ICICI Lombard General Insurance Company Limited

15 min read

About ICICI Lombard General Insurance Company

ICICI Lombard General Insurance is amongst India’s leading insurance providers in the private sector. It was established as a joint venture company of ICICI Bank, the largest private sector bank of India and Fairfax Financial Holdings, a Canadian based holding company.  It was incorporated as a public limited company on October 30th, 2020. 

The company offers a well-diversified and comprehensive range of insurance products including health insurance, motor insurance, crop insurance, personal accident insurance, marine insurance, fire insurance, engineering and liability insurance. 

Bharti AXA General Insurance has been merged with ICICI Lombard General Insurance Company with effect from 8th September 2021 resulting in an enhanced distribution channel supported by 1,00,000+ partners and a multitude of digital platforms. 

Key highlights of ICICI Lombard General Insurance

Gross Written Premium INR 135.92 billion for 19-20. 
Total policies issued 26.2 million policies
Claims settled 1.86 million claims 
Networked Hospitals 9300+ network hospitals 
Branches 273 branches across India

View Health Insurance Plans

Awards and Achievements of ICICI Lombard General Insurance Company

ICICI Lombard General Insurance Company has been recognised consistently for its innovative products and customer-centric approach. The awards received by the insurance company are a testimony to the trust of its customers reposed in the company. Some of the recent awards and achievements of ICICI Lombard General Insurance Company are as follows: 

  • ICICI Lombard was awarded as a General Insurance Superbrand by the customers. 
  • ICICI Lombard General Insurance was recognised among “20 Best Insurance in the Asia Pacific Region” for the year 2020. 
  • Recognized as “Insurance Company of the Year” by Snnyex Group in 2020. 

Key features of ICICI Lombard health insurance plans

Some of the most common coverage benefits found in most of the ICICI Lombard health insurance plans are as follows –

Type of coverage benefit Meaning 
Inpatient hospitalisation  This feature covers the expenses that incur when you are hospitalised for 24 hours or more. Whether you are hospitalised for an injury or an illness, you get covered for the room rent, ICU room rent, nurse’s fee, doctor’s fee and other medical charges
Pre and post hospitalisation The expenses that you incur before you are hospitalised are called pre-hospitalisation expenses. Such expenses are covered up to a specific number of days.

Post-hospitalisation expenses, on the other hand, mean the expenses that you incur after you are discharged from the hospital. These expenses are covered for up to a specific number of days after discharge 

Daycare treatments Daycare treatments are those which do not require hospitalisation for 24 hours. Such treatments are covered under the policy up to the sum insured 
Emergency medical assistance Under this coverage, you get 24*7 medical assistance from ICICI Lombard in a medical emergency. You can hire an ambulance, get ambulance assistance or opt for teleconsultations under this coverage benefit
Organ donor cover If you are undergoing an organ transplant surgery, the plan covers the cost of the donor’s organ hospitalisation and organ harvesting 
AYUSH cover Coverage for non-allopathic alternative modes is also offered by ICICI Lombard’s health insurance plans
Free health check-ups You can avail of free health check-ups every year for up to 2 insured members
Domiciliary treatments If you are treated at your own home due to a lack of hospital beds or because you are in no condition to be hospitalised, the underlying medical costs would be covered by the policy

 

Common exclusions in ICICI Lombard health insurance plans

Despite the comprehensive coverage, there are some instances where coverage under ICICI Lombard health insurance plans is not available. These instances are called policy exclusions. The complete list of exclusions can be found in the policy wordings. However, some of the common instances include the following –

  • Pre-existing illnesses are not covered during their waiting period
  • There is a 30 day initial waiting period after buying the policy. Illnesses occurring during this waiting period are excluded
  • A specific waiting period of 24 months is also applicable for specified illnesses. Such specified illnesses are not covered during the waiting period
  • Circumcision, cosmetic treatments and gender-change treatments
  • Cost of spectacles, hearing aids, pacemakers, etc.
  • Unproven or unscientific medical treatments
  • Claims due to war, mutiny, civil commotion, or nuclear threats
  • Self-inflicted injuries or attempted suicides
  • Alcohol and/or drug abuse
  • Acts of criminal nature or those that violate the law
  • Participation in hazardous activities or adventure sports

Features of ICICI Lombard health insurance plans

ICICI Lombard offers a range of health insurance policies that provide comprehensive coverage at unbeatable premium rates. At PayBima, we offer the most comprehensive health plan, Complete Health Insurance or iHealth, offered by ICICI Lombard. Have a look –

1. iHealth Shield

iHealth Shield is one of the variants of the iHealth policy which allows sum insured up to Rs.50 lakhs. You can buy the policy for yourself and your family with the option of customising the coverage as per your needs. Some of the salient features of iHealth Shield are as follows –

  • Unlimited Reset benefit

If you use up your sum insured during the policy year, the plan allows a free reinstatement of the sum insured back to its original level. This restoration benefit is allowed an unlimited number of times within the same policy year.

