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ICICI Lombard Complete Health Insurance

At ICICI Lombard, we believe that health insurance is not just a matter of saving tax or getting the protection you need. It can be so much more. It’s about partnering with you to find precisely what works for you based on your needs and then going the extra mile to deliver more than what we promise. We go about finding a policy that truly caters to your needs, based on multiple factors, some of which can be customised as per your needs. Once selected, a single policy will provide a health cover that fits you and your family like a glove.Read More

With more features and benefits, we’re redefining the way you stay protected.Read Less

FEATURES

PLAN OPTIONS/VARIANTS

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    Health Shield

    • In Patient Treatment: Medical expenses incurred, for hospitalization more than 24 consecutive hours.
    • Pre Hospitalisation: Medical expenses incurred 30 days before hospitalisation will be covered
    • Post Hospitalisation: Medical expenses incurred 60 days after hospitalisation will be covered
    • Daycare Procedures and Treatment: All medical expenses incurred while undergoing Day Care Procedures are covered
    • PED waiting period (Declared & Accepted): Covered immediately after 2 years of continuous coverage under the policy
    • In Patient AYUSH hospitalisation: Hospitalisation expenses for Ayurveda, Unani, Siddha and Homeopathy (AYUSH) treatment, on reimbursement basis.
    • Donor Expenses: Medical Expenses incurred by organ donor, on organ being donated to the insured.
    • Unlimited Reset benefit4: Reset up to 100% of the cover amount unlimited times in a policy year, if insufficient because of previous claims in that policy year.
    • Domiciliary hospitalisation: Coverage for medical expenses when the Insured cannot be moved to a hospital or if rooms in the hospital are unavailable.

       

    • Air Ambulance Cover: Cover up to the base Sum Insured for Air Ambulance expenses incurred during an emergency
    • Additional Sum Insured (ASI): 10% of Annual Sum Insured provided as ASI upon renewal every claim free year up to a maximum of 50%. In case of a claim, accumulated ASI is reduced by 10% of the Annual Sum Insured in the following year.
    • ASI Protector: Accrued ASI will not be impacted if all claims admissible in the previous year do not exceed Rs. 50,000 jointly.
    • Emergency Services

    • Domestic Road Ambulance: Cover up to 1% of Sum Insured maximum up to Rs.10,000 per hospitalisation
    • Ambulance Assistance: Ground medical transportation assistance by a Service provider
    • Tele Consultation: Consultations for routine health issues by a qualified Medical Practitioner / healthcare professional.
    • Value Added Service (VAS)

    • Health Check-up:  Free Health Check-up coupon for each Insured every policy year, upto 2 coupons per year for floater policies.
    • Online Chat with Doctor, E-Second opinion, Dietician & Nutrition e-consultation, Health Assistance
    • Wellness Program: Wellness points accrued can be redeemed against out-patient medical expenses

    Health Shield Plus

    • Health Shield Plus = Health Shield + the below Add-ons as inbuilt features

       

    • Claim Protector: Cover for IRDAI list of non-payable items

       

    • Sum Insured Protector: SI increases at renewal on the basis of inflation rate of previous year.

       

    • World Wide Cover: Hospitalization expenses incurred abroad shall be paid with a co-pay of 10%. This benefit is available for Sum Insured of 10 Lacs and above.

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    Health Elite

    • Health Elite = Health Shield + the below Add-ons as inbuilt features
    • Hospital Daily Cash: Fixed amount payable for every completed day of hospitalisation, for hospitalisation of minimum 3 consecutive days up to maximum of 10 consecutive days.
    • Convalescence Benefit: Rs.10,000 per insured paid once during the policy period in case of hospitalisation, for 10 consecutive days
    • Maternity with New Born Baby Cover5: Reimbursement for medical expenses incurred for delivery during hospitalisation. New born child is covered up to 91 days from its date of birth
    • Outpatient Treatment Cover: Reimbursement for the medical expenses incurred as an Outpatient (OPD).

    Health Elite Plus

    • Health Elite Plus = Health Shield + the below Add-ons as inbuilt features
    • Claim Protector: Cover for IRDAI list of non-payable items
    • Sum Insured Protector: SI increases at renewal on the basis of inflation rate of previous year.
    • World Wide Cover: Hospitalization expenses incurred abroad shall be paid with a co-pay of 10%. This benefit is available for Sum Insured of 10 Lacs and above.
    • Super No Claim Bonus
    • Hospital Daily Cash: Fixed amount payable for every completed day of hospitalisation, for hospitalisation of minimum 3 consecutive days up to maximum of 10 consecutive days.
    • Convalescence Benefit: Rs.10,000 per insured paid once during the policy period in case of hospitalisation, for 10 consecutive days
    • Maternity with New Born Baby Cover5: Reimbursement for medical expenses incurred for delivery during hospitalisation. New born child is covered up to 91 days from its date of birth
    • Outpatient Treatment Cover: Reimbursement for the medical expenses incurred as an Outpatient (OPD).
    • Nursing at Home: Fixed amount payable per day up to 15 days post hospitalisation for the medical services of a nurse.
    • Compassionate Visit: Cost incurred by immediate family members traveling to place of hospitalisation(exceeding 5 Days) of the insured

