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Health Insurance

How to download insurance copy using policy number?

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1. For queries or complaints related to ICICI Lombard, you may contact ICICI Lombard on 18002098888 (Toll-Free) or write to customersupport@icicilombard.com. For more details, you may visit the ICICI Lombard website, www.icicilombard.com .

2. For queries or complaints related to ICICI Prulife, you may contact ICICI Prulife on 1800222020 (Toll-Free) or write to lifeline@iciciprulife.com.
For more details, you may visit the ICICI Prulife website, www.iciciprulife.com .

What is Health Insurance portability?

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Health insurance portability means that you have the freedom to switch from one insurer to another without losing any continuity benefit with respect to PEDs, waiting period and other time bound exclusions, earned in the previous health insurance policies, subject to continuous insurance in the previous years

What are the documents required for a claim in Complete Health Insurance Policy?

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• Depending upon the circumstances of the case, additional information or additional documents can be asked for the settlement of the claim
• The documents should be in originals unless otherwise agreed by the Company
• Document in vernacular should be accompanied by the translation of the same in English and duly attested
• Copy of health card

List of Documents required:
• Duly completed Claim form signed by the insured 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
• Medical Practitioner's referral letter advising hospitalisation in non-accident cases

In Health Booster Policy When can I apply for portability? Will I need to undergo medical check-up?

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You should apply 45 days prior to your renewal date. Yes, for ICICI Lombard's Health Insurance Plans you will need to undergo medical check-up as per the underwriting guidelines of the company.

What do you understand by the term pre-existing disease in Health Booster Policy?

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Pre-existing Disease means any condition, ailment or injury related condition(s) for which you had signs or symptoms, and/ or were diagnosed, and/ or received medical advice/ treatment, within 48 months prior to the first policy issued by the insurer.

Is a medical test mandatory for everyone in Complete Health Insurance Policy?

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A medical test is mandatory for any insured member who is more than 45 years age.

If I go for Cashless Hospitalisation how will Claim Service Guarantee work in Health Booster Policy?

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In case of delay in response by ICICI Lombard beyond the time period of 4 hours (3 hours for enhancement, query & final bill), we shall be liable to pay ₹1,000 to the customer. Our maximum liability in respect of a single hospitalisation shall, at no time exceed ₹1,000.

What do you mean by entry age and exit age in Health Booster Policy?

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The age eligibility for taking the policy is the entry age and the age after which you cannot take or renew the policy is the exit age.

What is the procedure to cancel the policy in Complete Health Insurance Policy?

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You can cancel your policy by giving us a written notice of 15 days. Premium refund will be provided on a short-term basis for the unexpired policy period as per the rates detailed below, provided no claim has been payable under the policy. Policy Period Within 1 Month From 1 Month To 3 Months From 3 Months To 6 Months From 6 Months To 9 Months 9 Months To 12 Months 12 Months To 18 Months 18 Months To 21 Months 21 Months To 24 Months During 2ndYear 1 year 80% 60% 40% 20% 0% NA NA NA NA

What is a non-premium bearing endorsement in Complete Health Insurance Policy?

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A non-premium bearing endorsement is the endorsement for which no additional premium is charged.

Which diseases come under permanent exclusions of the Health Booster plan?

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Injury or diseases directly or indirectly attributable to war, invasion, act of foreign enemy, war like operations, cosmetics, aesthetics treatment unless arising out of accident. Cost of spectacles, contact lenses, and hearing aids (LASIK), dental treatment, or surgery of any kind unless requiring hospitalisation etc. (Refer policy wordings for details).

What is the exit age for Complete Health Insurance policy?

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There is no maximum exit age for this policy.

How long will ICICI Lombard take to settle my claim in Health Booster Policy?

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Once all necessary documents have been sent to us and queries have been answered, we will process your claim. If you are availing of the cashless facility, your claim will be settled within 4 hours directly with the hospital. In case of a reimbursement facility, your claim will be settled through NEFT within 14 days of submission of all the required documents. We will provide you the benefit under claim service guarantee if there is a delay beyond these specified timelines as per the T&C stated for this feature. Please refer policy wordings for details.

Does Complete Health Insurance Policy cover pre-existing diseases?

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Yes, pre-existing diseases are covered after specified waiting period, provided the policy is renewed continuously for the same period with the Company.

