Maternity Benefit (Normal+Cesarean Deliver/Pre-Post Natal(Rs. 2000 each)/ new Born Baby Cover upto Rs. 10,000 from day 1 to 91 days) Waiting Period for Maternity Benefit is 3 years: Normal Delivery upto Rs. 10,000, Cesarean Delivery upto Rs. 15,000.
Maternity Benefit (Normal+Cesarean Deliver/Pre-Post Natal(Rs. 2000 each)/ new Born Baby Cover upto Rs. 10,000 from day 1 to 91 days) Waiting Period for Maternity Benefit is 3 years: Normal Delivery upto Rs. 25,000, Cesarean Delivery upto Rs. 50,000.
Find your Health Insurance Fit
The coverage entails: With ICICI Lombard General Insurance Company Limited, choosing an insurance policy is not just a matter of saving tax at the end of the financial year. It is also about finding a policy that actually works for you. Once you have decided to take a policy, we will go about finding a policy that truly caters to your needs. Factors such as age, number of family members, and preferred insurance premium all come into play. As do factors such as hospitalisation cover and maternity cover, and a few others, 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.
Hospitalisation Cover: All expenses pertaining to in - patient hospitalisation such as boarding and nursing expenses, intensive care unit charges, surgeon’s and doctor’s fee, anesthesia, blood, oxygen, operation theatre charges etc. incurred during hospitalisation for a minimum period of 24 consecutive hours are covered under the basic hospitalisation cover.
Reset Benefit: We will reset up to 100% of the 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.
Day Care Surgeries / Treatments Coverage: All the medical expenses incurred while undergoing Specified Day Care Procedures / Treatment, (as mentioned in the list, please visit ICICI Lombard for complete details), which require less than 24 hours hospitalisation are covered.
In patient AYUSH treatment:Expenses for Ayurveda, 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.
Pre and Post Hospitalisation Expenses: Medical expenses incurred, immediately, 30 days before and 60 days after hospitalisation will be covered.
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.
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. (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 upto 91 days from the date of birth of the child. This cover will be provided only if maternity cover is opted.
Outpatient Treatment Cover: Reimbursement for the medical expenses incurred as an Outpatient (OPD).
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.
Wellness Program: Our wellness program intends to promote, incentivise and reward you for your healthy behavior through various wellness services. All the activities as mentioned in the desired section help you earn wellness points which will be tracked by us.
Hospital Daily Cash: A certain amount (as per the plan chosen) will be paid for each and every completed day of hospitalisation, if such hospitalisation is atleast for a minimum of 3 consecutive days and subject to maximum of 10 consecutive days.
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.
Critical Illness Cover: The customer can opt for Critical Illness Cover covering specified Critical Illnesses / medical procedures like Cancer of Specified Severity, First Heart Attack - of Specified Severity, Open Chest Cabg, Stroke Resulting in Permanent Symptoms, Permanent Paralysis of Limbs, Kidney Failure Requiring Regular Dialysis, Major Organ / Bone Marrow T ransplant, Multiple Sclerosis with Persisting Symptoms, Open Heart Replacement or Repair of Heart Valves, Coma of specified severity. 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 T otal 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.
Nursing at Home / Patient Care: 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 T ravel for family member): 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 traveling 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.
Medical Evacuation: Reimbursement of necessary and reasonable travel expenses, incurred as a result of evacuation to the nearest hospital under a medical emergency condition.
Features at glance: Life Long Renewability: The policy provides life - long renewal.
Pre - Existing Disease: Pre - Existing conditions / diseases will be covered immediately after 2 years of continuous coverage under the policy, if the policy is issued for the first time with ICICI Lombard. Such waiting period shall reduce if the insured has been covered under a similar policy before opting for this policy, subject however to portability regulations.
Floater Benefit: Floater cover to get family (self, spouse, dependent parents, dependent children, brothers and sisters) covered for the same Sum Insured under a single policy by paying one premium amount. Any individual above 3 months of age can be covered under the policy provided 1 adult is also covered under the same policy.
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.
Policy Period: Option of choosing 1 or 2 year policy period under various plans offered.
Cashless Hospitalisation: Avail cashless hospitalisation at any of our network providers / hospitals.
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.
Tax Benefit: Avail tax deduction on premium paid under health insurance policy as per applicable provisions of Section 80D of Income T ax Act, 1961 and amendments made there to.
Pre - Policy Medical Check – up: No medical tests will be required for insurance cover below the age of46 years and Sum Insured up to Rs.10 Lakhs.
Free Look Period: Policy can be cancelled by giving written notice within 15 days of receiving the policy
What is Reset Benefit?
We will reset up to 100% of the 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:
The reset amount can only be used for all future claims within the same policy year , not related to the illness / disease / injury for which a claim has been paid in that policy year for the same person.
Reset will not trigger for the first claim
For individual policies, reset Sum Insured will be available on individual basis whereas for floater policies, it will be available on floater basis.
Any unutilised reset Sum Insured will not be carried forward to the subsequent policy year.