With ICICI Lombard General Insurance Co. Ltd, Choosing a Insurance policy is not just for your tax purposes for every financial Year, but it should actually work for you when you are in need.
Health issues does not come or planned for they are sudden and we cannot plan this uncertainty. As do factors such as hospitalization cover and maternity cover or few others help us that moment and that don’t disturb or financial planning when we are medically insured
Health Insurance and Term Plan is a basic of FINANCIAL PLANNING. This covers our financial losses and help us to maintain our financial goals.
As a CERTIFIED FINANCIAL PLANNER we recommend these two product first before we go head with Financial Planning
Hospitalisation Cover : All expenses pertaining to in – patient hospitalisation such as room rent, intensive care unit charges, surgeon ’s and doctor’s fee, anaesthesia, blood, oxygen, operation theatre charges etc. incurred during hospitalisation for a minimum period of 24 consecutive hours are covered under the basic hospitalisation cover.
Day Care Surgeries / Treatments Coverage: All the medical expenses incurred while undergoing specified Day care Procedures /Treatment, as mentioned in the list, which requires less than 24 hours hospitalisation are covered
Pre and Post Hospitalisation Expenses: Medical expenses incurred immediately, 30 days before 60 days after Hospitalization will be covered by ICICI Lombard.
In Patient AYUSH Treatment : Expenses for Ayurveda, Yoga and Naturapthy, Unani, Siddha and Homeopathy (AYUSH) treatment only when it has been undergone in a government hospital or in any institute recognised by the government and / or accredited by Quality Council of India / National Accreditation Board on Health on Re - imbursement basis.
Reset Benefit: We will reset up to 100% of the base Sum Insured once in a policy year in case the Sum Insured including accrued additional Sum Insured (if any) is insufficient as a result of previous claims in that policy year.
Domestic Road Emergency Ambulance Cover: Reimbursement up to ` 1,500 per hospitalisation for reasonable expenses incurred on availing an ambulance service offered by a hospital /ambulance service provider in an emergency condition.
Additional Sum Insured: An Additional Sum Insured of 10% of Annual Sum Insured provided on each renewal for every claim free year up to a maximum of 50%. In case of a claim under the policy, the accumulated Additional Sum Insured will be reduced by 10% of the Annual Sum Insured in the following year.
Wellness Program: Our Wellness program intends to promote, incentivise and reward you for your healthy behaviour through various wellness services. All the activities as mentioned in the desired section help you earn wellness points which will be tracked by us.
Free Health Check up: The customer is entitled for a Free Health Check - up at designated centres. The coupons would be provided to each Insured for every policy year, subject to a maximum of 2 coupons per year for floater policies.
Hospital cash: A certain amount (as per the plan chosen) is paid for each and every completed day of hospitalization, such hospitalization is at least for a minimum 3 consecutive days subject to maximum 10 days in a policy year.
Convalescence Benefit: A benefit amount of ` 10,000 per insured once during the policy period will be paid in case of hospitalisation arising out of any injury or illness as covered under the policy, for a period of consecutive 10 days or more
Maternity Benefit: Reimbursement for medical expenses incurred for delivery, including a cesarean section, during hospitalisation or lawful medical termination of pregnancy during the policy period. The 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 for a continuous duration of 3 years. (Such waiting period shall reduce if the insured has been covered under a similar policy before opting for this policy, subject, however to the portability regulations).
New Born Baby Cover: The new born child can be covered under this policy during hospitalisation for a maximum period up to 91 days from the date of birth of the child. This cover will be provided only if maternity cover is opted.
Nursing at Home: An amount of ` 3,000 per day for a maximum of up to 15 days post hospitalisation for the medical services of a nurse at your residence.
Compassionate Visit (Air Travel For Family ): In the event of hospitalisation exceeding 5 days, the cost of economy class air ticket up to ` 20,000 incurred by the customer’s “immediate family member” while travelling to place of hospitalisation from the place of origin / residence and back will be reimbursed. "Immediate family member” would mean spouse, children and dependant parents.
