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 ICICI Lombard Health Insurance

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ICICI Lombard Health Insurance

ICICI Lombard Health Insurance provides coverage for costs associated with receiving medical care for most diseases or injuries. An excellent health insurance provider to cover all of your medical needs. With coverage for hospitalisation, childcare operations, medical care at home (domiciliary hospitalisation), ambulance costs, pre and post-hospitalization, and more, ICICI Lombard Health Insurance plans offer comprehensive protection for you.

About ICICI Lombard Health Insurance

ICICI Lombard General Insurance's network includes more than 6,500 hospitals. The customer service team is readily available 24 hours a day via call and chat support, so customers may get assistance from them fast. Customers can quickly intimate claims through the IL Take Care app at the same time. To guarantee that all claims are paid promptly and without causing the customer any difficulty, ICICI Lombard maintains an internal claim settlement team. With 273 branches, ICICI Lombard is present all throughout the nation.

Why Should You Opt for ICICI Lombard Health Insurance?

Cashless Procedure: Cashless claims are settled quickly and easily, usually in less than four hours after the claim is registered. Claims for reimbursement are resolved in 14 days.

 

Lifelong Renewability: This feature guarantees that you'll be qualified for health insurance anytime you need it. Up to a 100% Reset Sum Insurance: On claims filed during the same policy year, the pre-determined sum insured is restored once, up to a maximum of 100%. For illnesses and injuries unrelated to the claim that has already been paid for, the reset sum insured is applicable.

 

Alternative Medical Medicines: Costs associated with alternative treatments such as Ayurveda, Unani, Siddha, and Homeopathy (AYUSH) treatments received at government hospitals, hospitals that have been granted authorization by the government, or facilities that are recognized by the Quality Council of India.

 

Additional Coverages: These coverage benefits can be added on top of the standard plan, depending on the specific requirements of policyholders. Examples include preventative healthcare coverage, maternity and newborn baby coverage, and others.

 

Value-added Services: These include free health checks, consultations with specialised medical professionals, and other services.

 

Tax Benefit: Section 80D of the Income Tax Act of 1961 allows for tax advantages to be claimed on annual premium payments made for health insurance policies.

Benefits of ICICI Lombard Insurance Plans

Customer service is one of the many things that ICICI Lombard is steadfastly committed to providing.

 

Incurred Claim Ratio: As of 2020-21, ICICI Lombard has an incurred claim ratio of 78% over 76.51% of the year 2018-19.

 

Technologically Sound: The business is well-known for being technologically advanced and has also won the 2014 Asia Insurance Technology Award for "Best Mobile Application."

Checklist before Buying ICICI Lombard Health Insurance

Effectiveness of the Coverage Provided

Health plans are created to satisfy the various demands and financial goals of their clients regardless of age, gender, etc. It is sometimes advised against choosing a health plan that covers the entire family and instead advises choosing one that covers each family member separately. Purchasing a plan that covers each member of the family separately can end up being more expensive overall. On the other hand, a family plan might not provide enough coverage for the whole family. Therefore, before committing to your plan, it is crucial that you verify the covered amount.

 

Exclusions from Coverage: 

 

Always pay close attention to the procedures, examinations, or diseases that your coverage does not cover. If you don't, you could find yourself footing a hefty charge after the procedure or paying for a therapy that is already covered.

 

Pre-existing Conditions: 

 

Pre-existing condition insurance requires a waiting time of at least a few years. So that you may make an informed decision, don't forget to verify the waiting period for the pre-existing condition you wish to be covered.

 

Network Hospitals: 

 

Verify that the names on the list of ICICI Lombard Network Hospitals correspond to those in your area or those you choose. Additionally, you will be able to benefit from cashless payments as a result, making hospitalisation simple.

 

Reimbursement Capping:

 

While making a decision, look into any applicable hospital daily cash restrictions, hospital room rent, and other related information.

​

Insurance Company Incurred Claim Ratio: 

An insurance company's incurred claim ratio reveals how effectively it handles claims. If you make a claim in the future, knowing your chances of having it resolved quickly will help you prepare for it. Before you buy a plan, familiarise yourself with the insurer's incurred claim ratio.

How to purchase ICICI Health Insurance at OneAssure

Book an appointment from our website www.oneassure.in and talk to our partner 

​

  1. Express your insurance needs, location, lifestyle details, and concerns if any

  2. Our partners will suggest a few curated plans for you

  3. You consult them on which one you should pick up

  4. Payment and registration

  5. Bam! Your lifetime insurance partner does the rest for you!

Types of ICICI Lombard Health Insurance cover

Consult your OneAssure partner at www.oneassure.in to get insights on the following plans offered. 

