Will my existing medical condition be covered from the first day under Royal Plus?

The plan lists a zero-day waiting period for pre-existing diseases. However, coverage is subject to accurate medical disclosure, underwriting acceptance and the policy terms. Confirm acceptance of your specific condition before relying on this benefit.

Does Claim Protector cover every non-medical expense?

Claim Protector covers specified otherwise non-payable items, subject to policy conditions. It is inbuilt for sum insured of ₹15 lakh and above. The exact list of eligible expenses and exclusions should be checked before purchasing.

Will the reset benefit increase my available cover after my first claim?

No. The reset benefit does not trigger for the first claim. It is described as unlimited for any illness, but for ₹5 lakh and ₹7.5 lakh sum insured options, it is available only once.

Can I use cashless treatment at a hospital outside the network?

Cashless treatment may be available under Cashless Everywhere, subject to the insurer's operating guidelines and claim admissibility. For planned procedures, notify the insurer at least 48 hours before admission; for emergencies, notify it within 48 hours of admission. Cashless approval is not guaranteed.

Can I choose a higher room category if my sum insured is ₹20 lakh or less?

The plan specifies a single private room for sum insured up to ₹20 lakh. Choosing accommodation outside the permitted category may affect claim payments, depending on the policy terms.

Are maternity and newborn expenses covered automatically?

Maternity is an optional cover for eligible members aged 18–45, with a limit of up to 10% of the sum insured, capped at ₹1 lakh, and a 2-year waiting period. Newborn cover and first-year vaccinations have separate limits and conditions. Confirm that the relevant benefits are included in your policy.

OneAssure

Health Insurance

ICICI Lombard

Health AdvantEdge Plus

ICICI Lombard Health AdvantEdge Plus

Q: How long are medical expenses covered before and after hospitalisation?

Eligible pre-hospitalisation expenses are covered for 60 days and post-hospitalisation expenses for 180 days, subject to policy conditions and claim admissibility.

Cover pre-existing diseases with no waiting period, reset the sum insured unlimited times for any illness after the first claim, once only at ₹5 lakh or seven-and-a-half lakh, and keep a 20% cumulative bonus up to 100% after a claim.

97.16%

Claim Settlement Ratio

9,000+

Network Hospitals

10/10

Plan Rating

Policy Policy Wording

Policy Brochure

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Our Verdict

Expert Review: ICICI Lombard Health AdvantEdge Plus

Final Verdict

Health AdvantEdge Royal Plus may suit buyers looking for a broad set of hospitalisation benefits, multiple sum insured choices and a cumulative bonus that is not reduced after claims. Its reset benefit, preventive health check-up, teleconsultation and ambulance benefits add to its coverage offering. However, buyers should review the first-claim restriction on reset, the single-private-room limit at lower sum insured levels, benefit-specific caps and the conditions attached to optional covers. The brochure's stated zero-day PED waiting period should not be interpreted as automatic acceptance or unconditional coverage of every pre-existing condition; disclosure, underwriting and policy wording remain important.

About

What Is Health AdvantEdge Plus?

ICICI Lombard Health AdvantEdge Royal Plus is a health insurance plan offering multiple sum insured options from ₹5 lakh to ₹3 crore. Its base benefits include inpatient treatment, modern treatment, inpatient AYUSH hospitalisation, domiciliary hospitalisation, daycare procedures and donor expenses, subject to policy terms. Pre-hospitalisation expenses are covered for 60 days and post-hospitalisation expenses for 180 days. The plan also includes domestic road and air ambulance benefits, home care treatment, unlimited teleconsultation and an annual preventive health check-up benefit.
The plan provides a guaranteed cumulative bonus of 20% of the sum insured, up to a maximum of 100%, without reducing the accumulated bonus when a claim is made. Its reset benefit can replenish cover for any illness, but it does not trigger for the first claim. For the ₹5 lakh and ₹7.5 lakh sum insured options, the reset benefit is available only once. Room accommodation is limited to a single private room for sum insured up to ₹20 lakh; the brochure states that no accommodation capping applies above ₹20 lakh.
Optional covers include maternity benefits, newborn baby cover and vaccinations, critical illness, personal accident, sum insured protector, Claim Protector, nursing at home, BeFit and compassionate visit. Some benefits are inbuilt at specified sum insured levels, while others require an additional premium. The applicable waiting periods, benefit limits, exclusions and conditions should be checked in the policy wording before purchase.

Plus Ratings

Plus

Insurer Rating

8.88

out of 10

Insurance Rating

10

out of 10

No Room Rent Limit

Yes

Consumables Covered

Yes

No Co-payment

Yes

Loyalty Bonus >= 500%

Yes

No Disease Sublimits

Yes

Unlimited Restoration

Yes

Additional Benefits (Informational Only — Not part of score)

PED Waiting <= 2 Years

No

Maternity Available

Yes

Waiting Period Waiver

Yes

Testimonials

Real People. Real Relief

These are the moments that show what we really do. We don't sell you a policy. We stand by you when it matters most.

I want to sincerely thank Sunad for being there for me throughout the entire claim process. He helped me through so many ups and downs, always patient and ready to support when things got tough. I honestly don’t know how I would have managed without his guidance and encouragement. Sunad made a difficult situation feel a lot less stressful, and I’m truly grateful for his kindness and steadfast help.

