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The Apollo Hospital Group Group
Unique in reach and brand name in organized healthcare
Over 25 years of presence and experience in healthcare Industry and the father of Corporate Health care in India.
ReachNation wide network of hospitals, pharmacies & clinicsIn addition to the Tele medicine (currently reaching 50,000, to be rolled
out across 5 states) and administering health insurance for the rural poor across the country.
BrandIndia’s largest, best reputed organized healthcare brand Apollo is a trusted brand, which is a strong differentiator in healthcare.
ExpertiseCurrent knowledge of patient histories, disease prevalence treatments & costs makes it an unique integrated healthcare service provider for India.
Customer ExpectationCross sell opportunities are large
Product bundling can also be done with the wellness clinics, pharmacies by bundling health maintenance programs with
insurance products.
GroupLeadership position in Europe in Health Insurance with
strategic investments into Provider, Wellness and Disease Management guided by superior technology platform for Health Insurance. One of the world’s top five private insurers.
ReachGlobal presence DKV present in 9 European countries, China and now India. Provides
service to 7.3 million customers. Income reached 5 billion Euros. Brand
Member of the Munich Re GroupDKV is synonymous to health insurance across the borders of Europe.
A member of the ERGO Insurance Group, belonging to the Munich Re. Expertise
Long lasting health care and Health insurance experienceActuarial , Technical and international Health Insurance expertise built
over 80 years Customer Expectation
Fair practicesBelieve in DKV’s strengths: Innovating new and comprehensive
products
Deutsche Krankenversicherung
Apollo DKV Health Insurance Company
Vision
To provide affordable and innovative health insurance solutions to
every citizen of India and become their first-choice partner in positive
health.
Mission
Our Mission is to:
Constantly introduce innovative health insurance and wellness
solutions that meet customer needs
Build an organization on the principles of transparency, trust and
integrity
Create opportunities for our employees to learn and grow in an
enjoyable work culture
Constantly deliver on our commitments to all the stakeholders
Apollo DKV’s Business Targets
Number of Lives:Apollo DKV expects to cover 2 million lives.
Market:With a market share of 10% in three financial years.
Presence:Six regional Offices and operation across 25 locations.
Product Innovation:Innovative health and travel insurance products lined with wellness and prevention components.
Systems and Technology:State of Art IT supports system across all locations.
Our promise to the country
In Apollo DKV,
we will constantly strive towards:
Partnership : with our customers for their
good health
Enhancement : of affordability and accessibility
Prevention : as an approach towards wellness
Wellness : leading towards…
Disease Management : our ultimate objective
“Prevention for Better Health”
"Let's Stay Healthy”
Our unique Brand Positioning
Our Product
Easy Health
Individual Health Insurance
Easy Health Product
What is Health InsuranceHospitalization Expenses Room rentMedicineConsultation FeeDiagnostic Fee Ambulance Pre-hospitalization expenses Cashless treatment Tax rebate under Section 80DCover ceasing age
Easy Health Product
Sum Insured Basis
Individual Sum Insured / Floater Sum Insured
Benefit Type
Indemnity / Benefit
Plans
Standard Exclusive Premium
Individual 1.00, 1.50, 2.00,
2.50, 3.00, 4.00,
5.00
3.00, 4.00,
5.00, 7.50
3.00, 4.00,
5.00, 7.50,
10.00
Family
Floater
2.00, 3.00,
4.00,5.00
3.00, 4.00,
5.00, 7.50
4.00, 5.00,
7.50, 10.00
Easy Health Product
Basic Features
In-patient treatment
Pre-hospitalisation
Post-hospitalisation
Domiciliary hospitalisation
Day Care Treatment
Daily Cash – Shared Accommodation
Organ Donor
Emergency Ambulance
Health Check-up
Easy Health Product
In-patient Treatment
Room rent, boarding expenses,
Nursing,
Intensive care unit,
Medical Practitioner,
Anaesthesia, blood, oxygen, operation theatre
charges, surgical appliances,
Medicines, drugs and consumables,
Diagnostic procedures, Cost of prosthetic and other devices or equipment if
implanted internally during a Surgical Procedure.
