Claim Settlement Ratio 87.71%
Claim Settlement Facility 100%
Network Hospitals 6700
COVID-19 Cover Yes
Incurred Claim Ratio 72%
The minimum and maximum sum insured under the ICICI Lombard health insurance plan is ₹3 lakhs and ₹ 50 lakhs.
The health insurance plan covers the medical expenses incurred prior to the hospitalization up to 30 days and after the hospitalization up to 60 days.
The plan covers the medical expenses incurred for alternative treatments such as Ayurveda Yoga Unani Siddha and Homeopathy up to the sum insured.
The policy covers the day care procedures where the insured person is admitted as an inpatient for a period less than 24 hours.
The health insurance plan covers the medical expenses incurred by the donor up to the sum insured for any organ transplant surgery, provided that the organ is donated for the insured person subject to a limit of ₹10 lakhs.
ICICI Lombard health insurance plan covers the air ambulance cover as well as road ambulance cover in case of emergencies. In case of road ambulance the maximum amount payable is 1% of the sum insured up to ₹10,000 per event of emergency hospitalization.
The health insurance policy provides a daily cash amount of up to ₹3000 per day in case of completion of each day of hospitalization up to a maximum of 10 days subject to the hospitalization being for a minimum of 3 days.
The health insurance policy offers a Convalescence Benefit of ₹10,000 once for each policy period in case of hospitalization for more than 10 consecutive days.
The medical expenses incurred towards maternity and childbirth would be covered up to ₹25,000 for normal delivery and up to ₹50,000 for Cesarean. Pre and post natal expenses would be paid up to ₹2000 each. There would be a waiting period of 3 years under this section.
The new born baby would be covered up to 91 days from the date of birth after which it has to be added in the health insurance policy on payment of additional premium.
The policy pays for the outpatient medical expenses up to ₹20,000 where the insured person is not hospitalized for more than 24 hours.
ICICI Lombard health insurance plan provides claim protection cover under which if a claim has been accepted under the inpatient section then the excluded items mentioned by IRDA would be paid subject to the maximum sum insured under the policy.
The plan covers the sum insured of the insured against rising inflation by linking it with the consumer price index. The sum insured will be increased on a Cumulative basis at each renewal on the basis of inflation rate in the previous year. The percentage increase would only be applicable on the annual sum insured under the policy and not on any additional sum insured.
This section covers the hospitalization expenses incurred by the insurance for treatment availed in any of the foreign countries including US and Canada. A co-pay of 10% will be applied for each and every claim admissible under the policy.