Prashant Pandey

Mumbai, Maharashtra

Had a great experience with them during a difficult time. After my mother’s accident, we had to pay the hospital bill upfront, as cashless wasn’t available. They guided us through the reimbursement process, helped file the claim, and consistently followed up with the insurer until it was settled. Their support with the post-hospitalization claim was equally prompt and thorough.

Jatin Gala

Mumbai, Maharashtra

My heartfelt thanks to the OneAssure team for making my insurance claim process effortless. Right from the very first interaction, they demonstrated professionalism, clear communication, and an impressive command of the procedures involved. Their swift updates, timely guidance, and persistent follow-through removed all the stress from what could have been a complicated experience.

Anju Renjith

Bengaluru, Karnataka

I am truly grateful for the support and guidance I received in settling my insurance claim. The entire process was handled with great professionalism, clarity, and efficiency. Their prompt response, deep knowledge of the procedures, and consistent follow-ups ensured a smooth and hassle-free experience.Thank you once again for your invaluable help, highly recommended!

Yogesh Meena

Jaipur, Rajasthan

I recently had the pleasure of purchasing health insurance for my parents through this company, and my experience has been exceptional...The team was incredibly patient and took the time to explain every detail to me. No matter how many times I asked questions, they were always calm and thorough in their explanations. Their professionalism and dedication made a significant difference in helping me make an informed decision.

Akash Kumar

West Bengal

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Inclusions and Exclusions

ICICI Lombard Health AdvantEdge Plus Inclusions and Exclusions

Room Rent

Normal: No Limit
ICU: No Limit If the sum insured health insurance policy is Rs.5 Lakh or above.

Advanced Treatments

Oral Chemotherapy
Robotic Surgeries
Stem Cell Therapy

Co-payment

Co payment is applicable as chosen by the insured.
It allows the insured to opt for 10% or 20% co-payment.

Cashless Healthcare Providers

10,000+ Healthcare Providers across India

Daycare Treatment

Covered. Requires hospitalization of more than 24 Hours.

AYUSH Treatment

AYUSH is covered up to Sum Insured.

Modern Treatment

Covered up to sum insured, subject to policy terms and exclusions.

ICU Charges

Up to sum insured for Apex Plus, subject to the applicable wording.

Cumulative Bonus

Guaranteed cumulative bonus: 20% of sum insured, up to 100%, under the historical Apex Plus brochure.

Consumable Cover

Listed non-medical expenses may require the optional Claim Protector benefit; verify the applicable schedule.

Initial Waiting Period

30 days for illnesses; accidental hospitalisation exempt.

Specific Waiting Period

2 years for specified diseases and procedures, subject to the policy wording.

PED Waiting Period

2 years, subject to disclosure and acceptance by the insurer.

Annual Health Checkup

Annual benefit from the first year; historical brochure specifies up to 0.5% of sum insured, capped at ₹10,000, on a cashless basis.

Post-Hospitalisation

Up to 180 days under the historical Apex Plus brochure.

Outpatient Department Cover (OPD Expense)

General OPD cover not verified. Teleconsultations are listed in the historical brochure as an included value-added service.

Deductible Option

Not verified for this variant.

Coverage Options

Individual/family cover; historical Apex Plus brochure also lists worldwide cover for sum insured of ₹25 lakh and above. Confirm current availability and conditions.

Maternity Cover

Optional; historical brochure specifies 10% of base sum insured, capped at ₹10 lakh, for up to 3 deliveries. Waiting periods and eligibility must be checked in the applicable wording.

Claim Settlement Ratio

FY 24-25: ~84%

Pre-Hospitalisation

Up to 60 days under the historical Apex Plus brochure.

Disease-wise sublimits

Certain benefits have specific limits, including ambulance, animal-bite vaccination, bariatric surgery and home-care treatment. Other limits depend on the policy terms.

Exclusions

Injuries or diseases resulting from war, invasion, acts of foreign enemies, civil unrest, or similar events are excluded.
Illnesses or injuries due to nuclear, chemical, or biological attacks or weapons are not covered under the policy.
Expenses for prostheses, corrective devices, and external durable medical equipment like wheelchairs and crutches are excluded, unless necessitated by an accident.
Treatments such as acupressure, acupuncture, magnetic therapies, and other non-allopathic treatments are not covered by the policy.
Procedures aimed at enhancing appearance, including plastic surgery, unless medically necessary due to injury or illness, are excluded.

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About the company

About ICICI Lombard

ICICI Lombard General Insurance is one of India’s leading private sector insurers, known for providing reliable and comprehensive insurance solutions. It is a joint venture between ICICI Bank, one of India’s largest private banks, and Fairfax Financial Holdings, a global financial services group. Established in 2001, ICICI Lombard has grown rapidly and now serves millions of customers across the country.
The company offers a wide range of products, including health, motor, travel, home, and personal accident insurance, catering to individuals, families, and businesses. Its health insurance offerings include regular health plans, super top-up plans, critical illness cover, and personal accident plans, all designed to provide financial protection against unexpected medical expenses.
ICICI Lombard stands out for its customer-focused approach, quick and transparent claim settlement, and a strong network of hospitals for cashless treatment. Many of its plans require minimal paperwork and no pre-policy medical check-ups, making it easy for customers to get insured. With digital tools for premium calculation, policy management, and instant claim assistance, ICICI Lombard combines technology with trusted service to make insurance accessible, simple, and dependable for every Indian.

FAQs

Frequently Asked Questions

Got questions about health insurance? You're not alone. Here are some of the most commonly asked questions to help you understand plans, coverage, claims, and benefits better.