Easy Health Product
Pre-hospitalisation The Medical Expenses incurred due to an
Illness in the 30 days immediately before the Insured Person was Hospitalised, provided that We have accepted an inpatient Hospitalisation claim
For 60 days, if we intimated at least 5 days before the Hospitalisation
Post-hospitalisation The Medical Expenses incurred in the 60 days
immediately after the Insured Person was discharged post Hospitalisation, provided that We have accepted an inpatient Hospitalisation claim
For 90 days, if we intimated at least 5 days before the Hospitalisation
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Easy Health Product Domiciliary Treatment
The Medical Expenses incurred by an Insured Person for medical treatment taken at home, which requires Hospitalisation
Could not be transferred to a Hospital, or
Hospital bed was unavailable
The condition continues for at least 3 days No payment for Asthma, Bronchitis, Tonsillitis and
Upper Respiratory Tract infection including Laryngitis and Pharyngitis, Cough and Cold, Influenza, Arthritis, Gout and Rheumatism, Chronic Nephritis and Nephritic Syndrome, Diarrhoea and all type of Dysenteries including Gastroenteritis, Diabetes Mellitus and Insupidus, Epilepsy, Hypertension, Psychiatric or Psychosomatic Disorders of all kinds, Pyrexia of unknown Origin.
Easy Health Product
Day Care Procedures
The Medical Expenses for a day
care procedure or surgery where
the procedure or surgery is taken
by the Insured Person as an
inpatient for less than 24 hours.
Easy Health Product Daily Cash - Shared Accommodation
Hospitalized in Shared Accommodation in a Hospital for each continuous and completed period of 24 hours if the Hospitalisation exceeds 48 hours
Organ Donor
The Medical Expenses for an organ donor’s treatment for the harvesting of the organ donated provided the donor is a blood relative
Pre and Post hospitalisation expenses for Donor is not covered
Emergency Ambulance
Expenses incurred on ambulance offered by a healthcare or ambulance service provider used to transfer the Insured Person to the nearest Hospital following an
emergency
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Easy Health Product
Additional Features
Daily Cash – Accompanying Child
Maternity Expenses
Out-patient Dental
Spectacles, Contact Lenses, Hearing Aid
E-opinion for Critical Illness
Coverage for New Born
Optional Rider
Critical Illness
Easy Health Product
Daily Cash – Accompanying Person
If the Insured Person Hospitalized is a child Aged 12 years or
less, We will pay a daily cash amount for 1 accompanying adult
for each complete period of 24 hours if Hospitalisation exceeds
72 hours
Maternity Expenses
Medical Expenses for a delivery (including caesarean section)
while Hospitalised or the lawful medical termination of
pregnancy during the Policy Period limited to 2 deliveries or
terminations
Waiting period of 4/6 years
Prenatal & post natal expenses covered up to sub limit
Newborn baby
If we have accepted a claim under Maternity expenses we will
cover the new born baby under Inpatient Treatment from Day 1
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Easy Health Product
Outpatient Dental Treatment
From the fourth year onwards We will pay 50% of the expenses for dental treatment taken from a Network dentist
We will only pay for Consultation, X-rays, extractions, amalgam or composite fillings, root canal treatments and prescribed drugs for the same
Spectacles, Contact Lenses, Hearing Aid
Every third year, We will pay up to 50% of the actual cost of One pair of spectacles or contact lenses, and/or A hearing aid
These items must be prescribed by a Network EYE/ENT specialised Medical Practitioner
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Easy Health Product
E-Opinion in respect of a Critical Illness
If an Insured Person suffers a Critical
Illness
At the Insured Person’s request We will
arrange a second opinion from Our panel
doctor.
