REACH US
• Life-long Renewal: We offer life-long renewal regardless of your health status or previous
claims made under your policy, unless the Insured Person or any one acting on behalf of an
Insured Person acts in a dishonest or fraudulent manner or if there is any misrepresentation
under or in relation to this policy or it poses a moral hazard.
• Waiting Period: The waiting periods mentioned in the policy wording will get reduced by
1 year on every continuous renewal of your policy.
• Renewal premium are subject to change with prior approval from IRDAI. Any change in
benefits or premium (other than due to change in Age) will be done with the approval of the
Insurance Regulatory and Development Authority and will be intimated at least 3 months in
advance.
• In the likelihood of this policy being withdrawn in future, intimation will be sent to insured
person about the same 3 months prior to expiry of the policy. Insured Person will have
the option to migrate to similar indemnity health insurance policy available with us at the
time of renewal with all the accrued continuity benefits such as Multiplier Benefit, waiver
of waiting period etc. Provided the policy has been maintained without a break as per
portability guidelines issued by IRDAI.
• Sum Insured Enhancement: Sum Insured can be enhanced only at the time of renewal
subject to no claim having been lodged/paid under the Policy. If the insured increases
the Sum Insured one grid up, no fresh medicals shall be required. In case 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 for the amount by which
the Sum Insured has been enhanced. However, the quantum of increase shall be at the
discretion of the company.
• Any Insured Person in the policy has the option to migrate to similar indemnity health
insurance policy available with us at the time of renewal subject to underwriting with all
the accrued continuity benefits such as Multiplier Benefit, waiver of waiting period etc.
Provided the policy has been maintained without a break as per portability guidelines
issued by IRDAI.
TERMS
OF RENEWAL
STATUTORY WARNING
Section 41 of Insurance Act 1938 as amended by Insurance Laws Amendment Act, 2015 (Prohibition of Rebates):
No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take out or renew or
continue an insurance in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of
the commission payable or any rebate of the premium shown on the policy, nor shall any person taking out or renewing
or continuing a Policy accept any rebate, except such rebate as may be allowed in accordance with the published
prospectuses or tables of the insurers. Any person making default in complying with the provision of this section shall be
liable for a penalty which may extend to 10 lakh rupees.
DISCLAIMER
Insurance is the subject matter of the solicitation. This is only a summary of the product features. The actual
benefits available are as described in the policy, and will be subject to the policy terms, conditions and exclusions.
The purchase of an Apollo Munich Health Insurance Company Limited product by Axis Bank Limited customers is
purely on a voluntary basis. For more details on benefits, exclusions, limitations, terms and conditions, please read
sales brochure/ policy wordings carefully, before concluding a sale. All Insurance applications are subject to the
Insurance Company`s underwriting and acceptance. For clarifications, customers can call on 1800 200 3003
or write to axiscare@apollomunichinsurance.com
Axis Bank Limited is a Licensed Corporate Agent (CA license no. 1891411) of Apollo Munich Health Insurance Company
Limited (IRDAI registration no.131). The insurance products are underwritten by Apollo Munich Health Insurance
Company Limited, having its registered with its registered office at Apollo Hospitals Complex, Jubilee Hills, Hyderabad-33.
This information is given by Axis Bank Limited (‘Axis Bank’) whose registered office is at ‘TRISHUL’, Third Floor, Opp.
Samartheshwar Temple, Nr. Law Garden, Ellisbridge, Ahmedabad 380006
Customers can contact/ get detailed process information for Post free look cancellation/ termination/
surrender/ and refund, Claims and Escalations/ service queries.
1800 200 3003
www.apollomunichinsurance.com
Axis Bank is a licensed corporate agent of Apollo Munich Health Insurance Company limited under the composite
license number 1891411. This Insurance policy is offered and underwritten by Apollo Munich Health Insurance
Company limited. Participation by Axis Bank customers shall purely be on voluntary basis. For more details on terms
and conditions please read sales brochure carefully before concluding a sale. • IRDAI Registration Number - 131
• CIN: U66030AP2006PLC051760 • UIN: IRDA/NL-HLT/AMHI/P-H/V.II/1/14-15
HEALTH INSURANCE
AS UNIQUE AS YOU.