    Add-ons

    • Below add ons are available for selection if not inbuilt, at a nominal extra cost/premium
    • Claim Protector: Cover for IRDAI list of non-payable items
    • Sum Insured Protector: SI increases at renewal on the basis of inflation rate of previous year.
    • World Wide Cover: Hospitalization expenses incurred abroad shall be paid with a co-pay of 10%. This benefit is available for Sum Insured of 10 Lacs and above.
    • Super No Claim Bonus
    • Hospital Daily Cash: Fixed amount payable for every completed day of hospitalisation, for hospitalisation of minimum 3 consecutive days up to maximum of 10 consecutive days.
    • Convalescence Benefit: Rs.10,000 per insured paid once during the policy period in case of hospitalisation, for 10 consecutive days
    • Maternity with New Born Baby Cover5: Reimbursement for medical expenses incurred for delivery during hospitalisation. New born child is covered up to 91 days from its date of birth
    • Outpatient Treatment Cover: Reimbursement for the medical expenses incurred as an Outpatient (OPD).
    • Nursing at Home: Fixed amount payable per day up to 15 days post hospitalisation for the medical services of a nurse.
    • Compassionate Visit: Cost incurred by immediate family members traveling to place of hospitalisation(exceeding 5 Days) of the insured
    • Critical Illness7: Fixed amount is paid up, on the diagnosis of specified Critical Illnesses
    • Personal Accident Cover6,7: Fixed amount is paid, upon the unfortunate event of Accidental Death or Permanent Total Disablement resulting from an accident

ELIGIBILITY

Eligibility

  • The minimum entry age for the customer to receive the policy is 6 years and there is no restriction on maximum entry age. Children between 3 months to 5 years can be insured under floater plan only.

Documentation

  • For transaction on net banking – no documentation
  • For transaction on Mobile App– no documentation

For paper based transactions

  • Health Insurance Proposal form
  • KYC Documents :ID Proof & address proof(PAN & Aadhar)

Know More for Claims and Exclusion

Bajaj Allianz life Smart Protect Goal

Disclamier

1Tax deductions under Section 80D is as per applicable provision of the Act (including any amendments thereto) and are subject to changes in the tax laws.
2Factors determining the renewal premium are (i) age slab of the senior most insured member at the time of renewal (ii) any change in the renewing policy.
3Only when it has been undergone in a AYUSH hospital or in AYUSH Day Care Center on Re - imbursement basis.
4Please note that reset will not trigger for first claim and reset cannot be used by same person and/or for same illness for which a claim has been paid in the policy year
5The waiting period for maternity cover is 3 years. The cover shall be limited to 2 deliveries / terminations during the period of insurance. Pre - natal and Post - natal expenses shall be covered under this benefit. This cover is applicable only for floater plan having Self and Spouse in the same policy. (Inbuilt under Health Elite and Health Elite Plus plans only)
6This cover can be availed only once during your lifetime. Once a claim becomes payable under this cover, no benefit will be provided under the same thereafter.
7Critical Illness and Personal Accident available only for adults, subject to maximum of 2 Adults only up to 60 years of age.
8Disclaimer: Cashless approval is subject to pre-authorisation by the company. Only expenses relating to hospitalisation will be reimbursed as per the policy coverage. Non-medical expenses will not be reimbursed.
9After two years from the Period of Insurance Start Date, Our maximum liability arising out of any Claim for a cataract treatment shall not exceeds Rs. 20,000 per eye, during each Policy Year of the Policy Period for plans with Sum Insured up to Rs 5Lacs. Sub limit of Rs 1,00,000 per eye per Policy year will be applicable for Cataract surgery for plans with Sum Insured above Rs 5Lacs.
10Following is an indicative list of the policy exclusions. Please refer to the policy clause for the complete list.
#as on 31st July 2020Read More

IDFC FIRST Bank Limited ("Bank") with registered office at KRM Tower, 8th Floor, No.1, Harrington Road, Chetpet, Chennai- 600031 is licensed as a corporate agent of ICICI Lombard General Insurance Company Limited under license no.CA0106 issued by Insurance Regulatory & Development Authority of India and does not underwrite the risk or acts as an insurer. This policy is issued to you by ICICI Lombard and is subject to the terms and conditions governing such policy. The contract of insurance is between ICICI Lombard and the insured only, and not between IDFC FIRST Bank and the insured. Bank’s customer participation in the policy is entirely voluntary.

