ICICI Pru Heart/Cancer Protect Plan

All About ICICI Pru Heart/Cancer Protect

ICICI Pru Heart/Cancer Protect is a health insurance plan that provides cover against specific ailments like heart diseases and cancer. The policy pays out the sum insured on the first diagnosis, irrespective of the actual medical costs.

(Note: All the information in this article has been sourced from the official website of ICICI Prudential Life Insurance Company.)

Below are some of the benefits of ICICI Pru Heart/Cancer Protect Policy:

Choice of protection: An individual can choose how much coverage he or she needs. There is coverage for both cancer and heart ailments. Condition-based pay-outs: On the first diagnosis of any covered illnesses, the insured will receive a lump sum amount.

• Minor Condition Level: 25% Pay-out (As % of Sum Assured)
• Major Condition Level: 100% after deducting earlier Minor Condition claim pay-outs, if any

Add-ons:

Hospital Benefit: The policyholder will receive daily cash benefit on hospitalization due to a covered ailment. The daily cash is given, irrespective of actual hospitalisation expenses.

Income Benefit: If the insured is diagnosed with any major condition, he or she will receive 1% of the base sum insured every month for 5 years.

Increasing Cover Benefit: The sum insured will increase by 10% simple interest every year until the first claim is filed. The benefit shall increase up to a maximum of 200% sum insured opted at inception

• Pre-existing diseases
• Self-inflicted injuries, insanity, suicide and deliberate participation of the policyholder in an illegal or criminal act with criminal intent
• Use of intoxicating drugs, alcohol, solvent, taking of drugs except under the direction of a medical practitioner
• Radioactive contamination due to nuclear accident
• Existence of any sexually transmitted diseases, HIV or AIDS
• Any illness on account of a congenital defect or disease that has manifested or wasdiagnosed before the policyholder attains the age of 17

To make a claim on ICICI Pru Heart/Cancer Protect Policy, the below steps need to be followed:

Intimation

To make it easy for policyholders to raise claims, ICICI Prudential has a number of modes to intimate claims. These include:

• At ICICI prudential life branches
• Central claims team at Mumbai
• Online claim intimation through company’s website
• SMS ‘ICLAIM Policy No’ to 56767
• Claim care cell 1860-266-7766

All of the required documents have to be submitted along with intimation for speedy processing.

Claims Processing

After the receipt of claim intimation as well as the supporting documents, a claim assessor will inspect it with reference to completeness of the documents and policy terms & conditions. In case any additional documents are required, then the same will be communicated to the claimant. At the time of claim processing, a dedicated claims manager is allocated for every claim. This individual will take responsibility of helping the claimant at every stage until a fair decision is made on the claim.

Decision and Pay-out

On the submission of all required documents and the completion of field investigation (as the case may be), the insurance company settles and communicates the claims decision. Most of the pay-outs are made through electronic modes, such as ECS and NEFT.

Documents Required to Claim ICICI Pru Heart/Cancer Protect Policy

ICICI Pru Heart/Cancer Protect pays out the sum insured on diagnosis of the disease or ailment. The insurance company will require the policyholder to produce i) filled-up and duly signed claim form and ii) medical records of diagnosis/doctor’s certificate of diagnosis in order to process the claim. In case a claim warrants detailed investigation, the company may ask for additional documents.