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ICICI Lombard Health Insurance

ICICI Lombard General Insurance Company (IRDA Reg. No 115) is a joint venture between ICICI Bank, one of the biggest private sector banks, and Lombard Canada, a name associated with Canada’s Fairfax Financial Holdings.

Established on 30th October 2000, ICICI Lombard General Insurance Company (IRDA Registration no. 115) offers a wide range of insurance products like home, motor, travel and health insurance. The company has brought together ICICI Bank's innovative approach, operational efficiency and great customer service, and Lombard Canada's expertise in non-life insurance products. ICICI Lombard has taken the hold of market and are doing very well in auto insurance, health insurance, travel insurance etc. They offer insurance to individuals and financial protection solutions to businesses.

Plans Offered by ICICI Lombard

iHealth

This is a basic health insurance plan offered by ICICI Lombard. The plan is available on individual and family floater basis. Mentioned below are the benefits of the plan:

Individual Coverage

  • This policy offers complete health coverage in the range of INR 2,00,000 and INR 10,00,000 for individuals of any age above 6 years.
  • Benefits provided include pre and post hospitalization expenses, day-care procedures, no-claim bonus, cashless benefit, health check-up, etc.
  • Hospital daily cash, critical illness coverage etc. can be added separately in the insurance policy.

Family Coverage

  • This is a basic family floater plan which covers health costs of the entire family in the range of INR 2,00,000 and INR 10,00,000.
  • A maximum of 2 adults and 3 children of any age above 3 months can be covered under this plan.
  • Benefits provided include pre and post hospitalization expenses, day-care procedures, no-claim bonus, cashless benefits, health check-up, etc.
  • Hospital daily cash benefit, critical illness coverage, etc. can be added separately in the policy.

If you are planning to buy ICICI Lombard iHealth insurance plan, or want to know more about the related terms and conditions, click here.

Health Care Plus

This is a top-up plan. These plans have an agreed upon deductible amount to be paid at the time of claim. More information about the coverage offered under the plan is mentioned below:

  • It is a plan for individuals between age 5 years and 65 years.
  • The coverage amount is in the range of INR 5,00,000 and INR 10,00,000 and the deductible amount is in range of INR 2,00,000 and INR 4,00,000.
  • Benefits like dental treatment, cashless claim, no sub-limits (no room rent limit, no ICU room limit etc.) among others are offered.

If you are planning to buy ICICI Lombard Health Care Plus insurance plan, or want to know more about the related terms and conditions, click here.

Personal Protect

This plan by ICICI Lombard offers coverage in case of accidents anywhere in the world. More information about the coverage is mentioned below:

  • The coverage is offered in the range of INR 3,00,000 to INR 25,00,000
  • Individuals between age 18 years and 80 years are covered under this policy.
  • A compensation amount, declared by the proposer, is paid to the nominee in case of accidental death.
  • The plan covers permanent or temporary total disabilities, injuries with broken bones or burns as well as ambulance costs.

To more about this plan, contact Coverfox.

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Benefits

  • Customer Service: Among other things, ICICI Lombard is strongly dedicated towards a customer-oriented service approach.
  • Claim Settlement: As on 31st March 2015, ICICI Lombard issued over 13.87 million policies and settled over 3.41 million claims. This is reflective of their excellent claim settlement record.
  • Technologically Sound: The company is known to be technologically well-equipped and has also received the ‘Best Mobile Application’ award by Asia Insurance Technology Award 2014.

Claim Process at ICICI Lombard

There are two ways to make a claim under a Health Insurance Policy: on a cashless basis and on a reimbursement basis. In simple terms, for making a claim on cashless basis, the treatment must be done only at a network hospital of the insurance company servicing your policy. For availing the treatment, you would have to first seek an authorization as per the procedures laid down and in the prescribed form. In case of claims on reimbursement basis, the insurance company has to be informed as per their prescribed procedures. The policyholder has to ensure that documents such as claim form, discharge summary, prescriptions and bills to be submitted for the claim on reimbursement are obtained after hospitalization.

The claim processing system at ICICI Lombard is as follows:

Cashless Service- seeking Pre-Authorization

  • Get admitted at any of the ICICI Lombard's network hospitals.
  • Send the duly filled pre-authorization form with relevant documents via fax.
  • Prescribed relevant documents include: investigation reports, consultation papers, Cashless ID and Photo ID.
  • After reviewing the claim request, the application maybe approved, rejected and cross-examined, as per policy terms and conditions.
  • The claim will be settled with the hospital, as per policy terms and conditions, once all the formalities have been completed.

Reimbursement Claim- Claim Submission

  • Collect all original treatment documents and expense invoices at the time of getting discharge.
  • Mail the duly filled claim form along with prescribed necessary documents to ICICI Lombard.
  • Necessary documents include: discharge form, payment receipts, final hospital bills, doctor's consultation papers, Medico Legal Certificate or FIR in accident cases, copy of health card.
  • After reviewing the claim request, the application maybe approved, rejected and cross-examined, as per policy terms and conditions.

In case of any emergencies, you need to inform ICICI Lombard within 24 hours of the admission. In case of planned emergencies, the notification has to reach the company two days prior to the hospitalization. The claim intimation can be done through ICICI Lombard's 24x7 toll free number 1800-2666 or by SMS 'HEALTHCLAIM' to 575758 (charge Rs 3 per SMS). The same could also be emailed to ihealthcare@icicilombard.com. Send relevant documents to the company's registered address.

Note: If you are a Coverfox customer, you can directly reach out to us for all your claim-related issues and queries.

Frequently Asked Questions

Which all hospitals are covered under ICICI Lombard's cashless network?

Cashless services are available at a network hospital. To locate an ICICI Lombard network hospital near you, click here.

What is hospital daily cash?

In case, a person is hospitalized for at least 3 consecutive days (subject to a maximum of 10 consecutive days) then a specified benefit amount for each and every completed day of hospitalization is paid. This payment is called hospital daily cash.

How many times can one claim Hospital daily cash?

Hospital daily cash can be claimed once in a policy year. It gets restored every year in a multi-year policy.

Will selecting critical illness and donor expense cover all insured?

A maximum of 2 adults (up to 60 years of age) are covered. Children are not covered.

How can I approach ICICI Lombard for portability?

You may visit any of ICICI Lombard's branches. Portability is also possible by approaching their individual agents, corporate agents and brokers. Remember that only like-to-like policies, i.e. basic to basic or top-up to top-up, are portable.

Where should I send my documents for making claims?

You can send the documents to the company's registered address: ICICI Lombard House, 414, Veer Savarkar Marg, Near Siddhi Vinayak Temple, Prabhadevi, Mumbai - 400025. Alternately, the claim intimation can be done through ICICI Lombard's 24x7 toll free number 1800-2666 or by SMS 'HEALTHCLAIM' to 575758 (charge Rs 3 per SMS).

Which other insurance products are offered by ICICI Lombard?

The company also offers car and two-wheeler insurance policies. To know more about the offered car insurance plan, click here.

Review of ICICI Lombard Health Insurance

ICICI Lombard’s iHealth Plan is a complete plan intended to cover your health-related expenditures during those trying times thereby reducing your monetary strain and perhaps minimizing succeeding ill-effects to your well-being. And if you are uncertain about the coverage, choose the base and top up the sum insured with a super top up plan offered at nominal premium. ICICI Lombard's Super Top Up plan, Healthcare Plus, shields you against medical expenses where your prevailing health policy coverage proves to be insufficient.