 

  1. ICICI Smart Super Health 

  2. ICICI Health AdvantEdge Royal & Apex

  3. ICICI Health Booster (Super top-up)

ICICI Lombard Health Insurance Renewal Process

In order to renew your ICICI health insurance, follow the steps mentioned below: 

 

  1. Visit the ICICI Lombard Health Insurance Company's website.

  2. Mention your date of birth and the name of your insurance provider's health plan.

  3. Press the "Proceed" button.

  4. Complete your online payment using one of the offered payment methods.

  5. You will receive a renewal certificate at the email address you have provided to ICICI Lombard Health Insurance.

ICICI Lombard Health Insurance Tax Benefits

Section 80D of the Income Tax Act provides tax deductions for medical expenditures made for the self and the family which can go from Rs.50,000 to Rs. 1,00,000.

Scenario
Medical insurance premium paid for Self, spouse and dependent children
Total deduction under IT Act Section 80D
Medical insurance premium paid forParents
Your parents & you < 60 years of age.
₹25,000
₹50,000
₹25,000
If both, you and your parents, are > 60 years of age.
₹50,000
₹1,00,000
₹50,000
If you and your family are < 60 years of age and your parents are > 60 years of age
₹25,000
₹75,000
₹50,000

ICICI Lombard Health Insurance Premium Calculation

You may determine the premium required for health insurance by using contacting our partner at www.oneassure.in. Simply input, our partners use your personal information and get quotes generated on oneassure partner app. They select the required coverage or sum assured, and the premium will be directly impacted. The cost of the health insurance policy increases with the level of coverage chosen.

Network Hospitals of ICICI Lombard General Insurance

With ICICI, you can access 6500+ network hospitals across India. For the complete list visit www.oneassure.in and scroll to the bottom. Through Network hospitals, you can avail yourself cashless claim settlement. In other words, you don't pay a single rupee from your pocket for medical bills.

Claim Process for ICICI Lombard Health Insurance Policy

If you are admitted to the hospital, you should contact your insurance provider at once to begin the claim procedure. Both cashless and reimbursement claims are possible. Let's take a look at the procedure:

  1. Submit the correctly filled in claim form after informing the insurance provider via the website or toll-free line.

  2. The hospital will verify and then deliver to the insurance company the required documentation that you have submitted.

  3. If you are admitted to a network hospital, the insurance company will pay the hospital immediately as part of the cashless claim payment after verification.

  4. If you are unable to be admitted to a network hospital or if your claim for cashless payment is denied for whatever reason, you will be entitled to payment under the reimbursement process

  5. For reimbursement, you will pay the hospital upon being discharged. However, you will be reimbursed after submitting the documentation and bill to the insurer.

Documents required to buy ICICI Lombard Health Insurance

You will need proof of identity such as Aadhar, PAN card, Driving license etc, proof of address and diagnostic medical tests if asked by ICICI

Documents required to claim ICICI Lombard Health Insurance

You should have specific paperwork on hand when filing maternity insurance claims to ensure a smooth process. The following are some of the documentation needed to file a claim, though the list varies by company.

 

  1. Duly filled claim form

  2. Policy documents

  3. Admission advice

  4. Discharge summary

  5. Fitness certificate

  6. KYC documents

  7. Consultation bill

  8. Original hospital bill

  9. Pharmacy bills

Documents Required in case of personal accident cover 

In the event of death

  1. Policy copy

  2. Claim form, properly completed and signed. The nominee must complete and sign the form.

  3. If necessary, certified copies of the F.I.R., death certificates, or inquest Panchnama

  4. If necessary, certified copies of the autopsy report

  5. Spot Panchnama certified copies, where applicable.

  6. any additional material that the ICICI Lombard Company requests.

Documents Required in case of personal accident cover

Permanent Disability

  1. Copy of the ICICI Lombard Health Insurance policy issued

  2. Claim form, properly completed and signed. The insured must complete and sign the form.

  3. Disability certificate from a district-authorized doctor that includes the percentage of disability.

  4. If necessary, certified copies of the Panchnama or the F.I.R.

  5. A recent snapshot of the customer demonstrates his disability.

  6. Original hospitalization-related bills, receipts, and discharge certificates from the hospital

  7. Original pharmacy invoices, valid prescriptions, true copy of test results, and payment receipts

Method of applying for Health Insurance Portability

  1. Apply for a portability request to the new insurance company from their website at least 45 days before the existing policy is due for renewal

  2. On receiving the portability request, the new insurer will offer a proposal & a portability form and give details of the various possible health insurance

  3. Choose a health plan that meets your needs, then send the new insurer the completed proposal and portability documents.

