ICICI Lombard General Insurance

Coverage

Sum Insured (₹)

5L/10L/15L/20L/25L/50L

Deductible (₹)

2L*/3L/5L/10L*

Family Definition

Self, Spouse & up to 2 Dependent Children

In-Patient Care Expenses (IP)

As per Plan

Day Care Treatment Expenses

Up to SI

Domiciliary Hospitalization Expenses

Up to SI

Organ Donor Expenses

Up to SI

AYUSH

Up to SI

Pre-Post Hospitalization Expenses

Up to SI - 60 - 90 days

Room Rent

No Restriction

Proportionate Deductions

Not Applicable

Waiting Period Factors

Pre-Existing Diseases

Covered after 36 months of continuous coverage

Sp. Illness Waiting Period

Covered after 2 years of continuous coverage

Initial Waiting Period

30 days – Applicable

Eligibility Conditions

Max. Entry Age

23 years for Children & 60 years for Self/Spouse

Min. Entry Age

91 days for Children & 18 years for Self/Spouse

Family Relationship is not allowed except Self, Spouse, 2 Children.

Cashless & Reimbursement is applicable.

Acceptance of Proposal is based on the declaration of Good Health.

Commission from General Insurance - Health Insurance Reg 5 (c)

Sr. No.

Class of Business

% of premium payable as agency commission (% of final premium excluding service tax)

1

Health Individual*

15%

2

Health Group (Employer-Employee only) – Annual

7.5%

3

Health Group (Non-Employer-Employee groups)

15%

4

Health Group (Credit link up to 5 years)

15%

5

Health Govt. Schemes

As specified in the govt. scheme/notification else as per health group (Employer - Employee only - Annual segment)

Commission from General Insurance - Other than Motor 5 (d)

1

Fire Retail

16.5%

2

Fire-Corporate (Risks with S.I. < Rs 2,500 cr.)

11.5%

3

Fire-Corporate (Risks with S.I. > Rs 2,500 cr.)

6.25%

4

Marine - Cargo

16.5%

5

Marine - Hull

11.5%

6

Miscellaneous - Retail

16.5%

7

Miscellaneous - Corporate/ Group**

12.5%

Commission from General Insurance - Motor Insurance Reg 5 (e)

1

Motor (Comprehensive)***

15%

2

Motor (Stand-alone TP)

2.5%

* Individual includes annual premium, 3 years single premium, 3 years’ regular premium

**Commission/remuneration shall be payable as per Government Notification

***Commission/remuneration shall be payable only to the OD portion of the Motor (Comprehensive) policy