Welcome to Apollo Munich Health Insurance Co. Ltd. · best Six Sigma project in the DMAIC –...
Transcript of Welcome to Apollo Munich Health Insurance Co. Ltd. · best Six Sigma project in the DMAIC –...
Urban spending in healthcare will increase due to a variety of factors
Why Health Insurance ?Factors
Increase in Lifestyle Diseases
Enhanced Quality of Hospitals
Increasing Affluence
Healthcare Spend in India
42
280
Fina
ncia
l Yea
r 201
0
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l Yea
r 202
0 (e
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ated
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USD Billion
How do you ensure you can get the best quality treatment even if it costs a lot?
Reduce savings- Postpone a dream
Borrow money- Lose dignity
Do nothing- Pray
Compromise- Feel guilty
Take Health Insurance- Protect what’s dear to you
Why Apollo Munich
We know healthcare.
We know insurance.
Over 5000 Experts across 26 locations worldwide,Customers from over 100 countries
53 Hospitals, 1068 Pharmacies, 8000 Doctors and Trust of 19 million patients
Philosophy
Let’s Uncomplicate.Not only a positioning but a belief 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.
Great Customer Service.
100% Lifelong Renewal.
Clear Policy Wordings and Conditions.
Tax Deduction under Section 80D*
Our Healthcare and Health Insurance expertise.
One of the Fastest Claims settlement in the Industry.
All our plans come with...
*Tax benefits are subject to changes in the Income Tax Act.
I am ALREADY INSURED
I will Buy it LATER
I can’t AFFORD it right now
I can take care of medical expenses by SACRIFICING my savings
?I don’t want to buy Easy Health because...
What if there was a plan...
that makes existing cover adequateTop up Existing policy either individual or Group
that remains active when you change jobsChange in job doesn’t expose you to high risk
is an easy buyInexpensive Proposition and easy to buy
gives you SUPER benefitGrow at retirement to a full fledged policy
• Tops up your existing group or individual policy by an additional Rs 5/ 7/ 10 lakhs at a minimal price.
• Remains active when you shift between jobs.
• Grows into a comprehensive health insurance plan at retirement.
Optima SuperOptima SuperOptima Super
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Optima SuperOptima SuperOptima SuperOptima SuperOptima Super
Suitability
The minimum and maximum entry age under this plan is 91 days and 65 years respectively (age is calculated as the completed age as on the last birthday).
Child between 91 days and 5 years can be insured only when either parent is getting insured under this policy
Cover Ceasing Age - No cover ceasing age under this policy
Coverage - On individual sum insured basis
Family Definition - Self, spouse, dependent children and dependent parents
Policy Period - 1 or 2 Year(s)
Sum Insured - Rs 500,000, Rs 700,000, Rs 10,00,000
Deductible* - Rs 1 Lac, 2 Lac, 3 Lac, 4 Lac, 5 Lac, 6 Lac, 7 Lac & 10 Lac
Pre Policy Checkup - No pre policy checkup required upto 45 years
* The Deductible is the amount of money that one would need to pay for his medical expenses (either through his own pocket or personal / group insurance plan) before any benefits from his health insurance policy can be used.
In-patient TreatmentHospitalization expenses due to an illness or accident.
Pre-Hospitalisation Medical expenses incurred in 60 days immediately before hospitalisation.
Post-Hospitalisation Medical expenses incurred in 90 days immediately after discharge from hospital.
Day Care ProceduresCoverage for enlisted 144 day care procedures which do not require 24 hours hospitalisation.
Organ Donor Medical expenses for harvesting of the organ donated to the Insured person.
Ambulance ServiceExpenses up to Rs. 2000 per hospitalization.
The policy pays for the benefits, exceeding the deductible opted by the insured member
BENEFITS
Making you RETIREMENT ready
Your small top up cover to become a comprehensive inpatient cover at RETIREMENT.
Rs. 5 Lakhs sum insured inpatient cover at RETIREMENT
No waiting periodAll major diseases covered at RETIREMENT.
Hassle free process and Risk free post RETIREMENT
Grow to a full cover at Retirement
Unique
SUPER BENEFIT
Remember:
Unique
SUPER BENEFIT
You need to buy the policy before 50 years of age and renew the policy continuously without interruption.
