• Apollo Munich Health Insurance Claims Procedure

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    Apollo Munich health insurance policies not only offer comprehensive healthcare packages for their customers but also provide a hassle free claim process in order to get the competitive edge in the market. There are two main types of claims that are provided by Apollo Munich - Cashless claims for either planned or emergency visits, and reimbursement claims where policyholders claim for refund of cash already spent towards hospitalization and other charges. Apollo Munich also boasts a large list of network hospitals where one can claim cashless hospitalization benefits . Whenever a policyholder applies for a claim it is advisable that they keep a copy of the documents they have submitted towards the claim.

    Incurred Claim ratio of Apollo Munich Health Insurance:

    ICR or Incurred claim ratio is the overall amount or value of claims paid by the company divided by the total sum of premiums collected by that company for a specified period. This data is published by the IRDA and the below table showcases the Incurred Claim ratio of Apollo Munich for the year 2014-15

    Net earned premium (in lakhs) Net claims paid (in lakhs) Incurred claims ratio
    65,558 41,343 63.03%

    The ICR of Apollo Munich is in good stead and shows that they have made a quality high selling product.

    Claim Procedure:

    With Apollo Munich Insurance, the claims procedure by far and large remains the same for almost all policies with slight differences for each policy. Policyholders can avail cashless claims or claim for expenses already incurred. The following claim procedure highlights the necessary steps required to file the claim.

    1. Cashless Claim:

      In cashless claim, one need not settle the bill themselves. They needn’t even pay cash the insurance company will be represented by a TPA who will settle the bill with the hospital directly. The procedure for cashless emergency claims and cashless planned claims vary

      • Cashless Claims Procedure for Emergency Admission:

        Emergency hospital visits are a cause of worry itself and to worry about insurance claims and money spent out of pocket will only add to it. Upon admission, one will have to check with Apollo Munich if cashless claims can be made. If the hospital of admission falls in the network of cashless hospitals supported by Apollo Munich then the following procedure needs to be followed.

        Intimate Apollo Munich of the emergency hospital admission within 24 hours. Reach out to the hospital insurance help desk and have them fill in the details of the cashless claim and send it over to Apollo Munich for a cashless claim. This claim needs to be certified by the attending doctor. The hospital insurance helpdesk will either send over the insurance claim themselves or one can fax it to Apollo Munich. The fax number can be availed by calling the toll free number and requesting for it. The toll free number is 1800-102-0333.

        • The TPA will then review the documents submitted. If additional documents are required, the TPA will request for their submission. If the TPA approves the claim, then the hospital bills and all expenses covered under the policy will be settled by the TPA and other expenses not covered by the policy will need to be settled by the patient/policyholder
        • For some reason if the claim is not supported, then the bills need to be settled by patient or policyholder and a request for reimbursement can be made. Decisions for rejection will be provided through a rejection letter. Rejection of a cashless claim does not signify rejection of the reimbursement
      • Cashless Claims Procedure for Planned Admission:

        If the patient or policyholder plans on getting a particular treatment at a hospital on the network panel and intends to avail the cashless claim then they need to follow the planned cashless claim procedure which is as follows:

        • Select the hospital from the network hospital list.
        • Then you must intimate Apollo Munich at least a minimum of 48 hours prior to admission. The patient or policyholder will be required to provide certain details such as policy number. Intimation can be done by calling the toll free number 1800-102-0333
        • The cashless request form must then be filled in by the patient or policyholder and faxed to Apollo Munich. The form needs to be submitted with a certification from the attending doctor along with the required medical records.
        • Apollo Munich will review the submitted documents and request and convey their decision to the hospital. In certain cases Apollo Munich may also request for additional documents. In case it is approved the hospital bill will directly be settled by Apollo Munich. In case of rejection, the bills need to be paid by the patient and then a claim for reimbursement can be made.
    2. Reimbursement of Treatment Expenses:

      When cashless claims are rejected, the bills paid by the patient or policyholder can be reimbursed by claiming for reimbursement of expenses. Cashless claims may be rejected for lack of supporting documents or because the hospital may not be on the network of cashless claim hospitals covered by Apollo Munich. The following procedure needs to be followed to make reimbursement claims:

      • You will have to intimate Apollo Munich on admission or treatment within a stipulated time frame. More often than not the sooner one intimates the insurance provider, the better the chances are of the claim being approved. The toll free number can be called to intimate claims for reimbursement. The toll free number is 1800-102-0333
      • Patients or policyholders must provide key information such as policy numbers while making intimations
      • You must quote the policy number while intimating.
      • The claim form can be downloaded from the website or be availed through the agents at the office locations. The claim documents may vary depending upon the policy held by the patient. These claim forms need to be submitted to the Apollo Munich office address. Mailing address can also be availed from the toll free number.
    • Documents Required:

      Documents required while applying for reimbursement claims are as follows:

      • The fully filled claim form along with the attending doctor’s certificate
      • Discharge summary along with other related documents such as hospital bills, pre and post hospitalization reports and their corresponding receipts, prescriptions notes along with their receipts and other documents as mentioned in the claim form
    • Claims Process:

      • The claim processing team will check the above documents and ask for additional documents if required. Additional documents if requested will be given a period of 7 days to be submitted
      • If the claim is admissible, the cheque will be dispatched within 30 days
      • If the claim is not admissible you will get a rejection letter stating the reasons for rejection.