  • Emergency services

In the case of medical emergencies, you can avail of teleconsultations and ambulance services under the plan.

  • Online chats with doctors

If you suffer any illness or injury, you don’t have to step out of your home to avail of doctor’s consultations. iHealth Shield offers the benefit of online chats with the doctor right from your home, and that too is free of cost.

  • E-Second opinion

You can also avail of an online second opinion from the company’s panel of medical experts in the case of severe illnesses.

  • Range of optional add-ons 

iHealth Shield offers a choice of 10 optional add-ons that you can add to your policy by paying a small additional premium. These add-ons help in enhancing the scope of the policy for complete protection.

2. iHealth Shield Plus 

A step up from the Shield variant, the Shield Plus variant offers additional coverage benefits, both inbuilt as well as optional. Here are the salient features of this plan option –

  • Air ambulance cover

The plan allows coverage for the expenses incurred in hiring an air ambulance in an emergency if you need to be hospitalised in another city for your treatment.

  • High sum insured levels

The sum insured in the plan starts from Rs.10 lakhs and goes up to Rs.50 lakhs. So, if you are looking to avail of a policy that offers high sum insured levels with a comprehensive scope of coverage, Shield Plus can be the suitable choice.

  • ASI and ASI Protector

If you don’t claim in the policy year you earn a 10% ASI (Additional Sum Insured). You can keep on earning the 10% ASI after every successive claim-free year up to a maximum of 50%. In the case of a claim, the ASI reduces by 10%.

However, the plan allows an ASI protector wherein, if your claim in the last year is up to Rs.50,000, the ASI would not be reduced.

  • Customisation

There are different types of add-ons available with the policy. These add-ons help in enhancing the coverage at an additional premium. You can choose any number of add-ons that you want and enhance your cover as per your needs.

  • Worldwide cover

In the case of planned treatments that you avail internationally, the plan would extend coverage for the hospitalisation costs with a co-payment of 10%. 

3. iHealth Elite

iHealth Elite is another variant that you can find in the iHealth plan offered by the company. The policy offers comprehensive coverage features and high sum insured options. The features of the policy are as follows –

  • High coverage for donor expenses

If you undergo organ donor treatments, the plan would allow coverage for up to Rs.10 lakhs so that you can pay for the associated medical costs. 

  • Hospital daily cash allowance

Upon hospitalisation, which continues for 24 hours or more, you get a daily allowance over and above the claim for your medical expenses. The allowance is fixed and ranges from Rs.1000 to Rs.3000 per day depending on the sum insured that you have selected.

  • Maternity cover

The plan allows coverage for the medical expenses incurred on pregnancy and childbirth. You can avail of coverage for up to Rs.25,000 for normal deliveries and Rs.50,000 for C-Section. There is also a cover for pre and post-natal expenses of Rs.2000 each and a newborn baby cover up to Rs.1 lakh. Maternity cover, however, is available after a waiting period of 3 years.

  • Cover for outpatient expenses

If you incur medical expenses on an outpatient basis, i.e. without being hospitalised, the same would be covered under the policy. This is an inbuilt coverage feature wherein you can enjoy coverage from Rs.5000 to Rs.20,000 depending on the sum insured that you choose.

  • Convalescence benefit

Long hospitalisations are unfortunate and so this plan pays a lump sum convalescence benefit of Rs.10,000 if you are hospitalised for 10 days or more. This benefit is paid in addition to the claim that you incur.

4. iHealth Elite Plus 

The last variant of the iHealth plan, Elite Plus is suitable for individuals looking for high sum insured levels for themselves and their families. The salient features of the plan are as follows –

  • Claim protector coverage

This cover enhances the claim payable under the policy by including the cost of consumables. The policy covers the cost of consumables which is otherwise excluded in normal plans.

  • Sum insured protector coverage

Under this cover, the sum insured is increased, automatically, at every renewal at the last year’s inflation rate. This ensures that your coverage keeps pace with the inflated medical expenses and covers you optimally. 

