Overview
ICICI Lombard GIC Ltd. is one of the leading private sector general insurance companies in India with a Gross Written Premium (GWP) of Rs135.92 billion for the year ended March 31, 2020. The company issued over 26.2 million policies and settled over 1.86 million claims as on March 31, 2020
Highlights for Health AdvantEdge Plus
Maternity Benefits
New Born Baby Cover
Vaccinations for new born baby in the first year
Critical Illness
Personal Accident (Death + PTD+PPD)
Features
Sub-limits
Health Check up
Free annual health check-up for all insured members according to the list of tests specfied in the policy document.
Ambulance
Transportation of the patient to the hospital and back home
Pre-Hospitalisation : 60 days
The amount of expenses incurred during this period prior to hospitalisation such as diagnostic tests, doctor fees, medicines, etc. for investigiation purpose are also payable by the insurer
Post Hospitalisation : 180 days
The amount of expenses incurred during this period after discharge from hospitalisation for the purpose of recovery such as follow-up tests, doctor fees, medicines, etc. are also payable by the insurer
Pre existing Disease cover : Pre-existing diseases covered after 24 months of renewal.
Coverage for all Pre-Existing Diseases covered after a certain specified waiting period with continuous renewal.
Waiting Period- Initial : 30 days
No claims are accepted within this period except due to accidents/ injury.
Waiting Period- Specific : 2 years
Listed specific illness
Waiting Period- PED : 24 months
No pre-existing ailment related claims are accepted within this period.
Room Rent : Upto Sum Insured
Room rent for in-patient hospitalisation
ICU Charges : Upto Sum Insured
Charges for ICU hospitalisation
Co pay : Available as a choice of 10% or 20%
% of the claim that the policyholder needs to pay out-of-pocket
Restore Benefit/ Recharge/ Refill : Full restoration of the Sum Insured is available from the second policy year after using a portion or all of it.
If the sum insured is exhausted due to hospitalisation expenses of one or more members, there is an automatic restoration of the sum insured for related or unrelated ailments.
Health Check up : Annually
Free annual health check-up for all insured members according to the list of tests specfied in the policy document.
No Claim Bonus : A 20% bonus (up to 100%) is given for every year without a claim.
% of the sum insured that rises every claim free year.
Video/telephone consultation : Unlimited teleconsultations
E-consultation with expert doctors empanelled with the insurer for a second opinion.
Domiciliary hospitalization : Upto Sum Insured
Home care treatment where there are no beds in the hospital or paitient is not in a condition to be moved to the hospital, This treatment is provided under the supervision of a registered medical practitioner.
Ambulance : Air Ambulance costs covered up to the Sum Insured limit. Road Ambulance expenses reimbursed up to 1% of the Sum Insured, capped at ₹10,000 per hospitalization. However, emergency charges by hospitals or ambulance services are payable.
Transportation of the patient to the hospital and back home
Convalescence benefit : Yes
A specific fixed amount of money paid as a recovery benefit for extended hospitalisation.
Organ Donor : Upto Sum Insured
The costs for a surgical procedure of removal or damaged organ from the patient's body which could otherwise be fatal.
Bariatric cover : Yes
Expenses related to obesity-related conditions such as high BP, sleep apnea, arthiritis asthma, etc.
Daycare : Yes
Covers in-patient hospitalisation expenses where the stay is <24 hours under a specified list of treatments
AYUSH : Yes
Alternative treatment coverage such as ayurvedic, unani, sidha and homeopathy which leads to hospitalisation.
Congenital Coverage : Internal Congenital Coverage provided but after a waiting period of 2 years
Covers medical expenses related to diagnosis and treatment of heriditary and internal congenital ailments/ conditions/ traits that exist from birth.
Modern Treatments : Yes
All advanced treatment with upgrade in technology.
Health Management/ Wellness : Earn wellness points through various activities, redeemable for doctor consultations, medication, diagnostics, dental care, etc.
Benefits provided for staying fit and managing health
Maternity Benefit : Yes
All expenses related to childbirth or legal medical termination of pregnancy, usually upto a specified limit.