Wide range of the Sum Insured
The customer has the option to choose from a wide range of Sum Insured, starting from Rs 5 lakh to Rs 1 crore, as per his / her needs.
Avail tax deduction on a premium paid under the Health Insurance policy, as per applicable provisions of Section 80D of the Income Tax Act, 1961 and amendments made thereto.
Floater cover to get family (self, spouse, dependent parents, dependent children, dependent brothers and sisters) covered for the same Sum Insured under a single policy by paying one premium amount. Individuals above 3 months of age can be covered under the policy, provided that 1 adult is also covered under the same policy. Maximum 2 adults and 2 kids can be covered under one policy.
Avail cashless hospitalisation at any of our network providers / hospitals. A list of these hospitals / providers is available on our website www.icicilombard.com.
Unlimited Reset benefit
We will reset up to % of the base Sum Insured unlimited times in a policy year, in case the Sum Insured including accrued additional Sum Insured (if any), Super No Claim Bonus (if any) and Sum Insured Protector (if any), is insufficient as a result of previous claims in that policy year, provided the claim is not related to the illness / disease / injury for which a claim has been paid in that policy year for the same person.
Health Check-up cover
Expense incurred towards the cost of health check-ups will be covered, as specified against the benefit in the Policy Schedule/Key Information sheet, every year.
PED covered after 30 days
Declared and accepted pre-existing diseases will be covered after a day initial waiting period. Any non-declaration of PED will lead to rejection of claims and cancellation of the policy.
360 Wellbeing Program
Avail Value Added Services (VAS) like free health check-ups, online chats with doctors, specialist e-consultations, Dietician and Nutrition e-consultations, information provided on offers related to healthcare services like consultation, diagnostics, medical equipment and pharmacy.
Out-patient Treatment cover*
Outpatient (OPD) medical expenses covered on cashless and reimbursement basis.
This cover can be availed only if both the insured and the spouse are covered under the same plan for a continuous duration of 12 months.
Home Health Care
In this benefit we will cover the medical expenses incurred by you on availing treatment at home, as prescribed by a medical practitioner.
In case the customer has opted for this cover, the IRDAI list of non-payable items shall become payable in case of a claim.
Additional Sum Insured (ASI) Protector
ASI accrued by the customer shall not be impacted if any one claim or multiple claims admissible in the previous year does not exceed the overall amount of Rs 50,000.
Day Care Surgeries / Treatments Coverage
All the medical expenses incurred while undergoing Day Care procedures / treatments which require less than 24 hours hospitalisation, are covered.
Super No Claim Bonus*
In case the customer has opted for this cover, there will be a 50% bonus awarded for every claim-free year, subject to a maximum of 100%. In the event of a claim in the policy year, the super no claim bonus will reduce by 50%.
In the event of hospitalisation exceeding days, the cost of economy class air tickets up to a certain amount (as per the plan chosen) incurred by the customer’s “immediate family member”, while traveling to the place of hospitalisation from the place of origin / residence and back, will be reimbursed. An “Immediate family member” would mean spouse, children and dependent parents.
In Patient AYUSH Treatment
Expenses for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH) treatment, only when it has been undergone in AYUSH Hospital or in the AYUSH Day Care Center on a reimbursement basis.
Air Ambulance cover
Air Ambulance expenses incurred to transfer the insured person, following an emergency to the nearest hospital, up to the Sum Insured, on a cumulative basis.
What is Health Insurance?
A medical insurance policy insures the policyholder against medical expenses incurred due to accidental injuries or sickness. Good health insurance allows you to focus on your treatment and recovery instead of worrying about hospital bills.
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1. Why does one need Health Insurance?
Healthcare is expensive. Technological advances, new procedures and more effective medicines have driven up the cost of healthcare. This increase has to be borne by the consumer, making treatment unaffordable for way too many. Health Insurance overcomes these obstacles so that you remain free of anxiety regarding your health. Think for a moment about the enormous medical costs you would incur, if you suffered a major accident tomorrow or were suddenly stricken by an illness. Uninsured people live with such risks every day. Health Insurance seeks to shield you from that risk. It provides the much needed financial relief. You also get tax benefits under section 80D of the Income Tax Act and amendments made thereto.
