Apollo Munich Optima Restore Benefit vs Max Bupa Re-fill Benefit

Published: November 26, 2017 at 9:16 am

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I compare the features of Apollo Munich Optima Restore Benefit and Max Bupa Health Companion Re-fill Benefit. This is the second module of step 4, ₹e-Assemble, “how to choose a suitable health insurance policy”. The main idea is to highlight the importance of reading policy wordings.

We will compare two key features: the no claim benefit in Apollo Munich vs the no-claim bonus in Max Bupa and the restore vs re-fill features. Although I maintain such features are only fringe benefits, many are attracted to these. Therefore it is important to dig deeper and understand them. As my teacher Prof. V. Balakrishnan used to say, “put pen to paper”, then all will become clear … soon.

Health insurers generally reward the insured if there is no claim, but these are subject to limitations.  For example, United India offers a 3% no claim discount in the premium after 3-claim free years and for every claim-free thereon subject to a maximum of 15% discount. This may seem pretty lacklustre compared to the privates that offer benefits for each claim free year. However, a no-claim discount is an actual reduction in costs whereas a no-claim bonus leading to a higher sum insured is notional – applicable only if there is a claim and if it exceeds the basic sum insured.

I would recommend first completing part A: ₹e-Assemble step 4: How to choose a suitable health insurance policy before going forward.

Apollo Munich Multiplier Benefit vs Max Bupa no-claim discount

Apollo Munich has a unique multiplier bonus schedule that offers 50% of the sum insured (SI) as a bonus for every claim free year, subject to a ceiling of 100% of the SI. However, if there is a claim, the bonus will be removed as fast as it was offered (see video)!!

Max Bupa, on the other hand, offers a lower (20%) bonus, but as explained below, the bonus is not removed if there is a claim.

Apollo Munich Optima Restore vs Max Bupa re-fill benefit

Apollo Munich Optima Restore Benefit Illustration
The alphabets J,F,M,A… represent months

In Apollo Munich Optima restore, the insurance cover will be “restored” upon a claim to an amount equal to the base SI. However, the restore option will kick in only when the entire sum insured and multiplier bonus is exhausted.

On the other hand, Max Bupa Re-fill benefit refers to an additional amount added to the sum insured after a claim that completely or partially exhausts the SI+bobus. The re-fill amount cannot exceed the SI.

Max Bupa Health Companion Re-fill Benefit illustration

For both policies, the additional cover will come into play only after a claim and will be in force only during a policy year. Also, the same individual cannot get treated with the restore or re-fill cover for the same illness (or related condition) in the same policy year.

Considering that Max Bupa no-claim bonuses are sticky (that is no removal upon a claim) and considering that the re-fill option is applicable for partial exhaustion of SI+bonus, I think Max Bupa has the edge. This is only wrt to these features and only between these two insurers.

Get Apollo Munich Optima Restore policy wordings

Get Max Bupa health companion policy wordings

Apollo Munich Optima Restore Benefit vs Max Bupa Re-fill Benefit

It is “re-fill” and not “ref-fill”. Apologies for the typo. Let me know if I have understood some aspect incorrectly.

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7 Comments

  1. Very helpful post. Please consider reviewing Royal Sundaram Lifeline plans, which are better in terms of features and have lower premium than Apollo / Max. I want to understand if there’s a catch there. Thank you.

  2. Sir,

    Both the policies are illusionary in terms of bonus offered – the permium for these policies is much higher than standard policies.Standard policies have 10% bonus when there are no claims and accumulated bonus is not reduced next year nor are there any conditions that it does not apply to same person for same illness.

    People are not understanding that medical premiums are increasing for the same amount of cover every year. So the premium which is affordable now may not be affordable in a few years. Without insurance it will not be possible to even have basic health care going forward(and yes – insurance is responsible for astronomical costs in first place).

    Request you to please write on how an average wage earner can afford healthcare in India?

    Following are the costs to consider:
    Doctors fees
    Pharmacy
    Diagnostics
    Operating Procedures
    Other hospitalization charges

    Of all the black swans in life, medical care(especially long term/chronic care) can easily bankrupt you and destroy your family, both emotionally and financially.

    1. Naturally, they are expensive! I have a United India policy and pay 45K for 5-6L individual cover for my family. So that is not cheap either. I dont know what you mean by average wage earner. The real average wage earner in India will not be reading this post and can only afford government health plans. The rest can only buy what they afford. I have made this clear enough here: ₹e-Assemble step 4: How to choose a suitable health insurance policy

  3. Sir,
    could you please give your opinion about public sector insurance companies vs private ones?
    it would be of great help for many of us.
    say,star offers 405 procedures covered while national offers only 140 procedures covered (Treatments/Procedures that require less than 24 hours hospitalisation due to technological advancement)
    pl guide.

  4. in Apollo Munich Optima Restore, advertisers keep tell me that the “Same Person Same disease” is also covered and is the important difference between Max Bupa Health Companion. But in you presentation it says “Same Person Same disease” is NOT covered, can you please confirm.

    Many thanks for sharing the major differences, it was very very informative.

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