Optima Restore Individual
Our first of a kind Optima
Restore plan offers a unique Restore benefit that automatically reinstates the
basic sum insured in case you exhaust it in a policy year. Sure it sounds too
good to be true but here is how it works: If you use up your coverage in an
individual policy and fall ill with another illness, we will restore the entire
sum insured for you to use, at no extra charge. It also rewards you with a
multiplier benefit in case you don’t claim in the policy. The multiplier
benefit doubles the sum insured in 2 claim free years!
Eligibility:-
We offer coverage from the
age of 5 years onwards with maximum entry age of 65 years. A dependent child
can be covered from the 91st day (if either parents are covered under this
policy).
You and/ or your family
members namely spouse, dependent children, dependent parents / parents in law
are eligible for buying this cover on individual sum insured basis. (we offer a
family discount of 10% if 2 or more family members are covered under the same
policy)
Maximum 6 members can be
added in a single policy. In an individual policy, a maximum of 4 adults and a
maximum of 5 children can be included in a single policy.
Your premium at renewal
may change due to a change in your age or changes in the applicable tax rate.
The policy period options
include period of 1 or 2 years(s). (We offer 7.5% discount if you opt for a 2
year policy)
Plan Benefits:-
In-Patient Hospitalisation -
The medical expenses for coverage for hospitalization of more than 24 hrs with
no room rent limits.
Pre-Hospitalisation -
The medical expenses that you incur due to illness during 60 days immediately
before you are hospitalized.
Post-Hospitalisation
-
The medical expenses you incur in the 180 days immediately after you are
discharged from hospital.
Day-Care
Procedures - The medical expenses for all day-care procedures
covered, which do not require 24 hours hospitalization due to technological
advancement, are covered.
Domiciliary
Treatment - The treatment expenses involved in getting
a treatment done at home which otherwise would need hospitalization.
Organ
Donor - Treatment expenses for the organ donor at the time of
organ transplant.
Daily
Cash for Choosing Shared Accommodation - A lump sum amount given
for selecting a shared room in a network hospital.
Emergency
Ambulance - Expenses incurred if ambulance service is
used on the way to hospital for hospitalization (up to Rs. 2000).
Health
Check-up - A comprehensive health check-up involving a number of
medical tests only once at the end of a block of two continuous policy years.
(For Sum insured above 15 lacs).
Restore
Benefit - Automatic re-instatement of the basic sum insured, if
the basic sum insured and multiplier benefit has been exhausted during the
policy year. Basic sum insured will be re-instated only once in a policy year.
E-opinion
-
On request of the Insured person diagnosed with a crticial illness, We will
arrange for a second opinion from a medical practitioner selected by the
insured person from Our panel. This benefit can be availed once in a policy
year.
Other Benefits
Multiplier
Benefit - You get a bonus of 50% of the basic sum insured for
every claim free year accumulating up to 100%. (In the event of a claim, the
bonus shall be reduced by 50% of the Basic Sum Insured at the time of renewal).
Cashless
Service - You need to obtain a pre-authorization for all planned
admissions atleast 48 hours prior to actual admission or regularize any
‘emergency’ admission within 24 hours post the admission. The details of the
process and the documentation requirements are given in the guide-book sent
along with the policy.
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 one grid up, no fresh medicals shall be
required. In cases where the sum insured increase is more than one grid up, the
case shall be subject to medicals. 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.
Portability
-
If you are insured with some other company’s health insurance and you want to
shift to us on renewal, you can. Our portability policy is customer friendly
and aims to achieve the transfer of most of the accrued benefits and makes due
allowances for waiting periods etc.
Tax
Benefits - With the Optima Restore Individual Health Insurance
Plan you can presently avail tax benefits for the premium amount under Section
80D of the Income Tax Act. (Tax benefits are subject to changes in Tax Laws)
For More details Kindly contact
Apollo Munich Health Insurance Advisor:- APURV GOURAV Mob:- +919970506893