This is only an indication of the cover offered. For complete details on risk factors, terms, conditions, coverages and exclusions, please read the sales brochure carefully before concluding a sale. ICICI trade logo displayed above belongs to ICICI Bank and is used by ICICI Lombard GIC Ltd. under license and Lombard logo belongs to ICICI Lombard GIC Ltd. Insurance is underwritten by ICICI Lombard General Insurance Company Limited, ICICI Lombard House, 414, Veer Savarkar Marg, Prabhadevi, Mumbai – 400025. . IRDA Reg.No.115. Toll Free 1800 2666. Fax No – 022 61961323. CIN (L67200MH2000PLC129408). customersupport@iciclombard.com. www.icicilombard.com. ICICI Lombard Complete health Insurance. Misc128. UIN ICIHLIP21383V052021.Read Less

FREQUENTLY ASKED QUESTIONS

1. Why do I need Health Insurance?

Healthcare is expensive. Technological advances, new procedures and more effective medicines have driven up the cost of healthcare. This increase has to be borne by the consumer, making treatment unaffordable. Health Insurance overcomes these obstacles so that you remain free of anxiety regarding your health. Think for a moment about the enormous medical costs you would incur if you suffered a major accident tomorrow or were suddenly stricken by an illness.. Health insurance seeks to shield you from  health related risk. It provides the much needed financial relief. You also get tax benefit under section 80D of the Income Tax Act and amendments made thereto.

2. How will health insurance pay for my emergency medical expenses?

Your health insurance will either pay your hospital bills directly if opted for the cashless facility in the network hospital or it will reimburse any payment made by you towards medical expenses incurred due to an illness or injury as per the policy terms.

3. What do you mean by Family Floater Policy?

Family Floater is one single policy that takes care of the hospitalization expenses of all  family members covered in that policy. The policy has one single sum insured, which can be utilized by any/all insured persons in any proportion or amount subject to maximum of overall limit of the policy sum insured, as per policy terms and conditions.

4. Will my health insurance cover begin from day one?

When you get a new policy, there will be a 30 days waiting period starting from the policy inception date, during which period any hospitalization charges will not be payable by the insurance companies. However, this is not applicable to any emergency hospitalization occurring due to an accident. This waiting period will not be applicable for subsequent policies under renewal. Furthermore, in the case of a declared & accepted pre-existing disease or specific diseases, you will have to serve the waiting period of 2 years for these diseases / conditions.

5. What is pre-existing condition in health insurance policy?

It is a medical condition/disease that existed before you obtained health insurance policy.

6. If my policy is not renewed in time before expiry date, will it be denied for renewal?

The policy will be renewable provided you pay the premium within 30 days (called as Grace Period) of expiry date. However, coverage would not be available for the period for which no premium is received by us. The policy will be lapsed and continuity benefit would not be applicable if the premium is not paid within the grace period.

7. What happens to the policy coverage after a claim is filed?

After a claim is filed and settled, the  sum insured will be reduced by the amount that has been paid out on settlement. For Example: In January you start a policy with a coverage of `5 Lakh for the year. In April, you make a claim of `2 Lakh. The coverage available to you for the May to December will be the balance of `3 Lakh.

8. What is Unlimited Reset Benefit?

It is a benefit that allows an insured to reinstate the entire sum insured in the policy year when it gets exhausted due to incurred claims. In case the entire cover is exhausted, it gets replenished automatically for the next hospitalization that occurs within the policy year. Reset will not trigger on first claim and cannot be used by same person for same illness for which the claim has already been paid in the policy.

9. Does my policy offer worldwide cover?

Basis the plan and add on selected, ICICI Lombard Complete Health Insurance policy covers Hospitalization expenses incurred abroad with a co-pay of 10%. Worldwide cover is inbuilt with Health Elite Plus & Health Shield Plus plans.

10. What is covered under Domiciliary Hospitalization?

Domiciliary Hospitalization offers coverage for medical expenses in a situation where the Insured Person is in such a state that he/she cannot be moved to a hospital or the treatment is taken at home if there's a non-availability of room in the hospital.

11. What is Super No Claim Bonus?

In case the customer has opted for this additional cover with extra premium, there will be a 50% bonus awarded for every claim free year subject to a maximum of 100% for SI options up to 10 Lakhs and up to 200% for SI options 15 Lakhs and above. Super No Claim Bonus is inbuilt with Health Elite Plus plan.

12. What is the maximum Sum Insured under the new plans?

All plans come with multiple Sum Insured options up to a maximum of 50 Lakhs.

13. Can I increase my Sum Insured at the time of renewal?

Yes, you can increase the Sum Insured at the time of renewal. However, fresh waiting period would apply for the enhanced Sum Insured (this condition would not apply on the original sum insured including the accrued Additional Sum insured).

More FAQs