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ICICI Lombard Health Advantage Plus

Objective

The objective of this policy is to cover the expenses of inpatient and outpatient treatment in a single policy.

Our View

Though the policy features a decent coverage at fair premium rates, lower policy renewal age tarnishes the policy. Old age is the stage when a health cover becomes a necessity. Buying a new policy at higher age will be expensive as a 70-year old will not be as healthy as a 30-year old. Even the policy coverage will shrink as compared to a policy bought when young. In addition, the waiting period, no-claim period will start all over again.

Suited for

It is more suitable for individuals as the maximum coverage  allowed is Rs 3 lakh which may not suffice to protect two members.

What does it do?

This policy covers both inpatient and outpatient treatments. The cover for outpatient treatment however, is restricted up to a fixed sum that varies with age and basic sum insured. Procedures which do not require a 24-hour stay in hospital due to technological advancements are also covered.
Apart from these benefits, the policy provides a cover for Swine flu or H1N1 influenza only if it did not exist at time of taking the policy. It can be bought either as an individual policy or as a floater policy for two adults. In case of floater policy, the floater benefit ends at 55 years of age, after which the policy may be continued as an individual cover.

Pros

It provides cover against Swine flu/ H1N1 influenza.

This policy can be bought online.

Premium paid towards this policy can be availed as deduction under section 80D of IT Act.

It provides no-claim bonus for each claim-free year

Cons

Floater policy benefits can be availed until 55 years of age beyond which the policy continues as an individual cover.

It provides cover of only upto Rs 3 lakh which may not be sufficient for two adults at higher age.

This policy does not cover beyond 70 years of age

Eligibility

Entry Age (years)

Minimum
5
Maximum
65
Maximum Policy Renewal Age (years)
70
Coverage Type
Individual/ floater (2 adults)

Sum Insured (Rs)

Maximum
3 lakh
Minimum
2 lakh
Policy Term (years)
1
No Claim Bonus
No claim bonus of 5% on continuous renewal upto 50% of initial sum insured
Pre Policy Medical Check Up
Not required upto 45 years of age
Policy Termination
Either of the policyholder or insurer can terminate the policy by giving a 15 days notice

Customer Service

Address
ICICI Lombard General Insurance Co. Ltd.
401-402, Interface Bldg; No.11,
Link Road, Malad (West),
Mumbai - 400064.
Mail to
[email protected]
Call to
1800 2666
Network Hospitals
Https://www.icicilombard.com/Content/ilom-en/Hospital_list/search.asp

Additions to the Plan

Scope Of Cover
Cashless Facilityavailable at network hospitals
Reimbursement facilityavailable at non-network hospital
Pre and post hospitalisationcovered; 30 days prior and 60 days post hospitalisation
Inpatient Hospitalisationcovered
Day care procedurescovered
Swine Flu/ H1N1 influenzacovered if not pre-existing
Outpatient Departmentcovers orthopedic, maternity, dental and general practitioner on a reimbursement basis
Exclusions and Waiting Period
Pre-existing diseasecovered after 2 years of continuous years of coverage with the company
No claim periodfirst 30 days from inception of the policy.
Waiting periodcertain treatments and conditions such as cataract, hernia, arthritis, sinusitis and dialysis will be covered after 2 years from policy inception
General exclusionsnon-allopathic treatmenttreatment for HIV/ AIDS or related condition

Cost Details

Annual Premium and OPD benefit
Sum Insured (in Rs.)2 lakh3 lakh
Age (in years)OPD* CoverPremiumOPD* CoverPremium
1 Adult
19-35900015000880015000
36-45850015000800015000
46-55600015000550015000
56-60600015000350015000
61-65700020000550020000
2 Adults
19-35800015000750015000
36-45700015000650015000
46-55300015000200015000
1 Kid**
5-181000015000950015000
*Out Patient Department cover
** Age of proposer should be 18 yrs or above