Life is truly priceless and protecting one’s health is essential. With Health Insurance, the Insured can medically cover himself/herself and his/her family members for Sum Insured as per one’s needs at an affordable premium. ICICI Lombard Smart Health Insurance Policy covers major hospitalization and daily expenses arising due to unfortunate events or medical conditions. Day care treatment, organ transplantation, and domiciliary hospitalization expenses too are included depending on the variant cover.
• Sum Insured Flexibility: As per one’s requirement, one can choose Sum Insured from Rs. 2 lakh, Rs. 3 lakh and Rs. 5 lakh. These are variants of the Smart Health Insurance Policy.
• No sublimit on room rent: The policy offers one the flexibility to choose any room for getting treated in a hospital as there is no capping on room rent in any variant of the plan.
• Critical Illness benefit: One would also have the option of taking cover against listed 20 Critical Illnesses
• Tax benefits: Under Section 80 D of the Income Tax Act 1961, one can avail of Tax benefit. Tax benefits are subject to change as per change in Tax laws, please consult tax advisor for details.
• Discount on renewal: Discount that is equivalent to 5% of renewal premium each year is provided.
• Medical Check up: One also receives reimbursement of medical check-up expenses at the end of four continuous years.
• Additional Benefits: Up to certain limit of sum insured, one can receive extra benefits of hospital cash allowance, home nursing allowance, and reimbursement charges for in-patient physiotherapy and ambulance.
| Inclusions | Exclusions |
• Hospitalization If one is admitted to a cashless or non-cashless hospital for a hospitalization period of 24 hours, the medical treatment expenses are either directly paid by ICICI Lombard to the hospital or it is reimbursed to the insured.
• Pre- and post-hospitalization expenses All expenses such as diagnosis, doctor’s fees, medicines, etc. for treatment before hospitalization as well as after hospitalization are covered.
• Domiciliary hospitalization: Care and treatment of domiciliary hospitalization involving medical treatment for a period exceeding 3 days for disease, illness, injury which is taken whilst confined at home in India, is covered. . The condition is the patient cannot be admitted to a hospital for lack of accommodation or other medical reasons.
• Day Care Treatment: Day care treatment is covered, in this, 24-hour hospitalization is not needed for dialysis, eye surgery, chemotherapy, eye surgery,lithotripsy, D&C, tonsillectomy taken in a hospital/nursing home.
Critical Illness Covered:
If opted for, the cover is provided for:
• Cancer
• First Heart Attack
• Coronary Artery Disease
• Coronary Artery bypass surgery
• Heart Valve Surgery
• Surgery to Aorta
• Stroke
• Kidney Failure
• Aplastic Anemia
• End Stage Lung Disease
• End Stage Liver Failure
• Coma
• Major Burns
• Major Organ/Bone Marrow
• Transplantation
• Multiple Sclerosis
• Fulminant Hepatitis
• Motor Neurone Disease
• Primary Pulmonary Hypertension
• Terminal Illness
• Bacterial Meningitis | • Expenses within 30 days of policy inception: Hospital expenses for treatment of illness that are undertaken within 30 days of buying the policy
Exclusions for first 2 years:
Cataract, laser surgery
Myomectomy, Hysterectomy unless because of malignancy
Dilation and curettage
Hernia, Hydrocele, fistula in anus, sinusitis, hemorrhoids/piles
Joint replacement, unless due to accident
All types of skin and all internal tumors / cysts / nodules / polyps of any kind, including breast lumps, unless malignant
Dialysis required for chronic renal failure
Gastric and duodenal erosions & ulcers
Permanent exclusions
Routine medical, eye and ear examinations, cost of spectacles
Dental treatment
Circumcision, sex change or treatment
Birth control procedures, hormone replacement therapy, caesarean section, fertility or conception operation
Acquired Immune Deficiency Syndrome (AIDS) and related diseases/illness related to HIV
Pre-existing diseases
Certain pre-existing diseases, illness or injury are covered only after completion of 4 years of waiting period from starting date of policy. |