Will selecting critical illness and personal accident cover all insured in Health Booster Policy?

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A maximum of two adults (up to maximum age of 60 years) can be covered. Children cannot be covered under this cover.

How many times can a customer claim Convalescence benefits in Complete Health Insurance Policy?

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A customer can claim Convalescence benefits once in a year.

What is the difference between individual and Floater options in Complete Health Insurance Policy?

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Individual plan covers only one insured in a policy. Floater plan covers more than one insured (max 2 Adults and 3 Children) and provides one sum insured to all.

What is the procedure to cancel the Health Booster policy?

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The policy can be cancelled by giving a 15 days’ written notice. Premium refund will be on short-term basis for the unexpired policy period as per the rates detailed below, provided no claim has been payable under the policy.

Can ICICI Lombard cancel my Health Booster 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. Prior to cancelling the policy, we will send a written notice to this effect through registered post, giving 15 days' notice to the policyholder.

Can extended family members be covered under my health policy?

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Your policy is designed to cover your immediate family members, which can include your spouse, dependent children, brother(s), sister(s), dependent parent(s), grandparent(s), grandchildren, mother-in-law, father-in-law, son-in-law, daughter-in-law, dependent brother-in-law and dependent sister-in-law. However, the total number of people covered under the policy cannot exceed more than 2 adults and 3 children.

In Health Booster Policy Will I get paid in case the delay is from my end in providing necessary documents?

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Unfortunately, the claim service guarantee feature is applicable in case of any delay from ICICI Lombard only.

What are the limits for Pre and Post Hospitalisation expenses in Health Booster Policy?

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It refers to payment of the Medical Expenses incurred by the insured immediately, 60 days before and 90 days after hospitalisation.

What should I do if I want to insure more than 2 adults or 3 children under Complete Health Insurance Policy?

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If the number of adults or number of children are more than 2+3, you need to buy an additional policy for the additional members. There can be a maximum of 2 adults and 3 children in a policy

Does a higher cover mean preferential treatment in case of hospitalisation and claim?

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No, a higher cover does not entitle you to preferential treatment. Irrespective of the insurance cover you buy - either a` 2 Lakh cover or a ` 4 Lakh cover - you will get high quality service and treatment at our network hospitals.

Can I add or remove family members from Health Booster Policy?

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Yes, you can add family members to your policy at any time by paying additional premium as applicable. However, removal can be done only at the time of renewal. The additions cannot increase the policy limit to more than 2 adults and 3 children. In the case of an individual policy, any other person cannot replace the insured. Please note that fresh waiting period will be applicable to the person added

What benefits do I get by renewing my Health Booster Policy with ICICI Lombard?

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There are several benefits in renewing your policy with ICICI Lombard:

  • It ensures uninterrupted coverage for your health and medical treatment requirements.
  • You will earn a 10% cumulative bonus on your sum insured for every claim free renewal, subject to a limit of 50%. For example, a policy with a sum insured of ₹3 lakh will earn ₹30,000 for each year of not making a claim, up to ₹1,50,000 of cumulative bonus.
  • Each year, you will also earn your complimentary health check-up coupon.

What is Reset benefit in Health Booster Policy?

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For plans with Sum Insured (SI)/deductible of ₹3 lakh and above, we will reset up to 100% of the SI once in a policy year, in case the SI including accrued ASI (if any) is insufficient to make the claim.

What do you mean by Co-payment in Health Booster Policy?

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Co-payment is a cost-sharing requirement under a health insurance Policy in which the policyholder/ insured will bear a specified percentage of the admissible claim amount. A Co-payment does not reduce the Sum Insured (SI).

What is the difference between a cashless and a reimbursement claim in Health Booster Policy?

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Cashless and reimbursement are two different ways to settle a claim:

a) Cashless claim is a claim where we pay the agreed claim amount directly to the hospital. You need not pay the hospital for the claim amount. You are required to inform us about the procedure or treatment and send us all the related paper work.

b) Reimbursement claim is a claim where you settle the bill with the hospital and then send us the relevant documents. We will reimburse you for the agreed claim amount.

What are deductibles in Health Booster Policy?

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It is the amount, over which Health Booster is activated. Any claim under deductible amount will not be reimbursed under this policy. A deductible does not reduce the sum insured.