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Optima Cash Policy from Apollo Munich

 Optima Cash is our top up plan that provides coverage for daily cash benefit in case of hospitalisation due to illness or accidents. In addition, it also offers vast covers such as Day care procedures, convalescence benefit, parent’s hospitalization etc.

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 parent is covered under this policy).
  • You and/ or your his family members namely spouse, dependent children (we offer a family discount of 10% if 2 or more family members are covered under the same 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).
Benefit

Plan Benefits

  • Sickness Hospital Cash -Daily cash amount paid for each continuous and completed period of 24 hrs , if the insured is hospitalised due to sickness.
  • Sickness ICU Cash - Twice the daily cash amount paid for each continuous and completed period of 24 hrs , if the insured is hospitalised due to sickness.
  • Accidental Hospital Cash - Daily cash amount is paid for each continuous and completed period of 24 hrs , if the insured is hospitalised due to accident.
  • Accident ICU Cash - Twice the daily cash amount for each continuous and completed period of 24 hrs , if the insured is hospitalised due to accident.
  • Day Care Procedure Cash - 50% of the Daily cash amount if the insured undergoes any of the 10 identified day care procedures which do not require 24 hours hospitalization due to technological advancements.
  • Joint Hospitalisation due to an Accident - Twice the daily cash amount for each continuous and completed period of 24 hrs , where two or more insured concurrently hospitalised due to accident.
  • Convalescence Cash - Lumpsum amount is paid if insured person is hospitalized beyond 7 continuous days.
  • Child Birth* - Lumpsum amount equivalent to twice the Sickness Daily Cash amount for maternity to female Insured in event of child birth.
  • Parent Accommodation* - Daily Cash amount for parent’s accommodation if the Insured child is aged 12 years or less and is hospitalised for more than 72 hours.

*Additional Benefits covered under platinum plan

Other Benefits

  • 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.
  • 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.
  • 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 Optima Cash 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)

Health Line Services & Discounts

We provide Health Line Services & Discounts at our listed partner’s network – You just need to call us and quote your customer ID to reach our experts and avail their help in primary consultation, health-related counseling, individual referrals, health information, nutrition and diet.

 

Renewal Policies

  • Optima Cash offers lifelong renewability i.e there is no maximum cover ceasing age in this policy.
  • Grace Period of 30 days for renewing the policy is provided under this policy.
  • Waiting periods as mentioned in the policy wordings gets reduced by 1 year on every continuous renewal of your Optima policy.
  • Renewal premium are subject to change with prior approval from IRDA. Any change in benefits or premium (other than due to change in age) will be done with the approval of the IRDA and will be intimated at least 3 months in advance.
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 4 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 .
  • Hospitalisation 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 Plan.
  • Items of personal comfort and convenience.
  • Experimental, investigative and unproven treatment devices and pharmacological regimens.

 



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Get In Touch

 

customercare@saubhagyaenterprises.in
      
      Contact us at: 011-22571217