SUPER benefit can be opted between the age group of 55-60 years or on fifth consecutive renewal. This benefit can be availed only at renewal.
Portability for WAIVER OF WAITING PERIODS would be provided to the extent of benefits covered in the policy.
Deductible
a) Mr. X has policy (Policy Period- 1 Jan’ 10 to 31 Dec’ 10) with Sum Insured of Rs. 500,000 and with a deductible of Rs. 500,000.
b) In May’ 10, he is hospitalized and a claim is filed for Rs. 400,000. Claim is not admissible in this scenario since his deductible is Rs. 500,000 (deductible reduced to Rs. 100,000 for the policy year).
c) In June’ 10, he is hospitalized and a claim is filed for Rs. 300,000. In this scenario claim payment will be made for Rs. 200,000 (300,000-100,000).
A cost-sharing requirement under a health policy. Claims will be paid when the medical expenses
exceed the deductible amount opted by the insured member. Deductible shall be applicable
on policy year basis (aggregate).
Example
Offerings Apollo Munich Majority of othersSUPER Benefit
Makes you Retirement readyExclusively with Optima Super Not Offered
Family DiscountIf 2 or more members are covered
10% Discount Not Offered
Life Long Policy RenewalNo cover ceasing age
100% Offer cover around 75 years only
No Sub-limits on Room RentNo need to compromise on facilities
when it comes to healthcare
Covered Limit of room rent up to 1% of the sum insured
Day Care ProceduresCoverage for minor treatments
not requiring hospitalisation
144 Day care procedures covered Coverage not offered by most Insurers
Organ Donor Expenses Covered Not Covered by most Insurers
Flexi PlanChange deductible option
Exclusively with Optima Super Not offered
What We OFFER & Others DON’T
• Deductible: Clams will be paid when the medical expenses exceed the deductible amount opted by the insured member. Deductible
shall be applicable only if aggregate of medical expenses in a policy year exeed the deductible amount
• 30 days waiting period: Medical expenses arising out of accidental emergency conditions only will be paid for the first 30 days of policy.
• 2 years disease specific waiting period: For specific diseases like cataract, hernia, hysterectomy, joint replacement, hydrocele etc. claims would be payable only after
insured member has completed 2 consecutive years as our insured customer
• Pre-existing Disease: In case you have any existing condition, please remember to declare all such medical conditions at the time of taking the
policy. Pre-existing diseases, except for any medical condition / disease for which we have applied specific exclusion, shall be covered from 5th year of the policy if the proposal is accepted and policy is issued to You.
• Optima SUPER will not cover: • 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.
Remember
Please refer to the policy wording for the comprehensive set of exclusions.
Centralized In-house Claims Management.
Cashless claims: No TPA involved. Cashless by AMHI directly to the Optima Super network.
Reimbursement claims: By centralized in-house claims unit at HO.
Customer Service: Apollo Munich Health Insurance
Grievance: Apollo Munich Health Insurance (Customer Service)
Claims Administration
Commitment
Policy Issuance:
Over 93% of the policies are issued within 7 working days while 83% of the times the policy is issued within 3 working days.
Cashless Authorization:
Over 90% of the times, the cashless authorization is done within 2 hours of claim intimation.
Claim Settlement:
Over 95% of the claims are settled within 30 days with average claims settlement duration of 15 days for clear cases.
customer
Optima Super for YOU
YOU
TO
ENJOY
BIG
pay nominal premium
opt for higher health risk cover
full fledged cover as it turns
with retirement
Ours is an uncomplicated success story.