  • Super no claim bonus

If you don’t claim in the first policy year, you would be rewarded with a super no claim bonus of 50%. The sum insured would increase by 50%, free of cost. Thus, you can double up the sum insured within 2 claim-free years. The super no claim bonus allows a maximum increase of up to 100% of the sum insured if the sum insured is Rs.10 lakhs. For higher levels, the maximum limit enhances to 200%.

  • International coverage

With this feature, you can avail of coverage for your hospital bills incurred in a foreign country. The coverage comes with a co-payment of 10% and is available if you choose a sum insured of Rs.10 lakhs and above.

  • Compassionate visit

If you are hospitalised for 5 days or more and your immediate family lives in another city, the policy would cover the cost of return airfare for one immediate family member, i.e. your spouse, child, or dependent parent.

  • Home nursing cover

This feature covers the cost of hiring a nurse at home to help you with your recovery post hospitalisation. Coverage under this benefit is available for up to 15 days after your hospitalisation. 

  • Hospital cash allowance with convalescence benefit

The plan allows a daily cash allowance if you are hospitalised for 24 hours or more. The allowance paid is Rs.3000/day for each day of hospitalisation. Moreover, if your hospitalisation equals 10 days or more, you also get a lump sum convalescence benefit of Rs.10,000.

  • Add-ons for critical illness and personal accident

The plan offers two optional coverage features of critical illness add-on and personal accident add-on. Under the former, specified critical illnesses are covered. If you are diagnosed with any covered illness, a lump sum benefit is paid. The personal accident add-on, on the other hand, covers accidental death and permanent disability and pays a lump sum benefit in either case.

Here’s a schedule showing the comparative analysis of each of these plans offered by the company –

Features  Shield Shield Plus Elite Elite Plus 
Inpatient hospitalisation Covered Covered Covered Covered
Pre and post hospitalisation  30 and 60 days 30 and 60 days 30 and 60 days 30 and 60 days
Daycare procedures  Covered  Covered  Covered  Covered 
AYUSH cover Covered  Covered  Covered  Covered 
Donor expenses Covered, up to the sum insured or Rs.10 lakhs, whichever is lower Up to Rs.10 lakhs Covered, up to the sum insured or Rs.10 lakhs, whichever is lower Up to Rs.10 lakhs
Unlimited Reset Benefit Available Available Available Available
Domiciliary hospitalisation Covered  Covered  Covered  Covered 
Air ambulance cover Covered  Covered  Covered  Covered 
ASI 10% of the sum insured up to 50% 10% of the sum insured up to 50% 10% of the sum insured up to 50% 10% of the sum insured up to 50%
ASI protector Available  Available  Available  Available 
Ambulance cover 1% of the sum insured or Rs.10,000 Rs.10,000 1% of the sum insured or Rs.10,000 Rs.10,000
Claim protector  Optional benefit Available  Optional benefit Available 
Sum insured protector Optional benefit Available  Optional benefit Available 
Worldwide cover Optional benefit for sum insured Rs.10 lakhs and above Available  Optional benefit for sum insured Rs.10 lakhs and above Available 
Super no claim bonus Optional benefit Optional benefit Optional benefit Inbuilt 
Hospital cash allowance Optional benefit

Rs.1000-Rs.3000 per day

Optional benefit

Rs.3000 per day

Inbuilt benefit

Rs.1000 to Rs.3000 per day

Inbuilt benefit

Rs.3000 per day

Convalescence benefit Optional benefit

Rs.10,000

Optional benefit

Rs.10,000

Inbuilt benefit

Rs.10,000

Inbuilt benefit

Rs.10,000

Nursing at home Optional benefit

Rs.2000 or Rs.3000 per day

Optional benefit

Rs.3000 per day

Optional benefit

Rs.2000 or Rs.3000 per day

Inbuilt benefit

Rs.3000 per day

Compassionate visit Optional benefit

Rs.10,000 or Rs.20,000

Optional benefit

Rs.20,000

Optional benefit

Rs.10,000 or Rs.20,000

Inbuilt benefit

Rs.20,000

Maternity cover Not available Not available Inbuilt benefit

Normal – Rs.15,000 or Rs.25,000

Caesarean – Rs.25,000 or Rs.50,000

Pre and post-natal cover – Rs.2000 each

Newborn cover – Rs.10,000 or Rs.1 lakh

Inbuilt benefit

Normal –Rs.25,000

Caesarean –Rs.50,000

Pre and post-natal cover – Rs.2000 each

Newborn cover –Rs.1 lakh

Outpatient cover Not available Not available Inbuilt benefit

Rs.5000 to Rs.20,000

Inbuilt benefit

Rs.20,000

Critical illness cover Optional benefit

Up to sum insured or 50% of sum insured

Optional benefit

Up to 50% of the sum insured

Optional benefit

Up to sum insured or 50% of sum insured

Optional benefit

Up to sum insured or 50% of sum insured

Personal accident cover Optional benefit Optional benefit Optional benefit Optional benefit
Entry age Minimum – 6 years onwards

