Insurance Plans 283 views May 23, 2020

ICICI Lombard Complete Health Insurance

Health issues come with a lot of overheads and expenses and it is really difficult for a normal earner to manage these expenses at once. Therefore, it is necessary to secure your health risks with a health insurance policy. You can have a look at the ICICI Lombard Complete Health Insurance Policy that will assure a lot of health cover and provides cashless settlement. It allows you to reset the amount of the Sum Assured up to 100%. You can also enjoy tax benefits in this health insurance plan. So, if you find this health insurance plan interesting then you must explore the various benefits and options available in this plan.

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Key Features of Complete Health Insurance Plan

  1. This insurance covers health and maternity expenses.
  2. Get Quick Claim Settlements within 14 days and cashless settlement within 4 hours.
  3. Get an insurance cover for the treatment at the AYUSH Hospitals.
  4. Reset the Amount of the Sum Assured up to 100% once in a year.
  5. There is no maximum age limit in this policy.
  6. Get Tax Deductions on the amount of the premium you paid for the plan.

Benefits of Complete Health Insurance of the ICICI Lombard

There are some benefits that you must explore before taking this health insurance plan. You might find all the benefits of the policy interesting.

Medical Expenses Coverage

This policy covers all the medical expenses incurred during hospitalization for more than 24 hours that includes room charges, doctor’s fee, surgeon’s fee, and other medical bills. It will cover all the expenses done prior to 30 days of hospitalization and post 60 days of hospitalization. All the expenses will be covered maximum up to the amount of the Sum Assured.

Floater Benefit

You have the option to cover self, spouse, dependent parents, brothers and sisters, and dependent children under the same insurance plan and Sum Assured. You will only have to pay a single premium and it gives multiple covers. Individual who is having an age of 3 months can also be covered in the same plan but on the condition that an adult is added in the same policy.

Increment in the Value of the Sum Assured

If you don’t make any claim in the policy year then the company will increase the amount of the Sum Assured by 10% every year. The maximum increment in the case of a claim-free year would be 50% of the Sum Assured. If in case you make a claim them the amount of the Sum Assured will be decreased by 10% in the next year.

Free Health Check-up

This benefit is only for the floater policyholders who can have a free health check-up at the designated centers. The Company will provide a maximum of 2 coupons in every policy year so that the insured can enjoy the benefits of the free health check-up.

No Pre-Medical Checkup

In the ICICI Lombard Complete Health Insurance Plan, if your age is below 46 years and you have chosen the Sum Assured of up to INR 10 Lacs then there is no need for a Pre-Medical Check-up. You can straightaway take the policy without going through the medical test formalities.

Free Look Period

The Company gives you a period of 15 days to have a look at the policy details. If you find the policy not interesting then you cancelled it by giving written notice to the company. But you only have the time of 15 days to cancel the policy once you buy it.

Tax Benefits

You can also enjoy tax deductions under section 80C of the Income Tax Act 1961 by showing the amount of premium you have paid for the policy. The amount of the premium will be deducted from your income while computing the net income for the applicable tax.

Reset Sum Assured

The company will reset the amount of the Sum Assured up to 100% if the Sum Assured including the additional Sum Assured is insufficient due to the claim of the previous year. This happens only once in a policy year.

AYUSH Treatment Coverage

The ICICI Lombard Complete Health Insurance Policy also covers the expenses incurred for the Ayurvedic, Unani, Siddha, and Homeopathy treatment. The risk for these treatments will only be covered if you go to a Government Hospital or any Institute recognized by the government.

Ambulance Cover

In case of a serious emergency, the first thing that comes in the mind of an individual is to call an ambulance. Therefore, this policy covers the Ambulance expenses as well up to Rs.1500 per hospitalization.

Add-on Option Available in this Policy

There are some Add-on Benefits that you can add in the same policy. The 3 options for the Add-on benefits are given below:-

Option 1

Hospital Daily Cash:- If you are hospitalized for 3 consecutive days then the company will give Rs.1000 (for the value of Sum Assured of Rs.3 Lacs, Rs.4 Lacs, and Rs.5 Lacs) and Rs.2000 (for the value of Sum Assured of Rs.7 Lacs and Rs.10 Lacs) for 10 consecutive days as the daily cash benefit.

Convalescence Benefit- In this benefit, the company will give Rs.10000 per insured only once in a policy year if the hospitalization occurs due to some injury or illness covered in this plan. The hospitalization must be of 10 consecutive days.

Option 2

Outpatient Treatment Cover- In this benefit, the company will cover all the medical expenses incurred as an Outpatient or at OPD.

Maternity Benefits-The Company will reimburse all the medical expenses incurred for the delivery even if it is cesarean and the hospitalization expenses. This benefit has a waiting period of 3 years and the cover will be limited up to two deliveries. The policy must be a floater policy and the self and spouse must be covered under the same plan.

New Born Baby Cover- All the medical expenses incurred during the hospitalization of a newborn baby is covered for up to 91 days from the date of birth in the ICICI Lombard Complete Health Plan. This benefit is only given by the company if you opt for maternity benefits.

Wellness and Preventive Healthcare- Expenses related to wellness and preventive health care like routine checkups and other fitness activities will also be reimbursed by the company.

Option 3

Critical Illness Cover- Critical Illnesses like Cancer of Specified Severity,

First Heart Attack – of Specified Severity, Open Chest Cabg, Stroke Resulting in Permanent Symptoms, Permanent Paralysis of Limbs, Kidney Failure Requiring Regular Dialysis, Major Organ / Bone Marrow Transplant, Multiple Sclerosis with Persisting Symptoms, Open Heart Replacement or Repair of Heart Valves, Coma of specified severity are also covered in this plan and you can take the reimbursement up to a maximum amount that you have chosen at the time of inception of the policy.

Donor Expenses-If you are going through an organ transplant surgery then the company covers up to Rs.50000 for the donor expenses in the Complete Health Insurance Plan.

Eligibility Criteria for Taking the Plan

  1. The minimum age for buying the plan must be 18 years and above.
  2. 3 Months is the minimum age for the children who must accompany an adult in the floater plan.
  3. If you are buying an individual plan for children then the child’s age must be 6 years or more.
  4. Children between the ages of 3 months to 5 years must have an adult in the plan.
  5. If the age of the applicant is 46 years and above then he has to go through a Pre-Medical test.
  6. ICICI Lombard Complete Health Insurance Policies bought for Parents, Spouse, Self, and dependent children are only eligible for the Tax
  7. Deductions under Section 80C of the Income Tax Act.

Diseases that are Not Covered in this Plan for 2 Years

  1. Cataract
  2. Myomectomy, hysterectomy unless because of malignancy
  3. Benign prostatic hypertrophy
  4. Dilatation and curettage, endometriosis
  5. Fissures and/or fistula in anus, hemorrhoids/piles
  6. Hernia and hydrocele
  7. Stone in the urinary and biliary systems
  8. Joint replacement, unless due to accident
  9. All types of skin and all internal tumors/cysts/nodules/polyps of any kind, including breast lumps, unless malignant
  10. Sinusitis and related disorders
  11. Dialysis required for chronic renal failure
  12. Gastric and duodenal erosions and ulcers
  13. Surgery on tonsils, adenoids, and sinuses
  14. Varicose veins/varicose ulcers
  15. Deviated nasal septum