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GHI for Senior Citizen

How can I cancel my policy before the expiry date?

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  1. Free look period: You can make a cancellation request at ICICI Bank branch within 15 days of receiving the policy certificate by sending us the free look request form available on our website or by submitting a written notice to the company either through registered post or from your registered e-mail ID. If you avail of this feature, the premium will be returned.
  2. Should you wish to cancel the policy after the free look period but before the expiry date, you can do so by following the above process. We shall refund premium on the short term rates as specified below for the remaining policy period.

Is any co-pay applicable under the plan?

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Yes, a co-pay of 20% shall apply on each and every claim under the policy.

How do I calculate the applicable premium for the customer?

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Customer’s and members completed age to be considered i.e. if the customer’s age is 60 years 10 months, his/her age should be considered as 60 years only and the applicable premium informed. The premium is basis the product Sum Insured (SI), number of members and the age of the eldest member insured, which is available on the form.

Do I have to do medical checkup before purchasing the product?

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Yes, for age above 65 years and in case of pre-existing disease, you have to undergo pre policy medical checkup at our designated network provider/service provider. In case your proposal is accepted, 100% of the costs for the pre policy medical checkup will be borne by us and in case it is rejected, the cost of pre policy medical checkup shall be deducted from the premium and the balance premium shall be refunded.

What is the eligible criteria for availing of the senior citizen Health Insurance Plan?

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An individual should be between 51 and 75 years of age.

How can I file a claim?

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  • Claim Intimation: If you need to make a claim, you must intimate us in any of the following ways:
  • Call our Customer Care toll free number <1800 2666>
  • SMS HEALTHCLAIM to <575758> (charged at Rs 3 per SMS)
  • E-mail us at <ihealthcare@icicilombard.com>
  • Do ensure that you intimate us of a planned hospitalisation at least 48 hours before admission. In the case of an emergency, we must be informed within 24 hours of admission. You can download the Claim Form from our website www.icicilombard.com > Claims > Health Claims > Claim Form .
  • Claim Documents: You shall be required to furnish the following documents for or in support of a claim:
    • Duly completed Claim form signed by you and the Medical Practitioner.
    • Original bills, receipts and discharge certificate/card from the Hospital/ Medical Practitioner
    • Original bills from chemists supported by proper prescription.
    • Original investigation test reports and payment receipts.
    • Indoor case papers/Operation theatre notes
    • Medical Practitioner’s referral letter advising Hospitalisation in non-accident cases.
    • Any other document as required by us or our Third Party Administrator (TPA) to investigate the claim or our obligation to make the payment for it.
  • For reimbursement of claims, you may send a complete document set to the below address:

Can ICICI Lombard cancel my policy before the expiry date?

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We may cancel your policy in the case of misrepresentation, fraud, non-disclosure of material facts or non-cooperation of the insured/policyholder.

I have received a health care card. Why do I need a health care card?

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A health care card is given to all the people insured and has all the details of the insured along with the policy number, insured name and policy end date. You will have to produce this when you avail of the cashless hospitalisation facility.

Does the plan cover homeopathy?

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Yes, alternate methods of treatment like Ayurveda, Unani, Siddha, and Homeopathy are covered up to 10% of SI under the plan.

Are there any sub-limits under the plan?

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There are no sub-limits under the plan, except for Cataract (Rs 25,000 for Rs 5 lakh SI and Rs 1,00,000 for Rs. 10 lakh SI every policy year) and knee replacement - 20% of SI.

What is the tenure of the policy?

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Policy tenure is for 1 year i.e. 12 months.

What happens if the customer’s or any of the members age bracket changes during policy issuance Turn Around Time (TAT)?

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ICICI Lombard considers the age of the customer as on the date given during the consent call. The policy starts from the date the customer’s account is debited for the premium.

Is nomination mandatory?

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Yes, nominee is mandatory.

How soon can I file a hospitalisation claim on my policy?

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There is a waiting period of 30 days from the start of the first time you buy the policy before which a claim cannot be made for any illness, except for hospitalisation due to injury or accident.

Would I receive confirmation on the changes done in the policy?

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Any changes made in the policy during the policy period will be made through an endorsement. All the endorsements will be confirmed with an Endorsement Letter which is sent to the customer after the changes are made.

What if I need to change any of the details currently reflected in the policy document?

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Should you find that there are any inaccuracies in your policy certificate, it is very important that you contact us to rectify them so as to ensure all material facts relating to your coverage are correct. Changes in the details of your policy can be such as spelling of your name and change of address, change of date of joining or contact details will not have any impact on the premium you have paid. These changes if deemed fit by us will be endorsed in the policy either by contacting ICICI Lombard on <18002666> or writing on or by calling ICICI Bank Customer Care.

When will I receive my policy certificate?

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It will take T+7 days for us to dispatch your policy certificate, T being the date of your Savings Account activation or amount being deducted from your Account, Credit or Debit Card.

Will my policy cover medical treatment at any hospital I choose?

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ICICI Lombard has an extensive network of hospitals with which it works to offer cashless and reimbursement facilities for your treatment. However, there are some hospitals that are delisted and ICICI Lombard will not cover any medical expenses for treatment taken in these hospitals. The updated list of delisted hospitals is also available on our website www.icicilombard.com . In case you require any further information, please call our toll free number 18002666.

How can I track my claim for current claim status details?

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Once a claim is submitted, its status can be tracked on our website by clicking on www.icicilombard.com/IL-Health-Care/Customer/ClaimStatus .

What tax benefit do I get for making premium payments?

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Yes, premium under the plan is eligible for tax benefits under Section 80D of Income Tax (IT) Act. This deduction is eligible under the prevailing tax laws, which are subject to change.

I had not declared a pre-existing disease when I had bought the policy earlier. Can I do so now? What is the impact on my policy?

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Any Pre-Existing Disease (PED) not declared at the time of policy inception will be considered as non-disclosure of the material facts and will lead to policy cancellation. To avoid this, all material facts related to PEDs should be declared before the policy issuance. However, should you need to declare any PED after policy issuance, please visit the nearest ICICI Lombard branch. The acceptance of the PED will be subject to our underwriting guidelines. In case the PED is a declined risk as per our underwriting guidelines, your policy may be subject to cancellation with zero refund of premium.

Does my policy cover the diseases that I already have at the time of buying the policy?

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Declared and accepted Pre-Existing Diseases (PEDs) will be covered after 24 months of continuous coverage.

Is the claim amount subject to tax?

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No, the claim amount you receive under your health policy is not subject to tax.