    This Insurance Company has not partnered with BankBazaar.com. For more details, please visit its website/branch office. The trademarks, logos and other subject matters of intellectual property belong to their respective owners.

    GST rate of 18% applicable for all financial services effective July 1, 2017.

    Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.

    Apollo Munich Health Insurance Claims Procedure Reviews

  • Page 1 of 14 1 2 3 4 5
    • Apollo Munich Health Insurance
      "Excellent"
      0.5 5.0/5 "Blown Away!"
      I took a health insurance from Apollo Munich through an advisor. Its been 3 years. The cash facilities are really good. The customer service was pretty good. I haven't gone for claim. The medical coverage was 5L. I used to pay around 13,000 rupees yearly.
      Was this review helpful? 0
      , mumbai
      Reviewed on Feb 12, 2018
    • Apollo Munich Health Insurance
      "Best insurance policy"
      0.5 5.0/5 "Blown Away!"
      I have taken this policy last three years ago.The premium amount is 10600 paid through Kotak bank credit card.This policy was taken 30 days ago.I have no claim experience till date.This policy is covered including the family members is three lakhs.
      Was this review helpful? 0
      , jaipur
      Reviewed on Feb 10, 2018
    • Apollo Munich Health Insurance
      "Good policy to use"
      0.5 5.0/5 "Blown Away!"
      The health insurance policy is good to use with the APOLLO MUNICH company. I have this health insurance policy with the APOLLO MUNICH for past 4 years. The customer support service is good with the APOLLO MUNICH and they give response to the customers. This policy covers only one member which is myself . This medical coverage amount is available up to 1 lakh. I am satisfied having the APOLLO MUNICH health insurance policy.
      Was this review helpful? 0
      , gurgaon
      Reviewed on Feb 07, 2018
    • Apollo Munich Health Insurance
      "Average policy "
      0.5 4.0/5 "Great!"
      Around 4 years ago , I have got the health insurance policy from Apollo Munich . the customer support is average with the Apollo Munich. This policy covers only 1member which is myself and this policy has the claim amount of Rs,1,00,000 in it.
      Was this review helpful? 0
      , vijayawada
      Reviewed on Feb 05, 2018
    • Apollo Munich Health Insurance
      "Health Security"
      0.5 5.0/5 "Blown Away!"
      Its a good product I got my Apollo Munich, the agent suggested best health policy. I have paid the premium around Rs.7000 for Life restore plan. I have taken the sum assured Rs. 5 lakhs its covers only for me. They are providing cash less facilities, financial security for unforeseen events. After one year they are providing 50% of medical benefits.
      Was this review helpful? 0
      , mumbai
      Reviewed on Jan 29, 2018
    • Apollo Munich Health Insurance
      "Excellent"
      0.5 5.0/5 "Blown Away!"
      I have taken a health insurance with APOLLO MUNICH. I have been paying a premium of rs 8000 per year. Till now I have not taken any service with health insurance. But have come across that there services are really great. Overall a good service.
      Was this review helpful? 0
      , bangalore
      Reviewed on Jan 25, 2018
    • Apollo Munich Health Insurance
      "Good Coverage"
      0.5 5.0/5 "Blown Away!"
      I have been using this Health Insurance for the 4th consecutive year now. I haven't had any claim experience until now with them. I have been paying a premium of Rs.17000 yearly for a coverage of Rs.15 Lakhs for me and my family. If I have no-claim experience for a year, they would increase the coverage for the next year.
      Was this review helpful? 0
      , new delhi
      Reviewed on Jan 24, 2018
    • Apollo Munich Health Insurance
      "Good insurance policy"
      0.5 3.5/5 "Pretty good"
      I have a health insurance policy with Apollo from last 2 years and it is a good insurance policy to use. This policy has to be renewed every year and i pay a premium of Rs 16000 for this insurance. I do not have claim experience and i have not taken any cashless treatment so far. I get a coverage of Rs 2.5 lakhs which is satisfactory.
      Was this review helpful? 0
      , ghaziabad
      Reviewed on Jan 24, 2018
    • Apollo Munich Health Insurance
      "Good Claim Experience"
      0.5 5.0/5 "Blown Away!"
      I have been using Apollo Munich for the past 3 years. Let me quickly recap the claim experience I had with them recently, in regard to a small operation I had. I just informed Hospital about my insurers, they talked with my Insurance people and within a hour the initial part was accepted and I went ahead with the operation cashless.
      Was this review helpful? 0
      , chennai
      Reviewed on Jan 23, 2018
    • Apollo Munich Health Insurance
      "Average service"
      0.5 3.5/5 "Pretty good"
