• Apollo Munich Health Insurance Claims Procedure

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    Cashless Treatment

    Customer Service

    Medical Coverage

    Claim Experience

    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 15 1 2 3 4 5
    • Apollo Munich Health Insurance
      "The Best"
      0.5 5.0/5 "Blown Away!"
      Since I'm working with health insurance. It is easy to claim in Apollo Munich. The best hospital list covered in this policy. The best health insurance company in PAN India. In my company, they are paying the insurance premium for me and my family.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jun 14, 2018
    • Apollo Munich Health Insurance
      "Good Service"
      0.5 3.0/5 "Satisfactory"
      I've a health insurance policy with the Apollo Munich Insurance company. I pay a premium of 19000, I do not have any claim experience with the policy. Sometimes I make payments via cheque and sometimes online. Overall their services are good even though I never had any claim experience with them.
      Was this review helpful? 0
      , new delhi
      Reviewed on Jun 12, 2018
    • Apollo Munich Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have my health insured with Apollo Munich from last 6 months, i am happy with the coverage value of this insurance policy and it is family policy. A premium of Rs 8000 has to be paid for this insurance. I have no claim experience and the coverage value of this insurance is 3 lakhs.
      Was this review helpful? 0
      , mumbai
      Reviewed on Jun 08, 2018
    • Apollo Munich Health Insurance
      "Excellent service"
      0.5 4.0/5 "Great!"
      I have got the health insurance policy around 15 years ago from the APOLLO MUNICH. I pay the premium amount of Rs,3736 every year to renew the policy. This policy covers only one member which is myself. The customer support service and the response is good with the Apollo Munich because they give intimations to renew the policy on time.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jun 04, 2018
    • Apollo Munich Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have my health insured with Apollo Munich from last 4 years, i am not aware of the premium amount as my company pays it. I have a coverage value of Rs 5 lakhs and i am satisfied with it. My claim experience was good with this insurance as they covered 90% and it was a cashless treatment.
      Was this review helpful? 0
      , hyderabad
      Reviewed on May 20, 2018
    • Apollo Munich Health Insurance
      "Health insurance with APOLLO MUNICH"
      0.5 3.0/5 "Satisfactory"
      I hold a health insurance from APOLLO MUNICH. This was a corporate insurance having a policy coverage of 2 to 3 lakhs. This policy do have cover for me and my spouse.There is no claim experience for the policy. They provide reimbursement facility.
      Was this review helpful? 0
      , vellore
      Reviewed on May 14, 2018
    • Apollo Munich Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have taken a family health insurance with Apollo Munich from last 3 years, i pay a premium of Rs 13000 which has to be paid every year for this insurance. I have a coverage value of Rs 5 lakhs and i am satisfied with it. I have not claimed anything so far from this insurance.
      Was this review helpful? 0
      , hyderabad
      Reviewed on May 07, 2018
    • Apollo Munich Health Insurance
      "Good policy to use"
      0.5 5.0/5 "Blown Away!"
      I have got the health insurance policy from the APOLLO MUNICH around 2 years ago, this is a corporate policy which is provided by my company. This policy covers 4 members in my family, which does not include my parents. This policy has a medical coverage up to Rs,4,00,000 in it. I would say it is a good policy to use.
      Was this review helpful? 0
      , new delhi
      Reviewed on May 02, 2018
    • Apollo Munich Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have a company provided health insurance with Apollo Munich from last 6 years, i have not claimed anything so far with this insurance policy. I am not aware of the premium amount as my company pays it. I have a coverage value of Rs 3 lakhs for this insurance.
      Was this review helpful? 0
      , chennai
      Reviewed on Apr 26, 2018
    • Apollo Munich Health Insurance
      "best experience"
      0.5 3.0/5 "Satisfactory"
      I had taken a Health insurance policy from the top most private sector insurance company APOLLO MUNICH. Most of all benefits are covered under one policy, so no need to top up my insurance plan. I had received my health card and my policy document by mail. They have a good network with a best corporate hospitals.