  4. In order to verify certain information, such as the applicant's claim history, medical records, etc., the new insurance firm will contact the prior insurer after receiving the forms with the relevant information or visit the IRDAI website.

  5. Within seven working days, the current insurer must provide all necessary information via the IRDAI's common data-sharing system. The decision to approve the porting request may be delayed by the new insurer in the event that this information is shared later than expected.

  6. Within 15 days of receiving all the information, the new insurer will determine whether to accept or reject the insurance. They will be forced to accept the portability application if a decision is not made within this time frame.

ICICI Lombard Health Insurance FAQs

  • I am young and healthy. Do I really need health insurance?
    Health insurance covers you against unforeseen health expenses. Even if you are healthy and haven't had the need to see a doctor in a while it is essential that you get yourself covered for future emergencies. Also, health insurance policy premiums at the time of subscription may be higher if you subscribe at a later age.While your health insurance coverage may/may not (depending on the policy taken) pay for things that aren’t too costly like routine doctor’s visits, the main reason to have coverage is to have protection against the large treatment expenses of serious illness or injury. Please do understand your policy and its inclusions and exclusions and make the right decision.
  • What happens if the primary insured person covered under a family floater policy expires?
    In case the primary insured expires post hospitalization then the claimable health expenses would be reimbursed. If the primary insured is also the eldest member in the family, then for the succeeding years after the death of the primary insured the premium would be calculated on the basis of the age of the next eldest member. For this to happen, the family should fill up the change of request form provided by the insurer. Please note that in case there were only two members covered under the policy then the family floater plan would be converted to an individual plan.
  • What are the things to look for while choosing a health insurance plan?
    When choosing a health insurance policy there are a few things which you should be ready with are: The number of members and relations to be covered- Because this will be the basis of buying a policy. Type of coverage – Individual, Family floater or group. Sum insured or coverage amount – Ensure that you consider future expenses too. Room rent – Check for the capping amount or criteria defined if applicable. Sub-limits or co-pay applicable – Check for the sub-limits applicable for some specific list of ailments or package treatments. Also, check if the plan has a copay feature. Network hospital list – Check for the list of network hospitals and try buying a policy which covers your regular hospital. Policy wording – Most important thing to check before buying a policy. In case you are not sure about the certain term or conditions you can always contact the insurer for clarification. Add-ons: Check for the add-ons that are available and choose the ones that you are definitely likely to use in the following year.
  • Can I cancel my policy and if yes will I get my premium back?
    Yes, you can cancel a policy after you buy it. A free look period of 15 days is provided to you after buying a policy to understand the terms and conditions. In case there is any objectionable clause you can cancel the policy and get a refund. Stamp duty, expenses on medical check-ups and proportionate risk premium (the number of days that the insurance company was at risk of bearing your health expenses) would be calculated while the premium amount is refunded. Refer to the policy termination or policy cancellation section in your policy wording to know the amount that would be refunded. Note: For the refund to happen there should be no claim during the policy period.
  • What are important exclusions under the mediclaim policy?
    There are four important types of exclusions in a Mediclaim policy they are: Time-related exclusions: e.g. Waiting period- general, specific ailments and pre-existing Non-medical expenses: e.g. Registration charges Illegal reasons: e.g. drugs, alcohol abuse, self-inflicted injuries Out-of-scope: e.g. Unproven medical procedures, HIV, adventure sports, etc.
  • Is health insurance policy applicable if hospitalization is for less than 24 hours?
    Yes, your health insurance policy is very much applicable even if the hospitalization is less than 24 hours. This is known as Day Care Treatment. Here, 24 hours hospitalization is not required and you do have a scope of coverage too. Day Care refers to any treatment or surgical procedure that is performed under general or local anaesthesia in a medical clinic/hospital or a day care centre requiring hospitalization for a period of fewer than 24 hours because of technological advancement. However, remember that OPD (out-patient department) are not a part of the Day Care treatments.
  • What will happen if my health insurance lapses when I am hospitalized?
    There can be 2 possible cases: Case 1: You are hospitalized just before the policy expiry date & have intimated the insurance company before the policy lapses (where the policy lapses while you are still in hospital), the company will pay the benefit as per the plan chosen Case 2: If your health insurance lapses and you are hospitalized during the grace period, on intimation during the grace period about the hospitalization, the company will pay the coverage as per the plan, and its terms and conditions.