AX/OR/BR/V0.02/022016AMHI/MA/H/0002/0139/122015/P
JSA/AMHI/M/A16/057
Apollo Munich Health Insurance Co. Ltd. Central Processing Center, 2nd & 3rd Floor, iLABS Centre,
Plot No. 404-405, Udyog Vihar, Phase-III, Gurgaon - 122 016, Haryana. Corp. Off: 1st Floor, SCF -19,
Sector - 14, Gurgaon - 122 001, Haryana. Regd. Off: Apollo Hospitals Complex, Jubilee Hills,
Hyderabad - 500 033, Telangana. Tel : +91 124 4584333 Fax: +91 124 4584111
• Any treatment within first 30 days of cover except any accidental injury.
• Any Pre-existing diseases/ conditions will be covered after a waiting period of 3 years.
• 2 years exclusion for specific diseases like cataract, hernia, hysterectomy, joint replacement etc.
• Expenses arising from HIV or AIDS and related diseases.
• Abuse of intoxicant or hallucinogenic substance like drugs and alcohol.
• Pregnancy, dental treatment, external aids and appliances.
• Hospitalization due to war or an act of war or due to nuclear, chemical or biological weapon and
radiation of any kind.
• Non-allopathic treatment, congenital diseases, mental disorder, cosmetic surgery or weight
control treatments.
For complete exclusions please refer to the policy document.
MAJOR
EXCLUSIONS
SMS ‘AXIS’ to 56767333
Apollo Munich brings you the, 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.
If someone’s illness in your family uses up the coverage in a floater policy and if any other
family member falls ill later during the same insured period, we will restore the entire amount
at no extra charge.
So, if you have a Rs. 5 lakhs policy and exhaust the entire amount, we will restore Rs.
5 lakhs, which you can use for some other illnesses or for any other member covered
under the family floater policy, if needed.
The Restore benefit would trigger once the basic sum insured and accumulated bonus
(if any) on the policy is completely exhausted.
The amazing restore benefit also comes with a never before renewal incentive. If you’ve had
a claim free year, we will increase your basic sum insured by 50% as a no claim bonus. If
you don’t claim even in the second year, we’ll double your basic sum insured as a no claim
bonus i.e. 100% of the basic Sum Insured.
So, if you have a 5 lakh policy and don’t claim in the first year, we will increase your cover to
7.5 lakh for the second year and 10 lakh in the third year (if you don't claim in the second
year), while you only pay a premium for a 5 lakh policy.
Lifelong renewal: Renew your cover
lifelong and stay covered forever.
No sub-limit on room rent: : With
this health plan you can get the room
you like and the treatment you deserve
without a hassle.
Cashless transactions:
OptimaRESTORE enables you to get
treated on a cashless basis across
4000 hospitals in over 800 cities.
No geography based sub-limits:
No matter where you buy your policy
you can get treated in any city or
hospital you like in the country with no
additional copays or sub-limits.
No claim based loading: We will
never load your renewal premium
because you claimed or fell ill after
taking our policy.
Quick turnaround time: You don’t
have to worry about pre-authorization,
90% of pre-authorization is done
within 2 hours.
Quick claim payment: When it
comes to claim settlement, we’re one
of the fastest in the industry to honor
every genuine claim.
Certified associates: When you deal
with us you can be assured that all our
field partners and sales executives are
well trained.
Easy upgrade: This health plan also
comes with an easy upgrade option.
You can upgrade your cover to the next
slab at the time of your policy renewal.
Unbelievable
RESTORE
BENEFIT
Unbelievable
MULTIPLIER
BENEFIT
OptimaRESTORE, offers you easy portability, so if you are insured under another Insurer’s
health insurance policy you can transfer to Apollo Munich with all your accrued benefits after
due allowances for waiting periods and enjoy all the unbelievable benefits of OptimaRESTORE.