      Was this review helpful? 0
      , bangalore
      Reviewed on Apr 20, 2018
    • Apollo Munich Health Insurance
      "extra ordinary experience"
      0.5 5.0/5 "Blown Away!"
      I had taken a health insurance policy from the top most private sector insurance company APOLLO MUNICH. They couriered my health card to my registered communication address. They have a good network with corporate hospitals. I had a good positive claim experience and i claimed nearly 95% of billed amount.extra ordinary experience
      Was this review helpful? 0
      , coimbatore
      Reviewed on Apr 18, 2018
    • Apollo Munich Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I hold a health insurance with Apollo Munich from last 3 years and it is one of the good health insurance. This insurance has to be renewed every year and i pay a premium of Rs 15000 for this insurance. I do not have claim experience so far with this insurance and i have a coverage of Rs 5 lakhs for this insurance.
      Was this review helpful? 0
      , mumbai
      Reviewed on Mar 31, 2018
    • Apollo Munich Health Insurance
      "Need transparency"
      0.5 1.0/5 "Really Bad"
      The service is not up to the mark from the APOLLO MUNICH health insurance company. I have got the health insurance policy from APOLLO MUNICH around 9 months ago. I had a surgery last month but I couldn't claim the medical claim amount . The transparency is not seen in the process. T
      Was this review helpful? 0
      , hyderabad
      Reviewed on Mar 28, 2018
    • Apollo Munich Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have a health insurance policy with Apollo Munich from last 15 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 25000 for this insurance. I do not have claim experience so far with this insurance and the coverage amount in this insurance is Rs 4 lakhs.
      Was this review helpful? 0
      , kolkata
      Reviewed on Mar 22, 2018
    • Apollo Munich Health Insurance
      "Average service"
      0.5 3.0/5 "Satisfactory"
      The service is good with Apollo Munich Health Insurance service. They provided me with the benefits for the whole family. The offers are not as much as I expected. I also have not claimed any service from Apollo Munich Health Insurance service. It was an average service with Apollo Munich Health Insurance service.
      Was this review helpful? 0
      , bangalore
      Reviewed on Mar 20, 2018
    • Apollo Munich Health Insurance
      "Good policy"
      0.5 5.0/5 "Blown Away!"
      I have taken health insurance from APOLLO MUNICH with a premium of 13000. It covers my whole family. They provide coupons for health check up. They provide both cashless and reimbursement. Still there is no claim experience .
      Was this review helpful? 0
      , new delhi
      Reviewed on Mar 12, 2018
    • Apollo Munich Health Insurance
      "Excellent service"
      0.5 5.0/5 "Blown Away!"
      I have taken Health Insurance with Apollo Munich.The premium amount is 6500 paid per annum by cheque.I don't have claim experience with them.The policy coverage amount is five lakhs.The policy is taken five months ago.They cover 100% cash less treatment.
      Was this review helpful? 0
      , chennai
      Reviewed on Mar 10, 2018
    • Apollo Munich Health Insurance
      "Good"
      0.5 5.0/5 "Blown Away!"
      My health insurance was taken in Apollo Munich. The services are very good. It was taken 7 years back. The policy covers for the entire family and the plan is 4L. There is no claim experience for the last years. They covers all the major and minor diseases. I am paying yearly 10K as a premium.
      Was this review helpful? 0
      , secunderabad
      Reviewed on Mar 09, 2018
    • Apollo Munich Health Insurance
      "Good service"
      0.5 4.0/5 "Great!"
      I have taken a Health insurance with Apollo Munich. I am holding the policy for last six months. I have no claim experience with them but they provide 100% coverage for cashless treatment.I pay a premium amount of 3000 quarterly.The policy coverage amount is five lakhs.
      Was this review helpful? 0
      , bangalore
      Reviewed on Mar 06, 2018
    • Apollo Munich Health Insurance
      "Best health policy"
      0.5 5.0/5 "Blown Away!"
      I had applied and got a Health insurance policy from the Top most insurance company APOLLO MUNICH. I recently renewed my health policy Rs. 6,000/-. I feel my premium amount is very affordable. Its a group policy for my family. Most of all benefits are covered under one policy. I didn't have any claim experience so I am unable to comment on it.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Mar 06, 2018
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