms, and the existing health cards will continue to be valid.

7. Branch Network

   If you want to extract information about existing branches, merger or relocation of branches, or introduction of new branch offices, you can visit the official website of HDFC Ergo.

What is Covered?

Pre and Post Hospitalization Expenses

HDFC ERGO Health Insurance understands the impact of rising medical expenses, so they have made sure that their insurance plans contain pre and post-hospitalization expenses related to in-patient hospitalization.

AYUSH Treatments

Most HDFC ERGO Health Insurance plans have in-built alternative treatment cover which you can utilize to your benefit. AYUSH treatments include Ayurveda, Unani, Siddha, and Homeopathy treatments.

Hospitalization Expenses

HDFC ERGO health insurance plans cover your hospital expenses like room rent, ICU charges, surgery expenses, doctor consultations, and other such expenses.

Day Care Treatments

Multiple procedures do not require a 24-hour hospitalization. With this in mind, a majority of the HDFC ERGO health insurance plans are designed to cover daycare procedures for policyholders.

Domiciliary Hospitalization

On a doctor’s recommendation, a policyholder can avail of medical care in the comfort of their home. HDFC ERGO health insurance plans cover domiciliary hospitalization up to specified sub-limits.

What is not Covered?

Self-Inflicted Injuries

HDFC ERGO health policies will not cover injuries or hospitalization caused by self-harm.

Cosmetic Procedures

HDFC ERGO Health Insurance plans do not cover any kinds of cosmetic surgeries or treatments.

Adventure Sports

HDFC ERGO Health Insurance plans will not cover you for hospitalizations or accidents caused due to adventure sports.

Obesity or Weight Control Treatments

HDFC ERGO Health Insurance plans mostly do not cover treatments related to obesity and weight management such as bariatric surgeries.

Involvement in Illegal Activities

HDFC ERGO health insurance company plans do not cover individuals or families for hospitalization or injuries caused due to unlawful activities.

HDFC ERGO Health Insurance Plans Buying Process

If you are looking forward to purchasing HDFC ERGO Health insurance online, follow the simple steps below:

1. Step 1

   Visit the PolicyX health insurance page, and enter your details such as name, age, number of members to be covered, and city.

2. Step 2

   Click on 'Get free quotes' and compare HDFC ERGO Health Insurance Plans as per your needs.

3. Step 3

   Select and pay premiums online for the purchased HDFC ERGO health insurance plan of your choice.

4. Step 4

   Our team of insurance experts at PolicyX will provide you with all the assistance required regarding claims and other queries post-purchase of your HDFC ERGO Health Insurance plan.

Documents Required For HDFC ERGO Health Policy Claim Settlement

Submit the following documents when filing for HDFC ERGO health claims:

• Duly completed and signed claim form, in original
• Valid photo-ID proof
• Medical practitioner's referral letter and prescription
• Original bills, receipts, and discharge cards from the hospital/medical practitioner
• Original bills from pharmacy/chemists
• Original pathological/diagnostic tests reports/radiology reports and payment receipts
• Indoor case papers
• First Information Report, final police report, if applicable
• Post-mortem report, if conducted
• Any other document as required by the company to assess the claim

How to Calculate the Premiums?

Compare and calculate the best health policies with the PolicyX premium calculator with these simple steps:

1. Step 1

   Visit the official website of 'PolicyX'.

2. Step 2

   Fill in details such as name, number of family members to be covered, city, and other information.

3. Step 3

   Click on 'Get Quotes'.

P.S - Connect with PolicyX health insurance experts for Apollo Munich health insurance policy renewal at 1800-4200-269.

HDFC ERGO Health Insurance Plan Claim Process Steps

You can file for cashless as well as reimbursement claims for your HDFC ERGO Health Insurance Plans by following these easy steps:

1. Step 1

   Visit the website of HDFC ERGO Health Insurance, and select the "Claim" option. Then click on "Claim Intimation" to check out the form.

2. Step 2

   Now select "health claim" and provide the required information, which includes the policy number, date of birth, and other details they ask for.

3. Step 3

   Now select the "claim type", whether you want to opt for a cashless claim or reimbursement. Click on "authorize" and you will receive an OTP on the verified number.

4. Step 4

   Get verified with the OTP and fill in the required hospital admission information, select the hospital, and fill in the hospital details in case of a non-network hospital.

5. Step 5

   Upload the asked documents and click on the "review" button.

6. Step 6

   After clicking on the review button, you need to submit the intimation for the company to review. You will receive a claim intimation number, which you need to note down for future purposes.

HDFC ERGO Health Insurance Renewal Process

Follow these steps for HDFC ERGO Health Insurance policy renewal:

1. Step 1

   Visit the official website of HDFC ERGO Health Insurance Company.

2. Step 2

   Click on the ‘Renew’ tab.

3. Step 3

   Mention your ‘Policy Number’ and ‘Date Of Birth’.

Connect with our insurance experts for HDFC ERGO health insurance policy renewal at 1800-4200-269.

How To Port To Apollo Munich Health Insurance?

To port your existing policy to Apollo Munich Health Insurance, follow the steps mentioned below:

1. Step 1

   Fill out the portability form, and send the application to Apollo Munich Health Insurance Company 45 days before your existing health plan renewal date.

2. Step 2

   As per the guidelines of IRDAI, the new insurance company will cross-check your medical and claims history from the previous insurer within 7 days of receiving the portability form.

3. Step 3

   Once the policyholder's details are verified, the new insurance company has to communicate its decision - either approval or rejection - within 15 days.