  • My employer provides me with health insurance coverage. Is it advisable to buy another policy on my own?
    It is strongly advised to take a private policy due to 2 reasons: If you change your job, you might not necessarily get health insurance from your new employer & you will be exposed to health costs in the transition period between jobs. The track record that you have built-in health insurance at your old employer will not transfer to the new company policy. Covering pre-existing diseases might be a problem. In most policies, pre-existing diseases are covered only from the 5th year onwards.
  • Is there any tax benefit that one can avail of while purchasing health insurance?
    Yes, there is a tax benefit available under Section 80D of the Income Tax act 1961. Every taxpayer can avail of an annual deduction of Rs. 15,000 from taxable income for the payment of health insurance premiums for self and dependents. For senior citizens, this deduction is Rs. 20,000. Please note that you will have to show proof for payment of the premium. (Section 80D benefit is different from the Rs 1,00,000 exemption under Section 80 C).
  • Is a medical checkup necessary before buying a policy?
    A medical checkup is necessary for a new health insurance policy for customers above the age of 40 or 45 years depending on the health insurer’s norms. Medical checkups are usually not needed for the renewal of policies.
  • Who is a Third Party Administrator?
    A Third Party Administrator (commonly referred to as TPA) is an IRDA (Insurance Regulatory and Development Authority) approved specialized health care service provider. A TPA provides the insurance company with a variety of services like networking with hospitals, arranging for cashless hospitalization as well as claims processing & timely settlement.
  • What do you mean by Cashless Hospitalization?
    In the event of hospitalization, the patient or their family will have a bill to pay the hospital. Under Cashless Hospitalization the patient does not settle the hospitalization expenses at the time of discharge from the hospital. The settlement is done directly by the Third-Party Administrator (TPA) on behalf of the health insurer. This is for your convenience. However, prior approval is required from the TPA before the patient is admitted into the hospital. In case of emergency hospitalization, approval can be obtained post-admission. Please note that this facility is available only at the network hospitals of the TPA.
  • What is the difference between Health Insurance & Critical Illness policies or Critical Illness Riders in insurance?
    A health insurance policy is reimbursement of medical expenses. Critical illness insurance is a benefit policy. Under a benefit policy upon the occurrence of an event, the insurance company pays the policyholder a lump sum amount. Under a critical illness policy, if the insured is diagnosed with any critical illness as specified in the policy, the insurance company will pay the policyholder a lump sum. Whether the client spends the amount received on the medical treatment or not depends on the client’s own discretion.
  • How does the insurance company decide whether a disease was a pre-existing one or not?
    While filling up the proposal form for insurance you need to provide details of the illnesses you have suffered during your lifetime. At the time of insurance, you should be aware of whether you have any disease and whether you are undergoing any treatment. The insurers refer such health issues to their medical panel to differentiate between pre-existing and newly contracted illnesses. Note: It is important to disclose any disease you might be suffering from before buying the health insurance policy. Insurance is a contract based on good faith and any willful non-disclosure of facts might lead to problems in future.
  • Can I seek treatment at home and be reimbursed for it under health insurance?
    Most policies offer the benefit of treatment at home: a) When the condition of the patient is such that he cannot be moved to the hospital Or b) When there is no bed available in any of the hospitals and only if it is like the treatment given at the hospital/nursing home which is reimbursable under the policy. This is called “domiciliary hospitalization” and is subject to certain restrictions both in terms of the amount which is reimbursable as well as the disease coverage.
  • What is a Critical Illness Insurance?
    Critical Illness Insurance is a policy that pays out a lump sum amount upto the Sum Insured upon diagnosis of a critical illness covered under the policy.
  • Why should I purchase Critical Illness Insurance?
    Critical Illness Insurance provides you and your family, the additional financial security on the diagnosis of a critical illness. The policy provides a lump sum amount which could be used for: Costs of the care and treatment Recuperation aids Debts pay off Any lost income due to a decreasing ability to earn Fund for a change in lifestyle.
  • What is a Fixed Benefit policy?
    Under a benefit policy on the happening of an insured event, the insurance company pays the policyholder a lump sum amount.
  • How does a Critical Illness benefit health insurance policy help you?
    The company will pay the Sum Insured as a lump sum on the first diagnosis of any one of the following Critical Illnesses, provided that the Insured Person survives a period of 30 days from the date of the first diagnosis. The following Critical Illnesses are covered under our plan:- Heart Attack (Myocardial Infarction) Coronary Artery Bypass Surgery Stroke Cancer Kidney Failure Major Organ Transplantation Multiple Sclerosis Paralysis