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Easy Health Product
Critical Illness- A term rarely heard 20 years ago has now become a reality- Cancer, Coronary Artery Bypass Surgery, Heart Attack, Kidney failure, Major Organ Transplant, Stroke- The sad & shocking part is that those suffering from CI survive for an average of 5 years after being diagnosed. It is those 5 yrs when the person is not earning (unproductive years). Medical expenses for CI is exorbitantly high, thus draining the family of all its saving.Cancer- There are an estimated 25 lakh cases of cancer in India at any given time. Nearly 7-8 lakh new cases are diagnosed each year with approximately 5 lakh deaths in the year.- The most frequent cancer types world wide are: Among men (in order of number of global deaths): Lung, Stomach, Liver, Colorectal, Oesophagus and Prostate.
Among women (in order of number of global deaths): Breast, Lung, Stomach, Colorectal and cervical.
Easy Health Product
- Tobacco us is the single largest preventable cause of cancer in the world. Tobacco use causes cancer of the lung, throat, mouth, pancreas, bladder, stomach, liver, kidney and other types: Environmental tobacco smoke (passive smoking) causes lung cancer.
Cardiovascular Diseases
- Current Projection suggest that by the year 2020 India will have the largest cardiovascular disease burden in the world. One fifths of the deaths in India are from coronary heart disease
Easy Health Product
Critical Illness
Cancer, Coronary Artery (Bypass) Surgery ,
Heart Attack (Myocardial Infarction), Kidney
Failure, Major Organ Transplantation, Multiple
Sclerosis, Paralysis, Stroke
The Insured Person is first diagnosed as
suffering from a Critical Illness during the Policy
Period and he survives for at least 30 days
following such diagnosis.
Maximum three claims in lifetime
Cover ceasing age – 70 years
Optional Rider – 50% or 100% of Sum Insured
On Individual Sum Insured basis
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Easy Health Product
Major Exclusions
30 days waiting period
2 year specific disease waiting period
Pre-existing disease covered from 4th year
HIV, AIDS
Internal & external congenital disease
Non-allopathic treatment
Artificial limb and external devices
Cosmetic treatment
Weight loss treatment
Maternity (if not opted and within waiting
period)
Easy Health Product
Cumulative Bonus
Available for every claim free year
Sum Insured increased by 10%
Maximum up to 50% of SI
In the event of Claim, CB reduced by 20% of
Sum Insured
Health Check-up
Available in Claim Free year
Subject to waiting period of 2/3/4 year
Expenses reimbursed towards health check-up
up to the sub limit
Easy Health Product
Cashless Hospitalization
Available in the Network hospital only
Subject to pre-authorization by TPA
Approximately 4000+ network hospitals
Specialized network for Dentist & ENT in the
coming years
Panel Doctors for Critical Illness
Easy Health Product
Who can be insured
Self, Spouse, Children and Parents
Entry Age
Self
Minimum 18 years and Maximum 60 years
Adult Dependent
Minimum 18 years and Maximum 60 years
Child Dependent
Minimum 5 years and Maximum 21 years
Can be covered from 91st day if parent covered under same policy
Cover Ceasing Age Nil
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Easy Health Product
Premium Calculation - IndividualPremium excludes service tax and cess
Family Discount
10% - 3 or more
Easy Health Product Premium Calculation – Family Floater
Premium excludes service tax and cess
Easy Health Product Premium Calculation – Critical Illness
Premium excludes service tax and cess
Easy Health Product
Portability
Comparable Individual Health
Insurance Plans
30 days exclusion waiver