Dependent children – 3 months to 5 years on a floater basis

Sum insured  Rs.5 lakhs, Rs.7 lakhs, Rs.10 lakhs, Rs.15 lakhs, Rs.20 lakhs, Rs.25 lakhs or Rs.50 lakhs  Rs.15 lakhs, Rs.20 lakhs, Rs.25 lakhs or Rs.50 lakhs Rs.5 lakhs, Rs.7 lakhs, Rs.10 lakhs, Rs.15 lakhs, Rs.20 lakhs, Rs.25 lakhs or Rs.50 lakhs  Rs.15 lakhs, Rs.20 lakhs, Rs.25 lakhs or Rs.50 lakhs
Term of the plan 1, 2 or 3 years
Premium payment frequency In one lump sum

Annually

Half-yearly

Quarterly

Monthly

Pre-existing waiting period 2 years

 

How to buy ICICI Lombard Health Insurance policy?

ICICI Lombard health insurance policies can be brought online through www.PayBima.com easily in the following steps: 

1. Select your health plan

Click on the above link to visit PayBima’s official website and click on health insurance to find the most suitable policy for you. 

2. Fill relevant details

A form will appear in which you are required to fill in the requested medical and personal details to enable PayBima to calculate the premium based on your eligibility and your coverage requirements. Fill in your name, the number of dependents, sum assured, age, gender, Pincode of your location and your contact details. PayBima also provides personalized consultation for buying the policy easily. 

3. Compare the plans

After providing all the details, PayBima will display the plans which best suits your coverage requirements and eligibility. ICICI Lombard’s health insurance plans will also be shown. You can easily compare the coverage of the plans with their premium and choose the policy which best suits you. 

4. Fill the proposal form online

After you have finalized your policy, you just have to fill out a proposal form by correctly providing your details. Ensure to provide correct details at the time of filling the proposal form so that you do not face any problem at the time of making a claim

5. Pay the premium

Payment of premium is the last step for buying the health insurance policy. Pay the premium online and the insurance company will instantly issue the policy provided there are no adverse declarations made by you about lifestyle habits and medical history in the proposal form

6. Medical screening

You may be required to undergo a pre-entrance health check-up based on certain factors such as your age, lifestyle habit, medical history and the coverage opted. Medical screening is required in case of high health risks. You can avail of the medical screening at any of the network hospitals of the insurance company. 

The process to renew the ICICI Lombard Health Insurance plan

PayBima not only provides a facility to buy a health insurance policy but also allows you to renew it by visiting its official website. ICICI Lombard health insurance policies allow lifelong renewals and you can enjoy uninterrupted coverage if you renew within the due date. 

Health insurance renewal can be done online by providing your policy number and other policy details. At the time of renewal, you can check your plan details and also make changes to your plan if required. Any changes made to the plan may be separately charged thereby increasing your premium. You can contact PayBima through email at paybima.care@mahindra.com or at 1800 267 67 67 to get assistance for renewing your ICICI Lombard complete health insurance policy. 

How can you claim ICICI Lombard Health Insurance policy?

PayBima offers a very simple and easy process to file a claim for an ICICI Lombard health insurance plan. The process is discussed as follows: 

1. Locating network hospital

ICICI Lombard General Insurance offers both reimbursement and cashless claim facility. To avail cashless claim facility, the first thing you need to do is locate the nearest network hospital of the insurance company by visiting the website of the insurance company. You can locate your nearest hospital from the list of hospitals with which the insurance company has a tie-up. 

2. Admission

After locating the nearest networked hospital, you can get admitted to it by showing your Identity proof and health card. 

3. Pre-authorization Claim form

A pre-authorization claim form is required to be submitted to the insurance company for cashless settlement of the health claims. You can download the form online from the company’s website or visit the nearest branch of the insurance company to get the form. The form should be submitted at least three to four days before hospitalization. You can also submit the form within 24 hours of hospitalization in case of emergency. 

4. Cashless approval

The insurance company will approve a cashless facility based on pre-authorized claim form submitted. After receiving approval from the insurer, the networked hospital will proceed with the treatment. All the bills for the treatment will be handled and paid by the insurance company. 

