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Health Top up - Terms and conditions

Product Name – Group Health Insurance
Product UIN: ICIHLGP02001V030102
Insurer Name - ICICI Lombard General Insurance Company Limited (IRDA Reg. No. 115)

a. The type of consumer for whom the product is intended –

  • “Customer” applying shall mean all ICICI Bank customers over the age of 18 years. The child to be insured should be above 91 days and less than 21 years and individual should be above 21 years and less than 55 years.


b. Main characteristics of the product, Options and coverage provided by the product, as applicable –

Key Benefits & Exclusions

S.No Title Description Refer To Policy Wordings
1. Product Name Group Health Insurance (UIN: ICIHLGP02001V030102)  
3 What are the major Exclusions in the Policy Sum Insured 10Lacs/15Lacs/20Lacs/25lacs/50Lacs Part II of the Schedule Clause 2. Scope of the Cover
Deductible Amount 3Lacs/4Lacs/5Lacs
Covers Medical expenses in excess of Deductible amount that will be applicable on aggregate for the following covers
In Patient treatment Covers Hospitalization expenses for a duration of more than 24 consecutive hours for an insured event
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 Procedure 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 a m o u n t 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.
Note: Following is an indicative list of the policy exclusions. Please refer to the policy clause for the complete list.
  • Naturopathy treatment, acupressure, acupuncture, magnetic and such other therapies
  • Unproven experimental treatment
  • Any expenses arising out of Domiciliary Treatment
  • Treatment taken outside the country
  • Cosmetic surgery
  • Lasik Surgery
  • Septoplasty
  • Infertility & Related Ailments
  • Admin/Registration/Service/Misc. Charges
  • Expenses on fitting of Prosthesis
  • Any device/instrument/machine contributing/replacing the function of an organ
  • Holter Monitoring are outside the scope of the policy
  • Sterility, venereal diseases or any sexually transmitted diseases
  • Dental treatment unless due to accident
  • Any case directly or indirectly related to criminal acts
  • Refractive error correction, hearing impairment correction
  • Substance abuse, self-inflicted injuries, STDs and HIV/ AIDS
Part II of the schedule Clause
3.4 Permanent Exclusions
4 Sub Limit Cataract will be capped at Rs. 1 Lakh per eye per Policy year Part II of the schedule Clause 3
5 Payout Basis
  • Cashless or Reimbursement of covered medical expenses up to specified Sum Insured as per the scope of cover
  • Cashless Facility available at over 4000+ network hospitals.
Part II oftheschedule4. Claim Administration

Only for the customers of ICICI Bank Limited (“ICICI Bank” or “Bank”) who intend to enroll under Group Health Insurance. (UIN - ICIHLGP02001V030102), (Master policy - 4015i/MSTR/190538709/00/000) policy underwritten by ICICI Lombard General Insurance Company Limited (“ICICI Lombard”). IRDAI Regn No. 115. ICICI Bank is acting in the capacity of the group master policy holder. This is just for information purpose and should not in any way be construed as any kind of promotion or endorsement of any insurance product by ICICI Bank Limited. Insurance is being provided to all customers of ICICI Bank. For more details, please refer the policy wordings or you may contact us on 18002666. T & C apply.

ICICI Bank Limited ("ICICI Bank") with registered office at ICICI Bank Tower, Near Chakli Circle, Old Padra Road, Vadodara, 390 007, Gujarat (CIN - L65190GJ1994PLC021012) is a Corporate Agent (Composite, IRDAI Regn No.: CA0112 valid till 31/03/2022) of ICICI Lombard. Insurance is underwritten by ICICI Lombard. For more details on risk factors, terms and conditions please read sales brochure carefully before concluding a sale. Purchase 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.

GROUP HEALTH INSURANCE. (UIN - ICIHLGP02001V030102)

Email - customersupport@icicilombard.com, Website - www.icicilombard.com. T&C apply.

BEWARE OF SPURIOUS PHONE CALLS AND FICTIOUS/FRADULENT OFFERS

  • IRDAI is not involved in activities like selling insurance policies, announcing bonus or investment of premiums.
  • Public receiving such phone calls are requested to lodge a police complaint.