  • Which documents are required at the time of Claim?
    The Insured shall arrange for submission of the following documents required for processing of the claim within 45 days from the date of Intimation. Duly Completed Claim Form Original Discharge Summary. Consultation Note/ Relevant treatment papers. All relevant medical reports along with supporting invoices and doctors requisition advising the same. Original and Final hospitalization bills with a detailed breakup. Pharmacy Bills along with prescriptions. Any other documents as may be required by the Company. On receipt of claim documents, claims will be processed in accordance with the terms and conditions of the Policy.
  • What is Personal Accident Insurance?
    Personal Accident Insurance protects your finances by providing a lump sum compensation in the unfortunate event of a fatal accident or one that disables you permanently. The compensation shields you and your loved ones from a financial crunch. This insurance also covers accidental hospitalization costs.
  • I am a homemaker who spends the majority of my time at home. Do I also need personal accident insurance?
    Accidents can happen to anyone. Motor accidents, rail accidents, natural calamities, the list is endless. These can sound scary. But, getting intimidated is not the solution, being financially prepared is. Opting for Personal Accident Insurance helps you to meet expenses in case a crisis arises.
  • I travel to different countries often for business and at times for leisure. What if I meet with an accident outside India?
    Accident policies offer worldwide coverage. Your claim will be paid even if you meet with an accident overseas. Contact OneAssure partner to help you understand terms of each policy before buying.
  • I already have health and life insurance coverage. Why should I buy Personal Accident Insurance?
    Life insurance offers a death benefit to your nominee in case you pass away. Health insurance provides compensation and/or reimbursement of hospitalization and other medical expenses. A Personal Accident Insurance policy, on the other hand, insures against the financial risk that could arise due to accidental permanent total disability or accidental death of an earning family member. In short, the policy is essential as it strengthens your financial portfolio securing the future of dependent family members against unforeseen events.
  • What happens if I am hospitalized after an accident? Will the hospitalization expenses be covered by my health insurance?
    Yes. Health insurance policies have optional covers that you get by paying an additional premium. An Accidental Hospitalization Cover provides reimbursement for medical expenses related to hospitalization and a Daily Cash Cover provides you with a cash allowance for each day of hospitalization.
  • Would I need to pay a high premium for availing of Personal Accident Cover?
    No. For example, the premium for a basic policy of Rs. 5 lakh (duration 1 year) is approximately Rs. 610*. It is but a small price for ensuring your family's financial security!
  • I have a family to support. Does Personal Accident Insurance cover death?
    Yes. All you need to do is mention the name of your nominee in the policy document. The sum insured will be paid to your nominee by the insurance company.
  • What is Travel Insurance?
    Travel insurance in India provides coverage for medical expenses incurred overseas for any treatment received as an inpatient or outpatient. All plans also cover trip-related exigencies like trip delays, trip interruptions, trip cancellations and related problems that may arise during your trip. Some plans also provide services such as travel-related advice, Medically required Evacuation to your home in India or a hospital overseas for continued medical treatment. Other assistance services include providing emergency cash or help in the event of the loss or theft of your money, valuables or travel documents.
  • Do I have to get a medical exam done before buying a travel insurance policy?
    No, there is no such requirement to get a medical test for travel insurance. Some companies might ask for medical tests for travellers more than seventy years for higher coverage. Coverage often to fifteen thousand dollars is provided without medical tests.
  • Where should I call for claims assistance while I am abroad?
    You can reach out to us at +91 63643 34343 and we’d be happy to help. You can also contact OneAssure partners for claims assistance. Rest assured that you will be provided with timely support. In addition, your policy document would also have the details to get in touch with you insurer directly.
  • Can I get travel medical insurance for senior citizens who are above 70 years?
    Yes, some insurers are offering travel insurance for travellers aged 71 to 85. Yes, senior citizen travellers who are aged 71 to 85 years are also eligible to buy a Bajaj Allianz travel insurance policy for 6 months with $50,000 coverage.
  • What is Sum Insured Restoration Benefit in Health Insurance?
    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. Most of the health plans these days offer the ‘restoration benefit'. It is just like a ‘magical backup’ to recharge your exhausted sum insured. In case the entire cover is exhausted, it gets replenished automatically for the next hospitalization that occurs within the policy year. In a situation when the sum insured is completely exhausted, sum insured restoration proves to be of great help not only to family floater policies but individual health insurance policies, equally.
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