Best Insurance Provider in the private sector, Outlook Money Award 2013. For being rated the 22nd Best Company to Work For in India, Great Place To Work 2013. On the back of robust business growth in FY12-13 across a variety of parameters and a high commitment towards customer service in terms of efficient claims settlement and showing innovative approaches to product and technology management and customer engagement, Health Insurer of the year 2013. Industry No. 1 in Insurance Category & Asia’s most promising brand – Apollo Munich, Asia’s Most Promising Brands and Leaders 2013. Asia’s most promising leader – Mr Antony Jacob, Asia’s Most Promising Brands and Leaders 2013. Excellence in Marketing – Asia’s Most Promising Brands and Leaders 2013for instituting a robust Health and Wellness Management technology platform, The Technology Maturity Award 2013. For excellence in six sigma practices within the organization as displayed through projects that are executed in the organization, Lean and Six Sigma Excellence Awards - 2013. Brand Sustainability, Brand Leadership awards 2013. HR Partner forum, Human Resources Shared service 2013 for all-round green computing initiatives, TOP Green IT Enterprise Award 2013. Mission Paryapta’ being the 2nd Best Six Sigma Project in Service industry (DMAIC & DFSS), 2nd Best Six Sigma Project. Best film (Financial Product category), Abby’s (Bronze) 2013. For being rated amongst Top 50 companies having upto 1000 employees; Best in its industry and ranked third in insurance industry, Great Place To Work 2012. Best Insurance Provider in the private sector, Outlook Money Award 2012 For our unbelievable product OptimaRESTORE, Innovation Award 2012. This award was in recognition of our unbelievable product, OptimaRESTORE, Innovation Of The Year award 2012. For our Unbelievable product OptimaRESTORE in the Best Product Innovation Award category, India Insurance Awards 2012. For being rated amongst top 50 in infinancial inclusion projects during 2011, Financial Inclusion Awards 2012. For the effectiveness exuberated by its marketing campaign – ‘Making Time to Pause’, Effie Awards 2012. For all-round green computing initiatives, TOP Green IT Enterprise Award 2012. For being a Role Model and Exemplary Leader in benchmarking talent and HR practices, Best Employer Brand Award 2012Silver for Marketing Campaign (OptimaRESTORE), Digiratti Award 2012. Insurance companies use the report ‘Social Media in the Indian Insurance Industry: User Maturity Benchmarking’ to evaluate the overall maturity of their social media usage and benchmark themselves against peers, User Maturity Benchmarking 2012. Best Company to work in its industry and Among the top 100 companies to work with having upto 1000 employees, Great Place To Work 2011. Futuristic Hall of Fame, Hall of Fame 2011 For the best Six Sigma project in the DMAIC – Services category, Symbiosis award 2011 For demonstrating market leadership in sales generated through the online medium, E-Business Leader 2011. For implementing a workflow-enabled system that supports straight through processing of the entire health product lifecycle with integration to all back end systems, Technology Leader Award 2011. Silver under Service Category, Indian Digital Media Awards 2011. For best recruitment ad in Services, The Remmy Award Nomination 2011. For its print media advertisement for inviting applications for sales positions, The Remmy Award 2011. Most Effective Outdoor Plan, OOH 2011 for Outdoor Advertising & Digital Signage. Best Outdoor Plan – Strategy, OOH 2011 for Outdoor Advertising & Digital Signage. Policy Administration SysteFor m (PAS) category, Policy Administration 2010. Design, distribution and servicing of health insurance products, ISO - 9001:2008 certification 2009. Best corporate wellness organisation, CII Wellness Award 2009. Best Media Plan of the year, Outdoor Advertising Awards 2009
Visit to our
73branch offices across IndiaOur Offices are present in all major cities which include HYDERABAD, CHENNAI, KOLKATA, BAN-GALORE, MUMBAI, DELHI, PUNE, AHMEDABAD, JAIPUR, CHANDIGARH, LUCKNOW and COCHIN
How to Buy
Contact us on our Toll free Number
1800-103-0555
Internet connectivity required
Branch Locator
Buy online now: 100% secure online transaction
www.apollomunichinsurance.com
Apollo Munich Health Insurance Co. Ltd • 2nd & 3rd Floor, iLABS Centre, Plot No. 404-405, Udyog Vihar, Phase-III, Gurgaon-122016, Haryana • Corp. Off. 10th Floor, Tower B,Building No 10, DLF Cybercity, DLF City Phase II, Gurgaon-122002, Haryana. Tel: +91-124-458433 Fax: +91-124-4584111 • Reg Off. Apollo Hospitals Complex, Jubilee Hills, Hyderabad-500033, AP • www.apollomunichinsurance.com • Email: [email protected] • Insurance is the subject matter of solicitation. • For more details on risk factors, terms and conditions please read sales brochure carefully before concluding a sale. • IRDA Registration Number - 131 • Corporate Identity Number: U66030AP2006PLC051760