      There is health insurance service with Apollo Munich ,the service from Apollo was good. But I never claimed any service from Apollo Munich,staffs of Apollo is friendly,it was a good experience with Apollo Munich health insurance service.
      Was this review helpful? 0
      , thane
      Reviewed on Jan 17, 2018
    • Apollo Munich Health Insurance
      "Average policy"
      0.5 3.0/5 "Satisfactory"
      I had got the Health Insurance policy with Apollo Munich around 2 years ago. The customer support is good with the Apollo Munich and they gave me better response in regards to my health insurance policy. This policy covers 2 members in my family.
      Was this review helpful? 0
      , visakhapatnam
      Reviewed on Jan 12, 2018
    • Apollo Munich Health Insurance
      "Average insurance policy"
      0.5 2.0/5 "Expected more"
      I had a health insurance with Apollo Munich from last 2-3 years and i was not happy with this insurance policy. This policy has to be renewed every year and i pay a premium of Rs 13000 for this insurance. I have not taken any cashless treatment and i do not have claim experience. The coverage and plan benefits are not up to the mark.
      Was this review helpful? 0
      , mumbai
      Reviewed on Jan 09, 2018
    • Apollo Munich Health Insurance
      "Premium Charges Increased a lot"
      0.5 1.0/5 "Really Bad"
      I used this Health some years back and the reason I switched from it was because they increased the premium by 60% within a year. I took a coverage of Rs.1 Lakhs. The number of Hospitals is quite good in it. Their cashless option is a good one though.
      Was this review helpful? 0
      , mumbai
      Reviewed on Jan 06, 2018
    • Apollo Munich Health Insurance
      "Average service"
      0.5 3.0/5 "Satisfactory"
      I have taken a Health Insurance with Apollo Munich.I make a payment through online get a policy coverage of six lakhs.The plan benefits are not satisfactory.I closed the policy as i don't feel i get the best offers comparatively.The service is good.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Dec 20, 2017
    • Apollo Munich Health Insurance
      "Good service"
      0.5 4.0/5 "Great!"
      I have been holding the Health Insurance with Apollo Munich.The premium amount is 4000 paid once in a year.I pat it through online i had to close it because i got a good policy with zero premium and has a good coverage amount including the dependants otherwise its the best where the policy coverage amount is 4 lakhs.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Dec 20, 2017
    • Apollo Munich Health Insurance
      "Good Protection"
      0.5 3.0/5 "Satisfactory"
      My company gave me medical cover from Apollo munich, they gave medical cover for my entire family. For me they gave me the value of Rs. 2 lakh for father and mother gave me Rs. 1 lakh of each. They got tie up with good hospital but I don't have any claim experience.
      Was this review helpful? 0
      , chennai
      Reviewed on Dec 19, 2017
    • Apollo Munich Health Insurance
      "Good policy"
      0.5 5.0/5 "Blown Away!"
      I have taken a Health Insurance with Apollo Munich.I have been holding tit for the last twenty years.I make a premium amount of 400 is debited from my salary account.I get a policy coverage of two lakhs including the dependants,this policy is applicable post retirement as well.
      Was this review helpful? 1
      , chennai
      Reviewed on Dec 11, 2017
    • Apollo Munich Health Insurance
      "Good Protection for the family"
      0.5 5.0/5 "Blown Away!"
      Apollo Munch got tie up with Canara bank, I make Rs. 3600 for the policy cover 3 lakhs, it covers my entire family. It has the tenure of three years, it gives cover for all critical disease, cancer, dental etc. They got tie up with good hospitals.
      Was this review helpful? 0
      , bangalore
      Reviewed on Dec 09, 2017
    • Apollo Munich Health Insurance
      "Good insurance"
      0.5 4.0/5 "Great!"
      I have a taken a Health Insurance policy with Apollo Munich.The premium amount is 17,000 paid annually.I get a policy coverage of six lakhs is paid through online.I have the policy for last five years.I don't have any claim experience so far.
      Was this review helpful? 0
      , noida
      Reviewed on Dec 08, 2017
    • Apollo Munich Health Insurance
      "Good policy to use"
      0.5 4.5/5 "Excellent!"
      I have the health insurance policy with Apollo Munich for past 5 years. The customer support is good with the Apollo Munich. This policy covers 2 members in my family, I have the claim amount of Rs,1lakhs with this policy, The cashless treatment options are available with this policy and I am satisfied using this policy.
      Was this review helpful? 0
      , bangalore
      Reviewed on Dec 07, 2017
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