2 year exclusion waiver
Pre-existing Exclusion waiver
Min waiting period of 1 year
Transfer of Cumulative Bonus
5% every year max 20%
No reduction in waiting period for
other benefits
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Easy Health Product
INDIVIDUAL Standard Exclusive Premium
Sum Insured per Insured Person per Policy Year
1.00, 1.50, 2.00, 2.50, 3.00, 4.00, 5.00 3.00, 4.00, 5.00 7.50 3.00, 4.00, 5.00 7.50, 10.00
1 a) In-patient Treatment Covered Covered Covered
1 b) Pre-hospitalization Covered Covered Covered
1 c) Post-hospitalization Covered Covered Covered
1 d) Day Care Procedures Covered Covered Covered
1 e) Domiciliary Treatment Covered Covered Covered
2 a) Daily Cash for choosing Shared Accommodation
Rs.500 per day, Maximum Rs.3,000Rs.500 per day,Maximum Rs.3,000
Rs.800 per day,Maximum Rs.4,800
Rs.500 per day,Maximum Rs.3,000
Rs.800 per day,Maximum Rs.4,800
2 b) Organ Donor Covered Covered Covered
2 c) Emergency Ambulance Upto Rs.2000 Upto Rs.2000 Upto Rs.2000
2 d) Daily Cash for accompanying an insured child
Not CoveredRs.300 per day,Maximum Rs.9,000
Rs.500 per day,Maximum Rs.15,000
Rs.300 per day,Maximum Rs.9,000
Rs.500 per day,Maximum Rs.15,000
2 e) Newborn baby Not Covered Optional Optional Optional Optional
3 a) Maternity Expenses Waiting Period of 6 years
Not Covered
Normal Delivery Rs. 15,000*Caesarean Delivery Rs. 25,000*(* Including Pre/Post Natal limit of Rs.1,500 and New Born limit of Rs.2,000)
Normal Delivery Rs. 25,000*Caesarean Delivery Rs. 40,000*(* Including Pre/Post Natal limit of Rs. 2,500 and New Born limit of Rs.3500)
Normal Delivery Rs. 15,000*Caesarean Delivery Rs. 25,000*(* Including Pre/Post Natal limit of Rs.1,500 and New Born limit of Rs.2,000)
Normal Delivery Rs. 25,000*Caesarean Delivery Rs. 40,000*(* Including Pre/Post Natal limit of Rs. 2,500 and New Born limit of Rs.3500)
3 b) Outpatient Dental TreatmentWaiting Period 3 years
Not Covered Not CoveredUpto 1 % of Sum insured subject to aMaximum of Rs.5,000
3 c) Spectacles, Contact Lenses, Hearing Aid Every Third Year
Not Covered Not Covered Upto Rs.5,000
3 d) E-Opinion in respect of a Critical Illness
Not Covered Not Covered Covered, One per policy year
4 Critical Illness Not CoveredOptional, if opted then the Critical Illness Sum Insured is as per the Insured Persons Table in the Schedule
Optional, if opted then the Critical Illness Sum Insured is as per the Insured Persons Table in the Schedule
5 Health CheckupUpto 1% of Sum InsuredEvery 4th Year
Upto 1% of Sum Insured subject to a Maximum of Rs.5,000 Every 3rd Year
Upto 1% of Sum Insured subject to aMaximum of Rs.5,000 Every 2nd Year
Benefits under 3b), 3c), 3d) and 5 are subject to pre-authorisation by the TPA
Easy Health Product
FAMILY FLOATER Standard Exclusive Premium
Sum Insured per Policy 2.00, 3.00, 4.00, 5.00 3.00, 4.00, 5.00 7.50 4.00, 5.00 7.50, 10.00
1 a) In-patient Treatment Covered Covered Covered
1 b) Pre-hospitalization Covered Covered Covered
1 c) Post-hospitalization Covered Covered Covered
1 d) Day Care Procedures Covered Covered Covered
1 e) Domiciliary Treatment Covered Covered Covered
2 a) Daily Cash for choosing Shared Accommodation
Rs.500 per day, Maximum Rs.3,000
Rs.500 per day,Maximum Rs.3,000
Rs.800 per day,Maximum Rs.4,800
Rs.500 per day,Maximum Rs.3,000
Rs.800 per day,Maximum Rs.4,800
2 b) Organ Donor Covered Covered Covered
2 c) Emergency Ambulance Upto Rs. 2000 Upto Rs. 2000 Upto Rs. 2000
2 d) Daily Cash for accompanying an insured child
Not CoveredRs.300 per day,Maximum Rs.9,000
Rs.500 per day,Maximum Rs.15,000
Rs.300 per day,Maximum Rs.9,000
Rs.500 per day,Maximum Rs.15,000
2 e) Newborn baby Not Covered Optional Optional
3 a) Maternity Expenses Waiting Period 4 years