2. How will Health Insurance pay for my emergency medical expenses?
Your Health Insurance will either pay your hospital bills directly, if opted for the cashless facility or it will reimburse any payment made by you towards medical expenses incurred due to an illness or injury, as per the policy terms.
3. What do you mean by the Family Floater Policy?
Family Floater is one single policy that takes care of the hospitalisation expenses of your entire family. The policy has one single Sum Insured, which can be utilised by any/all the insured person/s in any proportion or amount, subject to a maximum of the overall limit of the policy Sum Insured, as per policy terms and conditions.
4. Will my Health Insurance cover begin from day one?
When you get a new policy, there will be a day waiting period, starting from the policy inception date, during which period, any hospitalisation charge will not be payable by the insurance companies. However, this is not applicable to any emergency hospitalisation occurring due to an accident. This waiting period will not be applicable for subsequent policies under renewal. Furthermore, in the case of a declared and accepted pre-existing disease, you will have the benefit of NIL waiting for these diseases / conditions and pre-existing diseases would get covered after the initial 30 day waiting period. Also, there is a one year waiting period for specific diseases. Please refer to the policy wording for details.
5. What is pre-existing condition in a Health Insurance policy?
It is a medical condition/disease that existed before you obtained a Health Insurance policy.
6. If my policy is not renewed before the expiry date, will it be denied for renewal?
The policy will be renewable, provided you pay the premium within days (known as the Grace Period) of the expiry date. However, coverage would not be available for the period for which no premium is received by us. The policy will lapse if the premium is not paid within the grace period.
7. What happens to the policy coverage after a claim is filed?
After a claim is filed and settled, the policy coverage continues, however the Sum Insured would get reduced by the amount that has been paid out on settlement. For example: If you start a policy with a coverage of Rs 5 lakh for the year, in January, and in April, you make a claim of Rs 2 lakh, the coverage available to you from May to December will be the balance of Rs 3 lakh.
8. What is Unlimited Reset Benefit?
It is a benefit that allows an insured person/s to reinstate the entire Sum Insured in the policy year when it is insufficient, as a result of previous claims in that policy year. In case the entire cover is exhausted, it gets replenished automatically for the next hospitalisation that occurs within the policy year. Reset will not trigger on first claim and cannot be used by the same person for the same illness, for which the claim has already been paid in the policy.
9. Does my policy offer worldwide cover?
Worldwide is an optional cover. On the basis of the optional cover selected, Health Shield 360 Insurance policy covers hospitalisation expenses (including planned hospitalisation) incurred abroad as well.
10. What is covered under Domiciliary Hospitalisation?
Domiciliary Hospitalisation offers coverage for medical expenses in a situation where the insured person is in such a state that he/she cannot be moved to a hospital or the treatment is taken at home, if there's a non-availability of a room in the hospital.
11. What is Super No Claim Bonus?
In case the customer has opted for this additional cover with extra premium, there will be a 50% bonus awarded for every claim free year, subject to a maximum of 100%. In the event of a claim in the Policy year, the Super No Claim Bonus will reduce by 50%.
12. Can I increase my Sum Insured at the time of renewal?
Yes, you can increase the Sum Insured at the time of renewal. However, a fresh waiting period would apply for the enhanced Sum Insured.
This is only an indicative of the cover offered. For more details on risk factors, terms, conditions and exclusions, please read the terms & conditions/policy wordings carefully, before concluding a sale.
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, 2025) 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. E-mail - email@example.com, Website - www.icicilombard.com.
Only for the customers of ICICI Bank Limited who intend to enrol under the Health Shield 360 Insurance Policy (UIN - ICIHLGP22083V022122 (4177i), Master policy number 4177i/MSTR/220856891/00/000) underwritten by ICICI Lombard General Insurance Company Limited. Enrolment by ICICI Bank’s customer of any insurance products is purely voluntary, and is not linked to the availment of any other facility from ICICI Bank.
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