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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

Would I be able to avail of my medical & premium reimbursements in case my Complete Health Insurance Policy is rejected?

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In the event that your policy is rejected, you can definitely avail of premium reimbursements within 7 working days. However, we would not be able to reimburse your medical check-up expenses.

Will my Health Booster 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, ICICI Lombard will not cover any medical expenses for treatment taken at the delisted hospitals. The updated list of delisted hospitals is also available on our website www.icicilombard.com. For any clarification or more information, please call us on our toll-free number 1800 2666.

What is the maximum entry age in Complete Health Insurance Policy?

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There is no maximum entry age.

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.

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 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 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

What is the tenure for Complete Health Insurance Policy?

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The policy tenure is either 1 year or 2 years.

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.

What is the cost of the medical tests undergone by the insured in Complete Health Insurance Policy?

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Cost of the Pre Policy Medical Check-up for policy issuance is ₹800. The Company will pay 100% of the cost of the medical test. In case the health proposal is declined, medical cost will be deducted from the premium and the balance would be refunded.

How can I create my online account with ICICI Lombard to avail of these services?

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You can avail of these services through your personal login on our website.
a) Log on to www.icicilombard.com and click on the ICICI Lombard Healthcare option, which you will find under 'Claims & Wellness'

b) Go to the customer log in section and sign up to fill in and submit the form

c) You will get a reference number and message informing that your ID will be activated in 24 hours.

d) After you receive an e-mail with your login credentials, login to the system to avail the value added services available to you. With this online account, you can also access your policy certificate, policy information, claim forms, list of empanelled hospitals and more.

If you have any other question(s) or cannot access your account then please call us on our toll-free number 1800 2666 or e-mail us at customersupport@icicilombard.com.

How can I cancel my Health Bosster policy before the expiry date?

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A) Free look period: You can cancel and return your policy within 15 days of receiving it by sending us the free look request form available on our website or by submitting written notice to the company either through registered post or from your registered e-mail address.

You can also call us on our toll-free number 1800 2666 and let us know if you would like to cancel the policy. If you avail of this feature, the premium will be returned to you.

B) If you wish to cancel the policy after the free look period but before the expiry date, you can do so by following the same process as above. We shall refund premium on the short-term rates (as specified in policy wordings Part III) for the policy period remaining.

C) Premium refund will be done through NEFT mode only, please send us a duly filled and signed NEFT form available on our website.

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.

How can I renew my Health Booster Policy policy?

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You can renew your policy either by paying the renewal premium online or by calling us on our toll-free number 1800 2666. Alternatively, you may also visit your closest ICICI Lombard branch

What are the benefits of a health card in Health Booster Policy?

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A health card mentions the contact details and the contact numbers of the Third Party Administrator (TPA). In case of a medical emergency, you can call on these numbers for queries, clarifications and for seeking any kind of assistance. Moreover, you need to display your health card at the time of admission into the hospital

Do I need to intimate ICICI Lombard in case of any delay in claim settlement in Health Booster Policy?

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Absolutely not, as our systems are designed to pay the claim service guarantee amount directly to customers along with the reimbursement claim amount.

How can I file a claim in Health Booster Policy?

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If you need to make a claim, you must intimate us in any of the following ways:

a) Call our 24X7 Customer Care toll-free number 1800 2666

b) SMS HEALTHCLAIM to 575758 (charged at ₹3 per SMS)

c) E-mail us at ihealthcare@icicilombard.com

Ensure that you intimate us of a planned hospitalisation at least 48 hours before admission. In the case of an emergency, we must also be informed within 24 hours of admission. You can download claims forms from our website - www.icicilombard.com.

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.

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 an endorsement in Complete Health Insurance Policy?

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An endorsement is a written evidence of an agreed change in the policy. It is a document that incorporates changes in the terms of the policy. Additional premium will be charged as applicable.

As per Complete Health Insurance Policy Do I need to intimate ICICI Lombard in case of any delay in claim settlement?

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Absolutely not, as our systems are designed to pay the claim service guarantee amount directly to customers along with the reimbursement claim amount.

What is the procedure for reimbursement settlement in Complete Health Insurance Policy?

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• All the claims have to be intimated 48 hours prior to hospitalisation and within 24 hours post admission in case of emergency
• Intimate claim by sending an SMS HEALTHCLAIM to 575758 (charge ₹3 per SMS) or by calling our toll-free number 18002666 or e-mail us at ihealthcare@icicilombard.com
• Send the duly filled (and signed by insured and treating doctor) claim form and required documents to the Company
• Review of claim request by Company (as per policy terms & conditions)
• Claim Settlement by Company (as per policy terms & conditions) and reimbursement of the approved amount

Which diseases are covered under First 2 Years Exclusions in Complete Health Insurance Policy?

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Following ailments / treatments would not be covered in the first two years of the Period of Insurance

• Cataract*
• Benign Prostatic Hypertrophy
• Myomectomy, Endometriosis, Hysterectomy unless because of malignancy
• All types of Hernia, Hydrocele
• Fissures &/or Fistula in anus, haemorrhoids/piles
• Arthritis, gout, rheumatism and spinal disorders
• Joint replacements unless due to accident
• Sinusitis and related disorders
• Stones in the urinary and biliary systems
• Dilatation and curettage Endometriosis
• All types of Skin and internal tumors/ cysts/nodules/ polyps of any kind including breast lumps unless malignant
• Dialysis required for chronic renal failure
• Surgery on tonsils, adenoids and sinuses
• Gastric and Duodenal erosions & ulcers
• Deviated Nasal Septum
• Varicose Veins / Varicose Ulcers
* After 2 years of continuous coverage with us, a sub-limit of ₹20,000 per eye will be applicable for sum insured less or equal to ₹5 lakh and ₹1 lakh per eye for sum inured greater than ₹5 lakh during each Policy Year.

What is the minimum entry age for this Complete Health Insurance policy?

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6 years - individual 3 months under floater

In Complete Health Insurance 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 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

I have received a health card along with the policy kit. Why do I need a health card?

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A health card is given to all the people insured in your policy. This card has all the details of the insured along with the policy number, policy start date and end date. You will have to produce this when you avail of the cashless hospitalisation facility. It should also be carried along with the free health check-up coupon if you are availing of this facility at a diagnostic centre