5. Reimbursement Claim Facility

If you do not opt for a cashless claim and get admitted to a non-networked hospital, your claim would be settled on a reimbursement basis. In such cases, you are required to inform the insurance company before planned admission to a non-network hospital. You can inform the insurance company even after admission but before discharge in case of emergency admissions. After discharge from the hospital, you will have to settle all the bills which you can get reimbursed by filling up the claim form and attaching all the original receipts, bills and medical documents. The company will reimburse your amount after assessing your claim and validating your documents and proof. 

PayBima provides hassle-free and smooth claim settlement assistance to its customers. You can contact PayBima at 1800 267 67 67 or email at paybima.care@mahindra.com to get help with your claim settlement. 

Certain documents are required to be submitted to get a successful settlement of the claim. The documents include the following: 

  1. Duly filled and signed claim form
  2. Bank mandate for payment of reimbursement claim
  3. ID proof of insured such as Aadhaar Card, PAN Card, Birth Certificate, etc. 
  4. Pre-authorization form in case of cashless claims
  5. Original medical documents and bills, medical receipts, consultation notes, prescriptions, hospital reports for reimbursement claims. 

Review of ICICI Lombard Health Insurance

ICICI Lombard General Insurance is a celebrated brand name in the insurance sector for its customer-centric approach and comprehensive benefits. Other highlights of the company are as follows: 

  1. ICICI Lombard General Insurance Company was the first general insurance company to issue subordinated debt in India in 2016. 
  2. The insurance company has tie-ups with leading hospitals across the country helping you to locate a network hospital easily and get a cashless benefit. 
  3. It offers attractive rates of discounts to its customers making it affordable for them
  4. The plans are available online for a convenient and hassle-free buying experience. 

Popular Health Insurance Companies in India

Health Insurers in India
Universal Sompo General Insurance Company Limited Future Generali India Insurance Company Limited
Bajaj Allianz General Insurance Company Limited HDFC Ergo General Insurance Company Limited
Care Health Insurance Company Limited Aditya Birla Health Insurance Company Limited
Chola MS General Insurance Company Limited Manipal Cigna Health Insurance Company Limited
Niva Bupa Health Insurance Company Limited Royal Sundaram General Insurance Company Limited
SBI General Insurance Company Limited Tata AIG General Insurance Company Limited

Frequently Asked Questions

Q: Which family members can be covered on a floater basis?

ICICI Lombard health insurance plans allow coverage for you, your spouse, dependent children, dependent parents and siblings on a floater basis.

Q: Do I need to undergo pre-entrance health check-ups to buy ICICI Lombard’s health insurance plans?

Pre-entrance health check-ups are not required if you are below 46 years of age and you opt for a sum insured up to Rs.10 lakhs. However, in these cases too, if you declare an adverse medical history, pre-entrance health check-ups might be required.

Q: What is the free-look period under the policy?

ICICI Lombard’s health insurance plans allow a free look period of 15 days from the date of policy issuance. You can cancel the policy during this period and avail of a refund of your premium.

Q: Do ICICI Lombard health insurance plans allow any value-added services?

Yes, a range of value-added benefits is offered under ICICI Lombard health insurance plans. These benefits include online doctor chats, free health check-ups, e-consultation with dieticians and nutritionists, e-consultation with specialists, etc.

Q: If I make multiple claims for the same illness, can I use the reset benefit?

The reset benefit is available only for unrelated claims. So, if you suffer multiple claims but are for the same illness or injury, reset benefit would not be allowed.

SHARE THIS ON
Author Bio
Author Image

Gayatri Prabhu, Head-Digital Business at Mahindra Insurance Brokers Limited (MIBL) is one those few digital leaders who has the width and depth that is required to execute an ROI driven holistic digital strategy. She cuts through the noise, identifies the critical levers and leads her team to successful execution of the defined strategy. Her core mantra to win new and retain existing customers is: understand the consumer behavior and craft experiences around it.

Related Blogs

Would love to hear from you

Share your candid feedback. Your email address won’t be published, we promise!

All fields are required

Corporate Office : Mahindra Insurance Brokers Ltd ( A Mahindra Group Company ) Sadhana House, Ground Floor, 570 P. B. Marg, Behind Mahindra Towers, Worli, Mumbai 400018.

Licenced by IRDAI License No. 261; License Validity : 17-05-2022; Category : Composite Broker; CIN : U65990MH1987PLCO42609 Member of Insurance Brokers Association of India (IBAI).

Insurance is the subject matter of solicitation.

For a seamless experience, use the latest version of Chrome/Firefox/Internet Explorer.

Copyright © 2022 Mahindra Insurance Brokers. All Right Reserved.

SPEAK TO AN EXPERT