Main Highlight of the plan
This plan offers comprehensive coverage with option to opt for additional cover for additional cover for critical illness, daily cash allowance, coverage for organ donor and convalescence benefit.
Scope of cover
Note: This policy has pre-policy medical check-up requirement for individuals with age 46 years and above.
Coverage: Benefits & Features
ROOM RENT/ ROOM CATEGORY
This plan does not have limit on room rent expenses.
This plan does not have co-pay for any claim.
This plan offers no-claim bonus equal to 10% of sum insured up to a maximum of 50% after every claim free year. However, the cumulative bonus is reduced by 10% of sum insured once a claim is made.
Note: After any claim, only cumulative bonus would be reduced at the time of renewal. However, the basic sum insured will not be affected.
Sub-limits are applicable for specified surgeries or procedures in this plan. Please refer the policy document for the list of these sub-limits.
Good to have
This plan covers 30 days of pre hospitalization and 60 days of post hospitalization expenses.
This plan does not have a restore benefit.
This plan offers one free health check-up coupon every year (a maximum of 2 coupons in case of floater policy).
This plan offers coverage for ambulance expenses up to INR 1,500 per hospitalization.
For all the variants of this plan domiciliary expenses are covered up to sum insured.
This plan does not cover for outpatient hospitalization expenses.
CRITICAL ILLNESS COVERAGE
This plan has an option to opt for additional cover for listed critical illnesses for coverage above INR 2,00,000. For sum insured above INR 2,00,000 additional coverage up to sum insured is offered in this plan.
This plan does not cover medical expenses for alternative practices like Ayurveda, Unani, etc.
This plan does not covers dental expenses.
This plan has an option to opt for daily cash allowance which is provided after 3 days of hospitalization, for a maximum of 10 days. This allowance is in the range of INR 500 to INR 2,000 per day.
ORGAN DONOR COVER
This plan has an option to opt for coverage for organ donor during organ transplantation for the insured up to INR 50,000 for sum insured above INR 2,00,000.
This plan has an option to opt for convalescence benefit of INR 10,000. This benefit is available after 10 days of continuous hospitalization.
This plan covers maternity benefit after 3 years.
A cooling off period of 30 days is applicable on buying health insurance policy for the first year. No claims (other than claims related to an accident) can be made in this cooling off period. There is no cooling off period applicable on renewal of this policy. Waiting period of 90 days for claims related to additional cover for critical illness coverage. Waiting period of 2 years is applicable for some specific ailment. Refer to the policy wordings for the list of these specified ailments.
Waiting period for pre-existing diseases is 4 years for sum insured INR 2,00,000 and 2 years for sum insured in the range of INR 3,00,000 to INR 10,00,000.
Cosmetic surgery, Lasik eye treatments, drugs or alcohol abuse, genetic disorders, self-inflicted injuries, war related injuries, etc. are some of the exclusions. For the detailed list of please refer the ICICI Lombard Health Insurance policy document.