Apollo Munich Health Insurance

Apollo Munich health insurance company, now known as HDFC Ergo General Insurance offers exclusive plans for individuals, families, senior citizens, et...Read More

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2 lakh + Happy Customers

Network hospitals

12000+

Incurred claim ratio

98%

Sum insured

Up to 75L

No. of Plans

Solvency Ratio

1.75

Pan India Presence

200+

Customized Health Insurance Plan for you.

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1 Adult

2 Adults

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2 Adults & 2 Children

2 Adults & 3 Children

Other Members

Age of Eldest Member

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About Apollo Munich Health Insurance

Apollo Munich Health Insurance was founded in August 2007, following a joint venture between the Apollo Hospitals Group and Munich Health (a segment of Munich Re) based in Germany. The company was established in India as a stand-alone, private sector Health Insurance Provider. Since its inception, it has established a wide agency network and introduced several new concepts in the Indian Health Insurance space.

In 2020, HDFC acquired a majority stake of 51.25% of Apollo Munich Health Insurance. The acquired entity has been renamed to HDFC ERGO Health. As of FY 2019-20, HDFC ERGO Health has an overall market share of 6.2% and further occupies around 8% market share in the accident and Health Insurance segment.

12000+

Network
Hospitals

UP TO 1 Lakh

Tax
Benefit

90%

Claims Settled
in 2 hours

UP TO 2 Cr

Sum
Insured

24X7

Customer
Support

Product Range of Apollo Munich

Plan Names	Features
Optima Restore	100% of your cover gets restored instantly after making your first claim.
Optima Secure	Customers get a 100% increase in coverage after 2 years, in addition to a 100% restoration of base coverage.
Optima Senior	The policy can be availed for 1 or 2 years. It can be suitable for individuals above the age of 61.
Energy	It covers Type 2 Diabetes Mellitus, Impaired Fasting Glucose, Impaired Glucose Transpose. Sum Insured can range from Rs. 2 Lakhs to Rs. 10 Lakhs.
Easy Health	Sum Insured can range from Rs. 1 Lakh to Rs. 15 Lakh. It covers In-patient Hospitalization, Pre and Post Hospitalization, Day Care, among others.

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.

What are some of the
Features
that set them apart?

1

Special health plans for autism and diabetes
2

A comprehensive wellness system to promote a healthy lifestyle
3

Emergency air ambulance services
4

International travel for treatments
5

Unlimited teleconsultations

Benefits of the Merger

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 offerings of both the parties involved in the transaction.
Wider Distribution Network
HDFC ERGO General has an 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 the 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.

Policy Terms & Conditions

There will be no changes in your policy terms & conditions & will remain the same as detailed in the existing policy document.
Policy Renewal

On renewal, all continuity benefits shall be available as per the existing policy Terms & Conditions.
Claim Process

Existing Claim processes remain unchanged.
Health Card

Your existing Health Card will continue to be valid.
Accrued Benefits

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

Step 1
Visit the PolicyX health insurance page, and enter your details such as name, age, number of members to be covered, and city.
Step 2
Click on 'Get free quotes' and compare HDFC ERGO Health Insurance Plans as per your needs.
Step 3
Select and pay premiums online for the purchased HDFC ERGO health insurance plan of your choice.
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.

HDFC ERGO Health Insurance Renewal Process

Follow the steps for HDFC ERGO Health Insurance policy renewal

Step 1
Visit the official website of HDFC ERGO Health Insurance Company
Step 2
Click on the ‘Renew’ tab
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

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:

Step 1
Visit the website of HDFC ERGO Health Insurance, and select the "Claim" option. Then click on the "Claim Intimation" to check out the form.
Step 2
Now select "health claim" and require the information which is the policy number, date of birth, and other details they ask for.
Step 3
Now select the "claim type", whether you want to opt for a cashless claim or reimbursement. Click on the authorize and you will receive the OTP on the verified number.
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.
Step 5
Upload the documents asked and click on the "review" button.
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.

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 Port To Apollo Munich Health Insurance?

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

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.
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.
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.

More Queries?

If you have any more queries regarding Plans, Renewals, or Claim Procedures, contact our insurance experts at:
1800-4200-269 now!

Apollo Munich Health Insurance: FAQs

1. Will the benefits of my existing policy (Cumulative Bonus, Pre-Existing Diseases cover, etc.) continue or get affected by the merger?

As the product and policy guidelines remain the same, all continuity benefits are available as per existing policy terms and conditions.

2. With the name of the company changing, does the existing policy document under Apollo Munich name remain valid or will I receive a new policy document?

All active policies which are issued under Apollo Munich name shall remain valid till expiry and will not require any amendments. At the time of renewal, a fresh contract with the new company name i.e. HDFC Ergo shall be issued.

3. As an existing customer of Apollo Munic, can I access the Network Hospitals of HDFC ERGO General as well as Apollo Munich?

Apollo Munich customers can access the entire network of HDFC ERGO General. The company now has a network of over 10,000+ hospitals. The updated list of Network Hospitals is available on the website www.hdfcergohealth.com or www.apollomunichinsurance.com (which shall redirect you to HDFC Ergo’s official website)

4. Where can I register or intimate the claim?

There is no change in existing claim processes. You can register the claim by visiting www.hdfcergohealth.com / www.apollomunichinsurance.com or write to them at care@hdfcergohealth.com / customerservice@apollomunichinsurance.com. You can reach out them on their toll-free number 1800-102-0333.

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Apollo Munich Health Insurance

About Apollo Munich Health Insurance

Product Range of Apollo Munich

Benefits of the Merger

Coverage for Inadmissible/ Uncovered Expenses

Combined Product Suite

Wider Distribution Network

Enhanced Customer Experience

Cashless Network of 12,000+ Hospitals

Impact on Existing Customers of Apollo Munich Health Insurance Policies

Policy Terms & Conditions

Policy Renewal

Claim Process

Health Card

Accrued Benefits

Claim Settlement

Branch Network

What is Covered?

Pre and Post Hospitalization Expenses

AYUSH Treatments

Hospitalization Expenses

Day Care Treatments

Domiciliary Hospitalization

What is not Covered?

Self Inflicted Injuries

Cosmetic Procedures

Adventure Sports

Obesity or Weight Control Treatments

Involvement In Illegal Activities

HDFC ERGO Health Insurance Plans Buying Process

HDFC ERGO Health Insurance Renewal Process

HDFC ERGO Health Insurance Plan Claim Process Steps

Documents Required For HDFC ERGO Health Policy Claim Settlement

How To Port To Apollo Munich Health Insurance?

How to Calculate the Premiums?

More Queries?

Apollo Munich Health Insurance: FAQs

1. Will the benefits of my existing policy (Cumulative Bonus, Pre-Existing Diseases cover, etc.) continue or get affected by the merger?

2. With the name of the company changing, does the existing policy document under Apollo Munich name remain valid or will I receive a new policy document?

3. As an existing customer of Apollo Munic, can I access the Network Hospitals of HDFC ERGO General as well as Apollo Munich?

4. Where can I register or intimate the claim?

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Written By: Naval Goel

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