• Maximum Age: The maximum entry age is 65 years. There is no maximum cover ceasing
age in this Policy.
• Minimum Age: The minimum entry age is 91 days. Children between 91 days and 5 years
can be insured provided either parent is getting insured under this Policy.
• The cover will be valid for 1 or 2 year(s) as opted. An additional 7.5% discount is offered on
the premium if you choose a 2 year Policy.
• An individual and/or his family members namely spouse, dependent children and dependent
parents/parents-in-law are eligible for buying this cover on an individual or floater basis.
• A maximum of 6 members can be added in a single policy, whether on individual or floater
basis.
• In an individual policy, a maximum of 4 adults and a maximum of 5 children can be included
in a single policy. The 4 adults can be a combination of self, spouse and either set of
dependent parents or parents in law
• In a family floater policy, a maximum of 2 adults and a maximum of 5 children can be
included in a single policy. The 2 adults can be a combination of self, spouse or either set
of dependent parents or parents in law.
• The sum insured of the dependent insured members should be equal to or less than the
sum insured of the primary insured member. In case where two or more children are
covered, the sum insured for all the children must be same. Sum insured of dependent
parents /parents-in-law must be the same.
PORTABILITY
REMEMBER
RESTORE
INDIVIDUAL
RESTORE
FAMILY
2X
Basic Sum Insured per Insured
Person per Policy Year (Rs. in Lakh)
3.00, 5.00, 10.00, 15.00 20.00, 25.00, 50.00
1) In-patient Treatment Covered
Pre-Hospitalisation Covered Upto 60 days
Post-Hospitalisation Covered upto 180 days
Day Care Procedures All Day Care Treatments Covered
Domiciliary Treatment Covered
Organ Donor Covered
Emergency Ambulance Upto Rs. 2,000 per Hospitalisation
Daily cash for Choosing shared
accommodation
Rs. 800 per day for max
6 days
Rs. 1000 per day
for max 6 days
E-opinion in respect of critical
illnesses
One opinion per policy year
2) Restore Benefit Equal to 100% of Basic Sum Insured
3) Multiplier Benefit
Bonus of 50% of the Basic Sum Insured for every
claim free year, maximum upto 100%. In case of a
claim, bonus will be reduced by 50% of the Basic
Sum Insured at the time of renewal. However this
reduction will not reduce the Sum Insured below
the basic Sum Insured of the policy
Basic Sum Insured per
Policy Year (Rs. in Lakh)
3.00, 5.00, 10.00, 15.00 20.00, 25.00, 50.00
1) In-patient Treatment Covered
Pre-Hospitalization Covered upto 60 days
Post-Hospitalization Covered upto 180 days
Day Care Procedures All Day Care Treatments Covered
Domiciliary Treatment Covered
Organ Donor Covered
Emergency Ambulance Upto Rs. 2,000 per Hospitalisation
Daily cash for Choosing
shared accommodation
Rs. 800 per day for max
6 days
Rs. 1000 per day for max
6 days
E-opinion in respect of
critical illnesses
One opinion per policy year
2) Restore Benefit Equal to 100% of Basic Sum Insured
3) Multiplier Benefit
Bonus of 50% of the Basic Sum Insured for every claim free
year, maximum upto 100%. In case of a claim, bonus will
be reduced by 50% of the Basic Sum Insured at the time
of renewal. However this reduction will not reduce the Sum
Insured below the basic Sum Insured of the policy
You can avail tax benefits for the premium amount upto Rs. 25,000
for your immediate family and an additional benefit upto Rs. 30,000
in case of your parents under Section 80 D of the Income Tax Act. (Tax
benefits are subject to changes in tax laws.)
What makes OptimaRESTORE a unique health plan is not just the Unbelievable Restore
and Multiplier benefit but many other unique features that truly uncomplicated healthcare.
UNIQUE
FEATURES
Family Discount of 10% if 2 or more family members are covered
under Optima Restore Individual Sum Insured Plan.
An additional 7.5% discount is offered on the premium if you choose
a 2 year policy
TAX BENEFIT
DISCOUNTS
