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Optima Restore - Apollo Munich Health Insurance - MoneyBloom
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. 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.
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. 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.
Members covered: Individual and family plan. You can avail this policy for maximum combination of 2A2C
Policy Period: Policy available for 1yr and 2 yrs
Policy Available for: Sum Insured Rs.3L-50L
Optima Restore Benefits
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.
Optima Restore Features
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)
Optima Restore Claim Process
You can claim the money by filling the health insurance claim form, which can be collected either from company's office, from agents or online. The following information should be correct to claim for the reimbursement of medical expenses.
Name of the policy holder
Contact details
Policy number
Date and time of problem
Location of problem
Nature of problem
You can register your request for the claims or you can even speak to representative on phone number mentioned on the site or can even mail on the mail address provided. Before you begin filling in the form, it is suggested to read all the related instructions carefully.
Optima Restore Exclusions
All treatments within the first 30 days of cover except any accidental injury.
Any pre-existing condition will be covered after a waiting period of 3 years.
2 years waiting period for specific diseases like cataract, hernia, joint replacement surgeries, surgery of hydrocele etc.
Expenses arising from HIV or AIDS and related diseases.
Congenital diseases, mental disorder or insanity, cosmetic surgery and weight control treatments.
Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol.
Hospitalization due to war or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind.
Pregnancy, dental treatment, external aids and appliances unless covered under the specific Easy Health Insurance Plan.
