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About ICICI Lombard Health Insurance

ICICI Lombard General Insurance Company is a leading private sector general insurance company in the insurance market. The company offers a range of general insurance products both for retail customers as well as for corporate ones. The policies offered by the company have a comprehensive scope of coverage and the premiums are also low. Even in the health insurance segment, ICICI Lombard offers some of the best policies which provide extensive coverage to policyholder

Why choose ICICI Lombard health insurance? ICICI Lombard has a very good track record which makes the company reputed. Here are some reasons which make ICICI Lombard health insurance plans popular

  1. As on the financial year ending 31st March 2019, the company’s Gross Written Premium crossed INR 147 billion. This shows that the company has a good financial standing
  2. The company also settled more than 1.6 million claims as on the financial year ending 31st March 2019
  3. ICICI Lombard has received various awards and recognitions over the years. Some of these include the Most Broker Friendly Insurer Award in the year 2019, ET Aspire 2 Good Award in 2016-17 and 2017-18 for all-round excellence and activities in CSR, etc
  4. The company is tied-up with more than 5020 hospitals across India enabling you to avail easy cashless claim settlements
  5. The claims are also approved within 4 hours making them quick and hassle-free

ICICI Lombard Claim Settlement Ratio

99.7%

ICICI Lombard

94.21%

Industry Average

Health claim settlement ratio is the percentage of claims settled against the total claims received by the insurance company in a given fiscal year. ICICI Lombard has a claim settlement ratio of 99.7%, as compared to the industry average of 94.21%.

ICICI Lombard Health Insurance Plans

ICICI Lombard health insurance offers 4 health insurance plans. The premium of these plans starts from Rs. 83.29/yr. The sum insured ranges from Rs. 3 Lakh - 1 Cr. Details of the comprehensive coverage provided by the following 4 ICICI Lombard health insurance plans are listed below:

ICICI Lombard Complete Health Insurance Plan

Starting Premium- ₹ 6,265/yr

This is an indemnity health insurance plan which covers the actual medical costs that you incur in case of hospitalisation.The salient features of the plan are as follows

  1. The sum insured is refilled by 100% if it is exhausted in a year on a previous claim
  2. The sum insured is increased by 10% every year if you don’t make a claim in that year
  3. The plan also has a wellness program which rewards you for maintaining good health
  4. Free health check-ups are allowed every policy year
  5. There are optional coverage benefits too which help you in customising your policy and increasing its coverage
  6. There are four coverage options under the plan. They are I Health, Health Protect Plus, Health Smart and Health Smart Plus
  7. There is no maximum entry age. Individuals of all ages can buy the plan Coverage benefits of ICICI Lombard Complete Health Insurance Plan
  8. Here are the benefits which are covered under the plan *Inpatient hospitalisation *Daycare treatments*Post and pre hospitalisation*AYUSH treatments*Ambulance cover
  9. There are optional coverage benefits too which can be taken at an additional premium.These benefits include the following
    • Hospital daily cash
    • Convalescence benefit
    • Maternity benefit
    • Newborn baby cover
    • Nursing at home
    • Compassionate visit by a family member
    • Outpatient treatment cover
    • Wellness and preventive healthcare
    • Critical illness cover
    • Donor expenses
    • Personal accident cover
    • Medical evacuation

Eligible Age

91 days onwards

PED Waiting Period

2 years

Coverage

3 Lakh - 50 Lakh

NCB

5% increase in cover;max upto 50%

ICICI Lombard Health Booster

Starting Premium- ₹ 1,584/yr

This is a top-up health insurance plan which acts as a supplemental coverage if you have an existing health insurance plan. If you want to enhance the sum insured of your existing health insurance plan at lower premiums, you can opt for this top-up policy. The policy is also an indemnity oriented health insurance plan which covers the medical costs incurred on actuals basis. The plan has a sum insured and a deductible. If your claims exceed the chosen deductible limit, then only the Health Booster policy would cover the costs and pay the excess claim. Since this is a super top-up plan, the claims incurred in a policy year would be considered in aggregate when considering the deductible limit

