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Help & support
Secure yourself from surging medical costs and unexpected health issues with the Health Top Up Policy. The Health Top Up Policy is a super top-up plan that extends your coverage for illnesses and expenses not covered by your base plan or top-ups, it also comes with a deductible threshold.
What is Deductible
Deductible is your part of money to be paid during hospitalisation. Let’s divide insurance into two parts- Yours and Ours. A deductible is your part of the amount to pay to the hospital, be it out of your pocket or from your primary health insurance. Once the medical bill crosses the "deductible" threshold that’s where Our part comes in. Your Health Top Up policy is then activated and the rest of the amount is thus paid by us. So, while buying a Health Top Up policy, the sum insured amount that is not payable by us is the deductible. In case of multiple hospitalisations, if you’ve exceeded your deductible amount once, then post that, up to the sum insured with your Health Top Up policy, we will pay your hospitalisation costs. Let’s assume that you have a medical policy, with a sum insured of 5 lakhs and a Health Top Up policy of 15 lakhs with a deductible of 5 lakhs
In one policy year- | |
---|---|
Sum Insured (Health Top Up) | Rs. 15 lakhs |
Hospitalization 1: Claim of Rs. 7 lakhs | You (Or your base policy) pays: Rs 5 lakhs We pay: Rs 2 lakhs |
Remaining sum insured (Health Top Up) | Rs 13 lakhs |
Hospitalization 2: Claim of Rs 4 lakhs | You pay: Rs 0 We pay: Rs 4 lakhs |
Remaining sum insured (Health Top Up) | Rs 9 lakhs |
Hospitalization 3: Claim of Rs 9 lakhs | You pay: Rs 0 We pay: Rs 9 lakhs |
Company shall not be liable for the deductible amount as specified against the plan opted. The Company are not liable for any payment unless the hospitalization medical expenses exceed the deductible. No deductible shall be applicable for optional cover.
Sum Insured options
10Lacs/15Lacs/20Lacs/25lacs/50Lacs with Deductible Amount options of 3Lacs/4Lacs/5Lacs
Pre & Post Hospitalization
Medical Expenses incurred due to Illness up to 30 days period immediately before and 60 days immediately after an Insured Person's admission to a Hospital
Day Care Procedures
Medical expenses for All day care procedures and surgeries where such procedures or surgeries are undertaken by an Insured Person as an In-patient in a Hospital for continuous period of less than 24 hours
Domiciliary Cover
Covers Medical expenses incurred for Domiciliary Hospitalization up to Sum Insured
Cover for alternate methods of treatment
Reimbursement of expenses for Alternative treatment up to Sum Insured
Organ Donor Expense
Covers Medical Expenses incurred for an organ donor’s Hospitalization for an organ donated to the Insured Person
Domestic Road Emergency Ambulance
Ambulance expenses incurred to transfer the Insured Person following an emergency to the nearest Hospital. Maximum amount payable is Rs.3000 per event of emergency hospitalization
Air Ambulance
Covers expenses incurred on air ambulance services to transfer the Insured Person to the nearest Hospital in case of an emergency. Maximum amount payable under this cover is 10% of Sum Insured as stated in the Policy Schedule.
Following is an indicative list of the policy exclusions. Please refer to the policy wordings for the complete list.
Freelook Period
Offer can be cancelled during free look period (15 days from the date, the policy is received) by giving a written notice to Company or by calling on 1800 2666. In this case, Company will refund the premium paid subject to deduction of the expenses incurred by Company on medical examination of the Insured Person(s) and the stamp duty charges.
Cancellation
Disclosure to information norm: The policy shall be void and all premium paid hereon shall be forfeited to the company, in the event of misinterpretation, mis-description or non-disclosure of any material fact.
You may cancel this Policy by giving Us 15 days written notice for the cancellation of the Policy by registered post, and then We shall refund premium on short term rates for the unexpired Policy Period.
Renewal
The Policy can be renewed as a separate contract under the then prevailing ICICI Lombard Group Health Insurance product or its nearest substitute (in case the product ICICI Lombard Group Health Insurance is withdrawn by the Company) approved by IRDA.
The policy shall ordinarily be renewable except on grounds of fraud, moral hazard or misrepresentation or non- cooperation by the insured.
The policy could be subject to certain changes in terms and conditions including change in premium rate.
Premium rates may change at the time of renewal subject to change in plan &/or age band of senior most insured
Tenure
Policy tenure for a period of 1 year.
Waiting period
Pre-existing diseases: Declared and accepted PED covered after 24 months
Initial waiting period: 30 days for all illnesses (except Hospitalization due to injury).
Specific waiting period: First 24 months, for specific Illness and treatment.
The advertisement contains only an indicative of cover offered. For more details on risk factors, terms, conditions and exclusions, please read the terms & conditions/policy wording carefully before concluding a sale. Insurance is underwritten by ICICI Lombard General Insurance Company Limited. GROUP HEALTH INSURANCE. (UIN - ICIHLGP21380V042021 (Misc 11))
ICICI Bank Limited (“ICICI Bank”) with registered office at ICICI Bank Tower, Near Chakli Circle, Old Padra Road, Vadodara, 390 007, Gujarat (CIN: L65190GJ1994PLC021012) Toll Free No. 1860 120 7777 is only a Corporate Agent (Composite, IRDAI Regn No.: CA0112 valid till March 31, 2022) of ICICI Lombard General Insurance Company Limited having its registered office at ICICI Lombard House, 414, Veer Savarkar Marg, Near Siddhivinayak Temple, Prabhadevi, Mumbai 400025. IRDAI Reg. No. 115. Toll Free No. 1800 2666. Fax No. 022 61961323, CIN: L67200MH2000PLC129408. Email - customersupport@icicilombard.com, Website - www.icicilombard.com.
Enrolment by ICICI Bank’s customer of any insurance products is purely voluntary, and is not linked to availment of any other facility from ICICI Bank.
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