Not Covered
Normal Delivery Rs. 15,000*Caesarean Delivery Rs. 25,000*(* Including Pre/Post Natal limit of Rs.1,500 and New Born limit of Rs.2,000)
Normal Delivery Rs. 25,000*Caesarean Delivery Rs. 40,000*(* Including Pre/Post Natal limit of Rs. 2,500 and New Born limit of Rs.3500)
Normal Delivery Rs. 15,000*Caesarean Delivery Rs. 25,000*(* Including Pre/Post Natal limit of Rs.1,500 and New Born limit of Rs.2,000)
Normal Delivery Rs. 25,000*Caesarean Delivery Rs. 40,000*(* Including Pre/Post Natal limit of Rs. 2,500 and New Born limit of Rs.3500)
3 b) Outpatient Dental TreatmentWaiting Period 3 years
Not Covered Not CoveredUpto 1 % of Sum insured subject to aMaximum of Rs. 5000
3 c) Spectacles, Contact Lenses, Hearing Aid Every Third Year
Not Covered Not Covered Upto Rs. 5000
3 d) E-Opinion in respect of a Critical Illness
Not Covered Not Covered Covered, One per policy year
4 Critical Illness Not CoveredOptional, if opted then the Critical Illness Sum Insured is as per the Insured Persons Table in the Schedule
Optional, if opted then the Critical Illness Sum Insured is as per the Insured Persons Table in the Schedule
5 Health CheckupUpto 1% of Sum InsuredEvery 4th Year
Upto 1% of Sum Insured subject to aMaximum Rs. 5000 per person Every 3rd Year
Upto 1% of Sum Insured subject to aMaximum Rs. 5000 per person Every 2nd Year
Benefits under 3b), 3c), 3d) and 5 are subject to pre-authorisation by the TPA
Easy Health Product
Executive Summary: Easy Health RetailKey Product Differentiators
Guaranteed Renewal
Choice of SI and Plans
Outpatient Dental & Vision
New Born and Maternity
Member is covered from ‘cradle’ to ‘grave’ i.e. no age restriction once member is covered with us
Competition stops coverage at a certain age Sum insured ranges from 1L to 10L across the
range of Standard, Exclusive and Premium plans with several intermediate options
More floater options than competition on SI and family definition
Vision and Dental benefits available in the Premium product
Dental benefit has a waiting period of 3 years, Vision can be availed every 3rd year Maternity waiting period of six years in the individual product and 4 years in the floater
New born baby cover is optionally available in the Exclusive and Premium product (provided parents are covered with us)
Easy Health Product
Executive Summary: Easy Health RetailKey Product Differentiators
CI rider and E-Opinion
Critical Illness rider available as optional rider benefit with core inpatient offering (Exclusive and Premium). Competition offers as stand alone
E-Opinion offered as standard benefit with Exclusive and Premium products
Health Checkup
Up to 1% of SI for all products
Available every 4th, 3rd and 2nd year for Standard, Exclusive and Premium product respectively
Health Risk Assessment
‘Basic’ Health Risk Assessment available to all prospects
Sophisticated version, with detailed prescription, available to members
Discounted MHC
One coupon for discounted MHC provided to every policy holder
Discounts available at ‘exclusive’ hospitals / clinics / diagnostic centers (price range from rs. 1200 to rs. 1800)
Easy Health Product
Executive Summary: Easy Health RetailKey Product Differentiators
SMS based information
Welcome message
Basic information made available to members e.g. 3 nearest providers based on zip code
Community building
Through use of “Let’s Stay Healthy” Blog
Personalized health information, newsletters etc
Stay healthy card
Mailed to members in the event of a hospitalization event
Reinforce ‘Let’s Stay Healthy’ and focused on positive health
Health Line
Toll free contact number to for health tips and consultation manned by experts and professionals.
Personalized health consulting.