Let’s say that you buy a Health Booster policy where the sum insured is INR 10 lakhs and the deductible is INR 2 lakhs. Now, if you suffer a claim of INR 2.5 lakhs, the Health Booster policy would pay the excess claim of INR 50,000 which exceeds the deductible. If the claim is for INR 1.5 lakhs, the claim would not be met by the policy. However, if, in the same year, you incur another claim of INR 1 lakh, the aggregate claims become INR 2.5 lakhs. In this case, this ICICI Lombard health insurance policy would pay the excess claim of INR 50,000

Here are some of the salient features of the policy

  1. The policy is issued on an individual or family floater coverage basis
  2. You can renew the policy lifelong
  3. You can avail cashless treatments under the plan
  4. The coverage can be taken for up to 3 continuous years
  5. There is a range of sum insured and deductible options to choose from
  6. There is no maximum entry age making the plan suitable for individuals of all age
  7. The sum insured is reinstated if it is exhausted in a policy year
  8. An increase of 10% is allowed in the sum insured every year if you do not make claims
  9. You also get a free health check-up every year so that you can monitor your health regularly
  10. The company has designed various wellness-oriented programs.These programs reward you if you maintain a healthy lifestyle Coverage benefits of ICICI Lombard Health Booster Here are the coverage features which are available under the policy
    • Costs incurred on an inpatient basis if you are hospitalised for 24 hours or more
    • Costs incurred on 150-day care treatments which do not require hospitalisation of 24 hours or more
    • Costs incurred within 60 days before you are actually hospitalised
    • Costs incurred for up to 90 days after you are discharged from the hospital
    • Costs incurred on AYUSH treatments which are taken on an inpatient basis
    • Costs incurred on domiciliary treatments which are taken at your own home
    • Costs incurred in harvesting the organ for organ donor treatments
    • Costs incurred on an ambulance for taking you to the hospital for treatments Besides these inbuilt coverage benefits
  11. the plan also has a range of optional coverage features. These features include the following
    • Optional Cover I - This cover has a combination of two coverage benefits which are as follows
      • Hospital daily cash benefit wherein a fixed amount of benefit is paid daily if you are hospitalised for 24 hours or more
      • Convalescence benefit wherein a lump sum benefit is paid if you are hospitalised for a continuous period of 10 days
    • Optional Cover II- Under this cover option, there are three coverage benefits which are as follows
      • Personal accident cover wherein accidental deaths and permanent total disablements are covered. If any of these instances occur, the plan pays a lump sum benefit of INR 10 or 15 lakhs depending on the coverage selected
      • Temporary total disablement rehabilitation cover which covers temporary total disablements which render you unable to work. In such cases, you get a weekly payment of INR 5000 or INR 10,000 for up to 10 weeks
      • Repatriation of remains wherein coverage is allowed for transporting the mortal remains of the insured to his/her residence. This cover is available for INR 50,000 or INR 1 lakh
    • Optional Cover III - This is a critical illness optional cover where a specified list of critical illnesses is covered. If you are diagnosed with any of the covered illness, a lump sum amount would be paid.The amount would be INR 5 lakhs or 10 lakhs as selected by you.

Eligible Age

91 days onwards

PED Waiting Period

2 years

Coverage

5 Lakh - 50 Lakh

NCB

10% increase in cover;max upto 50%

ICICI Lombard Personal Protect Policy

Starting Premium- ₹ 384/yr

This is a comprehensive personal accident policy which covers accidental deaths and disablements. The policy is a fixed benefit health insurance plan which pays a lump sum benefit in case of claims irrespective of the actual costs incurred. The salient features of the plan are as follow

  1. All types of accidents are covered under the plan whether they are rail accidents, road accidents, air accidents or even due to terrorist activities
  2. Accidents due to natural calamities are also covered
  3. No medical check-ups are required to buy this policy
  4. The policy extends coverage not only in India but worldwide
  5. The premiums of the policy can be paid in instalments if you buy the plan online
  6. Your family members can also be covered under the policy

