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.
 Reach
Nation wide network of hospitals, pharmacies & clinics
In 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.
 Brand
India’s largest, best reputed organized healthcare brand
Apollo is a trusted brand, which is a strong differentiator in healthcare.
 Expertise
Current knowledge of patient histories, disease prevalence
treatments & costs makes it an unique integrated healthcare service
provider for India.
 Customer Expectation
Cross sell opportunities are large
Product bundling can also be done with the wellness clinics, pharmacies by
bundling health maintenance programs with insurance
products.
 Deutsche Krankenversicherung

 Group
Leadership 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.
 Reach
Global 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 Group
DKV 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 experience
Actuarial , Technical and international Health Insurance expertise built over
80 years
 Customer Expectation
Fair practices
Believe in DKV’s strengths: Innovating new and comprehensive products
 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
“Prevention for Better Health”

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

"Let's Stay Healthy”

Our unique Brand Positioning
 Our Product

Easy Health
Individual Health Insurance
 Easy Health Product

What is Health Insurance

Hospitalization Expenses
Room rent
Medicine
Consultation Fee
Diagnostic Fee
Ambulance
Pre-hospitalization expenses
Cashless treatment
Tax rebate under Section 80D
Cover 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, 3.00, 4.00, 3.00, 4.00,
2.50, 3.00, 4.00, 5.00, 7.50 5.00, 7.50,
5.00 10.00
Family 2.00, 3.00, 3.00, 4.00, 4.00, 5.00,
Floater 4.00,5.00 5.00, 7.50 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 NEW
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 NEW
 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 NEW
 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
 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 NEW
 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 NEW
 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 expensesNEW
we will
cover the new born baby under Inpatient Treatment from Day 1
 Easy Health Product
Outpatient Dental Treatment NEW
 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 NEW

 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
 Easy Health Product

E-Opinion in respect of a Critical Illness NEW

 If an Insured Person suffers a Critical

Illness
 At the Insured Person’s request We will
arrange a second opinion from Our panel
doctor.
 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 NEW
 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
 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 NEW
 Nil
 Easy Health Product
Premium Calculation - Individual
Premium 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 NEW
 Min waiting period of 1 year
 Transfer of Cumulative Bonus
 5% every year max 20%
 No reduction in waiting period for
other benefits
INDIVIDUAL Standard Exclusive Premium

Sum Insured per Insured Person per Policy

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
Year

1 a) In-patient Treatment Covered Covered Covered

1 b) Pre-hospitalization Covered Covered Covered

1 c) Post-hospitalization Covered Easy Health

Covered Product Covered

1 d) Day Care Procedures Covered Covered Covered

1 e) Domiciliary Treatment Covered Covered Covered

2 a) Daily Cash for choosing Shared Rs.500 per day, Rs.800 per day, Rs.500 per day, Rs.800 per day,
Rs.500 per day, Maximum Rs.3,000
Accommodation Maximum Rs.3,000 Maximum Rs.4,800 Maximum Rs.3,000 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 Rs.300 per day, Rs.500 per day, Rs.300 per day, Rs.500 per day,
Not Covered
insured child Maximum Rs.9,000 Maximum Rs.15,000 Maximum Rs.9,000 Maximum Rs.15,000

2 e) Newborn baby Not Covered Optional Optional Optional Optional

Normal Delivery Rs.

Normal Delivery Rs. Normal Delivery Rs. Normal Delivery Rs.
15,000*
25,000* 15,000* 25,000*
Caesarean Delivery
Caesarean Delivery Caesarean Delivery Rs. Caesarean Delivery
Rs. 25,000*
3 a) Maternity Expenses Rs. 40,000* 25,000* Rs. 40,000*
Not Covered (* Including Pre/Post
Waiting Period of 6 years (* Including Pre/Post (* Including Pre/Post (* Including Pre/Post
Natal limit of
Natal limit of Rs. Natal limit of Rs.1,500 Natal limit of Rs.
Rs.1,500 and New
2,500 and New Born and New Born limit of 2,500 and New Born
Born limit of
limit of Rs.3500) Rs.2,000) limit of Rs.3500)
Rs.2,000)

3 b) Outpatient Dental Treatment Upto 1 % of Sum insured subject to a

Not Covered Not Covered
Waiting Period 3 years Maximum of Rs.5,000

3 c) Spectacles, Contact Lenses, Hearing

Not Covered Not Covered Upto Rs.5,000
Aid Every Third Year

3 d) E-Opinion in respect of a Critical

Not Covered Not Covered Covered, One per policy year
Illness

Optional, if opted then the Critical Illness Sum Optional, if opted then the Critical Illness Sum
4 Critical Illness Not Covered Insured is as per the Insured Persons Table in Insured is as per the Insured Persons Table in
the Schedule the Schedule