Outpatient Treatment Cover: Reimbursement for the medical expenses incurred as an Outpatient (OPD) as per the plan chosen.
Wellness and Preventive Healthcare: All the expenses pertaining to routine health check - ups and for other wellness and fitness activities taken by you will be reimbursed up to the limit specified in the policy schedule.
Critical Illness Cover: The customer can opt for a Critical Illness Cover, covering specified Critical Illnesses /medical procedures such as Cancer of Specified Severity, Open Chest CABG, First Heart Attack - of Specified Severity, Kidney Failure Requiring Regular Dialysis, Major Organ / Bone Marrow Transplant, Stroke Resulting in Permanent Symptoms, Permanent Paralysis of Limbs, Open Heart Replacement or Repair of heart valves and End Stage Liver Disease. A benefit amount is paid up on the diagnosis of the chosen critical illness.
Donor Expenses: Reimbursement up to ` 50,000 for such medical expenses as incurred by the organ donor for undergoing any organ transplant surgery for your use.
Personal Accident Cover: The customer can also opt for a Personal Accident Cover where a fixed sum is paid upon the unfortunate event of Accidental Death or Permanent Total Disablement resulting from an accident. This 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.
Medical Evacuation: Reimbursement of necessary and reasonable travel expenses, incurred as a result of evacuation to the nearest hospital under a medical emergency condition.
We will reset up to 100% of the base Sum Insured once in a policy year in case the Sum Insured including accrued additional Sum Insured (if any) is insufficient as a result of previous claims in that policy year, provided that:
For Reimbursement Claims: We shall make the payment of admissible claim (as per terms and conditions of Policy) OR communicate non admissibility of claim within 14 days after You submit complete set of documents and information in respect of the claims. In case We fail to make the payment of admissible claims or to communicate non admissibility of claim within the time period, We shall pay 1%interest over and above the claim within the time period, We shall pay 1% interest over and above the rate defined as per IRDAI (Protection of Policyholder's interest) Regulation 2002.
For Cashless Claims: If you notify pre - authorisation request for cashless facility through any of our empanelled network hospitals along with complete set of documents and information, we shall respond within 4 hours of the actual receipt of such pre authorisation request with:
Sub Limits: The customer can get the hospitalisation cover with a reduced premium by limiting the medical expenses pertaining to specified medical and surgical procedures as per below.
No Sub - Limits shall be applicable on any major medical illness and procedures and joint replacement surgery. Major medical illness and procedures for the purpose of this policy shall mean and include the following:
Mandatory Cover:
Hospitalisation+ In Patient AYUSH + Domestic Road Emergency Ambulance Cover + 2 Years PED + Reset Benefit + Wellness Program
Sum Insured:
5 Lakh ` 7 Lakh ` 10 Lakh ` 15 Lakh ` 20 Lakh ` 30 Lakh ` 50 Lakh
No-Sub Limit:
No Sub- limit available for and above ` 5 Lakh
Optional Add on Covers:
Hospital Daily Cash+ Convalescence Benefit + Critical illness + Donor Expense
During FY2018, ICICI Lombard settled 99.9 % health insurance claims and 90.8% motor insurance claims (own damage) within 30 days of claim filing.*
ICICI Lombard has been awarded as the Indian Insurance Award of ‘Claim Leader – General Insurance’ only validates why we remain your smartest choice.
ICRA (an Associate of Moody's Investors Service) has assigned iAAA rating indicating highest claims paying ability to ICICI Lombard General Insurance Company Limited.
The rating indicates a fundamentally strong position. Prospect of meeting policyholder obligations is the best. The rating takes into consideration ICICI Lombard's strong parentage, the high growth prospects for the general insurance business in the country, ICICI Lombard's strong capitalisation level, its prudent underwriting and reinsurance strategy, and its satisfactory underwriting performance.
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