Coverage benefits under ICICI Lombard Personal Protect Policy This ICICI Lombard health insurance plan provides the following coverage benefits

  • Coverage against accidental death
  • Coverage against permanent total disability suffered in an accident
  • Coverage against permanent partial disability suffered in an accident
  • Coverage against temporary total disability suffered in an accident
  • Coverage for accidental hospital confinement. If the insured is admitted to a hospital after an accident, this cover pays a daily allowance for each day of hospital stay
  • Coverage for accidental hospitalisation expenses wherein the medical expenses incurred on hospitalisation due to an accident are covered
  • Convalescence benefit wherein the company pays a lump sum benefit if the insured is hospitalised due to an accident and the hospitalisation exceeds a specified number of days
  • Coverage for a lump sum benefit which would be payable if two or more insured members are injured in an accident and are hospitalised for a specified number of days Moreover,there are different optional coverage features which can be selected if you want to enhance the coverage of the plan

These optional coverage benefits come at an additional premium and include the following

  • Carriage of a dead body : Under this cover, the costs incurred in carrying the dead body back to the residence are covered
  • Medical benefits extension: If the insured suffers an accidental injury which is covered under the plan and is hospitalised, this extension would cover the hospitalisation costs incurred
  • Hospital daily allowance extension : In case the insured suffers from an accidental disablement and is hospitalised, the extension would give cash benefit for each day of hospitalisation
  • Permanent total disablement improvement extension : If the insured suffers from a permanent total disablement due to an accident, this add-on would pay an additional benefit apart from the claim payable under the policy
  • Permanent partial disablement improvement extension : If the insured suffers from a permanent partial disablement in an accident, the add-on pays an additional benefit along with the disability claim paid under the plan
  • Children’s education grant extension : If the insured dies or becomes permanently disabled in an accident, this extension would pay a lump sum amount which can be used to fund the insured’s children’s education
  • Ambulance charges extension : The expenses incurred in taking the insured individual to the hospital after an accident in an ambulance would be covered under this extension
  • Funeral expenses extension : This extension pays the cost incurred on making funeral arrangements for the insured who died in an accident
  • Repatriation of remains extension: Under this extension, coverage is available for the costs incurred in transporting the dead body from the accident spot to the residence

Eligible Age

18 years - 80 years

PED Waiting Period

NA

Coverage

3 Lakh - 25 Lakh

NCB

NA

Top Features From ICICI Lombard Health Plans

  • Covers complete OPD requirements:ICICI Lombard's Befit plan is tailored to cover the expenses of all your minor and severe health concerns, including teleconsultation with the doctor, pharmacy, and routine diagnostics on a cashless basis
  • Covers pre and post hospitalisation:One of the key benefits of a health insurance policy is that it covers your medical expenses incurred just before and after hospitalisation
  • Covers pre-existing diseases :A health plan covers you for a pre-existing disease once you have completed the waiting period mentioned in the policy certificate
  • Provides cashless treatment : At the time of hospitalisation, you don’t have to worry about arranging cash to pay your hospital bill. Your health insurance company will settle it directly with the hospital if it is in their network
  • Lets you claim tax benefit : You can claim a tax deduction on health insurance insurance premium under section 80D of the Income Tax Act, 1961
  • Provides additional sum insured : Keeping healthy has its own benefits. You can enjoy additional sum insured for every claim-free year as per the policy certificate of your health plan

Exclusions Across ICICI Lombard Health Plans

  • Diagnostic or pathological costs such as blood tests, scans, or other similar procedures, unless specifically covered under the policy or necessitated by the treatment
  • Any cosmetic or plastic surgery to change the appearance is excluded from our health insurance. However, we will cover the same surgery performed in the event of a burn, cancer, an accident, or any other essential medical condition
  • Treatment required as a result of engaging in any dangerous or adventurous activities is not covered under our health insurance policy
  • Drug, alcohol, or other toxic substance misuse, as well as any other addictive conditions and their repercussions
  • Medical expenses incurred due to an insured person committing or attempting to commit a criminal act or breach the law
  • Dietary or nutritional supplements and substances purchased without a recognised doctor's prescription are not covered under our health insurance
  • Medical expenses related to birth control, abortion, sterility and infertility
  • Dental procedures unless and until they arise due to an accident
  • Birth abnormalities, exterior congenital diseases, defects, or anomalies
  • Unproven treatments or costs associated with unproven treatments, supplies, or services.