Upto 1% of Sum Insured Upto 1% of Sum Insured subject to a Maximum Upto 1% of Sum Insured subject to a
5 Health Checkup
Every 4th Year of Rs.5,000 Every 3rd Year Maximum of Rs.5,000 Every 2nd Year
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 Easy Health

Covered Product Covered

1 d) Day Care Procedures Covered Covered Covered

1 e) Domiciliary Treatment Covered Covered Covered

2 a) Daily Cash for choosing Shared Rs.500 per day, Rs.800 per day, Rs.500 per day, Rs.800 per day,
Rs.500 per day, Maximum Rs.3,000
Accommodation Maximum Rs.3,000 Maximum Rs.4,800 Maximum Rs.3,000 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 Rs.300 per day, Rs.500 per day, Rs.300 per day, Rs.500 per day,
Not Covered
child Maximum Rs.9,000 Maximum Rs.15,000 Maximum Rs.9,000 Maximum Rs.15,000

2 e) Newborn baby Not Covered Optional Optional

Normal Delivery Rs. Normal Delivery Rs. Normal Delivery Rs. Normal Delivery Rs.
15,000* 25,000* 15,000* 25,000*
Caesarean Delivery Caesarean Delivery Rs. Caesarean Delivery Rs. Caesarean Delivery Rs.
3 a) Maternity Expenses Rs. 25,000* 40,000* 25,000* 40,000*
Not Covered
Waiting Period 4 years (* Including Pre/Post (* Including Pre/Post (* Including Pre/Post (* Including Pre/Post
Natal limit of Rs.1,500 Natal limit of Rs. Natal limit of Rs.1,500 Natal limit of Rs. 2,500
and New Born limit of 2,500 and New Born and New Born limit of and New Born limit of
Rs.2,000) limit of Rs.3500) Rs.2,000) Rs.3500)

3 b) Outpatient Dental Treatment Upto 1 % of Sum insured subject to a

Not Covered Not Covered
Waiting Period 3 years Maximum of Rs. 5000

3 c) Spectacles, Contact Lenses, Hearing Aid

Not Covered Not Covered Upto Rs. 5000
Every Third Year

3 d) E-Opinion in respect of a Critical Illness Not Covered Not Covered Covered, One per policy year

Optional, if opted then the Critical Illness Sum Optional, if opted then the Critical Illness Sum
4 Critical Illness Not Covered Insured is as per the Insured Persons Table in the Insured is as per the Insured Persons Table in the
Schedule Schedule

Upto 1% of Sum Insured Upto 1% of Sum Insured subject to a Upto 1% of Sum Insured subject to a
5 Health Checkup
Every 4th Year Maximum Rs. 5000 per person Every 3 rd Year Maximum Rs. 5000 per person Every 2 nd Year
Benefits under 3b), 3c), 3d) and 5 are subject to pre-authorisation by the TPA
 Easy Health Product
Executive Summary: Easy Health Retail
Key Product Differentiators
 Member is covered from ‘cradle’ to ‘grave’ i.e. no age
Guaranteed restriction once member is covered with us
Renewal
 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
Choice of SI and
Plans intermediate options
 More floater options than competition on SI and family
definition
 Vision and Dental benefits available in the Premium product
Outpatient  Dental benefit has a waiting period of 3 years, Vision can be
Dental & Vision
availed every 3rd year
 Maternity waiting period of six years in the individual
product and 4 years in the floater
New Born and
Maternity  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 Retail
Key Product Differentiators
 Critical Illness rider available as optional rider benefit with core
CI rider and inpatient offering (Exclusive and Premium). Competition offers
E-Opinion as stand alone
 E-Opinion offered as standard benefit with Exclusive and
Premium products

Health  Up to 1% of SI for all products

Checkup  Available every 4th, 3rd and 2nd year for Standard, Exclusive
and Premium product respectively

 ‘Basic’ Health Risk Assessment available to all prospects

Health Risk
Assessment  Sophisticated version, with detailed prescription, available
to members
 One coupon for discounted MHC provided to every policy
Discounted holder
MHC  Discounts available at ‘exclusive’ hospitals / clinics /
diagnostic centers (price range from rs. 1200 to rs. 1800)
 Easy Health Product
Executive Summary: Easy Health Retail
Key Product Differentiators
 Welcome message
SMS based
information  Basic information made available to members e.g. 3 nearest
providers based on zip code

 Through use of “Let’s Stay Healthy” Blog

Community
building  Personalized health information, newsletters etc

 Mailed to members in the event of a hospitalization event

Stay healthy
card  Reinforce ‘Let’s Stay Healthy’ and focused on positive health

 Toll free contact number to for health tips and

Health Line consultation manned by experts and professionals.
 Personalized health consulting.