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ICICI Lombard Claim Process

ICICI Lombard supports both cashless claims and reimbursement claims. This section covers the information on how to check ICICI Lombard health insurance claim status, fill ICICI Lombard health insurance claim form, and the claim settlement process.

In your ICICI Lombard health insurance policy, claims happen when you are hospitalised and incur medical costs. In ICICI Lombard’s Personal Protect Policy, claims occur when you suffer from an accidental disablement or death. For making health insurance claims, the process is as follows

  1. Inform the insurance company immediately of your claim
  2. If you are admitted in a networked hospital, a pre-authorization form needs to be filled and submitted to the insurance company for approval of cashless claims. You should fill and submit the form 3-4 days before a planned hospitalisation or within 24 hours of an emergency one.
  3. Once the form is submitted, ICICI Lombard would assess the claim and approve the cashless settlement
  4. Thereafter, you can take cashless treatments at the hospital and your medical bills would be settled by the insurance company
  5. After being discharged from the hospital, you should submit a claim form and all the relevant documents so that claim is settled quickly by the insurance company

If you are admitted to a non-networked hospital, you should bear the medical costs yourself. Thereafter, the claim form and the hospital bills should be submitted to ICICI Lombard for reimbursement of the medical costs that you have incurred

ICICI Lombard Health Insurance Renewal Process

Online Renewal Process for ICICI Lombard Health Insurance Policy


To renew your health insurance policy online with ICICI Lombard General Insurance, follow these steps:

  • Step 1: Visit the Official Website of ICICI Lombard General Insurance and click on the 'Renewal' tab, then select 'Health Policy.
  • Step 2: You can choose to renew with policy details, mobile number or loan account number and click on 'Proceed’.
  • Step 3: Review Policy Details and make any necessary modifications, such as adjusting the sum insured or adding supplementary coverage, before proceeding.
  • Step 4: Choose a suitable payment method from the available options and make the payment for the ICICI health policy renewal online.
  • Step 5: Upon successful renewal, you will receive a confirmation email informing you that the policy has been renewed.
     

Offline Renewal Process for ICICI Lombard Health Insurance Policy

If you prefer to renew your ICICI Lombard Health Insurance Policy through offline channels, you can do so by contacting them at 1800-2666. Additionally, you have the option to visit the nearest ICICI Bank branch to facilitate the renewal process.

ICICI Lombard provides a 30-day grace period after your insurance expires, allowing you to renew it without the need to submit a new application.

You can also reach out to your nearest Turtlemint insurance advisor who can assist you in quick renewal of your policy. Visit www.turtlemint.com now for your HDFC ERGO health policy renewal.

FAQs

Permanent partial disablement includes loss of one hand, loss of one foot, loss of sight in one eye, loss of hearing in one or both ears, loss of fingers and thumbs of hands and/or feet, loss of individual fingers or toes, etc.

Yes, ICICI Lombard health insurance plans allow coverage for senior citizens too. Both health insurance plans offered by the company, Complete Health Insurance and Health Booster, have no maximum entry age making them suitable for individuals of all ages.

You would need to submit your identity proof, age proof, residence proof and photographs with the application form to buy the policy.

Free health check-ups provided under ICICI Lombard health insurance plans are allowed only for adult members. Under both health insurance plans, free health check-ups are allowed for up to two insured members only.

Yes, your health card would be mandatory if you want to make a cashless claim. Health cards contain your policy details and unique identification number. They allow the hospitals to identify the insured members so that cashless treatments can be provided. So, if you are taking treatments at a networked hospital, carry your health card with you for claim purposes.

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